Effect of alpha-blocker use on morbidity and lower urinary tract symptoms in patients undergoing transrectal ultrasound-guided prostate biopsy

2021 ◽  
pp. 039156032110383
Author(s):  
Remzi Salar ◽  
Güven Erbay
Keyword(s):  
Prostate Biopsy ◽  
Voiding Dysfunction ◽  
Prostate Volume ◽  
Transrectal Ultrasound ◽  
Urine Volume ◽  
Maximum Flow ◽  
Control Group ◽  
Alpha Blocker ◽  
Urinary Tract Symptoms ◽  
Significant Difference

Objective: To evaluate voiding dysfunction and morbidity after transrectal ultrasound (TRUS)-guided prostate biopsy and to investigate whether pre-intervention alpha-blocker treatment had any effect on morbidity and voiding dysfunction. Material and methods: The study included 197 consecutive patients who underwent TRUS-guided prostate biopsy between January 2014 and January 2018. The patients were divided into two groups, those receiving alpha-blocker (silodosin) and those not receiving alpha-blocker treatment before the procedure (controls). All patients were evaluated before and one week after the procedure with the International Prostate Symptom Score (IPSS), measurements of maximum flow rate ( Qmax), post-void residual urine volume (PVR) and prostate volume, and procedure-related complications were also recorded. All analyzed parameters were compared by within-group and between-group evaluations. Results: There was no significant difference between the two groups in terms of IPSS, Qmax and prostate volume values before biopsy. In the follow-up evaluation performed on the seventh day after biopsy, IPSS, PVR and prostate volume were found to be increased, whereas Qmax was decreased in the control group ( p < 0.05). In the silodosin group, an increase in prostate volume was observed, but there were no significant changes in IPSS, Qmax and PVR values. Acute urinary retention (AUR) after the biopsy procedure developed in two patients (2%) in the silodosin group, and in nine patients (9.1%) in the control group ( p = 0.02). No significant difference was found between the two groups in terms of biopsy-related complications, except for AUR. Conclusion: We believe that alpha-blocker treatment initiated before biopsy may be advantageous in preventing voiding dysfunction that may develop after the procedure.

Analysis of Voiding Impairment after Prostate Biopsy and the Effect of Doxazosin Treatment: Outcomes from a Regional Cancer Center

2021 ◽  
pp. 1-6
Author(s):  
Yi Zheng ◽  
Fuding Bai ◽  
Nan Zhang ◽  
Huifeng Wu
Keyword(s):  
Prostate Biopsy ◽  
Transrectal Ultrasound ◽  
Urine Volume ◽  
Cancer Center ◽  
Control Group ◽  
Urinary Flow ◽  
Voiding Difficulty ◽  
Male Patients ◽  
Baseline Values

<b><i>Introduction:</i></b> The aim of this study was to investigate the association of transrectal ultrasound (TRUS)-guided prostate biopsy with voiding impairment and the efficacy of doxazosin treatment. <b><i>Methods:</i></b> A prospective observational study including 200 male patients undergoing TRUS-guided prostate biopsy was performed between May 2020 and December 2020. One hundred patients underwent biopsy with doxazosin (doxazosin group). The remaining 100 patients underwent biopsy without doxazosin (control group). All patients were questioned regarding post-biopsy voiding difficulty and acute urinary retention. The International Prostate Symptom Score (IPSS), maximal urinary flow rate (Q<sub>max</sub>), and residual urine volume were recorded before biopsy and at 7 and 30 days after biopsy. <b><i>Results:</i></b> There were no significant differences in baseline parameters between the two groups. The rate of post-biopsy voiding difficulty in the doxazosin group was significantly lower than that in the control group. Compared with baseline values, doxazosin treatment significantly improved IPSS, quality of life scores, and Q<sub>max</sub> after biopsy (<i>p</i> &#x3c; 0.05). The baseline values of IPSS and prostate size may be risk factors for post-biopsy voiding difficulty. <b><i>Conclusion:</i></b> TRUS-guided prostate biopsy causes transient voiding impairments, which may be improved by doxazosin treatment.

scholarly journals Correlation between the presence of inguinal hernia and the intensity of lower urinary tract symptoms

2011 ◽  
Vol 26 (suppl 2) ◽  
pp. 125-128 ◽  
Author(s):  
Rodolfo Borges dos Reis ◽  
Antonio Antunes Rodrigues Neto ◽  
Leonardo Oliveira Reis ◽  
Roberto Dias Machado ◽  
Steven Kaplan
Keyword(s):  
Clinical Evidence ◽  
Urine Volume ◽  
Control Group ◽  
Mean Values ◽  
Urinary Tract Symptoms ◽  
Significant Difference ◽  
Group 2 ◽  
Group 1 ◽  
Lower Urinary

PURPOSE: To verify the correlation between the presence of IH and the intensity of LUTS related to BPH quantified through the International Prostate Symptom Score (IPSS). METHODS: We prospectively selected 52 patients over the age of 55years; Patients were divided into 2 groups. Group 1: composed of 32 patients with IH; Group 2 (control group): composed of 20 patients with no clinical evidence of IH. All patients were assessed using the IPSS, uroflowmetry (Qmax), post-void residual urine volume (PVR) and prostate volume (PV). RESULTS: Groups 1 and 2 presented no difference in PV (p>0.05) and uroflowmetry (Qmax) (p>0.05). There was a statistical significant difference between the PVR mean values between groups 1 and 2. The presence of IH correlated with a higher IPSS score (r=0.38 p<0.05) despite the fact the no difference was detected between the incidence of patients with mild, moderate and severe LUTS in groups 1 and 2. CONCLUSION: Patients with IH present higher IPSS. The role of IPSS as a marker to predict the development of clinical IH still to be determined.

scholarly journals Predictors of Gleason score upgrading in patients with prostate biopsy Gleason score ≤6

2014 ◽  
Vol 8 (5-6) ◽  
pp. 342 ◽  
Author(s):  
Hasmet Sarici ◽  
Onur Telli ◽  
Orhan Yigitbasi ◽  
Musa Ekici ◽  
Berat Cem Ozgur ◽  
...  
Keyword(s):  
Gleason Score ◽  
Prostate Biopsy ◽  
Prostate Volume ◽  
Specific Antigen ◽  
Transrectal Ultrasound ◽  
Radical Retropubic Prostatectomy ◽  
Small Sample ◽  
Ultrasound Guided ◽  
Increased Risk ◽  
Biopsy Gleason Score

Introduction: The discrepancy between prostate biopsy and prostatectomy Gleason scores is common. We investigate the predictive value of prostate biopsy features for predicting Gleason score (GS) upgrading in patients with biopsy Gleason scores ≤6 who underwent radical retropubic prostatectomy (RRP). Our aim was to determine predictors of GS upgrading and to offer guidance to clinicians in determining the therapeutic option.Methods: We performed a retrospective study of patients who underwent RRP for clinically localized prostate cancer at 2 major centres between January 2007 and March 2013. All patients with either abnormal digital examination or elevated prostate-specific antigen at screening underwent transrectal ultrasound-guided prostate biopsy. Variables were evaluated among the patients with and without GS upgrading. Our study limitations include its retrospective design, the fact that all subjects were Turkish and the fact that we had a small sample size.Results: In total, 321 men had GS ≤6 on prostate biopsy. Of these, 190 (59.2%) had GS ≤6 concordance and 131 (40.8%) had GS upgrading from ≤6 on biopsy to 7 or higher at the time of the prostatectomy. Independent predictors of pathological upgrading were prostate volume <40 cc (p < 0.001), maximum percent of cancer in any core (p = 0.011), and >1 core positive for cancer (p < 0.001).Conclusions: When obtaining an extended-core biopsy scheme, patients with small prostates (≤40 cc), greater than 1 core positive for cancer, and an increased burden of cancer are associated with increased risk of GS upgrading. Patients with GS ≤6 on biopsy with these pathological parameters should be carefully counselled on treatment decisions.

scholarly journals Prospective randomized controlled study directly comparing tadalafil and tamsulosin for male patients with lower urinary tract symptoms

2018 ◽  
Author(s):  
Takumi Takeuchi ◽  
Satoshi Toyokawa ◽  
Yumiko Okuno ◽  
Noriko Ishida ◽  
Masanari Yamagoe ◽  
...  
Keyword(s):  
Urinary Tract ◽  
Lower Urinary Tract Symptoms ◽  
Lower Urinary Tract ◽  
Urine Volume ◽  
Maximum Flow ◽  
Controlled Study ◽  
Night Time ◽  
Once Daily ◽  
Urinary Tract Symptoms ◽  
Lower Urinary

AbstractLower urinary tract symptoms are widespread in elderly men and often suggestive of benign prostatic hyperplasia (LUTS/BPH). A randomized, prospective, and open-labeled trial directly comparing the effects of tadalafil (a phosphodiesterase 5 inhibitor) 5 mg once daily and tamsulosin (an α1-blocker) 0.2 mg once daily for 12 weeks in LUTS/BPH patients was conducted. Data were recorded before randomization as well as at 4, 8, and 12 weeks after medication. Fifteen patients allocated tadalafil and 20 allocated tamsulosin completed 12 weeks of medication. Total IPSS, IPSS voiding, and IPSS-QOL scores declined with medication, but there was no difference between drugs. IPSS storage scores reduced more in the tamsulosin group than tadalafil group. OABSS did not decline significantly with medication. IIEF5 was maintained in the tadalafil group, but declined in the tamsulosin group. The maximum flow rate and post-void residual urine volume did not significantly change with medication. Daytime, night-time, and 24-hour urinary frequencies as well as the mean and largest daytime, night-time, and 24-hour voiding volumes per void did not significantly change with medication. In conclusion, tamsulosin was more effective to reduce storage symptoms than tadalafil. Tadalafil had the advantage of maintaining the erectile function.

scholarly journals 3D versus 2D Systematic Transrectal Ultrasound-Guided Prostate Biopsy: Higher Cancer Detection Rate in Clinical Practice

2013 ◽  
Vol 2013 ◽  
pp. 1-5 ◽  
Author(s):  
Alexandre Peltier ◽  
Fouad Aoun ◽  
Fouad El-Khoury ◽  
Eric Hawaux ◽  
Ksenija Limani ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Cancer Detection ◽  
Prostate Biopsy ◽  
Detection Rate ◽  
Transrectal Ultrasound ◽  
Daily Practice ◽  
Cancer Detection Rate ◽  
Prior History ◽  
Detection Rates ◽  
Significant Difference

Objectives. To compare prostate cancer detection rates of extended 2D versus 3D biopsies and to further assess the clinical impact of this method in day-to-day practice.Methods. We analyzed the data of a cohort of 220 consecutive patients with no prior history of prostate cancer who underwent an initial prostate biopsy in daily practice due to an abnormal PSA and/or DRE using, respectively, the classical 2D and the new 3D systems. All the biopsies were done by a single experienced operator using the same standardized protocol.Results. There was no significant difference in terms of age, total PSA, or prostate volume between the two groups. However, cancer detection rate was significantly higher using the 3D versus the 2D system, 50% versus 34% (P<0.05). There was no statistically significant difference while comparing the 2 groups in term of nonsignificant cancer detection.Conclusion. There is reasonable evidence demonstrating the superiority of the 3D-guided biopsies in detecting prostate cancers that would have been missed using the 2D extended protocol.

scholarly journals Quinolone Prophylaxis in Transrectal Ultrasound Guided Prostate Biopsy: An Eight-Year Single Center Experience

2013 ◽  
Vol 2013 ◽  
pp. 1-6 ◽  
Author(s):  
Bing-Juin Chiang ◽  
Yeong Shiau Pu ◽  
Shiu-Dong Chung ◽  
Shih-Ping Liu ◽  
Hong-Jeng Yu ◽  
...  
Keyword(s):  
Prostate Biopsy ◽  
Transrectal Ultrasound ◽  
Infectious Complications ◽  
Pipemidic Acid ◽  
Ultrasound Guided ◽  
E Coli ◽  
Single Center Experience ◽  
Significant Difference ◽  
Group A ◽  
Group B

We retrospectively evaluated the efficacy of prophylaxis with pipemidic acid and levofloxacin in transrectal ultrasound guided prostate biopsy (TRUSP-Bx). From January 2002 to December 2004, patients receiving oral pipemidic acid 500 mg twice daily for three days with or without a preoperative intravenous cefazolin 1 gm injection comprised group A. Between January 2005 and December 2009, patients receiving oral levofloxacin 500 mg one hour before biopsy comprised group B. We calculated the annual febrile urinary tract infection (fUTI) rates. Patients’ characteristics, including age, prophylactic antibiotics, biopsy core numbers, pathologic results, PSA, and the spectrums and susceptibility of pathogens, were also evaluated. A total of 1313 (35.5%) patients belonged to group A, while 2381 (64.5%) patients belonged to group B. Seventy-three patients experienced postoperative infectious complications. There was a significant difference in the fUTI rate between groups A and B (3.7% versus 1.0%,P<0.001). The yearly fUTI rates varied from 0.6 to 3.9% between 2002 and 2009. Of the 73 patients with fUTI, those receiving levofloxacin prophylaxis were more likely to harbor fluoroquinolone-resistant pathogens (P<0.001).E. coliwas the most common pathogen in both groups. Levofloxacin remains effective and appears superior to pipemidic acid based prophylaxis.

scholarly journals The effectiveness of dried cranberries (Vaccinium macrocarpon) in men with lower urinary tract symptoms

2010 ◽  
Vol 104 (8) ◽  
pp. 1181-1189 ◽  
Author(s):  
Ales Vidlar ◽  
Jitka Vostalova ◽  
Jitka Ulrichova ◽  
Vladimir Student ◽  
David Stejskal ◽  
...  
Keyword(s):  
International Prostate Symptom Score ◽  
Lower Urinary Tract ◽  
Urine Volume ◽  
Vaccinium Macrocarpon ◽  
Control Group ◽  
C Reactive Protein ◽  
Residual Urine Volume ◽  
Reactive Protein ◽  
Urinary Tract Symptoms ◽  
Lower Urinary

Lower urinary tract symptoms (LUTS) are a common condition in older men. The objective of the present study was to evaluate the efficacy and tolerability of cranberry (Vaccinium macrocarpon) powder in men at risk of prostate disease with LUTS, elevated prostate-specific antigen (PSA), negative prostate biopsy and clinically confirmed chronic non-bacterial prostatitis. Forty-two participants received either 1500 mg of the dried powdered cranberries per d for 6 months (cranberry group;n21) or no cranberry treatment (control group;n21). Physical examination, International Prostate Symptom Score, quality of life (QoL), five-item version of the International Index of Erectile Function (IIEF-5), basic clinical chemistry parameters, haematology, Se, testosterone, PSA (free and total), C-reactive protein (CRP), antioxidant status, transrectal ultrasound prostate volume, urinary flow rate, ultrasound-estimated post-void residual urine volume at baseline, and at 3 and 6 months, and urineex vivoanti-adherence activity were determined in all subjects. In contrast to the control group, patients in the cranberry group had statistically significant improvement in International Prostate Symptom Score, QoL, urination parameters including voiding parameters (rate of urine flow, average flow, total volume and post-void residual urine volume), and lower total PSA level on day 180 of the study. There was no influence on blood testosterone or serum CRP levels. There was no statistically significant improvement in the control group. The results of the present trial are the first firm evidence that cranberries may ameliorate LUTS, independent of benign prostatic hyperplasia or C-reactive protein level.

scholarly journals Effect of preoperative prostate volume on the improvement of lower urinary tract symptoms in patients with benign prostatic hyperplasia undergoing transurethral resection of prostate

2019 ◽  
Vol 9 (2) ◽  
pp. e18-e18
Author(s):  
Behzad Lotfi ◽  
Sajjad Farazhi ◽  
Mohammadreza Mohammadi Fallah ◽  
Mansour Alizadeh ◽  
Rohollah Valizadeh ◽  
...  
Keyword(s):  
Urinary Tract ◽  
Benign Prostatic Hyperplasia ◽  
Transurethral Resection ◽  
Lower Urinary Tract ◽  
Prostate Volume ◽  
Prostatic Hyperplasia ◽  
Urinary Tract Symptoms ◽  
Significant Difference ◽  
Lower Urinary

Introduction: Benign prostate hyperplasia, pathophysiology contributes to bladder outlet obstruction due to functional obstruction caused by gland size enlargement resulting in the lower urinary tract symptoms (LUTS). Objectives: To determine the correlation of the prostate volume with surgical outcomes and postoperative LUTS in patients with benign prostatic hyperplasia (BPH) undergoing transurethral resection of the prostate (TURP). Patients and Methods: Patients with BPH who were refractory for medical treatment enrolled in the study. Patients divided into three groups with attention to their prostate volume conducted by transabdominal ultrasonography. To evaluate patients’ LUTS, the International Prostate Symptom Score (IPSS) questionnaire was filled for all patients preoperatively and during the first and third months follow up sessions. Results: In the current study, mean age of the patients was 66.92 ± 1.08 years. Of 111 patients, eight patients (7.2%) had prostate volume less than 30 cc, 59 patients (53.2%) had prostate volume between 30-60 cc, and 44 patients (39.6%) had prostate volume more than 60 cc. During first month postoperative, mean decrease in IPSS scores in patients with prostate volume less than 30 cc, prostate volume between 30–60 cc and prostate volume more than 30 cc were 27.72 ± 3.53, 27.32 ± 3.37 and 27.45 ± 2.87, respectively. The ANOVA test showed no significant difference between the groups (P= 0.93). Mean decrease in IPSS score during third month postoperative, had no significant difference between the three groups, too (P=0.71). Symptoms alleviation observed in 94.6% and 95.5% of the patients, during first and third months follow-up, respectively. Conclusion: There was no correlation between the IPSS scores decrease and patients’ symptoms recovery and preoperative prostate volume in patients with BPH who underwent TRUP.

scholarly journals Electroacupuncture for Bladder Function Recovery in Patients Undergoing Spinal Anesthesia

2014 ◽  
Vol 2014 ◽  
pp. 1-6 ◽  
Author(s):  
Yinqiu Gao ◽  
Xinyao Zhou ◽  
Xichen Dong ◽  
Qing Jia ◽  
Shen Xie ◽  
...  
Keyword(s):  
Adverse Events ◽  
Spinal Anesthesia ◽  
Urinary Retention ◽  
Urine Volume ◽  
Bladder Function ◽  
Control Group ◽  
Postoperative Urinary Retention ◽  
Function Recovery ◽  
Significant Difference ◽  
Secondary Endpoints

Purpose. To determine the efficacy of electroacupuncture on recovering postanesthetic bladder function.Materials and Methods. Sixty-one patients undergoing spinal anaesthesia were recruited and allocated into electroacupuncture or control group randomly. Patients in electroacupuncture group received electroacupuncture therapy whereas ones in control group were not given any intervention. Primary endpoint was incidence of bladder overdistension and postoperative urinary retention. Secondary endpoints included time to spontaneous micturition, voided volume, and adverse events.Results. All patients (31 in electroacupuncture group and 30 in control group) completed the evaluation. During postoperative follow-up, patients in electroacupuncture group presented a significant lower proportion of bladder overdistension than counterparts in control group (16.1% versus 53.3%,P< 0.01). However, no significant difference was found in incidence of postoperative urinary retention between the two groups (0% versus 6.7%,P> 0.05). Furthermore, a shorter time to spontaneous micturition was found in electroacupuncture group compared to control group (228 min versus 313 min,P< 0.001), whereas urine volume and adverse events had no significant difference between the two groups.Conclusions. Electroacupuncture reduced the proportion of bladder overdistension and shortened the time to spontaneous micturition in patients undergoing spinal anesthesia. Electroacupuncture may be a therapeutic strategy for postanesthetic bladder dysfunction.

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