Management of benign prostatic hyperplasia with antiandrogens and antiestrogens — clinical results (Review)

1989 ◽  
pp. 123-130
Author(s):  
R. Tenaglia ◽  
F. Di Silverio
2018 ◽  
pp. 1-9
Author(s):  
А.С. Векильян

Представлены клинические результаты хирургического лечения доброкачественной гиперплазии предстательной железы (ДГПЖ) объемом до 100 см3 методом биполярной трансуретральной резекции простаты (БТУР -74 пациента) в сравнении с открытой чреспузырной простатэктомией (ОПЭ - 96 пациентов), ранее применявшейся для подобных клинических случаев в урологической клинике "Железнодорожной больницы" г. Волгоград. При статистически равном операционном времени обоих хирургических методов для БТУР отмечено существенное снижение интраоперационной кровопотери, сроков послеоперационной катетеризации и пребывания в стационаре, минимальная частота геморрагических и инфекционно-воспалительных осложнений. Наблюдение за урологическим статусом пациентов в течение первого послеоперационного года показало одинаковую клиническую эффективность сравниваемых хирургических методов. Значительное снижение объема кровопотери в ходе операции БТУР можно считать большим достижением, поскольку улучшение видимости в зоне хирургического вмешательства позволяет оптимизировать гемостаз, предотвратить массивные кровотечения как во время, так и после операции, сократить сроки послеоперационной катетеризации мочевого пузыря, что в свою очередь, снижает частоту развития инфекционно-воспалительных осложнений. Более быстрое восстановление пациентов после эндоскопических операций имеет медико-социальное и экономическое значение, поскольку минимальное количество послеоперационных осложнений и сокращение сроков госпитализации позволяет существенно снизить затраты на лечение и быстрее нормализовать качество жизни пациентов. Полученные результаты демонстрируют перспективность внедрения биполярных методов эндоскопических операций для лечения ДГПЖ в хирургическую практику урологических стационаров в целях повышения безопасности оперативного лечения и экономии затрат на госпитализацию. The clinical results of surgical treatment of benign prostatic hyperplasia (BPH) up to 100 cm3 by bipolar transurethral resection of the prostate (BTUR - 74 patients) in comparison with open transvesical prostatectomy (OPE - 96 patients), previously used for such clinical cases in the urological clinic "Railway hospital" in Volgograd are presented. With statistically equal operating time of both surgical methods, there was a significant decrease in intraoperative blood loss, the terms of postoperative catheterization and hospital stay, the minimum frequency of hemorrhagic and infectious-inflammatory complications. Observation of the urological status of patients during the first postoperative year showed the same clinical efficacy of the compared surgical methods. A significant reduction in the volume of blood loss during the operation, can be considered a great achievement, since the improvement of visibility in the area of surgical intervention allows to optimize the hemostasis, to prevent massive bleeding during and after surgery, to reduce the duration of postoperative bladder catheterization, which, in turn, reduces the incidence of infectious-inflammatory complications. Faster recovery of patients after endoscopic surgery of medical,social and economic importance, as the minimum number of postoperative complications and reduction of hospitalization can significantly reduce the cost of treatment and quickly normalize the quality of life of patients. The results demonstrate the prospects of the introduction of bipolar methods of endoscopic surgery for the treatment of BPH in the surgical practice of urological hospitals in order to improve the safety of surgical treatment and save costs for hospitalization.


2000 ◽  
Vol 14 (8) ◽  
pp. 651-656 ◽  
Author(s):  
M.J.A.M. DE WILDT ◽  
L. WAGRELL ◽  
T.R. LARSON ◽  
T. ELIASSON

TSW Urology ◽  
2006 ◽  
Vol 1 ◽  
pp. 177-183
Author(s):  
Benjamin T. Larson ◽  
Nelson Netto ◽  
Christian Huidobro ◽  
Marcelo Lopez de Lima ◽  
Wagner Matheus ◽  
...  

2020 ◽  
Vol 31 (1) ◽  
Author(s):  
Esteban Noroña Vásconez ◽  
Patricia Páez Vargas

Background: Currently there are few scientific data comparing the three therapeutic modalities of Benign Prostatic Hyperplasia to determine the best clinical outcome, considering that it is a pathology whose incidence increases as population life expectancy arise. Objective: To compare the clinical results between the initial pharmacological, non-pharmacological and surgical treatment, based on clinical signs of prostatism in patients with benign prostatic hyperplasia during the period between January 2014 and December 2016. Study Design: Retrospective Cohort Study. Methods: 399 patients were divided according to the modality of treatment received: non-pharmacological, pharmacological and surgical. The decrease of the symptoms was compared with the first post-treatment consultation by using a matrix of evaluation of urinary symptoms elaborated by the authors, based on SPSS International Score; this tool stratified the patients by the severity of the symptomatology. SPSS ® software was used. Results: Within the non-pharmacological treatment, there was a mean difference of 1.67 (95% CI 0.49 - 2.85, p <0.05); for the pharmacological it was 0.21 (95% CI 0.92 - 1.34, p = 0.713) and for the surgical was 8.23 (95% CI 7.19 - 9.27, p <0.05). Significant differences were found between the three groups during the pretreatment phase, after stratifying them according to the degree of severity. Post-intervention, the clinical results of each treatment were compared, finding that in patients with mild symptoms there were no significant differences (p = 0.087), not so for patients with moderate and severe symptoms where a statistically significant difference was found. Conclusion: In patients with urinary symptoms classified as moderate and severe within this sample, surgical treatment decreased urinary symptomatology in greater proportion compared to pharmacological and non-pharmacological treatment.


1993 ◽  
Vol 23 (1) ◽  
pp. 68-71 ◽  
Author(s):  
J.J.M.C.H. de la Rosette ◽  
F.M.J.A. Froeling ◽  
F.M.J. Debruyne

1990 ◽  
Vol 143 (5) ◽  
pp. 949-954 ◽  
Author(s):  
Michael D. Sapozink ◽  
Stuart D. Boyd ◽  
Melvin A. Astrahan ◽  
Gabor Jozsef ◽  
Zbigniew Petrovich

2006 ◽  
Vol 6 ◽  
pp. 2474-2480 ◽  
Author(s):  
Benjamin T. Larson ◽  
Nelson Netto ◽  
Christian Huidobro ◽  
Marcelo Lopez de Lima ◽  
Wagner Matheus ◽  
...  

Benign prostatic hyperplasia (BPH) is one of the most common diseases ailing older men. Office-based procedures offer the advantage of being more effective than medications, while limiting the adverse effects, cost, and recovery of surgery. This study presents preliminary data on a new procedure that utilizes intraprostatic alcohol gel injection to ablate prostatic tissue. The purpose of this study is to evaluate the feasibility of using this gel as a treatment for BPH.A total of 65 patients with lower urinary tract symptoms (LUTS) due to BPH were treated with intraprostatic injections of alcohol gel. The gel is composed of 97% denatured alcohol and a patented polymer to cause viscosity. Three different methods of injection were utilized: transrectal (TR) injections (8), transurethral (TU) injections (36), and transperineal (TP) injections guided by biplaned ultrasound (21). Each method provided easy access to the center of the prostate, where a volume of gel, approximately 20–30% of the prostatic volume, was injected. Follow-up was based on changes in peak urinary flow (Qmax), IPSS scores, quality of life scores (QoL), adverse effects, and failures. Data are available at 3 and 12 months.The procedure was well tolerated with only local or no anesthesia in the TR and TP groups; the TU group received spinal anesthesia. All groups showed statistically significant (p< 0.0001) improvements in Qmax, IPSS, and QoL. The mean amount of gel injected was 8.05 ml, representing 21.56% of the prostatic volume. Qmax increased from a baseline mean of 8.50 to 12.01 ml/s at 3 months, and to 11.29 ml/s at 12 months. IPSS scores improved from a baseline mean of 21.12 to 10.00 at 3 months, and to 11.84 at 12 months. QoL scores were only available for 55 patients. QoL scores improved from a baseline of 3.93 to 1.98 at 3 months, and to 2.18 at 12 months. No extraprostatic injury or adverse effects were reported due to treatment.This preliminary study presents significant results showing that intraprostatic injection of alcohol gel could be an option for the treatment of BPH and LUTS. The viscosity of the gel allows for accurate imaging under ultrasound, no run back along the needle allowing for multiple methods of delivery, and the gel does not spread to extraprostatic tissue. This new technique could provide a simple and possibly less expensive clinic procedure for treating BPH, and warrants further study.


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