scholarly journals Super-selective prostatic arteries embolization in patients with benign prostate hyperplasia: prevention and treatment of complications

2021 ◽  
Vol 9 (4) ◽  
pp. 111-121
Author(s):  
B. M. Shaparov ◽  
S. A. Kapranov ◽  
A. A. Kamalov ◽  
V. K. Karpov ◽  
A. G. Zlatovratskiy
Keyword(s):  
Antibiotic Prophylaxis ◽  
Surgical Techniques ◽  
The United States ◽  
Prostate Hyperplasia ◽  
Rectal Pain ◽  
Main Method ◽  
Minimally Invasive Surgical ◽  
Acute Epididymitis ◽  
Postembolization Syndrome ◽  
Benign Prostate

Introduction. Super-selective prostatic arteries embolization (PAE) is a modern minimally invasive surgical method for the treatment of benign prostatic hyperplasia (BPH). PAE is included in the Russian clinical guidelines for the BPH treatment and approved for use in the United States and European countries.Purpose of the study. To analyze the most common PAE-associated complications and to develop preventive arrangements.Materials and methods. During the period from 2013 to 2020, PAE as the main method of BPH treatment was used in 168 patients with an average age of 69.3 ± 8.1 (53-82) years. All patients underwent two-day antibiotic prophylaxis before the operation and lasted 7-10 days. For catheterization of the prostatic arteries, 2.0-2.8 Fr microcatheters and 4-5 Fr microconductors were used. For embolization, hydrogel microspheres with a diameter of 100-300 µm and 300-500 µm were used, as well as poly polyvinyl alcohol (PVA) microparticles with a diameter of 100-500 µm.Results. Bilateral PAE was successfully performed in 146 cases; unilateral PAE was performed in 22 patients due to anatomical features. Seventeen (10.1%) PAE from the orifice, super-selective PAE was performed in 67 (39.9%) cases, the PErFecTED embolization was performed in 84 (50.0%) patients. The most common complication was acute urinary retention (AUR) in 28 (16.6%) patients: trocar cystostomy was required in 11 (6.5%) patients, AUR was resolved using conservative therapy in 17 (10.2%) patients. In 23 (14.2%) cases, complications associated with unintentional embolization of the anastomoses of the prostate arteries were identified: rectal pain and/or the appearance of blood in the stool in 19 (11.3%) patients, the appearance of trophic ulcers on the glans penis in 5 (2.8%) patients. In addition, several adverse events that were not complications were noted: postembolization syndrome in 50 (29.7%) patients, and worsening of LUTS in 41 (24.4%) patients. Seven (4.1%) patients had acute epididymitis; 4 (2.4%) patients had a hematoma at the puncture site.Conclusion. PAE can cause a limited number of complications. It is necessary to unify the system for reporting PAE complications. Antibiotic prophylaxis is recommended. The use of visualization and X-ray navigation methods make it possible to make the PAE safer. The PErFecTED technique in combination with small particle sizes increases the risk of complications. The surgeon's experience and proficiency in special surgical techniques are essential. The transradial approach is promising, but further observation and an increase in patient samples are required. The question of choosing the optimal embolization drug continues to be relevant.

scholarly journals Alpha-1 blockers and susceptibility to COVID-19 in benign prostate hyperplasia patients : an international cohort study

2021 ◽  
Author(s):  
Akihiko Nishimura ◽  
Junqing Xie ◽  
Kristin Kostka ◽  
Talita Duarte-Salles ◽  
Sergio Fernández Bertolín ◽  
...  
Keyword(s):  
Cohort Study ◽  
Large Scale ◽  
Benign Prostate Hyperplasia ◽  
Medical Center ◽  
The United States ◽  
Negative Control ◽  
United States Department ◽  
Columbia University ◽  
Prostate Hyperplasia ◽  
Benign Prostate

AbstractAlpha-1 blockers, often used to treat benign prostate hyperplasia (BPH), have been hypothesized to prevent COVID-19 complications by minimising cytokine storms release. We conducted a prevalent-user active-comparator cohort study to assess association between alpha-1 blocker use and risks of three COVID-19 outcomes: diagnosis, hospitalization, and hospitalization requiring intensive services. Our study included 2.6 and 0.46 million users of alpha-1 blockers and of alternative BPH therapy during the period between November 2019 and January 2020, found in electronic health records from Spain (SIDIAP) and the United States (Department of Veterans Affairs, Columbia University Irving Medical Center, IQVIA OpenClaims, Optum DOD, Optum EHR). We estimated hazard ratios using state-of-the-art techniques to minimize potential confounding, including large-scale propensity score matching/stratification and negative control calibration. We found no differential risk for any of COVID-19 outcome, pointing to the need for further research on potential COVID-19 therapies.

scholarly journals Assessment of the infectious factor in transurethral surgery of benign prostate hyperplasia

2021 ◽  
Vol 9 (3) ◽  
pp. 79-91
Author(s):  
M. I. Kogan ◽  
Yu. L. Naboka ◽  
S. N. Ivanov
Keyword(s):  
Urinary Tract Infection ◽  
Benign Prostate Hyperplasia ◽  
Surgical Techniques ◽  
Infectious Complications ◽  
Prostate Hyperplasia ◽  
Surgical Interventions ◽  
Chronic Urinary Tract Infection ◽  
Benign Prostate ◽  
Underlying Pathology ◽  
Insufficient Knowledge

Performing surgical interventions for benign prostate hyperplasia against the background of chronic urinary tract infection or prostatitis can adversely affect the course of the postoperative period and mediate the development of complications. Therefore, it is important to understand the pre- and postoperative bacterial status of the patients in various endourological surgical techniques and its relationship with possible infectious complications. This review raises the problem of insufficient knowledge regarding the clinical structure of infections during transurethral surgery, assessment of their relationship with the course of the underlying pathology and the severity of symptoms.

scholarly journals THE PLACE OF PROSTATE ARTERY EMBOLIZATION IN A TREATMENT FOR BENIGN PROSTATE HYPERPLASIA

2018 ◽  
pp. 108-116
Author(s):  
D. V. Dushkova ◽  
Yu. A. Vasilev ◽  
K. P. Melnik ◽  
S. A. Ukhov
Keyword(s):  
Endovascular Embolization ◽  
Alternative Methods ◽  
Artery Embolization ◽  
Prostate Hyperplasia ◽  
Minimally Invasive Surgical ◽  
Age Related ◽  
Prostate Adenoma ◽  
Benign Prostate ◽  
Methods Of Treatment ◽  
Lower Urinary

Minimally invasive surgical procedures represent an extensive group of techniques that complement the arsenal of treating physicians to help patients. One of the directions are intravascular operations. Endovascular embolization of the prostate arteries is a competitive form of treatment for prostate adenoma in patients with contraindications to an open surgical manual. It is known, that prostate adenoma more often affects age-related men who have a variety of concomitant diseases. Such patients are not shown transurethral resection of the gland due to the severity of their condition. Therefore, to help these patients develop alternative methods of treatment. The article reviews the world data on the effectiveness of endovascular operations in patients with symptoms of the lower urinary tract.

HUBUNGAN USIA, OBESITAS DAN RIWAYAT PENYAKIT DIABETES MELLITUS DENGAN KEJADIAN BENIGN PROSTATE HYPERPLASIA (BPH) DERAJAT IV DI RSUD DR. M. HAULUSSY AMBON PERIODE 2012-2014

2017 ◽  
pp. 141-151
Author(s):  
Andrew Ruspanah
Keyword(s):  
Diabetes Mellitus ◽  
Benign Prostate Hyperplasia ◽  
Chi Square ◽  
Cross Sectional ◽  
Prostate Hyperplasia ◽  
Benign Prostate

Pendahuluan. Benign Postate Hiperplasia (BPH) adalah penyakit yang umumnya terjadi pada pria lansia yang disebabkan oleh penuaan. Hiperplasia prostat adalah pertumbuhan jaringan nodul fibroadenomatosa pada prostat. Pembesaran prostat jinak merupakan penyakit yang tersering kedua setelah batu saluran kemih didapatkan secara klinis di Indonesia. Tujuan. Penelitian ini bertujuan untuk mengetahui hubungan antara usia, obesitas dan riwayat diabetes mellitus dengan kejadian Benign Prostate Hyperplasia (BPH) grade IV di Rumah Sakit Dr. M. Haulussy Ambon periode 2012-2014. Metode. Jenis penelitian ini adalah penelitian analitik desain Cross-Sectional, dengan menggunakan catatan medis data di ruang operasi di Rumah Sakit Dr. M. Haulussy Ambon Tahun 2012-2014 dan memperoleh jumlah sampel yang memenuhi kriteria inklusi sebanyak 239, yang diambil dengan teknik total sampling. Analisis dilakukan dengan analisis univariat dan bivariat menggunakan uji Chi Square. Hasil yang di temukan dalam penelitian ini bahwa kejadian BPH lebih besar pada mereka yang berusia> 65 tahun dan 56-65 tahun dibandingkan dengan usia 46-55 dan <46 tahun dengan hasil tes menunjukkan adanya hubungan antara usia dengan BPH dengan nilai (p= 0,000), ada hubungan antara obesitas dengan nilai BPH (p=0,019) dan riwayat diabetes mellitus setelah menggunakan uji Chi-Square, hubungan antara riwayat diabetes mellitus dengan BPH dengan nilai (p = 0,000). Kesimpulan. Ada hubungan antara umur, obesitas dan riwayat diabetes mellitus dengan kejadian BPH.

Eco-friendly spectrophotometric methods for assessment of alfuzosin and solifenacin in their new pharmaceutical formulation; Green profile evaluation via eco-scale and GAPI tools

2020 ◽  
Vol 16 ◽  
Author(s):  
Mamdouh R. Rezk ◽  
Mina Wadie ◽  
Soheir A. Weshahy ◽  
Mahmoud A. Tantawy
Keyword(s):  
Minor Component ◽  
Time Saving ◽  
Prostate Hyperplasia ◽  
Spectrophotometric Methods ◽  
Ratio Difference ◽  
Ich Guidelines ◽  
Mean Centering ◽  
Benign Prostate ◽  
Urological Diseases

Background: Alfuzosin is recently co-formulated with solifenacin for relieving two coincident urological diseases, namely; benign prostate hyperplasia and overactive bladder Objective: Herein, green, simple and rapid spectrophotometric methods were firstly developed for simultaneous determination of the two cited drugs in their co-formulated pharmaceutical capsule Methods: Alfuzosin, which is the major component in the dosage form, was directly assayed at its extended wavelength at 330.0 nm. The challenging spectrum of the minor component, solifenacin, was resolved by five spectrophotometric methods, namely; dual wavelength (DW) at 210.0 & 230.0 nm, first derivative (1D) at 222.0 nm, ratio difference (RD) at 217.0 - 271.0 nm , derivative ratio (1DD) at 223.0 and mean centering of ratio spectra (MC) at 217.0 nm Results: The Proposed methods were successfully validated as per ICH guidelines. Alfuzosin showed linearity over the range of 4.0 - 70.0 μg/mL, while that of solifenacin were 4.0 - 50.0 μg/mL for DW, 2.0 - 70.0 μg/mL for 1D and RD methods, 1.0 - 70.0 μg/mL for 1DD and 4.0 - 70.0 μg/mL for MC method. Statistical comparison with their official ones showed no noticeable differences. The methods showed good applicability for assaying drugs in their newly combination. Besides eco-scale, the greenness profile of the methods was assessed and compared with the reported spectrophotometric one via the newest metric tool; green analytical procedure index (GAPI). Conclusions: The proposed methods are superior in not only being smart, accurate, selective, robust and time-saving, but also in using distilled water as an eco-friendly and cheap solvent

Urtica dioica in the Management of Benign Prostate Hyperplasia (BPH)

2020 ◽  
Vol 10 (5) ◽  
pp. 535-542
Author(s):  
Mohaddese Mahboubi
Keyword(s):  
Molecular Mechanisms ◽  
Life Quality ◽  
Urtica Dioica ◽  
Urinary Flow ◽  
Prostate Hyperplasia ◽  
Long Time ◽  
Tract Infections ◽  
Preclinical And Clinical Studies ◽  
Benign Prostate ◽  
Maximum Urinary Flow

Background:: Benign Prostatic hyperplasia (BPH) is known as a disease prevalent in men after the age of 50 years old. Ninety percent of men with the age of 80 years and over have BPH. BPH is associated with functional problems like dysuria, nocturia, polyuria, urinary incontinence and recurrent urinary tract infections. Urtica dioica or nettle is a popular medicinal plant for management of BPH in men. Objective:: This article evaluates the efficacy and safety of nettle and its related possible mechanisms in the management of BPH. Methods:: For the preparation of this manuscript, all the information was gathered from accessible and inaccessible resources (Web, Books, Thesis, etc.). Results:: The results of preclinical and clinical studies confirmed the efficacy of nettle roots extracts (methanol, ethanol, and petroleum ether) in the improvement of BPH in term of IPSS score, and patient's life quality. An increase in mean and maximum urinary flow rates and a reduction in prostate volume and residual urine level were observed after treatment with nettle extract. Nettle roots should be used for 6-12 months as its use is possible for a long time without any serious adverse effects. Conclusion:: Designing the clinical trials to compare the efficacy of different extracts from roots or leaves and investigation of molecular mechanisms of action could be the approaches for future.

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