scholarly journals RETROSPECTIVE MULTICENTRIC STUDY ON THE POST-SURGERY SYMPTOMATIC AND OBJECTIVE IMPROVEMENT OF BENIGN PROSTATIC HYPERPLASIA PATIENTS

2021 ◽  
pp. 143-145
Author(s):  
NEERAJ GUPTA ◽  
SUNIL KUMAR MAINI ◽  
VISHNU PAL ◽  
PUNIT TIWARI ◽  
LOYA BM
Keyword(s):  
Benign Prostatic Hyperplasia ◽  
Inverse Relationship ◽  
Prostatic Hyperplasia ◽  
Urinary Flow ◽  
Multicentric Study ◽  
Flow Rates ◽  
Post Surgery ◽  
Objective Evidence ◽  
Objective Improvement ◽  
Maximum Urinary Flow

Objectives: To evaluate patients of benign prostatic hyperplasia (BPH) preoperatively and identify those who would benefit from surgery, to evaluate outcome of surgery for BPH with respect to symptomatic and objective improvement of patients, and to compare the results of different surgeries for BPH being done different hospitals at Bhopal, which included transurethral resection of the prostate (TURP), transurethral incision of prostate (TUIP)/bladder neck incision (BNI), and Freyer’s prostatectomy? Methods: The present study was carried out at different hospitals of Bhopal. Patients presenting to the surgery outpatient department with symptoms of obstruction, namely, weak urinary stream, frequency hesitancy, intermittency, urgency, nocturia, etc., were included in the study. Some of the subjects included were patients presenting during emergency timings with complaints of retention of urine or occasionally other symptoms. The American Urological Association (AUA) Symptom Index questionnaire was administered to all such patients. They were also evaluated by ultrasound examination and patients having BPH on ultrasound (USG) were further evaluated by uroflowmetry. Results: Prostatic weight correlated well with the maximum urinary flow rates with an inverse relationship. Both maximum and average urinary flow rates (Q max and Qav) were improved by all the three surgeries However, TURP and Freyer’s prostatectomy showed greater improvement as compared to TUIP/BNI. Combination of AUA scoring, USG, and uroflowmetry helped us document improvement in our BPH patients and compared it favorably with other studies. Conclusion: Uroflowmetry was a simple assessment tool easy to learn and use. It was also inexpensive and formed a useful extension to clinical examination providing objective evidence of obstruction. It also helped to indirectly quantity the severity of obstruction. Symptom severity did not correlate with prostate size. Small prostates caused symptoms in the severe range also while even large prostates sometimes caused little symptoms. Prostatic weight correlated well with the maximum urinary flow rates with an inverse relationship.

Relationship among symptom score, prostate volume, and urinary flow rates in 543 patients with and without benign prostatic hyperplasia

The Prostate ◽  
1998 ◽  
Vol 34 (2) ◽  
pp. 121-128 ◽  
Author(s):  
Alessandro Sciarra ◽  
Giuseppe D'Eramo ◽  
Paolo Casale ◽  
Andrea Loreto ◽  
Maurizio Buscarini ◽  
...  
Keyword(s):  
Benign Prostatic Hyperplasia ◽  
Symptom Score ◽  
Prostate Volume ◽  
Prostatic Hyperplasia ◽  
Urinary Flow ◽  
Flow Rates

scholarly journals Safety and efficacy of photoselective vaporization of the prostate using the 180-W GreenLight XPS laser system in patients taking oral anticoagulants

2018 ◽  
Vol 46 (3) ◽  
pp. 1230-1237 ◽  
Author(s):  
Alper Eken ◽  
Bülent Soyupak
Keyword(s):  
Benign Prostatic Hyperplasia ◽  
International Prostate Symptom Score ◽  
Oral Anticoagulants ◽  
Laser System ◽  
Urine Volume ◽  
Prostatic Hyperplasia ◽  
Urinary Flow ◽  
Residual Urine Volume ◽  
Photoselective Vaporization ◽  
Maximum Urinary Flow

Objective To evaluate the safety and efficacy of the 180-W GreenLight XPS laser system for the treatment of benign prostatic hyperplasia in patients taking oral anticoagulants. Methods All consecutive patients admitted for lower urinary tract symptoms associated with benign prostatic hyperplasia from November 2012 to October 2016 and who underwent photoselective vaporization of the prostate with the 180-W GreenLight XPS laser were included in the study. The perioperative outcomes examined were the operating time, laser time, energy usage, and duration of postoperative catheterization. Functional parameters (International Prostate Symptom Score, maximum urinary flow rate, and post-void residual urine volume), prostate volume, and serum prostate-specific antigen concentration were examined at baseline and 3 months. Perioperative complications, if any, were noted. Results All functional parameters (International Prostate Symptom Score, maximum urinary flow rate, and post-void residual urine volume) significantly improved from baseline to 3 months. A small number of patients experienced at least one minor adverse event. There was no difference in the rate of adverse events between patients who were and were not taking anticoagulants. Conclusions Photoselective vaporization with a 180-W laser is an efficacious and safe treatment for benign prostatic hyperplasia, even in patients taking anticoagulant medications.

scholarly journals Body Mass Index and Risk of Prostate Volume, International Prostate Symptom Score, Maximum Urinary Flow Rate, and Post-Void Residual in Benign Prostatic Hyperplasia Patients

2019 ◽  
Vol 13 (4) ◽  
pp. 155798831987038 ◽  
Author(s):  
Bing-Hui Li ◽  
Tong Deng ◽  
Qiao Huang ◽  
Hao Zi ◽  
Hong Weng ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Benign Prostatic Hyperplasia ◽  
Body Mass ◽  
Flow Rate ◽  
Prostate Volume ◽  
Prostatic Hyperplasia ◽  
Urinary Flow Rate ◽  
Urinary Flow ◽  
Increased Risk ◽  
Maximum Urinary Flow

The objective of this study was to evaluate association between body mass index (BMI) and prostate volume (PV), international prostate symptom scores (IPSS), maximum urinary flow rate ( Qmax), and post-void residual (PVR) of Chinese benign prostatic hyperplasia (BPH) patients. All newly diagnosed BPH patients between September 2016 and August 2018 were selected and 788 patients were included. According to BMI, the patients were categorized into four groups, while according to PV, IPSS, Qmax, and PVR, they were categorized into two groups based on clinical significant cutoffs. Univariable and multivariable logistic regressions and a restricted cubic spline (RCS) were applied to explore the relationship of BMI with categorical PV, IPSS, Qmax, and PVR. Compared with normal BMI, obesity presented significant association with increased risk of larger PV (>80 ml) in both unadjusted and adjusted models (unadjusted odds ratio [OR] = 1.772, 95% CI [1.201, 2.614], p = .004; adjusted OR = 1.912, 95% CI [1.212, 3.017], p = .005); however, underweight or overweight did not present a significant connection with such risk. No significant effect was identified for BMI on IPSS, Qmax, or PVR in either unadjusted or adjusted model. Nonlinear test including BMI using RCS and adjusting for confounders showed no significance ( p > .05); however, a significant linear relationship was ascertained between BMI and the risk of larger PV ( p < .001). In conclusion, there was a significant linear association between BMI and the risk of larger PV in BPH patients. Hence, this suggests urologists should consider both BMI and PV when providing surgical treatment for BPH patients.

scholarly journals Clinical Significance of Intravesical Prostatic Protrusion Index in Patients with Clinical Diagnosis of Benign Prostatic Hyperplasia. 

2021 ◽  
Author(s):  
Seyed Reza Yahyazadeh ◽  
Seyed Shahaboddin Izadi
Keyword(s):  
Quality Of Life ◽  
Benign Prostatic Hyperplasia ◽  
International Prostate Symptom Score ◽  
Prostate Volume ◽  
Prostatic Hyperplasia ◽  
Urinary Flow ◽  
Postvoid Residual Urine ◽  
Intravesical Prostatic Protrusion ◽  
Maximum Urinary Flow

Abstract Purpose: To investigate the clinical significance of the intravesical prostatic protrusion (IPP) index in benign prostatic hyperplasia (BPH) patients to clarify its diagnostic value in predicting the clinical and structural abnormalities of the prostate. Materials and Methods: In this descriptive and analytical cross-sectional study, we include every man older than 50 years old with lower urinary tract symptoms (LUTS), predominantly voiding or obstructive, suggestive of BPH. The patients were evaluated to determine the following indices: IPSS (International Prostate Symptom Score) Index, QoL (quality of life), prostate volume (PV) and postvoid residual urine (PVR), serum PSA level, and the maximum urinary flow rate (Qmax) obtained by uroflowmetry. Subsequently, the assessment of the IPP index was undertaken by transabdominal ultrasonography. The categorization of the IPP index was done into 3 grades: grade one (below 5 mm), grade two (between 5 and 10 mm), and grade three (greater than 10 mm). Results: The significant direct correlation between the intravesical prostatic protrusion and international prostate symptom score, quality of life, prostate volume, postvoid residual urine, and serum PSA as well as inversely with the maximum urinary flow rate was confirmed both before and after the medical treatment. Also, the need for surgical intervention increased significantly with increasing IPP levels. Conclusion: The intravesical prostatic protrusion can be used to evaluate and predict the severity of symptoms and outcomes in patients with clinical BPH.

scholarly journals Efficacy and safety of Finasteride (5 alpha-reductase inhibitor) monotherapy in patients with benign prostatic hyperplasia: A critical review of the literature

2020 ◽  
Vol 91 (4) ◽  
pp. 205-210
Author(s):  
Gian Maria Busetto ◽  
Francesco Del Giudice ◽  
Daniele D'Agostino ◽  
Daniele Romagnoli ◽  
Andrea Minervini ◽  
...  
Keyword(s):  
Clinical Trials ◽  
Benign Prostatic Hyperplasia ◽  
Adverse Events ◽  
Clinical Efficacy ◽  
Critical Review ◽  
Reductase Inhibitor ◽  
Prostate Volume ◽  
Prostatic Hyperplasia ◽  
Urinary Flow ◽  
Efficacy And Safety

Background: Combination therapy with 5 alpha-reductase inhibitor (5-ARI) and alpha-blocker can be considered as a gold standard intervention for medical management of lower urinary tract symptoms related to benign prostatic hyperplasia (LUTS/BPH). On the other hand, 5-ARI monotherapy and in particular Finasteride alone is currently getting focus of attention especially due to lack of systematic reviews investigating efficacy outcomes and/or adverse events associated. Objectives: Aim of the present critical review was to analyze current knowledge of clinical efficacy and incidence of adverse events associated with 5-ARI treatment for LUTS/BPH. Materials and methods: A systematic review of clinical trials of the literature of the past 20 years was performed using database from PubMed, Cochrane Collaboration and Embase. A total of 8821 patients were included in this study and inclusion criteria for studies selection were: data from randomized clinical trials (RCTs) focusing their attention on the clinical role of Finasteride monotherapy for symptomatic BPH. Parameters of research included prostate specific antigen (PSA), prostate volume (PV), International Prostate Symptom Score (IPPS), postvoid residual urine (PVR), voiding symptoms of IPSS (voiding IPSS), maximum urinary flow rate (Qmax), and adverse events (AEs). Results: Overall 12 original articles were included and critically evaluated. Sample sizes of patient actively treated with finasteride varied from 13 to 1524 cases analyzed in a single study. Follow-up after treatments ranged from 3 to 54 months. The effect of finasteride in reducing prostate volume (PV) was moderate (standardized mean difference (SMD) effect between 0.5 to 0.8 for all trials evaluable) while the effect on IPSS score and Qmax was considered significant (SMD in the 0.2 to 0.5 variation range). No severe AEs and/or psychiatric disorders were retrieved among the studies. Sexual health dysfunctions were significantly influenced by finasteride therapy when compared with placebo treated patients. Conclusions: Although significant clinical benefits of finasteride monotherapy were demonstrated, the effective size of the available reports included in the analysis is limited. Additional head-to-head studies would be needed to re-evaluate clinical efficacy and safety of 5-ARI in combination or not with alpha blockers.

Monopolar vs. Bipolar Trans Urethral Resection of Prostrate (TURP) - A Comparative Outcome Analysis in Benign Prostatic Hyperplasia - A Single Centre Experience in Western Odisha

2021 ◽  
Vol 8 (31) ◽  
pp. 2875-2879
Author(s):  
Sucheta Panigrahi ◽  
Acharya Suryakanta Pattajoshi ◽  
Sanjay Kumar Mahapatra ◽  
Raja Kumar Subudhi P ◽  
Biswajit Sahu
Keyword(s):  
Benign Prostatic Hyperplasia ◽  
Operating Time ◽  
Prostatic Hyperplasia ◽  
Outcome Analysis ◽  
Symptom Improvement ◽  
P Value ◽  
Urinary Flow ◽  
Prostate Hyperplasia ◽  
Bipolar Group ◽  
Post Operative Period

BACKGROUND In this study we wanted to compare the clinical outcomes in terms of symptom improvement and perioperative results of monopolar and bipolar trans urethral resection of prostrate (TURP) for benign prostatic hyperplasia (BPH) and evaluate the advantages of bipolar transurethral resection over the monopolar resection. METHODS A total of 150 patients who underwent trans urethral resection of prostate (TURP) surgical procedure, (n = 75 for monopolar TURP) and (n = 75 for bipolar TURP) for BPH enrolled between December 2018 to November 2020 at the Department of Urology in VSSIMSAR, Burla, Odisha. RESULTS Significant differences were found in operating time in minutes (45.11 ± 4.029 vs 41.99 ± 5.020, P < 0.025) between monopolar and bipolar TURP. The mean sodium falls in post-operative period in bipolar and monopolar TURP was 7 Meq and 3 Meq respectively which was statistically significant (P - value less than 0.05). Bipolar TURP is equally effective as monopolar in reducing the international prostate symptom score (IPSS), improvement in quality of life, maximum urinary flow rate. Trans urethral resection (TUR) syndrome was reported in two patients who had undergone monopolar resection without any incidence in bipolar group. 3 patients in monopolar group developed clot retention compared to 1 in bipolar group in post-operative period. Fall in haemoglobin (Hb) and packed cell volume (PCV) was more with monopolar group but insignificant. CONCLUSIONS Bipolar TURP is safe and equally effective as monopolar TURP with advantage of shorter operative time and absence of dilutional hyponatremia and TUR syndrome, but needs large randomized trials with long follow up to confirm its efficacy and safety. KEYWORDS Monopolar TURP; Bipolar TURP; Benign Prostate Hyperplasia

How Reliable is a Single Measurement of Urinary Flow in the Diagnosis of Obstruction in Benign Prostatic Hyperplasia?

1993 ◽  
Vol 72 (2) ◽  
pp. 181-186 ◽  
Author(s):  
H. MATZKIN ◽  
R. VAN DER ZWAAG ◽  
Y. CHEN ◽  
LYNNE A. PATTERSON ◽  
Z. BRAF ◽  
...  
Keyword(s):  
Benign Prostatic Hyperplasia ◽  
Prostatic Hyperplasia ◽  
Urinary Flow ◽  
Single Measurement
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