scholarly journals Transurethral Intraprostatic Botulinum Toxin-a Injection in Patients with Benign Prostatic Hyperplasia: A Case Series and Literature Review

2022 ◽  
Vol 16 (1) ◽  
pp. 9-16
Author(s):  
Mahmoud Tavakkoli ◽  
◽  
Hamidreza Ghorbani ◽  
Amin Nobahar ◽  
Maryam Emadzadeh ◽  
...  
Keyword(s):  
Benign Prostatic Hyperplasia ◽  
Botulinum Toxin A ◽  
Specific Antigen ◽  
Case Series ◽  
Optimal Number ◽  
Prostatic Hyperplasia ◽  
Urinary Flow ◽  
Pubmed Database ◽  
The Mean

Background: We aimed to assess the efficacy of Intraprostatic Onabotulinumtoxin-A (BTA) on the International Prostate Symptom Score (IPSS) and other objective measures of patients with Benign Prostatic Hyperplasia (BPH). Methods: Fifteen patients were included in this study. The drug (BTA; 150 IU) was reconstituted in 20 mL of 0.9% saline before administration to the patients. After providing urethral anesthesia, 20 intraurethral injections were made to lateral lobes of the prostate, 10 injections in each lobe. Follow-up visits were planned 3 and 12 months after the intervention. Pre- and post-interventional IPSS, Prostate-Specific Antigen (PSA), Prostate Volume (PV), Post-Void Residue (PVR), and maximum urinary flow rate (Qmax) compared via paired t-test. Finally, we reviewed the Pubmed database to provide a more precise conclusion. Results: The Mean±SD age of patients was 69±8.24 years, and the mean IPSS score decreased significantly from 24.3±3.3 to 14.6±3.7 (p<0.001) and 16.86±3.06 (p<0.009) on the 3rd and 12th months, respectively. The Mean±SD PSA, PVR, Qmax, and PV were 3.26±1.38, 82.33±35.55, 8.56±1.76, and 47.86±8.93, respectively at baseline. These factors significantly improved to 2.72±1.33 (P<0.000), 71.33±30.55 (p<0.000), 9.5±1.33 (p<0.011), and 42.86± 6.04 (p<0.000), respectively, on the 12th month follow-up. Conclusion: Although the overall results support the efficacy of BTA for BPH, the best route of administration, the most effective dose, the optimal number, and the volume of injections need further investigations. The probable placebo effect and underlying medical conditions (e.g., insulin resistance) should be considered as the confounding factors.

scholarly journals The correlation between obesity and prostate volume in patients with benign prostatic hyperplasia at Charlotte Maxeke Johannesburg Academic Hospital

2021 ◽  
Vol 27 (1) ◽  
Author(s):  
Eshely Mampa ◽  
Mohamed Haffejee ◽  
Pascaline Fru
Keyword(s):  
Benign Prostatic Hyperplasia ◽  
Health Care Systems ◽  
Specific Antigen ◽  
Transrectal Ultrasound ◽  
High Body Mass Index ◽  
Prostatic Hyperplasia ◽  
Urinary Flow ◽  
Academic Hospital ◽  
Subsequent Increase ◽  
The Mean

Abstract Background Benign prostatic hyperplasia (BPH) is on the increase placing a substantial burden on health care systems. Recent studies have shown that men with high body mass index (BMI) and central obesity, as denoted by waist circumference (WC) have bigger prostate volumes (PV) with subsequent increase in lower urinary tract symptoms (LUTS) than men with normal BMI. The purpose of this research was to investigate the correlation between Obesity and PV in patients with BPH. Methods The study included 178 men aged between 50 and 75 years with BPH seen at Charlotte Maxeke Johannesburg academic hospital (CMJAH) Urology Outpatient Department between September 2018 and February 2019. Weight and height measurements were obtained to calculate BMI. Furthermore, WC was measured using a measuring tape, while a transrectal ultrasound (TRUS) was used to measure PV. Patient demographics, clinical characteristics such as hypertension, diabetes, smoking and prostate specific antigen (PSA) were also noted. Results Patients in the study had a mean age of 64.87 ± 6.526 years and the mean BMI was 27.31 ± 3.933 kg/m2. The mean PV of each BMI group were 52.92 ± 38.49, 61.00 ± 33.10 and 64.86 ± 37.46 cm3 for normal, overweight and obese groups, respectively, and the average PV score was 59.36 ± 36.507 cm3. The mean PSA score was 4.30 ± 3.126 with a range of 1.3–6.4, while the mean WC was 98.67 cm. There was no correlation between BMI and PV (p value = 0.195) as well as between PV and WC, hypertension, diabetes or smoking. The results revealed that the relationship between PV with PSA level as well as age was significant (p value = 0.001, p value = 0.009, respectively). Conclusion The results showed no correlation between BMI and PV. Diabetes and hypertension as well had no positive correlation with PV. A follow-up study may be indicated to look at the correlation between obesity, LUTS and urinary flow rates to establish whether aggressive management of obesity would have significant impact on the management of BPH.

What Is the Interaction between Urine C-Reactive Protein, Prostatic Inflammation, and Doxazosin Treatment in Patients with Benign Prostatic Hyperplasia? A Pilot Study

2021 ◽  
pp. 1-5
Author(s):  
Ahmet Asfuroglu ◽  
Melih Balci ◽  
Yilmaz Aslan ◽  
Cagdas Senel ◽  
Ozer Guzel ◽  
...  
Keyword(s):  
International Prostate Symptom Score ◽  
Prostatic Hyperplasia ◽  
Urinary Flow ◽  
C Reactive Protein ◽  
Alpha Blocker ◽  
Reactive Protein ◽  
The Mean ◽  
Maximum Urinary Flow ◽  
First Admission

<b><i>Introduction:</i></b> It was aimed to show the relationship between benign prostatic hyperplasia and inflammation by measuring urinary C-reactive protein values before and after alpha-blocker treatment. <b><i>Methods:</i></b> A total of 71 patients with a total prostate-specific antigen &#x3c;3.5 ng/mL, International Prostate Symptom Score &#x3e;7, and maximum urinary flow rate &#x3c;15 mL/s were included in the study. Doxazosin 4 mg p.o. once daily was started orally as an alpha-blocker treatment. Serum and urine C-reactive protein values, International Prostate Symptom Score, maximum urinary flow rate, and the post-void residual volume of patients were recorded at the first admission and in the first month of alpha-blocker treatment. <b><i>Results:</i></b> The mean age of the patients was 59.2 ± 7.5 years. The mean serum C-reactive protein values of the patients at the first admission and follow-up were 2.62 ± 1.8 (range, 0–5) mg/L and 2.83 ± 1.6 (0–6) mg/L, respectively. The mean urine C-reactive protein values of the patients at the first admission and follow-up were 0.45 ± 0.11 (range, 0.28–0.99) mg/L and 0.14 ± 0.04 (range, 0.79–0.328) mg/L, respectively, which was statistically significantly different. In the subgroup analysis, the urine C-reactive protein level change was more prominent in severely symptomatic patients than in moderately symptomatic patients. <b><i>Conclusion:</i></b> Our results showed that C-reactive protein was detectable in urine, alpha-blocker treatment significantly reduced urine C-reactive protein levels, and the decrease was more prominent in severely symptomatic patients.

scholarly journals First Multi-Center All-Comers Study for the Aquablation Procedure

2020 ◽  
Vol 9 (2) ◽  
pp. 603 ◽  
Author(s):  
Thorsten Bach ◽  
Peter Gilling ◽  
Albert El Hajj ◽  
Paul Anderson ◽  
Neil Barber
Keyword(s):  
Prostate Volume ◽  
Transrectal Ultrasound ◽  
Prostatic Hyperplasia ◽  
Urinary Flow ◽  
Procedure Time ◽  
Symptomatic Benign Prostatic Hyperplasia ◽  
Real World Evidence ◽  
The Mean ◽  
Maximum Urinary Flow

Waterjet-based prostate resection (Aquablation procedure) is an increasingly recognized treatment for symptomatic benign prostatic hyperplasia (BPH). We confirmed the safety and effectiveness of the Aquablation procedure in the commercial setting in 178 men at five sites. The mean prostate volume was 59 cc. The procedure time averaged 24 min and total anesthesia duration was 50 min. The International Prostate Symptom Score (IPSS) decreased from 21.6 at the baseline to 6.5 at the 12-month follow-up, a 15.3-point improvement (p < 0.0001). The maximum urinary flow rate increased from 10 cc/s at the baseline to 20.8 cc/s at month 12 (increase of 11.8 cc, p < 0.0001). Ejaculatory function was relatively preserved. Prostate volume assessed with transrectal ultrasound decreased 36% by month three. Five patients (2.7%) underwent a transfusion in the first week after the procedure. Real-world evidence shows that Aquablation is safe and effective for the treatment of BPH.

scholarly journals Spontaneous prostatic haematoma in a case of benign prostatic hyperplasia

2019 ◽  
Vol 12 (3) ◽  
pp. e228787
Author(s):  
Devanshu Bansal ◽  
Amlesh Seth
Keyword(s):  
Benign Prostatic Hyperplasia ◽  
Urinary Bladder ◽  
Urinary Retention ◽  
Transurethral Resection ◽  
Obstructive Uropathy ◽  
Prostatic Hyperplasia ◽  
Urinary Flow ◽  
Urethral Catheterisation ◽  
Definitive Surgery

A 61-year-old man presented with urinary retention with obstructive uropathy (urea/creatinine: 126/9.2 mg/dL) secondary to a large prostatic haematoma while being medically managed for benign enlargement of the prostate. The patient did not have any fever or local symptoms and the prostate was enlarged and non-tender on examination. Ultrasound and MRI of the pelvis showed a 9.4×10.4×11.1 cm sized prostatic haematoma seen displacing and compressing the urinary bladder anteriorly with bilateral hydroureteronephrosis. The patient was managed with per-urethral catheterisation, haemodialysis and injectable antibiotics. Percutaneous pigtail placement into the prostatic haematoma led to gradual drainage of the haematoma with improvement in the renal parameters. Definitive surgery in the form of transurethral resection of the prostate was done at a later date. Intraoperatively multiple encapsulated cavities containing organised clots were deroofed. On follow-up, the patient did well and had good urinary flow and normal renal parameters.

scholarly journals Comparative clinical profile of patients of Benign Prostatic Hyperplasia (BPH) with and without Metabolic Syndrome: a prospective observational study

2017 ◽  
Vol 6 (10) ◽  
pp. 2452
Author(s):  
Vikrant Panwar ◽  
B. L. Pandey ◽  
U. S. Dwivedi ◽  
Alok Singh
Keyword(s):  
Metabolic Syndrome ◽  
Benign Prostatic Hyperplasia ◽  
Statistical Tests ◽  
Fasting Blood Glucose ◽  
Specific Antigen ◽  
Density Lipoprotein ◽  
Prostatic Hyperplasia ◽  
Clinical Profile ◽  
Adrenergic Blocker

Background: Benign Prostatic Hyperplasia (BPH) is one of common disorder in men of old age group. The pathogenesis of BPH is multi-factorial and still not been fully elucidated. There are numerous reports which suggest possible link between several metabolic alterations known as Metabolic Syndrome. In the present study, the aim was to establish relation between Benign Prostatic Hyperplasia and Metabolic Syndrome and to find out effects of therapeutic intervention of Metabolic Syndrome on prostatic parameters.Methods: 93 patients of Benign Prostatic Hyperplasia enrolled who met qualifying criteria for inclusion in study and divided into three groups on the basis of Metabolic Syndrome and its treatment administered. Administration of alpha adrenergic blocker was common to all patients of all groups. Metabolic parameters including Fasting blood glucose, High-density lipoprotein (HDL), Triglycerides (TGs), waist circumference and prostatic parameters that is prostate volume, prostate specific antigen (PSA), uroflometry, International prostate symptom score (IPSS) were assessed at baseline, after 3 and 6 months follow-up. Further appropriate statistical tests were applied for comparison of parameters among groups.Results: Patients receiving no treatment for Metabolic Syndrome were having most deranged prostatic parameters as compared to patients without Metabolic Syndrome or patients with Metabolic Syndrome receiving treatment for same. Further patients receiving treatment for Metabolic Syndrome and alpha adrenergic blocker were having better clinical profile than patients of alpha adrenergic blocker alone.Conclusions: These findings show probable link between Metabolic Syndrome and worse prostatic profile. Metabolic Syndrome must be looked for and treated in patients of Benign Prostatic Hyperplasia. Metabolic derangements must not be overlooked and must be treated accordingly.

scholarly journals P128 BOTULINUM TOXIN A IN CONJUNCTION WITH NEGATIVE PRESSURE WOUND THERAPY AND MESH-MEDIATED FASCIAL TRACTION PROVIDES HIGH RATE OF FASCIAL CLOSURE IN PATIENTS WITH OPEN ABDOMEN

2021 ◽  
Vol 108 (Supplement_8) ◽  
Author(s):  
Irene Schmidt ◽  
Hans Friis Andersen ◽  
Nellie Zinther
Keyword(s):  
Botulinum Toxin ◽  
Open Abdomen ◽  
Botulinum Toxin A ◽  
Case Series ◽  
High Rate ◽  
Fascial Closure ◽  
Toxin A ◽  
Fascial Defect ◽  
The Mean

Abstract Aim Presentation of our data on Vacuum-Assisted Wound Closure and Permanent Onlay Mesh-Mediated Fascial Traction (VAWCPOM) in combination with Botulinum Toxin A (BTX-A) injection in the lateral abdominal wall as a treatment of the open abdomen (OA). Material and Methods This is a retrospective case series including patients treated for OA from January 2017 till March 2021 with VAWCPOM and BTX-A. Patient records were collected from medical charts, incl. age, sex, body mass index (BMI), comorbidity, initial fascial defect size, time until fascial closure, complications and, when available, outpatient follow-up. Results A total of 33 patients with OA were included. The mean age was 62,5 years, male/female ratio was 15:18, with a mean BMI of 35,4 kg/m2. The mean width of the fascial defect was 13,5 cm (5 - 25cm). The rate of fascial closure was 96,9%, achieved within a mean of 22,7 days. Fascial closure was not attainable in one patient who developed enterocutaneous fistula under treatment. 22 patients experienced in-hospital complications. Short-term follow-up was conducted in 22 patients, with hernia recurrences in three. Conclusions Treatment of OA remains a surgical challenge. This case series shows promising results with a high rate of fascial closure using a combination of VAWCPOM and BTX-A and an acceptable rate of postoperative complications in this severely challenging patient group. The rate of primary closure indicates that this may be the future management of open abdomen.

scholarly journals Effects of Transurethral Resection of Prostate (TURP) on Quality of Life in Case of Benign Prostatic Hyperplasia

2019 ◽  
Vol 5 (2) ◽  
pp. 143-147
Author(s):  
Md Abul Hossain ◽  
Md Akter Alam ◽  
Md Fazal Naser ◽  
Md Shafiqul Azam
Keyword(s):  
Quality Of Life ◽  
Benign Prostatic Hyperplasia ◽  
Flow Rate ◽  
Transurethral Resection ◽  
Prostatic Hyperplasia ◽  
Urinary Flow Rate ◽  
Transurethral Resection Of Prostate ◽  
Urinary Flow

Background: BPH is one of the most common cause of LUTS which significantly impairs the quality of life. TURP is minimally invasive surgical procedure for Benign Prostatic hyperplasia which has impact on quality of life. Impact on quality of life can be measured by QoL score and effect of TURP can be evaluated. Objective: The purpose of the present study was to evaluate the impact of transurethral resection of prostate (TURP) on Quality of Life (QoL) score. Methodology: This prospective study was carried out in the Department of Urology, Shaheed Suhrawardy Medical College and Hospital, Dhaka, from July 2015 to June 2016. Total fifty patients between 50 to 72 years attending for the treatment of benign prostatic hypertrophy (BPH) with lower urinary tract symptoms (LUTS) were included for the study according to inclusion & exclusion criteria. All of them were evaluated with baseline international prostate symptoms score (IPSS), QoL score, peak urinary flow rate (Qmax), voided volume, voiding time and PVR and were recorded in a predesigned data sheet. Selected patients underwent Transurethral Resection of Prostate. They were followed after 1 month and 3 months with same parameter and compared with the baseline values. Results: The baseline international prostate symptoms score (IPSS) in this study was 25.18±1.45. At one month and three months follow up visits after TURP, the IPSS was decreased to 15.0±1.07 and 8.14±0.76 respectively. There was significant improvement of peak urinary flow rate (Qmax) in the postoperative period, at the 1st follow up visit after one month of TURP (15.78±1.42, p<0.001) and at the 2nd follow visit after three months of TURP (18.78, p <0.001). The mean QoL score was 5.30±0.46 before TURP. After one month of TURP it was 3.20±0.45 and after 3 months of TURP it was 1.86±0.57. Conclusion: There is a significant improvement of quality of after TURP. Journal of National Institute of Neurosciences Bangladesh, 2019;5(2): 143-147

Homoeopathic Treatment of Benign Prostatic Hyperplasia: A Case Series

2018 ◽  
Vol 31 (03) ◽  
pp. 209-219
Author(s):  
Girish Gupta ◽  
Arun Kumar ◽  
Reteka Sexena ◽  
Chaturbhuja Nayak
Keyword(s):  
Benign Prostatic Hyperplasia ◽  
Controlled Trial ◽  
Specific Antigen ◽  
Case Series ◽  
Uttar Pradesh ◽  
Prostatic Hyperplasia ◽  
Post Treatment ◽  
Open Label ◽  
Basic Principles ◽  
Randomised Controlled

Background Benign prostatic hyperplasia (BPH) is one of the most common diseases in age group above 50 years. Symptoms relating to urination are usually frequency, urgency, and hesitancy and vary from case to case. Very few studies are reported on homoeopathic treatment of BPH. Hence, an evidence-based observational study on five patients of BPH was done using homoeopathic medicines. The objective of this case series is to assess the usefulness of individualised homoeopathic medicines in the treatment of cases of BPH. Methodology An open-label observational prospective study was done on patients of BPH at Gaurang Clinic and Centre for Homoeopathic Research, Lucknow, Uttar Pradesh, India, and five patients included in this cases series were treated during 2007–2009. Individualised homoeopathic medicines were prescribed to these patients, after proper case taking, repertorisation and consultation of Materia Medica. Patients were assessed using parameters like International Prostate Symptom Score, uroflowmetry, ultrasonography and prostate-specific antigen. Results Baseline and post-treatment parameters were assessed, which showed significant improvement in post-treatment values along with relief of symptoms in all five patients. Conclusion Results of the study are encouraging and in accordance with the basic principles of homoeopathic prescribing (i.e. classical approach), exhibiting the benefits of constitutional medicines. All the patients showed improvement in their symptoms and laboratory parameters. However, studies with larger sample size and randomised controlled trial study design are suggested.

Ultrasound-guided transperineal laser ablation for percutaneous treatment of benign prostatic hyperplasia: a new minimally invasive interventional therapy

2021 ◽  
pp. 028418512110032
Author(s):  
Huai-Jie Cai ◽  
Jian-Hua Fang ◽  
Fan-Lei Kong ◽  
Chen-Ke Xu ◽  
Chuang-Hua Chen ◽  
...  
Keyword(s):  
Benign Prostatic Hyperplasia ◽  
Laser Ablation ◽  
Minimally Invasive ◽  
Prostate Volume ◽  
Interventional Therapy ◽  
Prostatic Hyperplasia ◽  
Urinary Flow ◽  
Ultrasound Guided ◽  
Prostate Hyperplasia

Background Although there are different treatments for benign prostate hyperplasia, their efficacy and safety differ. We are currently exploring a new minimally invasive interventional therapy for benign prostatic hyperplasia (BPH). Purpose To determine the feasibility, effectiveness, and safety of ultrasound-guided transperineal laser ablation (US-TPLA) for the treatment of BPH. Material and Methods Twenty patients with BPH (mean age = 73.9 ± 9.2 years) who underwent US-TPLA from June 2018 to January 2020 with a subsequent six-month follow-up were retrospectively reviewed. After local anesthesia, a 21-G trocar was inserted into the prostate tissue under ultrasound monitoring, followed by 1064 nm diode laser irradiation. Changes in international prostate symptom score (IPSS), quality of life (QoL), maximum urinary flow rate (Qmax), postvoid residual (PVR), prostate volume, and complications were evaluated six months after surgery. Results All patients underwent the operation successfully without serious complications. After six months, the average IPSS improved from 22.7 ± 5.3 to 9.1 ± 3.2 ( P < 0.001), the QoL improved from 4.9 ± 1.7 to 2.3 ± 1.3 ( P < 0.001), the Qmax improved from 8.5 ± 3.0 to 15.2 ± 4.8 mL/s ( P < 0.001), the PVR increased from 78.7 ± 58.8 to 30.3 ± 34.2 ( P < 0.05), and the mean prostate volume ranged from 70.8 ± 23.8 to 54.7 ± 20.9 mL ( P < 0.05). Conclusion US-TPLA is safe and feasible for the treatment of BPH. An evaluation at the six-month follow-up is effective.

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