Transurethral Electrovaporization Research Articles

The application of evidence-based nursing in transurethral electrovaporization of prostate

Objective To explore the clinic effect on applying the evidence - based nursing to prevent the patients with the skin to pressure sore, the hypothermia, damage of the high frequency electricity knife, deep venous thromboembolism (DVT) by transurethral electrovaporization of the prostate (TUVRP) . Methods The application of evidence - based nursing in eight - six cases with BPH by TUVRP were analyze retrospectively. Results Only 1 case with DVT after operated and 1 case is burned by electricity. In 86 cases all of the patients are not complicated with pressure sore and the hypothermia Conclusion The effective measure of nursing intervention, enable the nursing staff to have the profound understanding to each kind of complication prevention necessity, effectively ceased each kind of complication occurrence, improved the operating room nursing quality. Key words: Evidence - based nursing; BPH ; Surgery; Transurethral electrovaporization

Transurethral Electrovaporization of the Prostate as an Alternative to Transurethral Resection: A Five-Year Follow-up

Transurethral Electrovaporization of the Prostate as an Alternative to Transurethral Resection: A Five-Year Follow-up

Transurethral Electrovaporization of the Prostate as an Alternative to Transurethral Resection: A Five-Year Follow-up

Transurethral Electrovaporization of the Prostate as an Alternative to Transurethral Resection: A Five-Year Follow-up

Benign Prostatic Hypertrophy

Benign prostatic hypertrophy is an extremely common condition affecting as many as 90% of men over the age of 70 years according to the National Institutes of Health. The gold standard surgical treatment is currently transurethral resection of the prostate (TURP). Side effects of this procedure include disruption of sexual function which many, particularly young patients, find unacceptable. A number of minimally invasive procedures have recently been developed including transurethral microwave therapy (TUMT), transurethral needle ablation (TUNA), transurethral electrovaporisation (TUEVP) and laser surgery. However, knowledge of these treatments amongst patients and professionals is somewhat limited. The following is a review of selected websites which discuss the condition and its current management.

The Combined use of Transurethral Electrovaporization Ablation and Transurethral Resection of High-risk benign Prostatic Hyperplasia

目的 探讨高危前列腺增生症的有效治疗方法.方法 回顾分析2000年1月～2006年10月我院52例高危前列腺增生症患者采用经尿道前列腺电汽化术(transurethral electrovaporization of prostate,TRVP)联合经尿道前列腺电切术(transurethral resection of prostate,TRUP)治疗的诊治过程及预后情况.结果 手术平均时间70 min,平均切除腺体重量45g,术中无发生大出血、电切综合征等并发症,全部患者安全渡过围手术期,拔除尿管后,全部患者恢复自主排尿.术后随访5～36个月,IPSS评分由术前平均27分下降至术后平均6分;QOL评分由术前平均5分下降至术后平均1分;QMAX由术前平均6.1ml升高至术后平均16.3ml;剩余尿量由术前平均230ml下降至术后平均23ml.结论 采用TRVP联合TRUP治疗高危前列腺增生症,兼有两者优点,并发症少、安全性大、疗效显著是治疗高危BPH的有效方法。

Application of Clinical Pathway in Benign prostatic Hyperplasia Patients

目的 探讨临床路径在前列腺增生症行经尿道前列腺汽化电切手术患者中的应用.方法 将60例经尿道前列腺汽化电切手术患者随机分为观察组和对照组,每组各30例.观察组按制定好的临床路径表格实施医疗护理,对照组采用传统的医疗护理方法.结果 观察组患者的住院天数、住院费用、并发症发生率明显低于对照组(P＜0.01),患者的满意度(P＜0.05)、健康知识明显高于对照组(P＜0.01).结论 按临床路径实施医疗护理经尿道前列腺汽化电切术患者,可减少住院天数,降低医疗费用,促进患者术后生活自理能力的恢复,保证医疗护理质量,提高工作效率和病人满意度。

A Prospective, Randomized Trial Comparing Conventional Transurethral Prostate Resection With PlasmaKinetic® Vaporization of the Prostate: Physiological Changes, Early Complications and Long-Term Followup

We compared standard transurethral prostate resection with bipolar PlasmaKinetic prostate vaporization for bladder outflow obstruction using a Gyrus PlasmaKinetic Plasma V bar. A total of 160 men were enrolled in a prospective, randomized trial. Those at higher risk for cancer were excluded by prostate specific antigen and digital rectal examination with or without transrectal ultrasound biopsy. A total of 81 men underwent prostate vaporization and 79 underwent transurethral prostate resection. Preoperative International Prostate Symptom Score and quality of life score, uroflowmetry, post-void residual urine and transrectal ultrasound prostate volume were recorded. Preoperative and postoperative serum hemoglobin, hematocrit and sodium were measured. Perioperative fluid absorption was calculated using weighing on table and blood loss using the Hemocue system. Longer followup of International Prostate Symptom Score and quality of life score, uroflowmetry and post-void residual urine was available in 149 men, including 76 who underwent prostate vaporization and 73 who underwent transurethral prostate resection. Data were analyzed using the 1 or 2-sample t and chi-square tests. The 2 groups were comparable in all preoperative parameters. Perioperative fluid absorption, intraoperative blood loss, preoperative and postoperative serum hematocrit, and sodium changes were not statistically different. Mean resection time was 4 minutes shorter for transurethral prostate resection (28.5 vs 32.6 minutes, p = 0.08). Patients with transurethral prostate resection showed a greater hemoglobin decrease (1.39 vs 0.8 gm/dl, p = 0.002) and required more irrigation postoperatively (28.3 vs 20.4 l, p = 0.001). Four patients with transurethral prostate resection required transfusion compared with none who underwent prostate vaporization. After transurethral prostate resection hospital stay was longer (3.36 vs 3.02 days, p = 0.03). Cancer was detected in 8 patients with transurethral prostate resection (10%), of whom 7 are under prostate specific antigen surveillance and 1 received radical radiotherapy. Mean long-term followup was 258 days (range 82 to 884). Prostate vaporization and transurethral prostate resection were equally effective at followup, as evidenced by changes in maximum urine flow, International Prostate Symptom Score, quality of life score and post-void residual urine. The 2 operations are highly effective in experienced hands. PlasmaKinetic prostate vaporization resulted in less postoperative bleeding and a slightly shorter hospital stay. The lack of a histological specimen with this version of PlasmaKinetic prostate vaporization may mean that clinically significant cancers are missed.

Transurethral Electrovaporization of the Prostate: Is it any Better Than Standard Transurethral Prostatectomy? 5-Year Follow-Up

Background and Purpose: At present, transurethral resection of the prostate (TURP) is regarded as the most effective treatment for benign prostate hyperplasia (BPH). In the present randomized study, we compared TURP with transurethral electrovaporization of the prostate (TUVP). Patients and Methods: A series of 77 BPH patients who underwent operation between 1996 and 2001 were included in the study, 40 who had TURP with a standard resection loop and 32 who had TUVP with a Spike loop. All available patients were evaluated preoperatively, at 1 month and 3 months after the operation (N = 73), and 5 years after the operation (N = 44). The International Prostate Symptom Score (IPSS), sexual function questionnaire, uroflowmetry (Qmax), postvoiding residual urine volume (PVR), and transrectal ultrasonography were used. In addition, postoperative serum sodium concentration, serum hematocrit, duration of catheterization, and operation time were compared. Results: In the TUVP group, the mean IPSS decreased from 17....

Integrated transuretheal electrovaporization ablation of prostate and transuretheal resection of prostate for patients with benign prostatic hyperplasia

目的 探讨汽化切割并电切术治疗前列腺增生症(BPH)的临床效果.方法采用经尿道汽化切割(TUVP)并用前列腺电切(TURP)治疗前列腺增生症62例.结果手术时间短,无严重并发症,疗效满意.结论 TUVP结合TURP治疗前列腺增生安全,效果好。

Bipolar electrosurgery for benign prostatic hyperplasia: transurethral electrovaporization and resection of the prostate

The gold standard for surgical treatment of benign prostatic hyperplasia continues to be transurethral resection of the prostate, which is traditionally performed using a monopolar electrocautery system resulting in the possibility of certain well-recognized complications. This has led to the development of alternative surgical procedures such as vaporization of the prostate and most recently use of bipolar systems. The advantages of bipolar electrosurgery include the ability to use isotonic saline during surgery, reduced blood loss and less heat damage to the surrounding tissue. We have reviewed some of the technical aspects of the bipolar systems as well as their clinical use. Bipolar electrovaporization of the prostate (Gyrus Medical Ltd, Cardiff, Wales) has been established for a few years and some data are available suggesting that the system is safe and effective, at least in the short term. The new technique of bipolar transurethral resection of the prostate has been studied in a small number of studies with promising results. Bipolar transurethral resection is a novel approach in treatment of the prostate. A real paucity of clinical data is seen regarding the outcomes with this form of surgery. Although the generator and the resecting loop are different to the monopolar system, the resection technique is very similar which may be attractive to practising urologists. The need for large multi-centre studies in effectiveness of bipolar transurethral resection of the prostate is apparent.

Update of the minimally invasive therapies for benign prostatic hyperplasia

The elevated impact benign prostatic hyperplasia has on patient quality of life has determined continuous research into the development of minimally invasive therapies aimed at restoring or preserving a good quality of life. The purpose of this review is to highlight recent developments in the field of minimally invasive treatment of benign prostatic hyperplasia, and to determine their possible impact on everyday clinical practice. Recent publications have described some interesting new therapies and provided data concerning long-term follow up and cost-effectiveness that have been lacking up until now. The review mainly focuses on transurethral microwave thermotherapy, interstitial laser coagulation, transurethral laser ablation, laser prostatectomies (resection and enucleation), transurethral ethanol injection therapy, transurethral electrovaporization, and high-power (80-W) potassium titanyl phosphate laser vaporization. Recent developments, new approaches and long-term reports of previously described minimally invasive therapies for the treatment of benign prostatic hyperplasia are presented. Cost-effectiveness studies were also carried out to complete the comparison with standard everyday procedures. Currently, transurethral microwave thermotherapy seems to offer the soundest basis for management of the condition, providing the longest term follow up and the largest numbers of studies completed to date. Among surgical alternatives, holmium laser enucleation has gained ground as an encouraging new approach, being similar to standard transurethral resection of the prostate, but reducing perioperative morbidity with the same long-term results. More randomized comparisons correctly conducted need to be undertaken before an accurate general picture is available for the urologist.

Transurethral Electrovaporization of the Prostate: Is It Any Better Than Standard Transurethral Prostatectomy? 5-Year Follow-Up

At present, transurethral resection of the prostate (TURP) is regarded as the most effective treatment for benign prostate hyperplasia (BPH). In the present randomized study, we compared TURP with transurethral electrovaporization of the prostate (TUVP). A series of 77 BPH patients who underwent operation between 1996 and 2001 were included in the study, 40 who had TURP with a standard resection loop and 32 who had TUVP with a Spike loop. All available patients were evaluated preoperatively, at 1 month and 3 months after the operation (N=73), and 5 years after the operation (N=44). The International Prostate Symptom Score (IPSS), sexual function questionnaire, uroflowmetry (Qmax), postvoiding residual urine volume (PVR), and transrectal ultrasonography were used. In addition, postoperative serum sodium concentration, serum hematocrit, duration of catheterization, and operation time were compared. In the TUVP group, the mean IPSS decreased from 17.3 to 6.5, the PVR from 88 to 35 mL, and the prostate volume from 39 to 24 cc, while the Qmax increased from 6.3 to 12.9 mL/sec and the average flow from 2.6 to 7.9 mL/sec. In the TURP group, the mean IPSS decreased from 17.6 to 6.1, the PVR from 95 to 38 mL, and the prostate volume from 38 to 23 cc, while the Qmax increased from 5.9 to 13.2 mL/sec and the average flow from 2.4 to 8.3 mL/sec. Thus, significant improvements were observed in both groups, and the differences between them 5 years later were not significant P>0.05). Postoperative serum hemoglobin and hematocrit were significantly lower in the TURP group (P>0.05). However, no difference was seen in serum sodium concentrations. Also, there was no difference in the duration of the operations. The catheterization period was 22+/-5.7 hours in the TUVP group, while it was 75.7+/-10.5 hours in the TURP group (P<0.001). When morbidities observed during follow-up were evaluated, no significant difference was seen. The TUVP procedure is as effective as TURP with similar morbidity. The advantages of TUVP are that the urethral catheter is withdrawn earlier, hospitalization is shorter, and bleeding is less. Its disadvantage is that tissue cannot be sampled for histologic diagnosis. In our opinion, in order to exploit the advantages of this technique, TUVP should be preferred in elderly patients without any suspicion of prostate cancer for whom bleeding during operation is a source of risk.

Early results of transurethral vaporisation of prostate in Nigeria.

to determine the effectiveness of transurethral electrovaporisation of prostate for the relief of obstructive prostatic disease in Nigeria. Consecutive patients presenting with obstructive prostatic disease with prostate size of less than 40gm were treated by transurethral electrovaporisation of prostate using a 5mm rollerball electrode. A total of 27 patients were entered into the study, 7(26%) had clinically malignant prostates; 2 patients (7%) had immediate post operative retention requiring resection of residual prostate. No patients exhibited the clinical features of TUR syndrome, all patients were discharged by the 4th post operative day and required no blood transfusions. Transurethral electrovaporisation is effective for treatment of obstructive prostatic disease, benign or malignant. using the 5mm rollerball instead of the recommended vaportrode still confers benefit over TURP. TEVP confers all the benefits of TURP with less mobidity.

1527: High-Power KTP Photoselective Laser Vaporization Prostatectomy (PVP) Versus Transurethral Electrovaporization of The Prostate (TVP) for The Treatment of Benign Prostatic Hyperplasia (BPH): A Prospective Comparative Trial

You have accessJournal of UrologyDiscussed Poster, Tuesday, May 11, 2004, 1:00 - 5:00pm1 Apr 20041527: High-Power KTP Photoselective Laser Vaporization Prostatectomy (PVP) Versus Transurethral Electrovaporization of The Prostate (TVP) for The Treatment of Benign Prostatic Hyperplasia (BPH): A Prospective Comparative Trial Alexis E. Te, Jaspreet S. Sandhu, Ricardo Gonzalez, Celeste Egan, and Steven A. Kaplan Alexis E. TeAlexis E. Te More articles by this author , Jaspreet S. SandhuJaspreet S. Sandhu More articles by this author , Ricardo GonzalezRicardo Gonzalez More articles by this author , Celeste EganCeleste Egan More articles by this author , and Steven A. KaplanSteven A. Kaplan More articles by this author View All Author Informationhttps://doi.org/10.1016/S0022-5347(18)38735-4AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail "1527: High-Power KTP Photoselective Laser Vaporization Prostatectomy (PVP) Versus Transurethral Electrovaporization of The Prostate (TVP) for The Treatment of Benign Prostatic Hyperplasia (BPH): A Prospective Comparative Trial." The Journal of Urology, 171(4S), p. 402 © 2016 by American Urological AssociationFiguresReferencesRelatedDetails Volume 171Issue 4SApril 2004Page: 402 Advertisement Copyright & Permissions© 2016 by American Urological AssociationMetricsAuthor Information Alexis E. Te More articles by this author Jaspreet S. Sandhu More articles by this author Ricardo Gonzalez More articles by this author Celeste Egan More articles by this author Steven A. Kaplan More articles by this author Expand All Advertisement PDF DownloadLoading ...

Minimally Invasive Treatment of BPH: An Update

Objectives: Aim of this review is provide updated information regarding the current role of minimally invasive treatment (MIT) for lower urinary tract symptoms (LUTS) due to benign prostatic obstruction (BPO). Methods: We reviewed the literature and report on the statements of BPH guidelines released by the European Association of Urology (EAU) and the American Urological Association (AUA). We largely concentrate on randomised clinical trials (RCT) and long-term follow-up series (≥12 months). Results: When assessing the current role of MIT a number of parameters, such as the need for anaesthesia, intra- and postoperative complications, morbidity, short- and long-term outcome have to be considered. MIT can be divided into (i) thermal-based therapies, (ii) laser therapies, (iii) ablative therapies and (iv) other technologies. The currently most attractive MITs are high-energy TUMT, Holmium-laser enucleation and transurethral electrovaporisation. Conclusions: BPH guidelines such as those of the EAU and AUA give clear recommendations in this evolving field. MITs not considered established by BPH guidelines should not be used outside clinical trials.

Transurethral electrovaporization of benign prostatic hyperplasia

目的 评价经尿道前列腺电汽化手术(TVP)治疗前列腺增生症的疗效.方法总结TVP治疗随访6个月以上1 420例前列腺增生症病人的安全性、有效性和疗效.结果平均手术时间为52 min,出血量平均78 ml,术后不需膀胱持续冲洗,平均留置导尿管时间40.7 h,最大尿流率由术前的8.7 ml/s上升至术后3个月的19.7 ml/s和6个月的20.3 ml/s.前列腺症状评分术前为22.3,术后3个月降低至6.8以及6个月时的6.0(P＜0.001) 结论 TVP是治疗良性前列腺增生症安全而有效的方法。

Vaporization of the prostate.

Transurethral resection of the prostate remains the treatment of choice for men with symptomatic benign prostatic enlargement. Concerns regarding the morbidity of this operation have led to the development of alternative surgical procedures. Vaporization of the prostate can be achieved using either laser energy or electrosurgery. The advantage of these approaches is that they allow tissue removal with reduced blood loss. Vaporization techniques have been around for almost a decade and more powerful lasers have recently become available. This has led to a minor resurgence in interest in laser vaporization. We reviewed articles on all forms of vaporization of the prostate published in the 12 months from August 2002. Electrovaporization of the prostate is an effective treatment for men who require surgery for benign prostatic enlargement. The results are well maintained at 5 years follow-up with low reoperation rates. Scanty data are available for the Gyrus (Gyrus Medical Ltd, Cardiff, Wales) bipolar electrovaporization system but preliminary results suggest there is no significant advantage over transurethral resection of the prostate. Early forms of laser vaporization of the prostate are not as effective as either transurethral resection of the prostate or transurethral electrovaporization of the prostate and have a higher retreatment rate. Newer, more powerful lasers have been recently introduced with encouraging initial results in small numbers of patients. Electrovaporization of the prostate is a safe, effective and durable alternative to transurethral resection. Early laser vaporization techniques have high retreatment rates, which limit their cost-effectiveness. Few data are yet available on high-powered lasers for bladder outflow obstruction. Whether any vaporization technique will stand the test of time is unclear.

Transurethral electrovaporization of the prostate (TUVP) is effective, safe and durable.

Transurethral electrovaporization of the prostate (TUVP) is one of the alternative, minimally invasive procedures to treat BPH with promising initial results. We reviewed the available English literature to evaluate the long-term safety, efficacy and durability of TUVP using various vaporizing electrodes. We performed a MEDLINE keyword search and assessed all prospective randomized studies, which compared TUVP to standard transurethral resection of the prostate (TURP) that reached 1 y follow-up. Data were analysed for improvement of IPSS and Q(max), operation time, hospital stay, perioperative bleeding, postoperative irritative symptoms, long-term side effects and reoperation rate. We reviewed a total of 244 TUVP compared to 259 TURP patients in six prospective randomized studies that reached 1 y follow-up. Less perioperative bleeding, shorter catheterization time (mean of TUVP: 30 h vs TURP: 61 h) and shorter hospital stay (mean of 1.4 days vs TURP: 3.4 days) were reported in the TUVP patients. The improvement in IPSS (71%) and mean Q(max) (20 ml/s) was similar in both groups. The reoperation rate was 2% per year in both vaporization and resection patients. In conclusion, analysis of the prospective randomized trials that reached 1 year follow-up revealed that TUVP is as effective as standard TURP in the treatment of BPH. Long-term side effects and reoperation rates are comparable and the initial improvement was maintained over 1 year for the majority of patients.

5-year outcome of a prospective randomized trial to compare transurethral electrovaporization of the prostate and standard transurethral resection

ObjectivesTo update our prospective randomized trial comparing the safety, efficacy, and durability of transurethral electrovaporization of the prostate (TUVP) using the VaporTrode with standard transurethral resection of the prostate (TURP). MethodsA total of 104 patients, taken from the waiting list for surgery for benign prostatic hyperplasia were randomized to TUVP (52 patients, mean age 67.5 years) or TURP (52 patients, mean age 70.2 years). In each group, 51, 47, and 40 patients completed 1, 2, and 3 years of follow-up, respectively. Of the 104 patients, 27 TURP and 26 TUVP patients completed 5 years of follow-up. ResultsBoth groups were comparable in terms of the mean preoperative International Prostate Symptom Score, quality-of-life score, maximal urinary flow rate, and postvoid residual volume. The follow-up data at 5 years showed a significant and maintained improvement in the mean International Prostate Symptom Score (TUVP: 5.9 ± 6.3 versus TURP: 8.6 ± 7.1, P = 0.16), quality-of-life score (TUVP: 1.1 ± 1.2 versus TURP: 1.7 ± 1.4, P = 0.09), and mean maximal urinary flow rate (TUVP: 21 ± 9 mL/s versus TURP: 17.9 ± 13.1 mL/s, P = 0.17), with decreases in the mean postvoid residual volume (TUVP: 27.3 ± 44.3 mL versus TURP: 10.7 ± 13.1 mL, P = 0.08). Two patients in each group (4%) developed urethral strictures. Two TURP patients (4%) developed bladder neck strictures compared with one TUVP patient (2%). In each arm, 7 patients (13%) underwent reoperation during a 5-year period (approximate reoperation rate: 3% in each arm per year). Postoperatively and during 3 years of follow-up, impotence was reported in 17% of the TUVP group and 11% of the TURP group (P = 0.49); retrograde ejaculation was reported in 72% of the TUVP group and 89% of the TURP group (P = 0.47). ConclusionsOur 5-year follow-up results confirm that TUVP is as effective as standard TURP in the treatment of moderate-size benign prostatic hyperplasia. The reoperation rate and long-term complication rate are comparable and the initial improvement has been maintained during a 5-year period for most patients in both groups.

The efficacy of transurethral electrovaporisation (TVP) against classic transurethral resection (TUR-P)

The efficacy of transurethral electrovaporisation (TVP) against classic transurethral resection (TUR-P)