Treatment Of Benign Prostatic Enlargement Research Articles

Treatment of benign prostatic enlargement with alpha-blockers: an updated review.

Treatment of benign prostatic enlargement with alpha-blockers: an updated review.

Electrovaporization of the prostate in patients with benign prostatic enlargement.

To determine the effectiveness and safety of transurethral electrovaporization in the treatment of benign prostatic enlargement (BPE). The study comprised 91 patients (median age 65 years) with BPE (median prostate volume 61 mL). Patients were assessed with a general and urological history, the International prostate symptom score (IPSS), urinary tract and prostatic ultrasonography, uroflowmetry and biopsy of the prostate. An electrosurgical generator (cutting at 200 W and coagulating at 70 W) with grooved electrodes was used to vaporize the prostate. The variables assessed before and after treatment were the IPSS, quality-of-life score, uroflowmetry, complications, and the duration of hospitalization. The mean operative duration was 45 min, blood loss was negligible and the mean duration of catheterization was 24 h. Recatheterization was necessary in 5.5% of patients. The median values before and after treatment were: IPSS, 19 and 5; QOL score, 4 and 2; and maximum urinary flow rate 8.3 and 22.1 mL/s (all P < 0.001). In nearly all cases, the Siroky nomogram showed that patients became unobstructed. Electrovaporization of the prostate has many advantages over other techniques used in the treatment of BPE, including transurethral resection (TURP). It is cheaper than laser-assisted prostatectomy in particular and is also simpler to perform. Higher-risk patients can be treated, it uses existing electrosurgical equipment with minor modifications and only the electrodes, which are inexpensive, differ from TUR loops; the TURP resectoscope can be used and there is almost no need for blood transfusion. Intra- and post-operative morbidity is very low, recatheterization rare, the hospital stay brief and the results equal to or better than those obtained with TURP. Convalescence is generally uneventful and rapid because haematuria is rare and, when present, mild. Patients can return to work earlier than after TURP. Although a promising technique, only a longer follow-up will allow firm conclusions about its suitability.

Transurethral microwave thermotherapy: an evolving technology in the treatment of benign prostatic enlargement

British Journal of UrologyVolume 76, Issue 5 p. 531-538 Transurethral microwave thermotherapy: an evolving technology in the treatment of benign prostatic enlargement M.J.A.M. DE WILDT, Corresponding Author M.J.A.M. DE WILDT Department of Urology, University Hospital Nijmegen, the Netherlands MD, Research Fellow.2 University Hospital Nijmegen, PO Box 9101, 6500 HB Nijmegen, the Netherlands.Search for more papers by this authorJ.J.M.C.H. DE LA ROSETTE, J.J.M.C.H. DE LA ROSETTE Department of Urology, University Hospital Nijmegen, the Netherlands MD PhD, Director of The Prostate Centre.Search for more papers by this author M.J.A.M. DE WILDT, Corresponding Author M.J.A.M. DE WILDT Department of Urology, University Hospital Nijmegen, the Netherlands MD, Research Fellow.2 University Hospital Nijmegen, PO Box 9101, 6500 HB Nijmegen, the Netherlands.Search for more papers by this authorJ.J.M.C.H. DE LA ROSETTE, J.J.M.C.H. DE LA ROSETTE Department of Urology, University Hospital Nijmegen, the Netherlands MD PhD, Director of The Prostate Centre.Search for more papers by this author First published: November 1995 https://doi.org/10.1111/j.1464-410X.1995.tb07774.xCitations: 25 AboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinked InRedditWechat Citing Literature Volume76, Issue5November 1995Pages 531-538 RelatedInformation

Urodynamic assessment in the laser treatment of benign prostatic enlargement.

To determine if bladder outlet obstruction can be adequately relieved after laser prostatectomy. Since November 1992, a total of 105 patients underwent laser treatment of the prostate because of complaints related to benign prostatic enlargement (BPE). To date, urodynamic data from a study of pressure flow analysis are available for 79 patients both at baseline and at 6 months after treatment. Patients were evaluated using changes in symptoms (IPSS symptom score), peak flow rate (Qmax), post-voiding residual volume (PVR), detrusor pressure at maximum flow (Pdet at Qmax), and the linear passive urethral resistance relation (LPURR). Moreover, patients with minimal bladder outlet obstruction were compared to patients with severe bladder outlet obstruction. There was a significant improvement in mean IPSS score from 21.3 at baseline to 5.3 at the 6-month follow-up. The Qmax improved from 7.9 mL/s to 17.8 mL/s, and the PVR decreased from 91.6 mL to 15.6 mL. At baseline, > 80% of the patients were considered obstructed according to the analysis of pressure flow, whereas 6 months after laser treatment, only 5% of the patients were still considered obstructed. A comparison of the outcome between minimally obstructed patients and severely obstructed patients showed comparable improvements. Laser therapy of the prostate was, according to urodynamic parameters, capable of relieving outlet obstruction and minimally obstructed patients also showed a significant relief of outlet obstruction.

Internal Urethrotomy of the Prostatic Urethra or Transurethral Resection in Benign Prostatic Hyperplasia

Transurethral resection of the prostate is the most common technique for the treatment of benign prostatic enlargement. The inconveniences of prostatic resection are retrograde ejaculation and bladder neck stenosis in small prostates. A randomized prospective trial was done to compare the results of conventional transurethral resection of the prostate in 22 patients and urethrotomy of the prostatic urethra in 27 with respect to postoperative retrograde ejaculation, persistent urinary symptomatology and maximal flow rates. After a mean followup of 25 months we concluded that internal urethrotomy of the prostatic urethra is the operation of choice in patients with a prostate of up to 30gm. (J. Urol., 144: 918–920, 1990)