Treatment Of Benign Prostatic Hyperplasia Research Articles

Analysing the learning curve of prostate enucleation with the Holmium laser: A retrospective, single-center experience.

Holmium laser enucleation of the prostate (HoLEP) is a proven surgical technique for the treatment of benign prostatic hyperplasia (BPH). However, its challenging learning curve prevents its widespread adoption by urologists. The aim of this study was to analyse the learning curve of HoLEP and to determine the factors accelerating it. This was a retrospective, monocentric cohort study of the first 60 cases of HoLEP performed by three operators. The primary outcome measure was operative efficiency, defined as the ratio of preoperative prostate volume estimated by trans-abdominal ultrasound (TAUS)to total surgical time in minutes. The studied learning curve parameters included the number of previously performed cases (NPPCs) and monthly case density (CD) (number of monthly performed cases before the studied one). Overall, 180 patients with a mean age of 71 (±9) years and a mean prostate volume (g) of 80.4 (±41) were included. The mean operative efficiency in the population was 0.74 (±0.37) g/min. Operative efficiency was increased in patients who had been operated on by surgeons with a CD ≥3 (CD ≤2: 0.66 (±0.27) g/min vs. CD ≥3: 0.79 (±0.43) g/min; P=0.012). At 3months, 46 patients (29%) developed stress urinary incontinence (SUI). Early SUI was significantly decreased in patients who had been operated on by surgeons with a CD ≥3 (CD ≤2: 37%, (n=26) vs CD ≥3: 22%, (n=20); P=0.045). A high frequency HoLEP procedures, set as one case per week, appeared to accelerate learning curves by improving operative efficiency. A high CD was also associated with reduced rates of early SUI. 5.

A novel outcomes categorization for current minimally invasive ejaculation-sparing treatments of benign prostatic hyperplasia: Results of a multicentric series

A novel outcomes categorization for current minimally invasive ejaculation-sparing treatments of benign prostatic hyperplasia: Results of a multicentric series

A prospective multicenter comparison between holmium laser enucleation of the prostate (HoLEP) and aquabeam robotic system for the treatment of benign prostatic hyperplasia

A prospective multicenter comparison between holmium laser enucleation of the prostate (HoLEP) and aquabeam robotic system for the treatment of benign prostatic hyperplasia

Transuretral water vapour thermal therapy (RezumTM) versus Transperineal Laser Ablation of the Prostate (TPLA) for the treatment of benign prostatic hyperplasia: A real-world prospective comparative analysis

Transuretral water vapour thermal therapy (RezumTM) versus Transperineal Laser Ablation of the Prostate (TPLA) for the treatment of benign prostatic hyperplasia: A real-world prospective comparative analysis

Greenlight laser (XPSTM) 180w prostatectomy for treatment of benign prostate hyperplasia in patients with uncorrectable bleeding tendency

Greenlight laser (XPSTM) 180w prostatectomy for treatment of benign prostate hyperplasia in patients with uncorrectable bleeding tendency

Lower Urinary Tract Symptoms (LUTS) after Aquablation for the treatment of Benign Prostatic Hyperplasia (BPH): Evaluation of symptoms category (filling versus voiding phase) prevalence rates

Lower Urinary Tract Symptoms (LUTS) after Aquablation for the treatment of Benign Prostatic Hyperplasia (BPH): Evaluation of symptoms category (filling versus voiding phase) prevalence rates

Cost-effectiveness of alternative first- and second-line treatments for benign prostatic hyperplasia in Singapore

Cost-effectiveness of alternative first- and second-line treatments for benign prostatic hyperplasia in Singapore

Acute tubular necrosis after transurethral resection of the prostate: a case report.

We had a 67-year-old male patient who had benign prostate hyperplasia unresponsive to tamsulosin. He underwent TURP surgery. After that, he had acute tubular necrosis because of hemolysis. We performed hemodialysis to decrease serum creatinine level. Acute tubular necrosis is the result of hemolysis. Rapid absorption of large volumes of glycerin may lead to hypotension and acute kidney injury. Using distilled water for irrigation during TURP may lead to severe complications like hypotension and acute tubular necrosis.

12-month outcomes from the first north american study of the zenflow spring system for the treatment of benign prostatic hyperplasia (BPH)

12-month outcomes from the first north american study of the zenflow spring system for the treatment of benign prostatic hyperplasia (BPH)

Robot-assisted simple prostatectomy versus holmium laser enucleation for the treatment of benign prostatic hyperplasia in large (>100 ml) prostates: Updated comparative analysis from a high-volume center

Robot-assisted simple prostatectomy versus holmium laser enucleation for the treatment of benign prostatic hyperplasia in large (>100 ml) prostates: Updated comparative analysis from a high-volume center

Robot-assisted simple prostatectomy for the treatment of large benign prostatic hyperplasia: A systematic review and meta-analysis of comparative studies

Robot-assisted simple prostatectomy for the treatment of large benign prostatic hyperplasia: A systematic review and meta-analysis of comparative studies

Effects of Alginate Oligosaccharide on Testosterone-Induced Benign Prostatic Hyperplasia in Orchiectomized Rats.

Benign prostatic hyperplasia (BPH) is an age-related disease of the urinary system that affects elderly men. Current treatments for BPH are associated with several adverse effects, thus highlighting the need for alternative agents. Alginate oligosaccharide (AOS), a water-soluble functional oligomer derived from brown algae, inhibits prostate cancer cell proliferation. However, the effects of AOS on BPH and the underlying molecular mechanisms remain unclear. Therefore, here, we aimed to investigate the therapeutic potential of AOS in BPH by using human benign prostatic epithelial cells (BPH-1) and a rat model of testosterone-induced BPH. Treatment with AOS inhibited in vitro and in vivo proliferation of prostatic epithelial cells and the testosterone-induced expression of androgen receptor (AR) and androgen-associated genes, such as those encoding 5α-reductase type 2 and prostate-specific antigen. Oral administration of AOS remarkably reduced the serum levels of dihydrotestosterone (DHT) and testosterone as well as the expression of proliferating cell nuclear antigen, inflammatory cytokines, and enzymes, which showed increased levels in prostatic tissues of rats with testosterone-induced BPH. Taken together, these data demonstrate that AOS suppresses testosterone-induced BPH in rats by downregulating AR and the expression of androgen-associated genes, supporting the hypothesis that AOS might be of potential use for the treatment of BPH.

Editorial Comment.

No AccessJournal of UrologyAdult Urology26 Jan 2023Editorial CommentThis article comments on the following:Impact of Prostate Urethral Lift Device on Prostate Magnetic Resonance Image Quality Subodh K. Regmi Subodh K. RegmiSubodh K. Regmi Department of Urology, University of Minnesota, Minneapolis, Minnesota More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003156.01AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack Citations ShareFacebookLinked InTwitterEmail "Editorial Comment." The Journal of Urology, Publish Ahead of Print, pp. – REFERENCES 1. . MRI evaluation of patients before and after interventions for benign prostatic hyperplasia: an update. AJR Am J Roentgenol. 2021; 218(1):88-99. Google Scholar 2. Impact of prostate urethral lift device on prostate magnetic resonance image quality. J Urol. 2023; 209(4). Google Scholar 3. Prostatic urethral lift vs transurethral resection of the prostate: 2-year results of the BPH6 prospective, multicentre, randomized study. BJU Int. 2017; 119(5):767-775. Google Scholar © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetailsRelated articlesJournal of Urology11 Jan 2023Impact of Prostate Urethral Lift Device on Prostate Magnetic Resonance Image Quality Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Subodh K. Regmi Department of Urology, University of Minnesota, Minneapolis, Minnesota More articles by this author Expand All Advertisement PDF downloadLoading ...

The role of phytoandrogens for benign prostatic hyperplasia treatment

Benign prostatic hyperplasia (BPH) is a common urological condition in aging men. High levels of androgens, including testosterone (T) and dihydrotestosterone (DHT), are closely associated with BPH occurrence and development. Currently, the main clinical drugs used for BPH treatment are 5α-reductase inhibitors and α-receptor blockers, both of which aim to decrease abnormal androgenic signaling while having several unignored side effects. Recently, various natural herbs, such as tonifying yang traditional Chinese medicine (TCM), have been found to have androgenic activities, some of which are also effective for BPH treatment. Here, we review the androgenic activities of phytoandrogens, together with their therapeutic effects in BPH, and summarize the mechanisms involved, providing evidence that such herbs serve as selective androgen receptor modulators. Graphical abstract: http://links.lww.com/AHM/A46

Clinical analysis of transurethral holmium laser enucleation in the treatment of benign prostatic hyperplasia with prostatic inflammation: A prospective research study.

To investigate the clinical efficacy of holmium laser enucleation of the prostate (HoLEP) in the treatment of benign prostatic hyperplasia (BPH) with prostatic inflammation (PI). We prospectively collected and followed up data on patients with BPH who underwent HoLEP at the Affiliated Hospital of Weifang Medical University between July 2021 and July 2022. According to the postoperative pathological results, the patients were divided into two groups: BPH without PI group (BPH group) and BPH with PI group. Statistical analysis was performed on clinical data, including age and body mass index (BMI), prostate volume (PV), postoperative residual urine volume (PVR), preoperative serum total prostate-specific antigen (tPSA), serum-free prostate-specific antigen (fPSA), preoperative and postoperative maximum urinary flow rate (Qmax), International Prostate Symptom Score (IPSS) before and 3 months after surgery, quality of life index (QoL) before and 3 months after surgery, and postoperative complications. A total of 41 patients were included in this study, including 16 in the BPH group and 25 in the BPH with PI group. There were no significant differences in preoperative age, BMI, PV, PVR, tPSA, fPSA, and f/tPSA between the BPH and BPH with PI groups (P > 0.05). The preoperative mean Qmax of the BPH and BPH with PI groups were 9.44 ± 2.449 and 7.52 ± 2.946 [mean ± standard deviation (SD)] ml/s, mean IPSS were 17.75 ± 5.335 and 24.24 ± 5.861 (mean ± SD), and mean QoL were 4.13 ± 0.806 and 4.48 ± 0.8 (mean ± SD), respectively. The postoperative mean Qmax of the BPH and BPH with PI groups were 20.38 ± 4.787 and 14.32 ± 3.827 (mean ± SD) ml/s, mean IPSS were 2.69 ± 1.25 and 5.84 ± 3.579 (mean ± SD), and mean QoL were 0.13 ± 0.342 and 0.92 ± 0.759 (mean ± SD), respectively. In both groups, Qmax significantly increased (P < 0.05) and IPSS and QoL significantly decreased after HoLEP (P < 0.05). Before and after surgery, the Qmax in the BPH with PI group was lower than that in the BPH group, and the IPSS and QoL levels in the BPH with PI group were higher than those in the BPH group (P < 0.05). Compared with the BPH group, the increase in Qmax in the BPH with PI group was smaller and the decrease in IPSS was larger (P < 0.05), but the variation in QoL was not statistically significant (P > 0.05). Improvements in Qmax, IPSS, and QoL in BPH patients with PI after HoLEP surgery were lower than those in BPH patients alone. PI may be a predictor of a worse response to surgical treatment. However, more multicenter randomized controlled trials with larger samples and long-term follow-up are needed to verify this.

Prostat lazer cerrahileri sonrası erektil ve ejakülatuvar fonksiyonlar

Benign prostatic hyperplasia (BPH) is a common health condition in aging men resulting in lower urinary tract symptoms (LUTS) and poor quality of life. Until recently, transurethral prostatectomy (TUR-P) was considered the gold standard for prostate surgery, but prostate enucleation methods using advanced laser technologies have become a strong competitor to TUR-P and have become widely used. The effects of all surgical procedures performed for prostate on sexual functions have been the subject of many studies. In today’s world where quality of life is emphasized and technological advances are increasing, the search for treatment methods with minimal effect on sexual function in the surgical treatment of BPH has increased. In this review, the effects of laser surgeries in the treatment of BPH on erectile and ejaculatory function will be presented with the current literature. Keywords: benign prostatic hyperplasia, HOLEP, ThuFLEP, erectile function, ejaculatory function

Modified plasmakinetic enucleation and resection of the prostate by three glands: proposal of a novel anatomical treatment for benign prostatic hyperplasia

Transurethral resection of the prostate (TURP) cannot completely resect hyperplastic tissues and is often associated with high recurrence rate and short recurrence interval. Western and Chinese scholars have reported higher incidences of stress urinary incontinence (SUI) with traditional enucleations. This study investigated the potential applicability of Modified Plasmakinetic Enucleation and Resection of the Prostate by three glands (MPKERP) in treating benign prostatic hyperplasia (BPH). Between April 2020 and June 2021, 28 patients underwent MPKERP for BPH. The surgical procedures included (1) surgical capsule exploration; (2) moderate range enucleation; (3) middle gland enucleation; (4) sector resection at 12 o’clock in the lithotomy position; (5) cut residual distal urethral mucosa; (6) lateral hyperplastic glands enucleation. All 28 patients recovered well after the surgery, and the curative effect was satisfactory. The average operation time was 68.9 ± 21.8 min, the average weight of excised glands was 62.5 ± 19.1 g, the average indwelling catheter time was 4.6 ± 0.6 d, and the average bladder washing time was 28.6 ± 9.5 h. The average postoperative 1-day hemoglobin decrease was 10.2 ± 9.8 g/L. Only one severe hyperplasia patient had transient SUI (incidence rate: 3.6%). No complications, such as urethral stricture, dysuria, urinary incontinence and urinary retention, were reported during follow-up. International Prostate Symptoms Score (IPSS), quality of life (QOL), maximum urinary flow rate (Qmax) and post-void residual volume (PVR) significantly improved three months after surgery (p &lt; 0.0001). The MPKERP can enucleate and resect the hyperplastic glands anatomically in an orderly manner and pay attention to expanding space, reducing resistance, reducing the damage of pushing and pulling, protecting the urethral sphincter complex (USC), and reducing the incidence of urinary incontinence. Altogether, our findings support MPKERP as an improved surgical technique worthy of promotion, and it is more suitable for grass-roots hospitals that lack hardware equipment.

Ex vivo vaporization performance study of human prostate tissue using in-house designed thulium fiber laser

Introduction: Laser technologies including thulium, Holmium: Yttrium aluminum garnet (Ho: YAG), Potassium-titanyl-phosphate and diode laser have been explored in recent years for the treatment of benign prostatic hyperplasia. These thermal modalities impart their effect through ablative and coagulative mechanisms of action. Although Ho: YAG laser is a gold standard clinical tool in urology, its properties are not sufficient for cutting or coagulation of prostatic tissue. Thulium: YAG laser is a promising alternative laser but with limitations. The recent technological advancements in thulium fiber laser (TFL) provide various advantages along with a compact system for urosurgical applications. This paper depicts the work done in initial validation of an in-house designed TFL in ex vivo vaporization and vaporesection of human prostatic tissue. Comparison of its ablation rate and coagulation zone was done with the existing laser systems. Methods: An in-house designed TFL having maximum continuous wave (CW) power level of 70 W at 1.94 mm optical wavelength had been used for the ex vivo experiment on human prostatic tissue. The rate of tissue vaporization and zone of thermal coagulation were assessed. Results: The in-house made (CSIR-CGCRI, Kolkata, India) CW TFL used at power of 60 W at 1.94 mm was capable of providing tissue vaporization rate of 0.13–0.45 g/min with a thermal coagulation zone of 100 mm. Conclusions: In our study, the TFL was efficient in vaporization, vaporesection, and coagulation of the prostatic tissue under controlled circumstances. Compared to the existing laser systems, the TFL could be a new alternative in Endourology.

Treatment of Benign Prostatic Hyperplasia

Benign prostatic hyperplasia (BPH) is one of the widespread diseases affecting aging males globally. As prostatic cell proliferation, it clinically influences a great degree of bladder outlet obstruction and is characterized by bothersome lower urinary tract symptoms. Assessments and treatments should not only be conducted based on the prostate volume or condition, related symptoms and quality of life should be considered also. The present analysis focuses on the update of management for BPH, including pharmacotherapy and slightly invasive surgical options. Despite alpha-1 adrenoceptor antagonists, many other factors and even combination therapy were extensively studied. Regarding slightly invasive surgical treatments, including Aquablation, water vapor thermal therapy, prostatic artery embolization, prostatic urethral lift, and nitinol butterfly-like stent, we analyzed the latest findings of studies, as well as safety issues. Finally, we highlighted current guidelines for clinical practice and future direction for further investigation.

Alfa blokerlerin ejakülasyon üzerine etkisi: Literatür güncellemesi

Ejaculation disorders are a complex and multifactorial condition that can significantly impact individuals’ quality of life. Alpha blockers, which are used in the treatment of benign prostatic hyperplasia (BPH), are associated with various sexual side effects, including changes in ejaculation. In this review, the physiological mechanisms and clinical outcomes of the effects of alpha blockers on ejaculation, as documented in the literature, are discussed. Keywords: alpha blocker, benign prostatic hyperplasia, ejaculation