Effect of saline perfusion before catheter removal in patients with benign prostatic hyperplasia treated with GreenLight laser photoselective vaporization of the prostate
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Abstract Purpose: To investigate the effect of saline perfusion before catheter removal in patients with benign prostatic hyperplasia (BPH) treated with GreenLight laser photoselective vaporization of the prostate (PVP). Materials and Methods: Patients (n=200) with BPH treated with PVP were divided into perfusion (n=100) and control (n=100) groups. For the perfusion group, saline (200 mLor the maximum capacity tolerated) was irrigated into the bladder after standardized external urethral disinfection, and the catheter was removed. Catheter removal was routinely performed in the control group. Perioperative adverse events and clinical outcomes were compared between the groups. Results: Patients in the perfusion group exhibited a shorter waiting time [3 (0–4) vs. 15 (8.75–26) min; P < 0.001] and better satisfaction grade [24 (21.75–26) vs. 23 (20–25); P =0.016] of first urination than those in the control group. The perfusion group exhibited lower anxiety levels regarding first urination than the control group [1 (1–2) vs. 1.5 (1–2), respectively; P =0.012]. Urinalysis revealed that the perfusion group had significantly lower white blood cell (WBC) count than the control group on the day [25.5(8–37.75) vs. 43.5(24.0–64.75); P<0.001] and 2 weeks [20.5(11–27) vs 31.0(20–42); P <0.001] after catheter removal. No significant differences in treatment-related adverse events were observed [(perfusion (n=15), control (n=20)]. Conclusion: Saline perfusion before catheter removal in patients with BPH treated with PVP could shorten the waiting time for first urination, improve patient anxiety and satisfaction, and reduce postoperative urinary WBC levels.Keywords:
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In 32 patients with benign prostate hyperplasia different urodynamic parameters were investigated before treatment by transurethral microwave thermotherapy and after this treatment. After three months positive changes were recorded as regards the storage as well as micturition phase which did not change during the subsequent six months. Transurethral microwave therapy is a suitable therapeutic method of benign hyperplasia of the prostate in mildly obstructive patients.
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Individual anatomical structural variations, including intravesical prostatic protrusion (IPP), prostatic urethral angle (PUA), prostatic urethral length, or prostatic apex shape, were correlated with micturition symptoms. We aimed to investigate the effects of these variables on micturition symptoms in men with benign prostatic hyperplasia (BPH)/lower urinary tract symptoms (LUTS).This observational study was based on data from 263 men with the first visit to health promotion center and without BPH/LUTS treatment between March 2020 and September 2022. A multivariate analysis was performed to determine the variables affecting total international prostate symptom score, maximum flow rate (Qmax), and voiding efficacy (postvoid residual volume to total bladder volume ratio).Of 263 patients, decreasing PUA increases the severity of international prostate symptoms score (mild, 141.9°; moderate, 136.0°; severe, 131.2°; P<0.015). A multivariate analysis reported that the total international prostate symptom score was correlated with age (P=0.002), PUA (P=0.007), and Qmax (P=0.008). Qmax was negatively associated with IPP (P=0.002). In subanalysis for large prostate volume (≥30 mL, n=81), international prostate symptom score was correlated with PUA (P=0.013), Qmax was correlated with prostatic apex shape (P=0.017), and length of proximal prostatic urethra (P=0.007). IPP was not identified as a significant factor. For small prostate volume (<30 mL, n=182), age (P=0.011) and prostate volume (P=0.004) are correlated with increasing Qmax.This study presented that individual anatomical structure variations influenced the micturition symptoms according to prostate volume. To identify the major resistant factors in men with BPH/LUTS, further studies are required to investigate which components played a role in major resistant factors for micturition symptoms.
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Benign prostatic hyperplasia (BPH), also known as benign prostatic hypertrophy, is a histologic disease in proliferation of the cellular elements of the prostate occurs, leading to an enlarged prostate gland. Chronic BOO due to BPH may cause urinary retention, impaired kidneys, repetitive urinary tract infections, high degree hematuria, and bladder stones.
Objective:To study the interconnection of prostatic volumes with post micturitiing residual urine volume (PMR) in males with benign prostatic hyperplasia (BPH). Methods: It was a cross-sectional research comprising of 220 subjects who underwent Ultrasonography scan over duration of 4 months. This study was performed in Sanabil Health Services Hospital Lahore, from 15-6-2021 to 16-10-2021. Men of all ages diagnosed for BPH were a part of this research. The subjects with prostatic malignancies, who underwent mild urinary tract and/or prostate surgeries and men with UTI or bladder calculi, were included in this experiment. Abdominal ultrasonography was conducted using a curved array probe of 3.5-5 MHz frequency. The outcomes were Prostate volumes and post PMR volumes. Results: In total, 220 subjects were evaluated. Out of these, benign prostatic hyperplasia was not found in 60(27.3%) and was present in 160(72.7%). Normal PMRV was found in 75(34.1%) and was raised in 145(65.9%). A remarkable mean difference of pre-void volume was observed in patients with BPH and without BPH. The p-value was 0.000<0.05. A significant mean difference of post void volume was observed in patients with BPH as p-value is 0.000<0.05.Conclusion:Ultrasound has been proven to diagnose early prostatic enlargement and other prostate related pathologies, our study found out that there is a remarkable connection between PMR Volume and BPH i.e., with increasing prostatic weight, urinary retention increases.
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Transrectal ultrasonography
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Aim. To assess the surgical treatment outcomes for benign prostatic hyperplasia. Methods. The surgical treatment outcomes for benign prostatic hyperplasia were analyzed in 72 patients. 44 patients underwent transvesical prostatectomy ended with blind urinary bladder stitch, 28 patients with a prostate volume of less than 60 ml were offered transurethral resection of prostate. The patients’ mean age was 73.6 years. Inclusion criteria were: average urination flow rate (Qav) 10 ml/sec, total international prostate symptom score (I-PSS) 19, residual urine volume 50 ml. Prostate volume ranged from 29 to 150 ml. All interventions were performed using regional anesthesia. The effect of surgical treatment was assessed 3 months after the surgery was performed. Results. Self urination was restored at 2-3rd day. All patients had no residual urine. Urine flow parameters in patients after transvesical prostatectomy were: maximum urination flow rate (Qmax) - 24±1.3 ml/sec, Qav - 11.6±1.1 ml/sec; in patients after transurethral resection of prostate: Qmax - 17.2±0.8 ml/sec, Qav - 11.4±1.2 ml/sec. I-PSS index in the transvesical prostatectomy group was 2.3±0.3 compared to 9.7±1.1 points in transurethral resection of prostate group. Irritative symptoms prevailed in patients from transurethral resection of prostate group, 23 (82%) of them have improved after 1 month treatment with α1-adrenoblockers. Conclusion. Transvesical prostatectomy ended with blind urinary bladder stitch is still a radical and effective option for benign prostatic hyperplasia surgical treatment. Transurethral resection of prostate is effective in patients with prostate volume less than 60 ml and requires additional medical correction of irritative symptoms during the postoperative period.
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In the article the results of conservative and operative treatment of 122 patients ranging in age from 42 to 80 years of age with acute delay of urine caused by benign prostate hyperplasia in the urology Department Alexander Hospital 2016 to 2018 years. n men, the most common cause of SSM is safe giperplazia (adenoma) prostate (BPH), found in the 45–53% of observations, tending to cause heart attacks in prostate tissue and increased Alpha-adrenergic activity. The main pathogenetic factor SSM in men is BPH, where heart attacks occur in the prostate tissue and increased Alpha-adrenergicheskaja activity. In 1 group comprised 42 patients diagnosed for the first time, SSM, caused by BPH, in Group 2–80 patients with multiple SSM caused by BPH. All patients of Group 1 after combination therapy of Alpha alfuprost MICRORAION adrenoblokatorom in combination with jelefloksom noted restore self-sustaining urination. In Group 2 at 72 patients recovered partially and urinating they have plus sizes BPH, they performed Transurethral enucleation of BPH with positive effect.
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Urinary retention
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Bladder stones
Nephrology
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Bladder stones
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Benign prostatic hypertrophy (BPH) produces a variety of changes in the urodynamic pattern of micturition and is usually associated with high detrusor voiding pressure and poor urine flow-rate. In most previous experimental models, designed to simulate this condition, some degree of obstruction is immediately imposed by the technique employed to produce urethral occlusion. Consequently these models cannot reproduce the gradual onset of obstruction. In the present study a canine prostatic enlargement model, using 5alpha-dihydrotestosterone (DHT) + 17beta-estradiol (E) was adapted in order to produce a more gradual onset of partial obstruction and impaired voiding.Hormonally induced prostatic enlargement was produced using seven beagles, given DHT 75 mg/day together with E 0.75 mg/day for 28 days via an implantable pump. The functional effects of DHT + E treatment on micturition pressure/flow were measured in the conscious animal. Identical measurements were also made using a separate older group of five beagles with symptoms of BPH. In addition seven beagles similarly instrumented were used as controls.Pressure/flow studies show that DHT + E produced obstructive micturition, characterized by a significantly increased micturition detrusor pressure, from 33.3 +/- 10.5 to 50.8 +/- 10.7 cmH(2)O and significantly decreased low urine flow-rate from 8.6 +/- 2.1 to 6.9 +/- 0.9 ml/sec. Associated with the obstructive micturition, this treatment increased wet prostate weight from 11.9 +/- 2.5 to 31.6 +/- 10.0 g. Prostate volume of the BPH beagles was 29.3 +/- 8.9 g. Morphologic studies show that DHT + E produced epithelial hyperplasia extending focally into the lumen.Hormonally induced prostate growth produced bladder obstruction, in terms of pressure/flow characteristics, that are analogous to BPH. It is suggested that this type of hormonal treatment can be used to create a model for the study of the effects of controlled increased in prostate growth and the development of BPH on micturition.
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Beagle
Dihydrotestosterone
Prostatism
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Objective:To evaluate the effect and safety of surgical treatment of transurethral plasmakinetic resection of prostate (TUPKVP)in advanced age and danger of benign prostatic hyperplasia (BPH) patients.Methods:61 cases of BPH were treated by transurethral plasmakinetic resection of prostate (TUPKVP).Results:The mean prostatic weight was 53 g and blood loss 30 to 100 ml.No TURS and no real urinary incontinence and no blood transfusion.All cases obtained un obstructed micturition after treatment.Following up 3 to 12 months,their international prostate symptom score (IPSS) were significantly improved by TUPKVP.Conclusion:TUPKVP is a safe and effective way in the treatment of advanced age and danger benign prostatic hyperplasia(BPH) patients.
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Objective To study the efficacy and safety of photoselective vaporization of the prostate for the treatment of benign prostatic hyperplasia.Methods A total of 216 men(56 to 93 years old) with lower urinary tract symptoms secondary to benign prostatic hyperplasia received photoselective vaporization of the prostate with an 80W quasicontinuous KTP laser.Prostatic volume was 24～134g.Results Mean operative time was 48.8min.After the cathetre was pulled out in 24 hours,the(patients) could generally urinate well.At one-month follow-up,the mean I-PSS decreased from 26±3.7 to 13.4±1.9(P0.01),whole the Qmax increased from(6.82±2.47)ml/s to(17.23±4.78)ml/s(P0.01).Complications consisted of hematuria in 4 cases,urinary infection in 6 cases and 1 acute epididymitis.(Conclusion)PVP is a safe,effective and simple procedure for the treatment of BPH with less pain and quick recovery.
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[Objective] To evaluate the efficacy and safety of photoselective vaporization of the prostate (PVP) for the treatment of benign prostatic hyperplasia (BPH). [Methods] A total of 50 patients with lower urinary tract symptoms secondary to benign prostatic hyperplasia received photoselective vaporization of the prostate with an 80W quasicontinuous KTP laser. The therapeutic results were assessed using the following variables: the operative time, catheterization time, complaints, mean Qmax, I-PSS, QOL and postvoid urine residual volume (PRV). [Results] Operative time was 40～120 min. After the catheter was pulled out in 1~3 d, the patients could generally urinate well. During 1~6 months′ follow-up, the mean I-PSS decreased from (23.4±4.7) to (6.3±2.6) (P 0.01); QOL decreased from (4.9±0.8) to (1.3±0.6) (P 0.01); Qmax increased from (6.2±2.4) mL/s to (21.3±2.7) mL/s (P 0.01); PVR decreased from (174.2±22.7) mL to (36.3±4.6) mL (P 0.01). Complications consisted of hematuria in 2 cases, dysuria in 1 case, urinary infection in 1 case and meatal stenosis in 1 case. [Conclusion] PVP is a safe, effective and simple procedure for the treatment of BPH with less pain and quick recovery.
Dysuria
Urination
Meatal stenosis
Laser vaporization
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