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Transurethral resection of the prostate with preservation of the bladder neck decreases postoperative retrograde ejaculation. Wideochir Inne Tech Maloinwazyjne 2018; 14:96-101. [PMID: 30766635 PMCID: PMC6372866 DOI: 10.5114/wiitm.2018.79536] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2018] [Accepted: 10/07/2018] [Indexed: 11/17/2022] Open
Abstract
Introduction Even though transurethral resection of the prostate (TURP) is the standard surgical treatment for benign prostatic hyperplasia (BPH), there is a high rate of postoperative retrograde ejaculation. Aim To evaluate the effectiveness of TURP with preservation of the bladder neck in comparison with that of standard TURP. Material and methods This is a retrospective study. 137 men with BPH were divided into two groups: TURP with preservation of the bladder neck and standard TURP were performed respectively in group A and group B. The patients were evaluated preoperatively and at 3, 6 and 12 months after surgery by International Prostate Symptom Score (IPSS), health-related quality of life (HRQL) score, maximum urinary flow rate (Qmax), postvoid residual urine volume (PVR) and the rate of complications including retrograde ejaculation. Results There was no statistically significant difference between groups in terms of the operative duration, catheterization period, hemoglobin decrease, and hospital stay. At the 3-month follow-up, the rates of incontinence and retrograde ejaculation in group A were lower than those in group B. At the 6- and 12-month follow-ups, the difference in the frequency of retrograde ejaculation remained constantly stable whereas the incontinence rates were similar in both groups. The IPSS, HRQL score, Qmax, PVR and the rate of complications including hematuria, clot retention, urinary tract infection, urethral stricture, and bladder neck contracture evaluated at 3, 6 and 12 months also displayed a very similar response in the two groups. Conclusions Comparable with standard TURP, TURP with preservation of the bladder neck appears to provide a satisfactory clinical outcome in decreasing early postoperative incontinence and lowering the rate of retrograde ejaculation.
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Tan X, Zhang X, Li D, Chen X, Dai Y, Gu J, Chen M, Hu S, Bai Y, Ning Y. Transurethral vaporesection of prostate: diode laser or thulium laser? Lasers Med Sci 2018; 33:891-897. [PMID: 29633057 DOI: 10.1007/s10103-018-2499-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2017] [Accepted: 03/27/2018] [Indexed: 12/29/2022]
Abstract
This study compared the safety and effectiveness of the diode laser and thulium laser during prostate transurethral vaporesection for treating benign prostate hyperplasia (BPH). We retrospectively analyzed 205 patients with BPH who underwent a diode laser or thulium laser technique for prostate transurethral vaporesection from June 2016 to June 2017 and who were followed up for 3 months. Baseline characteristics of the patients, perioperative data, postoperative outcomes, and complications were compared. We also assessed the International Prostate Symptom Score (IPSS), quality of life (QoL), maximum flow rate (Qmax), average flow rate (AFR), and postvoid residual volume (PVR) at 1 and 3 months postoperatively to evaluate the functional improvement of each group. There were no significant differences between the diode laser and thulium laser groups related to age, prostate volume, operative time, postoperative hospital stays, hospitalization costs, or perioperative data. The catheterization time was 3.5 ± 0.8 days for the diode laser group and 4.7 ± 1.8 days for the thulium laser group (p < 0.05). Each group had dramatic improvements in IPSS, QoL, Qmax, AFR, and PVR compared with the preoperative values (p < 0.05), although there were no significant differences between the two groups. Use of both diode laser and thulium laser contributes to safe, effective transurethral vaporesection in patients with symptomatic BPH. Diode laser, however, is better than thulium laser for prostate transurethral vaporesection because of its shorter catheterization time. The choice of surgical approach is more important than the choice of laser types during clinical decision making for transurethral laser prostatectomy.
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Affiliation(s)
- Xinji Tan
- Xiangya International Medical Center, Xiangya Hospital, Central South University, Changsha, 41008, Hunan, China.,The Department of Geriatric Urology, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Xiaobo Zhang
- Xiangya International Medical Center, Xiangya Hospital, Central South University, Changsha, 41008, Hunan, China. .,The Department of Geriatric Urology, Xiangya Hospital, Central South University, Changsha, Hunan, China. .,Urolithiasis Institute of Central South University, Xiangya Hospital, Central South University, Changsha, Hunan, China. .,The Department of Urology, Xiangya Hospital, Central South University, Changsha, Hunan, China.
| | - Dongjie Li
- Xiangya International Medical Center, Xiangya Hospital, Central South University, Changsha, 41008, Hunan, China
| | - Xiong Chen
- Xiangya International Medical Center, Xiangya Hospital, Central South University, Changsha, 41008, Hunan, China
| | - Yuanqing Dai
- The Department of Geriatric Urology, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Jie Gu
- Xiangya International Medical Center, Xiangya Hospital, Central South University, Changsha, 41008, Hunan, China.,The Department of Geriatric Urology, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Mingquan Chen
- Xiangya International Medical Center, Xiangya Hospital, Central South University, Changsha, 41008, Hunan, China.,The Department of Geriatric Urology, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Sheng Hu
- Xiangya International Medical Center, Xiangya Hospital, Central South University, Changsha, 41008, Hunan, China.,The Department of Geriatric Urology, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Yao Bai
- Xiangya International Medical Center, Xiangya Hospital, Central South University, Changsha, 41008, Hunan, China.,The Department of Geriatric Urology, Xiangya Hospital, Central South University, Changsha, Hunan, China.,The Department of Urology, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Yu Ning
- The Department of Anesthesiology, Xiangya Hospital, Central South University, Changsha, Hunan, China
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Abou-Taleb A, El-Shaer W, Kandeel W, Gharib T, Elshaer A. Bipolar Plasmakinetic Enucleoresection of the Prostate: Our Experience with 245 Patients for 3 Years of Follow-Up. J Endourol 2017; 31:300-306. [PMID: 28073286 DOI: 10.1089/end.2016.0746] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVE The aim of this study was to evaluate the safety, feasibility, and effectiveness of bipolar transurethral plasmakinetic enucleation of the prostate (PKEP). PATIENTS AND METHODS Between January 2010 and October 2013, 245 patients with lower urinary tract symptoms due to benign prostatic hyperplasia underwent transurethral enucleation of prostate using bipolar plasma vaporization energy. Patients were evaluated preoperatively by full detailed history, routine preoperative investigation digital rectal examination, serum prostate-specific antigen, abdominal and transrectal ultrasonography, and maximum flow rates (Qmax). RESULTS Patients' ages ranged from 50 to 81 (65.5 ± 6) years with transrectal ultrasound-measured prostate volume of 97.1 ± 36.7 mL resulting in an operating time of 76.9 ± 27.9 minutes, and postoperative irrigation and catheterization times were 3.5 ± 3.2 and 12.7 ± 6.1 hours, respectively. No significant complication occurred intra- or postoperatively. Qmax increased from 7.1 ± 3.2 mL/second preoperative to 18.4 ± 4.2 mL/second (p < 0.001). The International Prostate Symptom Score decreased from 25 ± 6 to 7.9 ± 2.4 (p < 0.01). CONCLUSION This study confirmed that PKEP is a safe, easy to learn, and durable technique suitable for any prostate sizes.
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Affiliation(s)
| | - Waleed El-Shaer
- Department of Urology, Banha University Hospital , Banha, Egypt
| | - Wael Kandeel
- Department of Urology, Banha University Hospital , Banha, Egypt
| | - Tarek Gharib
- Department of Urology, Banha University Hospital , Banha, Egypt
| | - Alaa Elshaer
- Department of Urology, Banha University Hospital , Banha, Egypt
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Geavlete B, Bulai C, Ene C, Checherita I, Geavlete P. Bipolar Vaporization, Resection, and Enucleation Versus Open Prostatectomy: Optimal Treatment Alternatives in Large Prostate Cases? J Endourol 2015; 29:323-31. [DOI: 10.1089/end.2014.0493] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Bogdan Geavlete
- Department of Urology, “Saint John” Emergency Clinical Hospital, Bucharest, Romania
| | - Catalin Bulai
- Department of Urology, “Saint John” Emergency Clinical Hospital, Bucharest, Romania
| | - Cosmin Ene
- Department of Urology, “Saint John” Emergency Clinical Hospital, Bucharest, Romania
| | - Ionel Checherita
- Department of Nephrology and Dialysis, “Saint John” Emergency Clinical Hospital, Bucharest, Romania
| | - Petrisor Geavlete
- Department of Urology, “Saint John” Emergency Clinical Hospital, Bucharest, Romania
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Qian X, Yu G, Qian Y, Xu D, Liu H, Kong X, Zhu Y, Wang Z, Zheng J, Qi J. Efficacy of 5α-reductase inhibitors for patients with large benign prostatic hyperplasia (>80 mL) after transurethral resection of the prostate. Aging Male 2015. [PMID: 26225794 DOI: 10.3109/13685538.2015.1068750] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
PURPOSE To prospectively evaluate 5α-reductase inhibitors (5αRIs) for benign prostatic hyperplasia (BPH) patients with a large prostate (>80 mL) after transurethral resection of the prostate (TURP). MATERIALS AND METHODS Eighty-seven patients were recruited from January 2007 to October 2014. Patients were randomized into a trial and a control group. The trial group was treated with 5αRIs for 3 years after TURP, while the control group received a placebo. We evaluated the indicators before, peri and after TURP. RESULTS There were no significant differences in the indicators before and peri-TURP. Six months later, there were significant differences in PSA and hematuria (HU). Three years after TURP, there were significant differences in prostate volume (PV), level of prostate-specific antigen (PSA), the maximum flow rate (Qm), and HU between the trial and control groups. Additionally, there were significant differences in the PV, PSA, international prostate symptom score (IPSS), patient quality of life (QoL) in the trial group alone between those treated with finasteride and those treated with dutasteride. CONCLUSIONS After TURP for large BPH, administration of 5αRIs for 3 years improved PV, PSA, Qm and HU. Additionally, dutasteride produced superior improvements in PV, PSA, IPSS and QoL compared with finasteride.
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Affiliation(s)
- Xiaoqiang Qian
- a Department of Urology , Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine , Shanghai , P.R. China
| | - Guopeng Yu
- a Department of Urology , Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine , Shanghai , P.R. China
| | - Yu Qian
- b Department of Urology , Kongjiang Hospital , Shanghai , P.R. China
| | - Ding Xu
- a Department of Urology , Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine , Shanghai , P.R. China
| | - Hailong Liu
- a Department of Urology , Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine , Shanghai , P.R. China
| | - Xiangjie Kong
- a Department of Urology , Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine , Shanghai , P.R. China
| | - Yunkai Zhu
- c Department of Ultrasound in Medicine , Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine , Shanghai , P.R. China
| | - Zhong Wang
- d Department of Urology , Ninth Hospital Affiliated to Shanghai Jiaotong University School of Medicine , Shanghai , P.R. China , and
| | - Junhua Zheng
- e Department of Urology , Tenth Hospital Affiliated to Shanghai Tongji University School of Medicine , Shanghai , P.R. China
| | - Jun Qi
- a Department of Urology , Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine , Shanghai , P.R. China
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