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Kutchukian S, Chicaud M, Berthe L, Coste F, Lapouge P, Alshehhi H, Buob D, Traxer O, Panthier F, Doizi S. Comparison of holmium:yttrium-aluminium-garnet (YAG), thulium fiber laser, and pulsed thulium:YAG lasers on soft tissue: an ex vivo study. BJU Int 2024. [PMID: 38994628 DOI: 10.1111/bju.16447] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/13/2024]
Abstract
OBJECTIVES To assess laser-tissue interactions through ablation, coagulation, and carbonisation characteristics in a non-perfused porcine kidney model between three pulsed lasers: holmium (Ho): yttrium-aluminium-garnet (YAG), thulium fiber laser (TFL), and pulsed thulium (p-Tm):YAG. MATERIALS AND METHODS A 150-W Ho:YAG, a 60-W TFL, and a 100-W p-Tm:YAG lasers were compared. The laser settings that can be set identically between the three lasers and be clinically relevant for prostate laser enucleation were identified and used on fresh, unfrozen porcine kidneys. Laser incisions were performed using stripped laser fibers of 365 and 550 μm, set at distances of 0 and 1 mm from the tissue surface at a constant speed of 2 mm/s. Histological analysis evaluated shape, depth, width of the incision, axial coagulation depth, and presence of carbonisation. RESULTS Incision depths, widths, and coagulation zones were greater with Ho:YAG and p-Tm:YAG lasers than TFL. Although no carbonisation was found with the Ho:YAG and p-Tm:YAG lasers, it was common with TFL, especially at high frequencies. The shapes of the incisions and coagulation zones were more regular and homogeneous with the p-Tm:YAG laser and TFL than with Ho:YAG laser. Regardless of the laser used, short pulse durations resulted in deeper incisions than long pulse durations. Concerning the distance, we found that to be effective, TFL had to be used in contact with the tissue. Finally, 365-μm fibers resulted in deeper incisions, while 550-μm fibers led to wider incisions and larger coagulation zones. CONCLUSION Histological analysis revealed greater tissue penetration with the p-Tm:YAG laser compared to the TFL, while remaining less than with Ho:YAG. Its coagulation properties seem interesting insofar as it provides homogeneous coagulation without carbonisation, while incisions remained uniform without tissue laceration. Thus, the p-Tm:YAG laser appears to be an effective alternative to Ho:YAG and TFL lasers in prostate surgery.
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Affiliation(s)
- Stessy Kutchukian
- Service d'Urologie, AP-HP, Hôpital Tenon, Sorbonne Université, Paris, France
- GRC n°20, Groupe de Recherche Clinique sur la Lithiase Urinaire, Hôpital Tenon, Sorbonne Université, Paris, France
- PIMM, UMR 8006 CNRS, Arts et Métiers ParisTech, Paris, France
- Service d'Urologie, CHU de Poitiers, Poitiers, France
| | - Marie Chicaud
- Service d'Urologie, AP-HP, Hôpital Tenon, Sorbonne Université, Paris, France
- GRC n°20, Groupe de Recherche Clinique sur la Lithiase Urinaire, Hôpital Tenon, Sorbonne Université, Paris, France
- PIMM, UMR 8006 CNRS, Arts et Métiers ParisTech, Paris, France
- Service d'Urologie, CHU de Limoges, Limoges, France
| | - Laurent Berthe
- PIMM, UMR 8006 CNRS, Arts et Métiers ParisTech, Paris, France
| | - Frédéric Coste
- PIMM, UMR 8006 CNRS, Arts et Métiers ParisTech, Paris, France
| | - Pierre Lapouge
- PIMM, UMR 8006 CNRS, Arts et Métiers ParisTech, Paris, France
| | - Hussa Alshehhi
- Service d'Anatomopathologie, AP-HP, Hôpital Tenon, Sorbonne Université, Paris, France
| | - David Buob
- Service d'Anatomopathologie, AP-HP, Hôpital Tenon, Sorbonne Université, Paris, France
| | - Olivier Traxer
- Service d'Urologie, AP-HP, Hôpital Tenon, Sorbonne Université, Paris, France
- GRC n°20, Groupe de Recherche Clinique sur la Lithiase Urinaire, Hôpital Tenon, Sorbonne Université, Paris, France
- PIMM, UMR 8006 CNRS, Arts et Métiers ParisTech, Paris, France
| | - Frédéric Panthier
- Service d'Urologie, AP-HP, Hôpital Tenon, Sorbonne Université, Paris, France
- GRC n°20, Groupe de Recherche Clinique sur la Lithiase Urinaire, Hôpital Tenon, Sorbonne Université, Paris, France
- PIMM, UMR 8006 CNRS, Arts et Métiers ParisTech, Paris, France
| | - Steeve Doizi
- Service d'Urologie, AP-HP, Hôpital Tenon, Sorbonne Université, Paris, France
- GRC n°20, Groupe de Recherche Clinique sur la Lithiase Urinaire, Hôpital Tenon, Sorbonne Université, Paris, France
- PIMM, UMR 8006 CNRS, Arts et Métiers ParisTech, Paris, France
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Branchu B, Léon P, Fournier R, Lasserre T, Tambwe R, Hoquetis L, Joncour C, Larré S. [Impact of antiplatelet and anticoagulant treatments on bleeding complications in patients treated with HoLEP]. Prog Urol 2020; 30:639-645. [PMID: 32409241 DOI: 10.1016/j.purol.2020.04.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2020] [Revised: 04/10/2020] [Accepted: 04/15/2020] [Indexed: 10/24/2022]
Abstract
INTRODUCTION We aimed to assess the impact of antiplatelet and anticoagulation therapy for patients undergoing HoLEP. METHODS We performed a study during the learning curve on a consecutive series of patients who underwent HoLEP surgery from 2015 to 2018. The patients were divided into 3 groups: a control group, patients with antiplatelet therapy and patients with anticoagulation therapy. RESULTS A total of 223 patients underwent HoLEP surgery during this period: 124 in the control group, 63 in the antiplatelet group and 36 in the anticoagulant group. In the anticoagulant group, we observe significant differences with the control group for the catheterization time (2.05 days vs 5.17 days; P<0.001), the hospital length of stay (1.5 nights vs 4.49 nights; P<0.001) and complications (8.9% vs 58%; P<0.001). No difference between the control and antiplatelet groups in terms of catheterization time, hospital length of stay and complications (2.05 days vs 2.68 days; 1.5 nights vs 1.6 nights) but variation in terms of complications and bleeding complications (8.9% vs 21%; P<0,001; 8.1% vs 19%; P<0,001) CONCLUSION: Our study shows that HoLEP is therefore associated with a higher risk of bleeding for patients treated with anticoagulation therapy. Complications increase morbidity with longer catheterization time, hospitalization times and higher transfusion's rates, revision surgery and readmission. LEVEL OF EVIDENCE 3.
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Affiliation(s)
- B Branchu
- Service d'urologie, CHU de Reims, rue Cognacq-Jay, 51100 Reims, France.
| | - P Léon
- Service d'urologie, clinique Pasteur, 17200 Royan, France
| | - R Fournier
- Service d'urologie, CHU de Reims, rue Cognacq-Jay, 51100 Reims, France
| | - T Lasserre
- Service d'urologie, CHU de Reims, rue Cognacq-Jay, 51100 Reims, France
| | - R Tambwe
- Service d'urologie, CHU de Reims, rue Cognacq-Jay, 51100 Reims, France
| | - L Hoquetis
- Service d'urologie, CHU de Reims, rue Cognacq-Jay, 51100 Reims, France
| | - C Joncour
- Service d'urologie, CHU de Reims, rue Cognacq-Jay, 51100 Reims, France
| | - S Larré
- Service d'urologie, CHU de Reims, rue Cognacq-Jay, 51100 Reims, France
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Moiroud M, Ait Said K, Vaudreuil L, Alharbi F, Leon G, Tillou X. Prostate Laser Photovaporization in Older People With and Without Bladder Catheter. J Am Geriatr Soc 2019; 67:1888-1894. [PMID: 31188479 DOI: 10.1111/jgs.16019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2019] [Revised: 05/12/2019] [Accepted: 05/13/2019] [Indexed: 11/30/2022]
Abstract
OBJECTIVES To compare results of prostate laser photovaporization (PVP) by age groups to evaluate morbidity and functional results. Then, to specifically analyze surgical data for patients with an indwelling bladder catheter. DESIGN Monocentric retrospective study of a prospective maintained database of all laser PVPs performed at our university hospital between December 2012 and June 2017. SETTINGS AND PARTICIPANTS A total of 305 patients (three groups: younger than 70, 70-80, and older than 80 years) were operated on in our hospital center for the treatment of urinary tract disorders related to benign prostatic hyperplasia. RESULTS A difference was found between the three age groups, with a higher rate of complications for patients older than 80 years (45%) (P = .013). Rate of patients with postoperative bladder catheters at 1 year was higher for patients older than 80 years (15%) (P = .004). Postoperative quality-of-life (QoL) score was worse for patients older than 80 years (P = .04). For patients with an indwelling bladder catheter undergoing surgery, morbidity was greater in patients older than 80 years, but the difference was not significant. International Prostate Symptom Score and QoL score were not significantly different between the three groups. Rate of patients with a remaining bladder catheter at 1 year was higher for patients older than 80 years (17.1% vs 7.1% for patients between 70 and 80, and 4.8% for patients under 70.) but with no statistical difference. CONCLUSION PVP had a greater morbidity in octogenarians compared to younger subjects. Functional results were less satisfactory for patients older than 80 years compared to younger ones. For subjects operated on with an indwelling bladder catheter, no significant difference in outcome and morbidity was found between the three groups. J Am Geriatr Soc 67:1888-1894, 2019.
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Affiliation(s)
- Martin Moiroud
- Department of Urology and Transplantation, Centre Hospitalier Universitaire de Caen, Caen, France
| | - Khelifa Ait Said
- Department of Urology and Transplantation, Centre Hospitalier Universitaire de Caen, Caen, France
| | - Lionel Vaudreuil
- Department of Urology and Transplantation, Centre Hospitalier Universitaire de Caen, Caen, France
| | - Feras Alharbi
- Department of Urology and Transplantation, Centre Hospitalier Universitaire de Caen, Caen, France
| | - Gregoire Leon
- Department of Urology and Transplantation, Centre Hospitalier Universitaire de Caen, Caen, France
| | - Xavier Tillou
- Department of Urology and Transplantation, Centre Hospitalier Universitaire de Caen, Caen, France
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Prostatic injection of botulinum toxin is not inferior to optimized medical therapy in the management of lower urinary tract symptoms due to benign prostatic hyperplasia: results of a randomized clinical trial. World J Urol 2018; 36:921-929. [DOI: 10.1007/s00345-018-2193-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2017] [Accepted: 01/19/2018] [Indexed: 12/11/2022] Open
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Evrard PL, Mongiat-Artus P, Desgrandchamps F. [Morbi-mortality of transurethral resection of the prostate in patients aged 75 and over]. Prog Urol 2017; 27:312-318. [PMID: 28377079 DOI: 10.1016/j.purol.2017.02.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2016] [Revised: 02/22/2017] [Accepted: 02/27/2017] [Indexed: 11/19/2022]
Abstract
INTRODUCTION Monopolar transurethral resection of the prostate is one of standard surgical treatment of benign prostatic hyperplasia. The objective of this study was to evaluate early postoperative complications in patients aged 75 years old and more using a standardized classification. MATERIAL AND METHODS We included all patients aged at least 75 on the day of surgery between 1 January 2008 and 31 December 2013. The reporting of complications was carried from the Clavien-Dindo classification. RESULTS One hundred and seventy-six patients were included in this study. A total of 47.2% of patients experienced at least one complication. The majority of patients (79.5%) had complications grade 1 or 2 according to Clavien-Dindo classification. One patient died postoperatively at day 27. Most complications were urological (55%). A high Charlson score and low plasma hemoglobin levels have been identified as a risk factor for complications. CONCLUSION Monopolar transurethral resection of the prostate is followed by significant morbidity in older patients, higher than in the general population. LEVEL OF EVIDENCE 4.
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Affiliation(s)
- P-L Evrard
- Service urologie, hôpital Saint-Louis, 1, avenue Claude-Velfaux, 75010 Paris, France.
| | - P Mongiat-Artus
- Service urologie, hôpital Saint-Louis, 1, avenue Claude-Velfaux, 75010 Paris, France
| | - F Desgrandchamps
- Service urologie, hôpital Saint-Louis, 1, avenue Claude-Velfaux, 75010 Paris, France
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[Serious and unexpected complications of benign prostatic obstruction surgery: Results of the LUTS Committee survey from urologists of the French Urological Association]. Prog Urol 2015; 25:583-9. [PMID: 26159052 DOI: 10.1016/j.purol.2015.06.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2015] [Accepted: 06/12/2015] [Indexed: 11/23/2022]
Abstract
PURPOSE Rare and severe complications of benign prostatic hyperplasia (BPH) surgery are poorly documented in the literature. Our purpose was to make an inventory of severe and unexpected complications of BPH faced by urologists of the French Association of Urology (AFU). MATERIAL AND METHODS A declarative 13-question survey was sent by e-mail 2 months before the 108th French Congress of Urology to the urologist's members of the AFU. Complications were split in complications due to material and complications directly related to the surgery. RESULTS Overall, 216 (16.2%) urologists surveyed but only 85 forms were usable. Complications related to the material was divided into: excessive temperature of the serum irrigation leading to urethral and bladder burns (n=5), material default leading to interruption of the procedure (n=1) or incomplete hemostasis (n=2) and endoscope rupture (n=1). Peroperative complications related to surgery were divided into surgical complications: haemorrhage (n=7), urethral wounds (n=6), perforation and/or explosion (n=16), rectal wounds (n=11), obstructive renal failure (n=1); and medical complications: TURP syndrome (n=2), cardiovascular (n=5) and septic shock (n=6). CONCLUSION This is the first French declarative study having allowed the identification of severe and unexpected complications of BPH surgery. The recorded occurred complications were very eclectic and secondary to all types of techniques used.
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Descazeaud A, Barry Delongchamps N, Cornu JN, Azzouzi A, Buchon D, Benchikh A, Coloby P, Dumonceau O, Fourmarier M, Haillot O, Lebdai S, Mathieu R, Misrai V, Saussine C, de La Taille A, Robert G. Guide de prise en charge en médecine générale des symptômes du bas appareil urinaire de l’homme liés à une hyperplasie bénigne de la prostate. Prog Urol 2015; 25:404-12. [DOI: 10.1016/j.purol.2015.02.008] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2015] [Revised: 02/17/2015] [Accepted: 02/26/2015] [Indexed: 11/25/2022]
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Lebdai S, Rahmène Azzouzi A, Delongchamps NB, Benchikh A, Campeggi A, Cornu JN, Dumonceau O, Faix A, Fourmarier M, Haillot O, Lukacs B, Mathieu R, Misrai V, Robert G, de La Taille A, Descazeaud A. [Evaluation of the impact of CTMH guidelines on the management of benign prostatic hyperplasia]. Prog Urol 2014; 25:47-53. [PMID: 25453357 DOI: 10.1016/j.purol.2014.09.049] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2014] [Revised: 09/19/2014] [Accepted: 09/24/2014] [Indexed: 11/25/2022]
Abstract
INTRODUCTION The French guidelines on the management of benign prostatic hyperplasia (BPH) have been published in 2012 by the LUTS committee of the French Urological Association. The aim of this study was to evaluate the impact of these guidelines on the BPH management by French urologists. MATERIAL AND METHODS A questionnaire has been distributed by email to 1141 urologists members of the French Association of Urologists in November 2013. RESULTS We collected 222 responses (response rate: 19%). The guidelines have been read by 73% of the urologists. The guidelines were followed most of the time by 76% of them, 11% followed them systematically and 4.5% did not follow them. The new terminology was used by 28 to 52% according to the items. The symptoms were evaluated by the IPSS score (33%), by interrogatory alone (64%) or by neither of them (3%). Prostate volume was not systematically taken for account in the treatment strategy by 57% of the urologists. Sexual function was assessed systematically by 28% of the urologists, 11% used a questionnaire (IIEF: 92%). PSA was tested respectively by 70 and 51% of the urologists at the initial evaluation and the follow-up. After introduction of a monotherapy, 56% of the urologists evaluated the efficacy at 3 months. CONCLUSION The French guidelines for the management of benign prostatic hyperplasia (BPH) by the LUTS committee of the French Urological Association were well known and used by French urologists. Some improvements can be expected for the use of the IPSS score, the evaluation of the sexual function, and the use of the new terminology. LEVEL OF EVIDENCE 4.
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Affiliation(s)
- S Lebdai
- Service d'urologie, CHU d'Angers, 4, rue Larrey, 49933 Angers cedex 9, France.
| | - A Rahmène Azzouzi
- Service d'urologie, CHU d'Angers, 4, rue Larrey, 49933 Angers cedex 9, France
| | | | - A Benchikh
- Service d'urologie, hôpital Bichat - Claude-Bernard, groupe des hôpitaux universitaires Paris-Nord-Val-de-Seine, université Denis-Diderot, Paris-VII, 75018 Paris, France
| | - A Campeggi
- Service d'urologie, CHU Mondor, 75000 Paris, France
| | - J N Cornu
- Service d'urologie, hôpital Tenon, Assistance publique-Hôpitaux de Paris, université Pierre-et-Marie-Curie - Paris-6, 75020 Paris, France
| | - O Dumonceau
- Service d'urologie, clinique Turin, 75008 Paris, France
| | - A Faix
- Clinique mutualiste Beausoleil, 34070 Montpellier, France
| | - M Fourmarier
- Service d'urologie, centre hospitalier d'Aix-en-Provence, 13616 Aix-en-Provence, France
| | - O Haillot
- Service d'urologie, CHU de Tours, 37044 Tours, France
| | - B Lukacs
- Service d'urologie, clinique Turin, 75008 Paris, France
| | - R Mathieu
- Service d'urologie, hôpital Pontchaillou, CHU de Rennes, 35000 Rennes, France
| | - V Misrai
- Service d'urologie, clinique Pasteur, 31300 Toulouse, France
| | - G Robert
- Service d'urologie, CHU de Bordeaux, université Bordeaux-Segalen, 33076 Bordeaux, France
| | | | - A Descazeaud
- Service de chirurgie urologique, CHU de Limoges, 87042 Limoges, France
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Lebdai S, Descazeaud A. Prise en charge des symptômes du bas appareil urinaires liés à l’hypertrophie bénigne de prostate. Prog Urol 2014; 24:929-33. [DOI: 10.1016/j.purol.2014.07.010] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2014] [Revised: 07/16/2014] [Accepted: 07/22/2014] [Indexed: 11/25/2022]
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Raimbault M, Watt S, Bourgoin H, Brichart N, Bruyère F. Analyse comparative coût–efficacité de la photovaporisation prostatique par laser Greenlight et de l’adénomectomie pour hypertrophie de la prostate de gros volume. Prog Urol 2014; 24:470-6. [DOI: 10.1016/j.purol.2013.12.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2013] [Revised: 12/03/2013] [Accepted: 12/08/2013] [Indexed: 10/25/2022]
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Vinceneux FX, Tanchoux C, Latteux G, Galliot I, Bruyère F. [Analysis of postoperative urgenturies after prostate photovaporization by the laser Greenlight ®]. Prog Urol 2014; 24:191-5. [PMID: 24560209 DOI: 10.1016/j.purol.2013.10.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2012] [Revised: 09/27/2013] [Accepted: 10/03/2013] [Indexed: 11/29/2022]
Abstract
UNLABELLED Urgencies are classically described after prostate photovaporization (PVP). The objective of this study was to analyze the incidence of urgency in patients who underwent PVP using the International Prostate Symptom Score (IPSS) to defined urgencies. METHOD This is a single-center prospective cohort study assessing patients who underwent surgery between May 2005 and January 2011. The questions 2 and 4 of the IPSS and open questions were selected to evaluate urgency during the follow-up. RESULTS Two-hundred and four patients were operated during this period and 93 complete records were analyzed. Twenty-one percent of these patients had a clinical urgency after 1 month and 1,9% at 12 months (significant improvement, P<0.001) corresponding to scores greater than 4 for questions 2 and 4 of the IPSS. Answer scores to questions 2 and 4 improved significantly over 12 months (P<0.001). The clinical urgencies decreased significantly as well as answers to questions 2 and 4 of the IPSS. CONCLUSION Urgencies decreased significantly between 3 and 12 months of postoperative follow. Questions 2 and 4 of the IPSS score appeared to be a standardized definition of these urgencies.
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Affiliation(s)
- F-X Vinceneux
- Service d'urologie, CHU Bretonneau, 2, boulevard Tonnelle, 37044 Tours cedex, France
| | - C Tanchoux
- Service d'urologie, CHU Bretonneau, 2, boulevard Tonnelle, 37044 Tours cedex, France
| | - G Latteux
- Service d'urologie, CHU Bretonneau, 2, boulevard Tonnelle, 37044 Tours cedex, France
| | - I Galliot
- Service d'urologie, CHU Bretonneau, 2, boulevard Tonnelle, 37044 Tours cedex, France
| | - F Bruyère
- Service d'urologie, CHU Bretonneau, 2, boulevard Tonnelle, 37044 Tours cedex, France; Centre d'innovations technologiques, université François-Rabelais, Tours, France.
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Ghozzi S, Ghorbel J, Ben Ali M, Dridi M, Maarouf J, Khiari R, Ben Rais N. [Bipolar versus monopolar transurethral resection of the prostate: a prospective randomized study]. Prog Urol 2014; 24:121-6. [PMID: 24485082 DOI: 10.1016/j.purol.2013.08.307] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2013] [Revised: 07/13/2013] [Accepted: 08/01/2013] [Indexed: 11/25/2022]
Abstract
PURPOSE To compare bipolar with standard monopolar transurethral resection of the prostate (TURP). MATERIAL AND METHODS A prospectively randomized study was conducted between January 2010 and September 2011. Primary end points studied were efficacy (maximum flow rate [Qmax], International Prostate Symptom Score) and safety (adverse events, decline in postoperative serum sodium [Na+] and haemoglobin [Hb] levels). Secondary end points were operation time and duration of irrigation, catheterization, and hospitalization. RESULTS Sixty consecutive patients were randomized and completed the study, with 29 patients in the monopolar TURP group and 31 in the TURIS group. At baseline, the two groups were comparable in age, prostate volume, mean prostate-specific antigen value, International Prostate Symptom Score, and they had at least 12 months of follow-up. Declines in the mean postoperative serum Na+ for bipolar and monopolar TURP groups were 1.2 and 8.7 mmol/L, respectively. However, there was no statistical difference in the decline in postoperative Hb between the two groups. The mean catheterization time was 26.6 and 52 hours in the bipolar and standard groups, respectively. This difference was statistically significant as was the difference in the time to hospital discharge. The IPSS and Qmax improvements were comparable between the two groups at 12 months of follow-up. CONCLUSION No clinically relevant differences in short-term efficacy are existed between the two techniques, but bipolar TURP is preferable due to a more favorable safety profile and shorter catheterization duration.
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Affiliation(s)
- S Ghozzi
- Service d'urologie, hôpital militaire principal d'instructions de Tunis, Montfleury, 1008 Tunis, Tunisie.
| | - J Ghorbel
- Service d'urologie, hôpital militaire principal d'instructions de Tunis, Montfleury, 1008 Tunis, Tunisie
| | - M Ben Ali
- Service d'urologie, hôpital militaire principal d'instructions de Tunis, Montfleury, 1008 Tunis, Tunisie
| | - M Dridi
- Service d'urologie, hôpital militaire principal d'instructions de Tunis, Montfleury, 1008 Tunis, Tunisie
| | - J Maarouf
- Service d'urologie, hôpital militaire principal d'instructions de Tunis, Montfleury, 1008 Tunis, Tunisie
| | - R Khiari
- Service d'urologie, hôpital militaire principal d'instructions de Tunis, Montfleury, 1008 Tunis, Tunisie
| | - N Ben Rais
- Service d'urologie, hôpital militaire principal d'instructions de Tunis, Montfleury, 1008 Tunis, Tunisie
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Lahlaidi K, Ariane MM, Fontaine E. [Up-to-date on the treatment of benign prostatic hyperplasia. Which adenoma to treat and how to do it?]. Rev Med Interne 2013; 35:189-95. [PMID: 24262410 DOI: 10.1016/j.revmed.2013.10.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2013] [Accepted: 10/03/2013] [Indexed: 11/18/2022]
Abstract
Benign prostatic hyperplasia is a state of the nature rather than a disease. It affects mainly men over 50 years and represents a public health problem. A literature review on the therapeutic management of benign prostatic hyperplasia was carried out from a selection of publications with the highest level of evidence. Medical treatment is based on herbal medicine, alpha-blockers and 5-alpha-reductase inhibitors. Surgical treatment is used in case of complications or failure of medical management. Surgical options are numerous. Transurethral prostate resection and prostate adenomectomy are the most usual procedures. Due to their significant morbidity, other less invasive procedures have recently been developed. The choice of treatment will depend on prostate volume and anatomy and patient's comorbidities.
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Affiliation(s)
- K Lahlaidi
- Service d'urologie, hôpital européen Georges-Pompidou, AP-HP, 20, rue Leblanc, 75015 Paris, France
| | - M M Ariane
- Service d'urologie, hôpital européen Georges-Pompidou, AP-HP, 20, rue Leblanc, 75015 Paris, France
| | - E Fontaine
- Service d'urologie, hôpital européen Georges-Pompidou, AP-HP, 20, rue Leblanc, 75015 Paris, France.
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14
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Current world literature. Curr Opin Urol 2012. [PMID: 23202289 DOI: 10.1097/mou.0b013e32835bb149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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15
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Descazeaud A, Robert G, Delongchamps N, Cornu JN, Saussine C, Haillot O, Devonec M, Fourmarier M, Ballereau C, Lukacs B, Dumonceau O, Azzouzi A, Faix A, Desgrandchamps F, de la Taille A. Bilan initial, suivi et traitement des troubles mictionnels en rapport avec hyperplasie bénigne de prostate : recommandations du CTMH de l’AFU. Prog Urol 2012. [DOI: 10.1016/j.purol.2012.10.001] [Citation(s) in RCA: 60] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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16
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Yan H, Ou TW, Chen L, Wang Q, Lan F, Shen P, Li J, Xu JJ. Thulium laser vaporesection versus standard transurethral resection of the prostate: A randomized trial with transpulmonary thermodilution hemodynamic monitoring. Int J Urol 2012; 20:507-12. [PMID: 23088252 DOI: 10.1111/j.1442-2042.2012.03183.x] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2012] [Accepted: 09/06/2012] [Indexed: 11/29/2022]
Affiliation(s)
- Hao Yan
- Department of Urology; Xuanwu Hospital; Beijing; China
| | - Tong-Wen Ou
- Department of Urology; Xuanwu Hospital; Beijing; China
| | - Liang Chen
- Department of Urology; Xuanwu Hospital; Beijing; China
| | - Qi Wang
- Department of Urology; Xuanwu Hospital; Beijing; China
| | - Fei Lan
- Department of Anesthesiology; Xuanwu Hospital; Beijing; China
| | - Peng Shen
- Department of Intensive Care Unit; Puren Hospital; Capital Medical University; Beijing; China
| | - Jin Li
- Department of Urology; Xuanwu Hospital; Beijing; China
| | - Jian-Jun Xu
- Department of Urology; Xuanwu Hospital; Beijing; China
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