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Zhang YB, Cheng YN. A randomized controlled trial of neuromuscular electrical stimulation for chronic urinary retention following traumatic brain injury. Medicine (Baltimore) 2019; 98:e14106. [PMID: 30633223 PMCID: PMC6336629 DOI: 10.1097/md.0000000000014106] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
Abstract
BACKGROUND This study aimed to evaluate the effectiveness of neuromuscular electrical stimulation (NMES) therapy for chronic urinary retention (CUR) following traumatic brain injury (TBI). METHODS This 2-arm randomized controlled trial (RCT) enrolled 86 eligible patients with CUR following TBI. All included patients were randomly allocated to a treatment group (n = 43) or a sham group (n = 43). The administration of NMES or sham NMES, as intervention, was performed for an 8-week period treatment, and 4-week period follow-up. In addition, all subjects were required to undergo indwelling urinary catheter throughout the study period. The primary outcome was assessed by the post-voiding residual urine volume (PV-VRU). The secondary outcomes were evaluated by the voided volume, maximum urinary flow rate (Qmax), and quality of life, as assessed by Barthel Index (BI) scale. In addition, adverse events were also recorded during the study period. All primary and secondary outcomes were measured at baseline, at the end of 8-week treatment, and 4-week follow-up. RESULTS At the end of 8-week treatment, the patients in the treatment group did not achieve better outcomes in PV-VRU (P = .66), voided volume (P = .59), Qmax (P = .53), and BI scores (P = .67), than patients in the control group. At the end of 4-week follow-up, there were also no significant differences regarding the PV-VRU (P = .42), voided volume (P = .71), Qmax (P = .24), and BI scores (P = .75) between 2 groups. No adverse events occurred in either group. CONCLUSIONS In summary, the findings of this study showed that NMES therapy may not benefit patients with CUR following TBI.
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Affiliation(s)
| | - Yan-na Cheng
- Department of Nephrology, The Affiliated Hospital of Yan’an University, Yan’an, China
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Kirac M, Guneri Ç, Deniz N, Biri H. Does the Intensity of Cutting Power Affect Postoperative Symptoms During Transurethral Resection with a Monopolar System? Indian J Surg 2015; 77:589-93. [PMID: 26730069 PMCID: PMC4692864 DOI: 10.1007/s12262-013-0933-1] [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: 01/21/2013] [Accepted: 06/03/2013] [Indexed: 10/26/2022] Open
Abstract
The aim of this study was to investigate the effect of intensity of cutting power on postoperative symptoms after transurethral resection (TURP) with a monopolar system for benign prostatic hyperplasia. One hundred thirty-six men with benign prostatic obstructions undergoing elective transurethral prostatectomy were enrolled in the study. Patients were divided into three groups according to the intensity of cutting power. The cutting power intensities were 80-119 W for group 1, 120-159 W for group 2, and 160-200 W for group 3, respectively. In the postoperative period, patients were evaluated with International Prostate Symptom Score (IPSS) and quality-of-life (QoL) questionnaires. In the postoperative period, maximal flow rate (Q max), and post-voiding residue (PVR) were significantly improved in patients who had monopolar TURP performed. When compared to the other groups, the IPSS score was found to be significantly higher in group 3 at 3, 4, and 8 weeks. In addition, the QoL assessment scores for group 3 were superior at 3 weeks. The improvements of Q max and PVR were similar among the three groups (p < 0.0001). At the end of 3 months, IPSS and QoL were significantly improved in all groups. The intensity of cutting power during prostate resection with a monopolar system may affect the postoperative improvements and symptoms.
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Affiliation(s)
- Mustafa Kirac
- />Department of Urology, Koru Hospital, Ankara, Turkey
- />Bağlıca mah. Karaçamur caddesi Green park sitesi A blok no: 25-Etimesgut, Ankara, Turkey
| | - Çagrı Guneri
- />Department of Urology, Koru Hospital, Ankara, Turkey
| | - Nuri Deniz
- />Department of Urology, Koru Hospital, Ankara, Turkey
| | - Hasan Biri
- />Department of Urology, University of Gazi, Ankara, Turkey
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Yoon PD, Chalasani V, Woo HH. Systematic review and meta-analysis on management of acute urinary retention. Prostate Cancer Prostatic Dis 2015. [DOI: 10.1038/pcan.2015.15] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Green W, Campain N, Peracha A, Ratan H, Walton T, Parkinson R. Very high residual volumes should not prevent transurethral resection of the prostate being offered to men presenting with urinary retention. Scand J Urol 2014; 48:549-53. [DOI: 10.3109/21681805.2014.932841] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- William Green
- Department of Urology, Nottingham City Hospital,
Nottingham, UK
| | - Nick Campain
- Department of Urology, Nottingham City Hospital,
Nottingham, UK
| | - Amjad Peracha
- Department of Urology, Royal Derby Hospital,
Derby, UK
| | - Hari Ratan
- Department of Urology, Nottingham City Hospital,
Nottingham, UK
| | - Thomas Walton
- Department of Urology, Nottingham City Hospital,
Nottingham, UK
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Aho TF. Holmium laser enucleation of the prostate: a paradigm shift in benign prostatic hyperplasia surgery. Ther Adv Urol 2013; 5:245-53. [PMID: 24082919 PMCID: PMC3763780 DOI: 10.1177/1756287213498923] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023] Open
Abstract
Holmium laser enucleation (HoLEP) was developed in the 1990s as a more efficient and cost effective method of benign prostatic hyperplasia surgery than laser vaporization and resection techniques. As a true anatomical enucleation it mimics open prostatectomy and is as durable. There is a significant body of level 1 evidence in support of HoLEP, including 2 meta-analyses and 14 randomized trials which compare HoLEP with a number of other procedures. This review describes the development of and summarizes the evidence for HoLEP.
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Affiliation(s)
- Tevita F Aho
- Department of Urology, Cambridge University, Addenbrookes Hospital, Hills Rd, Cambridge, CB22 5AN, UK
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Shin YS, Park JK. Changes in surgical strategy for patients with benign prostatic hyperplasia: 12-year single-center experience. Korean J Urol 2011; 52:189-93. [PMID: 21461283 PMCID: PMC3065131 DOI: 10.4111/kju.2011.52.3.189] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2010] [Accepted: 02/21/2011] [Indexed: 11/18/2022] Open
Abstract
Purpose The purpose of this study was to evaluate the annual changes in prostate variables and style of surgical treatment of patients with benign prostatic hyperplasia (BPH) over the past 12 years. Materials and Methods The subjects were 918 patients (January 1999-November 2010) who were treated by either open prostatectomy or transurethral resection of prostate (TURP). Every year, the performance ratio between open prostatectomy and TURP was evaluated. Before surgery, total and transitional zone volumes of the prostate were measured by transrectal ultrasonography (TRUS). After surgery, resection weight and residual volume of the prostate were measured by TRUS. Results From 2001 through 2010, the performance ratio of TURP increased greatly from 89% to 97%. During 1999 to 2010, the total volume of the prostate increased from 40.0 cc to 55.0 cc in the TURP group and from 74.1 cc to 116.7 cc in the open prostatectomy group. During 1999 to 2010, the mean resection volume of the TURP group increased from 2.3 cc to 20.1 cc. Also, the mean resection volume of the open prostatectomy group increased from 59.3 cc to 114.3 cc. During 1999 to 2003, the resection time of the TURP group decreased from 72.9 minutes to 43.2 minutes. Conclusions During 1999 through 2010, the performance ratio between open prostatectomy vs TURP was high for TURP. The total volume and resection volume of the prostate increased annually, and the resection time decreased annually.
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Affiliation(s)
- Yu Seob Shin
- Department of Urology, Chonbuk National University Medical School, Jeonju, Korea
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Jia G, Heverhagen JT, Polzer H, Jacko RV, Liang J, Zhang J, Levine AL, Rosol TJ, Knopp MV. Dynamic contrast enhanced magnetic resonance imaging as a biological marker to noninvasively assess the effect of finasteride on prostatic suburethral microcirculation. J Urol 2007; 176:2299-304. [PMID: 17070316 DOI: 10.1016/j.juro.2006.07.056] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2005] [Indexed: 10/24/2022]
Abstract
PURPOSE We assessed dynamic contrast enhanced magnetic resonance imaging as a biological marker of in vivo changes in microcirculation in the prostatic suburethral region. MATERIALS AND METHODS A total of 12 male beagle dogs with spontaneous benign prostatic hyperplasia were randomly allocated to 1 control group and 1 finasteride (Merck and Co., Whitehouse Station, New Jersey) treated group. Two baseline dynamic contrast enhanced magnetic resonance imaging examinations and 3 followups were performed to assess prostate microcirculation. Treatment duration was 3 months. The pharmacokinetic parameters evaluated in prostatic suburethral areas were the maximum enhancement ratio in AU, time to maximum signal enhancement in minutes, amplitude in AU and the exchange rate constant in minutes(-1). RESULTS After completion of the therapeutic regimen time to maximum signal enhancement was significantly longer in the finasteride group than in controls (p < 0.01). Amplitude and the exchange rate constant decreased 39% and 34%, respectively, in the finasteride group at the end of treatment, which significantly differed from results in the control group (p < 0.05). CONCLUSIONS Dynamic contrast enhanced magnetic resonance imaging is capable of noninvasively assessing the prostatic microcirculation changes induced by finasteride. Pharmacokinetic parameters show considerable promise to be biomarkers for the development of benign prostatic hyperplasia drugs such as 5alpha-reductase inhibitors by the in vivo monitoring of microvascular changes. A relevant clinical application could be the pretreatment assessment of finasteride effectiveness to decrease perioperative bleeding at transurethral prostate resection and in treatment for hematuria.
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Affiliation(s)
- Guang Jia
- Department of Radiology, Ohio State University, Columbus, Ohio, USA
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Ruszat R, Wyler S, Seifert HH, Reich O, Forster T, Sulser T, Bachmann A. Photoselective Vaporization of the Prostate: Subgroup Analysis of Men with Refractory Urinary Retention. Eur Urol 2006; 50:1040-9; discussion 1049. [PMID: 16481099 DOI: 10.1016/j.eururo.2006.01.019] [Citation(s) in RCA: 47] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2005] [Accepted: 01/13/2006] [Indexed: 10/25/2022]
Abstract
OBJECTIVES The purpose of this study was to evaluate the feasibility and efficacy of photoselective vaporization of the prostate (PVP) in patients with refractory urinary retention (RUR) secondary to benign prostate hyperplasia (BPH). METHODS Perioperative data, postoperative outcomes, and adverse events within 24 months in 70 patients with RUR were compared to 113 men with no urinary retention (NUR) before surgery. RESULTS Follow-up for the two groups was as follows (RUR vs. NUR at 1, 3, 6, 12, and 24 months): peak urinary flow rate: 16.9 vs. 19.4 ml/s, 16.3 vs. 20.9 ml/s, 17.7 vs. 19.7 ml/s, 18.2 vs. 21 ml/s, and 19.4 vs. 23.3 ml/s; International Prostate Symptom Score: 7.6 vs. 10.7, 7 vs. 7.5, 5.7 vs. 6.2, 5.5 vs. 6.5, and 4.4 vs. 6.5, respectively. Postoperative urinary retention and complication rates were comparable for the two groups. In five patients (2.7%), a reoperation with PVP or transurethral resection of the prostate was necessary. Bladder neck contracture and urethral stricture developed in 0.5% (n=1) and 4.9% (n=9), respectively. CONCLUSION PVP seems to be a safe and effective surgical tool in patients with RUR caused by prostatic enlargement. The complication rate is comparable to that of patients with NUR before PVP.
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Affiliation(s)
- Robin Ruszat
- Department of Urology, University Hospital Basel, Basel, Switzerland
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Elzayat EA, Habib EI, Elhilali MM. Holmium laser enucleation of prostate for patients in urinary retention. Urology 2005; 66:789-93. [PMID: 16230139 DOI: 10.1016/j.urology.2005.04.049] [Citation(s) in RCA: 35] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2005] [Revised: 03/30/2005] [Accepted: 04/21/2005] [Indexed: 11/24/2022]
Abstract
OBJECTIVES To evaluate holmium laser enucleation of the prostate in patients presenting in urinary retention secondary to benign prostatic hyperplasia. METHODS From May 2000 to May 2004, 169 patients, with a mean age of 74 years, who presented in urinary retention secondary to benign prostatic hyperplasia underwent holmium laser enucleation of the prostate. The mean urinary volume drained at catheterization was 670 mL (range 132 to 2000). All the patients were assessed preoperatively, 1, 3, 6, and 12 months postoperatively, and every year thereafter. All the patients were evaluated by physical examination, digital rectal examination, symptom evaluation using the International Prostate Symptom Score questionnaire, uroflowmetry (whenever possible), postvoid residual urine volume measurement, and prostate-specific antigen. The mean preoperative prostate volume estimated by transrectal ultrasonography was 101 cm3 (range 20 to 351). RESULTS The mean catheter time and hospital stay was 1.6 and 1.7 days, respectively. The peak urinary flow rate, postvoid residual urine volume, and International Prostate Symptom Score and quality-of-life score were significantly improved by 1 month after surgery and continued to improve during subsequent follow-up. Three patients (1.75%) were unable to void postoperatively; one required a suprapubic catheter and two used clean intermittent catheterization. Four patients (2.4%) were receiving anticoagulant therapy and required blood transfusion. Bladder neck contracture and urethral stricture developed in 1.7% and 1.2%, respectively. CONCLUSIONS Holmium laser enucleation of the prostate represents a safe and effective treatment for patients with benign prostatic hyperplasia presenting in urinary retention. It has low morbidity and provides immediate symptom and voiding improvement.
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Affiliation(s)
- Ehab A Elzayat
- Division of Urology, McGill University School of Medicine, Montreal, Quebec, Canada
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Tooher R, Sutherland P, Costello A, Gilling P, Rees G, Maddern G. A Systematic Review of Holmium Laser Prostatectomy for Benign Prostatic Hyperplasia. J Urol 2004; 171:1773-81. [PMID: 15076275 DOI: 10.1097/01.ju.0000113494.03668.6d] [Citation(s) in RCA: 110] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
PURPOSE We undertook a systematic review to assess the safety and efficacy of holmium laser prostatectomy compared to transurethral resection of the prostate. MATERIALS AND METHODS We searched literature databases through August 2002. Holmium laser studies, including holmium laser resection of the prostate (HoLRP) and holmium laser enucleation of the prostate (HoLEP), of any design, and the transurethral prostatectomy (TURP) arms of randomized controlled trials (RCTs) with sample sizes greater than 50 patients, date restricted to 1995 onward, were included for comparison. RESULTS Three RCTs comparing HoLRP and TURP, and 2 RCTs comparing HoLEP and TURP were identified. For each of the holmium procedures there was also 1 nonrandomized comparative study and a number of case series (HoLRP 13, HoLEP 10). With the exception of 1 randomized trial the quality of the available evidence was poor, with the other RCTs lacking information regarding methods of randomization, allocation concealment and blinding. The majority of studies were characterized by relatively short followup periods and significant losses to followup. In terms of safety the data suggest that the holmium laser procedures are superior to TURP with regard to a number of key indicators of blood loss (transfusion rates, postoperative bladder irrigation, duration of catheterization and length of hospital stay), although amount of blood loss was rarely reported. In terms of efficacy the holmium laser procedures appear to be similarly effective to TURP in relieving the symptoms of benign prostatic hyperplasia. CONCLUSIONS Holmium laser prostatectomy is at least as effective as TURP for managing the symptoms of benign prostatic hyperplasia. However, at the present time the long-term durability of the holmium procedures with respect to TURP cannot be determined due to a lack of published studies with sufficient followup.
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Affiliation(s)
- Rebecca Tooher
- ASERNIP-S, Royal Australasian College of Surgeons, Stepney, South Australia
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Berger AP, Wirtenberger W, Bektic J, Steiner H, Spranger R, Bartsch G, Horninger W. Safer transurethral resection of the prostate: coagulating intermittent cutting reduces hemostatic complications. J Urol 2004; 171:289-91. [PMID: 14665896 DOI: 10.1097/01.ju.0000098925.76817.3a] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
PURPOSE Transurethral resection of the prostate (TURP) is still the gold standard for the surgical treatment of symptomatic benign prostatic hyperplasia. However, the associated morbidity and blood loss remain concerns. A coagulating intermittent cutting (CIC) device with constant voltage pulses and controlled pulse intervals was recently developed. The impact of CIC on bleeding and blood transfusion rates as well as the occurrence of the TUR syndrome were investigated. MATERIALS AND METHODS From January 2000 to July 2002, 271 consecutive patients with symptomatic benign prostatic hyperplasia underwent TURP with the CIC device. In addition to blood transfusion rates, serum hemoglobin and electrolytes were determined in all patients immediately before and after TURP. RESULTS The mortality rate in the 271 patients subjected to TURP was 0.0%. Mean decrease in hemoglobin after TURP was 1.08 mg/dl. Intraoperative and postoperative blood transfusions were required in 7 patients (2.6%), and clinical signs of the transurethral resection syndrome were noted in 1.1% of patients. CONCLUSIONS Coagulating intermittent cutting dramatically improves the safety of TURP by decreasing intraoperative and postoperative blood loss, and the rate of blood transfusions. With this blood sparing device we anticipate a lower incidence of hemostatic complications from TURP.
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Nishizawa K, Kobayashi T, Watanabe J, Ogura K. Interstitial laser coagulation of the prostate for management of acute urinary retention. J Urol 2003; 170:879-82. [PMID: 12913721 DOI: 10.1097/01.ju.0000082581.19298.49] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE We evaluated the clinical efficacy and benefit of interstitial laser coagulation of the prostate (ILCP) in patients with benign prostatic hyperplasia (BPH) presenting with acute urinary retention. MATERIALS AND METHODS Patients presenting with acute urinary retention were prospectively evaluated. Patients underwent ILCP and outcomes were evaluated by post-void residual urine, maximum flow rate, International Prostate Symptom Score, and disease specific quality of life score at baseline, 1, 3, 6 and 12 months. RESULTS A total of 85 patients were enrolled in the study and 53 were diagnosed with acute urinary retention secondary to BPH. A total of 33 were not catheter-free after a week and 28 of them agreed to undergo ILCP. Mean preoperative prostate volume was 54.6 ml (range 23.0 to 130.0) and mean residual volume presenting with retention was 602 ml (range 200 to 1,150). There were no intraoperative or postoperative adverse events except urinary infection in 2 patients. Mean catheterization duration was 6.3 days (range 3 to 18) and all patients became catheter-free postoperatively. Mean followup was 16.9 months (range 7 to 31). Mean maximum flow rate (+/-SD) was 11.2 ml per second (+/-5.7) 3 months after treatment. Mean International Prostate Symptom Score and quality of life scores decreased from 23.1 (+/-6.4) at baseline to 8.0 (+/-5.3) at 3 months (p <0.001), and 5.0 (+/-1.2) to 1.9 (+/-1.6, p <0.001), respectively. Mean estimated prostate volume decreased by 19.4% (54.6 to 44.0 ml) 6 months postoperatively (p <0.001). Only 2 patients had recurrent urinary retention during followup. CONCLUSIONS Our study suggested that ILCP is a safe and effective therapy for patients with BPH presenting with acute urinary retention.
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Affiliation(s)
- Koji Nishizawa
- Department of Urology, Hamamatsu Rosai Hospital, Hamamatsu, Japan
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Haltbakk J, Hanestad BR, Hunskaar S. Use and misuse of the concept of quality of life in evaluating surgical treatments for lower urinary tract symptoms. BJU Int 2003; 91:380-8. [PMID: 12603419 DOI: 10.1046/j.1464-410x.2003.04077.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To investigate how quality of life (QoL) components measured by given instruments direct the QoL perspective in treatment studies of lower urinary tract symptoms (LUTS) and benign prostatic hyperplasia (BPH). METHODS Computer searches were conducted in Medline, CINAHL and Psychinfo; MeSH terms covering QoL and surgical treatments for BPH and LUTS were combined for the search. The analysis was based on a framework linking components of QoL to patient outcome. RESULTS Of the 74 papers meeting the inclusion criteria, 48 were published in 1997-2001, showing the increase of interest of the topic. Most of the papers reported the change in QoL by a one-item scale, whilst only a few reported results from several of the components in the QoL concept. Some papers regarded the change in general health status or parts of health status as changes in QoL. Functional status and symptoms, and the bother of symptoms, were often regarded as indicators of a change in QoL. CONCLUSION These analyses show an increasing interest in measuring QoL after surgery for LUTS and BPH. In most of the studies analysed, the batteries of instruments selected were too narrow in scope to study the complexity of QoL. Most papers are based on instruments sensitive to change, but the reports do not distinguish the basic assumptions for understanding relationships important in QoL research and as a result, the reason for change is open to question.
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Affiliation(s)
- J Haltbakk
- Department of Public Health and Primary Health Care, University of Bergen, Norway.
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Abstract
PURPOSE OF REVIEW Over the past 10-15 years a variety of endoscopic laser techniques have evolved for the treatment of benign prostatic hyperplasia. The laser is merely an energy source with the ability to coagulate, incise, vaporize, resect and dissect (enucleate), all fundamentally different procedures. Generalization regarding "laser prostatectomy" is therefore inappropriate. The potential for shorter hospital stays and decreased morbidity while maintaining the efficacy and durability of transurethral resection of the prostate has been the driving force behind the laser techniques that acutely remove tissue, whereas the ideal minimally invasive non-tissue removing laser technique is a well-tolerated office procedure, performed under local anaesthesia. We define the various laser techniques currently available for the treatment of benign prostatic hyperplasia, and review developments reported during the period July 2001 to July 2002. RECENT FINDINGS Although there are few long-term data available on laser techniques, more medium-term data is emerging. Issues such as cost-effectiveness and applicability to certain sub-groups of patients are being investigated as each laser technique aims to find its own niche in the ever-expanding treatment armamentarium for benign prostatic hyperplasia. SUMMARY Satisfactory moderate term results are now available for several minimally invasive laser techniques including interstitial laser coagulation and visual laser ablation of the prostate. There are promising early results for holmium laser enucleation of the prostate and potassium titanyl-phosphate, which have the potential to rival transurethral resection if proved durable in the long-term. Holmium laser enucleation is currently a serious contender for the "gold standard" for large prostates.
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Affiliation(s)
- Tevita F Aho
- Department of Urology, Tauranga Hospital, Tauranga, New Zealand
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