2010 Update: Guidelines for the management of benign prostatic hyperplasia

Nickel, J. Curtis; Méndez-Probst, Carlos E.; Whelan, Thomas F.; Paterson, Ryan F.; Razvi, Hassan

doi:10.5489/cuaj.901

Cited by 27 publications

(46 citation statements)

References 53 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…According to the Canadian Urological Association guidelines on BPH, transurethral resection of the prostate (TURP) remains the gold standard of surgical treatment for men with bothersome moderate to severe lower urinary tract symptoms (LUTS). 1 Transurethral laser approaches are appropriate and effective treatment alternatives to TURP with lower perioperative complications. 1 These laser approaches, among other procedures, include holmium laser enucleation of the prostate (HoLEP) and photoselective vaporization of the prostate (PVP).…”

Section: Introductionmentioning

confidence: 99%

Assessment of photoselective vaporization of prostate skills during Urology Objective Structured Clinical Examinations (OSCE)

Noureldin

Elkoushy

Fahmy

et al. 2015

CUAJ

View full text Add to dashboard Cite

Introduction: We evaluated the use of the GreenLight Simulator (GL-SIM) (American Medical Systems, Guelph, ON) in the skill assessment of postgraduate trainees (PGTs) in photoselective vaporization of the prostate (PVP). We also sought to determine whether previous PVP experience or GL-SIM practice improved performance. Methods: PGTs in postgraduate years (PGY-3 to PGY-5) from all 4 Quebec urology training programs were recruited during 2 annual Objective Structured Clinical Examinations (OSCEs). During a 20-minute OSCE station, PGTs were asked to perform 2 exercises: (1) identification of endoscopic landmarks and (2) a PVP of a 30-g normal prostate. Grams vaporized, global scores, and number of correct anatomical landmarks were recorded and correlated with PGY level, practice on the GL-SIM, and previous PVP experience. Results: In total, 25 PGTs were recruited at each OSCE, with 13 PGTs participating in both OSCEs. When comparing scores from the first and second OSCEs, there was a significant improvement in the number of grams vaporized (2.9 vs. 4.3 g; p = 0.003) and global score (100 vs. 165; p = 0.03). There was good correlation between the number of previously performed PVPs and the global score (r = 0.4, p = 0.04). Similarly, PGTs with previous practice on the GL-SIM had significantly higher global score (100.6 vs. 162.6; p = 0.04) and grams vaporized (3.1 vs. 4.1 g; p = 0.04) when compared with those who did not practice on GL-SIM. Furthermore, there were significantly more competent PGTs among those who had previously practiced on the GL-SIM (32.7% vs. 10.2%; p = 0.009). PGY level did not significantly affect grams vaporized or global score (p > 0.05). Conclusion: Performance on the GL-SIM at OSCEs significantly correlated with previous practice on the GL-SIM and previous PVP experience rather than PGY level. Furthermore, there were significantly more competent PGTs among those who had previously practiced on the GL-SIM. IntroductionBenign prostatic hyperplasia (BPH) is a common progressive disease in aging men. According to the Canadian Urological Association guidelines on BPH, transurethral resection of the prostate (TURP) remains the gold standard of surgical treatment for men with bothersome moderate to severe lower urinary tract symptoms (LUTS).1 Transurethral laser approaches are appropriate and effective treatment alternatives to TURP with lower perioperative complications. 1These laser approaches, among other procedures, include holmium laser enucleation of the prostate (HoLEP) and photoselective vaporization of the prostate (PVP). Although these laser approaches are associated with shorter convalescence and lower perioperative morbidity, they are also associated with a steep learning curve. For example, at least 20 mentored cases are required for the urologist to be comfortable with HoLEP.2 Hence, the Halstedian concept of "see one, do one, teach one" is no longer valid. In addition, reductions in postgraduate trainee (PGT) working hours together with increased public demand for patient s...

show abstract

Section: Introductionmentioning

confidence: 99%

Assessment of photoselective vaporization of prostate skills during Urology Objective Structured Clinical Examinations (OSCE)

Noureldin

Elkoushy

Fahmy

et al. 2015

CUAJ

View full text Add to dashboard Cite

show abstract

“…Residual urine volume does not correlate well with other signs of symptoms of prostatism. 6 Prostatic carcinoma is more common in India compared to other Asian Countries. 21 Incidence of prostatic cancer increases rapidly with age than any other cancer.…”

Section: Post-void Residual Volumementioning

confidence: 99%

“…In severe cases, the patient may develop urinary retention, kidney blockage (Hydronephrosis), or renal failure. 5,6,7 The AUASS is recommended as the symptoms scoring instrument used in the initial assessment of each patient presenting with symptoms of prostatism. When the AUASS System is used, symptoms classified as mild (0 to 7), moderate (8 to 19), and severe (20 to 35).…”

Section: Introductionmentioning

confidence: 99%

“…4,10,11 Patient often present with acute retention of urine with varying degree of renal impairment, hence are catheterised and kept on drugs and investigated for surgical intervention on later dates. 5,6,7 In our institute, large number of the patients of both sexes and all ages with urinary symptoms are admitted throughout the year. Majority of the elderly male above the age of 55 years presents with symptoms of BPH of various ranges, which prompted us to take up the present study.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Benign Prostatic Hyperplasia: Clinicopathological Study of 138 Cases

Singh¹,

Ambedkar²,

Gaharwar³

et al. 2016

jemds

View full text Add to dashboard Cite

AIMS AND OBJECTIVESTo study the incidence of Benign Prostatic Hyperplasia (BPH) in reference to age of the patients, to study the common symptoms and signs of BPH and classify on the basis of American Urological Association Symptoms Score (AUASS), to evaluate the role of various investigations, to study the relation of weight/volume and size of prostate, and to grade the prostate on the basis of AUASS. MATERIAL AND METHODSTotal 138 patients with symptoms of BPH were selected and detailed history was elicited with special reference to AUASS, according to which BPH was graded, investigated properly, and managed accordingly. RESULTSOverall incidence of BPH out of total patients admitted (8562) in surgical wards during period of one year was found 1.61%. Majority of the patients were in the age group 61-70 years and average age in present study was 67.8 years. According to AUASS, most of the patients (62.32%) had moderate grade symptoms (Score 8-19) followed by patients (37.68%) had severe symptoms (Score 20-35). On digital rectal examination, 73.18% of the patients had grade II prostate, 14.42% had grade III, and grade I in 12.31%. The blood urea and serum creatinine levels were normal in majority of the patients, 62.77% and 58.69% respectively. On USG prostate, most of the patients (65.81%) had prostatic weight in range of 41-60 grams and majority of the patients (47.22%) had PVR volume of urine ranging between 101-200 mL. Weight of prostatic specimen on prostatectomy showed that most of the patients (64.86%) had prostatic weight in range of 41-60 grams. On histopathological examination of prostatectomy samples, it was found that 91.90% of specimens showed BPH and rest 8.10% were suggestive for carcinoma prostate. CONCLUSIONBPH is a condition intimately related to ageing, which needs treatment when symptoms are bothersome and reduces the quality of life. Patients with mild-to-moderate enlargement of the prostate in 5 th and 6 th decade of life often respond to watchful waiting and medical treatment. Patients presenting with acute or chronic retention with or without haematuria finally needs surgical intervention.

show abstract

“…Further diagnosis of prostate hyperplasia confirmed with urology department after it used USG. 6 Abdominal obesity is obesity that is determined by waist circumference (WC) measurements. WC ≥ 90 cm in adult male is defined as Ab-Ob.…”

Section: Instruments and Materials Collection Proceduresmentioning

confidence: 99%

Waist circumference increased risk of benign prostatic hyperplasia through an increase in the level of interleukin-6 and insulin resistance in abdominal obesity patients

et al. 2017

View full text Add to dashboard Cite

Inflammation in abdominal obesity (Ab-Ob) is associated with insulin resistance condition and hyperinsulinemia. Numerous studies have found that prevalence of prostatic hyperplasia was higher in individuals with central obesity. This study is aimed at testing and verifying whether and to what extent waist circumference (WC), interleukin-6 (IL-6), and insulin resistance (HOMA-IR) increase the risk of benign prostatic hyperplasia (BPH) in Ab-Ob.The study design was match-paired case-control. Eighty patients were recruited for this study. Data analysis was done with student t-test, multivariate logistic regression analysis, and path analysis. IL-6 was measured with sandwich enzyme immunoassay with Quantikine Immunoassay Kit (R&D System, Inc. USA), hsCRP was measured with the immunometric assay, and fasting insulin level was measured with Chemiluminescence Immunometric method (Immulite ®2000).From multivariate logistic regression analysis, we found that WC, IL-6, and HOMA-IR increase the risk of BPH significantly with an odds ratio (OR) value of 1.09 (IK = 1.03-1.15), p = 0.005; 1.69 (IK = 1.10-2.58), p = 0.015; and 1.37 (IK = 1.05-1.79), p = 0.021, respectively. Path analysis showed the existence of a significant relationship between WC and BPH (critical ratio [CR] = 2.87, p = 0.004), between WC and IL-6 (CR = 5.9, p < 0.001), and between WC and HOMA-IR (CR = 3.87, p ≤ 0.001). There was a significant correlation between HOMA-IR and BPH (CR = 2.07, p = 0.039), between IL-6 and BPH (CR = 2.19, p = 0.029), and also an indirect relationship between WC and BPH through the increase of IL-6 and HOMA-IR.We concluded that WC increased the risk of BPH through the increase of IL-6 and HOMA-IR in abdominal obesity patient.

show abstract

2010 Update: Guidelines for the management of benign prostatic hyperplasia

Cited by 27 publications

References 53 publications

Assessment of photoselective vaporization of prostate skills during Urology Objective Structured Clinical Examinations (OSCE)

Assessment of photoselective vaporization of prostate skills during Urology Objective Structured Clinical Examinations (OSCE)

Benign Prostatic Hyperplasia: Clinicopathological Study of 138 Cases

Waist circumference increased risk of benign prostatic hyperplasia through an increase in the level of interleukin-6 and insulin resistance in abdominal obesity patients

Contact Info

Product

Resources

About