A case of successful plasma transurethral enucleationof benign prostatic hyperplasia the size of 530 cm3

Sevryukov, F A; Nakagawa, K; Кочкин, А Д; Volodin, Mark Albertovich; Семенычев, Д В

doi:10.18565/urology.2019.2.59-63

Cited by 13 publications

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“…В сравнительных исследованиях доказано, что применение эндоскопических трансуретральных пособий при ДГП вместо открытых операций с различным доступом и даже при их эндовидеохирургическом сопровождении, имеет ряд преимуществ: меньшая кровопотеря, длительность катетеризации мочевого пузыря (МП) и госпитализации, минимальное количество послеоперационных тромбогеморрагических и инфекционных осложнений [5][6][7][8][9]. Важным достижением названных хирургических методов также следует считать возможность применения у пациентов с тромбогеморрагическим риском, выполнения симультанных операций без значимого увеличения операционного времени и отсутствие ограничений по размеру ДГП, вплоть до гигантских ее размеров (свыше 250 см3) [10,11].…”

Section: Introductionunclassified

Modern Methods of Endoscopic Enucleation of Benign Prostatic Hyperplasia and Prospects for Their Modification

Bolgov

Sevryukov

Zhezdrin

et al. 2021

jour

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The disadvantage of bipolar and holmium enucleation in transurethral surgery of benign prostatic hyperplasia (BPH) is the frequent postoperative urination disorders. To increase the effectiveness of surgical treatment, a modification of the surgical technique is necessary.Objective: to compare the perioperative results of endosurgical treatment of large sized BPH using transurethral bipolar (TUEB), laser (HoLEP) and modified laser prostate enucleation (HoLEP-M) methods. Patients and methods: A randomized prospective study was conducted according to the results of surgical treatment of 1104 patients with BPH with a volume of 80 to 350 cm3, divided by methods of endoscopic enucleation of the prostate. A mod-ification of the HoLEP technique was to optimize access to the surgical site with the designation of new anatomical landmarks.Results: Comparison of surgical methods showed their equivalence in the volume of removed tissue, the low frequency of hemorrhagic and infectious complications, the dynamics of urological indicators in the delayed period. TUEB has the least parameters for the time of surgical intervention (98.2 ± 2.24 min.), the vol-ume of blood loss (65.5 ± 1.83 ml), the terms of postoperative catheterization of the bladder (2.0 ± 0.32 days), and the days of hospitalization (3.2 ± 0.40 days). The safety of laser methods is higher than TUEB, during which 3.1% of closed perforations of the prostatic capsule and bladder were observed (versus 0.8-1.5% with laser methods). Modification of the HoLEP technique allows reducing the frequency of late dysuric disorders by 2-3 times, urinary incontinence by 3.4-4 times, cicatricial complications by 1.7-2 times.Conclusion: Bipolar and laser methods of transurethral enucleation of the prostate of large sizes are comparable by criteria of complete removal of prostatic tissue, effectiveness and tolerability in patients with thrombohemorrhagic risk. In terms of the frequency of intraoperative injuries, the safety of laser methods is higher due to the reduced penetrating ability of laser energy. Modification of surgical access to the prostate preserves the prostatic urethra as much as possible and is a promising measure for the prevention of late obstructive and functional complications of transurethral interventions.

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Section: Introductionunclassified

Modern Methods of Endoscopic Enucleation of Benign Prostatic Hyperplasia and Prospects for Their Modification

Bolgov

Sevryukov

Zhezdrin

et al. 2021

jour

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“…GPH has been described in several individual patients as case reports in a review of international scientific literature [1][2][3][4][5][6][7][8][9][14][15][16][17][18][19]. Individual cases of patients with severe LUTS from GPH whom underwent treatment with surgery or minimally invasive ablative urological treatment have also been reported [20][21][22][23][24][25][26]. However the safety and long-term efficacy of PAE for treatment of large cohorts of patients with severe LUTS from GPH has not been examined.…”

Section: Introductionmentioning

confidence: 99%

Prostate artery embolization has long term efficacy for treatment of severe lower urinary tract symptoms from giant prostatic hyperplasia

et al. 2020

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Background Patients with severe lower urinary tract symptoms (LUTS) from giant prostatic hyperplasia (GPH): prostate volume greater than 200 mL that do not respond to medical therapy may not be eligible for surgical treatments due to morbidities, technical challenges, and patient preference. This retrospective investigation examined the long-term efficacy and safety of prostatic arterial embolization (PAE) as a treatment option for severe LUTS due to GPH in a large patient cohort. Methods Of 529 patients who underwent PAE between January 2016 and January 2020, 72 patients had severe LUTS from GPH and were retrospectively evaluated. PAE was performed with two embolic agents in sequence: 100–250 μm particles followed by 2 mm and 3 mm coils. Clinical assessment was performed with international prostate symptoms score (IPSS), quality of life (QoL), peak flow rate (Qmax), post-void residual volume (PVR), and prostate specific antigen (PSA) measurements before and 12 months and 24 months after PAE. Prostate volume (PV) was measured by multiparametric magnetic resonance (MR) imaging before and 12 months and 24 months after PAE. Results Patients with severe LUTS from GPH experienced significant clinical improvements in IPSS, QoL, Qmax, PVR, PSA, and PV at 12 months and 24 months after PAE. Mean IPSS decreased from 26.5 to 18.0 (P < 0.01) to 10.5 (P < 0.01). Mean QoL decreased from 6.0 to 4.0 (P < 0.01) to 2.0 (P < 0.01). Mean Qmax increased from 8.0 to 14 mL/s (P < 0.01) to 18 mL/s (P < 0.01). Mean PVR decreased from 198.0 to 152.0 mL (P < 0.01) to 90 mL (P < 0.01). Mean PV decreased from 303.0 mL to 258.0 mL (P < 0.01) to 209.0 mL (P < 0.01). Mean PSA decreased from 11.2 ng/mL to 9.5 ng/mL (P < 0.05) to 7.9 ng/mL (P < 0.05). No major complications occurred. Conclusions PAE is a safe treatment with long term efficacy for severe LUTS from GPH. PAE may be a viable therapeutic option for patients with severe LUTS from GPH whom fail medical therapy and are not candidates for surgical treatments.

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“…GPH, which is defined as prostate volume larger than 200 mL, has been described in several individual patients as case reports in a review of international scientific literature (14)(15)(16)(17)(18)(19). Individual cases of patients with severe LUTS from GPH whom underwent treatment with surgery or minimally invasive ablative urological treatment have also been reported (20)(21)(22)(23)(24)(25)(26). However the safety and long-term efficacy of PAE for treatment of large cohorts of patients with severe LUTS from GPH has not been examined.…”

Section: Introductionmentioning

confidence: 99%

Prostate artery embolization has long term efficacy for treatment of severe lower urinary tract symptoms from giant prostatic hyperplasia

Somwaru¹,

Metting

Flisnik

et al. 2020

Preprint

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Background Patients with severe lower urinary tract symptoms (LUTS) from giant prostatic hyperplasia (GPH): prostate volume larger than 200 mL that do not respond to medical therapy may not be eligible for surgical treatments due to morbidities, technical challenges, and patient preference. This retrospective study examined the safety and long-term efficacy of prostatic arterial embolization (PAE) as a treatment option for severe LUTS due to GPH in a large cohort of patients. Methods 72 patients with GPH and severe LUTS who underwent PAE were retrospectively evaluated. PAE was performed bilaterally with two embolic agents in sequence: 100 µm to 250 µm embolic particles followed by 2 mm and 3 mm coils. Clinical assessment was performed by collecting international prostate symptoms score (IPSS), quality of life (QoL), and post-void residual volume (PVR) before PAE and 12 months and 24 months after PAE. Prostate volume (PV) was measured by multiparametric magnetic resonance (MR) imaging before PAE and 12 months and 24 months after PAE. Results Patients with severe LUTS from GPH experienced significant clinical improvements in IPSS, QoL, PVR, and PV at 12 months and 24 months after PAE. Mean IPSS decreased from 26.5 to 18.0 (P < .0.01) at 12 months and to 10.5 (P < .0.01) at 24 months. Mean QoL decreased from 6.0 to 4.0 (P < 0.01) at 12 months and to 2.0 (P < 0.01) at 24 months. Mean PVR decreased from 198.0 mL to 152.0 mL (P < 0.01) at 12 months and to 90 mL (P < 0.01) at 24 months. Mean PV decreased from 303.0 mL to 258.0 mL (P < 0.01) at 12 months and to 209.0 mL (P < 0.01) at 24 months. There were no major complications. Conclusions PAE is a safe treatment option with long term efficacy in patients with severe LUTS due to GPH. PAE may be a viable therapeutic option for patients with severe LUTS from GPH whom fail medical therapy and are not candidates for surgical treatments.

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A case of successful plasma transurethral enucleationof benign prostatic hyperplasia the size of 530 cm3

Cited by 13 publications

References 0 publications

Modern Methods of Endoscopic Enucleation of Benign Prostatic Hyperplasia and Prospects for Their Modification

Modern Methods of Endoscopic Enucleation of Benign Prostatic Hyperplasia and Prospects for Their Modification

Prostate artery embolization has long term efficacy for treatment of severe lower urinary tract symptoms from giant prostatic hyperplasia

Prostate artery embolization has long term efficacy for treatment of severe lower urinary tract symptoms from giant prostatic hyperplasia

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