Intraurethral prostate injections with mepivacaine epinephrine: Effects on patient comfort, treatment time and energy consumption during high-energy transurethral microwave thermotherapy

Knutson, Tomas; Johansson, Annika; Damber, Jan‐Erik; Fall, Magnus; Veselý, Štěpán; Peeker, Ralph

doi:10.1080/00365590903092889

Cited by 8 publications

(2 citation statements)

References 15 publications

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“…It is reasonable to assume that a larger prostate needs more energy delivered in order to achieve the same percentage of volume reduction, compared to a smaller prostate. In the study by Knutson et al the addition of MA when using PLFT/ CoreTherm also confirmed reduced treatment time and energy delivery [14].…”

Section: Discussionmentioning

confidence: 80%

Prostate volume and age are predictors of energy delivery using the CoreTherm Concept in patients with LUTS/BPO: a study on thermal dose

Stenmark

Brudin

Kjölhede

et al. 2020

Scandinavian Journal of Urology

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Objective: The primary aim of this study was to evaluate the scientific evidence supporting the use of thermal dose as a secondary (or an alternative) endpoint when using the CoreTherm Concept. Material and methods: Baseline and treatment data from 283 consecutive treatments were evaluated. All patients had lower urinary tract symptoms (LUTS) caused by benign prostatic hyperplasia (BPH). After evaluation, benign prostatic enlargement (BPE) with benign prostatic obstruction (BPO) was evident. As treatment, the CoreTherm Concept was used in all patients with LUTS/BPO. Data parameters were retrospectively extracted and included patient age, prostate volume, energy delivery, treatment time and calculated cell kill. In addition, assessment of temperature curves and calculated intraprostatic blood flow was made to define an optimal treatment. In total, 199 treatments assessed as optimal were included in the study. Results: There was a significant correlation between pretreatment prostate volume and energy delivery (p < .001). Age also influenced energy consumption significantly (p ¼ .01). Conclusion:The solid correlation between pretreatment prostate volume and age versus total energy deposition implies the recommendation that a pretreatment calculation of an appropriate energy deposition should be used in all treatments as an alternative treatment endpoint.

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Section: Discussionmentioning

confidence: 80%

Prostate volume and age are predictors of energy delivery using the CoreTherm Concept in patients with LUTS/BPO: a study on thermal dose

Stenmark

Brudin

Kjölhede

et al. 2020

Scandinavian Journal of Urology

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“…Reducing intraprostatic blood flow during surgical procedures has been addressed previously. For example, intraprostatic injections of mepivacaine and adrenaline (MA) immediately prior to transurethral microwave thermotherapy (TUMT) have been shown to significantly decrease blood flow during treatment, considerably shortening treatment time as well as energy consumption [11][12][13][14].…”

Section: Introductionmentioning

confidence: 99%

A randomised study of TURP after intraprostatic injection of mepicacaine/adrenaline versus regular TURP in patients with LUTS/BPO

Stenmark,

Brundin,

Gunnarsson

et al. 2023

SJU

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Introduction: During transurethral resection of the prostate (TURP), the most established surgical treatment of lower urinary tract symptoms (LUTS) due to benign prostatic obstruction (BPO), the prostate can bleed profusely, bringing about anaemia and compromised oxygen delivery to the entire body.Objective: The primary objective of this study was to assess the efficacy of mepivacaine and adrenaline (MA) injected into the prostate on bleeding. The primary endpoint was to measure blood loss per resected weight of prostate tissue.Material and methods: This randomised controlled trial evaluated 81 patients with LUTS/BPO. Patients were randomly allocated to regular TURP or TURP with intraprostatic injections of MA.Results: On univariable analyses there was a significant difference in resection weight in favour of the experimental group, not reflected by a statistically significant difference in the other studied outcome parameters. Nevertheless, in multivariable analyses, blood loss per resection weight, which was the primary outcome, showed a significant decrease in favour of the experimental group. Clavien–Dindo complication classification showed three men with a grade I complication and two men with grade II.Conclusions: The results obtained in this study showed that it is beneficial to apply intraprostatic injections of MA in immediate conjunction with TURP, in terms of blood loss per resected gram. The study is, however, small and corroboration of our results in more extensive prospective studies may therefore be warranted before embarking upon this technique.

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Microwave Therapy

Gravas¹

2012

Smith's Textbook of Endourology

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Intraurethral prostate injections with mepivacaine epinephrine: Effects on patient comfort, treatment time and energy consumption during high-energy transurethral microwave thermotherapy

Cited by 8 publications

References 15 publications

Prostate volume and age are predictors of energy delivery using the CoreTherm Concept in patients with LUTS/BPO: a study on thermal dose

Prostate volume and age are predictors of energy delivery using the CoreTherm Concept in patients with LUTS/BPO: a study on thermal dose

A randomised study of TURP after intraprostatic injection of mepicacaine/adrenaline versus regular TURP in patients with LUTS/BPO

Microwave Therapy

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