Objectives:To compare the depth of thermal necrosis after use of bipolar resection and vaporization technique comparing intra-individually bipolar loop and bipolar button electrodes.Methods:Transurethral resection and...Objectives:To compare the depth of thermal necrosis after use of bipolar resection and vaporization technique comparing intra-individually bipolar loop and bipolar button electrodes.Methods:Transurethral resection and vaporization of the prostate was performed in 55 male patients(260 specimens in total).In a standardized procedure,a bipolar resection loop was used for resection,and a bipolar button electrode was used for vaporization.Both electrodes were applied in each patient,either in the left or in the right lateral lobe.The depth of necrotic zones in the resected or vaporized tissue of each patient was measured in a standardized way by light microscopy.Results:The mean depth with standard deviation of thermal injury caused by the loop electrode was 0.0495±0.0274 mm.The vaporization electrode caused a mean thermal depth with standard deviation of 0.0477±0.0276 mm.The mean difference of necrosis zone depths between the two types of electrodes(PlasmaButtoneresection loop)was 0.0018 mm(p=0.691).Conclusion:For the first time,we present directly measured values of the absolute necrosis zone depth after application of plasma in the transurethral treatment of benign prostatic hyperplasia.The measured values were lower than in all other transurethral procedures.Standardized procedures of measurement and evaluation allow a statistically significant statement that the low necrosis depth in bipolar procedures is independent of the applied electrodes.展开更多
BACKGROUND Rezūm™water vapor therapy is a new minimally invasive endoscopic technology for the management and treatment of benign prostatic hyperplasia.CASE SUMMARY A 63-year-old male presented to our department with...BACKGROUND Rezūm™water vapor therapy is a new minimally invasive endoscopic technology for the management and treatment of benign prostatic hyperplasia.CASE SUMMARY A 63-year-old male presented to our department with severe dysuria,frequency,urgency,and interrupted stream 2 mo after receiving Rezūm™therapy.The symptoms were caused by a retained floating emphysematous necrotic sloughed tissue.We also discovered a persistent bacterial infection that was resistant to parenteral antimicrobial therapy.The treatment of the patient included surgical removal of the necrotic tissue.CONCLUSION Despite the good safety profile and minimal adverse events related to Rezūm™therapy,major complications can still occur.展开更多
Background Transurethral resection of prostate （TURP） has been considered as the standard treatment for benign prostatic hyperplasia （BPH）. However, issues that have not yet been overcome for TURP include bleeding...Background Transurethral resection of prostate （TURP） has been considered as the standard treatment for benign prostatic hyperplasia （BPH）. However, issues that have not yet been overcome for TURP include bleeding and absorption of irrigation fluid. Thus, novel improvement of the surgery is necessary. This study aimed to evaluate the efficacy and safety of bipolar plasma vaporization of the prostate （BPVP） with ＂button-type＂ electrode against standard TURP for BPH.展开更多
Background Transurethral resection of prostate （TURP） has been widely used as a golden standard therapy of benign prostatic hyperplasia for over 40 years. However, not all patients achieved favorable outcome postop...Background Transurethral resection of prostate （TURP） has been widely used as a golden standard therapy of benign prostatic hyperplasia for over 40 years. However, not all patients achieved favorable outcome postoperatively. Since the level of bladder outlet obstruction and the dysfunction of detrusor （overactive and underactive） were both found to affect surgical efficacy, urodynamics was recommended as routine preoperative examination in selecting proper surgical candidates by International Continence Society in spite of its invasiveness and high cost. The aim of this research was to compare the predictive value between ultrasonography and urodynamics for TURP efficacy and determine if preoperative urodynamic test could be replaced by ultrasonography.Methods Two hundred and seventy-one patients took part in the retrospective analysis. All the subjects had preoperative evaluation of symptoms, life quality, and combined examination of ultrasonography and urodynamics. Surgical efficacy was measured according to the recovery of international prostate symptom score, quality of life score, and maximal flow rate 6 months after TURP. Fisher’s linear discriminant analysis was applied to establish the predictive models of surgical efficacy by choosing parameters from ultrasonography or urodynamics as independent factors. Receiver’s operating characteristic curve was then plotted to compare the values between the models.Results Sensitivity, specificity, positive and negative predictive value of models consisting of parameters from both ultrasonography and urodynamics were favorable. Corresponding models of ultrasonography and urodynamics were found to have non-significant difference in area under curve （P〉0.05）.Conclusions Preoperative ultrasonography has as strong value as urodynamics does in predicting surgical outcome of patients undergone TURP and might take the place of urodynamics in selecting surgical candidates. Further prospective analysis with larger popularity and longer period of follow up should be launched to verify the result of this research.展开更多
In the past 2 decades,endoscopic enucleation of the prostate has become a safe and effective surgical treatment for benign prostatic hyperplasia(BPH),with comparable outcomes to traditional surgeries.Transurethral vap...In the past 2 decades,endoscopic enucleation of the prostate has become a safe and effective surgical treatment for benign prostatic hyperplasia(BPH),with comparable outcomes to traditional surgeries.Transurethral vapor enucleation and resection of the prostate(TVERP),transurethral vapor enucleation of the prostate(TVEP),and ultrasound-navigated TVEP(US-TVEP)are new,innovative endoscopic enucleation procedures.These procedures are named Xie’s Prostate Enucleations(Xie’s Procedures for short).Current clinical data indicate that Xie’s Procedures are safe and effective treatment options for patients with BPH,especially for patients with larger prostates.Further prospective,randomized clinical trials compared with traditional transurethral resection of prostate(TURP)are still needed.展开更多
目的:探讨经尿道前列腺等离子双极电切术(TUPKP)与经尿道前列腺电切术(transurethral resection of the prostate,TURP)治疗良性前列腺增生(BPH)的疗效。方法:选取2021年1月—2022年1月麻城市人民医院就诊的230例BPH患者作为研究对象,...目的:探讨经尿道前列腺等离子双极电切术(TUPKP)与经尿道前列腺电切术(transurethral resection of the prostate,TURP)治疗良性前列腺增生(BPH)的疗效。方法:选取2021年1月—2022年1月麻城市人民医院就诊的230例BPH患者作为研究对象,按照不同手术方法将其分为TURP组(n=120)与TUPKP组(n=110);TURP组采用TURP治疗,TUPKP组采用TUPKP治疗。对比两组临床指标、远期疗效指标[国际前列腺症状评分(IPSS)、生活质量评分(QOL)、最大尿流量(Qmax)、残余尿量(PVR)]及两组术后并发症发生情况。结果:TUPKP组手术时间、置管时间及住院时间均短于TURP组(P<0.05),术中出血量小于TURP组(P<0.05),TUPKP组切除腺体重量大于TURP组(P<0.05)。术前,两组IPSS、Qmax、PVR及QOL比较差异均无统计学意义(P>0.05);术后3个月,两组IPSS、PVR及QOL均降低(P<0.05),且TUPKP组均低于TURP组(P<0.05),两组Qmax高于术前,且TUPKP组大于TURP组(P<0.05)。TUPKP组并发症发生率低于TURP组(P<0.05)。结论:与TURP相比,TUPKP手术创伤小,术中出血量少,可显著缩短手术时间、住院时间,且可有效改善前列腺症状,降低残余尿量,提升生活质量,术后并发症少。展开更多
文摘Objectives:To compare the depth of thermal necrosis after use of bipolar resection and vaporization technique comparing intra-individually bipolar loop and bipolar button electrodes.Methods:Transurethral resection and vaporization of the prostate was performed in 55 male patients(260 specimens in total).In a standardized procedure,a bipolar resection loop was used for resection,and a bipolar button electrode was used for vaporization.Both electrodes were applied in each patient,either in the left or in the right lateral lobe.The depth of necrotic zones in the resected or vaporized tissue of each patient was measured in a standardized way by light microscopy.Results:The mean depth with standard deviation of thermal injury caused by the loop electrode was 0.0495±0.0274 mm.The vaporization electrode caused a mean thermal depth with standard deviation of 0.0477±0.0276 mm.The mean difference of necrosis zone depths between the two types of electrodes(PlasmaButtoneresection loop)was 0.0018 mm(p=0.691).Conclusion:For the first time,we present directly measured values of the absolute necrosis zone depth after application of plasma in the transurethral treatment of benign prostatic hyperplasia.The measured values were lower than in all other transurethral procedures.Standardized procedures of measurement and evaluation allow a statistically significant statement that the low necrosis depth in bipolar procedures is independent of the applied electrodes.
文摘BACKGROUND Rezūm™water vapor therapy is a new minimally invasive endoscopic technology for the management and treatment of benign prostatic hyperplasia.CASE SUMMARY A 63-year-old male presented to our department with severe dysuria,frequency,urgency,and interrupted stream 2 mo after receiving Rezūm™therapy.The symptoms were caused by a retained floating emphysematous necrotic sloughed tissue.We also discovered a persistent bacterial infection that was resistant to parenteral antimicrobial therapy.The treatment of the patient included surgical removal of the necrotic tissue.CONCLUSION Despite the good safety profile and minimal adverse events related to Rezūm™therapy,major complications can still occur.
文摘Background Transurethral resection of prostate （TURP） has been considered as the standard treatment for benign prostatic hyperplasia （BPH）. However, issues that have not yet been overcome for TURP include bleeding and absorption of irrigation fluid. Thus, novel improvement of the surgery is necessary. This study aimed to evaluate the efficacy and safety of bipolar plasma vaporization of the prostate （BPVP） with ＂button-type＂ electrode against standard TURP for BPH.
基金The study was supported by grants from the Science and Technology Commission of Shanghai （No. 09411950100） and the National Natural Science Foundation of China （No. 81070600）.
文摘Background Transurethral resection of prostate （TURP） has been widely used as a golden standard therapy of benign prostatic hyperplasia for over 40 years. However, not all patients achieved favorable outcome postoperatively. Since the level of bladder outlet obstruction and the dysfunction of detrusor （overactive and underactive） were both found to affect surgical efficacy, urodynamics was recommended as routine preoperative examination in selecting proper surgical candidates by International Continence Society in spite of its invasiveness and high cost. The aim of this research was to compare the predictive value between ultrasonography and urodynamics for TURP efficacy and determine if preoperative urodynamic test could be replaced by ultrasonography.Methods Two hundred and seventy-one patients took part in the retrospective analysis. All the subjects had preoperative evaluation of symptoms, life quality, and combined examination of ultrasonography and urodynamics. Surgical efficacy was measured according to the recovery of international prostate symptom score, quality of life score, and maximal flow rate 6 months after TURP. Fisher’s linear discriminant analysis was applied to establish the predictive models of surgical efficacy by choosing parameters from ultrasonography or urodynamics as independent factors. Receiver’s operating characteristic curve was then plotted to compare the values between the models.Results Sensitivity, specificity, positive and negative predictive value of models consisting of parameters from both ultrasonography and urodynamics were favorable. Corresponding models of ultrasonography and urodynamics were found to have non-significant difference in area under curve （P〉0.05）.Conclusions Preoperative ultrasonography has as strong value as urodynamics does in predicting surgical outcome of patients undergone TURP and might take the place of urodynamics in selecting surgical candidates. Further prospective analysis with larger popularity and longer period of follow up should be launched to verify the result of this research.
文摘In the past 2 decades,endoscopic enucleation of the prostate has become a safe and effective surgical treatment for benign prostatic hyperplasia(BPH),with comparable outcomes to traditional surgeries.Transurethral vapor enucleation and resection of the prostate(TVERP),transurethral vapor enucleation of the prostate(TVEP),and ultrasound-navigated TVEP(US-TVEP)are new,innovative endoscopic enucleation procedures.These procedures are named Xie’s Prostate Enucleations(Xie’s Procedures for short).Current clinical data indicate that Xie’s Procedures are safe and effective treatment options for patients with BPH,especially for patients with larger prostates.Further prospective,randomized clinical trials compared with traditional transurethral resection of prostate(TURP)are still needed.
文摘目的:探讨经尿道前列腺等离子双极电切术(TUPKP)与经尿道前列腺电切术(transurethral resection of the prostate,TURP)治疗良性前列腺增生(BPH)的疗效。方法:选取2021年1月—2022年1月麻城市人民医院就诊的230例BPH患者作为研究对象,按照不同手术方法将其分为TURP组(n=120)与TUPKP组(n=110);TURP组采用TURP治疗,TUPKP组采用TUPKP治疗。对比两组临床指标、远期疗效指标[国际前列腺症状评分(IPSS)、生活质量评分(QOL)、最大尿流量(Qmax)、残余尿量(PVR)]及两组术后并发症发生情况。结果:TUPKP组手术时间、置管时间及住院时间均短于TURP组(P<0.05),术中出血量小于TURP组(P<0.05),TUPKP组切除腺体重量大于TURP组(P<0.05)。术前,两组IPSS、Qmax、PVR及QOL比较差异均无统计学意义(P>0.05);术后3个月,两组IPSS、PVR及QOL均降低(P<0.05),且TUPKP组均低于TURP组(P<0.05),两组Qmax高于术前,且TUPKP组大于TURP组(P<0.05)。TUPKP组并发症发生率低于TURP组(P<0.05)。结论:与TURP相比,TUPKP手术创伤小,术中出血量少,可显著缩短手术时间、住院时间,且可有效改善前列腺症状,降低残余尿量,提升生活质量,术后并发症少。
