RESUMO
OBJECTIVE: To evaluate the outcome in patients undergoing photoselective vaporization of the prostate for benign prostatic obstruction as part of the Clinical Research Office of the Endourological Society Global GreenLight Laser Study. METHODS: Data were collected on 713 patients with lower urinary tract symptoms suggestive of benign prostatic obstruction undergoing photoselective vaporization of the prostate at 25 centers worldwide, between April 2010 and April 2012. Three types of GreenLight laser powers were used: 80 W, 120 W or 180 W. Intraoperative and postoperative complications were recorded. Outcome parameters measured at baseline, 6-12 weeks, 6 months and 12 months were: uroflow measurements, International Prostate Symptom Score; prostate-specific antigen and International Index of Erectile Function. RESULTS: Operating time was shortest with the 180-W laser at 53.8 min. Intraoperatively, bleeding occurred in 3.1% of patients. Statistically significant changes were reported in maximum flow rate, postvoid residual urine, International Prostate Symptom Score, quality of life score and prostate-specific antigen (P < 0.01) at each time-point assessed for the 80- and 120-W lasers as well as for the 180-W laser, with the exception of prostate-specific antigen at 6 months and 12 months. There were 14 Clavien-Dindo grade III-A complications and two grade III-B. The incontinence rate at 12 months was 6.3%, 4.5%, and 2.6% for the 80, 120 and 180 W lasers, respectively. The overall blood transfusion rate was 0.4%. CONCLUSIONS: Objective and subjective improvement after GreenLight laser treatment worldwide was significant at 1-year follow up. Morbidity and complications were low. Although not a randomized control study, the data can provide an indication of the outcome of the different GreenLight laser powers.
Assuntos
Terapia a Laser/métodos , Sintomas do Trato Urinário Inferior/fisiopatologia , Hiperplasia Prostática/cirurgia , Idoso , Perda Sanguínea Cirúrgica , Transfusão de Sangue , Cor , Disfunção Erétil/etiologia , Humanos , Terapia a Laser/efeitos adversos , Sintomas do Trato Urinário Inferior/etiologia , Masculino , Pessoa de Meia-Idade , Duração da Cirurgia , Antígeno Prostático Específico/sangue , Prostatectomia/efeitos adversos , Prostatectomia/métodos , Hiperplasia Prostática/complicações , Qualidade de Vida , Índice de Gravidade de Doença , Avaliação de Sintomas , Incontinência Urinária/etiologia , UrodinâmicaRESUMO
Se revisa la experiencia de los autores con la vasovasoanastomosis por la técnica macroquirúrgica modificada de la original del doctor Zhu Xie-Yang. Se traton 10 pacientes, y en todos se corroboró la presencia de espermatozoides en la espermatobioscopia postoperatoria. En dos pacientes se logró embarazo de la pareja. Las complicaciones fueron hematoma escrotal discreto en un paciente y dolor postoperatorio moderado en otro
Assuntos
Humanos , Masculino , Adulto , Pessoa de Meia-Idade , Avaliação de Processos e Resultados em Cuidados de Saúde , Planejamento Familiar , Procedimentos Cirúrgicos Operatórios , Vasovasostomia , Vasovasostomia/tendênciasRESUMO
Se presenta un caso de curvatura ventral del pene diagnosticado y tratado quirúrgicamente. Se discuten sus características clínicas y diagnósticas, en especial los resultados terapéuticos logrados mediante la técnica de Nesbit modificada por Gittes y Sislow. Se corroboran una vez más los beneficios de una técnica segura y sencilla de realizar, que desde su descripción en 1965 sigue siendo una buena alternativa, la cual se he mejorado con la hidrodistensión y la medición de los cuerpos cavernosos, lo cual permitió obtener mejores resultados en el tratamiento de esta enfermedad