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Int. braz. j. urol ; 48(2): 328-335, March-Apr. 2022. tab
Article in English | LILACS | ID: biblio-1364937


ABSTRACT Objectives: To compare thulium laser enucleation of prostate (ThuLEP) versus laparoscopic trans-vesical simple prostatectomy (LSP) in the treatment of benign prostatic hyperplasia (BPH). Materials and Methods: Data of patients who underwent surgery for "large" BPH (>80mL) at three Institutions were collected and analyzed. Two institutions performed ThuLEP only; the third institution performed LSP only. Preoperative (indwelling catheter status, prostate volume (PVol), hemoglobin (Hb), Qmax, post-voiding residual volume (PVR), IPSS, QoL, IIEF-5) and perioperative data (operative time, enucleated adenoma, catheterization time, length of stay, Hb-drop, complications) were compared. Functional (Qmax, PVR, %ΔQmax) and patient-reported outcomes (IPSS, QoL, IIEF-5, %ΔIPSS, %ΔQoL) were compared at last follow-up. Results: 80 and 115 patients underwent LSP and ThuLEP, respectively. At baseline, median PVol was 130 versus 120mL, p <0.001; Qmax 9.6 vs. 7.1mL/s, p=0.005; IPSS 21 versus 25, p <0.001. Groups were comparable in terms of intraoperative complications (1 during LSP vs. 3 during ThuLEP) and transfusions (1 per group). Differences in terms of operative time (156 vs. 92 minutes, p <0.001), Hb-drop (-2.5 vs. −0.9g/dL, p <0.001), catheterization time (5 vs. 2 days, p <0.001) and postoperative complications (13.8% vs. 0, p <0.001) favored ThuLEP. At median follow-up of 40 months after LSP versus 30 after ThuLEP (p <0.001), Qmax improved by 226% vs. 205% (p=0.5), IPSS decreased by 88% versus 85% (p=0.9), QoL decreased by 80% with IIEF-5 remaining almost unmodified for both the approaches. Conclusions: Our analysis showed that LSP and ThuLEP are comparable in relieving from BPO and improving the patient-reported outcomes. Invasiveness of LSP is more significant.

Humans , Male , Prostatic Hyperplasia/surgery , Prostatic Hyperplasia/complications , Laparoscopy , Laser Therapy , Lasers, Solid-State/therapeutic use , Prostate/surgery , Prostatectomy , Quality of Life , Thulium/therapeutic use , Treatment Outcome
Int. braz. j. urol ; 48(1): 200-201, Jan.-Feb. 2022.
Article in English | LILACS | ID: biblio-1356299


ABSTRACT Purpose: The expansion of technology is leading to a paradigm shift in several urological fields (1, 2). In particular, the adoption of lasers within the surgical treatment of patients with benign prostatic hyperplasia (BPH) is considered one of the most relevant innovations (3-5). In this video, we aimed to report our experience with holmium laser for the ablation of the prostate (HoLAP) in patients with obstructive lower urinary tract symptoms (LUTS) due to BPH. Materials and Methods: From 2018 to 2020, 10 patients with obstructive LUTS secondary to BPH were treated at our Institution with HoLAP (120W Holmium laser Lumenis® with Moses® technology). Main inclusion criteria were: 1) International Prostate Symptom Score ≥12; 2) prostate volume ≤65mL, 3) maximal flow rate (Qmax) ≤15ml/s at preoperative non-invasive uroflowmetry. Results: Mean patient age was 65 (range: 59-72) years. Preoperative mean prostate volume was 50 (range: 35-65) mL. Mean operative time was 66 (range: 45-85) minutes with a mean laser time/operative time ratio of 0.51 (range: 0.44-0.60). Voiding symptoms, Qmax and post voiding residual were significantly improved after 3 and 12 months (all p <0.05). No postoperative urinary incontinence was detected. Conclusions: The present findings suggest that HoLAP is a slightly time-spending procedure, thus its use should be limited to prostate volume <70-80mL. However, no postoperative complications were recorded at all. This technique showed to be a safe option in patients with low-intermediate prostate volume, also in patients whose antiaggregant/anticoagulant therapy is maintained.

Humans , Male , Prostatic Hyperplasia/surgery , Transurethral Resection of Prostate , Laser Therapy , Lasers, Solid-State/therapeutic use , Prostate/surgery , Prostatectomy , Technology , Holmium
Rev. Assoc. Med. Bras. (1992) ; 68(1): 50-55, Jan. 2022. tab
Article in English | LILACS | ID: biblio-1360703


SUMMARY OBJECTIVE: We aimed to investigate the rate of urethral stricture development, predictor factors, and the reliability following bipolar transurethral resection of the prostate. METHODS: A total of 124 patients participated in this study. Patient data were retrospectively reviewed. The patients were divided into group 1 (those who developed urethral stricture) and group 2 (those who did not develop urethral stricture). Annual checkups were performed after the postoperative months 1 and 6. The patients were checked by uroflowmetry + post-voiding residue and international index of erectile function. We evaluated the complications that developed during the perioperative period according to the Clavien system. RESULTS: Urethral stricture developed in 10.5% (13/124) of the patients. It was found that patients who underwent transurethral resection of the prostate for the second time (p=0.007), patients with a preoperative catheter or history of catheter insertion (p=0.009), patients with high preoperative median white blood cell (103) counts (p=0.013), and patients with long postoperative catheterization time had a higher rate of urethral stricture after bipolar transurethral resection of the prostate (p=0.046). No grade 4 and grade 5 complications were observed according to the Clavien system in patients. CONCLUSION: Factors such as second transurethral resection of the prostate surgery, history of preoperative catheter insertion, high postoperative white blood cell count, and long postoperative catheterization time increase the risk of urethral stricture after bipolar transurethral resection of the prostate.

Humans , Male , Prostatic Hyperplasia/surgery , Prostatic Hyperplasia/complications , Urethral Stricture/surgery , Urethral Stricture/etiology , Transurethral Resection of Prostate/adverse effects , Reproducibility of Results , Retrospective Studies
Med. lab ; 26(1): 91-98, 2022. ilus, Grafs, Tabs
Article in Spanish | LILACS | ID: biblio-1370967


El antígeno específico de próstata (PSA, del inglés, Prostate Specific Antigen) es una glicoproteína producida por la próstata, y es el marcador tumoral de mayor uso. Sin embargo, su baja especificidad para diferenciar entre cáncer de próstata y otras alteraciones no malignas, como la hipertrofia benigna de la próstata (HBP) y la prostatitis aguda, limitan su utilidad diagnóstica

Prostate Specific Antigen (PSA) is a glycoprotein produced by the prostate and is the most widely used tumor marker. However, its low specificity to differentiate between prostate cancer and other non-malignant conditions, such as benign prostate hypertrophy (BPH) and acute prostatitis, limits its diagnostic utility

Prostate-Specific Antigen , Prostatic Hyperplasia , Prostatitis , Platelet Membrane Glycoproteins , Biomarkers, Tumor
Braz. J. Pharm. Sci. (Online) ; 58: e18785, 2022. graf
Article in English | LILACS | ID: biblio-1364421


We were carried out to investigate the efficacy of Rape (Rapeseed, Brassica napus L.) flower on BPH (benign prostatic hyperplasia) in rats. We found that the extract from Rape flower prevented hyperplasia in testosterone-induced BPH model, the relevant animal model of human BPH. Extract reduced the weight of prostate and induced significantly cell apoptosis in prostate in BPH model. In addition, the extract controlled expression of TGF-ß1 in prostate gland and promoted urinary output in dose-dependence in BPH model. Our data provide that Rape flower may be useful for treatment of BPH

Animals , Male , Rats , Prostatic Hyperplasia/pathology , Efficacy , Brassica napus/anatomy & histology , Flowers/classification , Testosterone , Plant Extracts/analysis , Models, Animal
Asian Journal of Andrology ; (6): 191-194, 2022.
Article in English | WPRIM | ID: wpr-928523


Benign prostatic hyperplasia (BPH) is a common disease in elderly men, and transurethral laser prostatectomy (TULP) has been widely used in the clinic to remove bladder outlet obstruction caused by BPH. Previous animal models for wound repair after prostatectomy have many limitations, and there have been no previous reports of a mouse model of TULP. Therefore, this study aimed to establish a novel mouse model of TULP. Twelve healthy adult Kunming (KM) mice received transurethral laser vaporization prostatectomy with a 200-μm thulium laser. The mice were sacrificed, and wound specimens from the prostatic urethra and bladder neck were harvested at 1 day, 3 days, 5 days, and 7 days after surgery. Hematoxylin-eosin (HE) and immunohistochemistry were applied to confirm the establishment of the mouse TULP model. One day after the surgery, urothelium expressing uroplakin (UPK) was absent in the urethral wound site, and a large number of necrotic tissues were found in the wound site. There was no UPK-positive urothelium in the wound 3 days after surgery. At 5 days after surgery, monolayer urothelium expressing UPK was found in the wound site, indicating that the re-epithelization of the wound had been completed. On the 7th day after surgery, there were multiple layers of urothelium with UPK expression, indicating that the repair was completed. It is feasible to establish a mouse TULP model by using a microcystoscope system and a 200-μm thulium laser.

Aged , Animals , Humans , Laser Therapy , Male , Mice , Prostatectomy , Prostatic Hyperplasia/surgery , Thulium , Transurethral Resection of Prostate
Article in Chinese | WPRIM | ID: wpr-927984


The present study investigated the material basis of Urtica fissa for the inhibition of benign prostatic hyperplasia(BPH). The active fractions were screened, and the extracts of dichloromethane and ethyl acetate exhibited significantly inhibitory activities against 5α-reductase in vitro and BPH in model rats. The chemical constituents in the active fractions were systematically investigated, and 28 compounds were obtained, which were identified as lobechine methyl ester(1), dibutyl-O-phthalate(2), 1-monolinolein(3), epipinoresinol(4), 5-hydroxy-3,4-dimethyl-5-pentanyl-2(5H)-furanone(5), E-7,9-diene-11-methenyl palmitic acid(6), evofolin B(7), ficusal(8), threo-2,3-bis-(4-hydroxy-3-methoxyphenyl)-3-ethoxypropan-1-ol(9), α-viniferin(10),(9R,7E)-9-hydroxy-5,7-mengatigmadien-4-one-9-O-β-D-glucopyranoside(11), indole-3-carboxaldehyde(12), p-hydroxy ethyl cinnamate(13), benzyl alcohol-O-β-D-glucoside(14), L-methionine(15), 4-methoxyaniline(16), 6-aminopurine(17), 8'-acetyl oilvil(18), 4-methoxyl-8'-acetyl oilvil(19), vanillic acid(20), β-hydroxypropiovanillone(21), 7-hydroxy-6-methoxycoumarin(22), p-hydroxybenzaldehyde(23), pinoresinol(24), erythro-1,2-bis-(4-hydroxy-3-methoxyphenyl)-1,3-propanediol(25), urticol(26), urticol-7-O-β-D-glucopyranoside(27), and lobechine(28). Compounds 1-17 were isolated from U. fissa for the first time. Meanwhile, compound 1 was a new natural product. Compounds 10, 11, 19, 21, and 27 exhibited significant inhibitory effects on 5α-reductase.

Animals , Plant Extracts/pharmacology , Prostatic Hyperplasia/drug therapy , Rats , Urticaceae/chemistry
Rev. cuba. med. mil ; 50(3): e1150, 2021. graf
Article in Spanish | LILACS, CUMED | ID: biblio-1357319


Introducción: Entre las lesiones malignas que se describen, se encuentra el cáncer de pene. Esta entidad constituye del 2 al 5 por ciento de los tumores urogenitales masculinos; la lesión metastásica es muy poco frecuente. Objetivos: Describir las características clínicas y evolución tórpida de un paciente con metástasis en el pene, de una neoplasia del colon. Caso clínico: Paciente de 54 años, antecedentes personales de salud, fumador, historia de hiperplasia prostática benigna y prostatitis crónica. Ingresa con dolor en hemiabdomen inferior y tumoración abdominal. Se diagnostica plastrón intraabdominal. Es intervenido quirúrgicamente; la biopsia de la lesión informa adenocarcinoma de colon. A los 7 días de evolución aparecen lesiones en el glande, que resultaron metástasis del adenocarcinoma de colon. Fallece por complicaciones de la enfermedad. Conclusiones: Las metástasis de las neoplasias del colon, en el pene, son infrecuentes; indican un estadio avanzado de la enfermedad, con un pronóstico desfavorable(AU)

Introduction: Among the malignant lesions described is penile cancer. This entity constitutes 2 percent to 5 percent of male urogenital tumors, and metastatic lesion is very rare. Objectives: To describe the clinical characteristics and torpid evolution of a patient with metastases in the penis from colon neoplasia. Clinical case: 54-year-old patient, personal health history. Smoker, history of benign prostatic hyperplasia and chronic prostatitis, which begins with pain in the lower abdomen and abdominal tumor, intra-abdominal plastron is diagnosed and is surgically intervened with a biopsy of the lesion that reports colon adenocarcinoma. At 7 days of evolution, lesions appeared on the glans that resulted in metastasis of colon adenocarcinoma. He dies from complications of the disease within six months. Conclusions: Colonic neoplasm metastases in the penis are infrequent, they indicate an advanced stage of the disease, with an unfavorable prognosis(AU)

Humans , Middle Aged , Penile Neoplasms , Prostatic Hyperplasia , Adenocarcinoma , Neoplasm Metastasis , Prognosis
Rev. cuba. med. mil ; 50(3): e1095, 2021. graf
Article in Spanish | LILACS, CUMED | ID: biblio-1357318


Introducción: El carcinoma hepatocelular es un tumor hipervascular compuesto por vasos sanguíneos anormales, constituye la forma más frecuente de cáncer primario del hígado. Alrededor del 90 por ciento de estos tumores se desarrollan sobre una enfermedad hepática previa. Un aumento en la carga vascular debido a la hipertensión portal conlleva a sangrado. Objetivo: Presentar un paciente a quien se le practicó laparotomía exploradora de urgencia por hemoperitoneo de gran cuantía secundario a una rotura intratumoral sobre un hígado cirrótico. Caso clínico: Paciente de 66 años de edad, con antecedentes patológicos de diabetes mellitus tipo 2, hiperplasia benigna de próstata, alcoholismo crónico y cirrosis hepática. Acudió al cuerpo de guardia por dolor abdominal difuso y signos de hipovolemia aguda. Se realizó laparotomía de urgencia y se constata hemoperitoneo de gran cuantía, secundario a una rotura intratumoral. Se le realizó aspiración de contenido hemático, electrocoagulación y compresión por empaquetamiento. Se controló el sangrado. El paciente tuvo una evolución tórpida y falleció 24 horas posteriores a la laparotomía. Conclusiones: El hemoperitoneo secundario a rotura de un carcinoma hepatocelular, es una complicación poco frecuente, pero fatal; por lo que se hace necesario su estudio para lograr un diagnóstico y tratamiento oportuno(AU)

Introduction: Hepatocellular carcinoma is a hypervascular tumor made up of abnormal blood vessels. It is the most frequent form of primary liver cancer. About 90 percent of these tumors develop over a previous liver disease. An increase in vascular load due to portal hypertension leads to bleeding. Objective: To present a patient who underwent emergency exploratory laparotomy due to large hemoperitoneum secondary to an intratumoral rupture of a cirrhotic liver. Clinical case: A 66-year-old male patient with a pathological history of type 2 diabetes mellitus, benign prostatic hyperplasia, chronic alcoholism and liver cirrhosis. He came to emergency due to diffuse abdominal pain, as well as signs of acute hypovolemia. An emergency laparotomy was performed, confirming a large hemoperitoneum secondary to an intratumoral rupture. Blood content aspiration, electrocoagulation and compression by packing were performed, managing to control bleeding. He had a torpid evolution, dying 24 hours after the laparotomy. Conclusions: Hemoperitoneum secondary to rupture of a hepatocellular carcinoma is a rare, but fatal complication; therefore, its study is necessary to achieve a timely diagnosis and treatment(AU)

Humans , Male , Aged , Prostatic Hyperplasia , Carcinoma, Hepatocellular , Hypovolemia , Hemoperitoneum , Liver Cirrhosis , Liver Neoplasms
Rev. Ciênc. Méd. Biol. (Impr.) ; 20(2): 235-239, set 29, 2021. tab, fig
Article in Portuguese | LILACS | ID: biblio-1354397


Introdução: no Brasil, o câncer de maior incidência nos homens é o câncer de próstata (CaP), com 6,9% de mortalidade. Atualmente, discute-se a aplicabilidade do antígeno prostático específico (PSA) em políticas de rastreamento para CaP e os riscos associados ao sobrediagnóstico. Objetivo: correlacionar a dosagem do PSA com fatores de risco, história clínica e a presença de neoplasia prostática. Metodologia: estudo descritivo transversal que analisou, comparativamente, dados clínico-epidemiológicos e níveis séricos de PSA de 200 pacientes. Valores de PSA foram estratificados em três categorias (<2,5, 2,5­10,0 e >10 ng/ml). Resultados: os fatores de risco analisados foram relacionados significativamente com o aumento do PSA e neoplasia prostática. A prevalência de CaP (11%) e hiperplasia prostática (61%) foi observada nos pacientes com maior dosagem de PSA, enquanto 1% dos pacientes apresentou CaP sem alteração do PSA e 4% tiveram CaP com 2,5­10,0 ng/ml de PSA. Maiores níveis séricos do biomarcador foram relacionados a diabetes (70%), hipertensão (77%), uso crônico de medicações (60%) e ausência de exames periódicos (58%). O grupo com PSA >10 ng/ml teve média de idade maior que o primeiro (p = 0,002) e o segundo grupos (p = 0,027). Conclusão: a prevalência de hiperplasia prostática benigna associada à alteração do PSA, e o elevado risco de exames falso-positivos evidenciam a preocupação com o sobrediagnóstico. No contexto dos dados clinico-epidemiológicos avaliados, a possibilidade de resultados falso-positivos e falso-negativos associados à dosagem do PSA deve ser considerada, ressaltando a importância de adoção de exames complementares para rastreio do CaP.

Introduction: in Brazil, the cancer with the highest incidence in men is prostate cancer (PCa), with 6.9% mortality. Currently, the applicability of prostate specific antigen (PSA) in screening policies for PCa and the risks associated with overdiagnosis are discussed. Objective: to correlate the PSA level with risk factors, clinical history and the presence of prostatic neoplasm. Methods: a cross-sectional descriptive study that analyzed, comparatively, clinical-epidemiological data and serum PSA levels of 200 patients. PSA values were stratified into three categories (<2.5, 2.5­10.0 and> 10 ng / ml). Results: the risk factors analyzed were significantly related to the increase in PSA and prostatic neoplasm. The prevalence of PCa (11%) and prostatic hyperplasia (61%) was observed in patients with higher levels of PSA, while 1% of patients had PCa without PSA changes and 4% had PCa with 2.5­10.0 ng/ml PSA. Increased serum levels of the biomarker were related to diabetes (70%), hypertension (77%), chronic use of medications (60%) and periodic exams (58%). The group with PSA> 10 ng/ml had a mean age greater than the first (p = 0.002) and the second group (p = 0.027). Conclusion: the prevalence of benign prostatic hyperplasia associated with PSA change and an increased risk of false-positive tests show a concern with overdiagnosis. In the context of clinical-epidemiological data, the possibility of false-positive and false-negative results associated with the PSA measurement have to be considered, highlighting the importance of complementary tests for PCa screening.

Humans , Male , Middle Aged , Aged , Prostatic Hyperplasia , Biomarkers , Risk Factors , Prostate-Specific Antigen , Prostatic Intraepithelial Neoplasia , Epidemiology, Descriptive , Cross-Sectional Studies , Blacks , Diabetes Mellitus , Drug Utilization
Int. braz. j. urol ; 47(4): 747-752, Jul.-Aug. 2021. tab
Article in English | LILACS | ID: biblio-1286764


ABSTRACT Purpose: To describe the otorhinolaryngological adverse effects of the main drugs used in urological practice. Materials and Methods: A review of the scientific literature was performed using a combination of specific descriptors (side effect, adverse effect, scopolamine, sildenafil, tadalafil, vardenafil, oxybutynin, tolterodine, spironolactone, furosemide, hydrochlorothiazide, doxazosin, alfuzosin, terazosin, prazosin, tamsulosin, desmopressin) contained in publications until April 2020. Manuscripts written in English, Portuguese, and Spanish were manually selected from the title and abstract. The main drugs used in Urology were divided into five groups to describe their possible adverse effects: alpha-blockers, anticholinergics, diuretics, hormones, and phosphodiesterase inhibitors. Results: The main drugs used in Urology may cause several otorhinolaryngological adverse effects. Dizziness was most common, but dry mouth, rhinitis, nasal congestion, epistaxis, hearing loss, tinnitus, and rhinorrhea were also reported and varies among drug classes. Conclusions: Most of the drugs used in urological practice have otorhinolaryngological adverse effects. Dizziness was most common, but dry mouth, rhinitis, nasal congestion, epistaxis, hearing loss, tinnitus, and rhinorrhea were also reported. Therefore, doctors must be aware of these adverse effects to improve adherence to the treatment and to minimize damage to the health of patients.

Humans , Male , Prostatic Hyperplasia , Pharmaceutical Preparations , Prazosin , Doxazosin , Adrenergic alpha-Agonists , Tadalafil , Tamsulosin
Int. braz. j. urol ; 47(3): 525-532, May-June 2021. tab, graf
Article in English | LILACS | ID: biblio-1154515


ABSTRACT Objectives: Develop and validate a new and simplified score for evaluating the lower urinary tract symptoms in men. Materials and methods: We modified the existing visual prostate symptom score, including changes in the images, sequence, and new alternatives, resulting in a new visual score (LUTS visual score-LUTS-V). For the validation of the new tool, we used the International Prostatic Symptom Score as the gold-standard and the new LUTS-V to 306 men. The total IPSS score and the total LUTS-V score of each subject were evaluated to determine the agreement between the two instruments. ROC curve was used to evaluate the diagnostic accuracy and best cut-off of LUTS-V. Sensitivity, specificity, and diagnostic odds ratios were used to describe the diagnostic properties. Results: The mean age of the participants was 59 [52-87] years. There was a significant correlation between LUTS-V and IPSS. (r=0.72 (p <0.0001). The Bland-Altman analyzes demonstrate good agreement between the two questionnaires (bias=5.6%). LUTS-V demonstrated excellent diagnostic accuracy in detecting the most serious cases with an area under the ROC curve of 83% [78-87%] 95% CI. p <0.001). LUTS-V >4 was the best threshold, with a sensitivity of 74% and specificity of 78%. Conclusions: LUTS-V is a simple, self-administered tool with a significant discriminatory power to identify subjects with moderate to severe LUTS and may represent a useful instrument for the diagnosis and follow-up of men with urinary symptoms.

Humans , Male , Aged , Aged, 80 and over , Prostatic Hyperplasia/diagnosis , Lower Urinary Tract Symptoms/diagnosis , Surveys and Questionnaires , ROC Curve , Middle Aged
Rev. bioét. (Impr.) ; 29(2): 394-400, abr.-jun. 2021. tab
Article in Portuguese | LILACS | ID: biblio-1340951


Resumo A hiperplasia prostática benigna é uma patologia cuja incidência vem crescendo muito nos últimos anos, em todo o Brasil. A doença está correlacionada a fatores hormonais, e o tratamento farmacológico pode gerar efeitos adversos nos pacientes. O objetivo deste estudo é avaliar fatores socioeconômicos e socioculturais que interferem na cura ou reduzem a qualidade de vida. Analisamos dados de plataformas do Governo Federal entre janeiro de 2009 a setembro de 2019, observando fatores como etnia, nível de escolaridade e situação econômica dos pacientes. Em todas as regiões do Brasil esses fatores se mostraram importantes, pois podem afetar diretamente a incidência da doença e a adesão e continuidade do tratamento.

Summary Benign prostatic hyperplasia is a pathology whose incidence has been increasing in recent years throughout Brazil. The disease is correlated with hormonal factors, and pharmacological treatment can have adverse effects on patients. This study assesses the socioeconomic and socio-cultural factors that interfere with healing or reduce quality of life. We analyzed data from Federal Government platforms between January 2009 and September 2019, looking at factors such as ethnicity, education level and economic status of patients. In all regions of Brazil, these factors proved to be important, as they can directly affect the incidence of the disease and adherence and continuity of treatment.

Resumen La hiperplasia prostática benigna es una patología cuya incidencia ha ido creciendo mucho en los últimos años, en todo Brasil. La enfermedad se correlaciona con factores hormonales, y el tratamiento farmacológico puede generar efectos adversos en los pacientes. El objetivo de este estudio es evaluar factores socioeconómicos y socioculturales que interfieren con la curación o reducen la calidad de vida. Analizamos datos de plataformas del Gobierno Federal entre enero de 2009 y septiembre de 2019, observando factores como el origen étnico, el nivel educativo y la situación económica de los pacientes. En todas las regiones de Brasil, estos factores demostraron ser importantes, ya que pueden afectar directamente la incidencia de la enfermedad y la adherencia y continuidad del tratamiento.

Humans , Male , Female , Prostatic Hyperplasia , Quality of Life , Socioeconomic Factors , Finasteride , Social Vulnerability , Dutasteride
Int. braz. j. urol ; 47(2): 308-321, Mar.-Apr. 2021. tab, graf
Article in English | LILACS | ID: biblio-1154449


ABSTRACT Introduction and objective: To evaluate changes in verumontanum anatomy in patients with benign prostatic hyperplasia (BPH) who used 5-alpha reductase inhibitors (5-ARIs) and to propose an anatomical classification of the verumontanum. Materials and Methods: We studied 86 patients with BPH and 7 patients without the disease (age under 40 years-old who underwent kidney or ureteral lithotripsy). Of the patients with BPH, 34 (mean age=67.26) had 5-ARIs use and 52 (mean age=62.69) did not use the drug. During surgeries, photographs of the seminal colliculus were taken and later, with the aid of software (Image J), the length (longitudinal diameter) and width (transverse diameter) of the verumontanum were measured in all patients. During the procedure, we evaluated the different types of verumontanum. For statistical analysis, the R-Project software was used. Results: In the group of patients with BPH who were taking medication (group 1), the mean measures of length and width of the verumontanum were 4.69mm and 2.94mm respectively. In the group of patients with BPH who did not use the drug (group 2), the mean diameters were 4.54mm and 3.20mm respectively. In the control group (group 3), the average length and width were 5.63mm and 4.11mm respectively. There was an increase in longitudinal and transverse measurements of the control group with an increase in body mass index (BMI) (p=0.0001 and p=0.035 respectively). In addition, there was a reduction in transverse diameter in the group of BPH using 5-ARI with increased prostate volume (p=0.010). We found five different verumontanum types: "volcano" (51.61%), "lighthouse" (24.73%), "whale tail" (12.90%), "hood" (5.38%) and "castle door" (5.38%), which we propose as an anatomical classification. Conclusion: Veromontanum has smaller measurements in patients with BPH regardless of treatment. In the control group, there was an increase in verumontanum diameters with an increase in BMI. The volcano type of verumontanum was the most frequent regardless of groups and BMI.

Humans , Male , Prostatic Hyperplasia/surgery , Prostatic Hyperplasia/drug therapy , Urethra , Endoscopy , 5-alpha Reductase Inhibitors
Rev. cuba. med. gen. integr ; 37(1): e1310, tab
Article in Spanish | LILACS, CUMED | ID: biblio-1280309


Introducción: La hiperplasia prostática benigna constituye un problema de primer nivel de atención de salud por su alta prevalencia en los hombres. Objetivo: Identificar la presencia de síntomas del tracto urinario inferior relacionados a la hiperplasia prostática benigna y su repercusión en la calidad de vida de hombres de 50 o más años de edad, sin diagnóstico previo de hiperplasia prostática benigna, que asistieron al centro de salud de la parroquia Javier Loyola. Métodos: Estudio descriptivo transversal entre noviembre del 2018 y enero 2019, que incluyó al total pacientes (106), que asistieron al centro de salud de la parroquia Javier Loyola y que aceptaron completar la Escala internacional de síntomas prostáticos. Los datos fueron analizados por medio de la estadística descriptiva y el test de χ2. Resultados: El 35,3 por ciento de investigados pertenecieron al grupo etario de 40 a 50 años, la presencia de síntomas del tracto urinario inferior leves (38,8 por ciento), moderados (39,7 por ciento) y severos (21,5 por ciento). Prevalecieron en porcentaje de participantes los desocupados (22,4 por ciento), los albañiles (23,3 por ciento), los hipertensos (26,7 por ciento), diabéticos (17,2 por ciento) y obesos (14,7 por ciento). La severidad de los síntomas del tracto urinario inferior no se asoció significativamente al tipo de ocupación. El 61,2 por ciento de pacientes presentaban síntomas del tracto urinario inferior moderados o severos y un 56,8 por ciento percibieron que su calidad de vida se veía afectada de alguna manera por los síntomas del tracto urinario inferior. Conclusiones: Preocupa el alto porcentaje de participantes con síntomas del tracto urinario inferior moderados/severos sin un diagnóstico previo de hiperplasia prostática benigna y con percepción de que su calidad de vida se ve afectada. La severidad de los síntomas del tracto urinario inferior incrementó con la edad y no a otros factores, excepto la ocupación(AU)

Introduction: Benign prostatic hyperplasia constitutes a first-level healthcare concern, due to its high prevalence among men. Objective: To identify the presence of lower urinary tract symptoms related to benign prostatic hyperplasia and its impact on the quality of life of men aged 50 years or older, without a previous diagnosis of benign prostatic hyperplasia, who attended the health center of Javier Loyola Parish. Methods: Cross-sectional descriptive study carried out between November 2018 and January 2019, which included all the patients (106) who attended the health center of Javier Loyola Parish and agreed to complete the International Prostate Symptom Scale. The data were analyzed using descriptive statistics and the chi-square test. Results: 35.3 percent of the participants belonged to the age group from 40 to 50 years. The presence was observed of mild (38.8 percent), moderate (39.7 percent) and severe (21.5 percent) lower urinary tract symptoms. There was a prevalence of unemployed (22.4 percent), bricklayers (23.3 percent), hypertensive (26.7 percent), diabetic (17.2 percent) and obese (14.7 percent) participants. The severity of the lower urinary tract symptoms was not significantly associated with the type of occupation. 61.2 percent of patients had mild or severe lower urinary tract symptoms and 56.8 percent perceived that their quality of life was affected, in some way, by lower urinary tract symptoms. Conclusions: There is concern about the high percentage of participants with mild or severe lower urinary tract symptoms, without a previous diagnosis of benign prostatic hyperplasia, and with some perception that their quality of life is affected is. The severity of lower urinary tract symptoms increased with age but not with other factors, except occupation(AU)

Humans , Male , Prostatic Hyperplasia/epidemiology , Quality of Life , Epidemiology, Descriptive , Cross-Sectional Studies
Int. braz. j. urol ; 47(1): 131-144, Jan.-Feb. 2021. tab, graf
Article in English | LILACS | ID: biblio-1134328


ABSTRACT Objective: To generate high-quality data comparing the clinical efficacy and safety profile between monopolar transurethral resection of the prostate (M-TURP) and bipolar plasmakinetic resection of the prostate (PK-TURP) for benign prostatic hyperplasia (BPH). Materials and Methods: Prospective, randomized, single-blinded study conducted in a tertiary-care public institution (Dec/2014-Aug/2016). Inclusion criteria: prostate of <80g in patients with drug-refractory lower urinary tract symptoms (LUTS), complications derived from BPH, or both. Exclusion criteria: a history of pelvic surgery/radiotherapy, neurogenic bladder dysfunction or documented/suspected prostate carcinoma. Treatment efficacy evaluated at 1, 3, 6 and 12 months. Efficacy outcomes: international prostate symptom score (IPSS), quality-of-life (QoL) score, international index of erectile function-5 (IIEF-5), maximum urinary flow rate (Qmax), postvoid residual urine (PVRU) volume, and prostate volume (PV). Complications and sequelae also assessed. Comparisons performed with parametric/non-parametric tests. Results: Out of the 100 hundred patients, 84 qualified for the analysis (45 M-TURP/39 PK-TURP). No significant differences found in baseline characteristics or operative data, except for a longer operative time in PK-TURP (MD:7.9min; 95%CI:0.13-15.74; p=0.04). No differences found in IPSS, Qmax or PVRU volume. QoL score at 12 months was higher in PK-TURP (MD:0,9points; 95%CI:0.18-1.64; p=0.01). No differences in sexual function, PV, complications or sequelae were found. This study is "rigorous" (Jadadscale) and has a low risk of bias (Cochrane-Handbook). Conclusions: Based on this controlled trial, there is not significant variation in effectiveness and safety between M-TURP and PK-TURP for the treatment of BPH. The small difference in QoL between PK-TURP and M-TURP at the one-year follow-up is not perceivable by the patients and, therefore, not clinically relevant.

Humans , Male , Prostatic Hyperplasia/surgery , Transurethral Resection of Prostate/adverse effects , Quality of Life , Prospective Studies , Treatment Outcome
Rev. argent. urol. (1990) ; 86(1): 19-22, 20210000. ^etab
Article in Spanish | LILACS, BINACIS, UNISALUD | ID: biblio-1140748


OBJETIVOS: evaluar la influencia de la modalidad de respuesta (paciente vs. asistido por urólogo) en el cuestionario IPSS (International Prostate Symptom Score) y su relación con la edad y nivel de educación. MATERIALES Y MÉTODOS: Análisis prospectivo de 74 pacientes que acudieron a la consulta de urología por síntomas de Hiperplasia Prostática Benigna (HPB) con o sin tratamiento para su patología y que no hayan completado anteriormente el cuestionario internacional de síntomas prostáticos (IPSS). Los cuestionarios fueron completados en la misma consulta urológica, primero por el paciente y luego con ayuda del urólogo. Se categorizó por edad y nivel de educación. Se evaluó la diferencia entre los puntajes de IPSS obtenidos con la forma autocompletada y con asistencia del urólogo y si esta diferencia estaba relacionada con la edad y con el nivel de educación. Los datos fueron analizados utilizando test no paramétrico para datos apareados de Wilcoxon. RESULTADOS: no se encontró diferencia estadísticamente significativa entre el cuestionario completado por el paciente y el asistido por el urólogo. La media del score total fue de 13,66, y 13,67, respectivamente (p: 0.86). Al analizar los subgrupos, con respecto a la edad y al nivel de educación, tampoco se encontraron diferencias estadísticamente significativas. CONCLUSIÓN: en nuestra población de estudio, el cuestionario IPSS no fue influenciado por la modalidad de administración, tampoco por la edad ni por el nivel de educación.

OBJECTIVES: to evaluate the influence of the response modality (patient vs. urologist-assisted) in the IPSS questionnaire (international prostate symptom score) and its relationship with age and education level. MATERIALS AND METHODS: Prospective analysis of 74 patients who came to the urology clinic for symptoms of Benign Prostatic Hyperplasia (BPH) with or without treatment for their pathology and who have not previously completed the international prostate symptoms questionnaire (IPSS). The questionnaires were completed in the same urological consultation, first by the patient and then with the help of the urologist. It was categorized by age and education level. The difference between the IPSS scores obtained with the self-completed form and with the assistance of the urologist and whether this difference was related to age and level of education was evaluated. The data were analyzed using non-parametric test for paired Wilcoxon data. RESULTS: no statistically significant difference was found between the questionnaire completed by the patient and the one assisted by the urologist. The average of the total score was 13.66, and 13.67, respectively (p: 0.86). When analyzing the subgroups, regarding age and level of education, no statistically significant differences were found. CONCLUSION: In our study population, the IPSS questionnaire was not influenced by the modality of administration, neither by age nor by level of education.

Humans , Male , Middle Aged , Aged , Aged, 80 and over , Prostatic Hyperplasia , Surveys and Questionnaires , Age Factors , Educational Status , Quality of Life , Prospective Studies