Comparison between thulium laser resection of prostate and transurethral plasmakinetic resection of prostate or transurethral resection of prostate.

Benign prostatic hyperplasia (BPH) is one of the most common diseases in middle-aged and elderly men. In the present study, we aimed to compare the efficacy and safety of thulium laser resection of the prostate (TMLRP) with either transurethral plasmakinetic resection of the prostate (TUPKP) or transurethral resection of the prostate (TURP). A literature search was performed, eventually, 14 studies involving 1587 patients were included. Forest plots were produced by using Revman 5.2.0 software. Our meta-analysis showed that operation time, decrease in hemoglobin level, length of hospital stay, catheterization time, and development of urethral stricture significantly differed, whereas the transitory urge incontinence rate, urinary tract infection rate, and recatheterization rate did not significantly differ between TMLRP and either TURP or TUPKP. The blood transfusion rate was significantly different between TMLRP and TURP, but not between TMLRP and TUPKP. In addition, the retrograde ejaculation rate between TMLRP and TURP did not significantly differ. At 1, 3, 6, and 12 months of postoperative follow-up, the maximum flow rate, post-void residual, quality of life, and International Prostate Symptom Score did not significantly differ among the procedures. Thus, the findings of this study indicate that TMLRP may be a safe and feasible alternative.

[Efficacy and safety of use of likoprofit in patients with chronic prostatitis and prostatic adenoma].

The article summarizes the results of the clinical trials on application of likoprofit in patients with a chronic prostatitis and prostate adenoma, which were conducted by the Russian urologists for the last 8 years. Application of likoprofit in patients after TURP contributes to significantly earlier and effective restoration of microcirculation, which decreases the risk of development of postoperative complications and accelerates rehabilitation of patients. Studies in which likoprofit was applied in patients with a chronic prostatitis and prostate adenoma, proved that likoprofit also has antiedematous effect, improves the urination act, improves ejaculate parameters, positively impacts on sexual function, and has a high safety profile.

[Modern neurological treatment strategies for patients with spinal cord injury]. / Moderne neurourologische Therapiestrategien bei Patienten mit Rückenmarksschädigung.

Modern treatment methods for neurogenic bladder dysfunction take into consideration the primacy of obtaining good bladder storage capacity by merely lowering the leak point pressure. The medical benefit for the patient is seen in the stability of renal function and the social advantage in achieving continence. The development of modern findings on the management of neuro-urological disorders in spinal cord injury as well as the underlying principles, indications, and benefits of the most frequently applied treatment approaches are described.

The load on family and primary healthcare in the first six weeks after transurethral resection of the prostate.

OBJECTIVE: The extent of load on spouses and primary healthcare after transurethral resection of the prostate (TURP) and the number of treatment-related symptoms in the first 6 weeks after TURP were studied. MATERIAL AND METHOD: A combined interview (qualitative) and questionnaire (quantitative) study was carried out. In the first part of the study 10 spouses underwent semi-structured interviews concerning their husbands' treatment-related symptoms 6 weeks after TURP. Based on these interviews a questionnaire was framed. In the second part questionnaires were sent to 78 spouses whose husbands had undergone TURP 6 weeks before. RESULTS: 69 questionnaires were returned (88.5%). The median age of spouses and their husbands was 65 years (range 43-90) and 70 years (range 46-85), respectively. Length of hospitalization, including day of operation, was 3 days (range 2-9). There were 43 (62%) unscheduled contacts with the health system after discharge. In relation to discharge, 55 (79.7%) were incontinent to some degree and 29 (42%) were incontinent for more than 4 weeks, 26 (37.7%) had urinary tract infection, 30 (40%) had long-lasting bleeding, 10 (14%) urinary retention, and 41 (59.4%) urgency. Of the spouses, 20 (34.8%) had sleep disorders, 27 (39%) an affected social life and 22 (31.9%) extra work at home; 19 (27.5%) of the spouses felt that their husbands had been discharged too early, 55 (80%) were satisfied with the information given before the operation and 46 (68%) were satisfied with the information given in relation to discharge. The treatment results after 6 months are comparable to other studies. CONCLUSIONS: Among patients discharged after TURP there is a considerable number of treatment-related symptoms in the first few weeks affecting the family as well as health services. The study has resulted in better oral and written information in relation to discharge. More pads are delivered and patients have a urine culture and telephone consultation with a nurse 1 week after discharge.

[Complex therapy of irritative voiding disorders after transurethral resection of the prostate and adenomectomy].

Rehabilitation therapy was performed in 5 groups (n=122) of patients operated for prostatic adenoma (TUR of the prostate, transvesical prostatectomy) and having postoperative marked irritative miction disorders. Group 1 received antibacterial therapy (AT); group 2-- AT+alpha-adrenoblockers; group 3-- AT+transrectal laser and magnetic physiotherapy; group 4-- AT+alpha-adrenoblockers+transrectal laser and magnetic physiotherapy; group 5-- AT+prostatotropic phytotherapy (gentos). The worst result was achieved in group 1, the best one--in groups 3 and 4. Thus, adjuvant physiotherapy inclusion in the complex of postoperative rehabilitation of patients operated for prostatic adenoma is justified as it improves treatment efficacy.

[Combined therapy of voiding irritative disorders after surgical treatment of benign prostatic hyperplasia with Andro-Gin].

The results of operative and rehabilitative treatment of benign prostatic hyperplasia (BPH) was analysed for 69 BPH patients with postoperative irritative disorders of voiding. The patients were divided into four groups by rehabilitative therapy: group 1 received antibacterial therapy; group 2--antibacterial therapy+alpha-adrenoblockers; group 3--antibacterial therapy+transrectal laser and magnetic physiotherapy; group 4--antibacterial therapy+alpha-adrenoblockers+transrectal laser and magnetic physiotherapy. The worst result was obtained in group 1, the best one in groups 3 and 4 (the response was compatible). Thus, the addition of physiotherapy to the complex of postoperative rehabilitation of patients operated for BPH is justified and provides treatment improvement.

Transurethral resection of the prostate: the new old standard.

A literature search was performed for articles between June 2000 and July 2001 pertaining to transurethral resection of the prostate. Eight of the most interesting and/or groundbreaking articles, as deemed by the authors, were selected for review. Topics discussed include transurethral vaporization of the prostate, laser prostatectomy, preoperative finasteride, pelvic floor rehabilitation, the impact of the quantity of tissue removed, bladder infusion prior to catheter removal, and ethanol-glycine in assessment of the absorption of irrigation fluid.

Prostatic urethral strictures after transurethral microwave thermal therapy for benign prostatic hyperplasia.

Prostatic urethral strictures are rare. We present 3 cases in a study group of 27 who underwent high energy transurethral microwave therapy for benign prostatic hyperplasia. In all 3 cases, midprostatic strictures with ectopic area proximal to the stricture were seen by cystoscopy. Two of the strictures were urodynamically significant. The most likely explanation for their occurrence is direct damage of the prostatic urethra due to ischemia or heat damage of the prostatic urethra.