Document Detail


Transurethral ultrasound-guided laser-induced prostatectomy: clinical outcome and data analysis.
MedLine Citation:
PMID:  7531899     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: To analyze efficacy and side effects of the transurethral ultrasound-guided laser-induced prostatectomy (TULIP) procedure for the treatment of bladder outlet obstruction due to benign prostatic hyperplasia (BPH). Based on the results obtained so far, the influence of preoperative and intraoperative parameters on clinical outcome is analyzed. METHODS: Between May 1991 and March 1994, 89 men with symptomatic and obstructive BPH underwent a TULIP procedure and were followed after 3 and 6 weeks, and 3, 6, and 12 months postoperatively. RESULTS: On average, mean urinary peak flow increased from 7 to 15 mL/s, postvoidal residual urine decreased from 215 to 40 mL and symptoms (assessed by modified Boyarsky score) decreased from 17 to 5 at 12 months after TULIP: In about half of the patients peak flow increased to more than 20 mL/s on average, and approximately 85% of all men reported that their symptoms improved on average 80% during this time. Because of insufficient micturition, 7 patients subsequently underwent conventional transurethral resection of the prostate (TURP) and 1 had an open prostatectomy. Either partial or complete retrograde ejaculation was reported by 13 of 58 sexually active men. No blood transfusion was required and no post-transurethral resection syndrome occurred in any case. Analyses of preoperative and intraoperative parameters and clinical outcome with respect to prostate volume, urinary retention, type of BPH enlargement, sleeve size, and good and poor responders did not reveal any significant influence of any factor. There is, however, a trend toward a lower laser energy delivered in patients who failed or may be considered to be poor responders. CONCLUSIONS: In this unselected group of patients with BPH, who otherwise would have been TURP candidates, the TULIP procedure demonstrated the efficacy of this technique to relieve bladder outlet obstruction. Compared with TURP, the TULIP procedure proved to be advantageous in regard to less blood loss and rate of retrograde ejaculation. In addition, TULIP can be performed under analgesic sedation, which is especially advantageous in high-risk patients. Disadvantages, however, are that it takes a considerably longer time to obtain substantial improvements in subjective and objective symptoms and there are more irritative symptoms in the early postoperative phase.
Authors:
H Schulze; W Martin; P Hoch; J Pannek; G Haupt; T Senge
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Publication Detail:
Type:  Clinical Trial; Journal Article    
Journal Detail:
Title:  Urology     Volume:  45     ISSN:  0090-4295     ISO Abbreviation:  Urology     Publication Date:  1995 Feb 
Date Detail:
Created Date:  1995-03-10     Completed Date:  1995-03-10     Revised Date:  2010-03-24    
Medline Journal Info:
Nlm Unique ID:  0366151     Medline TA:  Urology     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  241-7     Citation Subset:  IM    
Affiliation:
Department of Urology, University of Bochum, Herne, Germany.
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MeSH Terms
Descriptor/Qualifier:
Aged
Aged, 80 and over
Humans
Intraoperative Period
Laser Therapy / adverse effects,  methods*
Male
Middle Aged
Postoperative Complications / epidemiology,  etiology
Preoperative Care
Prostatectomy / adverse effects,  methods*
Prostatic Hyperplasia / complications,  pathology,  surgery*,  ultrasonography
Reoperation
Treatment Outcome
Urethra
Urinary Bladder Neck Obstruction / etiology,  surgery*,  ultrasonography

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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