Management of LUTS after TURP and MIT
|
|
- Anne Pierce
- 5 years ago
- Views:
Transcription
1 Management of LUTS after TURP and MIT Hong Sup Kim Konkuk University
2 TURP & MIT TURP : Gold standard MIT TUIP TUNA TUMT HIFU LASER Nd:YAG, ILC, HoLRP, KTP LUTS after TURP and MIT Improved : about 70% Persistent LUTS : about 20~35% Nitti VW, et al. J Urol. 1997;157:600-3
3 LUTS after TURP & MIT Symptoms frequency 20~35% dysuria 10~23% poor flow & hesitancy 0.4~10% others incontinence (urge) 40% Nitti VW, et al. J Urol. 1997;157:600-3, Kuo HC. Urol Int. 2002;68:99-104
4 LUTS after TURP & MIT Causes (urodynamic study) bladder outlet obstruction 27.3% low detrusor contractility 18.7% pure detrusor instability 9.6% detrusor instability + inadequate detrusor contractility 14.4% poor relaxation of urethral sphincter 19.3% incontinence 40.0% Nitti VW, et al. J Urol. 1997;157:600-3, Kuo HC. Urol Int. 2002;68:99-104
5 Evaluation of LUTS after TURP & MIT urine analysis with microscopy urine culture, sensitivity and colony counts urine cytology uroflowmetry and check residual urine retrograde urethrography TRUS (due to incomplete resection) cystourethroscopy videourodynamic study (persistent LUTS)
6 Treatment outcomes after TURP & MIT TURP, TUIP, TUVP : 71% (66~76%) improved but 29% - not improved need for another therapy due to LUTS LUTS lower prostate volume (<30cc) without BOO results : not better than with BOO Madersbacher S, et al. BJU Int. 1999;83:227-37, Tkocz M, et al. Neurourol Urodyn. 2002;21:112-6
7 Advantage and disadvantage TURP : Gold standard Bleeding Incontinence TUR syndrome MIT Advantage low morbidity and low mortality Disadvantage possibility of incomplete resection prolonged irritative symptoms catheter indwelling times - more longer than TURP not achieved prostate specimen need for secondary operation Tomas AW, et al. BJU Int. 2004;93:745-50
8 Complications of KTP laser Complication Te AE et al (%) Malek RS et al (%) Prolonged dysuria (>10d) Transient (> 10 days) hematuria Transient urinary urge incontinence Urinary tract infection Retrograde ejaculation 26 * Urinary retention requiring recatheterization 5 1 Bladder neck contracture Urethral stricture Epididymitis * : number of patients retrograde ejaculation varied at different followup points Malek RS, et al. J Urol 2005;174: Te AE, et al. J Urol 2004;172:1404-8
9 Case Brief History 65/Male local clinic, KTP laser ablation - 8 month ago PSA : 9.1ng/ml, RGU, TRUS Prostate biopsy : nodular hyperplasia Treatment endoscopic incision of urethra & secondary TURP RGU TRUS
10 Obstructive symptoms after TURP & MIT Common causes incomplete resection of the prostate bladder neck contracture urethral stricture, meatal stenosis Urethral stricture Bladder neck contracture TURP 3.8% 4.0% TUIP 1.7% 0.4% low detrusor contractility (underactive bladder) Symptoms hesitancy, weak stream, prolonged voiding D/Dx low detrusor contractility Wasson JH, et al. N Engl J Med. 1995;332:75-9, Kuntz RM, et al. J Urol. 2002;168:1465-9
11 Obstructive symptoms after TURP & MIT Madersbacher S et al. BJU Int 1999;83:227-37
12 Obstructive symptoms after TURP & MIT Incomplete resection of prostate Treatment: α1-blocker, 5α-reductase inhibitor Secondary prostatic operation Urethral stricture and bladder neck contracture Diagnosis retrograde urethrography uroflowmetry and check residual urine cystoscopy Treatment urethral dilation endoscopic incision of urethra or bladder neck Kuntz RM, et al. J Urol. 2002;168:1465-9
13 Obstructive symptoms after TURP & MIT Low detrusor contractility (underactive bladder) with LUTS decreased clinical outcomes : LUTS after TURP and MIT treatment medication : α-blocker, bethanechol, cholinesterase inhibitor Double voiding trial CIC suprapubic cystostomy Tomas AW, et al. BJU Int. 2004;93:745-50
14 LUTS after TURP & MIT Tomas AW, et al. BJU Int. 2004;93:745-50
15 Obstructive symptoms after TURP & MIT Group A; unobstructed and underactive detrusor function Group B; obstructed and/or normal detrusor contractility
16 Irritative symptoms after TURP & MIT Common causes preoperative misdiagnosis idiopathic detrusor overactivity 66% improved after TURP and MIT but about 30% persistent LUTS increased vascular resistance of the bladder hypoxia of the detrusor muscles denervation of the detrusor muscles treatment anticholinergic drugs : propiverin, tolterodine, darifenacin, oxybutinin, trospium
17 Irritative symptoms after TURP & MIT Drug Grade of recommendation Drug Grade of recommendation Antimuscarinics Alpha-AR antagonist Tolterodine A Alfuzosin C Trospium A Doxazosin C Solifenacin A Prazosin C Darifenacin A Terazosin C Propantheline B Tamsulosin C Drugs with mixed action Oxybutinin Propiverine Flavoxate Antidepressant Imipramine A A C C Other drugs Estrogen * A highly recommended B recommended C recommended with reservation C OAB guideline 배뇨장애요실금학회 2007
18 Irritative symptoms after TURP & MIT Dysuria Nd:YAG laser, ILC, HoLRP, KTP common incidence rather than TURP prolonged dysuria rather than TURP treatment anti-inflammatory regimens diclofenac, etc. Kabalin JN, et al. J Urol. 1997;158:1923
19 Irritative symptoms after TURP & MIT Incontinence decreased Quality of Life incidence of urge incontinence : upto 40% causes sphincter incompetence : 30% detrusor instability : 20% Medical treatment mixed incontinence : 30% residual adenoma : 5% bladder neck contracture : 5% Surgical treatment Urethral stricture : 5% Kuo HC. Urol Int. 2002;68:99-104, Price DA et al. J Urol. 1982;52:529-31
20 Irritative symptoms after TURP & MIT Incontinence incidence of stress incontinence : TURP (2.2%), TUIP (1.8%) cause external sphincter injury management & medical treatment pad apply, external device apply pelvic floor exercise, biofeedback anticholinergic drugs, duloxetine electrostimulation surgical treatment periurethral injection therapy, artificial sphincter implantation inflatable paraurethral balloons Hubner WA, et al. BJU Int. 2005;96:587-94
21 Irritative symptoms after TURP & MIT
22 Secondary TURP after MIT Secondary prostatic operation following surgical treatment TURP approximately 1~2% per year Laser Nd:YAG approximately 2% per year ILC approximately 2% per year in the first year, rising to 9.6% thereafter HoLRP 1.4% per year during the 6-year study group HIFU TUNA TUMT 43.8% during the 4-year study group 20% during the 3-year study group 7% during the 2-year study group *ILC- interstitial laser coagulation, HoLRP Holuim laser resection of the prostate, TUNA transurethral needle ablation of the prostate, TUMT high-energy transurethral microwave thermotherapy European Association of Urology. Guidelies edit.
23 Intractable LTUS after TURP & MIT Treatment of intractable LUTS after TURP and MIT Secondary therapy botulinum toxin injection (??) sacral neuromodulation (??) need for further studies and future developments
24 Intractable LTUS after TURP & MIT
25 Conclusion The indication for surgical management is refractory LUTS to medical management. TURP is widely recognized as an efficacious procedure for the relief of symptomatic BOO due to BPH. TURP have been associated with significant morbidity. The efficacy of MIT in relief of BOO was observed to be less than TURP. need for secondary prostatic operation dysuria (laser ablation of the prostate)
26 Conclusion Symptoms alone are unreliable in predicting urodynamic findings with respect to BOO and detrusor instability after TURP and MIT. low detrusor contractility idiopathic detrusor overactivity inadequate detrusor contractiltiy poor relaxation of the urethral sphincter The treatment of persistent LUTS after TURP and MIT are important in improving QoL.
Index. urologic.theclinics.com. Note: Page numbers of article titles are in boldface type.
Index Note: Page numbers of article titles are in boldface type. A Ablation, of prostate, holmium laser, 485 495 African prune tree (Pygeum africanum), 454 455 Alfuzosin, 445 446 Alpha-adrenergic agonists,
More informationMODULE 3: BENIGN PROSTATIC HYPERTROPHY
MODULE 3: BENIGN PROSTATIC HYPERTROPHY KEYWORDS: Prostatic hypertrophy, prostatic hyperplasia, PSA, voiding dysfunction, lower urinary tract symptoms (LUTS) At the end of this clerkship, the medical student
More informationVictoria Sharp, MD, MBA, FAAFP. Clinical Professor of Urology and Family Medicine
Victoria Sharp, MD, MBA, FAAFP Clinical Professor of Urology and Family Medicine Victoria Sharp, MD, MBA, FAAFP Market Chief Medial Officer AmeriHealth Caritas Family of Companies Office phone: (515) 330-3740
More informationVoiding Dysfunction Block lecture, 5 th year student. Choosak Pripatnanont, Department of Surgery, PSU.
Voiding Dysfunction 2009 Block lecture, 5 th year student. Choosak Pripatnanont, Department of Surgery, PSU. Objectives Understand and explain physiologic function and dysfunction of lower urinary tract.
More informationPolicy for Prostatism/Lower Urinary Tract Symptoms in men
NHS Halton Clinical Commissioning Group NHS Liverpool Clinical Commissioning Group NHS St Helens Clinical Commissioning Group NHS South Sefton Clinical Commissioning Group NHS Southport and Formby Clinical
More informationManagement of Voiding Problems in Older Men. Dr. John Fenn Consultant, QEH 10 th October, 2005
Management of Voiding Problems in Older Men Dr. John Fenn Consultant, QEH 10 th October, 2005 Voiding Problems Poor stream Hesitancy Straining Incomplete emptying Intermittent micturition Terminal dribbling
More informationWhat should we consider before surgery? BPH with bladder dysfunction. Inje University Sanggye Paik Hospital Sung Luck Hee
What should we consider before surgery? BPH with bladder dysfunction Inje University Sanggye Paik Hospital Sung Luck Hee Diagnostic tests in three categories Recommendation: there is evidence to support
More informationMANAGING BENIGN PROSTATIC HYPERTROPHY IN PRIMARY CARE DR GEORGE G MATHEW CONSULTANT FAMILY PHYSICIAN FELLOW IN SEXUAL & REPRODUCTIVE HEALTH
MANAGING BENIGN PROSTATIC HYPERTROPHY IN PRIMARY CARE DR GEORGE G MATHEW CONSULTANT FAMILY PHYSICIAN FELLOW IN SEXUAL & REPRODUCTIVE HEALTH INTRODUCTION (1) Part of male sexual reproductive organ Size
More informationClinical guideline Published: 23 May 2010 nice.org.uk/guidance/cg97
Lower urinary tract symptoms in men: management Clinical guideline Published: 23 May 2010 nice.org.uk/guidance/cg97 NICE 2017. All rights reserved. Subject to Notice of rights (https://www.nice.org.uk/terms-and-conditions#notice-ofrights).
More informationWhat is Benign Prostatic Hyperplasia (BPH)?
What is Benign Prostatic Hyperplasia (BPH)? Benign prostatic hyperplasia (BPH) is an enlarged prostate. The prostate goes through two main growth periods as a man ages. The first occurs early in puberty,
More informationLower Urinary Tract Symptoms K Kuruvilla Zachariah Associate Specialist
Lower Urinary Tract Symptoms K Kuruvilla Zachariah Associate Specialist Lower Urinary Tract Symptoms Storage Symptoms Frequency, urgency, incontinence, Nocturia Voiding Symptoms Hesitancy, poor flow, intermittency,
More informationOriginal Policy Date
MP 7.01.39 Transurethral Microwave Thermotherapy Medical Policy Section Surgery Issue 12:2013 Original Policy Date 12:2013 Last Review Status/Date Reviewed with literature search/12:2013 Return to Medical
More informationManaging urinary morbidity after brachytherapy. Kieran O Flynn Department of Urology, Salford Royal Foundation Trust, Manchester
Managing urinary morbidity after brachytherapy Kieran O Flynn Department of Urology, Salford Royal Foundation Trust, Manchester Themes Can we predict urinary morbidity? Prevention of urinary morbidity
More informationIndex. urologic.theclinics.com. Note: Page numbers of article titles are in boldface type.
Index Note: Page numbers of article titles are in boldface type. A Ablative therapies, transurethral needle ablation, Adverse events, sexual side effects of BPH Aging, and incidence of BPH associated with
More informationBenign Prostatic Hyperplasia (BPH):
Benign Prostatic Hyperplasia (BPH): Evidence Based Guidelines for Primary Care Providers Jeanne Martin, DNP, ANP-BC Objectives 1. Understand the pathophysiology and prevalence of BPH 2. Select the appropriate
More informationEAU GUIDELINES POCKET EDITION 3
EAU GUIDELINES POCKET EDITION 3 CONTENTS: BENIGN PROSTATIC HYPERPLASIA URINARY INCONTINENCE UROLITHIASIS 2 3 EAU POCKET GUIDELINES POCKET EDITION 3 This is one of a series of convenient pocket size books
More informationDisclosures. Geriatric Incontinence and Voiding Dysfunction. Agenda. Agenda. UI: a Geriatric Syndrome. Geriatric Syndromes 9/7/2018.
Disclosures Geriatric Incontinence and Voiding Dysfunction None Shachi Tyagi MD, MS Assistant Professor Division of Geriatric Medicine University of Pittsburgh Medical Center UI: a Geriatric Syndrome Geriatric
More informationBenign Prostatic Hyperplasia (BPH)
Benign Prostatic Hyperplasia (BPH) Definition Prostate gland enlargement is a common condition as men get older. Also called benign prostatic hyperplasia (BPH), prostate gland enlargement can cause bothersome
More informationTHE ACONTRACTILE BLADDER - FACT OR FICTION?
THE ACONTRACTILE BLADDER - FACT OR FICTION? Jacob Golomb Department of Urology Chaim Sheba Medical Center Tel Hashomer NEUROGENIC UNDERACTIVE DETRUSOR Central (complete/incomplete): Spinal cord injury-
More informationPROSTATIC EMBOLIZATION FOR BENIGN HYPERPLASIA
St. Louis Hospital PROSTATIC EMBOLIZATION FOR BENIGN HYPERPLASIA INITIAL CLINICAL RESULTS Faculty of Medical Sciences New University of Lisbon JOÃO PISCO LUÍS CAMPOS PINHEIRO TIAGO BILHIM HUGO RIO TINTO
More informationClinical Study Treatment Strategy According to Findings on Pressure-Flow Study for Women with Decreased Urinary Flow Rate
Advances in Urology Volume 2009, Article ID 782985, 5 pages doi:10.1155/2009/782985 Clinical Study Treatment Strategy According to Findings on Pressure-Flow Study for Women with Decreased Urinary Flow
More informationWednesday 25 June Poster Session 9: BPH 1 Chairmen: M. Speakman and D. Rosario
Wednesday 25 June 14.30 15.30 Poster Session 9: BPH 1 Chairmen: M. Speakman and D. Rosario P080 Unreliable residual volume measurement after increased water load diuresis G. ALIVIZATOS, A. SKOLARIKOS,
More informationChapter 2: Methodology
Chapter 2: Methodology TABLE OF CONTENTS Introduction... 2 Study Selection and Data Abstraction... 2 Data Synthesis... 8 Guideline Development and Approvals... 9 Conflict of Interest... 10 Copyright 2010
More informationEffect of Transurethral Resection of the Prostate Based on the Degree of Obstruction Seen in Urodynamic Study
www.kjurology.org http://dx.doi.org/10.4111/kju.2013.54.12.840 Voiding Dysfunction/Female Urology Effect of Transurethral Resection of the Prostate Based on the Degree of Obstruction Seen in Urodynamic
More informationCan 80 W KTP Laser Vaporization Effectively Relieve the Obstruction in Benign Prostatic Hyperplasia?: A Nonrandomized Trial
pissn: 2287-428 / eissn: 2287-469 World J Mens Health 212 December 3(3): 16-165 http://dx.doi.org/1.5534/wjmh.212.3.3.16 Original Article Can 8 W KTP Laser Vaporization Effectively Relieve the Obstruction
More informationLower Urinary Tract Symptoms (LUTS) and Nurse-Led Clinics. Sean Diver Urology Advanced Nurse Practitioner candidate Letterkenny University Hospital
Lower Urinary Tract Symptoms (LUTS) and Nurse-Led Clinics Sean Diver Urology Advanced Nurse Practitioner candidate Letterkenny University Hospital 01/02/2018 Lower Urinary Tract Symptoms LUTS - one of
More informationAll about the Prostate
MEN S HEALTH Dr Nick Pendleton January 16 th 2018 All about the Prostate 1 What does it do? Functions of the Prostate 1. Secretes Prostatic Fluid slightly alkaline fluid, 30% of volume of seminal fluid,
More informationGUIDELINES ON NON-NEUROGENIC MALE LUTS INCLUDING BENIGN PROSTATIC OBSTRUCTION (BPO)
GUIDELINES ON NON-NEUROGENIC MLE LUTS INCLUDING BENIGN PROSTTIC OBSTRUCTION (BPO) (Text update pril 2014) S. Gravas (chair),. Bachmann,. Descazeaud, M. Drake, C. Gratzke, S. Madersbacher, C. Mamoulakis,
More informationInitial Experience of High Power Diode Laser for Vaporization of Prostate Muhammad Rafiq Zaki, Mujahid Hussain, Tahir Mehmood, Murtaza Hiraj
Original Article Initial Experience of High Power Diode Laser for Vaporization of Prostate Muhammad Rafiq Zaki, Mujahid Hussain, Tahir Mehmood, Murtaza Hiraj Abstract Objectives: Prospective evaluation
More informationThe Enlarged Prostate Symptoms, Diagnosis and Treatment
The Enlarged Prostate Symptoms, Diagnosis and Treatment MAC00031-01 Rev G Financial support for this seminar has been provided by NeoTract, Inc., the manufacturer of the UroLift System. 1 Today s Agenda
More informationGUIDELINES ON NEUROGENIC LOWER URINARY TRACT DYSFUNCTION
GUIDELINES ON NEUROGENIC LOWER URINARY TRACT DYSFUNCTION M. Stöhrer (chairman), D. Castro-Diaz, E. Chartier-Kastler, G. Kramer, A. Mattiasson, J-J. Wyndaele Introduction NLUTD (neurogenic lower urinary
More informationEarly-Stage Clinical Experiences of Holmium Laser Enucleation of the Prostate (HoLEP)
JRural Med 2007 ; 2 : 93 97 Original article Early-Stage Clinical Experiences of Holmium Laser Enucleation of the Prostate (HoLEP) Shuzo Hamamoto 1,TakehikoOkamura 1,HideyukiKamisawa 1,KentaroMizuno 1,
More informationExecutive Summary. Non-drug local procedures for treatment of benign prostatic hyperplasia 1. IQWiG Reports - Commission No.
IQWiG Reports - Commission No. N04-01 Non-drug local procedures for treatment of benign prostatic hyperplasia 1 Executive Summary 1 Translation of the executive summary of the final report Nichtmedikamentöse
More informationAn Anteriorly Positioned Midline Prostatic Cyst Resulting in Lower Urinary Tract Symptoms
Case Report INJ 2010;14:125-129 An Anteriorly Positioned Midline Prostatic Cyst Resulting in Lower Urinary Tract Symptoms Joo-Yong Lee, Dong-Hyuk Kang, Hee-Young Park, Jung-Soo Park, Young-Woo Son, Hong-Sang
More informationGuidelines on Neurogenic Lower Urinary Tract Dysfunction
Guidelines on Neurogenic Lower Urinary Tract Dysfunction (Text update March 2009) M. Stöhrer (chairman), B. Blok, D. Castro-Diaz, E. Chartier- Kastler, P. Denys, G. Kramer, J. Pannek, G. del Popolo, P.
More informationOveractive Bladder Syndrome
Overactive Bladder Syndrome behavioural modifications to pharmacological and surgical treatments Dr Jos Jayarajan Urologist Austin Health, Eastern Health Warringal Private, Northpark Private, Epworth Overactive
More informationRecommandations de prise en charge des vessies neurogènes EAU 2006
Annexe 4-1 Recommandations de prise en charge des vessies neurogènes EAU 2006 (Version courte) 685 686 GUIDELINES ON NEUROGENIC LOWER URINARY TRACT DYSFUNCTION M. Stöhrer (chairman), D. Castro-Diaz, E.
More informationPOLICIES AND PROCEDURE MANUAL
POLICIES AND PROCEDURE MANUAL Policy: MP048 Section: Medical Benefit Policy Subject: Surgical and Minimally Invasive Therapies for the Treatment of Benign Prostatic Hypertrophy I. Policy: Surgical and
More informationMale Lower Urinary Tract Symptoms: Management in primary care and beyond. Daniel Cohen PhD FRCS(Urol) Consultant Urological Surgeon
Male Lower Urinary Tract Symptoms: Management in primary care and beyond Daniel Cohen PhD FRCS(Urol) Consultant Urological Surgeon 1 LUTS Very common: 1/3 men over age of 50 have moderate to severe LUTS
More informationOveractive Bladder: Diagnosis and Approaches to Treatment
Overactive Bladder: Diagnosis and Approaches to Treatment A Hidden Condition* Many Many patients self-manage by voiding frequently, reducing fluid intake, and wearing pads Nearly Nearly two-thirds thirds
More informationLasers in Urology. Sae Woong Choi, Yong Sun Choi, Woong Jin Bae, Su Jin Kim, Hyuk Jin Cho, Sung Hoo Hong, Ji Youl Lee, Tae Kon Hwang, Sae Woong Kim
www.kjurology.org http://dx.doi.org/10.4111/kju.2011.52.12.824 Lasers in Urology 120 W Greenlight HPS Laser Photoselective Vaporization of the Prostate for Treatment of Benign Prostatic Hyperplasia in
More informationProstate Disease. Chad Baxter, MD
Prostate Disease Chad Baxter, MD Managing BPH and LUTS Chad Baxter, MD Department of Urology cbaxter@mednet.ucla.edu 33 nd Annual UCLA Intensive Course in Geriatric Medicine & Board Review Prevalence of
More informationUrinary Adverse Events after Radiation Therapy for Prostate Cancer
Urinary Adverse Events after Radiation Therapy for Prostate Cancer Sexual Medicine Society of North America Scottsdale, Arizona 2016 Jaspreet S. Sandhu, MD Department of Surgery/Urology Memorial Sloan
More informationProstate gland disorder พ.ต.ต.นพ.ส ร ต ก ตต ศ ภพร นพ.(สบ.2) โรงพยาบาลต ารวจ ส าน กงานต ารวจแห งชาต
Prostate gland disorder พ.ต.ต.นพ.ส ร ต ก ตต ศ ภพร นพ.(สบ.2) โรงพยาบาลต ารวจ ส าน กงานต ารวจแห งชาต Prostate cancer Overview Diagnosis Treatment Lower urinary tract symptoms EPIDEMIOLOGY The most common
More informationHow Do New Data from Clinical Trials Allow Us to Optimise the Assessment and Treatment of Patients with Benign Prostatic Hyperplasia?
available at www.sciencedirect.com journal homepage: www.europeanurology.com How Do New Data from Clinical Trials Allow Us to Optimise the Assessment and Treatment of Patients with Benign Prostatic Hyperplasia?
More informationBenign Prostatic Hyperplasia. Jay Lee, MD, FRCSC Clinical Associate Professor University of Calgary
Benign Prostatic Hyperplasia Jay Lee, MD, FRCSC Clinical Associate Professor University of Calgary Copyright 2017 by Sea Courses Inc. All rights reserved. No part of this document may be reproduced, copied,
More informationGUIDELINES ON NON-NEUROGENIC MALE LUTS INCLUDING BENIGN PROSTATIC OBSTRUCTION
GUIDELINES ON NON-NEUROGENIC MLE LUTS INCLUDING BENIGN PROSTTIC OBSTRUCTION (Text update March 2015) S. Gravas (Chair), T. Bach,. Bachmann, M. Drake, M. Gacci, C. Gratzke, S. Madersbacher, C. Mamoulakis,
More informationLUTS after TURP: How come and how to manage? Matthias Oelke
LUTS after TURP: How come and how to manage? Matthias Oelke Department of Urology Global Congress on LUTD, Rome, 26 th June 2015 Disclosures Consultant, speaker, trial participant and/or research grants
More informationManagement of Voiding Dysfunction after Prostate Radiotherapy
Management of Voiding Dysfunction after Prostate Radiotherapy Up to Date Symposium on Uro-Oncology December 7, 2012 Belo Horizonte, Brazil Jaspreet S. Sandhu, MD Department of Surgery/Urology Memorial
More informationName of Policy: Transurethral Microwave Thermotherapy
Name of Policy: Transurethral Microwave Thermotherapy Policy #: 449 Latest Review Date: September 2013 Category: Surgery Policy Grade: B Background/Definitions: As a general rule, benefits are payable
More informationDr Jonathan Evans Paediatric Nephrologist
How do I manage a patient with intractable daytime wetting: Dr Jonathan Evans Paediatric Nephrologist Of 107 children aged 11-12 with day-wetting 91 (85%) were dry at 15-16 yr Swithinbank et al BJU 1998
More informationGUIDELINES ON NEURO-UROLOGY
GUIDELINES ON NEURO-UROLOGY (Text update pril 2014) J. Pannek (co-chair), B. Blok (co-chair), D. Castro-Diaz, G. del Popolo, J. Groen, G. Karsenty, T.M. Kessler, G. Kramer, M. Stöhrer Eur Urol 2009 Jul;56(1):81-8
More informationAssociation of BPH with OAB: The Plumbing or the Pump?
Association of BPH with OAB: The Plumbing or the Pump? Ryan P. Terlecki, MD FACS Associate Professor of Urology Director, Men s Health Clinic Director, GURS Fellowship in Reconstructive Urology, Prosthetic
More informationNeurogenic bladder. Neurogenic bladder is a type of dysfunction of the bladder due to neurological disorder.
Definition: Neurogenic bladder Neurogenic bladder is a type of dysfunction of the bladder due to neurological disorder. Types: Nervous system diseases: Congenital: like myelodysplasia like meningocele.
More informationGUIDELINES ON NEURO-UROLOGY
GUIDELINES ON NEURO-UROLOGY (Limited text update March 2015) B. Blok (Co-chair), J. Pannek (Co-chair), D. Castro Diaz, G. del Popolo, J. Groen, T. Gross (Guidelines ssociate), R. Hamid, G. Karsenty, T.M.
More informationDiagnostic approach to LUTS in men. Prof Dato Dr. Zulkifli Md Zainuddin Consultant Urologist / Head Of Urology Unit UKM Medical Center
Diagnostic approach to LUTS in men Prof Dato Dr. Zulkifli Md Zainuddin Consultant Urologist / Head Of Urology Unit UKM Medical Center Classification of LUTS Storage symptoms Voiding symptoms Post micturition
More informationAMERIHEALTH / INDEPENDENCE BLUE CROSS
AMERIHEALTH / INDEPENDENCE BLUE CROSS Urinary outlet obstruction is difficulty in the passage of urine from the bladder to the urethra caused by compression or resistance on the bladder outflow channel
More informationOriginal Article - Lasers in Urology. Min Ho Lee, Hee Jo Yang, Doo Sang Kim, Chang Ho Lee, Youn Soo Jeon
www.kjurology.org http://dx.doi.org/10.4111/kju.2014.55.11.737 Original Article - Lasers in Urology http://crossmark.crossref.org/dialog/?doi=10.4111/kju.2014.55.11.737&domain=pdf&date_stamp=2014-11-16
More informationA Comparative Study of Trans Urethral Resection Versus Trans Urethral Incision for Small Size Obstructing Prostate
ORIGINAL ARTICLE A Comparative Study of Trans Urethral Resection Versus Trans Urethral Incision for Small Size Obstructing Prostate ABSTRACT Rafique Ahmed Sahito, Abdul Jabbar Pirzada, Masood Ahmed Qureshi,
More informationPHOTOSELECTIVE POTASSIUM-TITANYL-PHOSPHATE LASER VAPORIZATION OF THE BENIGN OBSTRUCTIVE PROSTATE: OBSERVATIONS ON LONG-TERM OUTCOMES
0022-5347/05/1744-1344/0 Vol. 174, 1344 1348, October 2005 THE JOURNAL OF UROLOGY Printed in U.S.A. Copyright 2005 by AMERICAN UROLOGICAL ASSOCIATION DOI: 10.1097/01.ju.0000173913.41401.67 PHOTOSELECTIVE
More informationRezūm procedure for the Prostate
Rezūm procedure for the Prostate Mr Jas Kalsi Consultant Urological Surgeon This booklet has been provided to help answer the questions you may have with regards to your enlarged prostate and the Rezūm
More informationTREATMENT OF OVERACTIVE BLADDER IN ADULTS FUGA 2016 KGH
TREATMENT OF OVERACTIVE BLADDER IN ADULTS FUGA 2016 KGH CONTENTS Overactive bladder (OAB) Treatment of OAB Beta-3 adrenoceptor agonist (Betmiga ) - Panacea? LASER treatment - a flash in the pan or the
More informationLong-term Follow-up of Transurethral Enucleation Resection of the Prostate for Symptomatic Benign Prostatic Hyperplasia
Journal of Surgery 2016; 4(2): 40-44 http://www.sciencepublishinggroup.com/j/js doi: 10.11648/j.js.20160402.18 ISSN: 2330-0914 (Print); ISSN: 2330-0930 (Online) Long-term Follow-up of Transurethral Enucleation
More informationThe management of lower urinary tract symptoms in men
The management of lower urinary tract symptoms in men NICE guideline Draft for consultation, August 2009 If you wish to comment on this version of the guideline, please be aware that all the supporting
More informationSurgical Treatment of LUTS in Men with BPE
Patient Information English 35 Surgical Treatment of LUTS in Men with BPE The underlined terms are listed in the glossary. You have been diagnosed with benign prostatic enlargement (BPE) and your doctor
More informationDiagnosis and Mangement of Nocturia in Adults
Diagnosis and Mangement of Nocturia in Adults Christopher Chapple Professor of Urology Sheffield Teaching Hospitals University of Sheffield Sheffield Hallam University UK 23 rd October 2015 Terminology
More informationNON-Neurogenic Chronic Urinary Retention AUA White Paper
NON-Neurogenic Chronic Urinary Retention AUA White Paper Great Lakes SUNA Inside Urology March 16, 2018 Michelle J. Lajiness FNP-BC Nurse Practitioner DMC Urology Incidence Really unknown Lack consensus
More informationOverview. Urology Dine and Learn: Erectile Dysfunction & Benign Prostatic Hyperplasia. Iain McAuley September 15, 2014
Urology Dine and Learn: Erectile Dysfunction & Benign Prostatic Hyperplasia Iain McAuley September 15, 2014 Overview Review of the most recent guidelines for ED and BPH ED Guidelines CUA 2006 AUA 2011
More informationUrinary Incontinence among Aging Men
Urinary Incontinence among Aging Men Ehab A. Elzayat, MD, Urology Fellow, Dalhousie University, Halifax, NS. Ali Alzahrani, MD, Urology Fellow, Dalhousie University, Halifax, NS. Jerzy B. Gajewski, MD,
More informationInformation for Patients. Benign Prostatic Enlargement. English
Information for Patients Benign Prostatic Enlargement English Table of contents What is the prostate?... 3 What are BPH, BPE, and BPO?... 3 Symptoms... 3 Types of symptoms... 4 Diagnosis... 4 Medical history...
More informationUBC Department of Urologic Sciences Lecture Series. Voiding Dysfunction & BPH
UBC Department of Urologic Sciences Lecture Series Voiding Dysfunction & BPH Objectives Today 1. Anatomy of the lower urinary tract A) Innervation of the bladder B) Normal voiding 2. Classify Neurogenic
More informationTURP Complications & Treatments. G. Testa
TURP Complications & Treatments G. Testa Statistics Operative mortality 0.2 per cent Most common cause of death was sepsis which occurred >1 month after surgery 77% of patients had significant pre-existing
More informationNATIONAL INSTITUTE FOR HEALTH AND CARE EXCELLENCE Centre for Clinical Practice Surveillance Programme
NATIONAL INSTITUTE FOR HEALTH AND CARE EXCELLENCE Centre for Clinical Practice Surveillance Programme Clinical guideline CG97: The management of lower urinary tract symptoms in men Publication date May
More informationCauses of Transient Incontinence. Geriatrics: Urinary Incontinence, Dementia, and Delirium. Classification of Established Incontinence
Causes of Transient Geriatrics: Urinary, Dementia, and Delirium Carla Zeilmann, PharmD, BCPS St. Louis College of Pharmacy Therapeutics 3 Fall 2003 D delirium I infection A atrophic urethritis and vaginitis
More informationOffice Management of Benign Prostatic Enlargement
Focus on CME at McGill University Office Management of Benign Prostatic Enlargement Symptomatic benign prostate enlargement is a common medical problem encountered in our aging society. Watchful waiting,
More informationHee Young Park, Joo Yong Lee, Sung Yul Park, Seung Wook Lee, Yong Tae Kim, Hong Yong Choi, Hong Sang Moon
www.kjurology.org http://dx.doi.org/10.4111/kju.2012.53.2.92 Voiding Dysfunction Efficacy of Alpha Blocker Treatment According to the Degree of Intravesical Prostatic Protrusion Detected by Transrectal
More informationURINARY INCONTINENCE. Urology Division, Surgery Department Medical Faculty, University of Sumatera Utara
URINARY INCONTINENCE Urology Division, Surgery Department Medical Faculty, University of Sumatera Utara Definition The involuntary loss of urine May denote a symptom, a sign or a condition Symptom the
More informationNATIONAL INSTITUTE FOR HEALTH AND CARE EXCELLENCE
NATIONAL INSTITUTE FOR HEALTH AND CARE EXCELLENCE INTERVENTIONAL PROCEDURES PROGRAMME Interventional procedure overview of transurethral water jet ablation for lower urinary tract symptoms caused by benign
More information김준철 가톨릭대학교의과대학비뇨기과학교실
비뇨기계자율신경병증의치료 김준철 가톨릭대학교의과대학비뇨기과학교실 Introduction Urologic complications have increasingly become a concern in those affected by DM Genitourinary problems are included among these complications, related
More informationEAU GUIDELINES ON NON- NEUROGENIC MALE LUTS INCLUDING BENIGN PROSTATIC OBSTRUCTION
EAU GUIDELINES ON NON- NEUROGENIC MALE LUTS INCLUDING BENIGN PROSTATIC OBSTRUCTION (Limited text update March 2016) S. Gravas (Chair), T. Bach, A. Bachmann, M. Drake, M. Gacci, C. Gratzke, S. Madersbacher,
More informationObjectives. Prevalence of Urinary Incontinence URINARY INCONTINENCE: EVALUATION AND CURRENT TREATMENT OPTIONS
URINARY INCONTINENCE: EVALUATION AND CURRENT TREATMENT OPTIONS Lisa S Pair, MSN, CRNP Division of Urogynecology and Pelvic Reconstructive Surgery Department of Obstetrics and Gynecology University of Alabama
More informationEAU GUIDELINES ON NON- NEUROGENIC MALE LUTS INCLUDING BENIGN PROSTATIC OBSTRUCTION
EAU GUIDELINES ON NON- NEUROGENIC MALE LUTS INCLUDING BENIGN PROSTATIC OBSTRUCTION (Text update March 2017) S. Gravas (Chair), T. Bach, M. Drake, M. Gacci, C. Gratzke, T.R.W. Herrmann, S. Madersbacher,
More informationBenign Prostatic Hyperplasia. Management of Benign Prostatic Hyperplasia. Goals of Therapy
Benign Prostatic Hyperplasia Management of Benign Prostatic Hyperplasia Goals of Therapy Improve or abolish lower urinary tract symptoms (LUTS) Prevent or delay clinical progression of benign prostatic
More informationLUTS & Cancer pathway. Mr Francis Thomas Urology Consultant DRI &BDGH
LUTS & Cancer pathway Mr Francis Thomas Urology Consultant DRI &BDGH Topics Male and female LUTS Urinary retention Post void Residual urine Referral pathway LUTS Raised PSA Hematuria Services in community
More informationThulium Laser versus Standard Transurethral Resection of the Prostate: A Randomized Prospective Trial
european urology 53 (2008) 382 390 available at www.sciencedirect.com journal homepage: www.europeanurology.com Benign Prostatic Obstruction Thulium Laser versus Standard Transurethral Resection of the
More informationHospital and Tzu Chi University, Hualien, Taiwan
LUTS (2012) 4, 29 34 ORIGINAL ARTICLE Difficult Urination Does Not Affect the Successful Outcome after 100U OnabotulinumtoxinA Intravesical Injection in Patients with Idiopathic Detrusor Overactivity Yih-Chou
More informationChapter 3: Results of the Treatment Outcomes Analyses
Chapter 3: Results of the Treatment Outcomes Analyses Introduction To determine the appropriateness of individual therapies, as well as to develop practice recommendations, the American Urological Association
More informationURODYNAMICS IN MALE LUTS: NECESSARY OR WASTE OF TIME?
URODYNAMICS IN MALE LUTS: NECESSARY OR WASTE OF TIME? Andrea Tubaro, MD, FEBU Chairman Department of Urology Sant Andrea Hospital Sapienza University of Rome, Italy Disclosures Consultant, paid speaker,
More informationBladder dysfunction in ALD and AMN
Bladder dysfunction in ALD and AMN Sara Simeoni, MD Department of Uro-Neurology National Hospital for Neurology and Neurosurgery Queen Square, London 10:15 Dr Sara Simeoni- Bladder issues for AMN patients
More informationNew Treatment Modalities for Benign Prostatic Hyperplasia. Seung-June Oh, MD Department of Urology, Seoul National University Hospital
New Treatment Modalities for Benign Prostatic Hyperplasia Seung-June Oh, MD Department of Urology, Seoul National University Hospital Options for Treating BPH Pharmacotherapy blocker Agents for BPH + OAB
More informationCase Report Transurethral Incision of the Bladder Neck in a Woman with Primary Bladder Neck Obstruction after Kidney Transplantation
Case Reports in Transplantation Volume 2015, Article ID 312084, 4 pages http://dx.doi.org/10.1155/2015/312084 Case Report Transurethral Incision of the Bladder Neck in a Woman with Primary Bladder Neck
More informationBotulinum Toxin: Applications in Urology
Botulinum Toxin: Applications in Urology Dr. Lee Jonat, PGY-4 Department of Urologic Sciences University of British Columbia Outline Mechanism of Action Technical Considerations Adverse Events Neurogenic
More informationSurgical procedures for benign prostatic hyperplasia: A nationwide survey in Japan
International Journal of Urology (2011) 18, 166 170 doi: 10.1111/j.1442-2042.2010.02687.x Short Communicationiju_2687 166..170 Surgical procedures for benign prostatic hyperplasia: A nationwide survey
More informationPROSTATE ENLARGEMENT A GUIDE TO URINARY SYMPTOMS IN MEN A BOOKLET IN THE SERIES OF CONSUMER GUIDES ON MALE REPRODUCTIVE HEALTH FROM
PROSTATE ENLARGEMENT A GUIDE TO URINARY SYMPTOMS IN MEN A BOOKLET IN THE SERIES OF CONSUMER GUIDES ON MALE REPRODUCTIVE HEALTH FROM AT A GLANCE First published in March 2004 by Andrology Australia 5th
More informationDiagnosis and treatment of overactive bladder (non-neurogenic) in adults: AUA/SUFU guideline.
Diagnosis and treatment of overactive bladder (non-neurogenic) in adults: AUA/SUFU guideline. TARGET POPULATION Eligibility Decidable (Y or N) Inclusion Criterion non-neurogenic OAB Exclusion Criterion
More informationProstate Health PHARMACIST VIEW
Prostate Health PHARMACIST VIEW Prostate Definition Prostate is a gland made of fibromuscular tissue. It is about 4 cm and surrounds the neck of the bladder and the urethra. It produces seminal fluid.
More informationOUTCOMES OF HoLEP IN THE RETREATMENT SETTING
OUTCOMES OF HoLEP IN THE RETREATMENT SETTING Tracy Marien 1 MD, Mustafa Kadihasanoglu 1 MD, Teerayut Tangpaitoon 1 MD, Nadya York 2 MD, Andrew T. Blackburne 3 MD, Haidar Abdul-Muhsin 4 MD, Michael S. Borofsky
More information