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Combined prostatic urethral lift and remodeling of the prostate and bladder neck: a modified transurethral approach in the treatment of symptomatic lower urinary tract obstruction
- Source :
- World Journal of Urology. 36:1111-1116
- Publication Year :
- 2018
- Publisher :
- Springer Science and Business Media LLC, 2018.
-
Abstract
- The aim of the study was to evaluate the feasibility and safety of combining prostatic urethral lift (PUL) and a limited resection of the prostatic middle lobe or bladder neck incision in the treatment of lower urinary tract symptoms (LUTS) secondary to benign prostatic hyperplasia (BPH). Twenty-eight patients were treated at two tertiary centers and followed prospectively. Patient evaluations included patient characteristics, relief of LUTS symptoms, erectile and ejaculatory function, continence, operative time and adverse events. Patients were followed for a mean of 10.9 months. Patient characteristics were as follows: age 66 years (46–85), prostate volume 39.6 cc (22–66), preoperative IPSS/AUASI 20 (6–35)/QoL 3.9 (1–6)/peak flow 10.5 mL/s (4.0–19)/post-void residual volume (PVR) 123 mL (0–500). Mean operating time was 31 min (9–55). Postoperative complications were minor except for the surgical retreatment of one patient for blood clot retention (Clavien 3b). One patient required catheterization due to urinary retention. Reduction of symptoms (IPSS − 59.6%), increase in QoL (+ 49.0%), increase in flow (+ 111.5%), and reduction of PVR (− 66.8%) were significant. Antegrade ejaculation was always maintained. Our data suggest that a combination of PUL and transurethral surgical techniques is feasible, safe, and effective. This approach may be offered to patients with moderate size prostates including those with unfavorable anatomic conditions for PUL. This procedure is still ‘minimally invasive’ and preserves sexual function. In addition, it may add to a higher functional efficacy compared to PUL alone. DRKS00008970.
- Subjects :
- Male
Nephrology
medicine.medical_specialty
Urology
Urinary Bladder
Prostatic Hyperplasia
030232 urology & nephrology
03 medical and health sciences
0302 clinical medicine
Urethra
Lower urinary tract symptoms
Prostate
Germany
Internal medicine
medicine
Humans
Prospective Studies
Adverse effect
Aged
Aged, 80 and over
Urinary retention
business.industry
Transurethral Resection of Prostate
Middle Aged
medicine.disease
Combined Modality Therapy
Urinary Bladder Neck Obstruction
Neck of urinary bladder
Treatment Outcome
medicine.anatomical_structure
030220 oncology & carcinogenesis
Quality of Life
Feasibility Studies
medicine.symptom
Urinary tract obstruction
Sexual function
business
Subjects
Details
- ISSN :
- 14338726 and 07244983
- Volume :
- 36
- Database :
- OpenAIRE
- Journal :
- World Journal of Urology
- Accession number :
- edsair.doi.dedup.....a731de59e581cc8a1597fce2db975726