94 research outputs found
Systematic review and meta-analysis of Transurethral Needle Ablation in symptomatic Benign Prostatic Hyperplasia
BACKGROUND: Benign prostatic hyperplasia (BPH) constitutes a major clinical problem. Minimally invasive therapies for the treatment of symptomatic BPH include Transurethral Needle Ablation (TUNA), but it is unclear what impact this technique has on the disease and its role among other currently available therapeutic options. The objective of this study is to ascertain the efficacy and safety of TUNA in the treatment of BPH. METHODS: Systematic review of the literature until January 2005 and meta-analysis of clinical studies assessing TUNA in symptomatic BPH. Studies were critically appraised. Estimates of effect were calculated according to the random-effects model. RESULTS: 35 studies (9 comparative, 26 non-comparative) were included. Although evidence was limited by methodological issues, the analysis of relevant outcomes indicates that while TUNA significantly improves BPH parameters with respect to baseline, it does not reach the same level of efficacy as TURP in respect to all subjective and objective variables. Further, its efficacy declines in the long-term with a rate of secondary-treatment significantly higher than of TURP [OR: 7.44 (2.47, 22.43)]. Conversely, TUNA seems to be a relatively safe technique and shows a lower rate of complications than TURP [OR:0.14 (0.05, 0.14)] with differences being particularly noteworthy in terms of postoperative bleeding and sexual disorders. Likewise, TUNA has fewer anesthetic requirements and generates a shorter hospital stay than TURP [WMD: -1.9 days (-2.75, -1.05)]. Scarce data and lack of replication of comparisons hinder the assessment of TUNA vs. other local therapies. No comparisons with medical treatment were found. CONCLUSION: The body of evidence on which TUNA has been introduced into clinical practice is of only moderate-low quality. Available evidence suggest that TUNA is a relatively effective and safe technique that may eventually prove to have a role in selected patients with symptomatic BPH. TUNA significantly improves BPH parameters with respect to baseline values, but it does not reach the same level of efficacy and long-lasting success as TURP. On the other hand, TUNA seems to be superior to TURP in terms of associated morbidity, anesthetic requirements and length of hospital stay. With respect to the role of TUNA vis-Ã -vis other minimally invasive therapies, the results of this review indicate that there are insufficient data to define this with any degree of accuracy. Overall cost-effectiveness and the role of TUNA versus medical treatment need further evaluation
Retrospective Analysis of Short-Term Outcomes After Monopolar Versus Laser Endoscopic Enucleation of the Prostate: A Single Center Experience
COVID-19 model-based practice changes in managing a large prostate cancer practice: following the trends during a month-long ordeal
TENSION AND ENERGY-FREE ROBOTIC-ASSISTED LAPAROSCOPIC RADICAL PROSTATECTOMY WITH LATERAL DISSECTION DISSECTION OF THE NEUROVASCULAR BUNDLES: 1 YEAR FOLLOW UP
CORRELATION BETWEEN SURGEON'S EXPERIENCE AND PATHOLOGICAL AND ONCOLOGICAL OUTCOMES AFTER TRANSURETHRAL RESECTION OF THE BLADDER: RESULTS FROM A MULTICENTRIC RETROSPECTIVE STUDY
V40 NEW APPROACH FOR THE ULTRA-DISSECTION OF THE NEUROVASCULAR BUNDLES (NVB) DURING ROBOT-ASSISTED LAPAROSCOPIC RADICAL PROSTATECTOMY (RALP) IN SELECTED PATIENTS WITH PROSTATE CANCER
A critical analysis of laser prostatectomy in the management of benign prostatic hyperplasia
Radical prostatectomy after previous prostate surgery: Clinical and functional outcomes
Purpose: Radical prostatectomy has progressively become an elective treatment for primary localized prostate cancer as well as for incidental or subsequent prostatic cancer after previous surgery for obstructive benign disease. This increased acceptance opens concerns about oncological and functional outcomes. Materials and Methods: Between July 1999 and August 2003, 109 patients underwent radical retropubic prostatectomy for prostate cancer as a second line approach after surgery for primary bladder outlet obstruction. Of these patients 88 had undergone previous transurethral resection of the prostate and 21 had undergone open prostatectomy. Incidental and delayed prostate cancer was detected in 71 and 38 cases, respectively. Perioperative and postoperative morbidity was evaluated in all patients, while postoperative functional outcomes were assessed by a subjective questionnaire in 43. Results: As a second surgery, radical retropubic prostatectomy was generally more complex technically and it resulted in longer operative time compared to radical surgery in naive patients. In contrast, early and delayed postoperative morbidity increased moderately. Complete urinary continence was documented in 32 (74%) and 37 patients (86%) at the 6 and 12-month followups, respectively. In this patient cohort adequate erectile function was reported by 12%. Conclusions: Radical retropubic prostatectomy can be performed safely after previous prostate surgery for bladder outlet obstruction. However, a consistent surgical background in prostate surgery is needed to manage frequently unexpected difficulties. Candidates for second line prostate surgery should be informed that functional results are less predictable and satisfactory than those achieved after the same surgical approach in naive patients
Non-hormone-induced mixed epithelial and stromal tumor of kidney in a man : description of a rare case
Mixed epithelial and stromal tumor of the kidney is a recently recognized category of lesions occurring mostly in adult, middle-age women with a history of hormonal treatment. We present a rare case of a 58-year-old asymptomatic man without a history of hormonal treatment with a tumor characterized by proliferation of multiple cysts lined by single layers of epithelial cells and hypercellular stroma of spindle "ovarian-like" cells. Immunohistochemically, the stromal cells reacted against estrogen and progesterone receptors, vimentin, desmin, and CD34. A follow-up computed tomography scan performed 8 months after surgical enucleation of the lesion showed no signs of recurrence
LAPAROSCOPIC RENAL CRYOABLATION (LRC) OF SMALL RENAL MASSES: LESSON LEARNED AFTER 70 PROCEDURES
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