Global experience and progress in GreenLight-XPS 180-Watt photoselective vaporization of the prostate

Purpose: To evaluate changes in global perioperative data of GreenLight-XPS 180-Watt photo-selective vaporization of the prostate (GL-XPS) of the Global Greenlight Group (GGG) database. Methods: 3441 men, who underwent GL-XPS for symptomatic BPH between 2011 and 2019 at seven high volume international centers, were included. Primary outcome measurements were operative time (OT; min), effective laser time (LT; min of OT), as well as intraoperative and postoperative adverse events (AEs), all analyzed by year of surgery (2011–2019) and prostate volume (PV) group ( 150 ml). Results: The median age was 70 years (interquartile range 64–77), the median PV was 64 ml (IQR 47–90). The OT and LT slightly increased but stayed highly efficient all in all. Median OT was 60 min (IQR 45–83) and LT was 33 min (IQR 23–46). Median energy use was 253 kJ (IQR 170–375) with an energy density of 3.94 kJ/ml (IQR 2.94–5.02). The relative probability of perioperative AEs decreased by 17% each year (p  0.001). Conclusion: These findings from the GGG demonstrate significant improvement secondary to growing experience with GL-XPS between 2011 and 2019 in intraoperative AEs, including transfusions, and postoperative AEs. While staying highly efficient in OT and LT of GL-XPS within a 9-year period of experience

Vampires in the village Žrnovo on the island of Korčula: following an archival document from the 18th century

Središnja tema rada usmjerena je na raščlambu spisa pohranjenog u Državnom arhivu u Mlecima (fond: Capi del Consiglio de’ Dieci: Lettere di Rettori e di altre cariche) koji se odnosi na događaj iz 1748. godine u korčulanskom selu Žrnovo, kada su mještani – vjerujući da su se pojavili vampiri – oskvrnuli nekoliko mjesnih grobova. U radu se podrobno iznose osnovni podaci iz spisa te rečeni događaj analizira u širem društvenom kontekstu i prate se lokalna vjerovanja.The main interest of this essay is the analysis of the document from the State Archive in Venice (file: Capi del Consiglio de’ Dieci: Lettere di Rettori e di altre cariche) which is connected with the episode from 1748 when the inhabitants of the village Žrnove on the island of Korčula in Croatia opened tombs on the local cemetery in the fear of the vampires treating. This essay try to show some social circumstances connected with this event as well as a local vernacular tradition concerning superstitions

Salud masculina: un nuevo paradigma, estrategias para la atención de salud, apoyo, educación e investigación

ResumenLa salud masculina ha surgido como un nuevo campo de la medicina en respuesta a grandes diferencias en mortalidad y morbilidad masculinas en todo el mundo. Una visión con enfoque de género de la salud frente a las necesidades únicas que enfrentan niños y hombres ha impulsado a médicos y autoridades responsables a establecer estrategias específicas por género para la atención, promoción, educación e investigación de la salud. A menudo, se considera a los urólogos como los especialistas adecuados para abordar la salud masculina. Como comunidad, han sido instrumentos para liderar tanto la definición de salud masculina como las iniciativas de colaboración entre especialistas para abordar los temas de salud que enfrentan los hombres del Siglo 21

Sacral Neuromodulation in Patients With a Cardiac Pacemaker

The objective of this study was to describe our experience using sacral neuromodulation to treat urinary urgency, frequency, urge incontinence, and chronic urinary retention in patients with cardiac pacemakers. With the increasingly widespread use of InterStim for bladder function restoration, we are seeing more complex patients with multiple comorbidities, including cardiac conditions. Herein, we report 3 cases of individuals with cardiac pacemakers who underwent InterStim implantation to treat urinary conditions. This study is a case series of 3 patients with cardiac pacemakers who underwent sacral neuromodulation to treat refractory voiding dysfunction. The initial patient screening for InterStim therapy involved percutaneous nerve evaluation (PNE), in which a temporary untined lead wire was placed through the S3 foramen. Patients who did not respond to PNE proceeded to a staged implant. All patients in this study had a greater than 50% improvement of their urinary symptoms during the initial trial and underwent placement of the InterStim implantable pulse generator (IPG). Postoperative programming was done under electrocardiogram monitoring by a cardiologist. No interference was observed between the Inter-Stim IPG and the cardiac pacemaker. In this group of patients, sacral neuromodulation in the presence of a cardiac pacemaker appears to have been safe

Optimizing the management of benign prostatic hyperplasia

One of the challenges facing primary care physicians and specialists as the population ages is the management of lower urinary tract symptoms (LUTS) secondary to benign prostatic hyperplasia (BPH). While as many as 18% of men in their 40s report bother from an enlarged prostate, that figure rises dramatically, whereby 50% of men in their 50s and 90% of men in their 90s will complain of bothersome symptoms related to an enlarged prostate. Studies have shown that BPH is a progressive disease, which if left untreated can result in worsening of symptoms, acute urinary retention and renal failure. Until about 20 years ago the only management option available to urologists was surgery. In the early 1990s medical therapy emerged as the predominant treatment for BPH. Therapy may be tailored to target symptoms and progression of disease

Lifestyle and disease, male health and risks

Men throughout the world continue to have higher rates of morbidity and mortality compared to their female counterparts. The result of men living shorter and unhealthier lives impacts families, communities, economies and societies. The majority of the underlying cause relates to modifiable and preventable lifestyle choices made by men. Epidemics in obesity and diabetes are directly related to smoking, poor diet, excess alcohol consumption, and sedentary lifestyles. If physicians and policy makers are truly going to change the poor state of men’s health, the focus must be on the preventable illnesses resulting from lifestyle choices and behaviors

Salud masculina: estilo de vida, enfermedades y riesgos

Los hombres de todo el mundo siguen teniendo tasas más altas de morbilidad y mortalidad que su contraparte femenina. El resultado de esto es que los hombres viven menos y de forma menos sana, lo que impacta a las familias, comunidades, economías y sociedades. La mayoría de las causas subyacentes están relacionadas con estilos de vida evitables y modificables elegidos por los hombres. Las epidemias causadas por obesidad y diabetes están directamente relacionadas con el tabaquismo, mala alimentación, exceso de consumo de alcohol, y estilos de vida sedentarios. Si los médicos y autoridades responsables desean cambiar realmente el mal estado de salud de los hombres, deben concentrarse en las enfermedades evitables que son resultado de estilos de vida y comportamientos