Transurethral resection vs microwave thermotherapy of the prostate: a cost-consequences analysis.

Objective: To compare the costs and outcome of high-energy transurethral microwave thermotherapy of the prostate (HE-TUMT) with transurethral resection of the prostate (TURP), as the former is considered to be the best minimally invasive method for managing lower urinary tract symptoms (LUTS) suggestive of benign prostatic hyperplasia (BPH).

Patients And Methods: Between January 1996 and March 1997, 144 patients were randomized to treatment with HE-TUMT (78) using the Prostatron device and Prostasoft 2.5 software (EDAP Technomed, Lyon, France), or TURP (66).

Biofeedback vs verbal feedback as learning tools for pelvic muscle exercises in the early management of urinary incontinence after radical prostatectomy.

Objective: To evaluate the comparative effectiveness of electromyographic (EMG) biofeedback with verbal instructions as learning tools of pelvic muscle exercises (PMEs) in the early management of urinary incontinence after radical prostatectomy.

Patients And Methods: Forty-two consecutive patients (mean age 64 years, sd 4.2), with urinary incontinence after radical retropubic prostatectomy for localized prostate cancer, were randomized to receive biofeedback (group A, 28 men) or verbal feedback (group B, 14 men) as learning tools for PMEs immediately after catheter removal.

Long-term risk of re-treatment of patients using alpha-blockers for lower urinary tract symptoms.

Purpose: The efficacy of alpha-adrenoceptor blockers for the treatment of lower urinary tract symptoms has been proven in numerous studies. However, little is known about the efficacy of the longer term. We investigated the long-term risk of re-treatment in patients using alpha-adrenoceptor blockers for lower urinary tract symptoms and the parameters that influence this risk.

Long-term followup of randomized transurethral microwave thermotherapy versus transurethral prostatic resection study.

Purpose: We evaluate the durable effect of high-energy transurethral microwave thermotherapy and transurethral prostatic resection for treatment of patients with lower urinary tract symptoms suggestive of bladder outflow obstruction.

Materials And Methods: Between January 1996 and March 1997, 155 patients with lower urinary tract symptoms suggestive of bladder outflow obstruction were randomized to receive transurethral microwave thermotherapy (Prostatron*; device and commercial software) (82) or undergo transurethral prostatic resection (73). Initial patient evaluation was performed according to international standards.

Intra-prostatic vasculature studies: can they predict the outcome of transurethral microwave thermotherapy for the management of bladder outflow obstruction?

Background: Blood perfusion regulates intraprostatic temperatures during transurethral microwave thermotherapy (TUMT). We evaluated baseline intraprostatic vasculature, as a predictor of efficacy of TUMT.

Methods: Twenty-two patients, with lower urinary tract symptoms (LUTS) suggestive of bladder outflow obstruction, were treated with TUMT (Prostatron).

High energy transurethral microwave thermotherapy for the treatment of patients in urinary retention.

Purpose: We evaluated the efficacy of high energy transurethral microwave thermotherapy for treating urinary retention due to benign prostatic hyperplasia.

Materials And Methods: Between October 1993 and March 1999, 41 patients with urinary retention were treated with high energy transurethral microwave thermotherapy. Initial evaluation consisted of a history, clinical examination, urethrocystoscopy, transrectal prostate ultrasonography and urodynamic investigation with a pressure flow study.

Heat treatment of the prostate: where do we stand in 2000?

Various minimally invasive modalities that are aimed at alleviating lower urinary tract symptoms employ heat-induced ablation of hyperplastic prostatic tissue. Following extensive studies, most of these modalities were eventually abandoned. High-energy transurethral microwave thermotherapy has survived, however, and has gained a firm position as a therapeutic modality, along with transurethral resection of the prostate.

alpha-Blockade improves symptoms suggestive of bladder outlet obstruction but fails to relieve it.

Purpose: We investigated the effect of the alpha-blockers alfuzosin, terazosin and tamsulosin on urodynamic parameters after 6 months of therapy.

Materials And Methods: Between February 1992 and June 1998, 163 patients with lower urinary tract symptoms suggestive of bladder outlet obstruction were treated with alfuzosin (60), terazosin (66) and tamsulosin (37). Patients were evaluated with urodynamic studies, including pressure flow analysis, before treatment and after 6 months of therapy.

Abdomino-perineal repair of recurrent and complex bladder neck-prostatic urethra contractures.

Objective: To evaluate the effectiveness of abdomino-perineal repair in treating complex and recurrent bladder neck-prostatic urethra contractures.

Methods: The study included 6 patients retrospectively. Their ages ranged from 66 to 75 years (67.

Transurethral microwave thermotherapy in the armamentarium of therapeutic modalities for benign prostatic hyperplasia.

Transurethral microwave thermotherapy (TUMT) has gained a firm place in the spectrum of therapeutic modalities for management of patients with lower urinary tract symptoms suggestive of bladder outflow obstruction. To achieve optimum results following TUMT, intense research focuses on appropriate patient selection, heat-tissue interactions, and modification of technical specifications. Results of TUMT are good to excellent for the majority of patients, but there is a non-negligible number of patients who respond poorly.

Predictors of treatment outcome for high-energy transurethral microwave thermotherapy.

Background And Purpose: Transurethral microwave thermotherapy (TUMT) is an innovative alternative to transurethral resection of the prostate (TURP) for the treatment of lower urinary tract symptoms (LUTS) suggestive of bladder outflow obstruction (BOO). Although the results are satisfactory for the majority of the patients, a considerable number of patients have an unfavorable outcome. Thus, the identification of features able to predict efficacy of TUMT for individual candidates is an important issue.

Long-term follow-up of laser treatment for lower urinary tract symptoms suggestive of bladder outlet obstruction.

Objectives: The long-term results of different laser technologies in the management of lower urinary tract symptoms (LUTS) suggestive of bladder outlet obstruction (BOO) are not well known. We studied the durability of the effect of laser prostatectomy and tried to identify the factors predictive of treatment outcome.

Methods: Between December 1992 and November 1996, 190 patients underwent laser prostatectomy because of LUTS suggestive of BOO.

Clinical efficacy of a new 30-min algorithm for transurethral microwave thermotherapy: initial results.

Objective: To assess the efficacy of a new 30-min algorithm for high-energy transurethral microwave thermotherapy (TUMT, Prostasoft 3.5) in the treatment of men with lower urinary tract symptoms (LUTS) caused by benign prostatic hyperplasia.

Patients And Methods: A total of 108 men (mean age 66 years) with bothersome LUTS were treated with the new TUMT protocol.

Tolerability of 3.5 versus 2.5 high-energy transurethral microwave thermotherapy.

Purpose: To evaluate the tolerability of high-energy microwave thermotherapy in patients with benign prostatic hyperplasia (BPH) using two different treatment protocols (Prostasoft 2.5 and Prostasoft 3.5).

The value of urodynamics in laser prostatectomy.

Objective: To present the results of laser prostatectomy on urodynamic parameters, and to address the role of pressure/flow studies as diagnostic tools for optimal selection of candidates for this treatment modality.

Material And Methods: The world literature, available on Medline, presenting urodynamic parameters in patients subjected to laser prostatectomy was studied. We compared the data of different series, and when it was feasible from intrinsic features of a particular study, urodynamic results were plotted on the ICS Provisional Nomogram.

The tolerability of urodynamic studies and flexible cysto-urethroscopy used in the assessment of men with lower urinary tract symptoms.

Objective: To determine the overall tolerability of urodynamic studies used in the assessment of men with lower urinary tract symptoms (LUTS), by assessing the objective and subjective morbidity experienced during and after urodynamic studies, and to assess the voiding complaints caused by the combination of urodynamic studies with flexible cysto-urethroscopy.

Patients And Methods: A total of 103 men with LUTS, who underwent a urodynamic study combined with flexible cysto-urethroscopy, completed a questionnaire designed to assess objective and subjective symptoms and degree of bother, with emphasis on the urodynamic study. In addition, a urine specimen was analysed and cultured.

Neurogenic bladder dysfunction due to Behçet's disease.

Background: Behcet's disease is a chronic multisystem condition of unknown origin. Genitourinary tract involvement with genital apthous ulcers, epididymitis, urethritis and recurrent cystitis is encountered commonly. Neurogenic bladder dysfunction due to neural involvement of the syndrome, has been reported extremely rarely.

Transvaginal incisionless bladder neck suspension. A simplified technique for female genuine stress incontinence.

Objectives: Purpose of the present study is to evaluate the efficacy of a modified Gittes procedure in the management of Type I and Type II stress urinary incontinence of the female.

Patients And Methods: Thirty-two female patients with urodynamically proven Type I and Type II stress urinary incontinence had been subjected to transvaginal incisionless bladder neck suspension (modified Gittes procedure) from September 1991 to June 1996. Their mean age was 55.

Incontinence after surgery for benign prostatic hypertrophy: the case for complex approach and treatment.

Objective: Whether incontinence after surgery for benign prostatic hypertrophy (BPH) requires simple workup and treatment or being a more complex condition and multifactorial in etiology requiring combined surgical techniques should be investigated in more detail.

Methods: We retrospectively reviewed the records of 56 patients referred to us for post-prostatectomy incontinence after surgery for BPH. All patients were subjected to urodynamics.

Combined reconstructive and prosthetic surgery in complicated lower urinary tract dysfunction.

Purpose: The combined use of the appropriate reconstructive technique and available prosthetic material was evaluated to achieve an optimal functional result in complicated lower urinary tract dysfunction.

Materials And Methods: The study included 16 male and 8 female patients. Urinary dysfunction was classified into 2 main categories: 1) neuropathic and 2) nonneuropathic.