A Systemic Review and Meta-analysis of Transabdominal Intravesical Prostatic Protrusion Assessment in Determining Bladder Outlet Obstruction and Unsuccessful Trial Without Catheter.

Context: Urodynamic study (UDS) provides the most objective assessment of bladder outlet obstruction (BOO) but is impractical to be recommended routinely in outpatient services. Intravesical prostatic protrusion (IPP) had been described to obstruct urinary flow by creating an anatomical ball-valve effect, but there remains a lack of pooled evidence that can objectively correlate with BOO in benign prostatic hyperplasia.

Objective: To update the current evidence on the predictive role of IPP in determining BOO and unsuccessful trial without catheter (TWOC).

What is a disease? What is the disease clinical benign prostatic hyperplasia (BPH)?

Introduction: Though clinical benign prostatic hyperplasia (BPH) is a common disease worldwide, there is still much confusion in the literature and the many clinical guidelines as to its definition. Often the disease is associated with lower urinary tract symptoms (LUTS) and managed according to only symptoms. This leads to undertreatment in some patients with severe bladder outlet obstruction (BOO) with no symptoms, and overtreatment in patients with LUTS but no clinical BPH.

Patients with small prostates and low-grade intravesical prostatic protrusion - A urodynamic evaluation.

Objective: Despite high-grade intravesical prostatic protrusion (IPP) being closely related to bladder outlet obstruction (BOO), up to 21% of patients with low IPP remain obstructed. This study evaluates the characteristics and urodynamic findings of men with small prostates and low IPP.

Methods: One hundred and fourteen men aged >50 years old with lower urinary tract symptoms (LUTS) were assessed with symptoms, uroflowmetry, serum prostate-specific antigen (PSA), transabdominal ultrasound measurement of prostate volume (PV), IPP and post-void residual urine (PVRU).

Benign prostatic hyperplasia and male lower urinary symptoms: A guide for family physicians.

Male patients with lower urinary tract symptoms (LUTS) and benign prostatic hyperplasia (BPH) are increasingly seen by family physicians worldwide due to ageing demographics. A systematic way to stratify patients who can be managed in the community and those who need to be referred to the urologist is thus very useful. Good history taking, physical examination, targeted blood or urine tests, and knowing the red flags for referral are the mainstay of stratifying these patients.

Pathophysiology of clinical benign prostatic hyperplasia.

A disease can be defined as an abnormal anatomy (pathology) and/or function (physiology) that may cause harm to the body. In clinical benign prostatic hyperplasis (BPH), the abnormal anatomy is prostate adenoma/adenomata, resulting in a varying degree of benign prostatic obstruction (BPO) that may cause harm to the bladder or kidneys. Thus clinical BPH can be defined as such and be differentiated from other less common causes of male lower urinary tract symptoms.

Can men with prostates sized 80 mL or larger be managed conservatively?

Purpose: To analyze the long-term clinical outcomes of men with large prostate sizes of 80 mL and greater who were managed conservatively.

Materials And Methods: We retrospectively analyzed men with prostate sizes of 80 mL and greater from our electronic hospital database. Clinical parameters such as age, International Prostate Symptom Score (IPSS), quality of life (QoL) scoring, serum prostate-specific antigen (PSA), uroflowmetry variables, and transabdominal ultrasound findings were evaluated.

Early outcome of transurethral enucleation and resection of the prostate versus transurethral resection of the prostate.

Introduction: Recurrent prostate adenoma is a long-term complication following transurethral resection of the prostate (TURP). Transurethral enucleation and resection of the prostate (TUERP) is more appealing, since the nodular adenoma can be completely removed through endoscopy. TUERP is also hypothesised to result in a lower frequency of recurrent adenoma.

Can intravesical prostatic protrusion predict bladder outlet obstruction even in men with good flow?

Objective: Men with benign prostate hyperplasia (BPH) with good urinary flow may still have bladder outlet obstruction (BOO). Intravesical prostatic protrusion (IPP) has been shown to be able to predict BOO. We aim to investigate the use of IPP to predict BOO in men with good urinary flow.

Relationships between Prostatic Volume and Intravesical Prostatic Protrusion on Transabdominal Ultrasound and Benign Prostatic Obstruction in Patients with Lower Urinary Tract Symptoms.

Introduction: The objective of this study is to determine the relationships between prostatic volume (PV) and intravesical prostatic protrusion (IPP) with benign prostatic obstruction (BPO).

Materials And Methods: A total of 408 males (aged 50 years and above) who presented with lower urinary tract symptoms (LUTS) suggestive of benign prostatic hyperplasia (BPH) were recruited. All had International Prostate Symptoms Score (IPSS), quality of life (QOL) index, uroflowmetry (Qmax) and postvoid residual urine (PVR) measured by transabdominal ultrasonography (TAUS).

Diagnosis of prostate adenoma and the relationship between the site of prostate adenoma and bladder outlet obstruction.

Introduction: The objective of this study was to evaluate the accuracy of using intravesical prostatic protrusion (IPP) as a parameter for the diagnosis of prostate adenoma (PA), as well as to determine the relationship between the site of PA and bladder outlet obstruction. IPP was determined with the use of transabdominal ultrasonography (TAUS).

Methods: A total of 77 consecutive adult men aged 30-85 years with haematuria or undergoing checkup for bladder tumour were enrolled.

6th College of Surgeons lecture: the philosophy of balance: the art of healing.

With the rise of high tech medicine, and emphasis on the scientific aspects of medicine, there is danger that we may lose the balanced approach to healing, and lose the benefit of the traditional medical wisdom and emotional support, to improve the care of our patients. Allopathic or the mainstream medicine (Western medicine) is not the only way. With over-emphasis on the anatomy and pathology, the biochemistry and the molecular biology, we tend to treat the disease, and somehow neglect the patient.

Decision making in the management of benign prostatic enlargement and the role of transabdominal ultrasound.

Benign prostate enlargement (BPE) is a common disease affecting elderly men. It can present clinically in many ways including, but not exclusively, lower urinary tract symptoms (LUTS) and acute urinary retention (AUR). Therefore, in managing men with BPE, a correct diagnosis in the outpatient setting is important.

Staging of benign prostate hyperplasia is helpful in patients with lower urinary tract symptoms suggestive of benign prostate hyperplasia.

Introduction: We prospectively evaluated the staging of benign prostate hyperplasia (BPH) to decide transurethral resection of prostate (TURP) therapeutic modality and the final outcomes in patients with lower urinary tract symptoms (LUTS) suggestive of BPH.

Materials And Methods: Male patients above 50 years old presented with LUTS suggestive of BPH were included in this study. The initial assessment included the International Prostatic Symptoms Score (IPSS) and the Quality of Life (QOL) index, digital rectal examination (DRE).

Intravesical prostatic protrusion predicts clinical progression of benign prostatic enlargement in patients receiving medical treatment.

Objectives: To assess intravesical prostatic protrusion (IPP) as a novel predictor of clinical progression in patients with benign prostatic enlargement (BPE).

Methods: All patients attending the outpatient clinic at our institution who were being treated for lower urinary tract symptoms (LUTS) secondary to BPE between January 1997 and December 2003 were recruited into the study. International Prostate Symptom Score (IPSS) scores, uroflowmetry parameters, post-void residual urine volume (PVR), IPP and serum prostate-specific antigen (PSA) were collected.

A prospective randomized study comparing monopolar and bipolar transurethral resection of prostate using transurethral resection in saline (TURIS) system.

Objectives: To compare transurethral resection of prostate (TURP) using monopolar and bipolar transurethral resection in saline (TURIS) system.

Materials And Methods: A prospectively randomized study was conducted between January 2004 and January 2005. Patient demographics and indications for surgery were recorded.