Publications by authors named "Shah Hemendra N"
Objectives: To evaluate the safety and feasibility of "en-bloc" Holmium Laser Enucleation of the Prostate (HoLEP) with trainee involvement in patients with prostates larger than 200 cc.
Patients And Methods: A retrospective analysis was conducted on patients undergoing HoLEP using the "en-bloc" technique for prostate sizes > 200 cc between July-2017 and December-2023 at an academic teaching hospital. Perioperative data was collected, including patient demographics, clinical parameters, operative details and functional outcomes.
Purpose: To compare outcomes of transurethral resection of the prostate (TURP) across different regions worldwide over the past two decades.
Methods: A systematic review and meta-analysis of randomized clinical trials indexed to PubMed that assessed TURP. A total of 102 studies with 8,454 patients were included and grouped by continents: Europe, Asia, Africa, and Others (North America, South America, and Australia).
Introduction: Water Jet Ablation Therapy (WJAT) and Holmium Laser Enucleation of the Prostate (HoLEP) represent two common surgical treatments for Benign Prostatic Hyperplasia (BPH). Despite their increasing use, there is no study between these two methods. We aim to evaluate their efficacy and safety through a network meta-analysis (NMA), providing critical insights for clinical decision-making in the management of moderate to severe lower urinary tract symptoms (LUTS) due to BPH.
View Article and Find Full Text PDFPurpose: In patients with prostate cancer (PCa), focal therapy with High-Intensity Focused Ultrasound (HIFU) combined with benign prostatic hyperplasia (BPH) surgery has been used to improve immediate post-operative voiding symptoms. Our study aimed to evaluate the functional outcomes of patients undergoing simultaneous holmium laser enucleation of the prostate (HoLEP) + HIFU and compare them to those who underwent HoLEP for bladder outlet obstruction secondary to BPH.
Methods: We performed retrospective review of patients who underwent HoLEP + HIFU or HoLEP between June 2017 and May 2024.
We described two patients diagnosed with rare bladder metastasis (BM) from pancreatic adenocarcinoma, a prevalent neoplastic disease primarily associated with ductal adenocarcinoma. The overall prognosis for those patients with metastasis is very poor, with a 5-year survival rate of < 3%. The scarcity of cases in the literature makes this series a significant contribution as it presents the first documented instance of BM originating from pancreatobiliary ampullary cancer and a rare case associated with the Krukenberg tumor.
View Article and Find Full Text PDFPurpose: The goal of this systematic review is to assess the temporal changes in outcomes and complications of transurethral resection of the prostate (TURP) from 2000 to 2022.
Methods: We conducted a systematic review and meta-analysis of 103 randomized clinical trials from PubMed on TURP, involving 8521 patients. Studies were grouped by years: 2000-2004, 2005-2009, 2010-2014, and 2015-2022.
Prostatic Artery Embolization: Mid- to Long-Term Outcomes in 1,075 Patients.
J Vasc Interv Radiol
November 2024
Purpose: To assess the mid- to long-term safety and effectiveness of prostatic artery embolization (PAE) at a single-center cohort of 1,075 patients.
Materials And Methods: This institutional review board-approved retrospective study included patients with moderate-to-severe lower urinary tract symptoms (LUTS) or urinary retention who underwent PAE from January 2014 to July 2023. Patients were assessed at 1, 3, 6, and 12 months after PAE and yearly thereafter.
Article Synopsis
- Open simple prostatectomy (OSP) is still an important treatment for benign prostatic hyperplasia (BPH) in patients with large prostate volumes (>80 ml), especially when compared to newer methods like minimally invasive simple prostatectomy (MISP) and laser enucleation.
- A meta-analysis of 10 randomized controlled trials showed that while OSP significantly improves voiding symptoms, it has a higher risk of postoperative complications such as bleeding and transfusions.
- Although OSP remains a viable treatment option, its higher morbidity rates necessitate careful patient selection and ongoing research to enhance surgical techniques and overall outcomes.
Digital flexible ureteroscopes (DFUs) play a crucial role in endourological procedures, and scope breakages are often avoidable with proper measures in place. We aimed to evaluate the effect of mandatory training on DFU durability and to assess the influence of various factors on instrument damage. Mandatory training involving instructional videos on DFU care was introduced for all processing and operating room staff handling DFUs.
View Article and Find Full Text PDFArticle Synopsis
- The study aimed to assess the outcomes of Holmium laser enucleation of the prostate (HoLEP) in patients with obstructive uropathy caused by bladder outlet obstruction.
- Researchers reviewed cases from 2017 to 2023, comparing patients with and without obstructive uropathy, focusing on key metrics like kidney function and recovery times.
- The results indicated that while HoLEP is effective and safe, patients with obstructive uropathy have a higher risk of postoperative kidney injury and experience longer catheterization periods.
Objective: To evaluate the influence of preoperative post-void residual (PVR) volume on the outcomes of Holmium Laser Enucleation of the Prostate (HoLEP). Long-term bladder obstruction can impair bladder contractility, which has been linked to failure to improve lower urinary tract symptoms (LUTS) after bladder outlet procedures. Elevated PVR constitutes a proxy for chronic retention and detrusor underactivity that can be non-invasively determined in office.
View Article and Find Full Text PDFObjectives: We aim to compare efficacy and safety of water vapour therapy (Rezūm), transurethral needle ablation (TUNA) and transurethral microwave therapy (TUMT) for treating men with moderate to severe benign prostatic hyperplasia (BPH) symptoms.
Materials: PubMed/MEDLINE, EMBASE and Cochrane Library were searched from inception to 30 July 2023, followed by reference searching and dual-independent study selection. We analysed only randomized clinical trials.
Article Synopsis
- The study evaluates the combined effectiveness and safety of High-Intensity Focused Ultrasound (HIFU) and Holmium Laser Enucleation of the Prostate (HoLEP) for patients with localized prostate cancer (PCa) and large prostate sizes (> 60 g).
- It reviewed data from 100 patients treated between 2016 and 2023, comparing outcomes between those who underwent only HIFU and those who had the combined approach.
- Results showed that while the combined treatment led to better PSA results initially, both treatment groups had similar cancer recurrence rates, and although the combined treatment resulted in more initial urinary issues, long-term functionality appeared comparable between both treatments.
Article Synopsis
- Acquired urethral diverticula (UD) in males is an unusual condition, often occurring post surgeries like prostatectomy, and this case highlights its occurrence after holmium laser enucleation of the prostate (HoLEP) in a 69-year-old man.
- The patient had a significantly enlarged prostate and experienced multiple episodes of urine retention and infections, despite medical treatment; he was ultimately diagnosed with a 6-cm UD following urodynamics, cystoscopy, and imaging tests.
- After surgical intervention to remove the diverticulum, the patient still faced challenges with mixed urine incontinence, suggesting that UD may be a rare but important consideration in men with recurrent urinary tract infections and incontinence following prostate surgery.
Article Synopsis
- The review evaluates the role of natural language processing (NLP) in extracting data from electronic health records (EHRs) specifically for prostate cancer (PCa) management by analyzing existing literature.* -
- A literature search identified 14 studies that explored various aspects of PCa management, including clinical examinations, pain assessment, staging information, and patient-centered outcomes, all demonstrating moderate to high accuracy in data extraction.* -
- Despite showing effectiveness in extracting relevant clinical data, NLP faces challenges with nuanced language and context-specific terms, which can lead to inaccuracies, yet it remains valuable for automating outcome monitoring and reducing workload.*
Purpose Of Review: Surgical treatment of benign prostatic hyperplasia (BPH) carries a significant risk of ejaculation dysfunction. Preservation of antegrade ejaculation while providing effective, well tolerated, and durable treatment of BPH is a paramount component of physical and sexual well being for significant number of men. We reviewed available literature with an aim of providing status on antegrade ejaculation preserving BPH surgical therapies.
View Article and Find Full Text PDFObjectives: The objectives of this study are to evaluate the impact of incidental prostate cancer (iPCa) and its different grade group (GG) on the surgical outcomes of holmium laser enucleation of the prostate (HoLEP) and, furthermore, to assess the independent risk factors associated with the detection of iPCa.
Patients Or Materials And Methods: A retrospective chart review was conducted at a single institution for HoLEP cases that were performed between 2017 and 2022. Patients with a preoperative diagnosis of prostate cancer and those without baseline prostate-specific antigen (PSA) levels within 1 year were excluded.