Journal ArticleDOI
Transurethral microwave thermotherapy vs transurethral resection for treating benign prostatic hyperplasia: A systematic review
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TLDR
A systematic review of the literature comparing transurethral microwave therapy to TURP shows that although microwave therapy is safe and effective in the short term, it is not as effective as TURp.Abstract:
Technology has been used in the management of BPH, sometimes without much evidence to support its use. The first manuscript is a systematic review of the literature comparing transurethral microwave therapy to TURP. This shows that although microwave therapy is safe and effective in the short term, it is not as effective as TURP.
Authors from London report on their long-term (up to 12-years of follow-up) results when using the Urolume wallstent for urethral stricture. They describe the results in detail, and conclude that the stent should only be used in patients who are unfit for or who refuse urethroplasty.
OBJECTIVE
To conduct a systematic review of randomized controlled trials evaluating the efficacy and safety of transurethral microwave thermotherapy (TUMT) compared with transurethral resection of the prostate (TURP) in treating men with symptomatic benign prostatic hyperplasia (BPH).
METHODS
We searched Medline, the Cochrane Library and reference lists of retrieved studies to identify randomized trials of ≥ 6 months duration with ≥ 10 patients in each treatment arm. Data were extracted on study design, patient and treatment characteristics, urinary symptoms, urinary flow, adverse events and repeat treatment for BPH.
RESULTS
Six studies were evaluated, involving 540 patients. The mean age (67.8 years), baseline symptom score (19.5), and peak urinary flow (PUF, 8.6 mL/s) did not differ by treatment group. The pooled mean urinary symptom score decreased by 65% with TUMT and 77% with TURP. The weighted mean (95% confidence interval) difference for the symptom score at the follow-up was −1.83 (−3.09 to −0.58) points, favouring TURP. The pooled mean PUF increased by 70% with TUMT and 119% with TURP. The weighted mean difference for the PUF at the follow-up was 5.37 (4.22–6.51) mL/s, favouring TURP. Retrograde ejaculation (57.6% vs 22.2%), transfusions (5.7% vs 0%) and re-treatment for strictures (relative hazard 9.76) were all significantly more common after TURP, but re-treatment for BPH was significantly more common after TUMT (relative hazard 10.0).
CONCLUSIONS
TUMT techniques are effective and safe short-term alternatives to TURP for treating BPH. However, TURP provided greater symptom and urinary flow improvements and fewer subsequent BPH treatments than TUMT.read more
Citations
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Journal ArticleDOI
A Prostate-Specific Antigen–Activated Channel-Forming Toxin as Therapy for Prostatic Disease
Simon A. Williams,Rosemina Merchant,Elizabeth Garrett-Mayer,John T. Isaacs,J. Thomas Buckley,Samuel R. Denmeade +5 more
TL;DR: The observations demonstrate the potential safe and effective intraprostatic application of this engineered protoxin and the safety of PRX302 into the PSA-secreting prostate glands of cynomolgus monkeys, with no toxicity to neighboring organs or general morbidity.
Journal ArticleDOI
Histotripsy of the Prostate: Dose Effects in a Chronic Canine Model
TL;DR: Histotripsy was effective at fractionating parenchymal and urethral tissue in the prostate, in the presence of a sufficient dose, and could lead to a noninvasive method for debulking the prostate to relieve symptoms associated with benign prostatic hyperplasia.
Journal ArticleDOI
Virtual reality as an adjunctive pain control during transurethral microwave thermotherapy.
TL;DR: This report is novel in being, to the authors' knowledge, the first to demonstrate the efficacy of virtual reality in an elderly patient and the first documented use for a urologic clinic procedure and it is believed to be thefirst to demonstrate efficacy for the control of thermally induced pain.
Journal ArticleDOI
Is there an increase in genitourinary toxicity in patients treated with transurethral resection of the prostate and radiotherapy? A systematic review.
Hiromichi Ishiyama,Takahiro Hirayama,Takahiro Hirayama,Pavan Jhaveri,Takefumi Satoh,Arnold dela Cruz Paulino,Bo Xu,Edward Brian Butler,Bin S. Teh +8 more
TL;DR: It is suggested that TURP is one of the risk factors of GU toxicity after RT, and needs to be taken seriously when prostate cancer patients with T URP are considered for RT either external beam or brachytherapy.
References
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Journal ArticleDOI
Meta-Analysis in Clinical Trials*
TL;DR: This paper examines eight published reviews each reporting results from several related trials in order to evaluate the efficacy of a certain treatment for a specified medical condition and suggests a simple noniterative procedure for characterizing the distribution of treatment effects in a series of studies.
Journal ArticleDOI
Empirical evidence of bias. Dimensions of methodological quality associated with estimates of treatment effects in controlled trials.
TL;DR: Empirical evidence is provided that inadequate methodological approaches in controlled trials, particularly those representing poor allocation concealment, are associated with bias.
Journal ArticleDOI
The American Urological Association symptom index for benign prostatic hyperplasia. The Measurement Committee of the American Urological Association.
Michael J. Barry,Floyd J. Fowler,Michael P. O'Leary,Reginald C. Bruskewitz,Holtgrewe Hl,Winston K. Mebust,Abraham T.K. Cockett +6 more
TL;DR: The AUA symptom index for benign prostatic hyperplasia was developed and validated by a multidisciplinary measurement committee of the American Urological Association and is clinically sensible, reliable, valid and responsive.
Journal ArticleDOI
The American Urological Association Symptom Index for Benign Prostatic Hyperplasia
Michael J. Barry,Floyd J. Fowler,Michael P. O'Leary,Reginald C. Bruskewitz,H. Logan Holtgrewe,Winston K. Mebust,Abraham T.K. Cockett +6 more
TL;DR: The AUA symptom index for benign prostatic hyperplasia was developed and validated by a multidisciplinary measurement committee of the American Urological Association and is clinically sensible, reliable, valid and responsive.
Journal ArticleDOI
Mortality and Reoperation after Open and Transurethral Resection of the Prostate for Benign Prostatic Hyperplasia
Noralou P. Roos,John E. Wennberg,David J. Malenka,Elliott S. Fisher,Klim McPherson,Tavs Folmer Andersen,Marsha M. Cohen,Ernest W. Ramsey +7 more
TL;DR: It is suggested that transurethral prostatectomy is less effective in overcoming urinary obstruction than the open operation, and the possibility that transUREthral prostatic hyperplasia may result in higher long-term mortality is raised.
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