Techniques in urology最新文献_第2页

Periurethral transurethral microwave thermotherapy for the treatment of benign prostatic hyperplasia: an interim 1-year safety and efficacy analysis using the thermatrx TMx-2000. 经尿道微波热疗法治疗良性前列腺增生:使用热基质TMx-2000的1年中期安全性和有效性分析

Techniques in urology Pub Date : 2000-12-01

D M Albala, T M Turk, B R Fulmer, F Koleski, G Andriole, B E Davis, G R Eure, J N Kabalin, J Lingeman, J Nuzzarello, C Sundaram

{"title":"Periurethral transurethral microwave thermotherapy for the treatment of benign prostatic hyperplasia: an interim 1-year safety and efficacy analysis using the thermatrx TMx-2000.","authors":"D M Albala, T M Turk, B R Fulmer, F Koleski, G Andriole, B E Davis, G R Eure, J N Kabalin, J Lingeman, J Nuzzarello, C Sundaram","doi":"","DOIUrl":"","url":null,"abstract":"Transurethral microwave thermotherapy (TUMT) represents an accepted minimally invasive approach to the management of patients with benign prostatic hyperplasia (BPH). The TherMatrx TMx-2000 represents a further evolution in TUMT technique. This device uses periurethral transurethral microwave thermotherapy (P-TUMT) technology to directly target the BPH tissue adjacent to the prostatic urethra by using a catheter without a urethral-cooling surface. This article provides a technical review of the device and describes the results of a randomized, controlled multicenter study of P-TUMT for the treatment of symptomatic BPH. A discussion of the physiologic effects of P-TUMT is presented and compared to conventional TUMT. A comparison of P-TUMT to contemporary TUMT series in relation to efficacy and complications is also described. This study concludes that P-TUMT using the TherMatrx TMx-2000 device represents a minimally invasive, efficacious, and well-tolerated treatment for symptomatic BPH.","PeriodicalId":79536,"journal":{"name":"Techniques in urology","volume":"6 4","pages":"288-93"},"PeriodicalIF":0.0,"publicationDate":"2000-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21932700","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Initial and superior experience with 30 minute TUMT. 初步和卓越的经验，30分钟的TUMT。

Techniques in urology Pub Date : 2000-12-01

K M Tomera, F M Tomera, W R Clark

{"title":"Initial and superior experience with 30 minute TUMT.","authors":"K M Tomera, F M Tomera, W R Clark","doi":"","DOIUrl":"","url":null,"abstract":"Transurethral microwave thermotherapy (TUMT) is an evolving technique with different machines, protocols, intraprostatic temperatures, marketing claims, and clinical outcomes that can be confusing to the clinician. We report our initial and superior results with 30 Minute TUMT over previous treatment protocols in 16 patients. Patient discomfort and acceptance are greatly improved, with reduced analgesic requirements (11 vs. 24 mL of remifentanil), visual analogue pain scores of 0-2, and no power interruption required in any patients. All four patients in urinary retention are catheter-free 1 week after therapy. Post-treatment catheterization was required in only one patient who was voiding spontaneously before the procedure. Urinary flow rates and postvoid residuals improved in all patients. Prostatic cavities were found in all patients having prostate ultrasound 3 months after TUMT. 30 Minute TUMT is not simply a shortened 30-minute TUMT treatment. Rather it is a very different TUMT with an initial power of 80 W and initial urethral cooling water of 48 degrees F/8 degrees C. Mean maximum intraprostatic temperatures achieved are 154 degrees F/68 degrees C or 43 degrees F/24 degrees C greater than previous versions of microwave thermotherapy. 30 Minute TUMT s increased cooling and shorter times result in minimal discomfort and elimination of routine catheterization, but the initial 80-W energy and avoidance of power interruption provide higher intraprostatic temperatures and prostatic cavities in almost all patients in this office-based treatment.","PeriodicalId":79536,"journal":{"name":"Techniques in urology","volume":"6 4","pages":"276-7"},"PeriodicalIF":0.0,"publicationDate":"2000-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21932697","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Aspects on transurethral microwave thermotherapy of benign prostatic hyperplasia. 经尿道微波热疗治疗良性前列腺增生的研究进展。

Techniques in urology Pub Date : 2000-12-01

L Wagrell, T Schelin, M B Bolmsjö, A Mattiasson

引用次数: 0

Efficacy and safety of the new high-energy 30-minute transurethral microwave thermotherapy: results of 1-year follow-up in a multicenter study. 新型高能30分钟经尿道微波热疗的疗效和安全性:一项多中心研究1年随访结果

Techniques in urology Pub Date : 2000-12-01

J J de La Rosette, M P Laguna, G Pace, B B Kortmann, O Selvaggio, F M Debruyne, F P Selvaggi

{"title":"Efficacy and safety of the new high-energy 30-minute transurethral microwave thermotherapy: results of 1-year follow-up in a multicenter study.","authors":"J J de La Rosette, M P Laguna, G Pace, B B Kortmann, O Selvaggio, F M Debruyne, F P Selvaggi","doi":"","DOIUrl":"","url":null,"abstract":"Purpose: To assess the efficacy and durability of a new 30-minute 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.Materials and methods: A total of 167 men (mean age 67 years) with bothersome LUTS were treated with the new TUMT protocol. Evaluation included assessment of the short- and long-term objective and subjective outcome measures of this treatment.Results: The treatment is well tolerated. The International Prostate Symptom Score improved from a mean of 19.2 at baseline to 7.9 at 12 months after treatment. Maximum urinary flow improved from 8.9 to 16.4 mL/s at 12 months. Mean duration of catheterization was 16.1 days. Urodynamic evaluation showed a change from the obstructed to the nonminimally obstructed zone. There were no serious complications.Conclusion: High-energy TUMT using the new high-dose Prostasoft 3.5 protocol appears to be a safe, effective, and durable treatment. The faster procedure improves tolerance of the treatment. Subjective and objective improvements were significant and the treatment-related morbidity low.","PeriodicalId":79536,"journal":{"name":"Techniques in urology","volume":"6 4","pages":"271-5"},"PeriodicalIF":0.0,"publicationDate":"2000-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21932696","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Transurethral microwave thermotherapy versus transurethral resection of prostate. 经尿道微波热疗与经尿道前列腺切除术。

Techniques in urology Pub Date : 2000-12-01

V Ravery

{"title":"Transurethral microwave thermotherapy versus transurethral resection of prostate.","authors":"V Ravery","doi":"","DOIUrl":"","url":null,"abstract":"Purpose: Invasiveness, delayed morbidity, and the high cost of transurethral resection of the prostate (TURP) have resulted in the proposal of transurethral microwave thermotherapy (TUMT) as an alternative and less invasive treatment.Methods: Only a few randomized studies have evaluated the functional results of TUMT vs. TURP. Despite restricted inclusion criteria, they all concluded that TUMT is as effective as TURP in relieving subjective symptoms, but that it generally leads to less improvement in objective symptoms.Results: TUMT results seem to last at least 36 months; at 1-year follow-up, the rate of repeat treatment is 3.2%. The rates of morbidity in both groups are roughly in the same range. Acute urinary retention (10-13.5%) and postoperative voiding discomfort are the main occurrences after TUMT; bleeding, retrograde ejaculation (50-80%), and urethral strictures (3.1-6.6%) occur after TURP. Cost evaluation, related only to Targis and U.S. data, favors TUMT. However, it seems likely that the overall cost of TUMT procedures may decrease if TUMT becomes a widely used technique, including fair reimbursement from private insurance companies or from social security departments in European countries. TUMT is safe and effective to treat BPH.Conclusions: Nevertheless, to date, the improvement that occurs in most variables seems to be less than that after TURP.","PeriodicalId":79536,"journal":{"name":"Techniques in urology","volume":"6 4","pages":"267-70"},"PeriodicalIF":0.0,"publicationDate":"2000-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21932695","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Transurethral microwave thermotherapy. 经尿道微波热疗。

Techniques in urology Pub Date : 2000-12-01

B Djavan

引用次数: 0

Microwave thermotherapy in patients with chronic urinary retention. 微波热疗治疗慢性尿潴留患者。

Techniques in urology Pub Date : 2000-12-01

B Djavan, R Wammack, K Ghawidel, S Alavi, C Hasenzagel, P Dobronski, A Stoklosa, T Jakubcky, A Borkowski, M Marberger

{"title":"Microwave thermotherapy in patients with chronic urinary retention.","authors":"B Djavan, R Wammack, K Ghawidel, S Alavi, C Hasenzagel, P Dobronski, A Stoklosa, T Jakubcky, A Borkowski, M Marberger","doi":"","DOIUrl":"","url":null,"abstract":"Purpose: To evaluate the efficacy of high-energy transurethral microwave thermotherapy (TUMT) in the treatment of chronic urinary retention (CUR) due to benign prostatic hyperplasia (BPH).Materials and methods: In this prospective cohort study, 29 patients with CUR due to BPH underwent high-energy TUMT. Prior to treatment and during a 12-week follow-up, the following parameters were determined: quality of life (QOL) score, peak flow rate (Qmax) by uroflowmetry, and postvoid residual urine (PVR). In those with treatment failure (PVR > 150 mL or urinary retention), pressure-flow studies were performed and compared to pre-TUMT urodynamics.Results: Of the 29 patients, 21 (72%) regained the ability to void spontaneously at 5 weeks. The actuarial median time for spontaneous voiding to be restored was 3.5 weeks (95% confidence interval [CI] 2.9-4.8 weeks). Mean QOL score at 12 weeks post-TUMT (2.2; 95% CI 1.5-2.7) was lower than that at 1 week (4.6; 95% CI 3.9-5.8) by 51% (p < 0.0005). Further, a 55% increase in mean Qmax (p < .0005) determined by uroflowmetry was observed by 12 weeks vs. 1 week after high-energy TUMT. TUMT failed in 8 patients due to a hypocontractile detrusor.Conclusions: We concluded that high-energy TUMT is a potentially useful option for patient with CUR who are not candidates for prostatectomy.","PeriodicalId":79536,"journal":{"name":"Techniques in urology","volume":"6 4","pages":"278-81"},"PeriodicalIF":0.0,"publicationDate":"2000-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21932698","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Microwave applicators for thermotherapy of benign prostatic hyperplasia: a primer. 微波敷贴器热疗良性前列腺增生:引物。

Techniques in urology Pub Date : 2000-12-01

M B Bolmsjö, T Vrba

引用次数: 0

Transurethral microwave thermotherapy. 经尿道微波热疗。

Techniques in urology Pub Date : 2000-12-01 DOI: 10.1016/S1063-5777(02)00009-9

B. Djavan

引用次数: 0

Endourologic management of urinary fistulae. 尿瘘的泌尿系统管理。

Techniques in urology Pub Date : 2000-09-01

B F Schwartz, M L Stoller

{"title":"Endourologic management of urinary fistulae.","authors":"B F Schwartz, M L Stoller","doi":"","DOIUrl":"","url":null,"abstract":"Purpose: Historically, aggressive surgical exploration of renal fistulae has been associated with a 20% nephrectomy rate. We evaluated the role of minimally invasive techniques in the management of urinary fistulae.Materials and methods: A retrospective review identified 10 renal fistulae in nine patients. Six renal-cutaneous, two renal-colonic, and two renal-pleural fistulae were referred for evaluation and treatment.Results: Five men and four women (mean age 54 years, range 32-76) were referred to the University of California, San Francisco Urinary Stone Center from 1988 to 1996. Of the six renal-cutaneous fistulae, four were spontaneous and two were iatrogenic. The iatrogenic fistulae occurred after an open pyelolithotomy (1) and a renal exploration performed after extracorporeal shock wave lithotripsy (1). The spontaneous fistulae resulted from obstructing calyceal calculi (2), infundibular stenosis (1), and obstructed nephrostomy tube (1). The two renal-colonic fistulae resulted from percutaneous nephrolithotomies, and the two renal-pleural fistulae developed after renal surgery. Eight of 10 fistulae resolved with minimally invasive endoscopic techniques and relief of urinary obstruction. One nephrectomy was performed for a small nonfunctioning kidney after failed open pyelolithotomy. One patient refused all treatment and the fistula resolved spontaneously.Conclusions: Conservative management of both spontaneous and iatrogenic renal fistulae is possible by relieving urinary obstruction and using minimally invasive endoscopic techniques. Low nephrectomy rates can be expected using these methods.","PeriodicalId":79536,"journal":{"name":"Techniques in urology","volume":"6 3","pages":"193-5"},"PeriodicalIF":0.0,"publicationDate":"2000-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21798321","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0