Laser prostatic surgery: an update

This review presents an overview of the current state of the art of laser prostatic surgery. Several types of lasers have been used in the treatment of benign prostatic hyperplasia [BPH] over the past 15 years. Vaporization techniques have recently gained popularity and have been widely accepted by many urologists. Short-term results show that vaporization of a prostatic adenoma with higher-power potassium titanyl phosphate and holmium lasers is safe and effective in the treatment of symptomatic BPH. However, well designed randomized comparative trials with long-term follow-up are still needed. Holmium laser is a multi-purpose surgical tool and has multiple applications in urology. In the treatment of symptomatic BPH, holmium laser can be used in ablation, resection and enucleation of the prostate. Holmium laser enucleation of the prostate [HoLEP] is the most investigated laser procedure used in the treatment of symptomatic BPH. Several randomized controlled trails confi rmed the safety, efficacy, and durability of HoLEP regardless of the prostate size

comparative study of prism adaptation versus augmented surgery formula in the management of acquired comitant esotropia

This study compares two methods of surgical augmentation, namely prism adaptation and the augmented surgery formula, in the management of acquired comitant esotropia. Forty patients were included in the study. These were divided equally into two groups: Group A [Augmented Surgery Formula Group] and Group P [Prism Adaptation Group]. Group A patients underwent surgery based on an augmented surgery formula, defined as the average of the near deviation without correction and the distance deviation with correction. Group P patients had preoperative prism adaptation, at the end of which they were classified as prism adaptation responders [fusers] or nonresponders [nonfusers]. All group P patients underwent surgery for the prism-adapted angle. Among group P patients, 6 [30%] were classified as prism responders, while 14 [70%] were nonresponders. The three-month motor success rate was significantly higher in group P [90%] than in group A [55%], [z statistic=2.69, P=0.05]. On the other hand, the sensory success rate was insignificantly higher in group A [45%] than in group P [65%], [z statistic=1.29, p>0.05]. Prism adaptation is superior to the augmented surgery formula in precisely determining the surgical target angle in acquired comitant esotropia. The former has a special indication in non-accommodative esotropia, whereas the latter is the only feasible option in cases of esotropia exceeding 40 delta with correction. To maximize the benefit of prism adaptation, it is recommended that all prism-adapted patients [responders and nonresponders] undergo surgery for the prism-adapted angle

Transurethral microwave thermotherapy versus sham treatment: early report of a randomized double-blind study

Transurethral microwave thermotherapy [TUMT] for the management of clinical BPH has recently been introduced and investigated in a number of centres. A prospective double-blind randomized study was designed to evaluate the extent of any placebo response. The inclusion criteria were a total Madsen score > 8, a Qmax