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ObjectiveTo study and compare the nursing effect of different nursing modes in patients with dysuria after transurethral electrovaporization of the prostate. Methods50 patients with dysuria after transurethral electrovaporization of the prostate from January 2007 to March 2011 were selected as research objects,and they were randomly divided into group A and group B with 25 cases in each group,group A was taken care with routine nursing method,group B adopted evidence-based nursing mode,then the rate of self- maturate,usage rate of catheter,time of indwelling catheter,maximum flow rate,relapse of dysuria,satisfaction degree,treatment compliance and quality of life before and after the nursing of two groups were analyzed and compared. ResultsThe rate of self-maturate and satisfaction degree of group B were higher than those of group A,usage rate of catheter and relapse of dysuria were lower than those of group A,time of indwelling catheter was shorter than that of group A,treatment compliance and quality of life were all better than those of group A,there were significant differences. ConclusionsThe nursing effect of evidence-based nursing mode in patients with dysuria after transurethral electrovaporization of the prostate is good,it can significantly improve the quality of life and is popular among patients.
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Objective To assess the efficacy of radical transurethral electrovaporization for invasive bladder cancer. Methods Thirty-six patients with invasive bladder cancer from february 2008 to February 2010 were treated by transurethral electrovaporization resection of bladder tumor (TURBT). The operation procedure was based upon the principle of radical transurethral resection for bladder tumor. The tumor was resected to fatty layer outside the bladder wall. After operation Bacillus Calmette-Guerin (BCG) irrigation of bladder was given,all patients were followed up for 3 to 24 months. Results The recurrence occurred in 12 cases in 2 years,with a recurrence rate of 33. 3% (12/36). These recurrence cases were treated with TURBT again. Six cases dead in 2 years,with a mortality of 16. 7% (6/36). Conclusion TURBT is suitable for those who are older or weak,and not medically fit for radical cystectomy or those who refuse the open surgery,which can prolong the survival time and improve the quality of life.
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Objective To investigate the clinical efficacy and safety of transurthral electrovaporization of the prostate(TUVP) for benign prostatic hyperplasia( BPH) at high risk.Methods Forty-eight patients with BPH at high risk were treated with transurthral electrovaporization of the prostate(TUVP).The clinical data and therapeutic results were measured.Results All patients went through the perioperiative period safely and had been followed up for 3 to 14 months.Postvoid residual ( PVR) , the International Prostate Symptom Score (IPSS) and quality of life (QOL) before operations were (97.5 ± 16.9) ml, ( 28.4 ± 2.3 ) score and (5.5 ±0.6) score respectively.Three months after operation ,PVR ,IPSS and QOL were( 30.2 ± 12.3 ) ml, (8.2 ± 1.3 ) score and( 1.9 ±0.5) score respectively,there was significant difference between them(t =22.31,53.16,31.94,all P<0.05).Conclusion TUVP is an effective and safe method in treating BPH patients at high risk.
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Objective To analyze the effect of intravenous dripping of 3% sodium chloride solution on prevention of diluted hyponatremia during transurethral vaporization of the prostate (TUVP). Methods Eighty-five cases with benign prostatic hyperplasia (BPH) accompanied with typical lower urinary tract symptoms (LUTS) were divided into two groups during undergoing TUVP operation: the control group(n=38) given Ringer's solution dripping (3ml/min) and the concentrated sodium chloride injection group(n= 47) given 3% sodium chloride solution dripping (2～4ml/min). All of the operations were taken via Wolf electric resection system, and the operation time was≥60 min. The complete blood count and serum electrolyte were determined before operation and 60 minutes after operation beginning, and the data were compared between the two groups. Results The decrease amplitude of serum sodium was obviously smaller in concentrated sodium chloride injection group[(1.45±5.14)mmol/L] than that in the control group[(7.79±6.64) mmol/L] 60 minutes after operation beginning (P<0.05). Conclusions Giving 3% sodium chloride solution by intravenous drip during TUVP may reduce the severity of diluted hyponatremia and postpone the occurrence of hyponatremia, and thereby decrease the risk of transurethral resection syndrome.
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Objectives:To investigate the effects of transurethral electrovaporization of the prostate(TUVP)plus transurethral re-section of the prostate(TURP)for patients with benigh prostate hyperplasia(BPH).Methods:The technique of TUVP plus TURP was employed to treat 114 cases of BPH.Results:All patients underwent successful TUVP and TURP procedure intraoperatively,and recovered very well postoperatively.No serious complications were noted.Conclusions:TUVP plus TURP is a feasible and safe technique for patients with BPH.
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Objective To discuss the prevention and management of complications of transurethral electrovaporization of the prostate(TUVP).Methods A total of 820 patients underwent TUVP from June 1998 to August 2005.A Wolf electrovaporization system and a F_(24) 12? resectoscope were used.After the seminal colliculus was identified for making a reference plane,the prostatic tissues were removed untill the surgical envelope,and the bladder neck and the apex of prostate were surgically shaped.Results Complications occurred in 124 patients(15.1%,124/820).There were 17 cases of intraoperative complications(2.0%),including massive haemorrhage in 6 patients(0.7%),presymptoms of transurethral resection syndrome in 6 patients(0.7%),and perforation on the juncture of the bladder and the prostate in 5 patients(0.6%).There were 107 cases of postoperative complications(13.0%), including urethral stricture in 18 patients(2.2%),spasm of the bladder in 32 patients(3.9%),secondary hemorrhage in 3 patients(0.4%),retrograde ejaculation in 11 patients(1.3%),temporary incontinence in 13 patients(1.6%),infection of the urinary tract in 24 patients(2.9%),and acute pulmonary thromboembolism in 6 patients(0.7%). Conclusions Preoperative precautions and clear intraoperative exposure are essential to prevent the incidence of complications of TUVP.
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Objective To discuss clinical effects of transurethral electrovaporization of the prostate(TUVP) for the treatment of large benign prostatic hyperplasia(BPH).Methods A total of 126 cases of large BPH were treated with TUVP.Two longitudinal trenches were made at the position of 6 and 12 o'clock,respectively.Then the lateral lobe was retrogradely dissected from the proximal end of the seminal colliculus and was removed.Results The international prostate symptom scores(IPSS) decreased from 28.6?4.5 preoperatively to 10.7?2.6 postoperatively(t=38.661,P=0.000);the quality-of-life scores(QOL) decreased from 5.3?0.7 preoperatively to(2.0?)0.5 postoperatively(t=43.061,P=0.000);the maximum urinary flow rate(Qmax) increased from 5.7?3.6 ml/s preoperatively to 18.2?4.2 ml/s postoperatively(t=-25.365,P=0.000);the resident urine(RU) decreased from 312.4?56.6 ml preoperatively to 32.8?9.2 ml postoperatively(t=54.732,P=0.000).There were significant differences in all these parameters between preoperatively and postoperatively.Threatened transurethral resection syndrome(TURS) occurred during operation in 2 cases.Postoperatively,transient urinary incontinence was observed in 5 cases.Conclusions Transurethral electrovaporization of the prostate for the treatment of large BPH is effective and safe.
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Objective To evaluate peri-operative clinical effects of transurethral electrovaporization of the prostate(TUVP) combined with transurethral resection of the prostate(TURP) versus open prostatectomy for benign prostatic hyperplasia(BPH).Methods A total of 156 cases of BPH were surgically treated in this hospital from November 1997 to December 2004,including 53 cases of TUVP combined with TURP(Combination Group) and 103 cases of open suprapublic prostatectomy(Open Group). Results There were no significant differences in the operation time between the two groups(90?70 min vs 108?68 min;t=(-1.550),P=0.123).The Combination Group was superior to the Open Group in the blood transfusion rate(8% vs 38%;?~2=16.109,P=0.000),the time to clear urine(2?1 d vs 4?1 d;t=-11.831,P=0.000),the postoperative catheterization time(10?8 d vs 19?10 d;t=-5.680,P=0.000),the time to get out of bed(6?4 d vs 20?10 d;t=-9.785,P=0.000),and the postoperative hospital stay(20?14 d vs 34?24 d;t=-3.914,P=0.000).The incidence of complications was higher in the Combination Group than in the Open Group(15.1% vs 2.9%;?~2=6.173,P=0.013).Conclusions TUVP in combination with TURP for benign prostate hyperplasia has advantages of little invasion and rapid recovery.
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Objective To study the causes, prophylaxis, and treatment of the severe complications due to transurethral electrovaporization of the prostate (TVP). Methods We analyzed the complications found in 1 910 men with moderate and severe symptoms of prostatism treated with TVP from August 1997 to February 2003 and studied the causes, prophylaxis, and treatment of the severe complications due to TVP. Results Severe complications were found in 78 cases (4.1%). Late mass bleeding in 35 cases (0.18%) was resulted from the abscission of coagulated necrotic tissue of the prostate after TVP. Extraperitoneal water extravasation (hydrocele) in 27 cases (0.14%) was caused by the early incision of the peritoneum in TVP and could be prevented by avoiding early incision of the peritoneum and stopping operation in time. Severe urethral stricture in 9 cases (0.05%) was caused by using thick sheath of cystoscope and cutting the neck of urinary bladder improperly. Urinary bladder explosion in 2 cases (0.01%) was caused by accumulation of air during the process of TVP, but could be protected by removing the air and water in urinary bladder at intervals. Incontinence in 2 cases (0.01%) was resulted from the injured urinary sphincter muscle. Acute renal failure in 3 cases (0.015%) was caused by hypotension. Conclusion Severe complications due to TVP can be prevented and treated. The occurrence rate of severe complications can be decreased by the proper preventive measures and skilled techniques of the operators.
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PURPOSE: We compared the outcome of transurethral electro-vaporization of the prostate (TVP) with that of transurethral resection of the prostate (TURP) in patient with benign prostate hyperplasia (BPH). MATERIALS AND METHODS: Fifty-four patients with BPH were treated with TVP (Group I) and sixty-two with TURP (Group II). Patients were assessed at baseline for both safety and efficacy and in follow-up at 1 and 3 months. Efficacy parameters evaluated included American Urological Association (AUA) symptom score, peak urinary flow rate (Qmax) and post-void residual urine volume (ml). Safety parameters evaluated included incidence of side effects, operative time, postoperative catheterization time, change in hematocrit and serum sodium. RESULTS: The mean prostate size was 28.4+/-4.8gm in GroupI and 37.1+/-5.3gm in Group II. The mean operation time was shorter in Group I (48.2+/-10.5min) than in Group II (75.2+/-32.6min) (p<0.05). The change of hematocrit (%) was lower in Group I (from 40.2+/-4.1 to 38.7+/-4.1) than in Group II (from 40.3+/-3.8 to 34.9+/-5.5), (p<0.05). The mean catheterization time was 3.2+/-1.2 days and 4.9+/-1.9 days (p<0.05). The change of peak urinary flow rate, post-void residual urine volume, AUA symptom score, incidence of postoperative complications was not significantly different between each group. CONCLUSIONS: Although the TURP is the gold standard for the treatment of symptomatic BPH with high success rate, significant morbidities are associated with this procedure. Our early clinical experience highlights several advantages of electro-vaporization, particulary the low incidence of postoperative morbidity.
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Humans , Catheterization , Catheters , Follow-Up Studies , Hematocrit , Hyperplasia , Incidence , Operative Time , Postoperative Complications , Prostate , Prostatic Hyperplasia , Sodium , Transurethral Resection of ProstateABSTRACT
0.05). Conclusions Radical TUVBT can be selected as surgical treatment for muscle-invasive bladder cancer cases,especially for those who are older and weak,and not medically fit for radical cystectomy or those who refuse the open surgery.
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Objective To evaluate and compare the therapeutic effects of suprapubic transvesical prostatectomy (SPPC), Madigan prostatectomy (MPC) and transurethral electrovaporization ablation prostatectomy (TUVP) for the treatments of symptomatic BPH. Methods 216 symptomatic BPH patients randomly underwent SPPC(n=87), MPC(n=45) or TUVP(n=84) respectively and their therapeutic effects were evaluated. Results There are significant improvements in symptoms and physical signs in each group after operation. The morbidity rates of post-operative complications in SPPC,MPC and TUVP were 31 0%,11 1%,13 1% respectvely. SPPC group showed the longest average operative time and the most blood loss, both of which were the least in TUVP group. Conclusions SPPC was the most effective among the three procedures, but the trauma of SPPC to the patient was the most. Complication of MPC was the least. TUVP was the safest procedure with the least injury.
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Objective To summarize the perioperative care experience in patients with benign prostatic hyperplasia (BPH) treated by transurethral electrovaporization of the prostate (TVP). Methods A retrospective analysis of 693 cases of BPH treated by TVP from June 1998 to September 2002 was conducted. Results The operation time ranged (25～130) min (mean, 54 min). Four patients intraoperatively presented with the early symptoms of the transurethral resection syndrome (TURS) and were treated promptly, without deaths during operations. Follow-up checkups for (3～9) months in 422 cases showed that, from the preoperative period to the 3rd postoperative month, the I-PSS declined from (24.8?3.2) points to (11.4?1.9) points ( t=5.48; P
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PURPOSE: To evaluate comparative efficacy and safety of transurethral resection of the prostate(TURP) and electrovaporization(TVP), we reviewed the records of sixty patients with benign prostatic hyperplasia(BPH) who underwent TURP or TVP. MATERIALS AND METHODS: Sixty symptomatic patients formed the subject of this study. Preoperative and postoperative international prostate symptom score(I-PSS), uroflow- metry, operative details, and complications were recorded in each patient. Baseline, 6 and 12 months follow-up data were used for analyses. RESULTS: We compared 30 men treated by TURP with 30 men treated by TVP from March 1996 to July 1997. There were no significant difference in the preoperative patient characteristics including age, symptom duration, I-PSS, peak urinary flow rate and prostate volume on TRUS between the two groups. In the TURP group, mean I-PSS decreased from 20.5 at preoperation to 7.9 and 6.4, and mean peak urinary flow rate increased from 7.5ml/sec at preoperation to 15.8ml/sec and 17.3ml/sec at 6 and 12 months, respectively(p<0.01). In the TVP group, mean I-PSS decreased from 18.2 at preoperation to 8.0 and 6.8, and mean peak urinary flow rate increased from 8.4ml/sec at preoperation to 15.6ml/sec and 15.7ml/sec at 6 and 12 months, respectively(p<0.01). The changes of hemoglobin(2.1+/-0.7 versus 0.9+/-0.2g/dl) and hematocrit(4.9+/-1.2 versus 2.4+/-0.7%) were greater with TURP than with TVP(p<0.01). There was no significant difference in operation time(42.6+/-19.5 versus 40.5+/-21.7minutes, p=0.69). Catheterization time(4.5+/-1.6 versus 2.9+/-1.3days) and hospitalization time(5.9+/-1.9 versus 4.2+/-1.7days) were longer with TURP than with TVP(p<0.01). CONCLUSIONS: TURP and TVP were effective surgical procedures to treat patients with symptomatic BPH. Both significantly improved subjective symptoms and increased peak urinary flow rate. Morbidity, catheterization time, and hospital stays were less with electrovaporization. With this results, we conclude that TVP is an effective and safe alternative surgical modality for the treatment of BPH.
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Humans , Male , Catheterization , Catheters , Follow-Up Studies , Hospitalization , Length of Stay , Prostate , Prostatic Hyperplasia , Transurethral Resection of ProstateABSTRACT
PURPOSE: We did electrovaporization to reduce the absorbed volume of irrigant and bleeding during TURP, and compared the effects on intraoperative and postoperative serum electrolyte, osmolality, and blood loss between this method and the classic TURP. MATERIALS AND METHOD: Of the 45 BPH patients, 21 patients underwent TURP (Group l), while the other 24 patients were electrovaporized with vaportrode(Group ll). They were followed preoperatively, 30 min intraoperatively, immediate postoperatively, 6 hours and 24 hours postoperatively with measurements of serum sodium, potassium, glucose and BUN. The amount of absorbed irrigant, serum osmolality, effective osmolality, blood loss were calculated and compared between the two groups. RESULTS: Although the group ll showed a longer operation time and used a larger amount of irrigant than the group l, there was not a significant difference in the amount of blood loss between the two groups and lesser amount of irrigant was absorbed than the group l. There was not a significant decrease in postoperative serum Hb and Hct level compared with preoperative level in the group ll. Serum sodium level were significantly decreased during postoperative period every patients in the group l. The serum osmolality and effective osmolality levels were significantly decreased postoperatively as compared with the preoperative levels in the group l, but were not in the group ll. CONCLUSIONS: These results show that electrovaporization may be the effective method in preventing complications such as hyponatremia and hypoosmolality during perioperative period. This method may also be helpful in reducing blood loss.
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Humans , Glucose , Hemorrhage , Hyponatremia , Osmolar Concentration , Perioperative Period , Postoperative Period , Potassium , Prostatic Hyperplasia , Sodium , Transurethral Resection of ProstateABSTRACT
Recently, several alternatives have been attempted in the management of benign prostatic hyperplasia (BPH) to reduce morbidity of traditional transurethral resection of the prostate (TURP). Among new modalities, transurethral electrovaporization (TEVP) is considered as a promising alternative. To evaluate the safety and initial efficacy of TEVP using the roller loop electrode (ProSurg Inc. USA) on BPH patients, we compared the results of TEVP with those of TURP and visual laser ablation of the prostate (VLAP). In this study, a total of 115 patients with symptomatic BPH were underwent TEVP (n=17), TURP (n=59) or VLAP (n=39) since 1995. Before treatment, patients were evaluated with an International Prostate Symptom Score (IPSS) and the measurement of maximal uroflow rate (MFR) and postvoid residual urine (PVR). After treatment, the operative and hospital records were reviewed. The uroflowmetry and IPSS were re-evaluated 3-10 months after treatment. In clinical outcome of re-evaluation compared to the preoperative parameters, there was a clinically significant improvement in three procedures. TEVP resulted in 62% reduction in IPSS (TURP, 73% : VLAP, 69%), 84% improvement in MFR (TURP, 113% : VLAP, 91%), and 74% reduction in PVR (TURP, 88% : VLAP, 78%). TEVP had shorter duration of hospitalization and catheterization than the others. TEVP was associated with lower rates of treatment-related complication than TURP. In conclusions, TEVP is considered as a useful procedure to treat symptomatic BPH. And, the advantages of TEVP over TURP include excellent intraoperative hemostasis, lower morbidity, shorter hospital stay and simple technique. In addition to this, the advantages over VLAP include lower cost, shorter duration of catheterization and early symptom improvement.
Subject(s)
Humans , Catheterization , Catheters , Electrodes , Hemostasis , Hospital Records , Hospitalization , Laser Therapy , Length of Stay , Prostate , Prostatic Hyperplasia , Transurethral Resection of ProstateABSTRACT
PURPOSES: Transurethral resection of the prostate (TURP) for symptomatic benign prostate hyperplasia (BPH) remains a gold standard for surgical treatment, but significant morbidities are associated with the procedure. Transurethral electro-vaporization of prostate (TVP) using a grooved ball electrode, a modification of standard TURP, was tried on bladder outlet obstruction in an attempt to reduce the morbidity rate of TURP. We compared between the TVP and standard TURP to estimate the efficacy and safety. MATERIALS AND METHODS: A comparative trial of 44 patients with symptomatic BPH from May 1995 to December 1995 was performed. Of the patients 20 were received operation with TVP (Group I) and 24 were received with standard TURP (Group II). Patients were assessed at baseline for both safety and efficacy and in follow-up at 1 and 3 months. Efficacy parameters evaluated included American Urological Association (AUA) symptom score, peak urine flow (Qmax) and postvoid residual urine (ml). Safety parameters evaluated included incidence of side effects, operative time (in minutes), postoperative catheterization time, change in hematocrit and serum sodium. RESULTS: The mean age of each group was 63.7+-6.4 years (Group I) and 68.8+-7.6 years (Group II), the prostate size was 32.4+-3.4g and 34.5+-6.5g. The mean operation time was shorter in Group I (56+-11min) than Group II (85+-34min), (P<0.05). The change of Hematocrit(ml/dl) was lower in group I (from 41.1+-5.0 to 39.5+-4.2) than group II (from 39.6+-4.4 to 35.2+-5.5), (P<0.05). The mean catheterization time was 3.3+-1.3 days and 4.8+-1.7 days, (P<0.05). change of maximal flow rate, post-void residual volume and AUA symptom score was not significantly different between each group. The incidence of postoperative complications were not significantly different between each group. CONCLUSIONS: Although the TURP is the gold standard for the treatment of symptomatic BPH with high success rate, but significant morbidities rate are associated with this procedure. So, TVP is new and potentially useful modification of TURP. In this preliminary study, there has been significant clinical improvement maintained with minimal morbidity. This early clinical experience highlights several potential advantages of TVP, including rapid convalescence time, short hospital day, and minimal blood loss. So, TVP is one of the various therapeutic alternatives for BPH lowering the morbidity rate of standard TURP.