Benign prostatic hyperplasia and lower urinary tract symptoms:
Gespeichert in:
| Format: | Buch |
|---|---|
| Sprache: | English |
| Veröffentlicht: |
Philadelphia, PA
Saunders
2009
|
| Schriftenreihe: | Urologic clinics of North America
36,4 |
| Schlagworte: | |
| Online-Zugang: | Inhaltsverzeichnis |
| Beschreibung: | Etiology, epidemiology, and natural history / Wade Bushman -- Benign prostatic hyperplasia : symptoms, symptom scores, and outcome measures / Daniel A. Thorner and Jeffrey P. Weiss -- Role of invasive urodynamic testing in benign prostatic hyperplasia and male lower urinary tract symptoms / Jennifer L. Mehdizadeh and Gary E. Leach -- Established medical therapy for benign prostatic hyperplasia / Gregory B. Auffenberg, Brian T. Helfand, and Kevin T. McVary -- Electrosection and open surgery / David D. Thiel and Steven P. Petrou -- KTP/LBO laser vaporization of the prostate / Matthew S. Wosnitzer and Matthew P. Rutman -- Holmium laser applications of the prostate / Lori B. Lerner and Mark D. Tyson -- Minimally invasive therapy of lower urinary tract symptoms / Robert F. Donnell -- Treatment of bladder diverticula, impaired detrusor contractility, and low bladder compliance / Charles R. Powell and Karl H. Kreder -- Genitourinary pain syndromes, prostatitis, and lower urinary tract symptoms / Brian V. Le and Anthony J. Schaeffer -- A round table discussion : case studies of patients with lower urinary tract symptoms / Jerry G. Blaivas |
| Beschreibung: | XIII S., S. 403 - 575 Ill., graph. Darst. |
| ISBN: | 1437712797 9781437712797 |
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| adam_text | Titel: Benign prostatic hyperplasia and lower urinary tract symptoms
Autor: Blaivas, Jerry G.
Jahr: 2009
Benign Prostatic Hyperplasia and Lower Urinary Tract Symptoms
Contents
Preface xi
Jerry G. Blaivas and Jeff rey P.Weiss
Etiology, Epidemiology, and Natural History 403
Wade Bushman
Historically, benign prostatic hyperplasia (BPH) has been a major focus of urologic
practice and surgery. But a simplistic causal relationship among prostatic enlarge-
ment, progressive obstruction, lower urinary tract symptoms, retention, and compli-
cations of retention has been challenged by recognition of the incomplete overlap of
prostatic enlargement with symptoms and obstruction. The result has been a greater
focus on symptoms than prostatic enlargement and a shift from surgery to medical
treatment. Therefore, the question can be asked whether BPH per se, the glandular
enlargement as it contributes to bladder dysfunction, or hyperplastic enlargement as
a biomarker for generalized lower urinary tract dysfunction are concerns. This article
addresses these issues.
Benign Prostatic Hyperplasia: Symptoms, Symptom Scores, and Outcome Measures 417
Daniel A.Thornerand Jeff rey P.Weiss
The approach to a patient with benign prostatic hyperplasia and lower urinary tract
symptoms (LUTS) begins with a detailed history. The goal is to clearly identify the
patient s urinary complaints, including frequency of micturition, urgency, urge incon-
tinence, weak stream, the need to push or strain, hesitancy, intermittency, dysuria,
and hematuria. Bladder diaries and symptom questionnaires are useful as adjuncts
to information that is acquired in the history. The voiding diary is an essential part of
the workup. The voiding diary differs from a simple frequency-volume chart in that it
incorporates not only the frequency, voided volume, urge episodes, pad usage, and
fluid intake but also the data related to patient activities. It allows patients to have
a more thorough self-evaluation of their LUTS.
Role of Invasive Urodynamic Testing in Benign Prostatic Hyperplasia
and Male Lower Urinary Tract Symptoms 431
Jennifer L. Mehdizadeh and Gary E. Leach
The role of urodynamics in the evaluation of lower urinary tract symptoms in men
with benign prostatic hyperplasia is controversial despite the additional information
regarding bladder function and outlet obstruction it provides. This controversy is pri-
marily based on outcome studies that suggest men without proved bladder outlet
obstruction may benefit from outlet reduction with medication or surgical resection.
The aim of this article is to describe the role of urodynamic studies in the evaluation
of benign prostatic hyperplasia, including illustration of existing urodynamic tech-
niques, reviewing best practice guidelines and current literature, and providing rec-
ommendations for use of urodynamics in clinical practice.
Established Medical Therapy for Benign Prostatic Hyperplasia 443
Gregory B. Auffenberg, Brian T. Helfand, and Kevin T. McVary
Benign prostatic hyperplasia is characterized by smooth muscle and epithelial pro-
liferation primarily within the prostatic transition zone that can cause a variety of
Contents
problems for a patient, the most frequent being bothersome lower urinary tract
symptoms. In most cases, medical therapy has become the first-line treatment
modality of choice, with a variety of pharmacologic mechanisms proving to be ben-
eficial. Several large trials have shown the efficacy of alpha-receptor blocking and 5-
alpha reductase inhibiting medications when used alone and in combination. Newer
data has shown the benefit of anti-muscarinic medications in specific populations
who suffer from bladder outlet obstruction causing storage urinary symptoms. Phy-
totherapeutic supplements are numerous and used frequently; however, data sup-
porting safety and efficacy is limited, making treatment recommendations difficult.
The available clinical trial data for all of these types of therapy is discussed in this
article.
Electroresection and Open Surgery 461
David D.Thiel and Steven P. Petrou
Transurethral resection of the prostate (TURP) is the historical gold standard therapy
for lower urinary tract symptoms secondary to obstruction from benign prostatic hyper-
plasia (BPH). Over the last 15 years, medical therapy (alpha blockers and 5-alpha-
reductase inhibitors) and the advent of office-based prostatic ablation for BPH have
altered the treatment landscape of men suffering from lower urinary tract symptoms.
Efficacy and morbidity of newer minimally invasive surgical therapies are often com-
pared with traditional TURP data from the 1960s and 1970s. Technologic improve-
ments in lighting, resectoscope design, lens crafting, anesthetic care, and surgical
technique have dramatically improved the efficacy, morbidity, and mortality of the
modern TURP. This review outlines the indications, technique, and outcome data of
the modern TURP and its variant, the saline bipolar TURP. Current indications and out-
comes of simple prostatectomy (open, laparoscopic, and robotic) are also reviewed.
KTP/LBO Laser Vaporization of the Prostate 471
Matthew S.Wosnitzer and Matthew P. Rutman
Laser-based treatments have emerged in the past 15 years as an alternative to tran-
surethral resection of the prostate (TURP) for treatment of symptomatic benign pros-
tatic hyperplasia. Increasing demand for a minimally invasive procedure to alleviate
lower urinary tract symptoms with greater efficacy and fewer side effects has led to
the introduction of various lasers. The excellent clinical outcomes, low morbidity,
technical simplicity, and cost-effectiveness of GreenLight laser photoselective vapor-
ization have made this technology a valid and efficacious clinical alternative to TURP.
Holmium Laser Applications of the Prostate 485
Lori B. Lernerand Mark D.Tyson
The high-powered holmium laser is an excellent tool for the surgical treatment of be-
nign prostatic hyperplasia. This article discusses the background of holmium use in
the prostate and describes the surgical techniques of holmium laser ablation of the
prostate and holmium laser enucleation of the prostate. Operative challenges are
reviewed with suggestions as to how to avoid these problems or deal with them
when they arise. Surgical outcomes and a thorough literature review are both
presented.
Minimally Invasive Therapy of Lower Urinary Tract Symptoms 497
Robert F. Donnell
The establishment of guidelines, pharmacologic therapies, improved understanding
of lower urinary tract symptoms (LUTS) versus benign prostate hyperplasia (BPH),
Contents
respect for patient-centered goals, and improved discrimination of the patient with
occult prostate cancer have empowered change in the management of LUTS. These
developments have allowed urologists to recognize the limitations of transurethral
prostatectomy as the gold standard and search for ideal therapies to provide
treatments with an improved relief of symptoms, decreased complication rate and
cost, to correct BPH-associated morbidities and prevent future morbidities. Prog-
nostic parameters and their ability to predict progression may be important in the
future of LUTS management and selection of therapy.
Treatment of Bladder Diverticula, Impaired Detrusor Contractility,
and Low Bladder Compliance
Charles R. Powell and Karl J. Kreder
Bladder diverticula are common enough to be encountered by most urologists in
practice but are reported less frequently in the literature than they were 50 years
ago. Some patients can be managed nonoperatively, whereas others will need sur-
gical intervention consisting of bladder outlet reduction and possibly removal of
the diverticulum itself. In addition to the decision to operate, the timing of each inter-
vention deserves careful consideration. Cystoscopy, computed tomography with
contrast, urodynamic studies, cytology, and voiding cystourethrography play impor-
tant roles in informing the clinician. Many new techniques for treatment of the bladder
outlet and the diverticulum are available, such as laparoscopy and robotic surgery.
Genitourinary Pain Syndromes, Prostatitis, and Lower Urinary Tract Symptoms
BrianV. Le and AnthonyJ. Schaeffer
The overlap of pain and urinary voiding symptoms is common for urologic patients.
The etiology of these syndromes is frequently multifactorial and due to disorders
of the bladder and/or prostate. The evaluation and treatment of these syndromes
continues to evolve. Here we summarize the general approach to evaluation and
treatment of these pain syndromes.
A Round Table Discussion: Case Studies of Patients with Lower Urinary
Tract Symptoms
Jerry G. Blaivas
This article examines real-life case histories of men with routine and not so routine
conditions underlying lower urinary tract symptoms (LUTS), and demonstrates the
utility of what has become our standard evaluation: repeated bladder diaries, urinary
flow rate postvoid residual urine flow, cystoscopy, and videourodynamics, as well as
the routinely used LUTS questionnaire. Each case history was sent to each of the
other authors of this monograph who, on a case by case basis, answered queries
and made relevant comments. The patient evaluations and case histories are dis-
cussed by top experts who have authored articles in this issue.
Index
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| spelling | Benign prostatic hyperplasia and lower urinary tract symptoms guest ed. Jerry G. Blaivas ... Philadelphia, PA Saunders 2009 XIII S., S. 403 - 575 Ill., graph. Darst. txt rdacontent n rdamedia nc rdacarrier Urologic clinics of North America 36,4 Etiology, epidemiology, and natural history / Wade Bushman -- Benign prostatic hyperplasia : symptoms, symptom scores, and outcome measures / Daniel A. Thorner and Jeffrey P. Weiss -- Role of invasive urodynamic testing in benign prostatic hyperplasia and male lower urinary tract symptoms / Jennifer L. Mehdizadeh and Gary E. Leach -- Established medical therapy for benign prostatic hyperplasia / Gregory B. Auffenberg, Brian T. Helfand, and Kevin T. McVary -- Electrosection and open surgery / David D. Thiel and Steven P. Petrou -- KTP/LBO laser vaporization of the prostate / Matthew S. Wosnitzer and Matthew P. Rutman -- Holmium laser applications of the prostate / Lori B. Lerner and Mark D. Tyson -- Minimally invasive therapy of lower urinary tract symptoms / Robert F. Donnell -- Treatment of bladder diverticula, impaired detrusor contractility, and low bladder compliance / Charles R. Powell and Karl H. Kreder -- Genitourinary pain syndromes, prostatitis, and lower urinary tract symptoms / Brian V. Le and Anthony J. Schaeffer -- A round table discussion : case studies of patients with lower urinary tract symptoms / Jerry G. Blaivas Prostatic Hyperplasia Urologic Diseases Prostatahypertrophie (DE-588)4137018-1 gnd rswk-swf Prostatahypertrophie (DE-588)4137018-1 s DE-604 Blaivas, Jerry G. Sonstige (DE-588)140155171 oth Urologic clinics of North America 36,4 (DE-604)BV000001584 36,4 HBZ Datenaustausch application/pdf http://bvbr.bib-bvb.de:8991/F?func=service&doc_library=BVB01&local_base=BVB01&doc_number=018803618&sequence=000002&line_number=0001&func_code=DB_RECORDS&service_type=MEDIA Inhaltsverzeichnis |
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| title | Benign prostatic hyperplasia and lower urinary tract symptoms |
| title_auth | Benign prostatic hyperplasia and lower urinary tract symptoms |
| title_exact_search | Benign prostatic hyperplasia and lower urinary tract symptoms |
| title_full | Benign prostatic hyperplasia and lower urinary tract symptoms guest ed. Jerry G. Blaivas ... |
| title_fullStr | Benign prostatic hyperplasia and lower urinary tract symptoms guest ed. Jerry G. Blaivas ... |
| title_full_unstemmed | Benign prostatic hyperplasia and lower urinary tract symptoms guest ed. Jerry G. Blaivas ... |
| title_short | Benign prostatic hyperplasia and lower urinary tract symptoms |
| title_sort | benign prostatic hyperplasia and lower urinary tract symptoms |
| topic | Prostatic Hyperplasia Urologic Diseases Prostatahypertrophie (DE-588)4137018-1 gnd |
| topic_facet | Prostatic Hyperplasia Urologic Diseases Prostatahypertrophie |
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