Treatment of lower urinary tract symptoms and benign prostatic hyperplasia:
Gespeichert in:
| Weitere Verfasser: | , |
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| Format: | Buch |
| Sprache: | English |
| Veröffentlicht: |
Philadelphia, Pennsylvania
Elsevier
[2016]
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| Schriftenreihe: | Urologic clinics of North America
volume 43, number 3 (August 2016) |
| Schlagworte: | |
| Online-Zugang: | Inhaltsverzeichnis |
| Beschreibung: | xv Seiten, Seite 279-417 Illustrationen, Diagramme |
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| 245 | 1 | 0 | |a Treatment of lower urinary tract symptoms and benign prostatic hyperplasia |c editors Kevin T. McVary, Charles Welliver |
| 264 | 1 | |a Philadelphia, Pennsylvania |b Elsevier |c [2016] | |
| 300 | |a xv Seiten, Seite 279-417 |b Illustrationen, Diagramme | ||
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| 490 | 1 | |a Urologic clinics of North America |v volume 43, number 3 (August 2016) | |
| 490 | 0 | |a Clinics review articles | |
| 505 | 8 | |a Includes bibliographical references and index | |
| 650 | 4 | |a Urinary tract infections / Treatment | |
| 650 | 4 | |a Benign prostatic hyperplasia / Treatment | |
| 650 | 7 | |a MEDICAL / Urology |2 bisacsh | |
| 650 | 4 | |a Medizin | |
| 700 | 1 | |a Mcvary, Kevin T. |4 edt | |
| 700 | 1 | |a Welliver, Charles |4 edt | |
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Datensatz im Suchindex
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| adam_text | Titel: Treatment of lower urinary tract symptoms and benign prostatic hyperplasia
Autor: McVary, Kevin T
Jahr: 2016
Treatment of Lower Urinary Tract Symptoms and Benign Prostatic Hyperplasia
Contents
Foreword: Treatment of Lower Urinary Tract Symptoms and Benign
Prostatic Hyperplasia xiii
Samir S. Taneja
Preface
Kevin T. McVary and Charles Welliver
xv
Review of Prostate Anatomy and Embryology and the Etiology of Benign Prostatic
Hyperplasia 279
LaTayia Aaron, Omar E. Franco, and Simon W. Hayward
Prostate development follows a common pattern between species and depends
on the actions of androgens to induce and support ductal branching morphogenesis
of buds emerging from the urogenital sinus. The human prostate has a compact
zonal anatomy immediately surrounding the urethra and below the urinary bladder.
Rodents have a lobular prostate with lobes radiating away from the urethra. The hu-
man prostate is the site of benign hyperplasia, prostate cancer, and prostatitis. The
rodent prostate has little naturally occurring disease. Rodents can be used to model
aspects of human benign hyperplasia, but care should be taken in data interpreta-
tion and extrapolation to the human condition.
The Epidemiology of Benign Prostatic Hyperplasia Associated with Lower Urinary
Tract Symptoms: Prevalence and Incident Rates 289
Kathryn Brigham Egan
This article assesses the reported prevalence and incidence rates for benign pros-
tatic hyperplasia and lower urinary tract symptoms (BPH/LUTS) by age, symptom
severity, and race/ethnicity. BPH/LUTS prevalence and incidence rates increase
with age and vary by symptom severity. The BPH/LUTS relationship is complex
due to several factors. This contributes to the range of reported estimates and diffi-
culties in drawing epidemiologic comparisons. Cultural, psychosocial, economic,
and/or disease awareness and diagnosis factors may influence medical care access,
symptom reporting, and help-seeking behaviors among men with BPH/LUTS. How-
ever, these factors and their epidemiologic association with BPH/LUTS have not
been thoroughly investigated.
Diagnostic Work-Up of Lower Urinary Tract Symptoms 299
Sarah L. Hecht and Jason C. Hedges
The goal of work-up of lower urinary tract symptoms is to establish the severity and
cause of lower urinary tract symptoms and to predict with certainty which patients
will respond to which treatments. Clinical guidelines exist to guide urologists in
decision-making. All patients need a medical history with a validated symptom
score, a physical examination, and a urinalysis. Prostate-specific antigen, postvoid
urine residual, and peak urine flow rate provide additional information at little cost.
For more invasive testing high-level data are lacking and guidelines defer to the urol-
ogist. Even the most extensive work-up is imperfect, and thus the attempt to bal-
ance costs with benefits of invasive testing.
viii Contents
Alpha-blockers for the Treatment of Benign Prostatic Hyperplasia
311
Herbert Lepor
Over the last 2 decades the evolution of alpha-blockers for lower urinary tract symp-
toms (LUTS)/benign prostatic hyperplasia (BPH) has been to preserve effectiveness,
improve tolerability, and eliminate dose titration. Today, alpha-blockers represent
the first-line treatment of most men with BPH whereby the primary objective is relief
from bothersome LUTS.
5-Alpha-Reductase Inhibitors and Combination Therapy
325
Claudius Füllhase and Marc P. Schneider
By inhibiting the conversion from testosterone to dihydrotestosterone 5-Alpha reduc-
tase inhibitors (5ARIs) are able to hinder prostatic growth, shrink prostate volumes,
and improve BPH-related LUTS. 5ARIs are particularly beneficial for patients
with larger prostates ( 30-40 mL). Generally the side effects of 5ARI treatment are
mild, and according to the FORTA classification 5ARIs are suitable for frail elderly.
5ARI/alpha-blocker (AB) combination therapy showed the best symptomatic
outcome and risk reduction for clinical progression. Combining Phosphodieseterase
type 5 inhibitors (PDE5ls) with 5ARIs counteracts the negative androgenic sexual
side effects of 5ARIs, and simultaneously combines their synergistic effects on LUTS.
Antimuscarinics, ß-3 Agonists, and Phosphodiesterase Inhibitors in the Treatment of
Male Lower Urinary Tract Symptoms: An Evolving Paradigm
337
Nadir I. Osman, Reem Aldamanhori, Altaf Mangera, and Christopher R. Chappie
It is increasingly recognized that the bladder is the originator of storage lower urinary
tract symptoms, including overactive bladder in men. As these symptoms are most
bothersome for patients, there has been an increasing interest in the evaluation of
drug treatment to better target the bladder. Consequently, several new drug classes
have been introduced to the therapeutic armamentarium. Antimuscarinics, which
were previously avoided due to the concern regarding urinary retention, are now
used in routine practice; however, their use is still hampered by discontinuation
due to side effects.
«-Blockers, 5-a-Reductase Inhibitors, Acetylcholine, ß3 Agonists, and
Phosphodiesterase^ in Medical Management of Lower Urinary Tract Symptoms/
Benign Prostatic Hyperplasia: How Much Do the Different Formulations
Actually Matter in the Classes?
351
Bilal Chughtai, Dominique Thomas, and Steven Kaplan
Many monotherapies are currently available to clinically treat and alleviate symp-
toms of lower urinary tract symptoms secondary to benign prostatic hyperplasia:
a-blockers, 5ARIs, PDE5ls, ß-3-andrenoceptor agonists, and anticholinergic agents.
Current studies have evaluated the effective of these treatments in comparison to
other groups or in combination therapies. The current review evaluates the effective-
ness of class formulations. Based on the findings, a-blockers, specifically doxazosin
and terazosin, were most effective in reducing IPSS scores and peak urinary flow
rate, while being most cost-effective. However, further clinical investigations are
required to evaluate the clinical implications of different formulations.
Contents
ix
Prostatic Urethral Lift: A Unique Minimally Invasive Surgical Treatment of Male Lower
Urinary Tract Symptoms Secondary to Benign Prostatic Hyperplasia
Claus G. Roehrborn
The prostatic urethral lift (PUL) is a unique, nonthermal approach to treating lower
urinary tract symptoms (LUTS) secondary to benign prostatic hyperplasia (BPH). It
can be conducted under local anesthesia in an outpatient setting. In published clin-
ical studies, most voiding tested patients do not require a catheter. After PUL, pa-
tients experience rapid recovery with minimal adverse effects. Average symptom
response is significant by 2 weeks, improves through 3 months, and remains stable
through 4 years. Erectile and ejaculatory functions are preserved. This treatment
represents a desirable solution for many patients who currently have male LUTS
secondary to BPH.
Convective Water Vapor Energy for Lower Urinary Tract Symptoms/Benign Prostatic
Hyperplasia
Kenneth Jackson DeLay and Kevin T. McVary
Benign prostatic hyperplasia (BPH) refers to proliferation of smooth muscle and
epithelial cells within the transition zone of the prostate. Half of men over 40 develop
histologic BPH. About half of men with BPH develop an enlarged prostate gland,
called benign prostatic enlargement; among these, about half develop some degree
of bladder outlet obstruction. Bladder outlet obstruction and changes in smooth
muscle tone and resistance may result in lower urinary tract symptoms, including
storage disturbances (such as daytime urinary urgency, frequency, and nocturia)
and voiding disturbances (such as urinary hesitancy, weak urinary stream, straining
to void, and prolonged voiding).
Bipolar, Monopolar, Photovaporization of the Prostate, or Holmium Laser Enucleation
of the Prostate: How to Choose What s Best?
Jean-Nicolas Cornu
Endoscopic management of benign prostatic obstruction is based on resection, va-
porization, or enucleation. Enucleation provides the best efficacy and long-term
outcome. Lasers have advantages in patients at high risk of bleeding. Holmium
enucleation is the best evaluated technique, but has a steep learning curve. Green-
light photovaporization is a safe alternative to transurethral resection of the prostate
(TURP) in prostates of less than 100 mL, especially in patients at high risk of
bleeding. Bipolar devices can be used for resection, vaporization, and enucleation
and provides efficacy results similar to TURP in the short term with better safety.
Robotic-Assisted Simple Prostatectomy: An Overview
Marc Holden and J. Kellogg Parsons
Despite widespread use of medical therapy for benign prostatic hyperplasia, a need
remains for robust surgical therapy in select patients. Robotic-assisted simple pros-
tatectomy (RASP) is an efficacious and safe therapy for patients with bladder outlet
obstruction owing to large volume prostates. Data from 13 published cohorts sug-
gest functional outcomes equivalent to open simple prostatectomy with substan-
tially decreased length of hospital stay and risk of transfusion. However, there are
few longer term data.
X
Contents
Sexual Side Effects of Medical and Surgical Benign Prostatic Hyperplasia Treatments 393
Charles Welliver and Ahmed Essa
Treatments for lower urinary tract symptoms due to benign prostatic hyperplasia can
be evaluated by multiple metrics. A balance within the confines of patient expecta-
tions is key to determining the ideal treatment. A troubling adverse event for some
patients is sexual dysfunction. Because the cohort of men who seek treatment of
sexual dysfunction and lower urinary tract symptoms is essentially identical, these
disease processes frequently overlap. This article considers potential pathophysio-
logic causes of dysfunction with treatment and attempts to critically review the avail-
able data to assess the true incidence of sexual adverse events with treatment.
Testosterone and the Prostate: Artifacts and Truths 405
Kenneth Jackson DeLay and Tobias S. Kohler
Despite a lack of evidence, there have been stated concerns that testosterone
replacement therapy (TRT) can pose a risk to men suffering with lower urinary tract
symptoms (LUTS)/benign prostatic hyperplasia (BPH). TRT may improve compo-
nents of the metabolic syndrome, which is associated with worsening LUTS.
Furthermore, the evidence suggests that TRT may decrease prostatic inflammation,
which is also associated with worsening LUTS. The data on the relationship between
TRT and LUTS have never shown worsening of LUTS, often show no change in
LUTS, and occasionally show improvement.
Index
413
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| spelling | Treatment of lower urinary tract symptoms and benign prostatic hyperplasia editors Kevin T. McVary, Charles Welliver Philadelphia, Pennsylvania Elsevier [2016] xv Seiten, Seite 279-417 Illustrationen, Diagramme txt rdacontent n rdamedia nc rdacarrier Urologic clinics of North America volume 43, number 3 (August 2016) Clinics review articles Includes bibliographical references and index Urinary tract infections / Treatment Benign prostatic hyperplasia / Treatment MEDICAL / Urology bisacsh Medizin Mcvary, Kevin T. edt Welliver, Charles edt Urologic clinics of North America volume 43, number 3 (August 2016) (DE-604)BV000001584 43,3 HBZ Datenaustausch application/pdf http://bvbr.bib-bvb.de:8991/F?func=service&doc_library=BVB01&local_base=BVB01&doc_number=029239206&sequence=000001&line_number=0001&func_code=DB_RECORDS&service_type=MEDIA Inhaltsverzeichnis |
| spellingShingle | Treatment of lower urinary tract symptoms and benign prostatic hyperplasia Urologic clinics of North America Includes bibliographical references and index Urinary tract infections / Treatment Benign prostatic hyperplasia / Treatment MEDICAL / Urology bisacsh Medizin |
| title | Treatment of lower urinary tract symptoms and benign prostatic hyperplasia |
| title_auth | Treatment of lower urinary tract symptoms and benign prostatic hyperplasia |
| title_exact_search | Treatment of lower urinary tract symptoms and benign prostatic hyperplasia |
| title_full | Treatment of lower urinary tract symptoms and benign prostatic hyperplasia editors Kevin T. McVary, Charles Welliver |
| title_fullStr | Treatment of lower urinary tract symptoms and benign prostatic hyperplasia editors Kevin T. McVary, Charles Welliver |
| title_full_unstemmed | Treatment of lower urinary tract symptoms and benign prostatic hyperplasia editors Kevin T. McVary, Charles Welliver |
| title_short | Treatment of lower urinary tract symptoms and benign prostatic hyperplasia |
| title_sort | treatment of lower urinary tract symptoms and benign prostatic hyperplasia |
| topic | Urinary tract infections / Treatment Benign prostatic hyperplasia / Treatment MEDICAL / Urology bisacsh Medizin |
| topic_facet | Urinary tract infections / Treatment Benign prostatic hyperplasia / Treatment MEDICAL / Urology Medizin |
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