• Title/Summary/Keyword: TURP

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Early Clinical Experience with Transurethral Electrovaporization of the Prostate for Benign Prostatic Hyperplasia: Comparison with Transurethral Resection of the Prostate and Visual Laser Ablation of the Prostate (경요도전립선전기기화술의 초기 임상경험 : 경요도전립선절제술 및 레이저 전립선절제술과의 비교)

  • Kim, Jung-Hyun;Moon, Ki-Hak;Jung, Hee-Chang;Park, Tong-Choon
    • Journal of Yeungnam Medical Science
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    • v.15 no.2
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    • pp.297-305
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    • 1998
  • 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 JEVP 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 the advantages over VLAP include lower cost, shorter duration of catheterization and early symptom improvement.

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The Effect of Support for Lumbar Curve on Back Pain, Comfort, and Bleeding Complications in Patients on Bed Rest after Transurethral Resection of Prostate (요추 만곡 지지가 경요도적 전립선 절제술 후 침상 안정기 환자의 요통과 안위 및 출혈성 합병증 발생에 미치는 효과)

  • Lim, Ja-Young;Chaung, Seung-Kyo;Sohng, Kyeong-Yae
    • Journal of Korean Academy of Fundamentals of Nursing
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    • v.14 no.3
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    • pp.280-287
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    • 2007
  • Purpose: This study was done to identify effects of lumbar curve support on back pain and comfort during bed rest after transurethral resection of prostate (TURP). Method: A quasi-experimental design with a non-equivalent control group was used. All patients were diagnosed with benign prostatic hyperplasia and underwent TURP. Twenty participants were assigned to the experimental group and twenty to the control group. After TURP, the lumbar curve of patients in the experimental group was supported using gel pads for 6 hours while the control group received the usual care with the both leg straight. The intensity of back pain and comfort levels were assessed on immediate return to the unit and for six hours following TURP. Bleeding complications were detected from hemoglobin and hematocrit levels. Results: Support of lumbar curve was found to be significantly effective in reducing back pain. the need for analgesics was significantly less in the experimental group. Comfort levels were not significantly different between the two groups. There were no bleeding complications in either group. Conclusion: These results suggest that supporting of lumbar curve ameliorates back pain without causing an increased incidence of bleeding complications after TURP and this nursing intervention should help TURP patients to be more comfortable.

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Efficacy and Safety of Laser Surgery and Transurethral Resection of the Prostate for Treating Benign Prostate Hyperplasia: a Network Meta-analysis

  • Wang, Li;Yu, Qiu-Yan;Liu, Yan;Zhu, Zhen-Li;Huang, Yuan-Wei;Li, Ke
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.9
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    • pp.4281-4288
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    • 2016
  • Background: Traditional meta-analyses or systematic reviews of randomized controlled trials (RCTs) have been used to compare laser surgeries and transurethral resection of the prostate (TURP) for benign prostate hyperplasia (BHP), but they cannot provide a hierarchy regarding efficacy and safety of treatment. Objective: We therefore performed a network meta-analysis (NMA) to compare and create hierarchies for efficacy and safety of TUPR and laser surgeries for BPH. Materials and Methods: We searched for reports of RCTs published up to April 25, 2015. After methodological quality assessment and data extraction, we performed an NMA to compare TURP and laser surgeries for BPH. Results: We ranked the treatments of TURP and laser surgeries for BPH. For IPSS at 6 months, holmium laser resection of the prostate (HoLRP) ranked the first-best and at 12 months, holmium laser enucleation of the prostate (HoLEP). For Qmax at 6 and 12 months, HoLEP ranked the first-best; for operative time it was TURP; for cathedral removal time, diode laser enucleation of the prostate (DiLEP) ranked the first-best. Conclusions: Although TURP is considered the gold standard for treating BPH, it is not better in terms of efficacy and safety compared with the laser surgery. Our NMA created hierarchies for the 9 types of surgery in terms of efficacy and safety, which should help clinicians choose the best approach for the individual patient.

Incidentally Detected Adenocarcinoma Prostate in Transurethral Resection of Prostate Specimens: a Hospital Based Study from India

  • Varghese, Jophy;Kuruvilla, Priya Mariam;Mehta, Nisarg;Rathore, Ranjeet Singh;Babu, Manas;Bansal, Devesh;Pillai, Biju;Sam, Mohan P;Krishnamorthy, H
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.4
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    • pp.2255-2258
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    • 2016
  • Background: Awareness about prostate cancer has increased in the community, and prostate cancer screening examinations, including prostate specific antigen (PSA) assays, are now widely available. Prior to the PSA era, up to 27% of prostate cancers were detected incidentally at the time of transurethral resection of prostate (TURP). After PSA testing became widely available, the incidence of incidentally detected carcinoma prostate in TURP specimens without prior diagnosis reduced to 5-13%. However, the incidence of incidentally detected carcinoma prostate has been reported to vary across the globe since various factors can influence the identification of this malignancy in TURP specimens. In this paper, we focus on rates of incidentally detected prostate cancer in TURP specimens in our hospital and correlate it with various parameters. Materials and Methods: This retrospective study of histopathological findings of biopsy specimens was conducted for patients undergoing TURP during a period of 5 years from April 2010. The inclusion criteria were patients diagnosed with benign prostatic hyperplasia (BPH) (digital rectal examination (DRE) not showing any abnormally hard areas and normal age adjusted PSA values). Patients with elevated PSA, abnormal DRE, documented urinary tract infection and proved adenocarcinoma prostate (CaP) were excluded from the study. The total weight of prostatectomy specimen, occurrence of carcinoma prostate in the chips, percentage of total tissue resected showing malignancy and Gleason's scores were recorded. Results: A total of 597 patients belonging to the inclusion criteria were studied. The incidence of occult CaP in the study group was 5.2 % (31/597). Out of these, 8 belonged to T1a and 23 belonged to T1b stages. The age group 70 - 79 years had the maximum incidence of occult CaP. It was observed that the clinical grading of prostate did not have a bearing on the incidence of occult CaP whereas the weight of resected specimen correlated with the incidence of CaP. The incidence of occult CaP was greater with low volume prostates (<20 g). (P=0.15). Conclusions: The rate of incidentally detected adenocarcinoma prostate in patients undergoing TURP for clinically diagnosed BPH was found to be only 5.2 % in our study which is low when compared with similar studies done elsewhere. The age of the patient and weight of the resected specimen correlated with incidence of occult prostate cancer. The clinical grading of prostate by DRE however, demonstrated no correlation.

Prostate spindle cell neoplasm associated with early voiding difficulty after transurethral resection of the prostate

  • Chang Lim Hyun;Jung Sik Huh;Kyung Kgi Park
    • Journal of Medicine and Life Science
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    • v.20 no.2
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    • pp.94-98
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    • 2023
  • This report presents the case of 75-year-old men with spindle cell neoplasm. The patient underwent percutaneous nephrolithotomy and transurethral resection of the prostate (TURP) for renal stones and benign prostatic hyperplasia. One month postoperatively, the patient was able to void without any difficulty. Five months later, the patient experienced difficulty voiding and presented to the emergency room with severe pelvic pain. Computed tomography (CT) showed regrowth of the prostate mass into the posterior bladder and penile root. The prostate-specific antigen level remained constant at 1.14 ng/mL during the pre-and postoperative periods. Five months before the TURP operation, the patient's CT scan showed a soft and mildly enlarged prostate with no protrusion into the bladder. Biopsy of the prostate, however, showed a protruding mass, indicative of a spindle cell neoplasm. The patient was subsequently treated with the chemotherapeutic drug adriamycin. Unfortunately, treatment was unsuccessful, and the patient died 18 months later.

The Postoperative Pain Control for the Benign Prostatic Hypertrophy: Continuous Epidural Pain Block versus Intravenous Patient-Controlled Analgesia (양성 전립선 비대증 환자의 술후 통증치료)

  • Park, Sun-Gyoo;Kim, Jin-Yun;Rah, Eun-Gil
    • The Korean Journal of Pain
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    • v.11 no.2
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    • pp.268-272
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    • 1998
  • Background: Postoperative bleeding is a common complication in transurethral resection of prostate (TURP). Some patients become restless and combative after operation, particularly when in pain, producing bleeding from the prostatic bed. So many patients may be necessary to pain control for reduce bleeding. The purpose of this study is to compare recently used two Methods for post-operative analgesia. Methods: We studied 40 patients, ASA physical staus 1, 2, undergone TURP under general anesthesia. The patients divided into two groups: continuous epidural pain control group (I, n=20) received an epidural bolus of morphine 2 mg and 1% lidocaine 10 ml followed by a epidural 0.08% bupivacaine 40 ml and morphine 4.5 mg (basal infusion rate 0.5 ml/hr), intravenous patient-controlled analgesia (IV-PCA) group (II, n=20) received an intravenous bolus of fentanyl $50\sim100{\mu}g$ followed by a IV-PCA morphine 30 mg, ketorolac 180 mg and droperdol 2.5 mg (basal infusion rate 0.5 ml/hr, bolus 0.5 ml, lock-out interval 15 min). This study conducted the analgesic efficacy, side effect and patient's satisfaction for 1 day after TURP. Results: Continuous epidural pain control group had more significant analgesia than IV-PCA at postoperative 30, 60 min, but no significant difference was observed later in both group. Nausea and pruritus were scantly developed in both group but the incidence was no significant differeance. Patients responded good satisfaction over 70% in both group. Conclusions: Postoperative continuous epidural pain block and IV-PCA are both effective Methods of postoperative pain control with lower incidence of side effects.

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Crowned dens syndrome as a rare cause of anterior neck pain after transurethral resection of the prostate: a case report

  • Myeong Geun, Jeong;Bum Soon, Park;Eun-Seok, Son;Jang Hyuk, Cho
    • Journal of Yeungnam Medical Science
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    • v.40 no.3
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    • pp.289-292
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    • 2023
  • We describe the case of a 79-year-old man who presented with progressive aggravation of severe axial neck pain and fever 3 days after transurethral resection of the prostate (TURP), despite maintaining neutral neck posture during surgery. Laboratory examination revealed markedly elevated C-reactive protein levels and erythrocyte sedimentation rates. Computed tomography revealed crown-like calcifications surrounding the odontoid process. We diagnosed crowned dens syndrome (CDS) as the cause of acute-onset neck pain after TURP. The patient was treated with nonsteroidal anti-inflammatory drugs for 5 days, and his symptoms resolved completely. CDS is a rare disease characterized by calcific deposits around the odontoid process with acute onset of severe neck pain and restricted motion. Evidence of inflammation on serological testing and fever are typical of CDS. However, the prevalence and pathophysiology of CDS remain unclear. We hypothesized that systemic inflammation after prostate surgery may have induced a local inflammatory response involving calcification around the odontoid process.

Postoperative Analgesia of Intrathecal Morphine and Intramuscular Caroverine and Tiaprofenate in Transurethral Resection of the Prostate (지주막하 Morphine과 근주 Caroverine과 Tiaprofenate의 경요도 전립선 절제술후 진통효과)

  • Kim, Joung-Sung;Sun, Keum-Tae;Kim, Yoon-Soo;Lee, Kyu-Chang;Kang, Po-Soon;Lee, Ye-Choul
    • The Korean Journal of Pain
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    • v.13 no.1
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    • pp.55-59
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    • 2000
  • Background: Intrathecal injection of morphine is widely used in the management of postoperative pain because it provides long-lasting analgesia. Intramuscular caroverine and tiaprofenate are used to produce postoperative pain relief. This study was designed to evaluate the analgesic efficacy and quality of sleep achieved with intrathecal morphine and those of intramuscular caroverine and tiaprofenate in transurethral resection of the prostate (TURP). Methods: Forty patients undergoing elective TURP were randomly allocated into 2 groups as follows: Group M (n=20); 0.25 mg of morphine hydrochloride mixed in 7.5 mg of 0.5% hyperbaric bupivacaine was administered at the time of induction of spinal anesthesia. Group S (n=20); 7.5 mg of 0.5% hyperbaric bupivacaine was administered intrathecally and caroverine and tiaprofenate intramuscularly at every 8 hr and 12hr postoperatively for management of postoperative pain. We evaluated the analgesic efficacy with visual analog scale (VAS), quality of sleep, and side effects. Results: VAS at 6, 12 and 24 hours after operation were significantly less (p<0.01) in the group M than in the group S. Group M was superior to group S with respect to quality of sleep (p<0.01). In the group M, the incidence of nausea was 30% (6/20) and that of pruritus was 35% (7/20) and clinical respiratory depression did not occur. Conclusions: Intrathecal 0.25 mg morphine provides good postoperative analgesic effect. but intramuscular caroverine and tiaprofenate does not.

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Simultaneous dry-sorption of heavy metals by porous adsorbents during sludge composting

  • Ozdemir, Saim;Turp, Sinan Mehmet;Oz, Nurtac
    • Environmental Engineering Research
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    • v.25 no.2
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    • pp.258-265
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    • 2020
  • Heavy metal removal by using porous mineral adsorbents bears a great potential to decontaminate sludge compost, and natural zeolite (NZ), artificial zeolite (AZ), and expanded perlite (EP) seem to be possible candidates for this purpose. A composting experiment was conducted to compare the efficiency of those adsorbents for removal of iron (Fe), manganese (Mn), chromium (Cr), copper (Cu), zinc (Zn), nickel (Ni), and lead (Pb) from sewage sludge compost with no adsorbent amendment. For this purpose, 10 g of NZ and AZ and 5 g of EP was filled in a small bag made from non-biodegradable synthetic textile and was separately mixed in composting piles. The bags were separated from compost samples at the end of the experiment. AZ and NZ exhibited different reduction potentials depending on the type of heavy metal. AZ significantly reduced Cr (43.7%), Mn (35.8%), and Fe (29.9%), while NZ more efficiently reduced Cu (24.5%), Ni (22.2%), Zn (22.1%), and Pb (21.2%). The removal efficiency of EP was smaller than both AZ and NZ. The results of this simultaneous composting and metal removing study suggest that AZ and NZ can efficiently bind metal during composting process.

Evaluation of translucency of monolithic zirconia and framework zirconia materials

  • Tuncel, Ilkin;Turp, Isil;Usumez, Aslihan
    • The Journal of Advanced Prosthodontics
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    • v.8 no.3
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    • pp.181-186
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    • 2016
  • PURPOSE. The opacity of zirconia is an esthetic disadvantage that hinders achieving natural and shade-matched restorations. The aim of this study was to evaluate the translucency of non-colored and colored framework zirconia and monolithic zirconia. MATERIALS AND METHODS. The three groups tested were: non-colored framework zirconia, colored framework zirconia with the A3 shade according to Vita Classic Scale, and monolithic zirconia (n=5). The specimens were fabricated in the dimensions of $15{\times}12{\times}0.5mm$. A spectrophotometer was used to measure the contrast ratio, which is indicative of translucency. Three measurements were made to obtain the contrast ratios of the materials over a white background ($L^*w$) and a black background ($L^*b$). The data were analyzed using the one-way analysis of variance and Tukey HSD tests. One specimen from each group was chosen for scanning electron microscope analysis. The determined areas of the SEM images were divided by the number of grains in order to calculate the mean grain size. RESULTS. Statistically significant differences were observed among all groups (P<.05). Non-colored zirconia had the highest translucency with a contrast ratio of 0.75, while monolithic zirconia had the lowest translucency with a contrast ratio of 0.8. The mean grain sizes of the non-colored, colored, and monolithic zirconia were 233, 256, and 361 nm, respectively. CONCLUSION. The translucency of the zirconia was affected by the coloring procedure and the grain size. Although monolithic zirconia may not be the best esthetic material for the anterior region, it may serve as an alternative in the posterior region for the bilayered zirconia restorations.