Pressure-Flow Studies in Men with Benign Prostatic Hypertrophy before and after Treatment with Transurethral Needle Ablation

Background/Aims: In this study we wanted to examine the effects that transurethral needle ablation (TUNA) might have on the urodynamic characteristics of bladder outlet obstruction and to evaluate the clinical changes and the safety profile in patients undergoing the TUNA procedure, including the ef...

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Veröffentlicht in:Urologia internationalis 2001-01, Vol.66 (2), p.89-93
Hauptverfasser: Minardi, D., Garofalo, F., Yehia, M., Cristalli, A.F., Giammarco, L., Galosi, A.B., Muzzonigro, G.
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container_end_page 93
container_issue 2
container_start_page 89
container_title Urologia internationalis
container_volume 66
creator Minardi, D.
Garofalo, F.
Yehia, M.
Cristalli, A.F.
Giammarco, L.
Galosi, A.B.
Muzzonigro, G.
description Background/Aims: In this study we wanted to examine the effects that transurethral needle ablation (TUNA) might have on the urodynamic characteristics of bladder outlet obstruction and to evaluate the clinical changes and the safety profile in patients undergoing the TUNA procedure, including the effects on erectile and ejaculatory function. Materials and Methods: We evaluated 24 patients, aged between 66 and 81 (mean 73.4) years with a mean prostatic volume of 57 ± 15 ml. Before treatment, the clinical history was collected, then prostate-specific antigen (PSA) analysis, digital rectal examinations, I-PSS and quality-of-life (QOL) tests, uroflowmetry with residual volume, and pressure-flow studies were performed in all patients. After treatment, all the patients were evaluated at 6, 12 and 24 months by the same parameters. Results: After treatment, the I-PSS and QOL scores were considerably improved, and the mean flow rate and the residual volume were also improved. The serum PSA level remained unchanged. The prostatic volume was almost unchanged, and pressure-flow studies showed a reduction in the mean opening pressure and detrusor pressure at maximum flow after treatment. None of the patients complained of alterations in sexual activity nor retrograde ejaculation. Conclusions: Our study confirms that in patients with benign prostatic hyperplasia, the TUNA procedure results in no major complications and in significant clinical improvements. There was an improvement in the subjective and objective variables, such as symptom scores and frequency-volume charts and, in the majority of patients, subjective and objective improvements were sustained for the duration of this study, which included a 2-year follow-up with pressure-flow studies. From our experience we can say that the ideal candidate for TUNA treatment should be younger than 70 years, with a prostatic volume of
doi_str_mv 10.1159/000056577
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Materials and Methods: We evaluated 24 patients, aged between 66 and 81 (mean 73.4) years with a mean prostatic volume of 57 ± 15 ml. Before treatment, the clinical history was collected, then prostate-specific antigen (PSA) analysis, digital rectal examinations, I-PSS and quality-of-life (QOL) tests, uroflowmetry with residual volume, and pressure-flow studies were performed in all patients. After treatment, all the patients were evaluated at 6, 12 and 24 months by the same parameters. Results: After treatment, the I-PSS and QOL scores were considerably improved, and the mean flow rate and the residual volume were also improved. The serum PSA level remained unchanged. The prostatic volume was almost unchanged, and pressure-flow studies showed a reduction in the mean opening pressure and detrusor pressure at maximum flow after treatment. None of the patients complained of alterations in sexual activity nor retrograde ejaculation. Conclusions: Our study confirms that in patients with benign prostatic hyperplasia, the TUNA procedure results in no major complications and in significant clinical improvements. There was an improvement in the subjective and objective variables, such as symptom scores and frequency-volume charts and, in the majority of patients, subjective and objective improvements were sustained for the duration of this study, which included a 2-year follow-up with pressure-flow studies. From our experience we can say that the ideal candidate for TUNA treatment should be younger than 70 years, with a prostatic volume of &lt;60 cm H 2 O, with a baseline detrusor pressure at maximum flow of &lt;60 cm H 2 O, with a pretreatment residual volume of &lt;100 ml and with a QOL score of &lt;5.</description><identifier>ISSN: 0042-1138</identifier><identifier>EISSN: 1423-0399</identifier><identifier>DOI: 10.1159/000056577</identifier><identifier>PMID: 11223750</identifier><identifier>CODEN: URINAC</identifier><language>eng</language><publisher>Basel, Switzerland: Karger</publisher><subject>Aged ; Aged, 80 and over ; Biological and medical sciences ; Catheter Ablation ; Gynecology. Andrology. 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Materials and Methods: We evaluated 24 patients, aged between 66 and 81 (mean 73.4) years with a mean prostatic volume of 57 ± 15 ml. Before treatment, the clinical history was collected, then prostate-specific antigen (PSA) analysis, digital rectal examinations, I-PSS and quality-of-life (QOL) tests, uroflowmetry with residual volume, and pressure-flow studies were performed in all patients. After treatment, all the patients were evaluated at 6, 12 and 24 months by the same parameters. Results: After treatment, the I-PSS and QOL scores were considerably improved, and the mean flow rate and the residual volume were also improved. The serum PSA level remained unchanged. The prostatic volume was almost unchanged, and pressure-flow studies showed a reduction in the mean opening pressure and detrusor pressure at maximum flow after treatment. None of the patients complained of alterations in sexual activity nor retrograde ejaculation. Conclusions: Our study confirms that in patients with benign prostatic hyperplasia, the TUNA procedure results in no major complications and in significant clinical improvements. There was an improvement in the subjective and objective variables, such as symptom scores and frequency-volume charts and, in the majority of patients, subjective and objective improvements were sustained for the duration of this study, which included a 2-year follow-up with pressure-flow studies. From our experience we can say that the ideal candidate for TUNA treatment should be younger than 70 years, with a prostatic volume of &lt;60 cm H 2 O, with a baseline detrusor pressure at maximum flow of &lt;60 cm H 2 O, with a pretreatment residual volume of &lt;100 ml and with a QOL score of &lt;5.</description><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Biological and medical sciences</subject><subject>Catheter Ablation</subject><subject>Gynecology. Andrology. Obstetrics</subject><subject>Humans</subject><subject>Male</subject><subject>Male genital diseases</subject><subject>Medical sciences</subject><subject>Original Paper</subject><subject>Postoperative Care</subject><subject>Preoperative Care</subject><subject>Pressure</subject><subject>Prostatic Hyperplasia - physiopathology</subject><subject>Prostatic Hyperplasia - surgery</subject><subject>Tumors</subject><subject>Urethra</subject><subject>Urodynamics</subject><issn>0042-1138</issn><issn>1423-0399</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2001</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpt0M1rFDEYBvAgil2rB8-CBAXBw2g-NpvMsZbWFmotuD0Pb5I33dHZzDTJUBb6xzvrruvFXHJ4f3mSPIS85uwT56r-zKalFkrrJ2TG50JWTNb1UzJjbC4qzqU5Ii9y_snYhGv9nBxxLoTUis3I403CnMeE1XnXP9AfZfQtZtpG-g0jfWjLin7B2N5FepP6XKC0jl5sBkwl9cNqQy2GPiGF6CmEgokuE0JZYyy7w8sEcRtfVgk6eo3oO6QntpuC-viSPAvQZXy134_J7fnZ8vSiuvr-9fL05KpyUi1KNQ8BuAFwFrgwGECKgHMvLDMSuBbcGme1047zWnm78A68nh4mDXpurJLH5MMud0j9_Yi5NOs2O-w6iNiPudFsIVSttvDjDrrpszlhaIbUriFtGs6abdXNoerJvt2HjnaN_p_cdzuB93sA2UEXpiZcmw_O1MyYrXqzU78g3WE6jP9e8u6_09vL6z-gGXyQvwHWZZ0N</recordid><startdate>20010101</startdate><enddate>20010101</enddate><creator>Minardi, D.</creator><creator>Garofalo, F.</creator><creator>Yehia, M.</creator><creator>Cristalli, A.F.</creator><creator>Giammarco, L.</creator><creator>Galosi, A.B.</creator><creator>Muzzonigro, G.</creator><general>Karger</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20010101</creationdate><title>Pressure-Flow Studies in Men with Benign Prostatic Hypertrophy before and after Treatment with Transurethral Needle Ablation</title><author>Minardi, D. ; Garofalo, F. ; Yehia, M. ; Cristalli, A.F. ; Giammarco, L. ; Galosi, A.B. ; Muzzonigro, G.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c356t-4ffa18aacba128efa32fe4d2b083a1721b8cb7c7c1195db6dcad7bef38ed18b53</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2001</creationdate><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Biological and medical sciences</topic><topic>Catheter Ablation</topic><topic>Gynecology. Andrology. Obstetrics</topic><topic>Humans</topic><topic>Male</topic><topic>Male genital diseases</topic><topic>Medical sciences</topic><topic>Original Paper</topic><topic>Postoperative Care</topic><topic>Preoperative Care</topic><topic>Pressure</topic><topic>Prostatic Hyperplasia - physiopathology</topic><topic>Prostatic Hyperplasia - surgery</topic><topic>Tumors</topic><topic>Urethra</topic><topic>Urodynamics</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Minardi, D.</creatorcontrib><creatorcontrib>Garofalo, F.</creatorcontrib><creatorcontrib>Yehia, M.</creatorcontrib><creatorcontrib>Cristalli, A.F.</creatorcontrib><creatorcontrib>Giammarco, L.</creatorcontrib><creatorcontrib>Galosi, A.B.</creatorcontrib><creatorcontrib>Muzzonigro, G.</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Urologia internationalis</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Minardi, D.</au><au>Garofalo, F.</au><au>Yehia, M.</au><au>Cristalli, A.F.</au><au>Giammarco, L.</au><au>Galosi, A.B.</au><au>Muzzonigro, G.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Pressure-Flow Studies in Men with Benign Prostatic Hypertrophy before and after Treatment with Transurethral Needle Ablation</atitle><jtitle>Urologia internationalis</jtitle><addtitle>Urol Int</addtitle><date>2001-01-01</date><risdate>2001</risdate><volume>66</volume><issue>2</issue><spage>89</spage><epage>93</epage><pages>89-93</pages><issn>0042-1138</issn><eissn>1423-0399</eissn><coden>URINAC</coden><abstract>Background/Aims: In this study we wanted to examine the effects that transurethral needle ablation (TUNA) might have on the urodynamic characteristics of bladder outlet obstruction and to evaluate the clinical changes and the safety profile in patients undergoing the TUNA procedure, including the effects on erectile and ejaculatory function. Materials and Methods: We evaluated 24 patients, aged between 66 and 81 (mean 73.4) years with a mean prostatic volume of 57 ± 15 ml. Before treatment, the clinical history was collected, then prostate-specific antigen (PSA) analysis, digital rectal examinations, I-PSS and quality-of-life (QOL) tests, uroflowmetry with residual volume, and pressure-flow studies were performed in all patients. After treatment, all the patients were evaluated at 6, 12 and 24 months by the same parameters. Results: After treatment, the I-PSS and QOL scores were considerably improved, and the mean flow rate and the residual volume were also improved. The serum PSA level remained unchanged. The prostatic volume was almost unchanged, and pressure-flow studies showed a reduction in the mean opening pressure and detrusor pressure at maximum flow after treatment. None of the patients complained of alterations in sexual activity nor retrograde ejaculation. Conclusions: Our study confirms that in patients with benign prostatic hyperplasia, the TUNA procedure results in no major complications and in significant clinical improvements. There was an improvement in the subjective and objective variables, such as symptom scores and frequency-volume charts and, in the majority of patients, subjective and objective improvements were sustained for the duration of this study, which included a 2-year follow-up with pressure-flow studies. From our experience we can say that the ideal candidate for TUNA treatment should be younger than 70 years, with a prostatic volume of &lt;60 cm H 2 O, with a baseline detrusor pressure at maximum flow of &lt;60 cm H 2 O, with a pretreatment residual volume of &lt;100 ml and with a QOL score of &lt;5.</abstract><cop>Basel, Switzerland</cop><pub>Karger</pub><pmid>11223750</pmid><doi>10.1159/000056577</doi><tpages>5</tpages></addata></record>
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subjects Aged
Aged, 80 and over
Biological and medical sciences
Catheter Ablation
Gynecology. Andrology. Obstetrics
Humans
Male
Male genital diseases
Medical sciences
Original Paper
Postoperative Care
Preoperative Care
Pressure
Prostatic Hyperplasia - physiopathology
Prostatic Hyperplasia - surgery
Tumors
Urethra
Urodynamics
title Pressure-Flow Studies in Men with Benign Prostatic Hypertrophy before and after Treatment with Transurethral Needle Ablation
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