1522: High-Power KTP Photoselective Laser Vaporization Prostatectomy in Men with Large Prostates: The New York Presbyterian Series of 64 Patients
Year: 2004
Type: article
Abstract: INTRODUCTION AND OBJECTIVE:The intraprostatic ethanol injection is a minimally invasive treatment for benign prostatic hyperplasia.Although similar to ethanol, ethanol gel differs as to the way of action, not spreading to the adjacent tissues.There are 3 forms of intraprostatic injection: transurethral, transrectal and transperineal.The aim is to compare efficiency of ethanol gel injection (EGI) injection through 3 different routes, and also report histological findings due to intra-prostatic gel action.METHODS: Fifty-two patients were treated with EGI, being 10 transrectal, 37 transurethral and 5 transperineal injections.The average age was 66 years (ranging from 52 to 78) and average prostatic weight was 33 grams (20-70grams).Patients receiving gel via transrectal and transurethral EGI had spinal anesthesia and transperineal EGI was performed under local anesthesia in an outpatient setting.The volume of gel injected was calculated as 20-30% of prostatic volume.RESULTS: Patients were evaluated by means of maximum urinary flow (Qmax) and International Prostatic Symptoms Score (I-PSS) at 3 and 12 months after EGI .Table 1 Eighteen patients failed the treatment, 14 (37%) in the transurethral group, 3 (60%) in the transperineal and 1 (10%) in the transrectal group.Of those, 12 underwent transurethral resection and 6 were prescribed alpha-adrenergic blockers.Microscopic evaluation of the prostate after EGI showed distinct areas of localized macroscopic and microscopic necrosis.CONCLUSIONS: Subjective improvement in lower urinary tract symptoms (I-PSS questionnaire) and increased flow was observed in the 3 groups, without significant differences among them, but transperineal EGI presented the largest number of failures.The intraprostatic EGI for the treatment of benign prostatic hyperplasia, either transurethral, transrectal or transperineal, is easy to perform, showing good preliminary results, due to necrosis of prostatic hyperplastic tissue.Transrectal group (10 patients) Pre-operative 3 months post surgery (PS) 12 months PS Transurethral group (37 patients) Pre-operative 3 months PS 12 months PS Transperineal group (5 patients) Pre-operative 3 months PS 12 months PS Source of Funding: None 1520 Median Qmax (mUs) 5.9 ± 2.1 13.8 ±4.2 12.1 ±4.9 7.9 ± 2.6 11.2 ±3.5 9.8± 2.6 8.0 ± 1.6 13.4 ± 2 11.4± 1.7 Median 1-PSS 22.8 ±5.2 7.6±1.913.1 ±3.2 19.7 ±5.2 9±7 10.7 ± 7.4 23.4 ±2.9 10.2 ±2 13.5 ± 4.4
Source: The Journal of Urology
Language: English
Subfield: Urology
Field: Medicine
Domain: Health Sciences
Open Access status: bronze
OpenAlex ID: W2792624872