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Surgery For Benign Prostatic Hyperplasia
If medical treatment is not effective, surgery may need to be performed for benign prostatic hyperplasia. Invasive therapies There are two invasive surgical procedures done for BPH: * Transurethral resection of the prostate (TURP): In general prior to emergence of laser technologies, TURP had been considered the gold standard of prostate interventions for people who require a procedure. This involves removing (part of) the prostate by inserting a resectoscope (cystoscope) through the urethra. However, after this endoscopic surgery the ejaculations are dry in about 65% of patients, unless a novel, ejaculation preserving, altered technique of TURP is applied. * Simple prostatectomy can also be offered to men who have large prostates (>50 grams). This can be done by open technique, laparoscopically, or with robotic assistance. There are two types of transurethral resection of the prostate (TURP): the standard monopolar and the newer bipolar procedure. A 2019 Cochrane review of ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Benign Prostatic Hyperplasia
Benign prostatic hyperplasia (BPH), also called prostate enlargement, is a noncancerous increase in size of the prostate gland. Symptoms may include frequent urination, trouble starting to urinate, weak stream, urinary retention, inability to urinate, or urinary incontinence, loss of bladder control. Complications can include urinary tract infections, bladder stones, and chronic kidney problems. The cause is unclear. Risk factors include a family history, obesity, type 2 diabetes, not enough exercise, and erectile dysfunction. Medications like pseudoephedrine, anticholinergics, and calcium channel blockers may worsen symptoms. The underlying mechanism involves the prostate pressing on the urethra thereby making it difficult to pass urine out of the bladder. Diagnosis is typically based on symptoms and Physical examination, examination after ruling out other possible causes. Treatment options include lifestyle changes, medications, a number of procedures, and surgery. In th ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Transurethral Microwave Thermotherapy
Transurethral microwave thermotherapy (TUMT) is one of a number of effective and safe procedures used in the treatment of lower urinary tract symptoms caused by benign prostatic hyperplasia. It is an alternative treatment to pharmacotherapy such as alpha blockers, transurethral resection of the prostate (TURP), transurethral needle ablation of the prostate, photoselective vaporization of the prostate and prostatic removal or prostatectomy. Process Transurethral microwave thermotherapy is a non-surgical, minimally invasive therapy that can be performed under a local anesthetic on an outpatient basis. The treatment involves inserting a special microwave urinary catheter into the hyperplastic prostatic urethra. The microwave antenna within the catheter then emits microwaves to heat and destroy the surrounding prostatic tissue. The procedure can take from 30 minutes to one hour and is well tolerated by patients. Following the procedure, the prostatic tissue will be swollen and ir ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Bladder Training
Bladder training, also known as scheduled voiding and bladder re-education is urinating at specific times of the day. It is used as a first line treatment of overactive bladder on mixed urinary incontinence Urinary incontinence (UI), also known as involuntary urination, is any uncontrolled leakage of urine. It is a common and distressing problem, which may have a significant effect on quality of life. Urinary incontinence is common in older women ....{{cite book, title=Overactive Bladder: Practical Management, date=2015, publisher=John Wiley & Sons, isbn=9781118640593, page=77, url=https://books.google.com/books?id=e364CAAAQBAJ&pg=PA77 Bladder training Bladder training is a behavioral therapy aimed at improving bladder control and managing urinary incontinence. It is a non-invasive intervention commonly employed for various types of incontinence, including urge incontinence, stress incontinence, and mixed incontinence. The therapy focuses on gradually increasing the time in ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Kegel Exercise
Kegel exercise, also known as pelvic floor exercise, involves repeatedly contracting and relaxing the muscles that form part of the pelvic floor, now sometimes colloquially referred to as the "Kegel muscles". The exercise can be performed many times a day, for several minutes at a time, but takes one to three months to begin to have an effect. Kegel exercises aim to strengthen the pelvic floor muscles. These muscles have many functions within the human body. In women, they are responsible for holding up the bladder, preventing urinary stress incontinence (especially after childbirth), vaginal and uterine prolapse. In men, these muscles are responsible for urinary continence, fecal continence, and ejaculation. Several tools exist to help with these exercises, although various studies debate the relative effectiveness of different tools versus traditional exercises. The American gynecologist Arnold Kegel first published a description of such exercises in 1948. Mechanism of actio ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Urethral Sphincters
The urethral sphincters are two muscles used to control the exit of urine in the urinary bladder through the urethra. The two muscles are either the male or female external urethral sphincter and the internal urethral sphincter. When either of these muscles contracts, the urethra is sealed shut. The external urethral sphincter originates at the ischiopubic ramus and inserts into the intermeshing muscle fibers from the other side. It is controlled by the deep perineal branch of the pudendal nerve. Activity in the nerve fibers constricts the urethra. * The internal sphincter muscle of urethra: located at the bladder's inferior end and the urethra's proximal end at the junction of the urethra with the urinary bladder. The internal sphincter is a continuation of the detrusor muscle and is made of smooth muscle, therefore it is under involuntary or autonomic control. This is the primary muscle for prohibiting urination. * The female or male external sphincter muscle of urethr ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Urinary Incontinence
Urinary incontinence (UI), also known as involuntary urination, is any uncontrolled leakage of urine. It is a common and distressing problem, which may have a significant effect on quality of life. Urinary incontinence is common in older women and has been identified as an important issue in geriatric health care. The term enuresis is often used to refer to urinary incontinence primarily in children, such as nocturnal enuresis (bed wetting). UI is an example of a stigmatized medical condition, which creates barriers to successful management and makes the problem worse. People may be too embarrassed to seek medical help, and attempt to self-manage the symptom in secrecy from others. Pelvic surgery, pregnancy, childbirth, attention deficit disorder (ADHD), and menopause are major risk factors. Urinary incontinence is often a result of an underlying medical condition but is under-reported to medical practitioners. There are four main types of incontinence: * Urge incontinence ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Stress Incontinence
Stress incontinence, also known as stress urinary incontinence (SUI) or effort incontinence is a form of urinary incontinence. It is due to inadequate closure of the bladder outlet by the urethral sphincter. Pathophysiology Stress incontinence is the loss of small amounts of urine associated with coughing, laughing, sneezing, exercising or other movements that increase intra-abdominal pressure and thus increasing the pressure on the bladder. The urethra is normally supported by fascia and muscles of the pelvic floor. If this support is insufficient due to any reason, the urethra would not close properly at times of increased abdominal pressure, allowing urine to pass involuntarily. Most lab results such as urine analysis, cystometry and post-void residual volume are normal. Some sources distinguish between urethral hypermobility and intrinsic sphincter deficiency. The latter is more rare, and requires different surgical approaches. Men Stress incontinence in men is most ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Erectile Dysfunction
Erectile dysfunction (ED), also referred to as impotence, is a form of sexual dysfunction in males characterized by the persistent or recurring inability to achieve or maintain a Human penis, penile erection with sufficient rigidity and duration for satisfactory sexual activity. It is the most common sexual problem in males and can cause psychological distress due to its impact on self-image and sexual relationships. The majority of ED cases are attributed to physical risk factors and predictive factors. These factors can be categorized as vascular, neurological, local penile, hormonal, and drug-induced. Notable predictors of ED include aging, cardiovascular disease, diabetes mellitus, Hypertension, high blood pressure, obesity, Dyslipidemia, abnormal lipid levels in the blood, hypogonadism, smoking, Depression (mood), depression, and Adverse drug reactions, medication use. Approximately 10% of cases are linked to psychosocial factors, encompassing conditions such as depressio ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
European Association Of Urology
The European Association of Urology (EAU) is a non-profit organisation committed to the representation of urology professionals worldwide. All active urology professionals, including urology nurses, are eligible for membership of the EAU. The constituent bodies of the EAU include the: * Executive Committee (3 members elected by the General Assembly) * Executive Board (the Executive Committee and the chairs of the EAU Offices) * EAU Offices. Decisions made by the EAU General Assembly are implemented by the EAU Offices. The Executive Committee and EAU Offices are assisted by the EAU Central Office, which is based in Arnhem, The Netherlands, and run by the Executive Management. The European Academy of Urology is the advisory body to and of the EAU. The Academy consists of members who have previously had official responsibilities within the EAU. The EAU maintains close contacts with national urology organisations who represent the interests of urologists at a national level world ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Sham Surgery
Sham surgery (or placebo surgery) is a faked surgical intervention that omits the step thought to be therapeutically necessary. In clinical trials of surgical interventions, sham surgery is an important scientific control. This is because it isolates the specific effects of the treatment as opposed to the incidental effects caused by anesthesia, the incisional trauma, pre- and postoperative care, and the patient's perception of having had a regular operation. Thus sham surgery serves an analogous purpose to placebo drugs, neutralizing biases such as the placebo effect. Human research A number of studies done under Institutional Review Board-approved settings have delivered important and surprising results. With the progress in minimally invasive surgery, sham procedures can be more easily performed as the sham incision can be kept small similarly to the incision in the studied procedure. A review of studies with sham surgery found 53 such studies: in 39 there was improvement w ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Prostatic Urethral Lift
Prostatic urethral lift (marketed as Urolift) is a minimally invasive procedure for the treatment of benign prostatic hyperplasia. One of the First Surgeons to perform this procedure is Dr. Simon Barkagan. Located in Forest Hills queens. This procedure can be done under local anesthesia in an outpatient consultation. Procedure Using cystoscopy, the procedure inserts implants that lift and hold the enlarged prostatic tissue out of the way, thus dilating the prostatic urethra. Benefits This procedure likely improves quality of life without additional negative side effects when compared with a sham surgery. Compared with transurethral resection of the prostate, the standard surgery for treating benign prostatic hyperplasia, this procedure may be less effective in reducing urinary symptoms but may preserve ejaculation and have fewer unwanted effects on erections. Harms The most common side effects include dysuria and hematuria (typically resolving within 2–3 weeks) due to t ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Water Vapour Thermal Therapy
Prostate steam treatment (Rezum), also called water vapor thermal therapy (WVTT), is a minimally invasive surgical procedure for men with lower urinary tract symptoms resulting from prostate enlargement (benign prostatic hyperplasia, BPH). It uses injections of steam to remove obstructive prostate tissue from the inside of the organ without injuring the prostatic part of the urinary tube (prostatic urethra). History The Rezum system was introduced by NxThera (Maple Grove, Minnesota, US). It was approved by the United States Food and Drug Administration in 2015 and the National Institute for Health and Care Excellence (NICE) of the UK in 2018.National Institute for Health and Care Excellence (NICE)Rezum for treating benign prostatic hyperplasia Medtech innovation briefing, 24 August 2018 (containing also information on costs and cost effectiveness). As of August 2018 the system was in use in 5 National Health Service hospitals in England, and is due to be implemented in a furth ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
