Xiaolong S. Liu¹, Christine Folia², Leonard G. Gomella¹

Canadian Journal of Urology, Vol.18, Suppl.2, pp. 24-38, 2011

Abstract Coordination of care between the urologist and primary care physician is critical to effective treatment of a variety of urologic conditions. Medical therapies for benign prostatic hyperplasia, erectile dysfunction, hypogonadism, overactive bladder, and prostate cancer are widely available and a basic understanding of the pathophysiology of these disease states as well as the pharmacology of existing treatment options are necessary to avoid complications and maximize efficacy associated with patient outcomes. Important regulatory decisions have been made concerning the approval and lack of approval of several important urologic medications. Major advances have been made in the More >

Jack Barkin

Canadian Journal of Urology, Vol.18, Suppl.2, pp. 14-19, 2011

Abstract Significant lower urinary tract symptoms (LUTS) are very common in men over age 50. It is appropriate for the primary care physician to perform the work up to confirm that benign prostatic hyperplasia (BPH) is causing the LUTS. If the physician determines that the patient has moderate symptoms (an International Prostate Symptom Score [IPSS] ≥ 8), moderate “bother” (≥ 3 on the IPSS “bothersome index” question), and an enlarged (> 30 cc) prostate, then the most effective treatment is combination therapy with an alpha blocker and 5-alpha reductase inhibitor (5-ARI) at the time of confirmed More >

Michael McClelland Jr

Canadian Journal of Urology, Vol.18, No.2, pp. 5630-5633, 2011

Abstract Objective: This article describes an efficient and effective method of using the Olympus PlasmaButton (Olympus, Southborough, MA, USA) for transurethral vaporization of the prostate (TUVP).
Methods: This technique was developed over the past 18 months. During the procedure, patients underwent TUVP using the Olympus PlasmaButton, with vaporization focused on the inner aspect of the prostate until it was judged to be significantly open and unobstructed.
Results: Patients were found to tolerate the procedure well, with what appears to be durable clinical outcomes. Postoperative bleeding, both in the short and long term, has not been a significant concern using More >

Nicolas B. Delongchamps¹, Grégoire Robert², Alexandre de la Taille³, Olivier Haillot⁴, Charles Ballereau⁵, Christian Saussine⁶, François Kleinclauss⁷, Abdel-Rahmène Azzouzi⁸, Bertrand Lukacs⁹, Olivier Dumonceau¹⁰, Marc Fourmarier¹¹, Marian Devonec¹², Aurélien Descazeaud¹³

Canadian Journal of Urology, Vol.18, No.6, pp. 6007-6012, 2011

Abstract Introduction: To compare postoperative outcomes of patients on oral anticoagulation (OA) treated with transurethral plasma vaporization of the prostate in saline water (TUVis) and transurethral resection of the prostate (TURP).
Materials and methods: Between January and December 2009, 111 patients on OA therapy were treated with either TURP or TUVis in eight centers. Types of OA and perioperative management were collected. Postoperative outcomes were statistically compared between the two groups.
Results: A total of 57 (51%) and 54 (49%) patients were treated with TURP and TUVis, respectively. Types of OA were not significantly different between the two groups,… More >

Allan Toguri¹, Jack Barkin²

Canadian Journal of Urology, Vol.17, Suppl.1, pp. 26-34, 2010

Abstract The past decade has profoundly changed how physicians manage patients with benign prostatic hyperplasia (BPH). The concepts of symptom indices, symptom complexes, fl ow rates, prostate-specifi c antigen (PSA), prostate size and new medical approaches supported by new clinical studies, have provided family practitioners as well as specialists with evidence-based management algorithms to treat BPH. Men with BPH most often visit a physician due to their partner’s urging because of the many symptoms, with the most bothersome being nocturia. Today, primary care physicians are the gatekeepers for diagnosing and managing lower urinary tract symptoms (LUTS) More >

Brian T. Helfand, Ankur M. Manvar, Gregory B. Auffenberg, Robert Blackwell, Robert J. Hartman, Kevin T. McVary

Canadian Journal of Urology, Vol.17, No.3, pp. 5190-5194, 2010

Abstract Objectives: To report the initial clinical experience using a hybrid technique combining holmium laser ablation of the prostate (HoLAP) and holmium laser enucleation of the prostate (HoLEP) for the treatment of lower urinary tract symptoms (LUTS) secondary to benign prostatic hyperplasia (BPH).
Methods: A total of 18 patients with documented moderate to severe LUTS underwent the hybrid technique. Baseline characteristics were documented for all patients. Operative and resection times, as well as intra and perioperative complications, were recorded. Additionally, changes in American Urological Association symptom index (AUA-SI) and quality of life (QoL) scores and serum prostate-specific antigen… More >

Chukwudi O. Okorie¹, Louis L. Pisters²

Canadian Journal of Urology, Vol.17, No.4, pp. 5255-5258, 2010

Abstract Objectives: Hemostasis during suprapubic prostatectomy for benign prostatic hyperplasia (BPH) is commonly affected by placing sutures at the 5 o'clock position and the 7 o'clock position of the bladder neck. However, the urethral arterial branches of the inferior vesical artery that supplies the prostate extend from the 1 o'clock to 5 o'clock position and from the 7 o'clock to 11 o'clock position of the bladder neck, with the largest branches located posteriorly. This study analyses the effect of a modified suprapubic prostatectomy technique, which covered the area from the 1 o'clock position to the 11 o'clock… More >

Bob Djavan¹, Elisabeth Eckersberger¹, Markus Johannes Handl², Roland Brandner¹, Helen Sadri¹, Herbert Lepor¹

Canadian Journal of Urology, Vol.17, No.4, pp. 5249-5254, 2010

Abstract Background: Transurethral resection of the prostate (TURP) has been the gold standard of the treatment of benign prostatic hyperplasia (BPH). In recent years there has been a significant shift in the treatment of BPH and guidelines emphasize minimally invasive surgery as a new treatment option. Minimal invasive technologies (MITs), such as transurethral microwave thermotherapy (TUMT), laser ablations, transurethral needle ablation (TUNA) have emerged as an alternative to the TURP.
Objectives: To assess the retreatment rates of the most commonly used minimal invasive techniques.
Search strategy: Durability articles were selected by using defined search terms using PubMed as search engine.
… More >

Magdy A. Eltabey^1,2, Hammouda Sherif^1,2, Alaa A. Hussein^1,3

Canadian Journal of Urology, Vol.17, No.6, pp. 5447-5452, 2010

Abstract Introduction: This was a prospective, randomized clinical trial to compare the safety, efficacy, and medium-term durability of holmium laser enucleation of the prostate (HoLEP) combined with mechanical morcellation versus standard transurethral resection of the prostate (TURP) for the surgical treatment of patients with bladder outlet obstruction due to benign prostatic hyperplasia (BPH). The patients had prostates that were greater than 30 g and less than 100 g and were followed for 1 year.
Patients and methods: From April 2008 to December 2009, 80 consecutive patients with lower urinary tract obstruction (LUTS) due to BPH were randomized to… More >

Adam P. Klausner^1,2, Blake B. Anderson¹, Paul G. Espy¹, Vidal M. Despradel^1,2, B. Mayer Grob^1,2

Canadian Journal of Urology, Vol.17, No.6, pp. 5442-5446, 2010

Abstract Introduction: The purpose of this study was to evaluate the utility of prostate-specific antigen (PSA) screening for prostate cancer after subcapsular prostatectomy.
Materials and methods: Data from 41 consecutive patients who underwent subcapsular prostatectomy at a single institution over a 15 year period were collected retrospectively. Patients were categorized into benign and malignant groups based on a diagnosis of prostate cancer identified in the surgical specimen or during subsequent follow up. Collected data included patient age, preoperative and postoperative PSA values, prostate volume determined by surgical specimen weight, and pathologic diagnosis. Preoperative and postoperative PSA velocities were… More >