Holmium laser enucleation of the prostate in benign prostate hyperplasia patients with or without oral antithrombotic drugs: a meta-analysis

AbstractBackgroundThe continuous intake of antithrombotic drugs during holmium laser enucleation of the prostate (HoLEP) remains nonconsensual. We aim to pool those controversial evidence and provide practical guidance of oral antithrombotics on HoLEP for benign prostate hyperplasia (BPH).MethodPubMed, Embase and CENTRAL database were systematically searched up to June 2019 for trials on patients with and without oral antithrombotics undergoing HoLEP. Number of events and mean value with standard deviation were, respectively, extracted for dichotomous and continuous parameters. Subgroup analyses of anticoagulation and antiplatelet were also performed. All statistical analyses were conducted with Review Manager v.5.3 software. Newcastle –Ottawa Scale (NOS) was used to assess the quality of selected trials.ResultNine studies with 5528 patients were eventually selected, and patients included were generally older than 65  years. It revealed that the non-antithrombotic group had a lower rate of blood transfusion (OR 0.21, 95% CI 0.10–0.45,P 
Source: International Urology and Nephrology - Category: Urology & Nephrology Source Type: research

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ConclusionsbPAE is as effective as cPAE in treating benign prostatic hyperplasia with a potential to reduce nontarget embolization.
Source: Journal of Vascular and Interventional Radiology - Category: Radiology Source Type: research
ConclusionsHistorical ethnobotanical investigations could help to avoid creating repeating waves of popularity of plants that have already been tried for certain diseases and later abandoned as not fully effective. There is, of course, a chance that E. angustifolium could also finally be proven to be clinically safe and cost-effective for treating benign prostatic hyperplasia, but this has not yet happened despite recent intensive research. Documented traditional use would suggest investigating the dermatological, intestinal anti-hemorrhagic and pain inhibiting properties of this plant, if any.Graphical abstract
Source: Journal of Ethnopharmacology - Category: Drugs & Pharmacology Source Type: research
In this study, we compared results of bipolar TURP using the resection loop versus vaporization button for treatment of benign prostatic hyperplasia (BPH) to determine the relative safety profile.Patients and methodsBetween January 2013 and March 2014, 89 patients with BPH were randomized to surgical intervention either by Olympus (Gyrus) Bipolar loop TURP or Olympus (Gyrus) Bipolar button vaporization. Inclusion criteria were; BPH with Q-max    18 and prostate volume >  40 g. All patients were evaluated preoperatively and at 1, 3 and 9 months. Evaluation included IPSS, uroflowmetry, pro...
Source: International Urology and Nephrology - Category: Urology & Nephrology Source Type: research
Obsidio Inc., a medical device company based in Columbia, South Carolina, has developed an embolic hydrogel (called a gel embolic material: GEM) designed to be delivered minimally invasively through a clinical catheter for blood vessel occlusion. App...
Source: Medgadget - Category: Medical Devices Authors: Tags: Cardiac Surgery Exclusive Neurosurgery Oncology Vascular Surgery Source Type: blogs
CONCLUSIONS: Overall, HoLEP has proven to be an extremely durable and effective treatment for patients suffering from LUTS due to BPH. Both the Europeans and AUA guidelines on the surgical treatment of BPH recommend HoLEP as a size-independent treatment option for those men with moderate to severe symptoms. HoLEP is an excellent option for many patients who may not be good candidates for other procedures based on prostate size, age, or bleeding risk. PMID: 31481144 [PubMed - in process]
Source: Canadian Journal of Urology - Category: Urology & Nephrology Tags: Can J Urol Source Type: research
59-year-old African American male was referred for urologic evaluation of symptomatic anogenital warts. The patient was initially diagnosed with anogenital warts one year prior, however he did not seek further evaluation at that time. Subsequently, the lesions grew in size and number resulting in pain and occasional bleeding ultimately prompting him to seek medical attention. Additionally, he noted worsening post-void dribbling but denied other lower urinary tract symptoms (LUTS) or hematuria. The patient has a past medical history of benign prostatic hyperplasia (BPH) treated with Tamsulosin and Acquired Immune Deficiency...
Source: Urology - Category: Urology & Nephrology Authors: Source Type: research
CONCLUSION: PAE is safe and effective in the management of symptomatic BPH. Patients with the highest baseline IPSS and reduction in prostate volume on first post-PAE MRI are likely to derive most benefit from embolisation. PMID: 30955835 [PubMed - as supplied by publisher]
Source: Clinical Prostate Cancer - Category: Cancer & Oncology Authors: Tags: Clin Radiol Source Type: research
AbstractPurposeTo examine the complications and functional outcomes of high-risk patients on antithrombotic therapy (ATT) treated with photoselective vaporization of the prostate (PVP) using the Greenlight (GL) XPS-180 system.MethodsA retrospective analysis of prospectively maintained institutional database was performed. Men with symptomatic LUTS related to BPH were treated with 523-nm GL PVP using the XPS-180  W system. They were stratified according to ATT status: group 1 (control group), group 2 (acetylsalicylic acid), group 3 (antiplatelet agents other than acetylsalicylic acid) and group 4 (anticoagulation agent...
Source: World Journal of Urology - Category: Urology & Nephrology Source Type: research
This report exposes the value of SNIIRAM/SNDS enrichment by external databases, and the linkage issues. It is illustrated by examples: the well-known population-based cohort CONSTANCES created to answer to epidemiological research questions with a specific interest on occupational and social factors, chronic diseases, and aging; the CANARI study, a regional-based study that collected Gleason score in all pathology laboratories in Brittany and then, linked pathology results to an ad hoc extraction from SNIIRAM database; the goal was to investigate the risk of high grade prostate cancer in patients treated by 5-alpha-reducta...
Source: Therapie - Category: Psychiatry & Psychology Authors: Tags: Therapie Source Type: research
​BY ARJUN BHARADWAJ; MARGARET GAVOR, MBChB, MPH; &KHALID MALIK, MDA 65-year-old man presented to the emergency department complaining of sudden-onset left-sided abdominal pain followed by a “seizure.” His abdominal pain started a few hours prior to presentation, was sharp in nature, and radiated to his back and umbilicus. The pain waxed and waned, worsened when he walked or sat up, and at its worst was a 10/10. He took a laxative and two antacids, but received no relief.Each “seizure” episode lasted about 30 seconds and occurred every five minutes. He said he felt drained after each event but ...
Source: The Case Files - Category: Emergency Medicine Tags: Blog Posts Source Type: research
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