Bipolar vaporization of the prostate may cause higher complication rates compared to bipolar loop resection: a randomized prospective trial
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, prostate volume by ultrasound. Clavien complications and operative time were recorded. Statistical analysis was done using Statistical Package of Social Science (SPSS) version 17 so ftware.Results44 patients were included in bipolar TURP and 45 patients in vaporization arm. Preoperative mean prostate volume (59 g versus 58 g,p = 0.52) and mean IPSS (19 versus 20,p = 0.38) were equivalent in both groups. Vaporization was associated with a significant increase in operative time (mean of 81 ± 15 min range 40–110 versus 55 ± 10 min range 30–70 min,p
BACKGROUND: Childhood maltreatment is a well-known risk factor for developing a more severe and complex form of bipolar disorders (BD). However, knowledge is scarce about the interactions between childhood maltreatment and underlying genetic vulnerability ...
Postoperative duplex ultrasound (DUS) surveillance after transcarotid artery revascularization (TCAR) focuses on issues commonly associated with carotid artery stenting, primarily in-stent restenosis, but also the common carotid artery (CCA) access site. To address limited specific guidelines, DUS data from patients treated with TCAR in routine clinical practice were collected to illustrate expected values and compared with literature values.
The objective of this work covered assessment of blood flow volume in the internal carotid artery (ICA), external carotid artery (ECA), and vertebral artery (VA) in healthy volunteers and asymptomatic patients with carotid artery disease older than 65 years with the aim of implementation of blood flow volume measurements in clinical assessment of patients with carotid artery disease.
We report a case in which 12 years after a successful left carotid endarterectomy, a carotid-cutaneous fistula resulted in pulsatile bleeding from the neck that necessitated urgent intervention and surgical reconstruction.
This study reviewed the outcome of patients subjected to thoracic endovascular aortic repair (TEVAR) under full, low-dose, and no intraoperative systemic heparinization.
Contrast-enhanced ultrasound (CEUS) is an evolving diagnostic alternative to contrast-enhanced computed tomography, magnetic resonance imaging, and fluorescence angiography for the evaluation of vascular diseases. Microbubble contrast material allows imaging of blood flow in microvasculature beyond the resolution of standard imaging techniques and demonstrates potential for the evaluation of tissue perfusion. Several authors have investigated the application of CEUS in the evaluation of myocardial or skeletal muscle perfusion and tumor characterization.
Synthetic marijuana use has been reported in the last years as a possible causative factor of different cardiovascular events, including myocardial infarction, ischemic stroke, intracranial bleeding, and cerebral vasospasm. One case of aortic thrombosis was also reported, but that was in a patient using cocaine and synthetic marijuana together. A case of lower limb thromboembolism and synthetic marijuana use has not been reported to date. Intoxication, material impurity, blood vessel reactivity, and chemical interaction with other drugs have been proposed as possible mechanisms of these events.
Abstract INTRODUCTION: Prostate vaporization technology is becoming a standard of care for treatment of moderate, symptomatic benign prostatic hyperplasia (BPH). We compared two transurethral prostate vaporization technologies with respect to cost, efficiency, efficacy, safety, and surgical team satisfaction. METHODS: Fifty-five patients meeting standardized symptom criteria for BPH were randomized to either Olympus Plasma Button(TM) or Biolitec EVOLVE(®) diode laser vaporization. Primary outcome of cost with secondary outcomes of clinical efficacy, resection time, surgical team satisfaction, and safety w...
Conclusions: In spite of various contrary viewpoints in literature, surgeons prefer to operate on larger prostates using bipolar technology. B-TURP definitely reduces the incidence of bleeding and dilutional hyponatremia, making it a contender to replace M-TURP as the new gold standard.
Both bipolar TURP by resection loop or vaporization button has become the standard of care because it causes less intraoperative bleeding, and avoids free water absorption. Bipolar vaporization specifically has become deservedly popular because it is technically easy and results in near-zero intraoperative bleeding. However, published data shows that bipolar vaporization may be associated with increased late complications. We compare results of bipolar TURP using the resection loop versus vaporization button for BPH to determine the relative safety profile.