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Management of Benign Prostatic Hypertrophy - part 7

Nhiễm trùng đường tiểu, bí tiểu Gần đây các nghiên cứu đã chỉ ra rằng nhiễm trùng đường tiết niệu xảy ra trong khoảng 2% bệnh nhân trong giai đoạn hậu phẫu, mặc dù nó đã được báo cáo xảy ra ở 60% bệnh nhân (11,21). Như đã nêu ở trên, việc sử dụng kháng sinh dự phòng trong TURP | 158 Table 2 Clinical Outcomes for High-Intensity Focused Ultrasound Author Study design Baseline N Follow-up months AUA Symptom Scores Mean Qmax cc sec Comments N Baseline Follow-up N Baseline Follow-up Madersbacher Prospective 50 3 44 24.5 13.3 44 8.9 12.7 TURP 8 1994 24 Madersbacher Prospective 102 12 56 24.5 13.2 56 9.1 13.3 4 50 TURP 15 1997 25 Madersbacher Prospective 80 41 45 19.6 8.5 45 9.1 10.2 TURP 44 2000 26 Sanghvi Multicenter 22 12 22 23.5 10.7 23 8.7 12.6 TURP 8 1999 22 Sanghvi Prospective Prospective 24 14 14 22.6 6.5 11 9.1 13.9 2 24 US Pilot Study Male 1999 22 Mulligan Prospective 13 24 NR 23 7 NR 9.9 10.6 Health Centre Canada TURP 15 1997 21 Sullivan Prospective 20 3 20 20.2 9.5 20 9.2 13.7 2 13 1997 19 Chapter 10 ILC and HIFU for the Treatment of BPH 159 perforation of the descending colon. This was not a thermal injury but related to rectal balloon overfilling. This problem subsequently led to a redesign of the filling mechanism. Madersbacher et al. updated the clinical series in 1997 reporting on 102 patients treated for BPH 25 . Similar clinical results were seen with respect to the outcome parameters however the failure rate as measured by the need for TURP increased from 8 to 15 . A second severe complication was reported. This was a thermal injury to the rectum caused by inappropriately high power intensity which was subsequently adjusted. A trial update by Madersbacher et al. was reported in 2000 26 . They reported on 80 patients followed for a mean of 32.5 mo. Of the 80 patients 35 44 eventually required TURP because of treatment failure. The authors concluded that the long-term efficacy of HIFU was limited in spite of the early favorable results because of the high rate of TURP with longer follow-up. Possible explanations for failure were considered. These included the learning curve as with any new technology inadequate treatment volume or inadequate treatment at the bladder neck. Sanghvi et al. summarized the results of seven centers .