The ultimate overview of current therapies| UroChannel
Benign prostatic enlargement is almost inevitable for most aging men. Although it not always gives symptoms, treatment of an enlarged prostate is often nececcary. Dr. med. dr. phil. Stefan Buntrock, urologist from Göttingen has collected all the therapies currently available for this ultimate overview on UroChannel. The video deals with watchful waiting, medication such as alpha blockers and 5-alpha reductase inhibitors but also PDE-5 inhibitors, especially Tadalafil. After a short note on herbal remedies, surgical therapy is in focus. During the last 10 years, a lot of new therapies have evolved, including laser enucleation with the Holmium laser or laser resection with the Thulium laser. Standard of care for small prostates still is the conventional resection with a sling, either monopolar or bipolar (TUR-P). Laser evaporation with the greenlight laser is also possible, as well as new techniques as Aquabeam, Rezum, Urolift and i-TIND. Open adenomectomy was the standard of care for large prostates and is not used very often any more since it is a very invasive method, requiring an incision of the abdomen whereas all other methods are done minimally invasive. Prostate artery embolization is done by interventional radiologists, but follow-up should be done by urologists.
In most cases surgery is the answer to insufficient what are the current treatment options urology enlargement resulting in benign prostatic obstruction? and the overwhelming number of surgical possibilities classic monopolar transurethral resection to lasers to embolization. i will be going at a very fast pace, so you i will divide it into chapters that will make the most
Important questions i will have to in mild to moderate cases, watchful waiting as reduction of fluid intake at certain times, effect like alcohol and caffeine, double-voiding technique, etc. alphablockers and 5-a reductase inhibitors alphablockers have a relaxing effect upon there are selective alphablockers like tamsulosin subtype of alpha receptors distributed around
Like doxazosin and alfuzosin that have a more general effect on the whole body. they block the conversion from testosterone to dihydrotestosterone. especially dutasteride also has a pronounced also pde-5 inhibitors have a strong effect when it comes to urinary bother. only cialis / tadalafil is currently licensed for this purpose. i should mention that the combination
Of tadalafil two of them might lower blood pressure substantially. some may have a modest effect, but i will skip details in this video. of residual urine or high bother scores likely when i was a resident, we had two types of much has changed since then, but the overall removal of the enlarged tissue within the organ to restore free urinary flow. in smaller prostates
With sizes between 30 this is done with a loop that you heat up with electricity. hypotonic flushing liquid to operate in while this reduces the likelihood for possible complications because too much hypotonic solution will make laser resection with a thulium laser could the advantage of the lasers is less bleeding among others. it is the most invasive of all methods
Because opened and the enlarged parts of the prostate i am under the impression that this method here, we do a lot of enucleations through the urethra with the holmium laser. the enlarged part is released with the laser, with a special instrument and evacuated through the urethra. the laser acts upon contact and temperatures not so long ago, a robotic method involving
There is so much pressure on that beam that it cuts like knife. the results are good, but the risk of bleeding a couple of years ago, interventional radiologists this is done with a small catheter that is for example and placed under radiologic control when the prostate has insufficient blood supply, symptoms and urinary flow than transurethral resection. however, the
2022 guidelines of the european association of urology don’t issue a recommendation, the treated tissue will perish and eventually the prostatic urethral lift, called urolift, is a non-ablative technique. under cystoscopic control, small anchors with these sutures compress the tissue and it is pressed out of the way. intraprostatic injections with botox are also done.
Botox is successfully used in the overactive have much effect, so the guidelines advice against it. it is a cage-like, self-cutting device that the pressure from the rods of the cage will randomized trials concerning this method are ongoing. of course, this was just a short overview, more or less leaving out advantages and disadvantages. bye-bye!
Transcribed from video
The ultimate overview of current therapies| UroChannel By UroChannel