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Clinical predictors of severe late urinary toxicity after curative intensity-modulated radiation therapy for localized prostate cancer.

J Radiat Res 2021 Aug 31. Epub 2021 Aug 31.

Department of Radiation Oncology, Tohoku University School of Medicine, 1-1, Seiryo-machi, Aoba-ku, Sendai, 980-8574, Japan.

Intractable late urinary toxicity is a serious complication after radiotherapy for patients with localized prostate cancer (LPC). We assessed clinical factors correlated with severe late urinary toxicity in LPC treated with curative image-guided intensity-modulated radiation therapy (IMRT). A total of 452 patients with LPC treated with IMRT between 2002 and 2016 were retrospectively analyzed. Read More

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A practical approach to bladder preservation with hypofractionated radiotherapy for localised muscle-invasive bladder cancer.

Clin Transl Radiat Oncol 2021 Nov 8;31:1-7. Epub 2021 Aug 8.

The Christie NHS Foundation Trust, Manchester, UK.

Bladder preservation with trimodality treatment (TMT) is an alternative strategy to radical cystectomy (RC) for the management of localised muscle invasive bladder cancer (MIBC). TMT comprises of transurethral resection of the bladder tumour (TURBT) followed by radiotherapy with concurrent radiosensitisation. TMT studies have shown neo-adjuvant chemotherapy with cisplatin-based regimens is often given to further improve survival outcomes. Read More

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November 2021

Persistent use of medical therapy after surgery for lower urinary tract symptoms: a retrospective database analysis.

World J Urol 2021 Aug 26. Epub 2021 Aug 26.

Department of Urology, University of Miami, 1150 NW 14th St, Suite 309, Miami, FL, 33136, USA.

Purpose: To determine how many men are able to remain off of medical therapy for lower urinary tract symptoms (LUTS) following surgery for benign prostatic obstruction (BPO).

Methods: The TriNetX Analytics Network was used to identify men who were taking medical therapy for BPO (at least one of: alpha-1 blockers, anticholinergics, B3 agonists, or 5-alpha-reductase inhibitors) and subsequently underwent surgery for BPO. They were then placed into one of six cohorts, classified based on the type of surgery they received: transurethral resection of the prostate (TURP), Laser vaporization of prostate (PVP), transurethral incision of the prostate (TUIP), prostatic urethral lift (PUL), water-vapor thermal therapy (WV), or Laser enucleation of the prostate (LEP). Read More

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Efficacy of tranexamic acid in decreasing primary hemorrhage in transurethral resection of the prostate: A novel combination of intravenous and topical approach.

Urol Ann 2021 Jul-Sep;13(3):238-242. Epub 2021 Jul 14.

Department of Urology and Renal Transplant, SMS Medical College and Hospital, Jaipur, Rajasthan, India.

Background: Transurethral resection of the prostate (TURP) is the gold standard for benign prostatic enlargement; however, hemorrhage still remains one of the major complications.

Objective: The primary aim of this study was to evaluate the effect of tranexamic acid (TXA) in reducing intraoperative blood loss and need for blood transfusion. Secondary parameters compared were operating time, volume of irrigation fluid used, and reduction in hemoglobin concentration. Read More

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Effect of preoperative finasteride on perioperative blood loss during transurethral resection of the prostate and on microvessel density in patients with benign prostatic hyperplasia: An open label randomized controlled trial.

Urol Ann 2021 Jul-Sep;13(3):199-204. Epub 2021 Jul 14.

Department of Urology, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India.

Objective: Transurethral resection of the prostate (TURP) is a common procedure for the treatment of benign prostatic hyperplasia (BPH). Previous studies on the effect of 5-alpha reductase inhibitors on perioperative blood loss in TURP and microvessel density (MVD) in the prostate are equivocal. We evaluated whether pretreatment with finasteride for 2 weeks before surgery can reduce perioperative blood loss in TURP and MVD in the prostate. Read More

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Real-world data and treatment patterns of patients with lower urinary tract symptoms due to benign prostatic hyperplasia in Germany: an observational study using health insurance claims data.

World J Urol 2021 Jul 22. Epub 2021 Jul 22.

Faculty of Medicine, Department of Urology, Medical Centre - University of Freiburg, Freiburg, Germany.

Purpose: Benign prostatic hyperplasia (BPH) is associated with lower urinary tract symptoms (LUTS), representing one of the most common urological conditions. However, insights into the actual healthcare of this patient cohort in Germany are scarce. We aimed to retrospectively analyse management patterns of patients with LUTS in Germany using health insurance claims databases. Read More

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Acute Urinary Retention After Kidney Transplant: Effect on Graft Function, Predictive Factors, and Treatment.

Transplant Proc 2021 Jul-Aug;53(6):1933-1938. Epub 2021 Jul 16.

Service of Urology and Renal Transplantation, Hospital and University Center of Coimbra, Coimbra, Portugal.

Background: Benign prostatic hyperplasia (BPH) is common in older adults. Although BPH may be asymptomatic in patients with chronic kidney disease (CKD) with low diuresis, the condition may become troublesome when diuresis resumes after transplantation. This study evaluated the effect that developing acute urinary retention (AUR) in first 4 months after kidney transplantation (KT) can have on graft function at 6 months. Read More

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The role of prostate-specific antigen and multiparametric magnetic resonance imaging in the diagnosis of granulomatous prostatitis induced by intravesical Bacillus Calmette-Guérin vaccine therapy in patients with nonmuscle invasive bladder cancer.

J Cancer Res Ther 2021 Jul;17(3):625-629

Department of Urology, Cheeloo College of Medicine, Shandong Provincial Hospital, Shandong University; Department of Urology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China.

Aims: This study aimed to evaluate the role of serum prostate-specific antigen (PSA) levels and multiparametric magnetic resonance imaging (mpMRI) in the diagnosis of granulomatous prostatitis (GP) induced by intravesical Bacillus Calmette-Guérin vaccine (BCG) therapy in patients with nonmuscle invasive bladder cancer (NMIBC).

Subjects And Methods: We retrospectively analyzed eight patients with bladder cancer who underwent intravesical BCG therapy after transurethral resection of bladder tumor (TURBt) cancer. All these eight patients received 12-core transrectal ultrasound-guided prostate systemic biopsies. Read More

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A novel mouse model simulating transurethral laser vaporization prostatectomy.

Asian J Androl 2021 Jul 13. Epub 2021 Jul 13.

Medical School of Guizhou University, Guiyang 550000, China.

Benign prostatic hyperplasia (BPH) is a common disease in elderly men, and transurethral laser prostatectomy (TULP) has been widely used in the clinic to remove bladder outlet obstruction caused by BPH. Previous animal models for wound repair after prostatectomy have many limitations, and there have been no previous reports of a mouse model of TULP. Therefore, this study aimed to establish a novel mouse model of TULP. Read More

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Revisiting an Old Conundrum: A Systematic Review and Meta-Analysis of Intravesical Therapy for Treatment of Urothelial Carcinoma of the Prostate.

Bladder Cancer 2021 May 25;7(2):243-252. Epub 2021 May 25.

Division of Urology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.

Background: The optimal management of non-invasive (mucosal and/or ductal) urothelial carcinoma of the prostate remains elusive and there is a paucity of data to guide treatment.

Objective: Our objective was to systematically review and synthesize treatment responses to conservative management of non-invasive prostatic urothelial carcinoma using intravesical therapy.

Methods: A systematic literature search using MEDLINE, EMBASE, Cochrane Library, SCOPUS, and Web of Science databases from inception to November 2019 was performed. Read More

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Prostatic Artery Embolization for Benign Prostatic Hyperplasia: A Health Technology Assessment.

Authors:

Ont Health Technol Assess Ser 2021 4;21(6):1-139. Epub 2021 Jun 4.

Background: Benign prostatic hyperplasia (BPH) is a noncancerous enlargement of the prostate that commonly affects older people with prostates and may lead to obstructive urinary symptoms. Symptoms may initially be mild but tend to worsen over time. Prostatic artery embolization (PAE) is an endovascular procedure to treat BPH, wherein an interventional radiologist inserts a catheter into the patient to inject tiny particles intended to reduce blood flow to the enlarged prostate, causing it to shrink in size. Read More

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First case of ductal adenocarcinoma of the prostate with MAP3K1 homozygous deletion.

IJU Case Rep 2021 May 17;4(3):176-179. Epub 2021 Mar 17.

Department of Urology Keio University School of Medicine Tokyo Japan.

Introduction: Ductal adenocarcinoma of the prostate is a rare prostate cancer variant and associated with higher stage and greater risk of mortality. Optimal systemic therapy for metastatic ductal adenocarcinoma is not known.

Case Presentation: A 67-year-old man presented with ductal adenocarcinoma of the prostate accompanied by multiple lung metastases and advanced bone metastases. Read More

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Pathological and oncological outcomes in patients with sarcomatoid differentiation undergoing cystectomy.

BJU Int 2021 Apr 18. Epub 2021 Apr 18.

Urology Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA.

Objective: To evaluate whether urothelial carcinoma (UC) with sarcomatoid differentiation is associated with a lower pathological response rate to neoadjuvant chemotherapy (NAC) and worse oncological outcomes compared to UC without variant histology among patients undergoing radical cystectomy.

Patients And Methods: Patients with UC undergoing cystectomy from 1995 to 2018 at the Memorial Sloan Kettering Cancer Centre were identified. Patients with sarcomatoid differentiation at transurethral resection (TUR) or cystectomy, and patients without variant histology were selected. Read More

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Analysis of risk factors of bladder neck contracture following transurethral surgery of prostate.

BMC Urol 2021 Apr 11;21(1):59. Epub 2021 Apr 11.

Department of Urology, MacKay Memorial Hospital, No. 92, Sec. 2, Zhongshan N. Rd., Zhongshan Dist., Taipei, 104, Taiwan.

Backgrounds: The aim of the present study was to investigate the perioperative parameters associated with bladder neck contracture (BNC) after transurethral surgery of the prostate and to compare the incidence of BNC after transurethral resection of the prostate (TURP) or Thulium vaporesection (resection group) versus Thulium vapoenucleation or enucleation of the prostate (enucleation group).

Methods: Between March 2008 and March 2020, 2363 patients received TURP and 1656 patients received transurethral surgery of the prostate with Thulium laser (ThuP) at Mackay Memorial Hospital. A total of 62 patients developed BNC. Read More

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Improved global response outcome after intradetrusor injection of adult muscle-derived cells for the treatment of underactive bladder.

Int Urol Nephrol 2021 Jul 11;53(7):1331-1338. Epub 2021 Apr 11.

Beaumont Hospital, Royal Oak, MI, USA.

We report on the first regulatory approved clinical trial of a prospective open-label physician-initiated study assessing the safety and efficacy of intradetrusor injected Autologous Muscle Derived Cells (AMDC) treatment for underactive bladder (UAB). 20 non-neurogenic UAB patients were treated. Approximately 50-250 mg of quadriceps femoris muscle was collected using a spirotome 8-gauge needle. Read More

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Diagnosis of chronic prostatitis by noninvasive methods in elderly patients with benign prostatic hyperplasia in China.

Andrologia 2021 Jul 2;53(6):e14055. Epub 2021 Apr 2.

Department of Urology, School of Medicine, Xinhua Hospital, Shanghai Jiao Tong University, Shanghai, China.

Chronic prostatitis is hard to be identified in BPH patients in clinical works. This study aimed to diagnose chronic prostatitis in BPH patients by noninvasive methods. BPH patients who received transurethral resection of prostate from January 2014 to July 2015 were enrolled in current study. Read More

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Patients' perspective on prostatic artery embolization: A qualitative study.

SAGE Open Med 2021 12;9:20503121211000908. Epub 2021 Mar 12.

Department of Surgical and Perioperative Sciences, Urology and Andrology, Umeå University, Umeå, Sweden.

Objectives: The aim was to describe the patients' experience of undergoing prostatic artery embolization.

Methods: A retrospective qualitative interview study was undertaken with 15 patients of mean age 73 years who had undergone prostatic artery embolization with a median duration of 210 min at two medium sized hospitals in Sweden. The reasons for conducting prostatic artery embolization were clean intermittent catheterization (n = 4), lower urinary tract symptoms (n = 10) or haematuria (n = 1). Read More

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Antimicrobial Prophylaxis in Transurethral Resection of the Prostate: Results of a Randomized Trial.

J Urol 2021 Jun 9;205(6):1748-1754. Epub 2021 Feb 9.

Department of Urology, University Hospitals Leuven, Leuven, Belgium.

Purpose: We sought to determine whether omitting antimicrobial prophylaxis is safe in patients undergoing transurethral resection of the prostate without preoperative pyuria and a preoperative catheter.

Materials And Methods: We conducted a multicenter randomized controlled trial from September 17, 2017 until December 31, 2019 in 5 hospitals. Patients with pyuria (>100 white blood cells/ml) and a preoperative indwelling catheter were excluded. Read More

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Phamacological treatment of persistant lower urinary tract symptoms after a transurethral resection of the prostate is predictive of a new surgical treatment: 10 years follow-up study.

Neurourol Urodyn 2021 02 28;40(2):722-727. Epub 2021 Jan 28.

Azienda Ospedaliera Sant'Andrea- Università, "La Sapienza", Roma.

Aim: To evaluate possible risk factors of re intervention in patients with benign prostatic enlargement (BPE) undergoing transurethral resection of the prostate (TURP).

Materials And Methods: A consecutive series of patients with LUTS and BPE underwent TURP in our center in 2004 and 2005 and they were then followed up to September 2016. Patients were assessed at baseline, 3-, 6-month postoperatively and yearly thereafter with medical history, international prostate symptom score, prostate specific antigen, maximal urinary flow rate, post void residual urine. Read More

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February 2021

Prostate-Only Versus Whole-Pelvic Radiation Therapy in High-Risk and Very High-Risk Prostate Cancer (POP-RT): Outcomes From Phase III Randomized Controlled Trial.

J Clin Oncol 2021 Apr 26;39(11):1234-1242. Epub 2021 Jan 26.

Department of Radiation Oncology, Tata Memorial Hospital and Advanced Centre for Treatment Research and Education in Cancer (ACTREC), Homi Bhabha National Institute (HBNI), Mumbai, India.

Purpose: We report the clinical outcomes of a randomized trial comparing prophylactic whole-pelvic nodal radiotherapy to prostate-only radiotherapy (PORT) in high-risk prostate cancer.

Methods: This phase III, single center, randomized controlled trial enrolled eligible patients undergoing radical radiotherapy for node-negative prostate adenocarcinoma, with estimated nodal risk ≥ 20%. Randomization was 1:1 to PORT (68 Gy/25# to prostate) or whole-pelvic radiotherapy (WPRT, 68 Gy/25# to prostate, 50 Gy/25# to pelvic nodes, including common iliac) using computerized stratified block randomization, stratified by Gleason score, type of androgen deprivation, prostate-specific antigen at diagnosis, and prior transurethral resection of the prostate. Read More

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Personalized Preoperative Education Reduces Perioperative Anxiety in Old Men with Benign Prostatic Hyperplasia: A Retrospective Cohort Study.

Gerontology 2021 15;67(2):177-183. Epub 2021 Jan 15.

Department of Urology, 2nd Affiliated Hospital of Harbin Medical University, Harbin, China.

Introduction: Psychological health is important to old patients with benign prostatic hyperplasia (BPH) after prostatic surgery. In this retrospective cohort study, we evaluated the effect of personalized preoperative education in the reduction of perioperative anxiety in old BPH patients after prostatic surgery.

Methods: Senior patients (≥65 years) admitted with a diagnosis of BPH and scheduled for initial transurethral resection of the prostate from January 1, 2017 to November 30, 2019 were retrieved. Read More

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January 2021

The Predictive Role of Prostate-Specific Antigen Changes Following Transurethral Resection of the Prostate for Patients with Localized Prostate Cancer.

Cancers (Basel) 2020 Dec 29;13(1). Epub 2020 Dec 29.

College of Medicine, Chang Gung University, Taoyuan 131, Taiwan.

Regarding localized prostate cancer (PC), questions remain regarding which patients are appropriate candidates for conservative management. Some localized PC was an incidental finding in patients who received transurethral resection of the prostate (TURP) for urinary symptoms. It is known that TURP usually affects the level of prostate-specific antigen (PSA). Read More

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December 2020

[Diagnosis and treatment of 12 cases of sexual activity-related hematuria: Experience and literature review].

Zhonghua Nan Ke Xue 2020 Sep;26(9):815-819

Department of Urology, Changhai Hospital, Naval Medical University, Shanghai 200433, China.

Objective: To summarize and analyze the experience in the diagnosis and treatment of sexual activity-related hematuria.

Methods: A retrospective analysis was conducted on 12 cases of sexual activity-related hematuria treated in Changhai Hospital from October 2015 to April 2019. The patients ranged in age between 31 and 59 years, with a disease course of 2 weeks to 25 years, 6 complaining of urethral bleeding at penile erection and another 6 hematuria immediately after ejaculation, including 2 accompanied by hemospermia. Read More

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September 2020

[Possibilities of using sildenafil in patients with cardiovascular comorbidities who underwent transurethral resection of the prostate].

Urologiia 2020 Dec(6):38-43

Department of Urology and Andrology with a course of Specialized Surgery of FGBOU VO "Altai State Medical University" of the Ministry of Health of Russia, Barnaul, Russia.

Aim: To study the efficacy and safety of using sildenafil in patients with erectile dysfunction (ED) and concomitant cardiovascular diseases (CVD) who underwent transurethral resection of the prostate (TURP).

Material And Methods: A total of 59 patients (age from 50 to 75 years) with a diagnosis of benign prostatic hyperplasia (BPH), requiring surgical treatment due to inefficiency of drug therapy, I-PSS score more than 20 points), who were sexually active, but had erectile dysfunction (IIEF score < 21), coronary heart disease (NYHA class I) and stage 1-2 hypertension with stable blood pressure. All patients underwent bipolar TURP. Read More

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December 2020

Long-Term Results of NRG Oncology/RTOG 0321: A Phase II Trial of Combined High Dose Rate Brachytherapy and External Beam Radiation Therapy for Adenocarcinoma of the Prostate.

Int J Radiat Oncol Biol Phys 2021 07 10;110(3):700-707. Epub 2020 Nov 10.

Cedars-Sinai Medical Center.

Purpose: To report the long-term outcome of patients with prostate cancer treated with external beam radiation therapy and high dose rate (HDR) brachytherapy from a prospective multi-institutional trial conducted by NRG Oncology/RTOG.

Methods And Materials: Patients with clinically localized (T1c-T3b) prostate cancer without prior history of transurethral resection of prostate or hip prosthesis were eligible for this study. All patients were treated with a combination of 45 Gy in 25 fractions from external beam radiation therapy and one HDR implant delivering 19 Gy in 2 fractions. Read More

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Prostate cancer recurrence mimicking invasive urothelial cancer of the bladder.

Urol Case Rep 2020 Nov 21;33:101421. Epub 2020 Sep 21.

Department of Urology, National Defense Medical College, 3-2 Namiki, Tokorozawa, Saitama, 359-8513, Japan.

A 74-year-old male patient with stage D1 prostate cancer with the initial prostate-specific antigen (PSA) level of 5570 ng/mL had received androgen deprivation therapy and the serum PSA level had decreased to 0.23 ng/mL when he developed macroscopic hematuria. MRI and cystoscopy suggested invasive urothelial cancer of the bladder, and transurethral resection was performed. Read More

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November 2020

Safety and Efficacy of Outpatient Surgical Procedures for the Treatment of Benign Prostatic Enlargement in New York State and California (2005-2016).

J Urol 2021 Mar 7;205(3):848-854. Epub 2020 Oct 7.

Department of Urology, Weill Cornell Medical College/New York Presbyterian, New York, New York.

Purpose: We compared outcomes of transurethral prostatectomy and laser prostatectomy in a real-world setting.

Materials And Methods: We present a prospectively collected observational cohort study of 85,682 men with benign prostatic enlargement in New York State and California who received transurethral prostatectomy or laser prostatectomy in outpatient and ambulatory surgery settings from January 2005 to December 2016. We used propensity score matching to adjust for differences in patient characteristics between groups. Read More

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Robotic surgery in giant multilocular cystadenoma of the prostate: A rare case report.

World J Clin Cases 2020 Sep;8(18):4215-4222

Division of Urology, Department of Surgery, Chang Gung Memorial Hospital, Taoyuan 333, Taiwan.

Background: Giant multilocular cystadenoma (GMC) of the prostate gland is a very rare benign tumor. Although the benign nature has been known, complete surgical excision is the major treatment consensus because of its high recurrence rate. We report a rare case of GMC with accompanying lower urinary tract symptoms and repeated urine retention initially thought to be symptoms of benign prostatic hyperplasia, which was treated with robot-assisted laparoscopic radical prostatectomy. Read More

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September 2020

Intravesical bacteriophages for treating urinary tract infections in patients undergoing transurethral resection of the prostate: a randomised, placebo-controlled, double-blind clinical trial.

Lancet Infect Dis 2021 03 16;21(3):427-436. Epub 2020 Sep 16.

Department of Neuro-Urology, Balgrist University Hospital, University of Zürich, Zürich, Switzerland. Electronic address:

Background: Urinary tract infections (UTIs) are among the most prevalent microbial diseases and their financial burden on society is substantial. In the context of increasing antibiotic resistance, finding alternative treatments for UTIs is a top priority. We aimed to determine whether intravesical bacteriophage therapy with a commercial bacteriophage cocktail is effective in treating UTI. Read More

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Thulium laser transurethral vaporesection versus transurethral resection of the prostate for benign prostatic obstruction: the UNBLOCS RCT.

Health Technol Assess 2020 09;24(41):1-96

Bristol Urological Institute, Southmead Hospital, North Bristol NHS Trust, Bristol, UK.

Background: Transurethral resection of the prostate (TURP) is the standard operation for benign prostatic obstruction (BPO). Thulium laser transurethral vaporesection of the prostate (ThuVARP) vaporises and resects the prostate using a technique similar to TURP. The small amount of existing literature suggests that there may be potential advantages of ThuVARP over TURP. Read More

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September 2020