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Query: UMLS:C0036421 (PSS)
 10,989 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Although transurethral resection of the prostate (TURP) is the gold standard for treatment of BPH, a new, minimally invasive technique, called Interstitial Laser Coagulation (ILC), introduced by Muschter and Hofstetter, has been developed to treat BPH. ILC is base on the coagulation of prostatic tissue by means of diffused laser light using a diode laser system with a temperature feed-back (Indigo Medical 830e TM). We report our results in treating 20 patients with BPH and Bladder Outlet Obstruction (BOO), after a mean follow-up of 7 months. To define the indication for treatment and to monitor the success, urinary flow-rate (Omax), I-PSS symptoms score, residual urinary volume and prostate volume determined by ultrasound were recorded before treatment and after 3, 6, 12 months. Transurethrally, under spinal or regional anaesthesia, 2 or 3 insertions of the laser fibre in each prostatic lobe were performed beginning at the apex directly proximal to the bladder neck, made at 1 cm intervals, using a modified model Olympus cystoscope. After 6 months, Qmax increased from 6, 7 ml/sec to 11, 3 ml/sec; I-PSS score decreased from 18 to 8; residual urinary volume from 130 ml to 40 ml, prostate volume decreased from 60 to 48 ml. In selected cases, urodynamic evaluation was performed before and after treatment. Urodynamic findings were classified according Shafer diagram to grade B.O.O.: the score was 4 before treatment and 2 after 6 months. We observed UTI in 3 cases, retrograde ejaculation and acute urinary retention in 1 case, transitory irritative and obstructive syndrome in 8 cases after treatment. ILC is a simple, safe and effective treatment for BPH with significant improvements in both objective and subjective parameters. It is cheaper than others mini-invasive therapies and is able to treat any prostate volume, saving urethra and sexual function.
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PMID:[Interstitial laser coagulation of the prostate in patients with prostatic hypertrophy: preliminary results with medium-term follow-up]. 970 68

We report our experience with interstitial laser coagulation of the prostate (ILCP) using an Indigo 830j diode laser system for benign prostatic hyperplasia (BPH). From March 1998 to November 2000, we treated 45 patients between 51 and 95 years old (average 71.5) with symptomatic BPH. The mean prostatic volume before ILCP was 62.0 cm3. We experienced no serious complications. Three months after ILCP, the mean international prostate symptom score (I-PSS) quality of life (QOL) index and post-void residual volume (PVR) decreased significantly from 18.0 to 9.2, from 4.4 to 2.1 and from 103.6 ml to 44.5 ml, respectively. The mean maximum flow rate (MFR) increased from 7.6 ml/sec at baseline to 9.2 ml/sec 3 months after ILCP, but the difference was not statistically significant. Before and after ILCP, 8 patients were available to evaluate pressure-flow study data. The detrusor pressure at the maximum flow rate decreased significantly from 118.3 cmH2O at baseline to 78.6 cmH2O 3 months after ILCP. The improvement of the I-PSS, QOL index, MFR and PVR continued and at 24 months reached 5.7, 1.8, 11.6 ml/sec and 54.6 ml, respectively. In our assessment of the questionnaire addressing the patient's satisfaction after the treatment, the majority of the patients who answered the questionnaire were pleased with the results of ILCP. We assessed the relation of the overall treatment efficacy with the number of punctures and the total amount of the laser energy delivered, but we did not find any relation. Our clinical results suggest that the ILCP using Indigo 830j is an effective modality and the short-term treatment efficacy is favorable.
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PMID:[Interstitial laser coagulation for benign prostatic hyperplasia: clinical results of the Indigo diode laser system]. 1278 12