Retrospective assessment of indication for surgical treatment of BPH in patients with cystolithiasis
Authors:
František Chmelík 1; Kamil Belej 1; Oto Köhler 2; Ondřej Kaplan 2; Jiří Kočárek 1; Pavel Drlík 1; Šárka Brdlíková 1
Authors‘ workplace:
Urologické oddělení, Ústřední vojenská nemocnice – Vojenská fakultní nemocnice, Praha
1; Chirurgické oddělení, Nemocnice Na Homolce, Praha
2
Published in:
Ces Urol 2014; 18(4): 310-315
Category:
Original article
Overview
Aim:
The aim of this study was to evaluate the need for prostate surgery in patients who underwent cystolitholapaxy.
Methods:
From January 2001 to February 2014, a total of 108 cystolithotripsy procedures (CLT) were performed at our hospital. In all but one case CLT was performed exclusively using trans-urethral sonotrode or Holmium laser. Benign prostatic hyperplasia (BPH) was determined as the principal diagnosis in 86 men (80%). Twenty five of them (29 %) underwent CLT immediately followed by transurethral prostate surgery. Concurrent prostate surgery was performed in patients with a high risk of recurrence and in those expected to have poor compliance. Outcomes were investigated in a group of 61 patients, who underwent only CLT followed by pharmacological treatment. We retrospectively evaluated the need for prostate surgery in this group.
Results:
During follow-up, prostate surgery was indicated in 12 patients. Their transrectal ultrasound (TRUS)-measured median prostate volume was 68 ml. The median time from CLT to surgery was 4 months. Recurrent hematuria and retention were the most common indications for prostate surgery. Six patients refused the surgery and three were withdrawn due to their worsening health status. Thirty five patients returning for regular routine follow ups, had no signs of clinical worsening or recurrence of cystolithiasis. Their median follow-up was 4.3 years and the median prostate size was 56 ml.
Conclusion:
In this study, the newly introduced or modified drug therapy after cystolitholapaxy proved sufficiently effective and a safe alternative to prostate surgery in 40% of men.
Key words:
benign prostatic hyperplasia, cystolithiasis.
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Labels
Paediatric urologist Nephrology UrologyArticle was published in
Czech Urology
2014 Issue 4
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