BOOK
Treatment of Lower Urinary Tract Symptoms and Benign Prostatic Hyperplasia: Current methods, outcomes, and controversies, An Issue of Urologic Clinics of North America, E-Book
Kevin T. McVary | Charles Welliver
(2016)
Additional Information
Book Details
Abstract
Benign prostatic hyperplasia and the resulting lower urinary tract symptoms is a major part of almost any urologist’s clinical practice. Due to the high prevalence of the disease in our aging population, new concepts and treatments are constantly entering the marketplace. Differences in patient preferences and desired outcomes require the practicing urologist to understand not only the pathophysiology of the disease but how specific treatments may be better suited for some patients and not others. This issue will address the current concepts and treatments available to urologists.
Table of Contents
| Section Title | Page | Action | Price |
|---|---|---|---|
| Front Cover | Cover | ||
| Treatment of Lower Urinary Tract Symptoms and Benign Prostatic Hyperplasia\r | i | ||
| Copyright\r | ii | ||
| CME Accreditation Page | iii | ||
| PROGRAM OBJECTIVE | iii | ||
| TARGET AUDIENCE | iii | ||
| LEARNING OBJECTIVES | iii | ||
| ACCREDITATION | iii | ||
| DISCLOSURE OF CONFLICTS OF INTEREST | iii | ||
| UNAPPROVED/OFF-LABEL USE DISCLOSURE | iii | ||
| TO ENROLL | iv | ||
| METHOD OF PARTICIPATION | iv | ||
| CME INQUIRIES/SPECIAL NEEDS | iv | ||
| Contributors | v | ||
| CONSULTING EDITOR | v | ||
| EDITORS | v | ||
| AUTHORS | v | ||
| Contents | vii | ||
| Foreword: Treatment of Lower Urinary Tract Symptoms and Benign Prostatic Hyperplasia\r | vii | ||
| Preface\r | vii | ||
| Review of Prostate Anatomy and Embryology and the Etiology of Benign Prostatic Hyperplasia\r | vii | ||
| The Epidemiology of Benign Prostatic Hyperplasia Associated with Lower Urinary Tract Symptoms: Prevalence and Incident Rates\r | vii | ||
| Diagnostic Work-Up of Lower Urinary Tract Symptoms\r | vii | ||
| Alpha-blockers for the Treatment of Benign Prostatic Hyperplasia\r | viii | ||
| 5-Alpha-Reductase Inhibitors and Combination Therapy\r | viii | ||
| Antimuscarinics, b-3 Agonists, and Phosphodiesterase Inhibitors in the Treatment of\rMale Lower Urinary Tract Symptoms: An Evolving Paradigm\r | viii | ||
| a-Blockers, 5-a-Reductase Inhibitors, Acetylcholine, b3 Agonists, and\rPhosphodiesterase-5s in Medical Management of Lower Urinary Tract Symptoms/\rBenign Prostatic Hyperplasia: How Much Do the Different Formulations\rActually Matter in the Classes?\r | viii | ||
| Prostatic Urethral Lift: A Unique Minimally Invasive Surgical Treatment of Male Lower\rUrinary Tract Symptoms Secondary to Benign Prostatic Hyperplasia\r | ix | ||
| Convective Water Vapor Energy for Lower Urinary Tract Symptoms/Benign Prostatic Hyperplasia\r | ix | ||
| Bipolar, Monopolar, Photovaporization of the Prostate, or Holmium Laser Enucleation\rof the Prostate: How to Choose What’s Best?\r | ix | ||
| Robotic-Assisted Simple Prostatectomy: An Overview\r | ix | ||
| Sexual Side Effects of Medical and Surgical Benign Prostatic Hyperplasia Treatments\r | x | ||
| Testosterone and the Prostate: Artifacts and Truths\r | x | ||
| UROLOGIC CLINICS OF NORTH AMERICA\r | xi | ||
| FORTHCOMING ISSUES | xi | ||
| November 2016 | xi | ||
| February 2017 | xi | ||
| May 2017 | xi | ||
| RECENT ISSUES | xi | ||
| May 2016 | xi | ||
| February 2016 | xi | ||
| November 2015 | xi | ||
| Foreword:\rTreatment of Lower Urinary Tract Symptoms and Benign Prostatic Hyperplasia | xiii | ||
| Preface | xv | ||
| Review of Prostate Anatomy and Embryology and the Etiology of Benign Prostatic Hyperplasia | 279 | ||
| Key points | 279 | ||
| INTRODUCTION | 279 | ||
| HUMAN AND RODENT PROSTATE EMBRYOLOGY AND POSTNATAL DEVELOPMENT | 280 | ||
| ANATOMY OF THE HUMAN AND RODENT PROSTATE | 281 | ||
| ETIOLOGY OF BENIGN PROSTATIC HYPERPLASIA | 283 | ||
| ANIMAL MODELS IN THE STUDY OF BENIGN PROSTATIC HYPERPLASIA | 284 | ||
| SUMMARY | 285 | ||
| REFERENCES | 285 | ||
| The Epidemiology of Benign Prostatic Hyperplasia Associated with Lower Urinary Tract Symptoms | 289 | ||
| Key points | 289 | ||
| INTRODUCTION | 289 | ||
| DISEASE DESCRIPTION/TERMINOLOGY | 290 | ||
| Benign Prostatic Hyperplasia | 290 | ||
| Lower Urinary Tract Symptoms | 290 | ||
| RISK FACTORS AND COMORBIDITIES | 290 | ||
| PREVALENCE/INCIDENCE | 291 | ||
| Prevalence | 291 | ||
| Overall and by age | 291 | ||
| By disease severity | 291 | ||
| By race/ethnicity | 292 | ||
| Incidence | 292 | ||
| Overall | 292 | ||
| By age and disease severity | 293 | ||
| By race/ethnicity | 293 | ||
| DISCUSSION | 294 | ||
| Benign Prostatic Hyperplasia and Lower Urinary Tract Symptoms Estimates: Comparison | 294 | ||
| CLINICAL CORRELATION | 295 | ||
| SUMMARY | 295 | ||
| REFERENCES | 295 | ||
| Diagnostic Work-Up of Lower Urinary Tract Symptoms | 299 | ||
| Key points | 299 | ||
| INTRODUCTION | 299 | ||
| PATIENT HISTORY | 299 | ||
| Symptom Score | 299 | ||
| Frequency-Volume Charts | 300 | ||
| Additional History | 300 | ||
| PHYSICAL EXAMINATION | 300 | ||
| IMAGING AND ADDITIONAL TESTING | 300 | ||
| Urine Studies | 300 | ||
| Serum Creatinine | 301 | ||
| Prostate-Specific Antigen | 301 | ||
| Postvoid Residual Urine Volume | 302 | ||
| Peak Urine Flow Rate | 302 | ||
| Pressure-Flow Studies | 303 | ||
| Prostate Ultrasonography | 304 | ||
| Endoscopy | 305 | ||
| Additional Imaging | 306 | ||
| GUIDELINE OVERVIEW | 306 | ||
| SUMMARY | 307 | ||
| REFERENCES | 307 | ||
| Alpha-blockers for the Treatment of Benign Prostatic Hyperplasia | 311 | ||
| Key points | 311 | ||
| HISTORICAL PERSPECTIVE | 311 | ||
| DEVELOPMENT OF SELECTIVE ALPHA1 BLOCKERS FOR BENIGN PROSTATIC HYPERPLASIA | 312 | ||
| ALPHA 1 SUBTYPE SELECTIVE ALPHA-BLOCKERS | 315 | ||
| SILODOSIN, A UNIQUELY SELECTIVE ALPHA 1 SUBTYPE ANTAGONIST | 316 | ||
| ALPHA-BLOCKERS FOR TREATING ACUTE URINARY RETENTION | 317 | ||
| ALPHA-BLOCKERS VERSUS 5 ALPHA REDUCTASE INHIBITORS FOR TREATMENT OF LOWER URINARY TRACT SYMPTOMS/BENIGN PROSTATIC HYPERPLASIA | 317 | ||
| WHAT IS THE MECHANISM FOR ALPHA 1 BLOCKERS IN THE TREATMENT OF BENIGN PROSTATIC HYPERPLASIA? | 320 | ||
| ALPHA-BLOCKERS AS THE TREATMENT OF BENIGN PROSTATIC HYPERPLASIA IN THE YEAR 2016 | 321 | ||
| REFERENCES | 321 | ||
| 5-Alpha-Reductase Inhibitors and Combination Therapy | 325 | ||
| Key points | 325 | ||
| INTRODUCTION | 325 | ||
| 5-ALPHA-REDUCTASE INHIBITOR MONOTHERAPY | 325 | ||
| Finasteride | 325 | ||
| Dutasteride | 326 | ||
| Side Effects and Further Aspects of 5-Alpha-Reductase Inhibitors | 327 | ||
| Adverse side effects | 327 | ||
| Further aspects | 327 | ||
| Effects of 5-alpha-reductase inhibitors on prostate-specific antigen levels and prostate cancer risk | 328 | ||
| 5-ALPHA-REDUCTASE INHIBITOR COMBINATION THERAPY | 328 | ||
| Combination with Alpha-Blockers | 328 | ||
| Combination with Phosphodiesterase Type 5 Inhibitors | 332 | ||
| SUMMARY | 332 | ||
| REFERENCES | 333 | ||
| Antimuscarinics, β-3 Agonists, and Phosphodiesterase Inhibitors in the Treatment of Male Lower Urinary Tract Symptoms | 337 | ||
| Key points | 337 | ||
| INTRODUCTION | 337 | ||
| ANTIMUSCARINICS | 338 | ||
| Mechanism of Action | 338 | ||
| Clinical Efficacy | 338 | ||
| Clinical Safety | 340 | ||
| Summary | 341 | ||
| β-3 AGONISTS | 341 | ||
| Mechanism of Action | 341 | ||
| Clinical Efficacy | 341 | ||
| Clinical Safety | 341 | ||
| Summary | 342 | ||
| PHOSPHODIESTERASE INHIBITORS | 342 | ||
| Mechanism of Action | 342 | ||
| Induction of smooth muscle relaxation in the lower urinary tract | 342 | ||
| Regulation of the proliferation and differentiation of lower urinary tract stroma | 343 | ||
| Affect afferent nerve activity | 343 | ||
| Increasing lower urinary tract oxygenation | 343 | ||
| Regulating lower urinary tract symptoms–related inflammation | 343 | ||
| Clinical Efficacy | 343 | ||
| Clinical Safety | 343 | ||
| α-Blockers, 5-α-Reductase Inhibitors, Acetylcholine, β3 Agonists, and Phosphodiesterase-5s in Medical Management of Lower U ... | 351 | ||
| Key points | 351 | ||
| INTRODUCTION | 352 | ||
| PHARMACOLOGIC TREATMENT OPTIONS | 352 | ||
| α-Blockers | 352 | ||
| 5-α-Reductase Inhibitors | 352 | ||
| Anticholinergics Therapy | 353 | ||
| β-3-Andrenoceptor Agonists | 353 | ||
| Phosphodiesterase Type 5 Inhibitors | 353 | ||
| TREATMENT RESISTANCE/COMPLICATIONS | 354 | ||
| SUMMARY | 354 | ||
| REFERENCES | 354 | ||
| Prostatic Urethral Lift | 357 | ||
| Key points | 357 | ||
| INTRODUCTION: NATURE OF THE PROBLEM | 357 | ||
| SURGICAL TECHNIQUE | 358 | ||
| Preoperative Planning | 358 | ||
| Preparation and Patient Positioning | 359 | ||
| Surgical Approach | 359 | ||
| Surgical Procedure | 360 | ||
| Immediate Postoperative Care | 361 | ||
| REHABILITATION AND RECOVERY | 362 | ||
| CLINICAL RESULTS IN THE LITERATURE | 363 | ||
| Effectiveness | 363 | ||
| Safety | 365 | ||
| Sexual Function Preservation | 366 | ||
| Durability | 367 | ||
| SUMMARY | 367 | ||
| REFERENCES | 368 | ||
| Convective Water Vapor Energy for Lower Urinary Tract Symptoms/Benign Prostatic Hyperplasia | 371 | ||
| Key points | 371 | ||
| INTRODUCTION | 371 | ||
| REZUM SYSTEM | 372 | ||
| EFFECTS ON PROSTATIC ADENOMA | 372 | ||
| FUNCTIONAL OUTCOMES | 374 | ||
| IMPACT ON SEXUAL FUNCTION | 375 | ||
| SUMMARY | 375 | ||
| REFERENCES | 375 | ||
| Bipolar, Monopolar, Photovaporization of the Prostate, or Holmium Laser Enucleation of the Prostate | 377 | ||
| Key points | 377 | ||
| INTRODUCTION | 377 | ||
| MONOPOLAR TRANSURETHRAL RESECTION OF THE PROSTATE | 378 | ||
| Indications | 378 | ||
| Functional Results | 378 | ||
| Complications | 378 | ||
| Robotic-Assisted Simple Prostatectomy | 385 | ||
| Key points | 385 | ||
| INTRODUCTION | 385 | ||
| SURGICAL TECHNIQUE | 386 | ||
| Preoperative Evaluation and Preparation | 386 | ||
| Patient Setup | 386 | ||
| Prostate Exposure | 386 | ||
| Development of the Posterior Plane | 386 | ||
| Development of the Lateral and Anterior Planes | 387 | ||
| Transection of the Urethra and Removal of the Adenoma | 387 | ||
| Advancement of the Bladder Neck Mucosa | 387 | ||
| Bladder Closure | 387 | ||
| Postoperative Care | 387 | ||
| OUTCOMES | 387 | ||
| Operative Time | 387 | ||
| Operative Blood Loss and Transfusion | 389 | ||
| Hospital Duration of Stay | 389 | ||
| Complications | 389 | ||
| Duration of Catheterization | 389 | ||
| Functional Outcomes | 389 | ||
| Cost Comparison | 389 | ||
| SUMMARY | 389 | ||
| REFERENCES | 389 | ||
| Sexual Side Effects of Medical and Surgical Benign Prostatic Hyperplasia Treatments | 393 | ||
| Key points | 393 | ||
| INTRODUCTION | 393 | ||
| MEDICATIONS | 394 | ||
| Alpha Blockers | 394 | ||
| Nonselective alpha blockers | 394 | ||
| Selective alpha blockers | 394 | ||
| Comparisons of alpha blocker medications | 395 | ||
| 5-Alpha Reductase Inhibitors | 396 | ||
| Postulating a physiologic basis to sexual dysfunction | 396 | ||
| Study-specific outcomes | 396 | ||
| Combination of 5-Alpha Reductase Inhibitors and Alpha Blockers | 398 | ||
| Phosphodiesterase Type 5 Inhibitors | 398 | ||
| Anticholinergics | 398 | ||
| SURGICAL TREATMENTS | 398 | ||
| Background | 398 | ||
| Transurethral Resection of the Prostate | 399 | ||
| Ejaculatory dysfunction | 399 | ||
| Erectile dysfunction | 399 | ||
| Bipolar versus monopolar transurethral resection of the prostate | 399 | ||
| Transurethral Microwave Therapy | 400 | ||
| Transurethral Needle Ablation | 400 | ||
| Prostate Urethral Lift | 400 | ||
| Open Simple Prostatectomy | 400 | ||
| Holmium Laser Enucleation of the Prostate | 400 | ||
| Photoselective Vaporization of the Prostate | 400 | ||
| SUMMARY | 401 | ||
| REFERENCES | 401 | ||
| Testosterone and the Prostate | 405 | ||
| Key points | 405 | ||
| INTRODUCTION | 405 | ||
| NATURAL HISTORY OF TESTOSTERONE/HYPOGONADISM | 405 | ||
| NATURAL HISTORY OF BENIGN PROSTATIC HYPERPLASIA | 406 | ||
| ANDROGENS AND THEIR INTERACTION WITH BENIGN PROSTATIC HYPERPLASIA | 407 | ||
| SUMMARY | 410 | ||
| REFERENCES | 410 | ||
| Index | 413 |