Benign prostatic hyperplasia surgery

Unless the sphincter mechanism is compromised by surgery or trauma, SUI is exceedingly rare in males. The most common surgeries predisposing to SUI in males are radical prostatectomy for prostate cancer and transurethral resection of the prostate for benign prostatic hyperplasia. 

Urethral overactivity and/or bladder underactivity is known as overflow incontinence. The bladder is filled to capacity but is unable to empty, causing urine to leak from a distended bladder past a normal outlet and sphincter. Common causes of urethral overactivity include benign prostatic hyperplasia (see Chap. 82) prostate cancer (see Chap. 65) and, in women, cystocele formation or surgical overcorrection after UI surgery. 

Benign prostatic hyperplasia (BPH) (Prascar on/yj.Treatment of symptomatic BPH in men with an enlarged prostate to improve symptoms, reduce acute urinary retention risk, and reduce the risk of the need for surgery including transurethral resection of the prostate (TURP) and prostatectomy. 

Prostatic enlargement is the main disease of the lower urinary tract where drugs can be used to postpone, or avoid, surgery.The symptoms of benign prostatic hyperplasia are partially relieved either by r/ -adrenoceptor blockade or by inhibiting synthesis of dihydrotestosterone in the prostate. 

A woman, who was a neighbor, had a champion show dog with severe benign prostatic hyperplasia. Her veterinarian suggested a prostatectomy for this chronic condition. This was unacceptable, as the dog s owner received substantial income from the dog s stud fee. The dog was given saw palmetto and vitamin E, which reduced the symptoms and the need for surgery. Over the next few years the dog sired many more puppies."... 

Wasson JH, RedaDJ, Bruskewitz RC, etal, fordie Veterans Affairs Cooperative Study Group on Transurethral Resection of the Prostate. A comparison of transurethral surgery with watchful waiting for moderate symptoms of benign prostatic hyperplasia. N Engl J Med 1995 332 75-79. 

Andersen JT, Nickel JC, Marshall VR, et al. Finasteride significantly reduces acute urinary retention and need for surgery in patients wifii symptomatic benign prostatic hyperplasia. Urology 1997 49 839-845. 

In men, SUI is most commonly the result of prior lower urinary tract surgery or injury, with resulting compromise of the sphincter mechanism within and external to the urethra. Radical prostatectomy for treatment of adenocarcinoma of the prostate is probably the most common setting in which surgical manipulation leads to UI. Overall, SUI in the male is uncommon, and in the absence of prior prostate surgery, severe trauma, or neurologic illness, is extraordinarily rare. Transurethral resection of the prostate for benign prostatic hyperplasia (see Chap. 82) may also lead to SUI in men. 

Observations that hermaphroditic children who ultimately turned male were genetically deficient in 5a-reductase led to the idea that competitive inhibitors of this enzyme would greatly decrease levels of dihydrotestosterone. This might in turn reduce the oversize gland in the common affliction of elderly men called benign prostatic hyperplasia (BPH), and avoid the usual therapy—surgery. The synthetic 4-azasteroid finasteride (Proscar) was introduced (1992) to treat BPH in a defined patient population. 

Facio F, Kashiwabuschi R, Nishi Y, Leao R, McDonnell P, Burnett A. Benign prostatic hyperplasia. Clinical treatment can complicate cataract surgery. Int Braz J Urol 2010 36(5) 563-70. 

A hand-held multiarm concentric-tube robotic system for transurethral laser prostate surgery has been reported previously [49]. The system is expected to facilitate holmium laser enucleation of the prostate for treating benign prostatic hyperplasia. It consists of a camera, a 6-DOF arm for tissue manipulation, and a 3-DOF arm for laser guidance deployed through an 8.66-mm endoscope. 

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