Evaluation of treatments for benign prostatic enlargement



Although Parkinson’s disease (PD) is a neurological disorder, according to an article in the January 2009 issue of the Journal of the American Academy of Orthopaedic Surgeons, the disease also increases a person’s risk of experiencing complicated orthopaedic conditions. The author recommends that all Parkinson’s treatment plans include a multidisciplinary approach in order to address

Full Post: Parkinson’s increases risk for orthopaedic conditions

Research published by the National Institute for Health Research Health Technology Assessment (NIHR HTA) programme has found that transurethral resection, the most common operation for benign prostatic enlargement (BPE), remains a clinically and cost-effective treatment. BPE commonly causes older men to have difficulty passing urine and may require surgery to alleviate the problem.

Researchers at the University of Aberdeen, led by Professor James N’Dow, examined existing data to determine the risk factors and clinical and cost-effectiveness of less minimally invasive treatments for BPE compared to the current standard of transurethral resection. These included ’tissue ablative’ treatments such as holmium laser enucleation of prostate (HoLEP); transurethral vaporisation; and ‘minimally invasive’ techniques such as laser coagulation, microwave therapy and transurethral needle ablation. They also looked at the overall long term benefits to patients.

Methods similar to transurethral resection require an anaesthetic, stay in hospital, and can sometimes lead to unwanted side effects such as bleeding. However, some patients do not require general anaesthetic and treatment can be performed within an out patient department using alternative procedures. Newer procedures have been developed but there is uncertainty about their clinical and cost-effectiveness.

The research team concluded that transurethral resection provides a consistent, high level of long-term symptom improvement. Improvements in quality of life and urinary flow were also observed. The risks associated with the minimally invasive interventions were generally lower than transurethral resection, with fewer adverse events, such as the need for a blood transfusion. However, the need for repeat surgery was more common with the newer technologies, especially the minimally invasive interventions. The evidence also suggests that HoLEP could offer some advantage over transurethral resection (such as equally good urine flow but shorter hospital stay and reduced bleeding) although long-term follow-up data is needed.

Professor James N’Dow said, “Overall our findings do not support a change in surgical treatment of BPE and suggests that TURP should remain the standard approach. Which minimally invasive intervention is most promising is unclear and good quality randomised controlled trials are needed to prove whether they are superior. Until then personal preference will influence choice of procedure with some patients choosing minimally invasive treatment options for their decreased morbidity.

To view full details about the project visit www.hta.ac.uk/1468 and the report is also published in the BMJ.

http://www.hta.ac.uk

Link




Simbionix USA Corp, an international company using leading edge simulation to advance clinical performance, announces the world-wide release of a breakthrough training simulation of the laparoscopic colorectal procedure. Although minimally invasive surgical (MIS) techniques provide many advantages over traditional open surgery, surgeons have been slow to adopt laparoscopic colon resection, because it is a very

Full Post: New colorectal module from Simbionix advances laparoscopic cancer treatment



Back pain affects more than 80 percent of people and costs more than $100 billion annually in the U.S. But is the surgery cost effective? A study by researchers at Rush University Medical Center suggests that for patients with spinal stenosis, a laminectomy, or surgical removal of some soft bone and tissue, is a reasonable

Full Post: Cost effectiveness of spinal surgery examined



Urologists at the University of Rochester Medical Center (URMC) are advancing the frontiers of minimally invasive surgery as they begin to introduce single-port access (SPA) surgery to the Rochester region. Since November 2008, URMC urologists have completed six SPA surgeries entirely through the navel, including what is believed to be the nation’s first single incision

Full Post: Strong urologic surgeons perform cutting-edge minimally invasive surgery



Retinal detachment, a condition that afflicts about 10,000 Americans each year, puts an individual at risk for vision loss or blindness. In a new study in the current issue of the New England Journal of Medicine, a leading ophthalmologist at NewYork-Presbyterian Hospital/Weill Cornell Medical Center writes, however, that a high probability of reattachment and visual improvement is

Full Post: Surgical options for retinal detachment



Minimally invasive endovascular abdominal aortic aneurysm repair (EVAR) has been praised by many vascular surgeons and patients due to its benefits: shorter operating time, reduced hospital stays, faster recovery and less scarring. It is performed through two small groin incisions rather than a large, full-length abdominal incision used in open repair. Also, EVAR is often

Full Post: Study looks at endovascular abdominal aortic aneurysm repair