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  • State of the art: Advanced techniques for prostatic urethral lift for the relief of prostate obstruction under local anesthesia

    Walsh Patrick Lance, MD Eisenhower Medical Center, Rancho Mirage, California, USA

    Benign prostatic hypertrophy (BPH) affects an estimated 60% of men over the age of 50 and 90% of men over the age of 80. The prostatic urethral lift (PUL) is a safe and effective office-based procedure that is used worldwide for the treatment of BPH in men who are dissatisfied with medications due to side effects or lack of efficacy or don?t want to have a transurethral resection of the prostate due to the side effects and invasiveness of the procedure. In 2012 Barkin et al, published the standard technique for the delivery of the Urolift implant. The objective of this article is to describe the current state of the art advanced techniques for the delivery of the UroLift implant.

    Keywords: prostatic urethral lift, UroLift, benign prostatic hyperplasia, prostate, LUTS, PUL,

    Jun 2017 (Vol. 24, Issue 3, Page 8859)
  • Initial North American experience with the use of the Olympus Button Electrode for vaporization of bladder tumors

    Canter J. Daniel , Ogan Kenneth, Master A. Viraj, MD Department of Urology, Emory University School of Medicine, Atlanta, Georgia, USA

    The current treatment standard of care for patients who present de novo or with a recurrent bladder tumor is transurethral resection of the bladder tumor (TURBT) using monopolar or bipolar electrocautery in the form of a 90-degree loop electrode, which has been used since its introduction in 1952. This intervention, accomplished transurethrally, is both diagnostic and potentially therapeutic for patients with bladder cancer, especially for low grade, non muscle-invasive bladder tumors. Although usually safe and sufficient, this technique can create technical challenges, especially in the dynamically changing spherical space of the bladder. Bipolar energy has been available for many years and has been readily adopted for the endoscopic treatment of benign prostatic enlargement. A further refinement on bipolar energy has been the recent introduction of the Olympus Button Electrode (Olympus, Southborough, MA, USA). Coupling bipolar energy into the Olympus Button Electrode not only harnesses the benefits of less thermal spread but also obviates many of the geometric challenges associated with loop electrodes during resection of either large or inauspiciously placed bladder tumors. In this article, we detail our initial experience vaporizing bladder tumors with the Olympus Button Electrode. Although still very early in our experience, we have been able to completely vaporize very large tumors as well as tumors located in difficult parts of the bladder to access with minimal blood loss and no bladder perforations. Furthermore, our ability to obtain adequate grade and stage information has not been compromised by using this vaporization technique.

    Keywords: bipolar electrocautery, prostatic urethral lift, UroLift, benign prostatic hyperplasia,

    Apr 2012 (Vol. 19, Issue 2, Page 6211)
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October 2017, Vol.24 No.5
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