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Blue light cystoscopy for detection and treatment of non-muscle invasive bladder cancer
Mark Ryan J. , Gelpi-Hammerschm Francisco, Trabulsi J. Edouard , Gomella G. Leonard, MD Department of Urology, Kimmel Cancer Center, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
In patients with non-muscle invasive bladder cancer, fluorescence cystoscopy can improve the detection and ablation of bladder tumors. In this paper we describe the technique and practical aspects of hexaminolevulinate (HAL) fluorescence cystoscopy, also known as "blue light cystoscopy"
Keywords: blue light cystoscopy, bladder cancer, transurethral resection of the bladder tumor, Olympus Button Electrode,
Apr 2012 (Vol. 19, Issue 2 , Page 6227) -
Photoselective vaporization of the prostate in office and outpatient settings
Rosenthal D. Brian , DiTrolio V. Joseph, MD Urological Associates of Montgomery County, East Norriton, Pennsylvania, USA
The 980 nm/1470 nm diode laser represents the latest in laser technology for photovaporization of the prostate. Surgeons have already used this device in both inpatient and outpatient (office and ASC) setting to produce transurethral resection of the prostate (TURP) like lesions-albeit with fewer complications than traditional methods. The objective of this article is to report the techniques we used to demonstrate its efficacy and safety of the Evolve Dual (biolitec Inc., East Longmeadow, MA, USA) system in an outpatient surgery type setting.
Keywords: photovaporization, in office, holmium laser prostatectomy, holmium laser enucleation of the prostate (HoLEP), intravesical tissue morcellation,
Apr 2012 (Vol. 19, Issue 2 , Page 6223) -
UroLift system for relief of prostate obstruction under local anesthesia
Barkin Jack , Giddens Jonathan , Incze Peter , Casey Richard , Richardson Stephen , Gange Steven, MD Humber River Regional Hospital, University of Toronto, Toronto, Ontario, Canada
Many men with benign prostatic hyperplasia (BPH) forego therapy because they are dissatisfied with current treatment options. While surgical resection and ablation using many different forms of energy remain the reference standard for BPH treatment, many men seek a less invasive technique that will improve symptoms but not risk the complications associated with tissue removal. The Prostatic Urethral Lift opens the prostatic urethra with UroLift (NeoTract Inc., Pleasanton, CA, USA) permanent implants that are delivered under cystoscopic visualization. The implants literally 'hold open' the lateral prostatic lobes creating a passage through the obstructed prostatic urethra. Voiding and symptoms are significantly improved without the morbidity or possible complications following prostate resection. The entire procedure can be readily performed using local anesthesia. As with all new implant procedures, the technique has evolved with experience. The objective of this article is to describe the most current technique for the delivery of the UroLift implant in order to achieve maximal impact on symptom relief.
Keywords: prostate, LUTS, photovaporization, outpatient, 980-nm/1470-nm diode laser,
Apr 2012 (Vol. 19, Issue 2 , Page 6217) -
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) -
Holmium laser enucleation of the prostate technique for benign prostatic hyperplasia
Kelly C. Douglas , Das Akhil, MD Department of Urology, Thomas Jefferson University Hospital, Philadelphia Pennsylvania, USA
Holmium laser resection of the prostate (HoLRP) was first described by Gilling et al in 1995. HoLRP has now evolved into holmium laser enucleation of the prostate (HoLEP) with the advent of the intravesical soft-tissue morcellator. The procedure involves anatomical dissection of the prostatic tissue off the surgical capsule in a retrograde fashion using a high-powered holmium laser followed by intravesical morcellation of the prostatic tissue. Some groups believe that the HoLEP procedure is the endoscopic equivalent to a simple open prostatectomy and may be superior to transurethral resection of the prostate (TURP) or even open prostatectomy. The objective of this article is to explain the techniques for holmium laser enucleation of the prostate (HoLEP).
Keywords: photovaporization, pelvic organ prolapse, mesh, transvaginal mesh,
Feb 2012 (Vol. 19, Issue 1 , Page 6131)
