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Biomedical subjects

B P Shumaker

Publications and source records attributed to B P Shumaker.

11 recordsLinked to original sources
PubMed1998

Transurethral needle ablation for benign prostatic hyperplasia: 12-month results of a prospective, multicenter U.S. study.

OBJECTIVES: To report the safety and efficacy of the transurethral needle ablation (TUNA) procedure for the treatment of clinical benign prostatic hyperplasia (BPH). METHODS: One hundred thirty patients with BPH were enrolled in two identical protocols and treated by the TUNA procedure. Entry criteria included an American Urological Association symptom index (AUA SI) of 13 points or higher and a peak flow rate of 12 mL/s or less. Patients were followed up for 12 months. Efficacy parameters included the AUA SI, AUA problem index, BPH impact index (BPH II), quality of life (QOL) score, and peak flow rate. At each visit, side effects were elicited. Follow-up data are available for 93 patients at 12 months. All patients were given intraurethral lidocaine augmented by oral and/or parenteral sedation. No patient received spinal or general anesthesia. RESULTS: All patients tolerated the procedure well, and there were no deaths. Forty-one percent of patients (n = 53) had a catheter placed immediately after the procedure. At 12 months, the AUA SI had decreased from 23.7 to 11.9 (P < 0.0001) and the BPH II from 7.5 to 2.5 (P < 0.0001), whereas the peak flow rate had increased from 8.7 to 14.6 mL/s (P < 0.0001). Irritative voiding symptoms were noted in 20 patients (16%) at some point during follow-up. Two patients reported erectile dysfunction, and 1 reported retrograde ejaculation. CONCLUSIONS: In this prospective study of 130 patients with clinical BPH and lower urinary tract symptoms, TUNA provided substantive and lasting improvement according to AUA SI, BPH II, and QOL scores as well as peak flow rate over 1 year. The TUNA procedure was well tolerated, with few major side effects and complications noted. Longer follow-up is needed to document the maintenance of clinical benefit beyond 12 months.

Aged↗
PubMed1998

A prospective, randomized 1-year clinical trial comparing transurethral needle ablation to transurethral resection of the prostate for the treatment of symptomatic benign prostatic hyperplasia.

PURPOSE: We assess the 1-year efficacy and safety of transurethral needle ablation of the prostate compared to transurethral resection of the prostate for the treatment of symptomatic benign prostatic hyperplasia (BPH). MATERIALS AND METHODS: A prospective, randomized clinical trial of 121 men 50 years old or older with symptomatic BPH was performed at 7 medical centers across the United States. Of the men 65 (54%) were treated with transurethral needle ablation of the prostate and 56 (46%) underwent transurethral resection of the prostate. Mean and percentage changes from baseline and between cohorts for American Urological Association (AUA) symptom score, AUA bother score, quality of life score, peak urinary flow rate and post-void residual urine volume were measured at 1, 3, 6 and 12 months following treatment. Length of procedure, hospitalization, type of anesthesia, post-procedure catheterization, side effects and sexual function were compared. RESULTS: Transurethral needle ablation and resection resulted in a statistically significant improvement in AUA symptom, bother and quality of life scores, peak urinary flow rate and post-void residual. At 1-year followup, needle ablation and resection were equally effective in enhancing quality of life. Needle ablation had less effect on sexual function, with resection being associated with a greater incidence of retrograde ejaculation. Needle ablation could be performed as an outpatient procedure with local anesthesia while resection required anesthesia and hospitalization. Needle ablation was associated with markedly fewer side effects than resection. CONCLUSIONS: Compared to transurethral resection of the prostate, transurethral needle ablation of the prostate is an efficacious, minimally invasive treatment for symptomatic BPH that is associated with few side effects.

Catheter Ablation↗
PubMed1995

[The role of laparoscopy in the management of prostatic cancer].

Laparoscopic lymphadenectomy is a new surgical modality with increasing usage in the staging and management of prostate carcinoma. Since the presence or absence of metastatic disease in the pelvic lymph nodes must be assessed for proper treatment planning, and preoperative staging studies have a high rate of false negative results, histological evaluation of the pelvic lymph nodes should be performed prior to radical prostatectomy. Laparoscopic pelvic lymphadenectomy is a well tolerated, safe, and accurate alternative to the conventional open surgical procedure.

Humans↗
PubMed1986

Phototherapy of bladder cancer: dose/effect relationships.

Hematoporphyrin derivative photodynamic therapy has very important clinical applicability in the diagnosis and treatment of transitional cell carcinoma of the bladder, but many aspects of the photodynamic process are yet to be elucidated. This paper investigates the role of dihematoporphyrin ether (DHE) concentration, the duration of light exposure, and the initial size of the tumors in the treatment of a transplantable murine transitional cell tumor system. The best results were noted in tumors less than six mm. in diameter when treated with 15 mg./kg. DHE and exposed to 100 to 180 minutes of visible light. Animals with small initial tumor size combined with higher DHE concentration and longer light exposure time were most likely to show tumor response.

Animals↗
PubMed1986

The high incidence of benign testicular tumors.

Of 2,800 testicular procedures performed at our institution between 1965 and 1985, 233 inguinal explorations were done for suspicion of cancer. Malignancy was present in 161 patients but in 72 cases (31 per cent) benign lesions were found. Despite the benign nature of the lesion 51 of these patients (70 per cent) underwent radical orchiectomy. The incidence of benign testicular tumors is much higher than previously suspected and awareness of this condition should lead to increased testicular preservation in selected cases.

Diagnosis, Differential↗
PubMed1984

Appendicovesical fistula.

Appendicovesical fistula is a rare complication of unrecognized appendicitis. Only 99 previous cases have been reported in the literature. We reviewed these cases and contribute an additional one with hope that increased awareness of this entity may facilitate the correct diagnosis and avoid inappropriate management.

Adolescent↗
PubMed1980

Idiopathic rupture of bladder.

Idiopathic bladder rupture is uncommon but not rare. It should be considered in patients with depressed sensorium who present with mild azotemia, acidosis, and inability to void. A cystogram is diagnostic, and recovery is usually uneventful after primary bladder closure.

Alcoholism↗
PubMed1980

Renal cystography: unusual complication.

A patient is described in whom renal cyst aspiration and subsequent contrast material instillation caused pain, flank mass and spiking temperature, evantually necessitating exploration and drainage of a sterile abscess. Undiluted, hyperosmotic contrast material was the probable cause of this complication. A simple, easy way to calculate cyst volume and amount of contrast material to be used during cyst aspiration injection studies is discussed.

Contrast Media↗