350
HUANG ET AL.
17. Sahiner T, Atahan O, Aybek Z. Prostate electromyography: A new concept. Electromyogr Clin Neurophysiol 2000;40: 103–107.
Abbreviations Used BPH ¼ benign prostatic hyperplasia EMG ¼ electromyography IPSS ¼ International Prostate Symptom Score LUTS ¼ lower urinary tract symptoms PVR ¼ postvoid residual Qmax ¼ peak urine flow rate QoL ¼ quality of life TUDP ¼ transurethral dilation of the prostate TURP ¼ transurethral resection of the prostate USP ¼ transurethral split of the prostate
Address correspondence to: Weiguo Huang, MM Urinary Surgery The Affiliated Drum Tower Hospital of Nanjing University No. 321 Zhongshan Road Nanjing 210008 China E-mail: [email protected]
DOI: 10.1089/end.2014.0825
Editorial Comment for Huang et al. Pat Fulgham, MD
T
he authors have conducted a study to evaluate the mechanism and effectiveness of transurethral balloon dilation of the prostate for the management of bladder outlet obstruction. The patients selected had moderate to significant obstructive voiding symptoms, had moderately enlarged prostates (average 48 cc), and underwent a single session of transurethral balloon dilation of the prostate. The patients appeared to have good outcomes based on preoperative and postoperative evaluation of their quality of life and International Prostate Symptom Score scores, and the results were relatively durable. CT scans in some patients confirmed anterior disruption of the prostate with resultant sustained defect anteriorly in some. The authors conclude that the use of a columnar balloon is superior to the use of a spherical balloon in achieving this clinical outcome; however, there are no direct comparisons in this patient population between the use of a spherical balloon and the use of a columnar balloon. Review of the literature from the 1980s and 1990s, when transurethral balloon dilation of the prostate was introduced and in relatively widespread use, showed conflicting but generally disappointing results in terms of the durability of clinical outcomes.1–3 A review of the literature reveals that balloons similar to the one described in this study were in use at that time.3,4 It is possible that the differentiating aspect of the procedure described in this study was that the balloon was left fully inflated for 5 to 6 hours after the procedure. It is possible that this expansion and compression of the prostate could lead to
some vascular compromise of the tissue and perhaps result in more scar tissue formation and decreased collagen deposition as well as some atrophy of the glandular tissue itself. If the proposed mechanism of action is correct, very similar results could theoretically be obtained by simple transurethral incision of the prostate and capsule anteriorly. References
1. Vale JA, Miller PD, Kirby RS. Balloon dilatation of the prostate—should it have a place in the urologist’s armamentarium? J R Soc Med 1993;86:83–86. 2. Chiou RK, Binard JE, Ebersole ME, et al. Randomized comparison of balloon dilation and transurethral incision for treatment of symptomatic benign prostatic hyperplasia. J Endourol 1994;8:221–224. 3. Moseley WG. Balloon dilatation of prostate: Keys to sustained favorable results. Urology 1992;39:314–318. 4. McLoughlin J, Keane PF, Jager R, et al. Dilatation of the prostatic urethra with 35 mm balloon. Br J Urol 1991;67: 177–181.
Oncology Services, Texas Health Presbyterian Dallas, Dallas, Texas.
Address correspondence to: Pat Fulgham, MD Oncology Services Texas Health Presbyterian Dallas 8210 Walnut Hill Lane, Suite 014 Dallas, TX 75231 E-mail: [email protected]
Copyright of Journal of Endourology is the property of Mary Ann Liebert, Inc. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use.
HUANG ET AL.
17. Sahiner T, Atahan O, Aybek Z. Prostate electromyography: A new concept. Electromyogr Clin Neurophysiol 2000;40: 103–107.
Abbreviations Used BPH ¼ benign prostatic hyperplasia EMG ¼ electromyography IPSS ¼ International Prostate Symptom Score LUTS ¼ lower urinary tract symptoms PVR ¼ postvoid residual Qmax ¼ peak urine flow rate QoL ¼ quality of life TUDP ¼ transurethral dilation of the prostate TURP ¼ transurethral resection of the prostate USP ¼ transurethral split of the prostate
Address correspondence to: Weiguo Huang, MM Urinary Surgery The Affiliated Drum Tower Hospital of Nanjing University No. 321 Zhongshan Road Nanjing 210008 China E-mail: [email protected]
DOI: 10.1089/end.2014.0825
Editorial Comment for Huang et al. Pat Fulgham, MD
T
he authors have conducted a study to evaluate the mechanism and effectiveness of transurethral balloon dilation of the prostate for the management of bladder outlet obstruction. The patients selected had moderate to significant obstructive voiding symptoms, had moderately enlarged prostates (average 48 cc), and underwent a single session of transurethral balloon dilation of the prostate. The patients appeared to have good outcomes based on preoperative and postoperative evaluation of their quality of life and International Prostate Symptom Score scores, and the results were relatively durable. CT scans in some patients confirmed anterior disruption of the prostate with resultant sustained defect anteriorly in some. The authors conclude that the use of a columnar balloon is superior to the use of a spherical balloon in achieving this clinical outcome; however, there are no direct comparisons in this patient population between the use of a spherical balloon and the use of a columnar balloon. Review of the literature from the 1980s and 1990s, when transurethral balloon dilation of the prostate was introduced and in relatively widespread use, showed conflicting but generally disappointing results in terms of the durability of clinical outcomes.1–3 A review of the literature reveals that balloons similar to the one described in this study were in use at that time.3,4 It is possible that the differentiating aspect of the procedure described in this study was that the balloon was left fully inflated for 5 to 6 hours after the procedure. It is possible that this expansion and compression of the prostate could lead to
some vascular compromise of the tissue and perhaps result in more scar tissue formation and decreased collagen deposition as well as some atrophy of the glandular tissue itself. If the proposed mechanism of action is correct, very similar results could theoretically be obtained by simple transurethral incision of the prostate and capsule anteriorly. References
1. Vale JA, Miller PD, Kirby RS. Balloon dilatation of the prostate—should it have a place in the urologist’s armamentarium? J R Soc Med 1993;86:83–86. 2. Chiou RK, Binard JE, Ebersole ME, et al. Randomized comparison of balloon dilation and transurethral incision for treatment of symptomatic benign prostatic hyperplasia. J Endourol 1994;8:221–224. 3. Moseley WG. Balloon dilatation of prostate: Keys to sustained favorable results. Urology 1992;39:314–318. 4. McLoughlin J, Keane PF, Jager R, et al. Dilatation of the prostatic urethra with 35 mm balloon. Br J Urol 1991;67: 177–181.
Oncology Services, Texas Health Presbyterian Dallas, Dallas, Texas.
Address correspondence to: Pat Fulgham, MD Oncology Services Texas Health Presbyterian Dallas 8210 Walnut Hill Lane, Suite 014 Dallas, TX 75231 E-mail: [email protected]
Copyright of Journal of Endourology is the property of Mary Ann Liebert, Inc. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use.
