Minimally Invasive Prostate Convective Water Vapor Energy Ablation: A Multicenter, Randomized, Controlled Study for the Treatment of Lower Urinary Tract Symptoms Secondary to Benign Prostatic Hyperplasia.

Rezūm Water Vapor Thermal Therapy for Lower Urinary Tract Symptoms Associated With Benign Prostatic Hyperplasia: 4-Year Results From Randomized Controlled Study.

Three-Year Outcomes of the Prospective, Randomized Controlled Rezūm System Study: Convective Radiofrequency Thermal Therapy for Treatment of Lower Urinary Tract Symptoms Due to Benign Prostatic Hyperplasia

Erectile and Ejaculatory Function Preserved With Convective Water Vapor Energy Treatment of Lower Urinary Tract Symptoms Secondary to Benign Prostatic Hyperplasia: Randomized Controlled Study

Convective Thermal Therapy: Durable 2-Year Results of Randomized Controlled and Prospective Crossover Studies for Treatment of Lower Urinary Tract Symptoms Due to Benign Prostatic Hyperplasia

Rezūm System Water Vapor Treatment for Lower Urinary Tract Symptoms/Benign Prostatic Hyperplasia: Validation of Convective Thermal Energy Transfer and Characterization With Magnetic Resonance Imaging and 3-Dimensional Renderings.

Efficacy and Safety of Rezūm System Water Vapor Treatment for Lower Urinary Tract Symptoms Secondary to Benign Prostatic Hyperplasia

Objective: The objective of this study was to assess the
effectiveness and safety of convective radiofrequency (RF)
water vapor thermal therapy in men with lower urinary tract
symptoms (LUTS) associated with benign prostatic hyperplasia
(BPH); a pilot study design with 2-year follow-up evaluations.
Patients and methods: Men aged >=45 years with an International
Prostate Symptom Score >=13, a maximum urinary flow rate (Qmax)
<=15 mL/s, and prostate volume 20–120 cc were enrolled in a
prospective, open-label pilot study using convective RF water
vapor energy with the Rezum System. Patients were followed up
for 2 years after transurethral thermal treatment at 3
international centers in the Dominican Republic, Czech
Republic, and Sweden. The transurethral thermal therapy
utilizes radiofrequency to generate wet thermal energy in the
form of water vapor injected through a rigid endoscope into the
lateral lobes and median lobe as needed. Urinary symptom
relief, urinary flow, quality of life (QOL) impact, sexual
function, and adverseevents (AEs) were assessed at 1 week, 1,
3, 6, 12, and 24 months. Results: LUTS, flow rate, and QOL
showed significant improvements from baseline; prostate volumes
were appreciably reduced. Sexual function was maintained and no
de novo erectile dysfunction occurred. The responses evident as
early as 1 month after treatment remained consistent and
durable over the 24 months of study. Early AEs were typically
transient and mild to moderate; most were related to endoscopic
instrumentation. No procedure related to late AEs were seen.
Conclusion: The Rezum System convective RF thermal therapy is a
minimally invasive treatment for BPH/LUTS which can be
performed in the office or as an outpatient procedure with
minimal associated perioperative AEs. It has no discernable
effect on sexual function and provides significant improvement
of LUTS that remain durable at 2 years.

https://www.dovepress.com/getfile.php?fileID=33694

Two-year results after convective radiofrequency water vapor thermal therapy of symptomatic benign prostatic hyperplasia.

Nadory ledvin představuji i v soucasnosti stale aktualni problematiku. I kdyžje cetnost udavana kolem i % z celkoveho poctu malignich onemocněni, je v poslednim obdobi zaznamenavan významný vzestup incidence tohoto onemocněni. Naprostou větsinu tvoři renalni karcinomy, v klinicke praxi je vsak nutno myslet i na meně caste formy ledvinných tumoru, jako jsou např. angiomyolipomy (hamartomy). Renalni angiomyolipomje řazen k benignim nadorům, jeho incidence je udavana 0,3-3 % explorovaných nadoru ledvin. Za hlavni diagnostickou metodu je považovano CT-vysetřeni, ktere hodnoti předevsim přitomnost tukove tkaně, krevnich cev a hladkých svalových vlaken. Dle některých diagnostických algoritmů je CT-diagnostika považovana za definitivni, a pokud neni tumor symptomatický, je doporucovan konzervativni postup. Autoři se ve svem sděleni zabývaji hodnocenim diagnostickeho přinosu CT-vysetřeni u angio-myolipomů. Vychazi z vlastni zkusenosti detekce 3 liposarkomů u pacientů s původně popsaným angiomyolipomem a snaži se zpětným srovnanim nalezů revidovat původni nalezy. Sve hodnoceni autoři uzaviraji v tom smyslu, že CT-vysetřeni nelze považovat za definitivni a zcela spolehlive, zejmena v připadech, kdy se jedna o jednostranný tumor větsi než 4 cm. V těchto připadech je indikovana operacni revize, jejiž rozsah je dan peroperacnim nalezem.

Vítězslav Vít

Papers

Rezūm System Water Vapor Treatment for Lower Urinary Tract Symptoms/Benign Prostatic Hyperplasia: Validation of Convective Thermal Energy Transfer and Characterization With Magnetic Resonance Imaging and 3-Dimensional Renderings.

Efficacy and Safety of Rezūm System Water Vapor Treatment for Lower Urinary Tract Symptoms Secondary to Benign Prostatic Hyperplasia

Two-year results after convective radiofrequency water vapor thermal therapy of symptomatic benign prostatic hyperplasia.

Je CT vyšetření dostatečně spolehlivé při hodnoceníneoplastických procesů ledviny

Intravesikální imunoterapie povrchového karcinomu močovéhoměchýře BCG vakcínou