| 1. |
- Joelsson-Alm, Eva, et al.
(författare)
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Perioperative bladder distension : a prospective study
- 2009
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Ingår i: Scandinavian Journal of Urology and Nephrology. - 0036-5599 .- 1651-2065. - 0036-5599 ; 43:1, s. 58-62
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Tidskriftsartikel (refereegranskat)abstract
- Objective. Postoperative urinary retention and bladder distension are frequent complications of surgery. The aim of this study was to determine the incidence of perioperative bladder distension in a surgical setting and to identify predisposing factors among patients undergoing common general and orthopaedic procedures. Material and methods. This was a prospective observational study of 147 adult patients admitted to orthopaedic and surgical departments. Bladder volumes were measured with an ultrasound scanner on three occasions: after emptying the bladder before being transported to the operating theatre, and then immediately before and after surgery. Results. Thirty-three patients (22%) developed bladder distension (500 ml), eight preoperatively and 25 postoperatively. A total of 21 patients (14%) had a bladder volume 300 ml immediately before surgery. Orthopaedic patients were more likely to develop preoperative bladder distension than surgical patients and had significantly higher postvoid residual volumes. In the binary logistic regression analysis age, gender and time of anaesthesia could not predict bladder distension. Patients undergoing orthopaedic surgical procedures, however, were prone to bladder distension (odds ratio 6.87, 95% confidence interval 1.76 to 26.79, p=0.006). Conclusions. This study shows that orthopaedic surgical patients are more prone to bladder distension perioperatively. The conventional method of encouraging patients to void at the ward before being transported to the operating theatre does not necessarily mean an empty bladder at the start of the operation.
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| 2. |
- Fagerstrom, Tim, et al.
(författare)
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Complications and Clinical Outcome 18 Months After Bipolar and Monopolar Transurethral Resection of the Prostate
- 2011
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Ingår i: Journal of endourology. - : Mary Ann Liebert, Inc.. - 0892-7790 .- 1557-900X. ; 25:6, s. 1043-1049
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: To compare bipolar resection with the conventional monopolar transurethral resection of the prostate (TURP) with respect to peri- and postoperative complications and long-term outcome. Patients and Methods: Patients with consecutive benign prostatic hyperplasia needing surgery (n = 185) from the hospitals waiting list were randomized to TURP using either a bipolar or a monopolar system. Peri-and postoperative parameters were monitored, complications were registered, and timed micturition/International Prostate Symptom Score (TM/IPSS) forms were collected at 3 and 6 weeks and at 6 and 18 months. Results: Bipolar surgery was followed by a 16% to 20% higher percentage of the patients reporting ongoing improvement (fractional IPSS change greater than2) at 3 and 6 weeks after the surgery (p less than 0.05). There were fewer readmissions in the bipolar group than in the monopolar (5 vs. 13, p less than 0.05). No differences between the groups with respect to hospital stay and catheter duration was recorded. Bipolar and monopolar TURP resulted in marked and sustained improvements of IPSS, bother score, and TM. Conclusions: Bipolar TURP, using the transurethral resection in saline (TURis) system, resulted in significantly fewer postoperative readmissions, faster postoperative recovery, and equally long-lasting good results in TM/IPSS and bother score, as in monopolar TURP.
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| 3. |
- Fagerstrom, Tim, et al.
(författare)
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Degree of Vaporization in Bipolar and Monopolar Resection
- 2012
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Ingår i: Journal of endourology. - : Mary Ann Liebert. - 0892-7790 .- 1557-900X. ; 26:11, s. 1473-1477
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: To compare the in vitro degree of vaporization in bipolar and monopolar resection. less thanbrgreater than less thanbrgreater thanMaterials and Methods: Using either a bipolar system or a monopolar system, samples of chicken muscle and lamb kidney were resected in an isolated basin and then desiccated in an incubator. The percentual degree of vaporization for each sample was obtained as a difference between the total fresh weight of the sample and the calculated fresh weights of the resected tissue and remains. less thanbrgreater than less thanbrgreater thanResults: Reference samples showed that the water content was 73% in muscle and 77% in kidney. More muscle (mean 52%) than kidney (32%; P andlt; 0.0001) tissue was vaporized. The fraction of vaporized tissue was significantly higher in the bipolar technique. In muscle, the differences between monopolar and bipolar were 17% (P andlt; 0.05) and 26% (P andlt; 0.001), respectively, depending on the type of irrigation used. For kidney, the differences were 27% (P andlt; 0.01) and 34% (P andlt; 0.01), respectively. Further exploration of the degree of vaporization when using the bipolar resection showed that the choice of loop (P andlt; 0.0001), fluid (P andlt; 0.03), and tissue (P andlt; 0.0001) were all independently associated with the degree of vaporization. less thanbrgreater than less thanbrgreater thanConclusions: This study indicated that vaporization removes 50% more tissue than the weight of the resected tissue during conventional tissue resection. Bipolar standard loop resection resulted in a significantly higher degree of vaporization in both muscle and kidney than did monopolar technique. Bipolar resection worked satisfactorily in Ringers acetate.
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| 4. |
- Fagerström, Tim, et al.
(författare)
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Bipolar transurethral resection of the prostate causes less bleeding than the monopolar technique : a single-centre randomized trial of 202 patients
- 2010
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Ingår i: BJU International. - : Wiley-Blackwell. - 1464-4096 .- 1464-410X. ; 105:11, s. 1560-1564
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To compare bipolar with the conventional monopolar transurethral resection of the prostate (TURP) for blood loss and speed of resection.PATIENTS AND METHODS: In all, 202 consecutive patients from the hospital waiting list were randomized to undergo TURP using either a bipolar system (Surgmaster TURis, Olympus, Tokyo, Japan) or a monopolar system (24 F, Storz, Tübingen, Germany). The blood loss during and after surgery was measured using a photometer. Other variables compared included indices of resection speed and transfusion rate.RESULTS: There were no statistically significant differences in operative duration, resection weight, resection speed or radicality of resection. However, the median blood loss was 235 mL for the bipolar and 350 mL for monopolar TURP (P < 0.001). The decrease in blood haemoglobin concentration during the day of surgery was smaller in the bipolar group (5.5% vs 9.6%P < 0.001). Fewer patients were transfused with erythrocytes (4% vs 11%, P < 0.01), which can be explained by the much lower 75th percentile for blood loss in the bipolar group (at 472 vs 855 mL, respectively).CONCLUSIONS: Bipolar TURP using the TURis system was performed with the same speed as monopolar TURP but caused 34% less bleeding, the difference being greatest (81%) for the largest blood losses. Bipolar TURP also required fewer erythrocyte transfusions than the conventional monopolar technique.
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| 5. |
- Joelsson-Alm, Eva, et al.
(författare)
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Perioperative bladder distension : a prospective study
- 2009
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Ingår i: Scandinavian Journal of Urology and Nephrology. - : Informa Healthcare. - 0036-5599 .- 2168-1813 .- 1651-2065. ; 43:1, s. 58-62
-
Tidskriftsartikel (refereegranskat)abstract
- Objective. Postoperative urinary retention and bladder distension are frequent complications of surgery. The aim of this study was to determine the incidence of perioperative bladder distension in a surgical setting and to identify predisposing factors among patients undergoing common general and orthopaedic procedures. Material and methods. This was a prospective observational study of 147 adult patients admitted to orthopaedic and surgical departments. Bladder volumes were measured with an ultrasound scanner on three occasions: after emptying the bladder before being transported to the operating theatre, and then immediately before and after surgery. Results. Thirty-three patients (22%) developed bladder distension (500 ml), eight preoperatively and 25 postoperatively. A total of 21 patients (14%) had a bladder volume 300 ml immediately before surgery. Orthopaedic patients were more likely to develop preoperative bladder distension than surgical patients and had significantly higher postvoid residual volumes. In the binary logistic regression analysis age, gender and time of anaesthesia could not predict bladder distension. Patients undergoing orthopaedic surgical procedures, however, were prone to bladder distension (odds ratio 6.87, 95% confidence interval 1.76 to 26.79, p=0.006). Conclusions. This study shows that orthopaedic surgical patients are more prone to bladder distension perioperatively. The conventional method of encouraging patients to void at the ward before being transported to the operating theatre does not necessarily mean an empty bladder at the start of the operation.
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| 6. |
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| 7. |
- Nyman, Claes R, et al.
(författare)
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The patient's choice of androgen-deprivation therapy in locally advanced prostate cancer : Bicalutamide, a gonadotrophin-releasing hormone analogue or orchidectomy
- 2005
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Ingår i: BJU International. - 1464-4096 .- 1464-410X. ; 96:7, s. 1014-1018
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To investigate patient preference for three established androgen-deprivation therapies for locally advanced prostate cancer, the patient's capacity to decide his therapy, the reasons for selecting a certain mode of therapy, and patient satisfaction with the chosen therapy 3 months after initiation. PATIENTS AND METHODS: In all, 150 patients (mean age 75 years, range 57-89) with previously untreated locally advanced prostate cancer from 13 hospitals were consecutively given the chance to choose between the antiandrogenic oral drug bicalutamide, a gonadotrophin-releasing hormone analogue (GnRH) by injection, or surgical orchidectomy. After discussing the nature of their disease the patients took home written information about prostate cancer and the three different treatment options. After 1 week they were assessed using a questionnaire for biographical data, their attitude towards the different treatment alternatives and their choice of therapy. Three months later the patients completed a questionnaire about the treatment they had undergone. RESULTS: Sixty-three patients (42%) chose bicalutamide, 51 (34%) the GnRH analogue and 36 (24%) orchidectomy, 87% of those choosing bicalutamide, 84% GnRH and 94% orchidectomy, respectively, were sure about their choice but 12%, 17% and 3% of the patients, respectively, had some difficulty in deciding. The most important reasons for the therapy chosen were avoidance of injections and surgery, and a lower risk of impotence (bicalutamide), negative attitude to surgery and tablets (GnRH), and avoidance of injections and tablets (orchidectomy). Almost all patients (98%, 98% and 97%, respectively) were satisfied with their choice after 3 months of treatment. CONCLUSION: There are three equally effective forms of androgen deprivation for locally advanced prostate cancer without known metastases. There are major differences among these treatments in the mode of application and the likelihood and impact of side-effects. When patients are fully informed and play an active role in the treatment decision they are satisfied with their decision 3 months later. © 2005 BJU International.
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| 8. |
- Thellenberg-Karlsson, Camilla, 1972-, et al.
(författare)
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Bone-targeted Novel Cytotoxic Polybisphosphonate Conjugate in Castration-resistant Prostate Cancer : A Multicenter Phase 1 Study
- 2016
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Ingår i: Anticancer Research. - : International Institute of Anticancer Research. - 0250-7005 .- 1791-7530. ; 36:12, s. 6499-6504
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Osteodex (ODX) is a cytotoxic bone-targeting polybisphosphonate, intended for treatment of bone metastasis from castration-resistant prostate cancer (CRPC). The primary objective of this study was to describe the tolerability and toxicity of such treatment by defining its maximum tolerated dose (MTD) and dose-limiting toxicity (DLT).PATIENTS AND METHODS: Twenty-eight patients with castration-resistant prostate cancer and confirmed bone metastasis were assigned to seven infusions of ODX every third week, divided in seven ascending dose cohorts.RESULTS: No DLT's were observed and as pre-specified, the highest dose administered was defined as MTD. In total, 206 adverse events (AE) were recorded and 13,6% were classified as treatment-related, while none were serious or severe (SAE). No cumulative toxicity and no renal toxicity were recorded.CONCLUSION: ODX was well tolerated, with few and mild side-effects and with apparent treatment efficacy in the highest dose cohort. Further clinical development is currently in progress.
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