Comparação entre o peso percentual da próstata pós ressecção aberta e endoscópica associada à melhora clínica e alívio dos sintomas
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Tipo
TCC
Data de publicação
2023-11-27
Periódico
Citações (Scopus)
Autores
Nicoluzzi, Arthur
Andrade, Gustavo Ceccatto
Andrade, Gustavo Ceccatto
Orientador
Jaworski, Paulo Eduardo Dientrich
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Contexto: A Hiperplasia Prostática benigna é a neoplasia benigna mais comum entre homens ao envelhecer. Homens com HPB sintomático podem apresentar sintomas obstrutivos, irritativos ou uma combinação dos dois. O tratamento cirúrgico é indicado quando há falha na terapia medicamentosa, retenção urinária refratária, infecção de trato urinário recorrente, hematúria persistente, cálculos na bexiga e insuficiência renal. O procedimento mais comum é a ressecção transuretral da próstata (RTUP) de próstata até 80 gramas e prostatectomia transvesical (PTV) para maiores de 80 gramas. Objetivo: Analisar e comparar a eficácia de uma PTV e uma RTUP no tratamento cirúrgico de HPB associada a melhora clínica e alívio dos sintomas. Metodologia: Estudo prospectivo observacional analítico transversal com pacientes submetidos a RTUP e PTV por HPB no Hospital Universitário Evangélico Mackenzie (HUEM). A coleta de dados foi feita a partir da pesagem do adenoma retirado na PTV e dos fragmentos prostáticos, apoś serem secos com compressa e antes de serem colocados no formol, da RTUP por uma balança de precisão, da aplicação do questionário IPSS antes das cirurgias e no mínimo 3 meses após as cirurgias e análise de prontuários. Resultados: Observou-se diferença significativa entre os grupos quanto ao peso da próstata ao ultrassom (p < 0,001), volume ressecado (p < 0,001) e porcentagem da próstata ressecada (p < 0,001). As demais variáveis não obtiveram significância estatística. Conclusão: Não foi possível afirmar a superioridade de uma técnica sobre a outra nos parâmetros avaliados, devido a falta de diferenças significativas entre os grupos, por causa de uma baixa amostra populacional.
Introduction: Benign Prostatic Hyperplasia is the most common benign neoplasm among men as they age. Men with symptomatic BPH may experience obstructive symptoms, irritative symptoms, or a combination of the two. Surgical treatment is indicated when there is failure of drug therapy, refractory urinary retention, recurrent urinary tract infection, persistent hematuria, bladder examinations and renal failure. The most common procedure is transurethral resection of the prostate (TURP) for prostates up to 80 grams and transvesical prostatectomy (PTV) for those over 80 grams. Objectives: To analyze and compare the effectiveness of a PTV and a TURP in the surgical treatment of BPH associated with clinical improvement and symptom relief. Methods: Prospective observational analytical cross-sectional study with patients undergoing TURP and PTV due to BPH at Hospital Universitário Evangélico Mackenzie (HUEM). Data collection was carried out by weighing the adenoma removed in the PTV and the RTU-P prostate fragments, after being dried with a compress and before being placed in formaldehyde, using a precision scale, the application of the IPSS questionnaire before the surgeries and at least 3 months after surgeries and analysis of medical records.Results: A significant difference was observed between the groups in terms of prostate weight on ultrasound (p < 0.001), volume resected (p < 0.001) and percentage of prostate resected (p < 0.001). The other variables did not reach statistical significance. Conclusions: It was not possible to affirm the superiority of one technique over the other in the evaluated parameters, due to the lack of significant differences between the groups, due to a low population sample.
Introduction: Benign Prostatic Hyperplasia is the most common benign neoplasm among men as they age. Men with symptomatic BPH may experience obstructive symptoms, irritative symptoms, or a combination of the two. Surgical treatment is indicated when there is failure of drug therapy, refractory urinary retention, recurrent urinary tract infection, persistent hematuria, bladder examinations and renal failure. The most common procedure is transurethral resection of the prostate (TURP) for prostates up to 80 grams and transvesical prostatectomy (PTV) for those over 80 grams. Objectives: To analyze and compare the effectiveness of a PTV and a TURP in the surgical treatment of BPH associated with clinical improvement and symptom relief. Methods: Prospective observational analytical cross-sectional study with patients undergoing TURP and PTV due to BPH at Hospital Universitário Evangélico Mackenzie (HUEM). Data collection was carried out by weighing the adenoma removed in the PTV and the RTU-P prostate fragments, after being dried with a compress and before being placed in formaldehyde, using a precision scale, the application of the IPSS questionnaire before the surgeries and at least 3 months after surgeries and analysis of medical records.Results: A significant difference was observed between the groups in terms of prostate weight on ultrasound (p < 0.001), volume resected (p < 0.001) and percentage of prostate resected (p < 0.001). The other variables did not reach statistical significance. Conclusions: It was not possible to affirm the superiority of one technique over the other in the evaluated parameters, due to the lack of significant differences between the groups, due to a low population sample.
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Palavras-chave
hiperplasia prostática , ressecção transuretral da próstata , prostatectomia , prostatic hyperplasia , transurethral resection of the prostate , prostatectomy