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Eficacia de la fotovaporización prostática con láser verde en el tratamiento de la hiperplasia prostática en pacientes en tratamiento con inhibidores de la 5-alfa-reductasa
Green light laser efficacy in patients with prostatic hyperplasia treatment with 5-alpha reductase inhibitors
Joaquín Ulises Juan Escudero
Autor para correspondencia
chimojuan@hotmail.com

Autor para correspondencia.
, Emilio López Alcina, Macarena Ramos de Campos, Francisco Ramada Benlloch, Francisco Sánchez Ballester, Emilio Marqués Vidal
Servicio de Urología, Consorcio Hospital General Universitario de Valencia, Valencia, España
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        "resumen" => "<span class="elsevierStyleSectionTitle">Introducci&#243;n</span><p class="elsevierStyleSimplePara elsevierViewall">El progresivo envejecimiento de la poblaci&#243;n y la elevada prevalencia de la hiperplasia benigna prost&#225;tica &#40;HBP&#41;&#44; unidos a la existencia de tratamientos m&#233;dicos efectivos para esta afecci&#243;n&#44; produce que cada vez m&#225;s indiquemos la cirug&#237;a en pacientes tratados a largo plazo con inhibidores de la 5-alfa-reductasa &#40;5ARI&#41;&#46; En un principio&#44; los pacientes tratados con 5ARI no se consideraban buenos candidatos para la fotovaporizaci&#243;n prost&#225;tica con l&#225;ser verde&#46;</p> <span class="elsevierStyleSectionTitle">Objetivo</span><p class="elsevierStyleSimplePara elsevierViewall">En el siguiente trabajo&#44; mediante un estudio retrospectivo basado en nuestra experiencia&#44; pretendemos dilucidar si el tratamiento a largo plazo &#40;mas de 6 meses&#41; con inhibidores de la 5ARI reduce la eficacia del tratamiento con l&#225;ser verde en pacientes afectados de HBP&#46;</p> <span class="elsevierStyleSectionTitle">Material y m&#233;todos</span><p class="elsevierStyleSimplePara elsevierViewall">Entre septiembre de 2005 y enero de 2008 hemos tratado a 102 pacientes mediante fotovaporizaci&#243;n prost&#225;tica con l&#225;ser verde&#44; de los que 25 &#40;24&#44;5&#37;&#41; se encontraban en tratamiento con 5ARI durante al menos 6 meses&#59; los otros 77 &#40;75&#44;5&#37;&#41; pacientes formaron el grupo control&#46; Realizamos un estudio retrospectivo en el que comparamos los par&#225;metros cl&#237;nicos y funcionales pre y postoperatorios de los pacientes tratados con 5ARI respecto a los que no lo estaban&#46;</p> <span class="elsevierStyleSectionTitle">Resultados</span><p class="elsevierStyleSimplePara elsevierViewall">No encontramos diferencias estad&#237;sticamente significativas en cuanto a volumen prost&#225;tico &#40;50 cc y 49 cc&#41;&#44; IPSS &#40;17&#44;6 y 17&#44;8&#41;&#44; residuo posmiccional &#40;16&#37; y 18&#37;&#41; o ant&#237;geno prost&#225;tico espec&#237;fico &#40;PSA&#41; &#40;1&#44;4<span class="elsevierStyleHsp" style=""></span>ng&#47;ml y 2&#44;2<span class="elsevierStyleHsp" style=""></span>ng&#47;ml&#41; preoperatorios entre los grupos tratamiento y control&#44; respectivamente&#46; Del mismo modo&#44; si bien existieron diferencias en cuanto a la energ&#237;a usada &#40;180 kJ y 175 kJ&#41; y el tiempo quir&#250;rgico empleado &#40;63<span class="elsevierStyleHsp" style=""></span>min y 57<span class="elsevierStyleHsp" style=""></span>min&#41;&#44; ambas fueron m&#225;s elevadas en el grupo tratado con 5ARI&#44; estas diferencias no resultaron significativas estad&#237;sticamente&#46; Tampoco encontramos diferencias en los par&#225;metros cl&#237;nicos &#40;IPSS 13&#44;8 y 14 al primer mes&#41; ni flujom&#233;tricos &#40;Qm&#225;x 13&#44;9<span class="elsevierStyleHsp" style=""></span>ml&#47;s y 14&#44;5<span class="elsevierStyleHsp" style=""></span>ml&#47;s en la revisi&#243;n al primer mes&#41; entre pacientes tratados y no tratados&#46; Subjetivamente&#44; se apreci&#243; una mejor visualizaci&#243;n del campo endosc&#243;pico atribuida a un menor sangrado durante la intervenci&#243;n&#46;</p> <span class="elsevierStyleSectionTitle">Conclusiones</span><p class="elsevierStyleSimplePara elsevierViewall">Nuestros resultados no demuestran diferencias estad&#237;sticamente significativas entre pacientes con y sin tratamiento con inhibidores de la 5ARI en cuanto a par&#225;metros intra y preoperatorios&#44; por lo que pensamos que este tratamiento no disminuye la eficacia de la fotovaporizaci&#243;n prost&#225;tica con l&#225;ser verde&#46;</p>"
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        "titulo" => "Abstract"
        "resumen" => "<span class="elsevierStyleSectionTitle">Introduction</span><p class="elsevierStyleSimplePara elsevierViewall">High prevalence of BPH and gradual ageing of the population&#44; combined with the existence of effective medical treatments for this condition&#44; has led to an increasing use of surgery in patients on long-term treatment with 5-alpha reductase inhibitors &#40;5-ARIs&#41;&#46; Initially&#44; patients treated with 5-ARIs were not considered good candidates for photoselective vaporization of the prostate with green laser&#46;</p> <span class="elsevierStyleSectionTitle">Objective</span><p class="elsevierStyleSimplePara elsevierViewall">To assess&#44; using a retrospective study based on our experience&#44; wheter long-term treatment &#40;longer than 6 months&#41; with 5-alpha reductase inhibitors decreases effectivenes of photoselective vaporization of the prostate with green light laser in BPH&#46;</p> <span class="elsevierStyleSectionTitle">Materials and methods</span><p class="elsevierStyleSimplePara elsevierViewall">From September 2005 to January 2008&#44; 102 patients underwent photoselective vaporization of the prostate with green light laser&#46; Of these&#44; 25 patients &#40;24&#46;5&#37;&#41; had been treated with 5-ARIs for at least 6 months&#44; and the remaining 77 patients &#40;75&#46;5&#37;&#41; were used as controls&#46; A retrospective study was conducted to compare the pre- and postoperative clinical and functional parameters of patients with and without prior 5-RAI therapy&#46;</p> <span class="elsevierStyleSectionTitle">Results</span><p class="elsevierStyleSimplePara elsevierViewall">No statistically significant differences were found between the treated and control groups in preoperative prostatic volume &#40;50<span class="elsevierStyleHsp" style=""></span>mL vs 49<span class="elsevierStyleHsp" style=""></span>mL&#41;&#44; IPSS &#40;17&#46;6 vs 17&#46;8&#41;&#44; postvoiding residue &#40;16&#37; vs 18&#37;&#41;&#44; or PSA &#40;1&#46;4<span class="elsevierStyleHsp" style=""></span>ng&#47;mL vs 2&#46;2<span class="elsevierStyleHsp" style=""></span>ng&#47;mL&#41;&#46; Similarly&#44; while differences were seen in energy spread &#40;180 kJ vs 175 kJ for the treated and control groups respectively&#41; and operating time &#40;63<span class="elsevierStyleHsp" style=""></span>min vs 57<span class="elsevierStyleHsp" style=""></span>min&#41;&#44; these were not statistically significant&#46; No between-group differences were found either in clinical or flow rate parameters one month after surgery &#40;IPSS 13&#46;8 vs 14 and Qmax 13&#46;9mL&#47;s vs 14&#46;5 nL&#47;s in the treated and control groups respectively&#41;&#46; Surgeons reported a better visualization of the endoscopic field that was attributed to less bleeding during the procedure&#46;</p> <span class="elsevierStyleSectionTitle">Conclusions</span><p class="elsevierStyleSimplePara elsevierViewall">Our results show no statistically significant differences in peroperative and preoperative parameters between patients with and without treatment with 5-alpha reductase inhibitors&#46; We therefore think that photoselective vaporization of the prostate with green light laser is a safe and effective technique in patients treated with 5-ARIs&#46;</p>"
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Información del artículo
ISSN: 02104806
Idioma original: Español
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2022 Junio 0 4 4
2022 Mayo 0 4 4
2022 Abril 0 8 8
2022 Marzo 0 4 4
2022 Febrero 0 4 4
2022 Enero 0 3 3
2021 Diciembre 0 4 4
2021 Noviembre 0 3 3
2021 Octubre 0 2 2
2021 Septiembre 0 3 3
2021 Agosto 0 1 1
2021 Julio 0 4 4
2021 Junio 0 3 3
2021 Mayo 0 3 3
2021 Abril 0 1 1
2021 Marzo 0 2 2
2021 Febrero 0 4 4
2021 Enero 0 2 2
2020 Diciembre 0 2 2
2020 Noviembre 0 4 4
2020 Octubre 0 0 0
2020 Septiembre 0 4 4
2020 Agosto 0 12 12
2020 Julio 0 4 4
2020 Junio 0 4 4
2020 Mayo 0 5 5
2020 Abril 0 6 6
2020 Marzo 0 11 11
2020 Febrero 0 5 5
2020 Enero 0 8 8
2019 Diciembre 0 14 14
2019 Noviembre 0 6 6
2019 Octubre 0 6 6
2019 Septiembre 0 7 7
2019 Agosto 0 1 1
2019 Julio 0 7 7
2019 Junio 0 6 6
2019 Mayo 0 53 53
2019 Abril 0 35 35
2019 Marzo 0 5 5
2019 Febrero 0 19 19
2019 Enero 0 3 3
2018 Diciembre 0 15 15
2018 Noviembre 0 12 12
2018 Octubre 0 14 14
2018 Septiembre 0 2 2
2018 Agosto 0 1 1
2018 Julio 0 1 1
2018 Junio 0 3 3
2018 Mayo 0 4 4
2018 Abril 0 1 1
2018 Marzo 0 1 1
2018 Febrero 2 3 5
2018 Enero 3 2 5
2017 Diciembre 0 4 4
2017 Noviembre 5 4 9
2017 Octubre 2 3 5
2017 Septiembre 3 9 12
2017 Agosto 8 6 14
2017 Julio 3 5 8
2017 Junio 8 6 14
2017 Mayo 10 3 13
2017 Abril 9 1 10
2017 Marzo 11 39 50
2017 Febrero 6 10 16
2017 Enero 2 1 3
2016 Diciembre 5 13 18
2016 Noviembre 12 10 22
2016 Octubre 19 21 40
2016 Septiembre 14 4 18
2016 Agosto 9 1 10
2016 Julio 9 6 15
2016 Junio 32 22 54
2016 Mayo 21 23 44
2016 Abril 21 14 35
2016 Marzo 25 16 41
2016 Febrero 13 15 28
2016 Enero 15 14 29
2015 Diciembre 12 20 32
2015 Noviembre 18 11 29
2015 Octubre 22 9 31
2015 Septiembre 17 4 21
2015 Agosto 19 7 26
2015 Julio 14 6 20
2015 Junio 7 4 11
2015 Mayo 14 10 24
2015 Abril 26 17 43
2015 Marzo 16 20 36
2015 Febrero 15 12 27
2015 Enero 25 7 32
2014 Diciembre 54 14 68
2014 Noviembre 65 8 73
2014 Octubre 66 9 75
2014 Septiembre 45 2 47
2014 Agosto 53 2 55
2014 Julio 52 2 54
2014 Junio 50 5 55
2014 Mayo 40 1 41
2014 Abril 26 6 32
2014 Marzo 34 1 35
2014 Febrero 27 6 33
2014 Enero 24 2 26
2013 Diciembre 30 2 32
2013 Noviembre 17 8 25
2013 Octubre 24 5 29
2013 Septiembre 24 8 32
2013 Agosto 24 3 27
2013 Julio 8 3 11
2009 Septiembre 1660 0 1660
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es en pt

¿Es usted profesional sanitario apto para prescribir o dispensar medicamentos?

Are you a health professional able to prescribe or dispense drugs?

Você é um profissional de saúde habilitado a prescrever ou dispensar medicamentos