These include urinary cytology (if bladder cancer is a concern), genitourinary ultrasonography (for evaluation of renal dysfunction or urinary tract infection), post-void residual volume (if urinary retention is a concern and prior to initiation of an anticholinergic drug), and urethrocystoscopy (for urethral stricture, bladder calculi, and bladder cancer). Canberra, ACT: MSAC; 2002. Curr Opin Urol. Motor: 15 Amp Induction Motor, 1 PH, 60 Hz Voltage: Dual Voltage 120V 240V. They obtained a reduction in IPSS (mean of 17.1 points), an increase in IIEF (mean of 2.6 points), an improvement in QOL (mean of 2.6 points) and a volume reduction (mean of 28 %) at 12 months. 3-Year follow-up of temporary implantable nitinol device implantation for the treatment of benign prostatic obstruction. Cioanta I, Muschter R.Water-induced thermotherapy for benign prostatic hyperplasia. Canadian Agency for Drugs and Technologies in Health (CADTH). The mean I-PSS decreased from 24.4 at baseline to 5 at 3 months; IPSS quality-of-life (QOL) score decreased from 4.5 to 0.3 points; peak urinary flow rate increased from 7.1 to 16.5 ml/s and post-void residual (PVR) urine volume decreased from 119 to 43 ml (all p < 0.01). In a randomized clinical trial, Fotovat and colleagues (2021) examined the effect of melatonin along with tamsulosin in improving the BPH urinary symptoms. The procedure involved the insertion of up to four 21 G applicators in the prostatic tissue under ultrasound (US) guidance. Urolume endourethral prosthesis for the treatment of urethral stricture disease: Long-term results of the North American Multicenter UroLume Trial. In ancient times, arches were built in masonry, but the modern developments are giving birth to reinforced curved arch slabs. Fourth, retrospective enrollment, unclear inclusion criteria, and limited follow-up duration were aspects of certain studies that may limit interpretability of results. UL Listed. Is post tension better than rebar? Some are concerned about ease of pitching, others about weight, and others about stormworthyness. Maybe #3 zips are just a good trade-off for any tent. After concrete sets, the formwork is removed and PVC pods are not removed. The authors concluded that the safety and efficacy of the Optilume paclitaxel-coated balloon will need to be studied in RCTs with long-term follow-up. BMJ Open. 2021;206(4):818-826. They worked with DSM (makers of DCF) on the best bonding process, and now basically every good DCF tent comes from them. Accessed November 4, 2015. The arches are provided in the bridges to resist the wind loads acting on the bridge. The rate of repeat TURP/PVP was higher in the PVP group (6.7 % versus 3.9 %, not significant) within the follow-up of up to 2 years. The flat slabs are mostly popular in unconventional structures without column symmetry. Oeconomouand Madersbacher (2010)summarized the mechanisms through which BoNT-A could inhibit the progression of BPH and eliminate the lower urinary tract symptoms (LUTS) according to the findings of animal studies. Interventional Procedure Guidance 14. Evidence-Based Medicine [CD-ROM]. His writing has also appeared in Backpacker Magazine, Backpacking Light, and TrailGroove Magazine. Front Surg. Seldom indicated studies These studies, which are not usually necessary in patients with BPH, may occasionally be requested or performed by a urologist: Prostate ultrasonography Despite the fact that BPH often differentially occurs in the central or transitional zone of the prostate, ultrasound measurements of central zone volume do not appear to correlate better with lower urinary tract symptoms (LUTS) than measurements of total prostate volume . IQWiG Reports - Commission No. 1995;22(2):431-439. This latter mechanism is intended to besafer for the patient andyield improved results. Medical therapy is a first-line treatment option and surgery is usually performed to improve symptoms and decrease the progression of disease in patients who develop complications or who have inadequately controlled symptoms on medical treatment. 2007;177(3):1040-1046. iii) It is very economical if the same moulds are used for repetitive floor plans. Clinical Policy Bulletins are developed by Aetna to assist in administering plan benefits and constitute neither offers of coverage nor medical advice. National Institute for Clinical Excellence (NICE). The sexual outcomes have highlighted a better ejaculation rate for water jet dissection than TURP. Thank you. Lourenco T, Armstrong N, N'Dow J, et al. The slab which provided above the door for storage purpose is called Low roof slab. Ablative procedures gave improvements equivalent to TURP. Milroy E, Allen A. Furthermore, an UpToDate review on "Surgical treatment of benign prostatic hyperplasia (BPH)" (McVary, 2020) does not mention drug-coated balloon as a management / therapeutic option. Yafi FA, Tallman CT, Seard ML, Jordan ML. These researchers stated that aquablation is feasible, safe, and reproducible with promising outcomes for treating BPH. Motor: 15 Amp Induction Motor, 1 PH, 60 Hz Voltage: Dual Voltage 120V 240V. The mean prostate volume was 59 cc. Mean IPSS and QOL index improved from 18.3 to 2.7 and 4.8 to 0.9 (p < 0.0001 for both), respectively. Blade Tilt: 45 Left.. Santiago de ComPostela, Spain: Galician Agency for Health Technology Assessment (AVALIA-T); March 2009. The Society of Interventional Radiology (SIR)s research reporting standards for PAE (Uflacker et al, 2020) concluded that "Although sufficient evidence on PAE does exist and has allowed SIR to publish a multi-society consensus position statement, further high-quality studies (with a focus on non-inferiority) would improve the evidence base in support of this procedure. Mean (range) PV decreased significantly to 115.9 cm3 (27 to 248 cm3) at 3 months (p < 0.001); 2 patients experienced grade-II urosepsis complications, which were successfully treated with intravenous antibiotics. The technique using the loop for hemostasis following Aquablation has evolved since the conduct of these trials. Between March 2009 and September 2014, PAE was carried out in patients with a diagnosis of BPH, PV greater than 100 cm(3), and moderate-to-severe LUTS refractory to medical treatment for at least 6 months or who had acute urinary retention. The above policy is based on the following references: Last Review The authors concluded that larger, randomized studies with longer follow-up periods are needed for this technique to be formally established in the urology community. There are several techniques for laser prostatectomy that continue to evolve. Outcome parameters were evaluated at baseline; 1, 3, and 6 months; every 6 months between 1 and 3 years; and yearly thereafter up to 6.5 years. Res Rep Urol. WebA Dutch door (American English), stable door (British English), or half door (Hiberno English), is a door divided in such a fashion that the bottom half may remain shut while the top half opens. Eur Urol Focus. 2014;74(11):1132-1141. Portable water is considered to be satisfactory for mixing and curing. Prostatic urethral lift: Two-year results after treatment for lower urinary tract symptoms secondary to benign prostatic hyperplasia. 2003;92:843-850. Prostatic arterial embolization for benign prostatic hyperplasia: Short- and intermediate-term results. Zlotta AR, Djavan B.Minimally invasive therapies for benign prostatic hyperplasia in the new millennium: Long-term data. Bracing helps for retrofitting and strengthening an existing structure. Complications were assessed. Pisco J, Campos Pinheiro L, Bilhim T, et al. A fixed form paver or a slip form paver is used to spread, consolidate from the mould, screed and float-finish, and texture and cure the freshly laid concrete in one complete pass of the machine. Detrusor pressure at maximum flow was only measured at 6 months. Cantwell AL, Bogache WK, Richardson SF, et al. 2018;15(12):1728-1738. However, the number of laser techniques being performed is rapidly increasing. In addition, the details that caught my attention include its ease of use, livability, and potential performance in inclement weather. Azuma H, Chancellor MB. Or maybe #5 zippers are a more responsible choice for a number of reasons but dont sell as well in todays market where consumers look at numbers and product image above all else. Plante MK, Bunnell ML, Trotter SJ, et al. Assessments included International Prostate Symptom Score (IPSS), Male Sexual Health Questionnaire (MSHQ-EjD), International Index of Erectile Function (IIEF) and uroflow. The composite slab is made up of concrete and steel decking. Waffle slab is not used in typical construction projects. A systematic search of the PubMed and Embase databases was performed using the terms "benign prostate hypertrophy and miRNA" or ("benign prostate hypertrophy and microRNAs" or "miRNA" or "miR") on July 31, 2017. Kuo and Liu (2009) evaluated the effectiveness of BoNT-A in patients with large BPH with an unsatisfactory response to combined alpha-blocker and 5-alpha-reductase inhibitor therapy. The largest lesion volume was 35.1 cm(3). In the conventional type of slab there is no need for providing column caps. Baseline, peri-operative and 3-month urinary function data were collected. Ponti G, Maccaferri M, Micali S, et al. Post-operative voiding complaints are comparable to those with TURP. Screed is a concrete material generally we use 20mm aggregate in concrete whereas in screed we use baby chips(small broken stones) as aggregates. 2015;7:125-136. i) The reduced depth of the slabs between the grids increase the risk of fire transmission. vi) Less use of concrete leads to less CO2 emissions. Randomized comparison of prostatic artery embolization versus transurethral resection of the prostate for treatment of benign prostatic hyperplasia. They stated that in patients with mild BPH symptoms who are reluctant to take standard pharmaceutical medications may try these agents provided that the patient understands their current limitations. Mean PV decreased significantly from 141.7 ml to 98.1 ml at 3 months (p < 0.01) and 82.2 ml at 12 months (p < 0.01). The peak flow rate improved by greater than or equal to 30 % (2.4 ml/s) at all intervals compared with baseline. i) Simplified formwork since no beams are involved. Qmax of the short-term endpoint indicated statistically positive beneficial effects of acupuncture (MD -1.78, 95 % CI: -3.43 to -0.14). It lets us design longer spans in elevated members, like floors or beams. The slab has the same features of Post-tensioning slabs. Whereas to someone less concerned about weight the ideal all purpose shelter would be something more spacious, durable and functional. Those with moderate or severe BPH should be discouraged from alternative and complementary treatments. Two-year outcomes after aquablation compared to TURP: Efficacy and ejaculatory improvements sustained. In flat plates, the loads are transferred directly to the columns. iii) Shorter construction time if big table formwork is used. The surface of the slab shall be brush-textured in the transverse direction. In a phase II prospective study, Richter et al (2009) recorded the effectiveness and complications of holmium laser enucleation of the prostate (HoLEP) in the first post-operative year. Aetna considers the following approaches for the treatment of BPH experimental and investigational because the effectiveness of these interventions has not been established by the peer-reviewed medical literature: Aetna considers Prosta-Seq for diagnosis of benign prostatic hyperplasia (BPH) experimental and investigational because its effectiveness has not been established. 2002;19(6):426-435. Mayo Clin Proc. The authors concluded that this clinical registry confirmed that aquablation was feasible, safe, and effective, and provided immediate good functional results and similar outcomes to those of prior studies despite the lack of surgeons' previous experience with the technique. v) High load carrying capacity than conventional slabs. UL Listed. When used to treat BPH, studies have demonstrated that, like the HoLEP, the 80-W KTP laser is safe and effective in patients with large prostates and in those taking oral anti-coagulation. Interventional Procedure Guidance 275. Example: Generally all the Cantilever slabs are one Way slab. iii) Reduced thickness in the structural member cuts the footing size. Shim SR, Cho YJ, Shin IS, Kim JH. Guidelines from the AAUA (Foster et al, 2019) stated that "Water vapor thermal therapy may be offered to patients with LUTS attributed to BPH provided prostate volume < 80 g; however, patients should be counseled regarding efficacy and retreatment rates". This feature requires an active Backpacking Light Membership. The entire procedure can be readily performed using local anesthesia (Barkin et al, 2012). Whether these improvements affected safety or decreased symptomreduction efficacy in the long-term was not known. Enjoy your new purchase, everybody! Issue 182. Lower slump and higher compaction factor are needed for hand-operated machines. The authors concluded that the high-power diode laser provided significant improvements in IPSS and the maximal flow rate with low morbidity. Blade Tilt: 45 Left.. By means of a prospective, randomized, non-inferiority trial design with clearly defined outcomes, as well as inclusion and exclusion criteria, and carried out according to well-defined quality standards, data will aid in better estimating treatment safety and efficacy of Aquablation. However, for men with larger prostates (greater than or equal to 50 mL), IPSS reduction was 3.5 points greater across all follow-up visits in the Aquablation group compared to the TURP group (p = 0.0123). I agree less that the service life of 0.7oz DCF is meaningfully longer but that is a long discussion. BJU Int. And Dome slab is built on the conventional slab. The authors concluded that the Aquablation procedure was safe and effective in treating men with large prostates (80 to 150 cc) after 1 year of follow-up, with an acceptable complication rate and without a significant increase in procedure or resection time compared to smaller sized glands. The other outcomes (Qmax, prostate volume, and PVR volume) were not statistically different between the 2 groups. For instance, steelwork and the precast concrete slab should join together correctly to avoid relative movements. Br J Urol. The economic model suggested that minimally invasive procedures were unlikely to be cost-effective compared with TURP. border-radius: 4px; The authors concluded that the findings of this study indicated a negative association between CYP17 and BPH in Orientals. 2000;56(1):76-81. Insausti I, de Ocariz AS, Galbete A, et al. 2009;182(3):1078-1082. Holmium laser ablation versus photoselective vaporization of prostate less than 60 cc: Long-term results of a randomized trial. Before the grade slabs are constructed, the base layer of the earth should be properly compacted to prevent uneven settlements in the future. Stay tuned! The DCF used for the body of the tent has been used extensively in many other tents by other manufacturers and will last a while for users who care for their gear with intention. Silver Spring, MD: FDA; September 13, 2013. 1999;5(1):12-20. Arbor: 5/8 in. Case Rep Urol. The authors concluded that miR-221 has the potential to be used both as a biomarker and novel target in the early diagnosis and therapy of BPH. Follow-up assessments were conducted at 1, 3, 6 and 12 months post-operatively. These researchers stated that longer-term data and comparisons with other modalities appeared critical to a more thorough assessment of the role of Aquablation for the treatment of LUTS in men with BPH. The arrangement of diagonal bracing is shown in the image below. Patients were evaluated up to a median follow-up of 1 year post-procedure. an intuitive (rectangular) pitch that requires only four stakes; a spacious interior (a function of the offset poles and overall geometry); integrated fly that extends further to ostensibly provide better coverage in storms than similar tents. Thermal treatment with the Rezm device performed as an out-patient procedure has shown both safety and effectiveness in phase I and II studies. Often where I camp, there is no clear single windward side. Disclaimer 8. 2002;5(3):183-188. I was able to set it up, inspect its features, take a brief nap inside of it, and generally get a feel for its design and how it compares to other tents in this category. A randomised study to evaluate the efficacy of a biodegradable stent in the prevention of postoperative urinary retention after interstitial laser coagulation of the prostate. The procedure was performed by a single femoral approach. Benign prostatic hyperplasia. Int J Hyperthermia. J Urol. The authors stated that this study had 2 main drawbacks. Sci Rep. 2016;6:23503. the Rezm System) delivers sterile water vapor (steam) transurethrally directly into hyperplastic tissue. In addition, surgeon experience with Aquablation is still relatively limited and additional experience will probably improve outcomes. In concrete structures, this is achieved by placing high-tensile steel tendons/cables in the element before casting. i) Does not need tedious formworks and scaffolding. They stated that further follow-up is needed to draw final conclusions about the long-term effectiveness of PVP. Porpiglia and associates (2019) reported the clinical experience with a second-generation of iTIND for the treatment of LUTS due to BPH after 1 year of follow-up. Safety and efficacy of transurethral needle ablation of the prostate for symptomatic outlet obstruction. 2015;26(1):87-93. de la Rosette JJ, de Wildt MJ, Alivizatos G, et al. iii) The concrete has to be placed from bottom to top. A post-tensioning tendon is made up of one or more pieces of prestressing steel, coated with a protective coating, and housed inside a duct or sheathing. Bracing is essential in earthquake-resistant buildings to keep them standing. UpToDate [online serial]. Operative time averaged 59 mins, and the mean hemoglobin (Hb) drop was 1 g/dL. Kaye JD, Smith AD, Badlani GH, et al. Chuang YC, Chancellor MB. The depth of the hardy bricks is usually at least 200 mm. These researchers stated that further studies are needed to evaluate the durability of TIND outcomes over a longer follow-up, to better define the indications of this approach, and to demonstrate the advantages of second-generation device over the first. In two way slabs, the longer span is less than twice the shorter span. Industry Standard tool-free split guard design allows a true rise-and fall riving knife by using a lever on the inside the throat plate. Report a Violation 11. The combination of price, design, and materials leave little to be desired based on my limited hands-on experience. Laparoscopic prostatectomy for benign prostatic obstruction. list-style-type: decimal; The authors concluded that ThuLEP and PKEP are both safe and efficient procedures for the treatment of patients with BPH. Anyone know where I can get a Users Manual for a. AHCPR Publication No. J Urol. Tadalafil for the treatment of lower urinary tract symptoms secondary to benign prostatic hyperplasia: Pathophysiology and mechanism(s) of action. In post-tensioning, the longitudinal profile of the steel wires can be placed at any desired profile. Maximum urinary flow increased from 8.7 to 18.2 cc/sec. For large jobs, batching and mixing plants with automatic control devises are employed. There is a need for further research to establish: Language services can be provided by calling the number on your member ID card. BJU Int. On September 13, 2013, the FDA approved the marketing of the UroLift, the first permanent implant to relieve low or blocked urine flow in men aged 50 and older with BPH. They were very uncertain whether Aquablation may result in little to no difference in erectile function but offer a small improvement in preservation of ejaculatory function (both very low-certainty evidence). The steel decking of trapezoidal, rectangular or re-entrant shape is also used as a formwork over which the reinforcement cages can be placed and concreted. } Microsoft is quietly building a mobile Xbox store that will rely on Activision and King games. Arches like domes, transfer the loads through axial compression. There was no evidence of degradation in erectile or ejaculatory function after PUL. Traditional surgical methods of open enucleation and TURP have been effective in alleviating these symptoms however, these are operator-dependent and often come with significant side effects. Pisco et al (2013) evaluated the safety, morbidity, and short- and intermediate-term results of PAE for BPH after failure of medical treatment. Unrestricted access to all 2,300+ articles, gear reviews, skills, stories, and more. It is easy to install, engages less space, and is economical. Urology. So it is in China but nothing to do with cutting costs. Increasing the number of quality prospective RCTs with adequate follow-up is mandatory to tailor each technique to the right patient. Radiol Med. They can affect QOL and cause LUTS including urinary retention. Sertcelik N, Sagnak L, Imamoglu A, et al. 5-year follow-up. This is in agreement with the observations of Azzouzi et al (2006) as well as Chuang and Chancellor (2006). So including four tent stakes could be seen as better than zero. The pooled estimates of demographic and clinical baseline characteristics, peri-operative variables, complications, and post-operative effectiveness including IPSS, QOL, Qmax, and PVR were calculated. I wound up replacing the sliders last summer. The live load acting on the floor slabs is greater than the roof slabs. There were 197 men randomized (active 136, control 61). Lerner LB, McVary KT, Barry MJ, et al. World J Urol. However, HoLEP and PKEP showed pro-erectile effect even for patients with decreased baseline EF and short-term follow-up. After review of results from the first patient cohort, an additional 15 patients with clinical BPH were treated followed by gadolinium-enhanced magnetic resonance imaging (MRI) at 1 week. Mayo Clin Proc. Thank you for supporting Backpacking Light! NICE Guidance - Transurethral water jet ablation for lower urinary tract symptoms caused by benign prostatic hyperplasia. Anatomic success was achieved in 32/46 (70 %; 95 % CI: 54 to 82 %) at 12 months. UL Listed. The BPEP and OP techniques emphasized similar mean operating durations (91.4 versus 87.5 mins) and resected tissue weights (108.3 versus 115.4 g). J Vasc Interv Radiol. The rate of intra-operative bleeding (3 % versus 11 %), blood transfusions (0 % versus 5.5 %) and capsule perforations (0.4 % versus 6.3 %), and early post-operative clot retention (0.4 % versus 3.9 %) was significantly lower for PVP. Innovative technologies like Aquablation (AquaBeam) are still in their infancy, but the first clinical outcomes are promising, even in comparison with the reference method TURP. There was no active bleeding in any of the dogs during or after Aquablation. Secondary outcomes included further questionnaires, functional measures, MRI findings, and AEs; changes from baseline to 12 weeks were compared between treatments with 2-sided tests for superiority. The authors stated that until the exact etiology of BPH/BPE/BPO is known, it is unlikely the cure for this disorder will be found. (iv) Equipment has to be moved back and forth. Literature (through March 2010) was obtained via Medline searches and from the individual reviewers files. Clinical success was defined when symptoms and QOL were improved. Bhatia S, Sinha VK, Kava BR, et al. Sunken slab,19. They stated that further studies are needed to examine the role of PAE as compared to other forms of medical and surgical treatment. Braces are slight and oppose only tension forces, which will not fight compression forces. Bach et al (2020) evaluatedthe safety and effectiveness of the Aquablation procedure in the commercial setting in 178 men at five sites. Post-operative de-novo ejaculatory dysfunction was observed in 26.7 % of patients. Cross-bracing or X-bracing utilizes two diagonal components intersecting each other and are required to resist tension only. Significant improvements were observed in Qmax (12-month improvement of 12.5 cc/sec) and PVR (drop of 171 cc in those with PVR greater than 100 at baseline). As with any developing area of clinical research, the evolution from feasibility to larger-scale studies requires comparisons to established therapies with increasing rigor and prospective study. v) Less use of concrete leads to less CO2 emissions. Mean prostate volume was 107 cc (range 80-150 cc). The authors stated that PAE may be performed safely with minimal morbidity and without associated mortality. How much weight is actually saved between a #3 and a #5 compared to all the other material considerations that go into a lightweight/UL tent? A total of 3 studies were included, with a total sample size of 522 subjects (260 subjects in the experimental group and 262 subjects in the control group). Tammela TL, Talja M. Biodegradable urethral stents. The prefabricated slabs can be of the following types, Pre-tensioned slabsPost-tensioned slabsHollow core slabsRibbed slabs. In parallel, the mean (SD) IPSS QoL score drop reached 1.6 (1.3) by the end of the study. Keehn and Lowe (2015) noted that the use of complementary and alternative medications has become a multi-million dollar business in the United States and comprises more than 50 % of all filled prescriptions for BPH in Europe. A novel temporary prostatic stent for the relief of prostatic urethral obstruction. Going back to our discussion about DCF deformation, I wonder how using all or most of the perimeter stakes would subtly stretch the DCF along the hemlines over time? There are currently 2 studies available, 1 being a follow-up of the first pilot study. Mean operation time was 43.3 8.7 min, mean ablation time 15.9 3.9 min, mean energy deployed 10,522 3290.5 J, mean hospital stay 1.5 0.4 days, and mean catheterization time 17.3 10.0 days. 4. J Urol. 1995;45(5):846-856. Zumstein et al (2019) noted that PAE has been introduced into clinical practice for the treatment of LUTS secondary to BPH (BPH-LUTS) despite a lack of high-level evidence.
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