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Other Complications of Diabetes
Published in Jahangir Moini, Matthew Adams, Anthony LoGalbo, Complications of Diabetes Mellitus, 2022
Jahangir Moini, Matthew Adams, Anthony LoGalbo
Methods of preventing ED include quitting smoking, a healthy diet, avoiding excessive alcohol, maintaining a healthy weight, physical activity, and avoiding illegal drugs. Retrograde ejaculation is not totally preventable. Men requiring treatment for an enlarged prostate must consider less invasive surgeries such as transurethral microwave thermotherapy or transurethral needle ablation. Control of medical conditions that cause nerve damage may also aid in prevention. Diabetes medications must be taken as prescribed and appropriate lifestyle changes must be implemented. Prevention of vaginal dryness because of decreased lubrication requires the use of vaginal moisturizers such as K-Y Liquibeads or Replens, oral probiotic supplements that enhance vaginal health, and increased soy into the diet. There are also low- dose vaginal estrogen creams, tablets, and rings.
Alternative Tumor-Targeting Strategies
Published in David E. Thurston, Ilona Pysz, Chemistry and Pharmacology of Anticancer Drugs, 2021
Microwaves, used throughout the world for culinary purposes, can produce significant heat in living tissues. The heating effect can be focused using a shaped piece of metal, known as an antenna. An experimental treatment based on this, Transurethral Microwave Thermotherapy (TUMT), was originally developed to treat Benign Prostatic Hyperplasia (BHP) but more recently has been adapted for prostate cancer. In TUMT, a small metal antenna transmitting microwave energy is inserted into the urethra via a catheter to a location adjacent to the prostate gland (Figure 10.35). Microwave energy emitted from the antenna is then used to heat and kill cells within the prostate. A balloon is inflated in the bladder to ensure best positioning of the antenna, and cooling fluid is circulated within the catheter to prevent heat damage to the wall of the urethra. Also, to prevent the temperature from getting too high outside of the prostate, a temperature sensor is positioned in the rectum which turns off the treatment automatically if the temperature of surrounding tissues rises above a pre-set level. In the case of BHP the heat kills some of the prostate tissue, but as the prostate heals it shrinks, thus reducing the blockage of urine flow experienced by BHP patients. For prostate cancer patients the principle is the same, with the TUMT killing tumor tissue and reducing the size of the prostate.
Energy Sources in Urology
Published in Anthony R. Mundy, John M. Fitzpatrick, David E. Neal, Nicholas J. R. George, The Scientific Basis of Urology, 2010
Microwave energy may be applied transrectally and transurethrally to the prostate, and may induce hyperthermia or thermotherapy, depending on the target tissue temperature achieved. Transrectal hyperthermia, originally described in the treatment of prostate cancer (29) and subsequently BPH (30), has failed to show relief of the obstructive component of BPH and has largely been abandoned. Transurethral microwave thermotherapy (TUMT) aims to achieve high temperatures (45–80°C) in the prostate and involves the insertion of a specially designed Foley-type catheter into the bladder, allowing a microwave antenna to be positioned within the prostatic fossa (Fig. 5— ProstaLund Operations AB, Lund, Sweden; marketed by ACMI). Microwaves are then passed into prostate tissue to induce thermal coagulative necrosis.
Quality assurance guidelines for interstitial hyperthermia
Published in International Journal of Hyperthermia, 2019
H. Dobšíček Trefná, M. Schmidt, G. C. van Rhoon, H. P. Kok, S. S. Gordeyev, U. Lamprecht, D. Marder, J. Nadobny, P. Ghadjar, S. Abdel-Rahman, A. M. Kukiełka, V. Strnad, M. D. Hurwitz, Z. Vujaskovic, C. J. Diederich, P. R. Stauffer, J. Crezee
Interstitial heating techniques are based on the same heating principles as intracavitary and intraluminal techniques, but energy is delivered from interstitial needles or catheters implanted percutaneously into the tumor rather than placed within natural body cavities like cervix, bladder, esophagus and urethra. Benign prostatic hyperplasia may be treated with intraluminal transurethral microwave thermotherapy in the 45–60 °C range [17]. Intracavitary and intraluminal applicators may have active lengths similar to interstitial applicators but are generally not used in multiapplicator arrays and the diameter can be larger, up to 30 mm, depending on size of the cavity involved. These QA guidelines are intended for interstitial hyperthermia, although parts may be applicable to intraluminal and intracavitary hyperthermia which may be considered a special case of interstitial heating using only one applicator.
Patient related factors affecting in-hospital costs of a TURP procedure
Published in Scandinavian Journal of Urology, 2021
Erik Sagen, Reza Javid, Lina Liivrand, Ali Bencherki, Olle Nelzén, Ralph Peeker, Marianne Månsson
Inclusion criteria were as follows: all men operated with a TURP due to bothersome LUTS, refractory to pharmacological treatment, or due to urinary retention requiring either an indwelling catheter or clean intermittent self-catheterisation (CISC). Exclusion criteria were as follows: men with a previous TURP, transurethral incision of the prostate (TUIP) or transurethral microwave thermotherapy (TUMT). Men with known prostate cancer were also excluded as were men that had undergone open adenoma enucleation of the prostate.
Prostate volume and age are predictors of energy delivery using the CoreTherm Concept in patients with LUTS/BPO: a study on thermal dose
Published in Scandinavian Journal of Urology, 2020
Fredrik Stenmark, Lars Brudin, Henrik Kjölhede, Ralph Peeker, Johan Stranne
Lower urinary tract symptoms (LUTS) can be caused by benign prostatic hyperplasia (BPH). Patients with LUTS/BPH and benign prostatic enlargement (BPE) with benign prostatic obstruction (BPO) can be cured either by surgical removal or microwave ablation of the obstructive prostatic tissue. High-energy transurethral microwave thermotherapy is a minimally invasive outpatient treatment option for patients with LUTS/BPO.