Posted by Guan Chou on March 09, 1998 at 09:07:06:
In Reply to: Re: BPH after posterior urethroplasty posted by CLDing on February 27, 1998 at 19:25:36:
: I am very very suspicious of the claims of all the newer modalities in preserving
things. I agree with Chit Sin, that though TUNA claims to be fairly predictable it is
blind! How can it be predictable when prostate tissue is so variable and rf destruction is
so dependent on tissue consistency e.g. content of water.
: Secondly, John Blandy taught about the importance of resecting apical tissue as he has
shown that they can get very obstructive after the prozimal zones of the prostate has been
removed. Now in TUVP and laser etc we are talking about leaving the apical tissues behind
- perhaps this is the reason why the improvement in Qmax is not as good.
: TURP and preserving the BN is going to be very difficult uness one is prepared to leave
behind the bits of the prostate which grows through the BN.
: I started this patient on Proscar after explaining to him that in his circumstances, it will be worth hoping that he will be one of those whose BPH responds to Proscar.
Why proscar and not alpha blocker? If your patient's symptoms do not improve after 3
months , will you add on apha blocker or replace proscar with apha blocker?