 |
 | Home | Contact Us | FAQ | Search & Site Map | Link to Us |
 | Sign In | Join | Other 45 Sites in Network |
Medical Forum / Diseases and Disorders / Prostate BPH / March 2006PVP: medial lobe
1) How is a determination made that there is medial lobe enlargement? Can this be seen from urodynamics, or does it require cystoscopy? Or is it not apparent until the surgery itself? 2) Dr. Reiter of UCLA says he will not lase in cases of medial lobe protruding into the bladder, because of the effect on urination. Is he right? If so, how do urologists deal with urination problems due to medial lobe enlargement? Or do other urologists lase there? Or is it safer to take a conservative approach, and avoid lasing in the bladder neck? Jesse > 1) How is a determination made that there is medial lobe enlargement? > Can this be seen from urodynamics, or does it require cystoscopy? Or [quoted text clipped - 8 lines] > > Jesse Jesse...Dr. Sancha will have to answer these questions. I hope he hasn't left us, as I am eagerly awaiting his response to my kidney post :-) ...Pete Jesse, The median lobe enlargement can usually be seen on an ultrasound. A Cystoscopy obviously will allow seeing it also. I do PVP in patients with median lobes, and I vaporise the entire median lobe. It can be tricky at times, but it can be done safely. I do not know why Dr. Reiter would not use PVP on patients with median lobes. Fernando Gómez Sancha http://drgomezsancha2.blogspot.com On 2/28/06 6:29 PM, in article > 1) How is a determination made that there is medial lobe enlargement? > Can this be seen from urodynamics, or does it require cystoscopy? Or is [quoted text clipped - 8 lines] > > Jesse You can see it when you look in with the cystoscope (preop or interop). During a UDS you would just see it as obstruction (usually high bladder pressure and low flow). People with a good sized median lobe can do really well after a PVP or TURP. Many times they can be some of the most happy postop, if that part of the gland is acting as a "ball valve". Sometimes they can be a little tricky to take down with the laser, but not too big a deal. If you are going to do a TURP or PVP you just can not leave the thing behind. The tough part is that you do not want to burn the bladder with the laser or hurt the where each ureter comes into the bladder, but this is not a common problem. ME > On 2/28/06 6:29 PM, in article > [quoted text clipped - 25 lines] > laser or hurt the where each ureter comes into the bladder, but this > is not a common problem. Matthew...are you a medical professional, or a patient. And why would the laser damage the corner points of the trigone where the ureters come in (which is further on up from the bladder neck). It seems that the surgeon would have to be awful remiss to do that...Pete |
Reply to this Message |
 Sign In
 Join
 My Latest Posts My Monitored Threads My Blog My Photo Gallery My Profile My Homepage Start New Thread Enable EMail Alerts Rate this Thread
|
©2008 Advenet LLC Privacy Policy - Terms of Use
This website includes both content owned or controlled by Advenet as well as content owned or controlled by third parties.