ANTONIO MARMO LUCON
Projetos de Pesquisa
Unidades Organizacionais
Departamento de Cirurgia, Faculdade de Medicina - Docente
Instituto Central, Hospital das Clínicas, Faculdade de Medicina - Médico
Instituto Central, Hospital das Clínicas, Faculdade de Medicina - Médico
4 resultados
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- Prostate biopsy in patients with long-term use of indwelling bladder catheter: What is the rationale?(2012) ANTUNES, Alberto A.; BARBOSA, Joao Arthur B. A.; REIS, Sabrina T.; GUARIERO, Mary S.; FUKUSHIMA, Julia T.; DALL'OGLIO, Marcos F.; FREIRE, Geraldo de C.; LUCON, Antonio M.; LEITE, Katia R.; SROUGI, MiguelObjective: Acute urinary retention (AUR) is expected to occur in 2% to 39% men with benign prostatic hyperplasia. To date, no study has elucidated the effect of long-term use of indwelling bladder catheter on serum prostate specific antigen (PSA) levels and on the incidence of prostate cancer (CaP). The aim of the present study is to analyze the incidence of CaP in patients with long-term use of indwelling bladder catheter and determine some practice patterns on this issue. Materials and methods: The study comprised a retrospective analysis of data from 1,651 patients who had undergone transrectal ultrasound (TRUS)-guided prostate biopsy from July 2004 to June 2009. Among these patients, 198 (12%) were using an indwelling bladder catheter during the biopsy for at least 1 month. The incidence of CaP was recorded according to total PSA levels. Other variables such patient age, free/total PSA rate, PSA density, prostate volume, and duration of catheter use was also analyzed. Men with a digital rectal examination suspicious for cancer were not considered for analysis. Results: Median patient age was 71 years (37 to 89 years). Overall, 25% of patients presented a CaP diagnosis. CaP incidence according to the PSA levels was 0%, 18.9%, 24.5%, and 40.6% for patients with PSA <= 4.0, 4.1-10.0, 10.1-20.0, and >20.0 ng/ml, respectively. When prostate volume was analyzed together, we demonstrated that only 1 (2.4%) patient with PSA below 10.0 ng/ml and prostate volume >60 g had CaP. Median total PSA, PSA density, and prostate volume were statistically different between patients with and without CaP. Conclusions: Prostate biopsy should not be indicated for all patients with diagnosis of BPH and AUR who present an elevated PSA level. Patients with PSA below 10.0 ng/ml, and prostate volume >60 g should only undergo biopsy in selected cases. Patients with PSA >20.0 ng/ml and a prostate volume <= 60 g are at higher risk of CaP diagnosis.
conferenceObject CAN WE PREDICT WHICH PATIENTS WILL PRESENT RESOLUTION OF DETRUSOROVERACTIVITY (DO) AFTER TRANSURETHRAL RESECTION OF THE PROSTATE (TURP)?(2015) ISCAIFE, Alexandre; REIS, Sabrina T.; ALBERTINI, Aline; NUNES, Marco A.; LUCON, Antonio M.; NAHAS, Willian C.; SROUGI, Miguel; ANTUNES, Alberto A.bookPart Varicocele(2012) CAMARA, Cesar; ANTUNES, Alberto Azoubel; LUCON, Antonio Marmo- Can We Predict Which Patients will Experience Resolution of Detrusor Overactivity after Transurethral Resection of the Prostate?(2015) ANTUNES, Alberto Azoubel; ISCAIFE, Alexandre; REIS, Sabrina Thalita; ALBERTINI, Aline; NUNES, Marco Antonio; LUCON, Antonio Marmo; NAHAS, William Carlos; SROUGI, MiguelPurpose: We determined which clinical and urodynamic variables may be related to persistent detrusor overactivity after transurethral resection of the prostate. Materials and Methods: We studied 46 patients with bladder outlet obstruction due to benign prostatic hyperplasia who were treated with transurethral prostate resection from 2011 to 2012. All patients underwent urodynamic analysis preoperatively and 12 months postoperatively. Clinical and urodynamic variables in the preoperative period were correlated with the resolution of detrusor overactivity postoperatively. Results: Patients with detrusor overactivity in the preoperative period were older (65.2 vs 61.1 years, p = 0.041) and had a higher I-PSS (International Prostate Symptom Score) (25.2 vs 19, p = 0.014) and higher maximum flow rate (8.6 vs 6.6 ml per second, p = 0.039). Patients with persistent detrusor overactivity were statistically older than those with resolution (69 vs 63 years, p = 0.043). Detrusor overactivity persisted in 63.6% of patients with maximum cystometric capacity less than 250 ml compared to 20% of those with greater than 250 ml (p = 0.024). When analyzing urodynamic variables together, we found a 66.7% chance of persistent detrusor overactivity in patients with maximum cystometric capacity less than 250 ml and detrusor overactivity amplitude greater than 40 cm H2O (p = 0.041). When these characteristics were associated with early detrusor overactivity, the chance of persistent detrusor overactivity was 83.3% (p = 0.013). Conclusions: Advanced patient age together with low maximum cystometric capacity, and early and high detrusor overactivity amplitude are the most important predictors of persistent detrusor overactivity after relief of bladder outlet obstruction.