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Martins Pisco

Chair of Radiology

Hospital Saint-Louis

HQ Phone:  +33 1 42 49 49 49

Direct Phone: +351 ** *** ****direct phone

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Hospital Saint-Louis

1 ave Claude Vellefaux

Paris, Ile-de-France, 75010

France

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Web References(32 Total References)


New Surgery-Free Treatment for Enlarged Prostate Avoids Sexual Dysfunction

"Benign prostatic hyperplasia or BPH is so common that it's been said that all men will have an enlarged prostate if they live long enough, said Joo Martins Pisco, M.D., chief radiologist at Hospital Pulido Valente and director of interventional radiology at St. Louis Hospital, both in Lisbon, Portugal.
I believe that a minimally invasive interventional radiology treatmentprostatic artery embolization or PAEwill be the future treatment for benign prostatic hyperplasia or men's noncancerous enlarged prostates." Todays most used therapy is surgical transurethral resection of the prostate (or TURP). "While the gold standard treatment for enlarged prostates has been TURP, minimally invasive prostatic artery embolization is safe, performed under local anesthesia and has comparable clinical resultswithout TURP's limitations and risks," said Pisco. TURP can be performed only on prostates smaller than 60 cubic centimeters (cc); there is no size limitation for PAE treatment, said Pisco, who is also a professor at the Faculty of Medical Sciences, New University of Lisbon. "The best results are obtained on patients with prostates larger than 60 cubic centimeters and with very severe symptoms," he added. "Pelvic arterial embolization may be the only feasible and effective treatment for benign prostatic hyperplasia in those men who cannot have TURP due to the size of their prostate (80+ cubic centimeters) or because it is inadvisable for them to undergo general anesthesia," said Pisco. "Such symptoms can have significant negative impact in quality of life, leading many men to seek treatment," said Pisco. "We need innovative technologies, such as prostatic artery embolization, to continue to improve outcomes and minimize patient discomfort and morbidity when managing enlarged prostates," he added. The men were followed for more than nine months (on average), and PAE was found to be technically successful in 98.5 percent of the patientswith 77 men showing "excellent" improvement, six men "slight improvement" (but needing no medications) and one experiencing no improvement (due to receiving an incomplete embolization), Pisco added. Two hours after PAE, most men were passing urine less frequently. It was impossible to embolize both prostate arteries in the men showing "slight improvement" due to advanced atherosclerosis, said Pisco. "There is no sexual dysfunction following prostatic artery embolization, and a quarter of our patients report that sexual function improved after the procedure," added Pisco. How TURP is performed BPH can be treated by TURP, a procedure in which a scope is inserted through the penis and the prostate is removed piece by piece, or surgery through an abdomen incision (prostatectomy). During surgery, a man generally undergoes general anesthesia and needs to spend several days in a hospital. Major complications are frequent, such as blood loss, severe pain, sexual dysfunction, impotence, retrograde ejaculation, urinary incontinence, pain, infections and urethral stricture, said Pisco. Other treatments for enlarged prostate Other treatments for enlarged prostratesbesides prostatic artery embolization, TURP and prostatectomyinclude watchful waiting, drugs (to relax muscles near prostate to ease symptoms or help shrink the prostate) and other minimally invasive therapies (such as transurethral needle ablation and laser surgery), which have major disadvantages, such as providing less effective improvement in symptoms, poorer durability of symptomatic benefit, and greater risk of continued catheterization and reoperation. "Additional research is needed to explain why some patients improve better than others," said Pisco.


http://www.seniorjournal.com/NEWS/Health/2011/20110518-NewSurgery-Free.htm

"Benign prostatic hyperplasia or BPH is so common that it's been said that all men will have an enlarged prostate if they live long enough, said João Martins Pisco, M.D., chief radiologist at Hospital Pulido Valente and director of interventional radiology at St. Louis Hospital, both in Lisbon, Portugal.
"I believe that a minimally invasive interventional radiology treatment-prostatic artery embolization or PAE-will be the future treatment for benign prostatic hyperplasia or men's noncancerous enlarged prostates." Today's most used therapy is surgical transurethral resection of the prostate (or TURP). "While the gold standard treatment for enlarged prostates has been TURP, minimally invasive prostatic artery embolization is safe, performed under local anesthesia and has comparable clinical results-without TURP's limitations and risks," said Pisco. TURP can be performed only on prostates smaller than 60 cubic centimeters (cc); there is no size limitation for PAE treatment, said Pisco, who is also a professor at the Faculty of Medical Sciences, New University of Lisbon. "The best results are obtained on patients with prostates larger than 60 cubic centimeters and with very severe symptoms," he added. "Pelvic arterial embolization may be the only feasible and effective treatment for benign prostatic hyperplasia in those men who cannot have TURP due to the size of their prostate (80+ cubic centimeters) or because it is inadvisable for them to undergo general anesthesia," said Pisco. "Such symptoms can have significant negative impact in quality of life, leading many men to seek treatment," said Pisco. "We need innovative technologies, such as prostatic artery embolization, to continue to improve outcomes and minimize patient discomfort and morbidity when managing enlarged prostates," he added. The men were followed for more than nine months (on average), and PAE was found to be technically successful in 98.5 percent of the patients-with 77 men showing "excellent" improvement, six men "slight improvement" (but needing no medications) and one experiencing no improvement (due to receiving an incomplete embolization), Pisco added. Two hours after PAE, most men were passing urine less frequently. It was impossible to embolize both prostate arteries in the men showing "slight improvement" due to advanced atherosclerosis, said Pisco. "There is no sexual dysfunction following prostatic artery embolization, and a quarter of our patients report that sexual function improved after the procedure," added Pisco. How TURP is performed BPH can be treated by TURP, a procedure in which a scope is inserted through the penis and the prostate is removed piece by piece, or surgery through an abdomen incision (prostatectomy). During surgery, a man generally undergoes general anesthesia and needs to spend several days in a hospital. Major complications are frequent, such as blood loss, severe pain, sexual dysfunction, impotence, retrograde ejaculation, urinary incontinence, pain, infections and urethral stricture, said Pisco. Other treatments for enlarged prostate Other treatments for enlarged prostrates-besides prostatic artery embolization, TURP and prostatectomy-include watchful waiting, drugs (to relax muscles near prostate to ease symptoms or help shrink the prostate) and other minimally invasive therapies (such as transurethral needle ablation and laser surgery), which have major disadvantages, such as providing less effective improvement in symptoms, poorer durability of symptomatic benefit, and greater risk of continued catheterization and reoperation. "Additional research is needed to explain why some patients improve better than others," said Pisco.


http://kurabiolabs.com/author/admin/page/2/

The early and medium term results of this study into prostatic artery embolization or PAE are significant because they show PAE achieves comparable clinical results to that of the common surgical procedure "TURP", short for transurethral resection of the prostate, without the surgical risks, such as sexual dysfunction, urinary incontinence, retrograde ejaculation and blood loss, said study author Dr João Martins Pisco, chief radiologist at Hospital Pulido Valente and director of interventional radiology at St Louis Hospital, both in Lisbon.


http://www.kurabiolabs.com/_blog/Health_News/post/Enlarged_Prostate_Breakthrough_In_Minimally_Invasive_Treatment/

The early and medium term results of this study into prostatic artery embolization or PAE are significant because they show PAE achieves comparable clinical results to that of the common surgical procedure "TURP", short for transurethral resection of the prostate, without the surgical risks, such as sexual dysfunction, urinary incontinence, retrograde ejaculation and blood loss, said study author Dr João Martins Pisco, chief radiologist at Hospital Pulido Valente and director of interventional radiology at St Louis Hospital, both in Lisbon.
However, certain urodynamic results (such as flow rate of the urinary stream), were not as good with PAE as with TURP. The findings were presented at the Society of Interventional Radiology's 36th Annual Scientific Meeting in Chicago this week. Enlarged prostate, known as benign prostatic hyperplasia (BPH), is so common in men, it is often said that every man, if he lives long enough, will have it. BPH is not cancer, it is a condition where, as he gets older, a man's prostate gets bigger. Since the prostate surrounds the urethra, the tube that delivers urine from the bladder to the penis, there comes a point when its enlargement starts to squeeze the tube and impede flow. This causes symptoms like weaker urine flow, a need to pass urine more frequently or more urgently, and incomplete bladder emptying. Pisco, who is also a professor at the Faculty of Medical Sciences, New University of Lisbon, said "such symptoms can have significant negative impact in quality of life, leading many men to seek treatment," and we need new and inventive technologies like PAE to achieve better results with fewer side effects.


http://www.germanbiotech.com/gate/v3/news_details.php?news_id=9357

SAN FRANCISCO, March 28, 2012 /PRNewswire-USNewswire/ -- The Journal of Vascular and Interventional Radiology-the Society of Interventional Radiology's flagship publication-together with the SIR Foundation presented the 2011 JVIR Editor's Award for Outstanding Clinical Research Paper to Joao Pisco, M.D., Ph.D., and the honor for Outstanding Laboratory Investigation Paper to Hyun-Jung Yoon, M.D.
Pisco, who is chief radiologist at Hospital Pulido Valente and director of interventional radiology at St. Louis Hospital, both in Lisbon, Portugal, received this year's award for his article, "Prostatic Arterial Embolization to Treat Benign Prostatic Hyperplasia. "Dr. Pisco's paper embodied the hallmark of interventional radiologists to define vanguard therapies that, with the subsequent hard work of rigorous clinical research, can become the mainstay and mainstream," said Ziv J Haskal, M.D., FSIR, the journal's editor-in-chief. "Dr. Pisco's work is at the front of an exciting new such area, the nonsurgical treatment for symptomatic prostate enlargement-something that affects hundreds of thousands of men," Haskal said.


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