Clinical Research Directory

Dural Sac Area-Guided Spinal Anesthesia Dosing for TURP

This randomized controlled study will evaluate whether individualizing the dose of spinal anesthesia according to the ultrasound-derived dural sac cross-sectional area (DSCSA) can improve hemodynamic stability in patients undergoing transurethral resection of the prostate (TURP). Participants aged 40 years or older will be randomly assigned to one of two groups. In the individualized-dose group, the anteroposterior diameter of the dural sac will be measured by ultrasound at the L3-L4 level, and DSCSA will be calculated from this measurement. The dose of intrathecal bupivacaine will then be individualized according to the calculated DSCSA. In the control group, participants will receive a fixed dose of intrathecal bupivacaine. Both groups will also receive intrathecal fentanyl. The main outcome is the incidence of intraoperative hypotension. The study will also evaluate the number of hypotensive episodes, minimum mean arterial pressure, vasopressor and atropine requirements, sensory and motor block characteristics, respiratory monitoring parameters, cerebral oxygenation, and adverse events. The study aims to determine whether a DSCSA-guided dosing strategy can reduce excessive spinal block and improve hemodynamic stability while maintaining effective spinal anesthesia.

Modified Saddle Block vs Spinal Anesthesia for TURP

After obtaining informed consent, eligible patients will be enrolled in the study. Standard monitoring will be applied in the operating room and baseline blood pressure and heart rate will be recorded. Participants will be randomly assigned to receive either spinal anesthesia or a modified saddle block using hyperbaric bupivacaine administered in the lower back. The position of the patient after injection will differ according to the assigned anesthetic technique. The level of numbness produced by the anesthesia will be assessed, and patients with inadequate anesthesia will be excluded. Blood pressure and heart rate will be monitored regularly during surgery. Any significant decrease in blood pressure will be treated with intravenous phenylephrine. Any need to change to general anesthesia during the procedure will also be recorded.

Comparison of Convective Water Vapor Ablation (Convective Water Vapor Energy, WAVE™) With the Rezum™ System Versus Holmium Laser Enucleation of the Prostate (HoLEP) Versus Bipolar Transurethral Resection of the Prostate (TUR-P) in Patients With Benign Prostatic Syndrome (BPS) - A Randomized Study

Benign prostatic enlargement (BPH/BPS) is one of the most common benign diseases in adult men. About 50% of men are affected by the age of 50, and between the ages of 70 and 80 the prevalence rises to 70-80%. There are various surgical procedures available for the treatment of BPH. In this study, we are investigating three surgical procedures which, based on the current data, appear to be relatively equivalent; however, additional data are still needed to substantiate this. The aim of this study is to compare the three surgical methods REZUM vs. HoLEP vs. TUR-P for endoscopic transurethral subvesical de-obstruction with regard to both subjective and objective voiding function, as well as improvements in quality of life and sexual function. The goal of the study is to work out the possible advantages and disadvantages for future patient counseling, thereby defining more precisely the role of these surgical procedures within the armamentarium of urology. This is a single-center, randomized, prospective interventional study.