INTRODUCTION:Penetrating renal trauma has been treated traditionally by renal exploration. In view of the successful outcome of nonoperative treatment of major blunt renal trauma, there has been a gradual shift in the approach to penetrating renal injuries, in selected cases. This study reviews the local experience with the conservative approach to penetrating renal injuries.PATIENTS AND METHODS:The researchers retrospectively reviewed the medical records of patients with penetrating renal injuries during a period of 10 years at two medical centers (Meir in Kfar Saba and Hillel Yaffe in Hadera). The data included mechanisms of injury, grading of the injury, homodynamic stability presence of hematuria, associated injuries, management conservative versus operative, complications and outcome.RESULTS:The study group consisted of 18 patients, with mean age of 22.5 years (15-40 years). The mechanisms of injury were stab wounds (10 patients) and gunshot injuries (8 patients). Nine patients (50%) required surgical intervention for associated injuries. Nonoperative treatment of the urological injury was selected in 10 patients (55.5%), 4 of them required surgery for associated abdominal injuries but did not undergo renal or retroperitoneal exploration, 8 patients (44.5%), were managed primarily by renal exploration. Grade I-II renal injuries were treated conservatively while all grade V injuries were explored. Of grade III injuries, 3 were treated conservatively and renal exploration was performed in 2. Half of grade IV injuries (4 patients) were treated conservatively. Follow-up of conservatively treated patients, demonstrated a viable kidney in all cases. Nephrectomy was performed in 3/8 patients who were treated primarily by renal exploration. These patients had grade IV or V injuries. Renorrhaphy was performed in the remaining 5 patients of whom one required delayed nephrectomy. Overall, the injured renal unit was lost in half of the operated patients.CONCLUSIONS:The present study presents a successful conservative approach to penetrating renal injuries in 10 out of 18 cases. All renal units in the nonoperated patients were preserved in comparison to only half in the surgically treated patients. Hence, nonoperative treatment is a reasonable option for the majority of minor penetrating renal injuries as well as in many selected high-grade injuries. This approach provides maximal preservation of the injured kidney with manageable complications.

Objective: Many patients with erectile dysfunction (ED) stop using sildenafil due to subjective failure. This study examined whether counseling and maximal dosing (100 mg) could achieve better treatment compliance and could possibly improve treatment outcome.Material and methods: Patients were recruited by newspaper advertisements and referred to 5 ED centers throughout the country. Details about their previous experiences with sildenafil were recorded and following an explicit explanation about the nature and action of the drug, were offered to enter the study. Instructions on drug use were provided during each visit in which four 100 mg Sildenafil tablets were provided. Treatment outcomes were assessed by the international index of erectile function (IIEF) questionnaire after taking 4 and 8 tablets. In 2 ED centers a short video with sexual counseling content was added in between visits.Results: The study cohort was comprised of 220 patients aged 27-88 years. The majority reported having received limited or no instructions on drug use when sildenafil was first prescribed. A significant increase in IIEF erectile function domain scores (EFDS) between visits 1,2 and 3 was observed (10.96 +/- 0.40, 16.73 +/- 0.51 and 17.82 +/- 0.55 mean +/- SE, respectively), with 23.6% of the study patients achieving normal erectile function at the end of the study. The parameters of age and initial severity of ED most influenced treatment success.Conclusions: Counseling and dose adjustment were directly influential in achieving an excellent response to a second trial of sildenafil in patients with ED who had previously failed treatment with the drug, and obviated their needing to seek more invasive measures. (c) 2006 European Association of Urology. Published by Elsevier B.V. All rights reserved.

Objectives. To investigate the results of combined suprapubic cystolithotomy followed by transurethral resection (TUR) of the prostate (TURP) or TUR of the bladder neck in patients with infravesical obstruction and massive or numerous bladder stones. We also reviewed the medical literature and compared the success, morbidity, and mortality rates of the treatment modality presented here and the nonsurgical modality of transurethral lithotripsy and resection of the prostate or bladder neck.Methods. Through a 10-year period, 20 men with benign prostatic hyperplasia or bladder neck obstruction and massive or numerous bladder stones underwent cystolithotomy for stone clearance followed by TURP or TUR of the bladder neck. A second group of 20 randomly selected men who underwent TURP alone was studied retrospectively for time of surgery, number of days of postoperative indwelling catheter use, and hospital stay.Results. No deaths occurred. All stones were successfully evacuated (100% stone-free rate), The operative time and number of days of postoperative indwelling catheter use and hospital stay were notoriously shorter in the present series compared with the transurethral lithotripsy and TURP modality. A single case of fever (59,6 complication rate) occurred in each group. When comparing the data of the present series with a group of 20 men who underwent TURP only, no differences were found in the times of postoperative indwelling catheter use and hospital stay. Cystolithotomy performed before TURP prolonged the total time of surgery an average of 18.4 minutes.Conclusions. In the era of endoscopic and minimally invasive surgery, a small suprapubic cystostomy followed by TURP is still the treatment of choice in cases of infravesical obstruction and very large or numerous bladder stones. The procedure is quick and easy to perform and bears a low morbidity rate compared with transurethral lithotripsy and TURP A small cystotomy does not prolong the time of indwelling catheter use and hospital stay. (C) 2002, Elsevier Science Inc.

Our primary objective was to assess the feasibility of geriatric patients (>65 yr) bypassing the postanesthesia care unit (PACU) after ambulatory surgery. A secondary objective was to compare recovery profiles when using three different maintenance anesthetics. Ninety ASA physical status I-III consenting outpatients (>65 yr) undergoing short urologic procedures were randomly assigned to one of three anesthetic treatment groups. After a standardized induction with fentanyl and propofol, anesthesia was maintained with propofol (75-150 mug (.) kg(-1) (.)min(-1) IV), isoflurane (0.7%-1.2% end tidal), or desflurane (3%-6% end tidal), in combination with nitrous oxide 70% in oxygen. In all three groups, the primary anesthetic was titrated to maintain an electroencephalographic-bispectral index value of 60-65. Recovery times, postanesthesia recovery scores, and therapeutic interventions in the PACU were recorded. Although emergence times were similar in the three groups, the time to achieve a fast-track discharge score of 14 was significantly shorter in patients receiving desflurane compared with propofol and isoflurane (22 +/- 23 vs 33 +/- 25 and 44 +/- 36 min, respectively). On arrival in the PACU, a significantly larger percentage of patients receiving desflurane were judged to be fast-track eligible compared with those receiving either isoflurane and propofol (73% vs 43% and 44%, respectively). The number of therapeutic interventions in the PACU was also significantly larger in the Isoflurane group when compared with the Propofol and Desflurane groups (21 vs 11 and 7, respectively). In conclusion, use of desflurane for maintenance of anesthesia should facilitate PACU bypass ("fast-tracking") of geriatric patients undergoing short urologic procedures.

Objective: To review morbidity and late complications of ureteral stent insertion and to specifically evaluate hydronephrosis as a radiologic finding of obstruction in the presence of an indwelling ureteral stent. Methods: In this prospective study, we evaluated 110 stented kidneys in a group of 90 patients. Of 110 stents, 52 were left in place for 3 months, 23 for 6 months, 11 for 9 months, and 24 for up to 12 months, With the stent in place, patients were followed by plain abdominal X-ray 1 and 30 days after stenting. Further follow-up was performed through ultrasound and plain film every 3 months until scheduled date for stent removal or the appearance of complications. Results: In 11 of 110 cases (10%) there was stent fragmentation and in 9 (8.2%) stent migration. In 10 cases (9.1%), there was no change in the severity of the hydronephrosis, but because of flank pain or urinary tract infection with fever, the stents had to be removed. In 6 cases (5.4%) hydronephrosis developed or worsened after stenting. Of the 110 ureteral stents, 32.7% had to be removed because of late complications. Conclusions: Although ureteral stenting is undoubtedly an important procedure for the release of ureteral obstruction, the indications for stent insertion should be carefully considered in each patient, Late complications of ureteral stents are frequent and appear in one third of the patients. Close follow-up of stented patients is valuable in early detection of morbidity or complications, and in such cases the stent should be removed or exchanged as soon as possible, Copyright (C) 2000 S. Karger AG, Basel.

Objective To review the morbidity and complications of ureteric stent insertion and to evaluate specifically the effect of an indwelling ureteric stent on the changes in hydronephrosis after stenting.Patients and methods In a prospective study, 110 renal units with a stent in place were evaluated in 90 patients, Of the 110 stents, 52 were left in place for 3 months, 23 for 6, 11 for 9, 19 for 12 and five (forgotten stents) for 13-30 months. The patients were followed using plain abdominal X-ray at 1 and 30 days after stenting. They were further followed using ultrasonography and plain films every 3 months until the scheduled date for stent removal or the appearance of complications.Results Thirty-four patients had fever and bacteriuria after stent insertion. Of the 110 stents, 11 (10%) fragmented and nine (8%) migrated, Seventeen patients complained of flank pain on voiding. In 21 renal units (19%) there was no change in the severity of hydronephrosis, whereas in six (5.5%) hydronephrosis developed or worsened after stenting.Conclusion Although ureteric stenting is undoubtedly an important procedure to relieve ureteric obstruction, the indications for stent insertion should be considered carefully in every patient, The close follow-up of stented patients is valuable for the early detection of morbidity or complications and in such cases the stent should be removed or exchanged as soon as possible.

Study Objective: To evaluate the influence of spinal versus general anesthesia on bladder compliance and intraabdominal Pressure in elderly males undergoing elective transurethral resection of the ProstateDesign: Prospective, randomized, open-label study.Setting: Teaching hospitalPatients: 21 ASA physical status I, II and III patients at feast 18 years of age, undergoing transurethral surgery.Interventions: According to a computer-generated randomization schedule, patients were allocated to one of two groups. In Group Spinal (S) 10 mg of hyperbaric tetracaine was administered intrathecally. In Group, General Anesthesia (GA) patients received fentanyl intravenous (IV) I to 2 mu g/kg and propofol IV 1.0 to 2.0 mg/kg for induction of anesthesia. Thereafter, a laryngeal mash airway reins inserted and with spontaneous ventilation, anesthesia was maintained by administering isoflurane (end-tidal 0.7% to 1.2%) and 70% nitrous oxide (N2O) in oxygen. Intraabdominal pressure and bladder compliance were recorded prior to the induction of anesthesia and immediately before the onset of the surgical Procedure.Measurements and Main Results: The two groups were demographically comparable. In Group S, mean bladder compliance was significantly (p = 0.003) higher and mean intraabdominal pressure significantly lower (p = 0.007) when compared to baseline preanesthetic values. In Group GA, mean intraabdominal pressure significantly (p = 0.006) decreased when compared to baseline preanesthetic recordings. Following the induction of general anesthesia, a small change in bladder compliance was noted. However, statistical significance was not reached Data were analyzed and compared using Student's t-test (p < 0.05 was considered statistically significant).Conclusion: Both spinal and general anesthesia induced a significant decrease in intrabdominal pressure. While both techniques were associated with an increase in bladder compliance, statistical significance was demonstrated only in the spinal anesthesia treatment group. (C) 1999 by Elsevier Science Inc.

Urethral catheterization, the standard method of measuring residual urine, is uncomfortable and associated with risk of infection and trauma to the urethra. It has also been reported as inaccurate to a certain extent. We compared catheterization with ultrasound scanning in a prospective study of 52 men and 3 women. 100 measurements of postvoiding residual urine by portable ultrasound scanner, were each followed immediately by urethral catheterization (both procedures performed by an experienced nurse in our outpatient clinic). A difference of > 25 ml between measurements by scanner and by catheter was considered significant. The range of residual urine measured by scanner was 1-425 ml, and by catheter 1-410 ml. There was good matching between the 2 methods in 85 of 100 measurements (scanning accuracy 85%). In 30/85 matching was excellent while in 55 cases the mean difference was 8.5 +/- 6.2 ml, range 1-24 ml. The accuracy of scanning was 85%; there was perfect matching between the 2 methods in 30 cases. In the remaining 15 cases the mean difference was 41.8 +/- 13.6 ml (range 25-56). Each catheterization took 4-5 minutes and scanning 30 seconds. There were no complications after catheterization, but all reported discomfort and dysuria for 1-2 hours thereafter. Scanning was absolutely uneventful in all. The cost per catheterization, including medication, disposable materials and personnel time was approximately 80 NIS. Our 80-90 measurements of residual urine a month require annually about 80 hours and a budget of about NIS 80,000. Scanning requires only 8 hours, while the cost of the portable scanner is significantly less than NIS 80,000 and it can be used for more than a year. We conclude that measuring urine residual with the noninvasive scanner instead of by catheterization is easier, more accurate, and more cost-effective.

No AccessJournal of UrologyClinical Urology: Original Articles1 Feb 1999LONG-TERM INCIDENCE OF ACUTE MYOCARDIAL INFARCTION AFTER OPEN AND TRANSURETHRAL RESECTION OF THE PROSTATE FOR BENIGN PROSTATIC HYPERPLASIAis corrected byERRATUM MOSHE SHALEV, SANTIAGO RICHTER, ODED KESSLER, BARUCH SHPITZ, BRIAN FREDMAN, and ISRAEL NISSENKORN MOSHE SHALEVMOSHE SHALEV More articles by this author , SANTIAGO RICHTERSANTIAGO RICHTER More articles by this author , ODED KESSLERODED KESSLER More articles by this author , BARUCH SHPITZBARUCH SHPITZ More articles by this author , BRIAN FREDMANBRIAN FREDMAN More articles by this author , and ISRAEL NISSENKORNISRAEL NISSENKORN More articles by this author View All Author Informationhttps://doi.org/10.1016/S0022-5347(01)61931-1AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: Acute myocardial infarction was found to be the main cause of increased long-term mortality in patients after transurethral compared to open prostatectomy in various retrospective studies. We performed a randomized prospective study to compare morbidity and incidence of acute myocardial infarction in patients after transurethral compared to open prostatectomy for benign prostatic hyperplasia. Materials and Methods: We studied 365 patients who were assigned to transurethral (236) or open (129) prostatectomy only according to the size of the prostate and who were followed for 7 to 8 years. The clinical status of the patients in both groups before and after the operation was compared, and the rate of myocardial infarction and long-term mortality was studied. Results: More patients with a history of cerebrovascular accident (5.4 versus 0.8%) and indwelling catheters (16.3 versus 7.6%) before the operation were in the open prostatectomy group. Among the 236 patients operated on transurethrally 31 were reoperated on (6 more than once) during followup compared to 4 of the 129 patients who underwent open prostatectomy. In 15 patients from the transurethral prostatectomy group myocardial infarction developed compared to 9 patients in the open prostatectomy group. This difference was not statistically significant. The rate of acute myocardial infarction after prostatectomy, no matter which approach was used, was greater than 6% and it appeared to be higher when compared to the rate of infarction in the general population of the same age group, which is approximately 2.5% in our county. There was no statistically significant difference in the overall mortality rate between the transurethral and open prostatectomy groups, which was 14.4 and 8.5% respectively. Conclusions: Open prostatectomy is more effective in overcoming urinary obstruction than the transurethral approach. No significant differences in myocardial infarction or overall mortality rates were found between the 2 groups. References 1 : Mortality and reoperation after open and transurethral resection of the prostate for benign prostatic hyperplasia. New Engl. J. Med.1989; 320: 1120. Google Scholar 2 : An assessment of prostatectomy for benign urinary tract obstruction. Geographic variations and the evaluation of medical care outcomes. J.A.M.A.1988; 259: 3027. Google Scholar 3 : A population-based study of prostatectomy: outcomes associated with differing surgical approaches. J. Urol.1987; 137: 1184. Link, Google Scholar 4 : Further study of the increased mortality following transurethral prostatectomy: a chart-based analysis. J. Urol.1990; 144: 224. Link, Google Scholar 5 : Effect of irrigating fluids and prostatic tissue extract on isolated cardiomyocytes. Urology1995; 46: 821. Google Scholar 6 : Late cardiac effects of dotorubicin therapy for acute lymphoblastic leukemia of childhood. New Engl. J. Med.1991; 324: 808. Google Scholar 7 : Functional myocardial impairment in children treated with anthracyclines for cancer. Lancet1991; 337: 816. Google Scholar 8 : Hemoglobin, plasma lipids and coronary heart disease. Amer. Heart J.1973; 86: 842. Google Scholar 9 : Haematologic parameters as risk factors for cardiac infarct in an occupational health care setting. J. Clin. Epidemiol.1988; 41: 67. Google Scholar From the Departments of Urology and Anesthesiology, Meir General Hospital, Kfar Saba and Tel Aviv University Sackler School of Medicine, Tel-Aviv, Israel© 1999 by American Urological Association, Inc.FiguresReferencesRelatedDetailsRelated articlesJournal of Urology9 Nov 2018ERRATUM Volume 161Issue 2February 1999Page: 491-493 Advertisement Copyright & Permissions© 1999 by American Urological Association, Inc.MetricsAuthor Information MOSHE SHALEV More articles by this author SANTIAGO RICHTER More articles by this author ODED KESSLER More articles by this author BARUCH SHPITZ More articles by this author BRIAN FREDMAN More articles by this author ISRAEL NISSENKORN More articles by this author Expand All Advertisement PDF downloadLoading ...

Conclusions Open prostatectomy is more effective in overcoming urinary obstruction than the transurethral approach. No significant differences in myocardial infarction or overall mortality rates were found between the 2 groups.

No AccessJournal of UrologyClinical Urology: Case Reports1 Jul 1998LATE APPEARANCE OF COWPER'S SYRINGOCELE S. RICHTER, M. SHALEV, and I. NISSENKORN S. RICHTERS. RICHTER More articles by this author , M. SHALEVM. SHALEV More articles by this author , and I. NISSENKORNI. NISSENKORN More articles by this author View All Author Informationhttps://doi.org/10.1016/S0022-5347(01)63057-XAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail "LATE APPEARANCE OF COWPER'S SYRINGOCELE." The Journal of Urology, 160(1), pp. 128–129 References 1 : An account of two new glands near the prostate with their excretory ducts, lately discovered. Philos. Trans. Roy. Soc. London1699; 268. Google Scholar 2 : A study of the relationship between syringoceles and Cobb's collar.. Eur. Urol.1996; 30: 119. Google Scholar 3 : Lesions of Cowper's glands in children.. J. Urol.1979; 122: 121. Abstract, Google Scholar Department of Urology, Meir General Hospital, Kfar Saba and Tel-Aviv University Sackler School of Medicine, Tel-Aviv, Israel© 1998 by American Urological Association, Inc.FiguresReferencesRelatedDetailsCited byBrandes S (2018) RE: COWPER'S SYRINGOCELE: SYMPTOMS, CLASSIFICATION AND TREATMENT OF AN UNAPPRECIATED PROBLEMJournal of Urology, VOL. 164, NO. 5, (1666-1667), Online publication date: 1-Nov-2000.BEVERS R, ABBEKERK E and BOON T (2018) COWPER’S SYRINGOCELE: SYMPTOMS, CLASSIFICATION AND TREATMENT OF AN UNAPPRECIATED PROBLEMJournal of Urology, VOL. 163, NO. 3, (782-784), Online publication date: 1-Mar-2000. Volume 160Issue 1July 1998Page: 128-129 Advertisement Copyright & Permissions© 1998 by American Urological Association, Inc.MetricsAuthor Information S. RICHTER More articles by this author M. SHALEV More articles by this author I. NISSENKORN More articles by this author Expand All Advertisement PDF downloadLoading ...

Aims: To assess the risk of leaving cancer-positive surgical margins in the perineal approach for radical prostatectomy as compared to the retropubic approach.Methods: Seventy-six patients with clinically organ-confined prostate cancer (stage T1-2 NoMo) underwent radical prostatectomy. The 57 patients who underwent retropubic prostatectomy were compared to 19 patients in whom the perineal approach was undertaken. The two groups were compared for pre-operative PSA levels, clinical stage, biopsy Gleasson score, and any correlation between pre- and post-operative stage and grade of the disease and rate of cancer-positive surgical margins.Results: Although there were no significant differences in the rate of organ-confined diseases and specimen Gleasson score in the two groups, the rate of positive surgical margins in the perineal approach was significantly lower (15.7 vs 29.8%) and the rate of extracapsular disease with negative margins was significantly higher (15.7 vs 7%).Conclusions: The narrow surgical field in the perineal approach for radical prostatectomy does not pose a higher risk for positive surgical margins and it might be the procedure of choice in stage T1C prostate cancer with a Gleasson score of below 7.

Background: Early complications after ureteroscopy include discomfort, renal colic, urinary infection, and hematuria, Vesicoureteral reflux has been reported as a late complication, The presence of early vesicoureteral reflux after ureteroscopy has not been investigated.Methods: Forty patients were randomly selected for a study in which early vesicoureteral reflux after ureteroscopy was searched for through retrograde cystography,Results: In four patients (10%), vesicoureteral reflux was found. Follow-up cystograms 2 weeks after ureteroscopy were normal in all four,Conclusion: These results suggest that early vesicoureteral reflux after ureteroscopy is rare and that if it appears, it is of low grade and temporary.

During 8 years, 200 men underwent penile prostheses surgery due to sexual dysfunction. In 7/200 they were re-operated after complicated previous surgery. The prostheses implanted were semirigid (60) and inflatable (140) of different types: self-contained, 45; two-piece, 5; three-piece, 90, and manufactured by either American Medical Systems (AMS, Minnetonka, MN) or Mentor (Santa Barbara, CA, USA).

Penile recurvation that causes sexual dysfunction may be corrected surgically. A total of 35 men suffering from penile recurvation secondary to either congenital defect (29) or Peyronie's disease (6) were operated through simple plication of the tunica albuginea with a number of small non-absorbable sutures. After an average follow-up of 36 months, all patients have a functionally straight penis and retain normal erection.

Sexual dysfunction resulting from penile deformity is amenable to surgical correction. Thirty-five cases of penile deformity either 29 congenital or six secondary to Peyronie's disease were treated by simple plication of the tunica albuginea with non-absorbable sutures through a small skin incision made on the convex side of the curved penis. Postoperative complications such as impaired erection or loss of sensitivity of the glans were not reported. After an average follow-up of 36 months (range 12-60 months) all patients have straight erections and retain normal erectile function.

Journal of the American Geriatrics SocietyVolume 42, Issue 9 p. 1004-1005 The Use of a Prostatic Stent in High Risk Patients over 80 Years Old with Benign Prostatic Hyperplasia and Chronic Retention David Slutzker, David Slutzker Department of Urology, Meir General Hospital, Kfar Saba and Tel-Aviv University Sackler School of Medicine, Israel.Search for more papers by this authorSantiago Richter, Santiago Richter Department of Urology, Meir General Hospital, Kfar Saba and Tel-Aviv University Sackler School of Medicine, Israel.Search for more papers by this authorRuth Lang, Ruth Lang Infectious Diseases Unit, Meir General Hospital, Kfar Saba and Tel-Aviv University Sackler School of Medicine, Israel.Search for more papers by this authorIsrael Nissenkorn, Corresponding Author Israel Nissenkorn Department of Urology, Meir General Hospital, Kfar Saba and Tel-Aviv University Sackler School of Medicine, Israel.Department of Urology, Meir General Hospital, 44281 Kfar Saba, Israel.Search for more papers by this author David Slutzker, David Slutzker Department of Urology, Meir General Hospital, Kfar Saba and Tel-Aviv University Sackler School of Medicine, Israel.Search for more papers by this authorSantiago Richter, Santiago Richter Department of Urology, Meir General Hospital, Kfar Saba and Tel-Aviv University Sackler School of Medicine, Israel.Search for more papers by this authorRuth Lang, Ruth Lang Infectious Diseases Unit, Meir General Hospital, Kfar Saba and Tel-Aviv University Sackler School of Medicine, Israel.Search for more papers by this authorIsrael Nissenkorn, Corresponding Author Israel Nissenkorn Department of Urology, Meir General Hospital, Kfar Saba and Tel-Aviv University Sackler School of Medicine, Israel.Department of Urology, Meir General Hospital, 44281 Kfar Saba, Israel.Search for more papers by this author First published: September 1994 https://doi.org/10.1111/j.1532-5415.1994.tb06596.xCitations: 2Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onEmailFacebookTwitterLinkedInRedditWechat No abstract is available for this article. REFERENCES 1 Ekman P. BPH epidemiology and risk factors. Prostate 1989; 2(Suppl): 23–31. 2 Cools HJM, Van Der Meer JWM. Restriction of long-term indwelling urethral catheterisation in the elderly. Br J Urol 1986; 58: 683–8. 3 Muncie HL, Warren JW. Reasons for replacement of long-term urethral catheters: Implications for randomized trials. J Urol 1990; 143: 507–9. 4 Liedberg H. Catheter induced urethral inflammatory reaction and urinary tract infection. An experimental and clinical study. Scand J Urol Nephrol 1989; Suppl No 124, pp 5–43. 5 Nissenkorn I. Experience with a new self-retaining intraurethral catheter in patients with urinary retention: A preliminary report. J Urol 1989; 142: 92–4. 6 Nissenkorn I, Richter S. A new self-retaining intraurethral device. Br J Urol 1990; 65: 197–200. 7 Nissenkorn I, Richter S, Slutzker D. A simple, self-retaining intraurethral catheter for treatment of prostatic obstruction. Eur Urol 1990; 18: 286–9. 8 Carson CC. Nosocomial urinary tract infection. Surg Clin North Am 1988; 68: 5. 9 Meares EM. Current patterns in nosocomial UTIs. Infect Urol 1988; 1: 15–17. 10 Resnick MI. Prevention catheter-associated UTIs. Infect Urol 1988; 1: 18–20. 11 Nordling JR. Urinary retention treated with an intraurethral spiral (Prostakath). Abstract 290, 8th Congr Eur Assoc Urol, London, 1988. 12 Fabian KM. Der intraprostatische “partielle Katheter” (urologische Spirale) II. Urologe A 1984; 23: 229. Citing Literature Volume42, Issue9September 1994Pages 1004-1005 ReferencesRelatedInformation

From February 1990 through May 1991, 37 patients with benign prostatic hyperplasia were treated by transurethral hyperthermia according to two different protocols. In group 1, 10 patients with an indwelling catheter underwent six one-hour sessions twice a week for three weeks, at a temperature of 43°C. The 27 patients from group 11(11 with indwelling catheter) had two sessions of two hours each for one week, at a temperature of 44.5°C. Prostatic volume, Madsen symptom score, two estimates of peak flow, average flow, and residual urine measurements were recorded before treatment and one week, one month, six months, and one year after completing the sessions. Hyperthermia was applied through a metal ring, which was used both for heating and temperature control, mounted on a 16-F Foley-Tieman-like catheter. The follow-up period was five to fifteen months. From those who had an indwelling catheter, 5 of 10 patients (50%)from group I and 8 of 11 patients (72.7%)from group II regained spontaneous micturition and continued to void satisfactorily throughout the follow-up period. Nine of 16 patients without catheter (56.3%), showed objective and subjective improvement. Transurethral hyperthermia is a new, simple, noninvasive, and well-tolerated method for the treatment of benign prostatic hyperplasia.

We studied 143 men who underwent transrectal prostatic biopsies using the double-glove technique. No patient received any antimicrobial therapy before the procedure. Clean catch urine cultures were obtained at admission and two, four, and twenty-four hours, and two weeks after biopsy. Aerobic and anaerobic blood cultures were performed at admission, and at thirty minutes and four hours after the procedure. In addition, clinical parameters were monitored closely in the hospital for twenty-four hours after the biopsy. A total of 132 patients were considered evaluable. Temperatures of 37.6 degrees C or higher occurred in 3.8 percent of the patients. In no case was rigors recorded. In 4 of the patients studied (3%) post-biopsy urine cultures were infected with Escherichia coli. All post-biopsy blood cultures, both aerobic and anaerobic, were negative. Our data indicate that with the use of the double-glove technique, prophylactic administration of antibiotics is not necessary to prevent the infectious complications following transrectal biopsy of the prostate.