No abstract available.

No abstract available.

No abstract available.
Aged, 80 and over* ; Humans ; Transurethral Resection of Prostate*

To evaluate the results of transurethral resection of prostate (TURP) by a novice resectionist, a clinical study was made on the 106 patients who have undergone TURP for three years. The incidence of TURP commanded 20% of total major procedures, the patients in their seventies were the most common age group, and the most frequent indication was urinary retention (51% ). The average weight of resected tissue was 15.1+/-11.9gm, and the resection time. 73.5+/-34.3 minutes. The morbidity rate of immediate complications was 14.2% and that of postoperative complications, 26.4%. To make a comparison. I divided all 106 cases into 3 groups according to their operation date. Between group I (No. 1-No. 35) and group II (No. 36-No. 70), significant statistical differences were noted in the average weight of resected tissue per minute and in the amount of transfused packed RBC. Between group II and group II (No. 7l-No. 106), there was a significant decrease in the incidence of immediate complications. This study leads to the fact that TURP, one of the most common urologic operations. can be executed adequately by a novice resectionist after 70 procedures approximately. In order to reduce complications and the time required for novice resectionists to be experts, we need various efforts including improvement of educational equipments and TUR instruments.
Humans ; Incidence ; Postoperative Complications ; Prostatectomy ; Prostatic Hyperplasia ; Transurethral Resection of Prostate* ; Urinary Retention

No abstract available.
Catheters* ; Transurethral Resection of Prostate*

We describe our experience with visual primary urethral realignment, a new approach devised by authors, in the management of 5 male patients with proximal urethral injuries (3 bulbomembranous and 2 bulbous), utilizing a simple procedure with a flexible cystoscope through the tract made by a suprapubic cystostomy using a Campbell trocar set. No significant complication was experienced except for urethral strictures in 3 patients, easily corrected by visual internal urethrotomy. The new technique offers an alternative, much simpler with several advantages over the conventional methods : could be performed under a local anesthesia for the patients without accompanying damage to the intraperitoneal organs, enables the surgeon to visualize the damaged portion of the urethra for more accurate assessment of the damage, and does not require an open laparatomy, thus, offering an economical and a less invasive alternative approach with shorter hospitalization days and reduced pain for the patient.
Anesthesia, Local ; Cystoscopes ; Cystostomy ; Hospitalization ; Humans ; Male ; Surgical Instruments ; Urethra ; Urethral Stricture

Benign prostatic hyperplasia (BPH) is a prevalent disease, especially in old men, and often results in lower urinary tract symptoms (LUTS). This chronic disease has important care implications and financial risks to the health care system. LUTS are caused not only by mechanical prostatic obstruction but also by the dynamic component of obstruction. The exact etiology of BPH and its consequences, benign prostatic enlargement and benign prostatic obstruction, are not identified. Various theories concerning the causes of benign prostate enlargement and LUTS, such as metabolic syndrome, inflammation, growth factors, androgen receptor, epithelial-stromal interaction, and lifestyle, are discussed. Incomplete overlap of prostatic enlargement with symptoms and obstruction encourages focus on symptoms rather than prostate enlargement and the shifting from surgery to medicine as the treatment of BPH. Several alpha antagonists, including alfuzosin, doxazosin, tamsulosin, and terazosin, have shown excellent efficacy without severe adverse effects. In addition, new alpha antagonists, silodosin and naftopidil, and phosphodiesterase 5 inhibitors are emerging as BPH treatments. In surgical treatment, laser surgery such as photoselective vaporization of the prostate and holmium laser prostatectomy have been introduced to reduce complications and are used as alternatives to transurethral resection of the prostate (TURP) and open prostatectomy. The status of TURP as the gold standard treatment of BPH is still evolving. We review several preclinical and clinical studies about the etiology of BPH and treatment options.
Chronic Disease ; Delivery of Health Care ; Doxazosin ; Humans ; Indoles ; Inflammation ; Intercellular Signaling Peptides and Proteins ; Laser Therapy ; Lasers, Solid-State ; Life Style ; Lower Urinary Tract Symptoms ; Male ; Naphthalenes ; Phosphodiesterase 5 Inhibitors ; Piperazines ; Prazosin ; Prostate ; Prostatectomy ; Prostatic Hyperplasia ; Quinazolines ; Receptors, Androgen ; Sulfonamides ; Transurethral Resection of Prostate ; Volatilization

PURPOSE: The best predictors of prognosis in prostate cancer are the stage of disease and histologic differentiation. But, preoperative prediction of pathologic stage in prostate cancer is currently limited and histologic differentiation may be somewhat subjective. Therefore, more accurate predictors of biological progression are needed. The author designed this study to determine the prediction efficacies of neovascularity and proliferating cell nuclear antigen (PCNA) labeling index using immunohistochemical staining. MATERIALS AND METHODS: Immunohistochemical stains in 48 cases of prostate cancers and 5 cases of benign prostatic hyperplasia (BPH) were performed and analysed. Microvessels were identified by immunostaining of endothelial cells for factor VIII-related antigen. PCNA labeling indices were obtained in 200X field by counting more than 1,000 cells. RESULTS: 1. The mean microvessel count (MVC) was 34.2+/-5.9 per 200X field in BPH group and 63.5+/-38.6 (p<0.05) in prostate cancer group. The mean MVCs were 32.2, 38.3, 58.8, 78.1 and 86.8, from grade I to V respectively. According to stage, the mean MVCs were 40.8, 48.5, 55.0 and 89.0 from A to D. Between well (grade I-III) and poorly (grade IV-V) differentiated cancer group, there was significant difference in MVC (p<0.05). And also, the difference between localized and metastatic groups was statistically significant. High MVC (MVC->60) group survived longer than low MVC group, but the difference was not significant. 2. The mean PCNA labeling indices were 14.6+/-8.0% in BPH group and 32.3 +/- 15.4% in cancer group. According to Gleason grade, the mean PCNA labeling indices showed 33,4%, 30.8%, 26.3%, 38.0% and 36.6% from I to V respectively. The mean values were 23.1%, 27.4%, 30.4% and 36.2% in stage A, B, C and D. Between localized and metastatic groups, the difference of PCNA labeling index was not statistically significant. The mean survival of high labeling index (>=30%) group was 66.0 +/- 12.2 months contrasted with 72.4 +/- 14.6 months of low labeling index group (p>0.05). CONCLUSIONS: Microvessel density in prostate adenocarcinoma may be an another prognostic factor supporting clinical stage and histologic differentiation. But negative results were obtained for PCNA labeling index from this study. To further define MVC as a predictor of prostate cancer, more enthusiastic and well designed studies are needed.
Adenocarcinoma ; Coloring Agents ; Endothelial Cells ; Microvessels ; Neoplasm Metastasis* ; Prognosis* ; Proliferating Cell Nuclear Antigen* ; Prostate* ; Prostatic Hyperplasia ; Prostatic Neoplasms ; von Willebrand Factor

After the analysis of 40 pediatric patients who underwent exploratory surgery under the diagnostic impression of testicular torsion for the period of 8 years from January 1981 to December 1988 in terms of age distribution, clinical features, diagnostic methods, therapeutic options, outcome and follow up, the results can be summarized as follows : 1. The most common causes of the disorder were testicular torsion (50% ), and torsion of append ages (33%). The remaining 17% of the cases were acute epididymitis (13%), orchids (2%), and hydrocele (2%). The prevalent ages for testicular torsion was over 11 years old (80%). On the other hand, torsion of appendages mainly affected children below 11 years old. 2. The observation of the presence or absence of the cremasteric reflex helped to differentiate the diagnosis of acute scrotum. Testicular scanning in 2 cases with vague symptoms provided to determine testicular torsion. With the endoscopic evaluation of the inside of tunica vaginalis, which was the first trial in these cases, we diagnosed 2 cases of testicular torsion. 3. Among the 20 patients with testicular torsion, 7 required orchiectomy because of obvious necrosis. There were 13 testes considered to be salvageable and they were fixed successfully. The early salvage rate of surgery in testicular torsion was 100% (9/9) for the patients operated less than 24 hours after torsion, and 36% (4/11) for the patients over 24 hours. The overall immediate testicular salvage rate was 65% (13/20). 4. Semen analyses revealed normal for 2 patients who underwent orchiectomy for testicular torsion that had lasted over 48 hours. Testicular scans 2 weeks after fixation in 2 patients with testicular torsion that had lasted 12 and 16 hours, showed normal perfusion. In conclusion, immediate scrotal exploration followed by appropriate treatment would result to maximal testicular salvage, minor morbidity and rapid symptomatic improvement in patients with pediatric acute scrotum.
Age Distribution ; Child* ; Diagnosis ; Epididymitis ; Follow-Up Studies ; Hand ; Humans ; Male ; Necrosis ; Orchiectomy ; Perfusion ; Reflex ; Scrotum ; Semen Analysis ; Spermatic Cord Torsion ; Testis*

No abstract available.
Prostate* ; Urinary Bladder Neck Obstruction*