Prostakath represents a new idea. The spiral shaped spring inserted in the prostatic urethra keeps the enlarged prostatic lobes compressing the urethra so far apart that self voiding is possible. The physiologic function of the external sphincter is maintained due to the special form of the spiral. Prostakath was inserted in 13 patients with benign prostatic hypertrophy who had long-term indwelling bladder catheters and anesthetic contraindications to an operation. Of the 13 patients 1 did not reach 3 months of follow-up due to removal of Prostakath. The remaining 12 patients were followed with clinical evaluation. urine cultures, retrograde urethrography and urine flow rates at 1 day and 3 months. Final evaluation at 3 months showed normal voiding in 83% of the patients with an absence of significant residual urine in all. In 8 patients (67%) urinary flow rates varied between 10 and 20cc per second and in the remaining it was less than 10cc per second. In 92 % of the patients follow up urine cultures were negative. We believe that placement of Prostakath permits selected patients to be freed from long-term indwelling bladder catheters. This is a valid alternatives a prostatic operation in high risk patients with benign prostatic hypertrophy.
Catheters ; Follow-Up Studies ; Humans ; Prostatic Hyperplasia* ; Urethra ; Urinary Bladder

No abstract available.
Lithotripsy* ; Ureter*

Laser CHRP (coagulation and hemostatic resection of the prostate) is a new acceptable treatment modality for benign prostatic hyperplasia. A total of 14 patients with symptomatic bladder outlet obstruction due to benign prostatic hyperplasia was entered into a prospective trial of laser prostatectomy performed with the right- angle firing neodymium: YAG laser fiber and the contact tip firing neodymium: YAG laser fiber at 60 watts power setting. Mean estimated prostatic weight was 36.3gm. Six patients (43%) were in urinary retention requiring catheterization before treatment. Mean energy delivery was 34,442 joules (range 25,360 to 45,000) with a mean operative time of 41 minutes. Efficacy of treatment was assessed at 1, 6 and 12 months postoperatively by Madsen symptom scores, peak urinary flow rates and ultrasonic assessment of prostatic volume. At preoperative baseline the mean symptom score was 19.9, mean peak urinary flow rate 8.6cc per second, and mean ultrasonic assessment of prostatic volume 36.3gm. At 1 year postoperatively mean symptom score was 6.1, mean peak urinary flow rate was 18.3cc per second and mean ultrasonic assessment of prostatic volume was 26.4 gm. One patient required retreatment for residual tissue. There was one bladder neck contracture requiring incision.
Catheterization ; Catheters ; Contracture ; Fires ; Humans ; Lasers, Solid-State ; Neck ; Neodymium ; Operative Time ; Prospective Studies ; Prostatectomy ; Prostatic Hyperplasia* ; Retreatment ; Ultrasonics ; Urinary Bladder ; Urinary Bladder Neck Obstruction ; Urinary Retention

Rigid ureteroscopy is new one of established technique for the management of ureteral stones. Manipulation of calculi can be done under direct vision using flexible forceps or stone baskets with increased safety and efficacy. We have used a 5Fr. electrohydraulic lithotripsy to disintegrate stones that were two large to b removed by manipulation. Between May 1988 and October 1989. 140 ureteroscopies were performed for removal of ureteral stones. In 119 cases(85 %) the stone was removed successfully. Electrohydraulic lithotripsy was used successfully to remove the stone in 25 among 28 cases(89.3%). We conclude that ureteroscopic removal of ureteral stone under direct vision is a safe and effective method for treatment of ureteral stone.
Calculi ; Lithotripsy* ; Surgical Instruments ; Ureter* ; Ureteral Calculi* ; Ureteroscopy

Transeurethral Radiofrequency (TURF) Thermotherapy is a new acceptable treatment modality for benign prostatic hyperplasia. We treated 70 cases of BPH patients by TURF Thermotherapy (THERMEX-II). Among them, we got a follow-up observation on 37 patients (urinary retention: 16 cases, non-urinary retention:21 cases) each at 1 month and 3 months after treatment. Mean age of patients was 69.1 years and their mean prostatic weight was 40.5gr by transrectal prostatic ultrasonogram. All patients were treated single session for 2 hours without any sedation, and well tolerated with the temperature of 47-48degree. We evaluate patients with Boyarsky symptom score, urine flow rate, volume of residual urine and patient`s subjective symptoms before and after treat- The results were as follows ; 1. The mean Boyarsky symptom score was 15.4 before treatment, it became 9.9 at 1 month and 8.8 at 3 months after treatment. 2. In the retention patients : Mean maximal flow rate was 6.53ml/sec at 1 month. 8.47ml/sec at 3 months, and residual urine was 70ml at 1 month, 57ml at 3 months after treatment. 3. In the non-retention patients : Mean maximal flow rate increased from 4.74ml/sec to 10.29ml/ sec at 1 month. 10.76ml/sec at 3 months, and residual urine decreased from 60.7ml/ to 20ml at 1 month. 17.2ml at 3 months after treatment. 4. Complications were acute urinary retention (14.3% ) and gross hematuria (8.1%), but it was resolved by conservative treatment. There were no urinary tract infection, bladder spasm or other complications after treatment. We conclude TURF thermotherapy is one of the good and safe treatment in benign prostatic hyperplasia.
Follow-Up Studies ; Hematuria ; Humans ; Hyperthermia, Induced* ; Prostatic Hyperplasia* ; Spasm ; Ultrasonography ; Urinary Bladder ; Urinary Retention ; Urinary Tract Infections

PURPOSE: Extracorporeal shock wave lithotripsy(SWL) is currently prorposed for the first line treatment of most renal and ureteral stones. In general, SWL is very effective and non-invasive method than open surgery or endoscopic lithotripsy. We experienced 350 cases of SWL for 46 months and announced it. MATERIALS AND METHODS: We retrospectively reviewed the data of 324 patients(350 stones) who had been diagnosed as renal or ureteral stones and underwent SWL using Tripter Compact(R) lithotriptor from September 1994 to July 1998. Male to female ratio was 1.9:1 and patient`s ages ranged from 18 to 82 years(mean 43.7 years). We underwent SWL only with parenteral analgesics for pain control. RESULTS: In 350 stones, renal stones were 90 cases(25.7%) and ureteral stones were 260 cases(74.3%). In 90 renal stones, calyceal stones(include 1 staghorn stone) were 62 cases(68.9%) and renal pelvic stones were 28 cases(31.1%). In 260 ureteral stones, upper ureteral stones were 209 cases(80.4%), mid ureteral stones were 10 cases(3.8%), and lower ureteral stones were 41 cases(15.8%). The stones from 10 to 19mm in diameter were the majority of renal stones(53.3%), whereas in ureter, the stones smaller than 10mm in diameter were most common(41.5%). Less than 3 treatment sessions were needed for 147 cases(93.0%) of stones smaller than 10mm and for 146cases(76.0%) stones larger than 10mm. Less than 3 sessions were needed for 68 cases(75.6%) of renal stones and for 225 cases(86.5%) of ureteral stones. All renal stones were fragmented and the success rate for upper ureteral stones was 93.3%(195/209), for mid ureteral stones was 80.0%(8/10), and for lower ureteral stones was 80.5%(33/41). According to the size of stone, the success rate for the stones smaller than 10mm in diameter was 96.2%(152/158) and for the stones larger than 10mm was 90.6%(174/192). Total success rate was 93.1%(326/350). The complications after SWL were gross hematuria over 24hours(64 cases, 18.3%), flank pain(52 cases, 14.9%), gastrointestinal disturbances(7 cases, 2%), and Steinstrasse(31 cases, 8.9%). The causes of failure were incomplete fragmentation(21 cases, 87.5%) and mucosal impact(3 cases, 12.5%) of stones. Re-treatment rate was 59.7% and auxiliary procedure rate was 8.0%(efficiency quotient was 0.56). CONCLUSIONS: Our experiences shows extracorporeal shock wave lithotripsy is a safe and effective method for the treatment of renal and ureteral stones, and we expect the better outcome by development of techniques and equipments.
Analgesics ; Female ; Hematuria ; Humans ; Lithotripsy* ; Male ; Retrospective Studies ; Shock* ; Ureter ; Urinary Calculi

PURPOSE: This study examined the efficacy of ureteroscopic stone manipulation with comparing the success rates and complications rates. MATERIALS AND METHODS: The manipulation of calculi can be done under the direct vision of ureteroscope using dormia baskets with increasing safety and efficacy. The results of ureteroscopic removal of stones were reviewed in 636 cases. From January 1992 to October 1997, 636 patients underwent ureteroscopic removal of stones. RESULTS: There were 236 female and 400 male patients between 16 and 75 years old. The success rates of ureteroscopic removal of stones were related to location of the calculus: 95.8% in lower ureter, 87.7% in mid ureter and 90% in upper ureter(overall success rate was 95%). 35 cases(5.8%) of complication occurred in 604 cases of success: Severe ureteral mucosal injury in 25 patients, gross hematuria(>48hours) in 4 patients, ureteral mucosal prolapse in 3 patients, flank pain(>48hours) in 2 patients, ureteral perforation in 1 patient. CONCLUSIONS: Ureteroscopic removal of stones can be successful and safe treatment modality for lower urethral stones, especially with plentiful experience and good surgical skill.
Aged ; Calculi ; Female ; Humans ; Male ; Prolapse ; Ureter ; Ureteroscopes ; Ureteroscopy

Benign Prostatic Hyperplasia is one of the most important desease with a high frequency in urology. There is no doubt that the main stream of treatment is transurethral resection. of the prostate, however, marked improvement in drug therapy has been observed in recent years. Allylestrenol is a synthetic gestagen which was known to act directly on the prostate to exhibit its effect of reducing the size of the prostate by inhibiting the selective uptake of serum testosterone, inhibition of metabolism of testosterone to 5a-DHT (dihydrotestosterone) reductase, inhibition of 5a-DHT receptor binding. Our present study was carried out on 108 patients with benign prostatic hyperplasia to evaluate the efficacy and safety of antiandrogen therapy with allylestrenol. Allylestrenol was administered in a dose of 25 mg twice a day in the morning and evening after meal for 12 weeks to the patients and its efficacy was evaluated with peak urinary flow rate, Madsen Symptom Score at 4, 12 weeks after treatment and prostate volume at 12 weeks after treatment. Of these patients 46 completed the study and only 2 patients withdrew from the study owing to side effects. However,these side effects were not serious. At baseline (mean +SD) the mean peak urinary flow rate was 11.0+/-3.7 ml/sec, mean symptom score 10.2+4.0 and mean ultrasonic assessment of prostatic volume 36.8 +/-9.6 gm. At 4 weeks after treatment(mean + SD) mean peak urinary flow rate was 12+/-3.5 ml/sec, mean symptom score 7.7+/-4.2 (p > .0.05, p < 0.05). At 12 weeks after treatment (mean +SD) mean peak urinary flow rate was 12.8+4.7 ml/sec, mean symptom score 7.0+4.2 and mean ultrasonic assessment of prostatic volume 36.6+/-9.3 gm (p < 0.05, p < 0.05, p > 0.05).
Allylestrenol* ; Drug Therapy ; Humans ; Meals ; Metabolism ; Oxidoreductases ; Prostate ; Prostatic Hyperplasia* ; Rivers ; Testosterone ; Ultrasonics ; Urology

Transurethral balloon dilatation using specially designed catheters has been introduced in recent years. We applied endoscopically a high pressure, large diameter balloon dilator to 19 patients with benign prostatic hypertrophy who had high risk to an anesthesia. The patients were followed with clinical evaluation and urine flow rate. Clinical evaluation at 1 month showed normal voiding in 14 (74%) of 19 patients without symptom and signs. In 14 patients (74%) urinary peak flow rates varied between 10 and 20cc per second, and in the remaining they were less than l0cc per second. Gross hematuria occurred in 5 patients (26% ), but it was improved within 48 hours. The numbers of patients with 3 months, 6 months and 9 months follow-up were not so many, but their results were similar to those of 1 month follow-up. We believe that balloon dilatation of the prostate is a safe and simple technique for the patient of benign prostatic hypertrophy who is not allowed prostatectomy.
Anesthesia ; Catheters ; Dilatation* ; Follow-Up Studies ; Hematuria ; Humans ; Prostate* ; Prostatectomy ; Prostatic Hyperplasia

Transurethral balloon dilatation using specially designed catheters has been introduced in recent years. We applied endoscopically a high pressure, large diameter balloon dilator to 19 patients with benign prostatic hypertrophy who had high risk to an anesthesia. The patients were followed with clinical evaluation and urine flow rate. Clinical evaluation at 1 month showed normal voiding in 14 (74%) of 19 patients without symptom and signs. In 14 patients (74%) urinary peak flow rates varied between 10 and 20cc per second, and in the remaining they were less than l0cc per second. Gross hematuria occurred in 5 patients (26% ), but it was improved within 48 hours. The numbers of patients with 3 months, 6 months and 9 months follow-up were not so many, but their results were similar to those of 1 month follow-up. We believe that balloon dilatation of the prostate is a safe and simple technique for the patient of benign prostatic hypertrophy who is not allowed prostatectomy.
Anesthesia ; Catheters ; Dilatation* ; Follow-Up Studies ; Hematuria ; Humans ; Prostate* ; Prostatectomy ; Prostatic Hyperplasia