No abstract available.

No abstract available.

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*

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

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

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

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

PURPOSE: We studied the crystallographic component of the prostatic calculi according to the location on the transrectal prostatic ultrasonography to know the mechanism of the formation of the calculus. MATERIALS AND METHODS: From August, 1995 until May, 1997, 33 prostatic calculi from 24 patients(mean age 59 years, mean size 3.1mm) operated on for prostatism were analyzed by polarization microscopy(ZeissR), X-ray diffraction(PW-1720R, Philips) and infrared spectrophotometer(FTIR-205R, Nicolet). Location of calculi was divided two groups under guide of transrectal prostatic ultrasonography; periurethral and periadenoma type. The periurethral type showed hyperechoic density around the prostatic urethra and the periadenoma type showed hyperechoic density between adenoma and false prostatic capsule(peripheral zone). RESULTS: 22 calculi were the periurethral type and 11 were periadenoma type. Thirty stones from 20 periurethral type and 10 periadenoma type consisted two or three of the following calcium phospate, calcium oxalate and tricalcium phospate. These are mixed by the endogenous origin formed from the prostatic fluid and the exogenous origin formed at least in part from urine. Three stones (2 calcium oxalate, 1 uric acid) contained only one compound which participitate from urine. All of 11 calculi of the pericapsular type had an oxalate component. CONCLUSIONS: The calculi around the periadenoma region may be formed from not only endogenous component(calcium apatite stone) but also exogenous component(calcium oxalate) or intraductal precipitation of oxalate component which has never found in the prostatic fluid. These results may suggest the necessity of reevaluation about oxalate component within the prostatic fluid.
Adenoma ; Calcium ; Calcium Oxalate ; Calculi* ; Prostatism ; Ultrasonography* ; Urethra

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*