No abstract available.
Catheters* ; 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.

No abstract available.

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

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

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

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

We managed 118 patients with benign prostatic hyperplasia by transurethral resection during January 1994 and December 1995 in Eul Ji Medical Center and all patients were operated upon by 2 staff doctors. Among 118 cases, 7 cases with intraoperative complications such as bladder injury or severe prostatic capsule injury and 8 cases with combined neuropathic bladder or chronic urinary retention and 2 cases with urethral stricture were excluded. The average age of 101 cases were 66.4 years old (50-92), and average weight of resected adenoma was 10.0 gm (2-32). We categorized these patients randomly into 2 groups. In group I (n=48), we removed the urethral catheter within 2 days after TURP and in group II (n=53), we removed it after 3 days (mean 4.2 days) following surgery. The average hospital stay postoperatively was4.1 days in group I and 7.4 days in group II. Recatheterization rate was 8.3% (4/48) in group I and 5.6% (3/53) in group II (p>0.05). There was no statistical difference in other complication including failure to void, intraoperative bleeding, urethral stricture, incontinence and TUR syndrome. This study supports early catheter removal after TURP would become an accepted and routine postsurgical practice following uncomplicated TURP.
Adenoma ; Catheters* ; Hemorrhage ; Humans ; Intraoperative Complications ; Length of Stay ; Prospective Studies* ; Prostatic Hyperplasia ; Transurethral Resection of Prostate* ; Urethral Stricture ; Urinary Bladder ; Urinary Bladder, Neurogenic ; Urinary Catheters ; Urinary Retention

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