OBJECTIVETo investigate the effect of transurethral resection of the prostate (TURP) in the treatment of urinary retention following seed implantation for prostate cancer.

METHODSWe treated 2 cases of urinary retention following seed implantation for prostate cancer by TURP, and analyzed their clinical data.

RESULTSThe operations were successful in both of the cases, with mean operation time of 60 min. Postoperative nocturnal urination of the patients averaged 2 times per night as compared with 5 - 6 times per night preoperatively, and their scores on IPSS and quality of life were significantly improved after surgery.

CONCLUSIONTURP affords satisfactory results in the treatment of urinary retention following seed implantation for prostate cancer patients.

Aged ; Humans ; Male ; Postoperative Period ; Prostatic Neoplasms ; surgery ; Transurethral Resection of Prostate ; methods ; Urinary Retention ; surgery

Foreign Bodies ; diagnostic imaging ; surgery ; urine ; Humans ; Iatrogenic Disease ; Male ; Middle Aged ; Radiography ; Urinary Bladder ; diagnostic imaging ; surgery ; Urinary Retention ; diagnostic imaging ; etiology ; surgery ; urine

OBJECTIVE: To investigate the efficacy and safety of the bladder training in male patients before urinary catheter removal after mid-low rectal cancer surgery. METHODS: This was a prospective, open, randomized controlled study. INCLUSION CRITERIA: male patients; pathologically diagnosed as mid-low rectal adenocarcinoma; distance from tumor lower edge to anal margin ≤10 cm; standard radical surgery for rectal cancer, including intestinal resection and regional lymph node dissection. EXCLUSION CRITERIA: previous history of benign prostatic hyperplasia or history of prostate surgery; bladder dysfunction such as dysuria and urinary retention before surgery; local resection of rectal tumor or extended resection. According to the above criteria, 92 patients who underwent colorectal surgery at the Union Hospital of Fujian Medical University from June to December 2016 were prospectively included. The patients were randomly divided into bladder training group (n=43) and bladder non-training group (n=49) according to the random number table method. The study was approved by the Ethics Committee of the Union Hospital of Fujian Medical University (ethical approval number: 2016KY005) and registered with the China Clinical Trial Registration Center (ChiCTR) (registration No.ChiCTR-IOR-16007995). The implementation of patient's treatment measures, the data collection and analysis were based on the three-blind principle, using envelopes for distribution concealment. In the bladder training group, bladder training was routinely performed from the first day after operation to catheter removal, and in bladder non-training group the catheter was kept open till its removal. The catheter was removed in the early morning at the 5th day after surgery, and the spontaneous urine output was recorded and the residual urine volume of the bladder was measured after the first urination. The international prostate symptom score (IPSS) was applied to evaluate the patient's urinary function before and after surgery. RESULTS: The age of whole group was (58.6±10.9) years old, the body mass index was (22.4±2.7) kg/m , and the distance from tumor lower edge to anal margin was (6.5±1.9) cm. The baseline data, such as age, body mass index, distance from tumor lower edge to anal margin, preoperative IPSS score, preoperative bladder residual urine volume, neoadjuvant radiotherapy and chemotherapy, preventive ileostomy and surgical procedure were not significantly different between two groups (all P>0.05). There was no significant difference in IPSS scores evaluated at the second day (3.6±4.0 vs. 3.5±3.4, t=0.128, P=0.899) and one month (3.7±2.9 vs. 3.0±3.1, t=1.113, P=0.269) after catheter removal between the bladder training group and bladder non-training group. No significant difference in the postoperative residual urine volume of bladder (media 44 ml vs. 24 ml, Z=-1.466, P=0.143), the first spontaneous urination volume (median 200 ml vs. 150 ml, Z=-1.228, P=0.219) after catheter removal, and postoperative hospital stay [(8.2±4.5) days vs. (9.1±5.5) days, t=-0.805, P=0.423] was found. Urinary infection rate was 20.9%(9/43) in the training group, which was even higher than 8.2%(4/49) in the non-training group, but the difference was not significant(χ²=3.077, P=0.079). No patient needed re-catheterization in either group. CONCLUSIONS The routine bladder training after mid-low rectal cancer surgery does not improve the urinary function, and can not reduce the residual urine volume of bladder after catheter removal. This routine clinical practice is not helpful for the bladder function recovery after rectal cancer surgery.
Aged ; China ; Humans ; Laparoscopy ; Male ; Middle Aged ; Prospective Studies ; Recovery of Function ; Rectal Neoplasms ; surgery ; therapy ; Treatment Outcome ; Urinary Bladder ; surgery ; Urinary Retention ; therapy

Adult ; Aged ; Electroacupuncture ; methods ; Female ; Humans ; Male ; Middle Aged ; Postoperative Complications ; therapy ; Rectal Neoplasms ; surgery ; Treatment Outcome ; Urinary Retention ; therapy

PURPOSE: The aim of this study is to assess the safety and the efficacy of laparoscopic colorectal surgery compared to those of conventional open surgery and to determine the feasibility of laparoscopic colorectal surgery based on oncologic principles. METHODS: From March 2001 to January 2002, 27 consecutive patients were assessed for the possible use of laparoscopic surgery. Thirty patients were included in the open group. Forty-seven patients were included in the laparoscopic group. The decision regarding the suitability of a patient for the procedure was made by the surgeon. RESULTS: Laparoscopic surgery was attempted on 47 patients, and in 31 patients, it was completed successfully. Patients who underwent laparoscopic surgery required a smaller dose of analgesics and had an earlier bowel passage recovery and shorter hospital stay than patients who underwent open surgery. The mean operation times for the open group, the conversion group, and the laparoscopic group were 252 min, 269 min, and 272 min respectively (P>0.05). There was no difference in the number of lymph nodes dissected nor the length of the distal margin of the resected bowel in the case of anterior resection and low anterior resection of the laparoscopic group compared to the open and the conversion groups (P>0.05). Complications in the laparoscopic surgery group were anastomosis site leakage and bowel obstruction. In the open group, wound infection, urinary retention, anastomosis site leakage and bowel obstruction were found. The morbidities of the open group, the conversion group, and the laparoscopic group were 23.3%, 37.5%, and 12.9%, respectively. One mortality was observed in the conversion group. CONCLUSIONS: In this study, there is no evidence that the laparoscopic technique is inadequate for following the cancer surgery principle, So laparoscopic colorectal surgery is a safe and feasible treatment. The overall morbidity and mortality in this study were acceptable. Sufficient lymph node dissection and distal margin of the resected bowel were accomplished with laparoscopic surgery. Further long-term follow up, however, will be necessary to confirm the value of this technique.
Analgesics ; Colorectal Neoplasms ; Colorectal Surgery* ; Humans ; Laparoscopy ; Length of Stay ; Lymph Node Excision ; Lymph Nodes ; Mortality ; Urinary Retention ; Wound Infection

OBJECTIVETo compare the therapeutic effects among moxibustion, local hot compress and infrared irradiation on urinary retention after hemorrhoid and fistula operation so as to provide the clinical evidences for the promotion and application of moxibustion.

METHODSThe randomized controlled trial method was adopted to divide 60 cases of post-operative urinary retention into moxibustion group, hot compress group and infrared irradiation group, 20 cases in each group. In moxibustion group, suspending moxibustion was applied on Qihai (CV 6) and Zhongji (CV 3). In hot compress group, hot compress was applied on the bladder region above the symphysis pubis of the lower abdomen. In infrared irradiation group, MF-C701 multi-source infrared apparatus was used on the bladder region above the symphysis pubis of the lower abdomen. One intervention therapy was administered for the cases of post-operative urinary retention. The efficacy was assessed based on the numbers of urethral catheterization indwelled in 24 h after treatment.

RESULTSThere were 2 cases (10.0%) with urethral catheterization in moxibustion group, 10 cases (50.0%) in hot compress group and 9 cases (45.0%) in infrared irradiation group. The urethral catheterization rate in moxibustion group was lower than that of the other two treatment programs (both P < 0.05).

CONCLUSIONMoxibustion can reduce much effectively the rate of urethral catheterization indwelled for urinary retention after hemorrhoid and fistula operation as compared with local hot compress therapy and infrared irradiation on the lower abdomen.

Adult ; Female ; Hemorrhoids ; surgery ; Humans ; Male ; Middle Aged ; Moxibustion ; Postoperative Complications ; therapy ; Urinary Bladder Fistula ; etiology ; therapy ; Urinary Retention ; etiology ; therapy ; Young Adult

PURPOSE: Bladder drainage allows monitoring of urine output, intraoperative decompression of the bladder, and prevention of postoperative urinary retention. Commonly, bladder drainage is by transurethral cathterization, which is associated with a high incidence of bacteriuria, pain, discomfort, urethritis, abscess, and stricture. Suprapubic bladder drainage has been frequently reported to be superior to urethral drainage because of less urinary infections, less pain and discomfort, no urethritis, and easier care. We have prospectively compared the outcomes following suprapubic catheterization (SPC) with those following transurethral catheterization (TUC) in patients undergoing colorectal surgery. METHODS: A prospective randomized trial of SPC versus TUC was undertaken in 40 patients (M:F=26:14) undergoing colorectal surgery from April 2003 to December 2003. Twenty patients were catheterized through the urethra using a 16F Foley catheter. In the other twenty patients, an identical catheter was placed in the bladder through the suprapubic abdominal wall. Significant bacteriuria was defined as > or =10(5) organisms/ml. The pain and discomfort of patients were obtained by using a questionnaire. RESULTS: There were no difference in the incidence of complications between the SPC and the TUC. The number of patients with pain and discomfort was significantly greater and more severer for TUC, especially in males. According to operation type, abdominoperineal resection had the longest duration of catheterization. CONCLUSIONS: This study suggests that the use of SPC rather than TUC significantly reduces pain and discomfort of patients undergoing colorectal surgery.
Abdominal Wall ; Abscess ; Bacteriuria ; Catheterization* ; Catheters* ; Colorectal Surgery* ; Constriction, Pathologic ; Decompression ; Drainage ; Humans ; Incidence ; Male ; Prospective Studies* ; Surveys and Questionnaires ; Urethra ; Urethritis ; Urinary Bladder ; Urinary Retention

PURPOSE: To compare perioperative outcomes between running and interrupted vesicourethral anastomosis in open radical prostatectomy (RP). MATERIALS AND METHODS: The medical records of 112 patients who underwent open RP for prostate cancer at our institution from 2006 to 2008 by a single surgeon were retrospectively reviewed. Preoperative, intraoperative, and postoperative parameters were measured. RESULTS: Of 112 consecutive patients, 62 patients underwent vesicourethral anastomosis by use of the running technique, whereas 50 patients underwent anastomosis with the interrupted technique. The groups did not differ significantly in age, body mass index, prostate-specific antigen, prostate volume, or pathologic findings. The intraoperative extravasation rate was significantly lower in the running group (8.1% vs. 24.0%, p=0.01). The mean anastomosis time was 15.1+/-5.3 and 19.3+/-4.6 minutes in the running and interrupted groups, respectively (p=0.04). The rates of postoperative extravasation were similar for both groups (6.4% vs. 10.0%, p=0.12). The duration of catheterization was significantly shorter in the running group (9.0+/-3.0 days vs. 12.9+/-6.4 days, p<0.01). The rate of urinary retention after catheter removal and the rate of bladder neck contracture were not significantly different between the two groups. The rate of urinary continence at 3, 6, 9, and 12 months after RP was also similar in both groups. CONCLUSIONS: Both anastomosis techniques provided similar functional results and a similar rate of postoperative urine extravasation. However, running vesicourethral anastomosis decreased the rate of intraoperative extravasation and time for anastomosis, without increasing the risk of urinary retention or bladder neck contracture.
Aged ; Anastomosis, Surgical/methods ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Neoplasm Staging ; Prostatectomy/adverse effects/*methods ; Prostatic Neoplasms/pathology/*surgery ; Retrospective Studies ; Suture Techniques ; Treatment Outcome ; Urethra/*surgery ; Urinary Bladder/*surgery ; Urinary Incontinence/etiology/prevention & control ; Urinary Retention/etiology

It is largely unknown whether lower urinary tract symptoms (LUTS) or acute retention of urine (AROU) is linked to shorter life expectancy in men. We conducted a multicenter, retrospective database analysis of patients undergoing transurethral resection of prostate (TURP) to study their relationships. Multivariate Cox regression analysis and Kaplan-Meier analysis with stratification to age and indication of TURP were performed. We further performed an age- and sex-matched survival analysis with the general population using data from the Census and Statistics Department of the Hong Kong Special Administrative Region (Hong Kong, China). From January 2002 to December 2012, 3496 patients undergoing TURP were included in our study, with 1764 patients in the LUTS group and 1732 patients in the AROU group. Old age, ischemic heart disease, cerebrovascular accident, and AROU were risk factors of mortality. Patients aged <70 years (adjusted hazard ratio [HR]: 1.52, 95% confidence interval [CI]: 1.11-2.09, P = 0.010) and 70-80 years (adjusted HR: 1.39, 95% CI: 1.15-1.70, P = 0.001) in the AROU group had worse survival than those in the LUTS group, but such difference was not demonstrated in patients aged >80 years. Compared to the general population, younger patients in the LUTS group appeared to have better survival (<70 years, P = 0.091; 70-80 years, P = 0.011), but younger patients in the AROU group had worse survival (<70 years, P = 0.021; 70-80 years, P = 0.003). For patients aged >80 years, survival was similar with the general population in both the LUTS and AROU groups. In conclusion, AROU at young age was associated with mortality, while early detection and management of LUTS may improve survival.
Age Factors ; Aged ; Aged, 80 and over ; Databases, Factual ; Humans ; Kaplan-Meier Estimate ; Lower Urinary Tract Symptoms ; Male ; Middle Aged ; Prostate/surgery* ; Prostatic Hyperplasia/surgery* ; Retrospective Studies ; Risk Factors ; Survival Analysis ; Transurethral Resection of Prostate/methods* ; Urinary Retention/surgery*

PURPOSE: The definition of posttransobturator tape procedure (post-TOT) voiding dysfunction (VD) is inconsistent in the literature. In this study, we retrospectively investigated the risk factors for post-TOT VD by applying various definitions in one cohort. MATERIALS AND METHODS: The medical records of 449 patients were evaluated postoperatively. Acute urinary retention requiring catheterization, subjective feeling of voiding difficulty during follow-up, and postoperative postvoid residual (PVR) greater than 100 mL or PVR greater than 50% of voided volume (significant PVR) were adopted for the definition of VD. With these categories, multivariate analysis was performed for risk factors of postoperative VD. RESULTS: Ten patients (2.2%) required catheterization, 47 (10.5%) experienced postoperative voiding difficulty, and 63 (14.7%) showed significant PVR. In the multivariate logistic analysis, independent risk factors for postoperative retention requiring catheterization were previous retention history (p=0.06) and preoperative history of hysterectomy. Risk factors for subjective postoperative voiding difficulty were underactive detrusor (p=0.04) and preoperative obstructive voiding symptoms (p<0.01). Previous urinary retention history (p<0.01)) was an independent risk factor for concomitant postoperative voiding difficulty and significant PVR. Spinal anesthesia (p=0.02) and previous urinary retention history (p=0.02) were independent risk factors for significant postoperative PVR. CONCLUSIONS: With the use of several definitions of VD after the midurethral sling procedure, postoperative peak flow rate and PVR were significantly different between groups. Although there were no independent risk factors consistent with various definitions of VD, preoperative obstructive voiding symptoms and objective parameters suggesting impaired detrusor tend to have predictive power for post-TOT VD.
Adult ; Aged ; Aged, 80 and over ; Female ; Humans ; Hysterectomy/adverse effects ; Middle Aged ; Retrospective Studies ; Risk Factors ; Suburethral Slings/*adverse effects ; Urinary Catheterization ; Urinary Incontinence, Stress/physiopathology/*surgery ; Urinary Retention/diagnosis/*etiology/physiopathology ; Urodynamics