Erectile and ejaculatory failure after transurethral prostatectomy.

OBJECTIVES: To evaluate the clinical incidence of sexual dysfunction after transurethral resection of the prostate (TURP) and to identify risk factors. SETTING: Havering Hospitals NHS Trust, Essex, UK. PATIENTS AND METHODS: 253 patients who underwent TURP were assessed using a standard proforma regarding pre- and post-operative erectile and ejaculatory functions. The patients who developed post-operative erectile failure were compared with the unaffected group. RESULTS: 126 patients completed the study; 22 were pre-operatively impotent and remained so post-operatively. Of 104 patients who were sexually active 18 developed post-operative erectile impairment. Five patients (4.8%) had total erectile failure. Only 7% of patients retained ejaculation after the operation. Significant risk factors in the patients with post-operative erectile failure, were presentation with acute retention and development of profuse primary hemorrhage. CONCLUSION: The study reaffirmed that there is a low but significant clinical incidence (4.8%) of erectile failure after TURP which is associated with certain risk factors. Ejaculatory failure was higher in incidence but carried a lower clinical significance.

The value of percutaneous nephrostomy; Sri Lankan experience.

OBJECTIVE: To identify the most useful indications for image-guided percutaneous nephrostomy (PCN). DESIGN: Retrospective analysis of immediate outcome of the procedure in 46 patients. SETTING: Department of Radiology, The National Hospital of Sri Lanka, Colombo. PATIENTS: 46 patients on whom 59 PCNs done between June 1995 and August 1996. RESULTS: 57 PCNs were successful and 2 failed. Clinical improvement was observed in all patients with acute obstructive renal failure, pyorenephrosis and fistulae. Benefits were minimal in patients with chronic obstruction and none with terminal malignancy.