Urodynamic evaluation of surgical and endoscopic treatment of benign prostatic hyperlasia

Eighty eight patients suffering from outlet obstruction due to BPH were included in this study and divided into four groups: I open prostatectomy [TVP], II transurethral resection [TURP], III electrovaporization [TUEVP] and IV electrovaporesection [TUEVR]. All groups were age matched and had insignificant difference in means of prostatic size determined by TRUS. Patients with preoperative indwelling catheters were analyzed separately. Significant improvements were achieved in all groups in postoperative follow up of AUA symptom score in comparison with the baseline data. AUA score was significantly higher in TUEVP than in other groups during the first and third month visit. Detrusor instability was considerably reduced from 44.4%, 45.4%, 3.7% and 41.7% to 12.5%, 15.8%, 26.6% and 13.3% after relief of outflow obstruction in the four groups. However, this reduction was not statistically significant. Also, the degree of reduction in TUEVP was less than in the other groups. Other urodynamic parameters as low compliance, maximum flow rate, opening detrusor, detrusor pressure at maximum flow and volume of residual urine have significantly been improved after treatment without significant difference in the degree of improvement between the four groups

t-shaped tube as a stent/ureterostomy is a useful adjutant among the urologic armamentarium

This study aimed to assess the clinical use of T-tube as a stent/ureterostomy. In 36 cases subjected to open surgical procedures on the kidney and/or ureter, T-shaped tube ureterostomy was done using 37 tubes. The tube should be modulated before placement to enhance its drainage and facilitate its later removal. The tube should not traverse the ureterovesical junction. Transtubal ureterogram was done before tube removal. The T-tube was used for ureteric drainage in the presence of obstruction distal to the site of intervention [thirteen cases], potentially obstructing stones proximal to that site [four cases] or intraoperative stone migration [seven cases]. In occasional need for open nephrostomy for obstructive anuria, T-tube upper ureterostomy was easy and safe. The tube was used as a ureteric stent [eight cases] and to stent the injured pelviureteric junction [two cases]