Management of men with a first episode of acute urinary retention due to benign prostatic enlargement.

OBJECTIVE: To determine the effect of the existing management protocol of patients presenting with acute urinary retention due to benign prostatic enlargement on clinical efficacy and surgical practice. DESIGN: Prospective study. SETTING: The Urology Unit at the Teaching Hospital, Karapitiya, Galle. PATIENTS: 100 consecutive patients with a first episode of acute urinary retention due to a clinically benign enlarged prostate. MEASUREMENTS: Success of voiding urine after one week of treatment with an alpha adrenoceptor blocker (prazosin). Incidence of subsequent urinary retention during the follow up period of 6 months despite continuing treatment with the drug. RESULTS: Of the 94 patients who completed the follow up period of 6 months, 56 voided successfully after the initial trial without catheter at one week. However, 12 of them developed urinary retention during the follow up and required surgery. CONCLUSION: Treatment with an alpha adrenoceptor blocker followed by a single trial without catheter can avoid prostatic surgery in 40% of patients with acute urinary retention due to benign prostatic enlargement.

Tuberculous ureteric stricture.

The management of a young woman with a ureteric stricture is a challenge to the urologist. Genitourinary tuberculosis can cause ureteric strictures, with minimal symptoms. Untreated, it can lead to impairment of renal function. Diagnosis of genitourinary tuberculosis may be delayed until histopathological assessment. Drug treatment and reconstructive surgery produce good results.