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.

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.