RESUMO
PURPOSE: We investigated the effects of transurethral needle ablation (TUNA) in men with benign prostatic hyperplasia (BPH) using a pressure-flow study. MATERIALS AND METHODS: A total of 25 patients with symptomatic BPH, and an obstructive pattern on urodynamics, were treated with TUNA. We evaluated the patients before TUNA treatment using the International Prostate Symptom Score (IPSS), quality of life scores (QOL), uroflowmetry, postvoid residual volume (PVR) and pressure-flow studies, for a mean of 6 months following treatment. RESULTS: At 6 months after TUNA, the IPSS decreased from a mean of 22.69 to 7.65 (p<0.01). The QOL scores improved from a mean of 4.65 to 2.13 (p<0.01). The peak flow rate and PVR improved from a mean of 8.13ml/sec to 13.79ml/sec and 98.52ml to 39.52ml (p<0.01), respectively. A reduction in the mean detrusor pressure at maximum flow rate (67.21cmH2O to 47.43cmH2O, p<0.01) and the Abrams-Griffiths number (51.39 to 20.65, p<0.01) indicated that TUNA can significantly lower bladder pressure. With the exception of one patient, no patient complained of any severe side effects. CONCLUSIONS: In patients with BPH, TUNA resulted significant clinical improvements, with no major complications, and slightly decreased the bladder outlet obstruction. We suggest that TUNA is a safe and effective method for treating bladder outlet obstructions due to BPH, especially, in patients at high risk of operative morbidity and mortality, and for aged patients afraid of sexual dysfunction and retrograde ejaculation.
Assuntos
Humanos , Masculino , Ejaculação , Mortalidade , Agulhas , Próstata , Hiperplasia Prostática , Qualidade de Vida , Volume Residual , Atum , Bexiga Urinária , Obstrução do Colo da Bexiga Urinária , UrodinâmicaRESUMO
PURPOSE: We investigated the effects of transurethral needle ablation (TUNA) in men with benign prostatic hyperplasia (BPH) using a pressure-flow study. MATERIALS AND METHODS: A total of 25 patients with symptomatic BPH, and an obstructive pattern on urodynamics, were treated with TUNA. We evaluated the patients before TUNA treatment using the International Prostate Symptom Score (IPSS), quality of life scores (QOL), uroflowmetry, postvoid residual volume (PVR) and pressure-flow studies, for a mean of 6 months following treatment. RESULTS: At 6 months after TUNA, the IPSS decreased from a mean of 22.69 to 7.65 (p<0.01). The QOL scores improved from a mean of 4.65 to 2.13 (p<0.01). The peak flow rate and PVR improved from a mean of 8.13ml/sec to 13.79ml/sec and 98.52ml to 39.52ml (p<0.01), respectively. A reduction in the mean detrusor pressure at maximum flow rate (67.21cmH2O to 47.43cmH2O, p<0.01) and the Abrams-Griffiths number (51.39 to 20.65, p<0.01) indicated that TUNA can significantly lower bladder pressure. With the exception of one patient, no patient complained of any severe side effects. CONCLUSIONS: In patients with BPH, TUNA resulted significant clinical improvements, with no major complications, and slightly decreased the bladder outlet obstruction. We suggest that TUNA is a safe and effective method for treating bladder outlet obstructions due to BPH, especially, in patients at high risk of operative morbidity and mortality, and for aged patients afraid of sexual dysfunction and retrograde ejaculation.
Assuntos
Humanos , Masculino , Ejaculação , Mortalidade , Agulhas , Próstata , Hiperplasia Prostática , Qualidade de Vida , Volume Residual , Atum , Bexiga Urinária , Obstrução do Colo da Bexiga Urinária , UrodinâmicaRESUMO
Spontaneous urine extravasation due to metastatic cancer is extremely rare. We experienced a case of urine extravasation caused by ureteral metastasis from a cervical adenocarcinoma in a 69-year-old woman. On operating, a 3cm length ureter stricture was found in the upper third of the left ureter. There were no malignant cells in a frozen biopsy, and no urine leakage site was detected. An end-to-end ureteroureterostomy was performed by the tension-free method. The permanent histology of the ureterectomy specimen revealed a metastatic adenocarcinoma, identical to that obtained from the punch biopsy of the cervix. The urine leakage persisted following the end-to-end ureteroureterostomy, whereupon a nephroureterectomy was performed.
Assuntos
Idoso , Feminino , Humanos , Adenocarcinoma , Biópsia , Colo do Útero , Constrição Patológica , Metástase Neoplásica , UreterRESUMO
ESWL is an effective treatment for renal and ureteral calculi with few serious side effects. Most complications are related to an obstruction from stone fragments lodged within the ureter with an accompanying colic and/or infection and subcapsular or perirenal hematoma. Here we report a patient with a protein S deficiency sustaining a deep vein thrombosis following an ESWL for a mid ureter stone.
Assuntos
Humanos , Cólica , Hematoma , Deficiência de Proteína S , Proteína S , Trombose , Ureter , Cálculos Ureterais , Veias , Trombose VenosaRESUMO
ESWL is an effective treatment for renal and ureteral calculi with few serious side effects. Most complications are related to an obstruction from stone fragments lodged within the ureter with an accompanying colic and/or infection and subcapsular or perirenal hematoma. Here we report a patient with a protein S deficiency sustaining a deep vein thrombosis following an ESWL for a mid ureter stone.
Assuntos
Humanos , Cólica , Hematoma , Deficiência de Proteína S , Proteína S , Trombose , Ureter , Cálculos Ureterais , Veias , Trombose VenosaRESUMO
Osseointegrated titanium implants have become an integral therapy for the replacement of teeth lost. For dental implant materials, titanium, hydroxyapatite and alumina oxide have been used, which of them, titanium implants are in wide use today. Titanium is known for its high corrosion resistance and biocompatability, because of the high stability of oxide layer mainly consists of TiO2. With the development of peri-implantitis, the implant surface is changed in surface topography and element composition. None of the treatments for cleaning and detoxification of implant surface is efficient to remove surface contamination from contaminated titanium implants to such extent that the original surface elemental composition. In this sights, the purpose of this study was to evaluate rough surface titanium implants by means of scanning electron microscopy(SEM) and X-ray photoelectron spectroscopy(XPS) with respect to surface appearance and surface elemental composition. Moreover, it was also the aim to get the base for treatments of peri-implantitis. For the SEM and XPS study, rough surface titanium models were fabricated for control group. Six experimental groups were evaluated: 1) long-time room exposure, 2) air-powder abrasive cleaning for 1min, 3) burnishing in citric acid(pH1) for 1min, 4) burnishing in citric acid for 3min, 5) burnishing in tetracycline for 1min, 6) burnishing in tetracycline for 3min. All experimental treatments were followed by 1min of rinsing with distilled water. The results were as follows: 1. SEM observations of all experimental groups showed that any changes in surface topography were not detected when compared with control group. (750x magnification) 2. XPS analysis showed that in all experimental groups, titanium and oxygen were increased and carbon was decreased, when compared with control group. 3. XPS analysis showed that the level of titanium, oxygen and carbon in the experimental group 3(citric acid treatment for 1min, followed by 1min of distilled water irrigation) reached to the level of control group. 4. XPS analysis showed that significant differences were not detected between the experimental group 1 and the other experimental groups except of experimental group 3. The Ti. level of experimental group 2, air-powder abrasive treatment for 1min followed by 1 min of saline irrigation, was lower than the Ti. level of tetracycline treated groups, experimental group 5 and 6. From the result of this study, it may be concluded that the 1min of citric acid treatment followed by same time of rinsing with distilled water gave the best results from elemental points of view, and can be used safely to treat peri-implantitis.