ABSTRACT
Urethral catheterisation is often used in acute urinary retention (AUR). In this study, we aimed to evaluate the effect of urethral catheterisation on serum prostate-specific antigen (PSA) levels in men with AUR. Our study subjects comprised 35 men with a mean age of 63.7 +/- 7.35 years (range 55 - 80) who presented with AUR at our department between March 1999 and June 2000. Patients were randomly divided into two groups; 18 patients underwent urethral catheterisation in the first group (catheterisation group), while 17 underwent suprapubic percutaneous cystostomy in the second group (cystostomy group). Serum PSA levels before manipulation, and 2 and 12 hours and 7 days after treatment were determined. The change in median PSA values after manipulation was statistically significant in the catheterisation group (p < 0.05), but not in the cystostomy group (p > 0.05). The change in serum PSA was not clinically important in any of the patients. These results suggested that urethral catheterisation did not cause a significant alteration in serum PSA in men with AUR retention.
Subject(s)
Prostate-Specific Antigen/blood , Urinary Catheterization , Urinary Retention/blood , Urinary Retention/therapy , Acute Disease , Aged , Aged, 80 and over , Humans , Male , Middle AgedABSTRACT
PURPOSE: We evaluated the short and long-term outcome of neodymium:YAG visual laser ablation prostatectomy for treatment of benign prostatic hyperplasia (BPH). MATERIALS AND METHODS: A total of 230 patients with symptomatic BPH underwent visual laser ablation prostatectomy. Evaluation measures included the American Urological Association symptom score, maximum urinary flow rate, post-void residual urine volume and morbidity. RESULTS: Median followup was 36 months (range 6 to 79). Of the patients 220, 196, 180, and 167 were available at 6 months, 1, 2 and 3 years, respectively. Moreover, 98 patients were followed for a minimum 5 years. At 6 months maximum urinary flow rate increased from 6.7 to 17.9 ml. per second, post-void residual urine volume decreased from 159 to 52 ml. and the American Urological Association symptom score was reduced from 22 to 7.2. Improvement in the evaluation parameters also continued at 5 years. Early complications consisted of prostatitis, urinary retention, and bleeding in 6 (2.6%), 3 (1.4%) and 1 (0.4%) patient, respectively. Irritative symptoms persisting greater than 4 weeks were seen in 28 (12.2%) patients. Late complications were bladder neck contracture, urethral stricture, and urinary retention in 3 (1.4%), 2 (0.9%) and 2 (0.9%) patients, respectively. Of the 153 sexually active men 5 noticed erectile impotence at 6 months. There were 20 (12.0%) patients who reported retrograde ejaculation. The reoperation rate was 5.5%. CONCLUSIONS: Our results further confirmed that visual laser ablation prostatectomy is a safe and effective treatment for BPH. It has minimal morbidity and durable therapeutic effects. However, the major disadvantage is postoperative irritative voiding symptoms.
