Surgical challenge of massive bilateral staghorn renal calculi in a spinal cord injury patient.

We report a rare case of massive bilateral staghorn calculi in a spinal cord injury patient with significant renal compromise. The patient was successfully treated with percutaneous nephrolithotomy to achieve a stone-free status. The various options of treatment are discussed with special attention to the technical aspects necessary to achieve complete eradication of the stone burden during percutaneous nephrolithotomy. Furthermore, the importance of treating bladder dysfunction and urinary metabolic abnormalities is emphasized.

Radiofrequency Thermal Therapy for Benign Prostatic Hyperplasia by Transurethral Needle Ablation of the Prostate (TUNA): An Update.

Prevalence of symptomatic benign prostatic hypertophy (BPH) is 30% in the sixth decade of life and approaches 50% in the eighth decade of life. Comparable prevalence values are reported in Occidental and Oriental cultures, which suggests the disease susceprible to neither environmental nor cultural favoritism. "Prostatism" is the descriptive word for the BPH constellation of symptoms, which appear as a result of bladder outlets obstructed by an enlarged prostate. In traditional prostatism, prostate growth has a benign etiology. These urologie symptoms may be either irritative (difficulty postponing urination, frequent awakenings at night for urination), obstructive (weak stream, hesitancy), or both. In the context of so much morbidity associated with the BPH symptom complex, this disease is arguably the most bothersome disease for the elderly male. With improvements in healthcare, and with men having longer life expectancies, there is the appreciation of an expanded patient population. It has become possible to heat the prostate with radiofrequency energy (RF) to relieve symptoms associated with BPH using a heating technique called "transurethral needle ablation of the prostate" (TUNA). By both subjective and objective criteria, TUNA theraphy to the prostate for BPH compares favorably with traditional surgical treatment. Now the durability of the TUNA treatment is demonstrated beyond three years.