Evaluation of the intraocular pressure changes during micturition in patients with benign prostatic hyperplasia.

OBJECTIVE: To evaluate the effect of the Valsalva maneuver (VM) during micturition on intraocular pressure (IOP) in patients with benign prostatic hyperplasia (BPH). PATIENTS AND METHODS: IOP were measured before and during micturition in uroflowmetry testing by Tonopen-Avia (Reichert Inc., NY, USA) in 35 eyes of 35 patients with BPH. International Prostate Symptoms Score (IPSS) questionnaire was used for quantification of BPH symptoms. The subjects were divided into two groups according to IPSS questionnaire: patients with low IPSS scores and patients with high IPSS scores. RESULTS: The mean IOP before and during micturition in patients with BPH were 15.26 ± 4.39 mmHg and 16.23 ± 4.43 mmHg, respectively (p = 0.047). When patients with BPH were assigned to two distinct groups according to the IPSS scores, IOP did not differ in patients with low IPSS scores (p = 0.590), whereas mean IOP was significantly higher in patients with high IPSS scores (p = 0.007). CONCLUSIONS: The Valsalva maneuver, performed during micturition, can lead to significant IOP increase in patients with BPH, particularly in advanced disease.

Safety and efficacy of retrograde intrarenal surgery in patients of different age groups.

OBJECTIVES: To assess the efficacy and safety of retrograde intrarenal surgery (RIRS) to treat renal stones in different age groups of patients. PATIENTS AND METHODS: We performed a retrospective analysis of 947 patients who underwent RIRS for renal calculi between January 2008 and January 2014. Age at RIRS was analysed both as a continuous and categorical variable and patients were categorized into three age groups; aged ≤ 15 years at surgery (group i, n=51), 16 - 60 years (group Ii, n=726) and>60 years (group iii, n=170). We compared the 3 groups with the regard to stone characteristics, operative parameters and postoperative outcomes. RESULTS: The stone-free rate was 78.4% in group i, 77.5% in group ii, and 81.1% in group iii (P=.587). A multivariate logistic regression analysis showed that only stone size and stone number had significant influence on the stone-free rates after RIRS. Intraoperative complications occurred 13.7% in group i, 5.6% group ii, and 7.6% in group iii. Overall complication rates in children were higher than adult patients but the differences were not statistically significant. We found that only operation time was associated with the increased risk of intraoperative complications. Peroperative medical complications developed in 8 patients (.8%) in group ii and 2 patients (1.1%) in group iii. A 48-year-old man died from septic shock 5 days after the surgery. CONCLUSIONS: RIRS was observed to be a safe and effective procedure in all age groups of patients with stone disease, therefore age should not be considered as a limiting factor.