ABSTRACT
Of 5 patients with recurrent urethral strictures were treated with a self-expandable permanently implanted urethral stent 2 had stenosis within the stent 2.5 and 9 months after placement of the stent, respectively.
Subject(s)
Stents , Urethral Stricture/therapy , Humans , Male , Middle Aged , RecurrenceABSTRACT
OBJECTIVE: To assess the frequency of urine retention and of urinary tract infection after total hip replacement in order to: to minimize morbidity due to urine retention and urinary tract infection after total hip replacement; to limit the discomfort to the patient; to decrease the work load of the nursing staff, if possible. SETTING: University Hospital Rotterdam. DESIGN: Prospective, randomized. PATIENTS AND METHODS: In 61 patients after 63 total hip replacements the use of an indwelling catheter for 48 hours (group 1) was compared with catheterisation on indication only (group 2). RESULTS: Urine retention was less in group 1 than in group 2, 12/39 (31%) versus 15/24 (63%). In the subgroup males no difference was found between both groups. Urine retention was more frequent in elderly people. No other risk factors could be demonstrated. The number of patients with bacteriuria greater than 10(5) CFU/ml in group 1, 11/39 (28%) did not differ from group 2, 9/24 (38%). CONCLUSIONS: On the basis of these study results we recommend: In females: to use an indwelling catheter for 48 hours after total hip replacement; In males: to discuss this choice with the patient, because use of an indwelling catheter appears not to decrease the frequency of urine retention. The risk of discomfort caused by catheterisation and urine retention still exists. An indwelling catheter can, without increasing the risk of significant bacteriuria, eliminate this discomfort in the first 48 hours after operation.
Subject(s)
Hip Prosthesis , Urinary Catheterization , Urinary Retention/prevention & control , Urinary Tract Infections/prevention & control , Adult , Aged , Aged, 80 and over , Catheters, Indwelling , Female , Humans , Male , Middle Aged , Postoperative Complications/prevention & control , Prospective StudiesABSTRACT
A total of 102 patients with histologically proved prostate cancer was followed by transrectal ultrasonography to determine the volume of the prostate during endocrine treatment. The mean volume reduction of the prostate at 3 months after start of treatment was 37.1%, and it was greater in patients treated by orchiectomy (42.1%) compared to those treated by luteinizing hormone-releasing hormone (30.5%). Without consideration of other factors, patients in whom the volume of the prostate had regressed 50% or more at 3 months had a better prognosis (overall survival, intercurrent death corrected survival and survival without distant progression) compared to those with a smaller volume reduction. However, when adjusted for the 2 most important prognostic factors in this study, histological grade and M category, no benefit from a greater prostate reduction as shown by ultrasound could be demonstrated. Similar results applied to the ultrasound findings at month 6. In 24 of the 102 patients an increase of prostatic volume by more than 20% was found after a median interval of 18 months, which was considered local progression. During the observation period systemic progression was encountered in 61 patients. When local progression was observed, the rate of subsequent distant progression was increased by a factor of 2.7, irrespective of grade and M category.
