Suprapubic prostatectomy for benign prostatic hyperplasia in rural Asia: 200 consecutive cases.

OBJECTIVES: To assess the safety and efficacy of a suprapubic prostatectomy technique performed in a rural hospital in Asia. METHODS: A retrospective study of 200 consecutive suprapubic transvesical prostatectomies with a removable bladder neck partition suture for benign prostatic hyperplasia from 1995 to 1998 in a rural mission hospital in northern Pakistan was performed. RESULTS: Despite preoperative comorbidities in 28% of patients, the postoperative morbidity (14%) and mortality (1%) was low. The partition suture is credited with a very low transfusion rate (1%) and a lower intensity of nursing care in the postoperative period. Patient satisfaction was high with regard to both relief of symptoms and cost. CONCLUSIONS: This study demonstrated that suprapubic prostatectomy with a routine bladder neck partition suture for benign prostatic hyperplasia can be carried out with a high degree of safety and efficacy in a rural setting with limited facilities in a developing country.

Catheter tract seeding after percutaneous biliary drainage for pancreatic cancer.

Percutaneous biliary drainage is frequently used to decompress obstruction of a malignant origin. The development of a tumor along the drainage tract is rare and has been reported only where the catheter has transgressed the obstruction. The authors report seeding of a percutaneous drainage tract after short-term decompression of obstructive jaundice in a patient who underwent curative resection for pancreatic carcinoma and in whom the catheter was not passed through the tumor. Exfoliated cancer cells in the bile duct are believed to be responsible. Caution is suggested in the use of percutaneous biliary drainage for temporary drainage in the patient who is a candidate for curative resection.