Urethroplasty with balloon catheter in prostatic hypertrophy

Randomized clinical trial comparing balloon dilatation to transurethral resection of prostate for benign prostatic hyperplasia

To evaluate the effectiveness and clinical outcome of patients treated by balloon dilatation of the prostate (BDP) compared with transurethral resection of the prostate (TURP) we performed a prospective, randomized clinical trial. Fifty-one men were randomized to either BDP or TURP. Both groups demonstrated a significant decrease in symptom score from preoperative levels (TURP 13.6 to 6.0 [p < 0.05]; BDP 14.1 to 8.1 [p < 0.01] at 1 year). The TURP group improved peak urinary flows; while, after initial improvement, the balloon group returned to pre-procedure levels. At twelve months 14 of 19 BDP patients (74%) and 14 of 18 TURP patients (78%) considered themselves improved. BDP results in symptomatic improvement; however, the effect may not persist. Objective improvement after BDP does not always occur. The morbidity of BDP is low and compares favourably to that of TURP. Thus BDP does not appear to be as effective as TURP and may offer only temporary relief of symptoms.

Interventional radiology of the lower urinary tract and its relationship to surgical treatment

Interventional radiological techniques of the lower genitourinary (GU) tract are large and varied and continue to expand because of technological advances and also because budgetary restraints are being placed on our medical society. This has stimulated continuous search for alternative ways of treating disease in a more cost-effective fashion. As a result, there has been an overall decrease in morbidity and mortality, as well as postprocedural incapacity. We review the most important and newest modalities and provide some background of the processes affecting the lower GU tract.

Wallstent endoprostheses for the relief of prostatic urethral obstruction in high risk patients

Twenty-one patients with prostatic urethral obstruction who were unfit for surgery were treated with self-expandable stainless steel endoprostheses inserted under fluoroscopic guidance. The procedure was technically successful in all patients, although in one case a second stent was required 2 months later. One patient developed a urethral stricture in the 12-16 month follow up period. One case of epididymoorchitis and one case of septicaemia after stenting were treated successfully with antibiotics. Endoprostheses represent a satisfactory alternative to prostatectomy in high-risk patients.