Morning vs evening dosing with doxazosin in benign prostatic hyperplasia: efficacy and safety.

Three hundred and fifty-three patients with symptomatic benign prostatic hyperplasia were randomized to doxazosin or placebo, with morning or evening dosing, to compare the effect of dosing time on the efficacy and safety of doxazosin treatment. After 24 weeks of treatment, the mean International Prostate Symptom Score had decreased by 6.8 units in the doxazosin group compared with 4.

[Stents in therapy of urethral strictures].

The human urethra seems remarkably tolerant of foreign material within its lumen. Providing that a stricture has been adequately cut by means of urethrotomy, or dilated with bougies, the majority of urethras will tolerate both permanent and temporary stents with few problems. Temporary stents have the obvious advantage over permanent stents that no foreign material is left in the urethra but before these can be recommended it is essential that more clinical experience is gained and that long term results up to ten years after removal of the stent are published.

Anatomic limitations of prostatic urethra in using cylindrical stents.

The use of metal stents for the relief of prostate obstruction in the elderly has increased in popularity since 1980. The finding that fine metal wire stents become covered with prostatic epithelium led to the recent use of stents that can be left in place permanently. Because the prostatic urethra does not always conform to the cylindrical shape of these stents, and because the bladder neck/urethral angle is not a right angle and may not be circular in outline, problems may occur with positioning and subsequent inadequate epithelial covering.

Long-term results of urolume urethral stent for recurrent urethral strictures.

Purpose: We present the long-term results of the first 50 patients treated with a new urethral stent (UroLume) developed in 1985 for recurrent bulbomembranous urethral strictures.

Materials And Methods: All stents were inserted with the patient under general anesthesia using a standard endoscopic delivery system. Of the patients 27 were followed for 5 years or longer, 5 for 4 years and 18 for shorter periods due to death, illness or other factors.

An increase of neuropeptide Y but not nitric oxide synthase-immunoreactive nerves in the bladder neck from male patients with bladder neck dyssynergia.

Purpose: To determine the distribution of neuropeptides in male patients with bladder neck dyssynergia and benign prostatic hyperplasia.

Materials And Methods: Bladder neck tissue, obtained from male patients with bladder neck dyssynergia (BND) and control patients with benign prostatic hyperplasia (BPH), was studied immunohistochemically for protein gene product 9.5 (a general neuronal marker), vasoactive intestinal polypeptide, neuropeptide Y, calcitonin gene-related peptide, substance P, growth associated protein 43 and nitric oxide synthase.

A method of measuring fluid balance during transurethral resection of the prostate.

Objective: To design a practical system for non-invasively monitoring fluid balance during transurethral resection of the prostate (TURP) and other endoscopic procedures.

Materials And Methods: Load cell transducers are incorporated into a platform placed under the operating table. Output is passed to a digital weighmeter and then to a portable computer.

Precautions and complications in the use of the urolume wallstent.

The Urolume Wallstent was first used to treat urethral strictures in 1987. Its place in the treatment of urethral strictures is now well established and we have used it successfully in over 100 patients. Recent interest in alternative methods of treating benign prostatic hyperplasia (BPH) has led to the use of this and other stents in patients with symptomatic BPH who are a poor surgical risk.

Cardiovascular performance and core temperature during transurethral prostatectomy.

Hemodynamic performance and core temperature were recorded during transurethral prostatectomy in 52 patients who were stratified according to cardiac symptom score and then randomized to undergo standard (31) or isothermic (21) transurethral prostatectomy. During the standard procedure ambient temperature (21C) irrigant was used, while during isothermic prostatectomy warmed irrigant at 38C was used to prevent heat loss from the bladder, and a warming blanket and humidifying filter were used to decrease cutaneous and respiratory heat loss. Core temperature decreased by a mean of 0.

Three-dimensional imaging of the prostatic urethra--an exciting new tool.

Objective: To evaluate the technique of three-dimensional (3-D) ultrasound imaging of the urethra and its application in both research and clinical practice.

Patients And Technique: The study involved 23 patients: 10 with benign prostatic hyperplasia, four with urethral strictures, three post-insertion of prostatic stents, one with bladder neck dyssynergia, three post-transurethral resection of the prostate, and two with non-urological conditions. A transrectal ultrasound scan was initially performed to acquire a series of images of the urethra.

A modified prostatic UroLume Wallstent for healthy patients with symptomatic benign prostatic hyperplasia: a European Multicenter Study.

Objectives: This European multicenter study was aimed to assess the clinical reliability of a modified prostatic UroLume Wallstent (American Medical System, Minnetonka, MN) in the treatment of 135 healthy patients with symptomatic benign prostatic hyperplasia.

Methods: Ninety-one patients who were obstructed but still voiding spontaneously and 44 patients who had an indwelling catheter were treated by placement of a modified stent.

Results: A significant improvement in mean peak flow rates and residual urine volumes was maintained throughout follow-up.

A three month double-blind study of doxazosin as treatment for benign prostatic bladder outlet obstruction.

Objective: To evaluate the efficacy and tolerability of doxazosin in the treatment of bladder outflow obstruction resulting from benign prostatic hyperplasia (BPH).

Patients And Methods: One-hundred and thirty-five patients with symptomatic urodynamically confirmed obstructive BPH were treated for 12 weeks with either doxazosin (67 patients) or placebo (68 patients) after an initial 2 week baseline evaluation. The main outcome measures were urodynamic and symptomatic evaluation for efficacy.

Renal adenocarcinoma in young adults.

Renal adenocarcinoma is rare in young people. The prognosis of the condition would appear to be better in young people justifying a radical treatment rationale even in cases of advanced disease. This report describes a series of patients under the age of 30 with renal adenocarcinoma and a review of the literature.

Treatment of sphincter strictures using permanent UroLume stent.

The success of the permanent UroLume urethral stent in the treatment of recurrent bulbar urethral strictures led to its use in cases of recurrent strictures in the sphincter active membranous urethra. Among 6 patients treated 3 traumatic strictures have recurred despite the urethral stent but 3 post-prostatectomy strictures have been treated successfully in conjunction with an artificial sphincter to restore continence.

The UroLume stent in the management of benign prostatic hyperplasia.

There were 54 patients entered into this study of the UroLume permanent prostatic stent, most of whom were unfit for conventional prostatic surgery. The stents were inserted with the patient under local or regional anesthesia. Of the patients 34 presented in acute retention, 12 had chronic retention, 4 had severe and worsening symptoms, and 4 had symptoms and urodynamic evidence of obstruction occurring in the presence of Parkinson's disease.

Comparative study of selective alpha 1-adrenoceptor blockade versus surgery in the treatment of prostatic obstruction.

Alternative treatments for benign prostatic hyperplasia (BPH) are the source of much discussion at present. Pharmacotherapy has been demonstrated to have an increasing role in the management of BPH. This study contrasts the efficacy of the selective alpha antagonist prazosin as compared with placebo and the subsequent improvements seen following surgical treatment.

The urolume, a permanently implanted prostatic stent for patients at high risk for surgery. Results from 5 collaborative centres.

Ninety-six men considered unfit for prostatic surgery underwent the insertion of a permanently implanted super alloy mesh stent (Urolume) at 5 European centres. Ninety were able to void immediately, 2 required a second stent to enable them to void and 4 voided after a period of suprapubic catheter drainage. Seven patients required the subsequent insertion of a further stent to cover the prostatic urethra completely and in 8 cases the stent was removed.

The prostatron transurethral microwave device in the treatment of bladder outflow obstruction due to benign prostatic hyperplasia.

There is currently considerable interest in the development of non-surgical means of managing bladder outflow obstruction due to benign prostatic hyperplasia (BPH). We report the results of a 1-year follow-up of 140 men (mean age 67.2 years) presenting with symptoms of bladder outflow obstruction treated for 1 h in a single session by the Prostatron transurethral thermotherapy system.

Does residual urine predispose to urinary tract infection?

The relationship between the presence of post-micturition residual urine and urinary tract infection is unclear. We have performed a retrospective analysis of 342 studies on bladder emptying and compared the incidence of bacterial infection and pyuria in patients with residual urinary volumes of more or less than 100 ml. In patients with a residual volume > 100 ml 49/219 studies showed evidence of pyuria and 28/198 studies of patients whose residual urine was less than 100 ml showed evidence of infection.

A 12-week placebo-controlled double-blind study of prazosin in the treatment of prostatic obstruction due to benign prostatic hyperplasia.

A series of 93 normotensive patients with benign prostatic hyperplasia and maximum urinary flow rates < 15 ml/s, treated at 2 hospital centres using an identical protocol, was randomly assigned to receive a 12-week course of treatment with prazosin or placebo in a double-blind parallel group trial. A total of 75 patients completed the study and were suitable for the final analysis. Prazosin was administered orally in doses of 0.