Hydronephrosis caused by cystocele. Treatment by colpopexy to sacral promontory.

A case of marked bilateral hydroureteronephrosis due to extreme prolapse of the bladder is reported. This latter condition led also to obstructive urinary tract symptoms and residual urine. After repair of the cystocele in an unusual way by fixation of the vaginal vault to the sacral promontory, the caliber of the upper urinary tracts became almost normal and postvoiding residual urine disappeared.

Bladder neck incision in the female: a hazardous procedure?

Anterior bladder neck incision was carried out in 32 female patients suffering from difficult, mostly incomplete, bladder emptying. All patients underwent a full urodynamic investigation with voiding cystourethrography and endoscopy. Detrusor failure was observed in 20 patients; in the remainder, a mechanical iatrogenic bladder neck obstruction was held responsible for inefficient voiding.

Extended bladder neck incision for outflow obstruction in male patients.

Thirty-two male patients with mechanical or functional bladder outlet obstruction were treated by bilateral endoscopic bladder neck incision. In three cases a repeat incision was necessary. Subjective cure or improvement was obtained in 81%.

The value of intravesical prostaglandin E2 and F2 alpha in women with abnormalities of bladder emptying.

A clinical study of intravesical prostaglandin E2 (PGE2) and F2 alpha (PGF2 alpha) in the treatment of 13 female patients with difficulties in emptying their bladder is reported. Urodynamic investigations were performed before and after instillation of the drug. Although 3 patients had some reduction in residual urine volume, the remainder showed no obvious change and no patient experienced subjective improvement.

The use of indomethacin in the treatment of idiopathic bladder instability.

55 patients suffering from voiding disorders associated with primary detrusor instability, have been treated with indomethacin. All patients have remained resistant to conventional medical treatment. 7 patients did not complete the clinical trial.