An Alternative Minimally Invasive Technique for Large Prostates (>80 mL): Transvesical Prostatectomy Through a 3-cm Incision

Objectives: To assess the efficacy and the simplicity of a modified open transvesical prostatectomy for large prostates (>80 mL). Methods: A total of 165 patients with benign prostatic hyperplasia were treated with transvesical prostatectomy through a 3-cm incision. Prostate size was 85-144 cm3 (mean 101 cm3). Surgery is performed as the standard transvesical prostatectomy but skin incision is much smaller (proximately 3 cm), whereas muscle incision underneath is about 7 cm long. Prostate adenoma was removed with finger dissection without the placement of hemostatic sutures. Results: Operation time was 15-36 minutes (mean 24 minutes). Catheter was removed on the third day and patients left the hospital after successful voiding. Preoperative hematocrit was 40.6-49.2 (mean 43.4), while postoperative hematocrit was 28.3-42.4 (mean 38.3). Transfusion rate was 0-3 blood units (mean 1 U). Mean preoperative flow was 11.5 cm/s and mean postoperative flow was 22.3 cm/s. Mean IPSS score improve from 28 preoperatively to 15 postoperatively. Conclusions: Open transvesical prostatectomy with a 3-cm incision is a minimally invasive technique for the treatment of large prostates (>80 mL) in which transurethral prostatectomy or laser prostatectomy may not be the first choice. © 2010 Elsevier Inc. All rights reserved

DNA flow-cytometric, histological and hormonal analysis of sertoli cell only syndrome (SECOS)

Sertoli cell only syndrome (SECOS) was identified on histology in 21 cases (16,28%) among 129 testicular biopsies performed in our department for azoospermia over the last 5 years. In these patients history, clinical features, hormonal levels, and histological findings were analyzed. In addition DNA flow-cytometric analysis was performed and showed an almost complete absence of haploid cells. All patients presented with elevated serum FSH levels suggesting a Sertoli cell damage or reduced production of inhibin due to the absence of sermatogenic cells. An good correlation was found between histological findings and DNA histograms. In conclusion SECOS is a syndrome of unknown aetiology presenting in men with azoospermia. DNA flow-cytometric analysis is a reliable, rapid and easy method in the diagnosis of SECOS, and can replace histological examination

Tuberculosis of the prostate

We present five cases of tuberculous prostatitis. In all cases this was an incidental histologic finding after transurethral prostatectomy. The patients were all treated with an antituberculous drug regimen. A literature review of this rare condition is included

Extracorporeal shock wave lithotripsy for lower pole calculi: Our experience

Introduction: This study was performed in order to evaluate the immediate and long-term outcome of patients undergoing extracorporeal shock wave lithotripsy (ESWL) for isolated lower pole calculi. Methods: Three hundred and seventy renal units of 350 patients (240 men and 110 women; mean age 55 years) with isolated lower pole renal stones of smaller than 2 cm(2) were studied. Follow up ranged from 1 to 52 months (mean, 15 months) to time of censorship, significant period of secondary urologic evaluation. Results: Out of 370 renal units in 350 patients, 212 (57,29%) were stone-free 1 month after ESWL and 21 (5.67%) spontaneously became stone-free within another 1-52 months (mean, 15 months). Intervention was required after 1-52 months (mean, 17.5 months) and accomplished by ESWL alone (30/350 patients 8.57%) or combined with retrograde endoscopy (10/350 patients 2.85%) while retrograde manipulation was necessary in two of the 350 patients (0.57%). Conclusion: Extracorporeal shock wave lithotripsy is the initial treatment of choice in patients with lower pole stones <2 cm(2), because the overall stone-free rate is acceptable and because even in the residual calculi, the risk of suffering symptomatic episodes requiring secondary intervention is low