Double stent placement of the ureter after laser endoureterotomy achieved a higher success rate compared with single stent placement in cases of benign ureteral strictures. Although ureteral strictures (≤1.5 cm) achieved better outcome after laser endoureterotomy, strictures (>1.5 cm) favored better with double stent versus single stent placement.
ObjectivesTo evaluate a new technique, the rectal balloon (RB), to control blood loss after transvesical prostatectomy (TVP).Patients and methodsOver 2 years 100 patients were prospectively randomised into two equal groups. All patients underwent TVP for their benign prostatic hyperplasia but a RB (a balloon fixed to a three-way Foley catheter tip by a plaster strip, making it airtight) was used in group 2. The RB was placed in the rectum opposing the prostate and inflated (pressure controlled) for 15 min. Haemoglobin levels were assessed before and after TVP. Blood transfusion, the amount of saline used for irrigation, duration of catheterisation, hospital stay, and rectal complaints were recorded. Patients were followed up at 1 and 3 months after TVP.ResultsThe enucleated adenoma weight was 102 g in group 1 and 106 g in group 2. There was a significant difference between groups 1 and 2 in haemoglobin loss within the first 24 h after TVP, and in total loss, of 0.9 g and 0.2 g (P = 0.008), and 1.9 g and 1 g (P = 0.001), respectively. There was also a significant difference between the groups in the saline volume used for irrigation (11.4 vs. 2.5 L), catheter duration (5.7 vs. 4.3 days), and hospital stay (6.2 vs. 5.1 days), favouring group 2. Blood transfusions were needed in four patients in group 1 and one in group 2. There were no rectal complaints.ConclusionThe use of an inflated RB after TVP is a simple and safe procedure with no specific operative technique, that reduces postoperative blood loss, the incidence of blood transfusion, the volume of saline for irrigation, and shortens the catheterisation period and hospital stay, with no rectal complications.
ObjectivesTo compare the efficacy and safety of ethanolamine oleate (EO) as a sclerosing agent, vs. absolute ethanol (AE), in the treatment of symptomatic simple renal cysts.Patients and methodsBetween November 2009 and October 2012, 46 patients were prospectively randomised into two groups. All patients presented with a simple renal cyst underwent ultrasonographic aspiration and injection of a sclerosing agent. In group 1, 25 patients had the cyst injected with EO, and in group 2, 21 were treated with AE. One injection was used in cysts of <200 mL and two injections were used in larger cysts. Complete and partial success were defined as complete cyst ablation or a >50% reduction in cyst volume with symptomatic relief, respectively. Patients were followed up using semi-annual ultrasonography and computed tomography for 2 years.ResultsSclerotherapy was technically successful in all patients. There was no significant difference in cyst volume between the groups. After ≈2 years of follow-up there was complete symptomatic relief in both groups, and the overall radiological success rate was 100% of both groups, at 79% complete and 21% partial in group 1, and 83% complete and 17% partial in group 2. The frequency of transient complications in the form of microscopic haematuria was 7% and 13%, and of low-grade fever in 4% and 10% in groups 1 and 2, respectively.ConclusionEO can replace AE as a sclerosing agent for symptomatic simple renal cysts, as it has comparable efficacy with higher safety and tolerance.
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