PurposeTo investigate the prophylactic effect of Tamsulosin, a super-selective alpha-1a adrenergic blocking agent, on the development of urinary retention in men undergoing elective inguinal herniorrhaphy.Materials and MethodsFrom May 2010 through November 2011, a total of 80 males who underwent elective inguinal herniorrhaphy in a university hospital were included in this study. Patients were randomly assigned to one of two groups. In group one (control), the patients were given two doses of placebo orally, 6 hours before surgery and 6 to 12 hours after surgery. Patients in group two were given 0.4 mg of Tamsulosin orally in the same manner as the placebo. All patients were closely followed for 24 hours post-operatively, and any voiding difficulties or urinary retention was recorded.ResultsThere were 40 patients in group one (control group) and 40 patients in group two (Tamsulosin group). The patients' mean age was 64 years. In group one, 6 patients and in group two, 1 patient required catheterization. Thus, 15% of patients in group I and 2.5% of patients in group II had urinary retention. The difference in the requirement for catheterization was statistically significant (p=0.04). The technique of herniorrhaphy, the side of the body in which the hernia was located, the type of anesthesia, the duration of the surgery, and the severity of pre-operative urinary symptoms had no significant effect on the incidence of urinary retention.ConclusionsThe use of perioperative Tamsulosin represents an effective strategy to reduce the risk of post-operative urinary retention following inguinal herniorrhaphy.
Laparoscopic adrenalectomy is a viable treatment option for removal of benign adrenal lesions that can be performed safely and effectively by either the transperitoneal or retroperitoneal approach. All operative parameters are similar in the two approaches, except that the convalescence period and time to oral intake resumptions that are significantly shorter with retroperitoneal surgery.
Purpose: To evaluate the accuracy of Color Doppler ultrasonography for diagnosing post pyeloplasty elimination of obstruction in Ureteropelvic Junction Obstruction patients. Methodology: Patients with the diagnosis of UPJO enrolled in the study and underwent open pyeloplasty. Three to 6 months after the operation, patients were recalled and underwent isotope scan as the gold standard test and renal color Doppler ultrasonography to assess the success rate of pyeloplasty. Results: A total of 39 patients were evaluated and analyzed. The average follow-up time for patients was 9.1 months. The success rate of surgery in the study population was 100%. The mean RI of the affected side before the operation was 0.69 ± 0.01 and after the pyeloplasty, it reached to 0.65 ± 0.01. The difference between the mean RI of the affected side before and after the operation is 0.04 (P < 0.001). Age, type and severity of obstruction and the technique of surgery did not have any impact on these parameters. The difference between the RI of the affected and healthy side was termed ΔRI. ΔRI before and after the operation was 0.084 and 0.014, respectively. The decrease of ΔRI in the case of pyeloplasty is 0.07 on average (P < 0.001), which can be predicted for pyeloplasty success. Discussion: Color Doppler ultrasonography can be used as a non-invasive, fast, nonexpensive, and available modality for evaluating the outcome of pyeloplasty instead of the nuclear scan or IVP.
PurposeTo assess the efficacy of percutaneous unroofing in the treatment of simple renal cysts instead of laparoscopic decortication and open surgeries.Materials and MethodsFrom November 2009 to October 2010 at our department, 11 patients with 12 simple cyst units were managed by percutaneous unroofing. All cysts were evaluated with ultrasonography and abdominal computed tomography. If there were no contraindications, cyst wall resection was performed. A standard transurethral resectoscope was used to resect the cyst wall, and the parenchymal portion of the cyst was subsequently cauterized. The drain was left in place for 2 days.ResultsAt the 5-month follow-up, patients were asked about their symptoms and ultrasonography was performed. From 12 cyst units, 8 were completely resolved, 3 were reduced to less than 50%, and 1 was persistent to near its original size. Success was defined as a more than 50% reduction in cyst volume.ConclusionsSimple renal cysts can be safely managed by percutaneous unroofing with a success rate of more than 90%. This technique can offer several advantages over open surgery, such as decreased length of hospital stay, improved convalescence, and reduced risk of complications. Percutaneous resection also avoids the multiple trocar sites, extensive dissection, and technical difficulty associated with laparoscopy.
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