In an attempt to evaluate renal injury relative to open surgery, percutaneous nephrolithotripsy (PCN) and extracorporeal shock wave lithotripsy (ESWL) were studied in 52 patients with renal calculus disease. Preoperative and postoperative urinary levels of N-acetyl-glycosaminidase (NAG), a sensitive marker of renal tubular damage, were studied. No significant changes were noted in posttreatment urinary NAG values among patients who underwent ESWL or PCN. Although statistically nonsignificant, a constant mild increase of urinary NAG was observed after PCN, that has to be evaluated with long-term follow-up studies. The shock wave number or power in cases treated with ESWL as well as the number of renal punctures in the PCN group did not change the effect on renal tubular function. Diabetics and patients with chronic renal disease treated by ESWL did not show any significant change in posttreatment urinary NAG levels. In contrast to that, all patients treated by open surgery had significant, intense and prolonged increase of the postoperative NAG values, especially those treated by ischaemic nephrolithotomy. Comparing the three different therapeutic modalities, open surgical procedures had the most significant effect on renal function and this difference was statistically significant. We therefore suggest that ESWL does not endanger renal function, while open surgery must be reserved for selected cases.
Six antimicrobial agents were administered to 48 patients (divided in 6 groups) who underwent prostatectomy. Half of the patients received the antibiotic in a single dose one hour before the operation and the rest in divided doses 24 hours before the operation. The concentration levels in serum and in prostatic tissue were measured for each of the antibiotics and for each mode of administration. The obtained ratios of prostatic tissue to serum concentrations and the relative antimicrobial activity to local pathogens of each agent indicate that the agent of choice for prostatic disease is netilmicin followed by aztreonam, cefuroxime and the ticarcillin-clavulanic acid combination.
Objective To evaluate urodynamically patients with pro-(1.26) mL/s. Of the 42 patients who underwent filling cystometry, 26 (62%) had a first sensation of filling, statodynia, and thus define a specific urodynamic pattern that might add to the pathophysiology of the and 28 (67%) a first desire to void, at low volumes (<150 mL and <300 mL, respectively). Of the 25 syndrome and possibly aid definitive treatment. Patients and methods Forty-three patients (mean age patients who underwent a pressure/flow study, 16 (64%) had an obstructive pattern of micturition, as 38.1 years, sd 9.25, range 24-59) with symptoms suggestive of chronic prostatitis, e.g. dysuria, fredefined by a low Q max of 10.04 (1.38) mL/s and a high intravesical pressure at Q max of 83.3 (5.3) cmH 2 O. quency of micturition and a burning sensation in the perineum, were classified as having prostatodynia afterThe site of obstruction was at the level of the bladder neck, as confirmed by fluoroscopy. excluding prostatic infection by standard bacteriological methods. Thereafter, the patients were evaluatedConclusion A significant proportion of these patients had a particular urodynamic pattern of functional infravesurodynamically, including the measurement of free flow-rate, filling (water) cystometry, a pressure/flow ical obstruction at the level of the bladder neck and sensory disturbances. study of micturition, with fluoroscopy and electromyography of the external urethral sphincter.
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