In torsion of the testis a large proportion of testes saved by surgery develop secondary atrophy. External manual reduction may be used as a first treatment, but surgical fixation is mandatory before the patient leaves the hospital. Prophylactic fixation of the contralateral testis should always be performed as 30% of the patients will otherwise develop symptoms. The preventive operation causes no discomfort to the patient and no harm to the testis. The fertility of the torsion patients is reduced. Patients treated for unilateral testicular torsion seem to have bilateral testicular abnormality resulting in decreased spermatogenesis.
In a prospective, randomized study 60 patients with prostatism caused by small prostate glands (estimated weight < 20 g) had either transurethral prostatectomy (TURP, n = 31) or transurethral incision of the prostate (TUI, n = 29). Operating time and blood loss were significantly less in the group that underwent TUI. There were no differences between the groups in number of days with an indwelling catheter or days in hospital after operation. Eight patients in the TUI group required further operation, as did four in the TURP group, one of whom was discharged with a permanent indwelling catheter. In addition one patient developed a urethral stricture. Nine of the failures of treatment occurred within the first month. Fifty-one patients were followed up at 3 months and 47 were also seen at 12 months. Both operations significantly improved symptom scores and maximum flow rates compared with preoperatively, but the improvement in maximum flow rate was significantly better in the TURP group than in the TUI group. At 12 months TURP had also improved micturition time and voided volume, which TUI had not. Neither operation caused any significant change in sexual activity or erective potency postoperatively. Retrograde ejaculation was, however, seen in more than half of the patients in the TURP group, and only one in the TUI group. We recommend TUI for the treatment of prostatism caused by small prostate glands in patients who want to preserve normal ejaculation or are at poor surgical risk.
ABSTRACT.Purpose: To investigate the amount of endothelial cell loss (ECL) and refractive predictability by femtosecond laser-assisted cataract surgery (FLACS) compared to conventional phacoemulsification cataract surgery (CPS). Methods: Forty-seven patients had one eye operated by FLACS and the contralateral eye operated by CPS (stop and chop technique). Both eyes had intraocular aspheric lenses implanted. Uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), central corneal endothelial cell count and hexagonality with a non-contact specular microscope were assessed preoperatively, 1-3 days postoperatively and 3 months postoperatively. Within both groups, 70% gained a CDVA of 6/6. Mean surgery time was 9.3 min (SD AE 1.9) by FLACS and 8.0 min (SD AE 1.9) by CPS, (p = 0.0018). Mean phaco energy was 3.78 U/S (SD AE 5.1) and 5.45 U/S (SD AE 4.6) (p < 0.0001) by FLACS and CPS, respectively. Conclusion: We found no significant difference in ECL and refractive predictability between FLACS and CPS 3 months postoperatively.
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