The present study confirms the effectiveness of augmentation cystoplasty in increasing bladder capacity, improving bladder compliance and reducing detrusor overactivity. The preservation of renal function and low metabolic complication rate provide solid evidence for carrying out this time-honored procedure in patients with neurogenic or non-neurogenic bladder dysfunction.
Objectives: We report our results of an audit on extracorporeal shockwave lithotripsy (ESWL) of renal and ureteric stones using the Dornier Lithotripter S (Dornier MedTech, Wessling, Germany). Materials and Methods:We retrospectively reviewed the outcome of ESWL for patients treated between March and December 2003 (pilot). Prospective collection of data was performed for patients treated between October 2004 and March 2005 (re-audit) after an upgrade to the power unit of our shockwave emitter by the manufacturer in September 2004. Patient demographic data, target stone characteristics and treatment outcome were recorded. Analysis of the results between the two periods was made. Results: ESWL was performed on 232 and 220 target stones in the pilot and re-audit periods, respectively. Patient demographic data and stone characteristics were similar between the two periods. Clinical success (stone fragments less than 4 mm in size after one session of ESWL) was achieved in 31% and 61% (stonefree 19% and 38%) of patients in the pilot and re-audit periods, respectively (P < 0.0001, χ 2 test). Patients requiring re-treatment with ESWL to achieve success and auxiliary procedure reduced to 8% and 5%, respectively, in the re-audit period (pilot: 14% and 14%, respectively). The overall complication rate was reduced from 6.2% (pilot) to 3.3% (re-audit). Obstructive complications significantly reduced from 4.8% to 0.5% (pilot vs re-audit, Fisher's exact test, P = 0.012). Conclusion: Effectiveness of our lithotripter was significantly improved and obstructive complications were significantly reduced after an upgrade to the power unit of the electromagnetic shockwave emitter of our lithotripter.
Introduction: Laparoscopic radical prostatectomy (LRP) was first attempted in 1992. It was not until 1998 that this technique was recognized as an feasible alternative to traditional open surgery. Laparoscopy offers good visualization, magnification and allows precise dissection and intracorporeal suturing. An audit on the clinical outcomes was done on this novel technique. Patients and Methods: 28 patients underwent LRP from March 2002 to February 2004. Inclusion criteria for surgery were similar to conventional open surgery's criteria: patients with high chance for organ‐confined disease and life expectancy of more than 10 years were included. Earlier series of open retropubic radical prostatectomy in the same hospital was used as the audit's standard for comparison. Results: Favourable results over the open series were found with regard to catheter time, transfusion, hospital stay and later functional outcomes including continence and erectile function. Complications and oncological control was found to be similar for the two groups. Operative time was observed to have reduced from 480 min to less 200 min in the 28‐case series for the laparoscopic cases. Conclusion Early results suggested favourable outcomes, but longer follow up and a controlled comparative study is needed to justify any definite conclusion for this relatively novel technique.
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