Benign prostatic hypertrophy: retrograde transurethral dilation of the prostatic urethra in humans. Work in progress.

Abstract

Retrograde transurethral balloon dilation of the prostatic urethra was performed in five human volunteers with benign prostatic hypertrophy. Each patient underwent cystoscopy, uroflow studies, voiding cystourethrography, retrograde urethrography, and magnetic resonance imaging before dilation and at defined intervals afterward. The longest follow-up to date is 8 months. Patients were given topical anesthetics and mild sedatives, and dilation was performed with a 25-mm urethroplasty balloon catheter inflated at 3-6 atm for 10 minutes. All catheter manipulations were done with a guide wire and under fluoroscopic control. Significant resolution of symptoms of prostatism was seen in four patients. The unsatisfactory results in the last patient were believed to be caused by ineffectual dilation of predominantly middle lobe hypertrophy--a condition that is now regarded as a contraindication to dilation. This technique has promise to replace transurethral resection of the prostate as the treatment of choice for this common male ailment.

Balloon Dilatation for Entire Urethral Stricture

“…Several reports have revealed that concentric dilatation using torpedo-type balloons can be employed for postinflammatory and posttraumatic urethral strictures, and is more precise and less traumatic to the urethra [1,2], However, bal loon dilatation for the entire urethral stricture has been scarcely reported. Recently, balloon dilatation of the prostatic urethra with a large balloon catheter has been applied safely and successfully for benign prostatic hy perplasia [3], We have performed balloon dilatation of the prostatic urethra for patients with urinary retention due to benign prostatic hyperplasia with satisfactory results [4]. Then, we treated 2 cases of entire urethral stricture using a balloon dilatation catheter and also obtained a satisfactory outcome.…”

The importance of separation of prostatic lobes in relief of prostatic obstruction by balloon catheter urethroplasty: studies in dogs and humans

“…The technique of balloon urethroplasty in normal animals and humans with prostatic hypertrophy has been described in detail [4][5][6] In our patient in whom cystoscopy was repeated 1 month after the procedure, persistent separation of the pmostatic lobes was found.…”

Stone Incrustation: A Relevant Complication of the Intraprostatic Spiral

“…Once the spiral catheter was positioned correctly, the 17-Fr urethroscope was used to inspect the distal end of the spiral. An X-ray was taken for recording the position of the Patients with benign prostatic hyperplasia and uri nary retention usually need prostatic resection to void [1], If the operative riks is too high, other therapeutic modalities have been advocated, such as intraprostatic balloon dilatation [2], luteinizing hormone-releasing hormone agonist [3], cryosurgery [4], prostatic hyper thermia [5] and transurethral incision of the prostate under local anesthesia [6]. The intraprostatic spiral is another alternative to relieve obstruction of the bladder outlet.…”