Biomedical subjects
Publications and source records attributed to I A Aridogan.
A 52-year old male, with a history of radical nephrectomy due to renal cell carcinoma ten years ago, presented with a lesion on the scrotum which was diagnosed as a metastasis of renal cell carcinoma.
In this study our aim was to compare a first-generation intraprostatic stent (Prostakath) with a second-generation one (ProstaCoil) in patients with prostatic obstruction. The comparison was made in terms of ease of insertion, need for repositioning, migration, infection, stone formation and length of time in place. One hundred and seventeen patients with an age range of 52-94 years were included in this study. Forty-nine of the patients were treated with gold-plated stainless-steel-made stent (Prostakath) inserted under sonographic and 68 of the patients were treated with a nitinol-made stent (ProstaCoil) inserted under fluoroscopic guidance. Indications for stent insertion were similar for both groups. We found that immediate correct positioning was 83% for the Prostakath and 100% for the ProstaCoil. In 42% of the cases the Prostakath necessitated later repositioning because of partial migration and in 12% of the cases removal because of complete migration into the bladder or the anterior urethra. No migration was observed with the ProstaCoil. In 10% of these cases the Prostakath could not be inserted because of the instability of the stent. Due to its larger caliber the second-generation stent caused more transient irritative symptoms. No difference was found in stent-induced infections (10% for all stents). Encrustations were found in 40% of the patients at 1 year with the Prostakath, but in 30% with the ProstaCoil at 2 years. Maximal indwelling time was 12 months with the Prostakath and 36 months with the ProstaCoil. We conclude that the second-generation stent was more advantageous because of its larger caliber allowing catheterization and endoscopic examinations, more flexibility and much longer indwelling time.
Each of the treatment alternatives of benign prostatic hyperplasia (BPH) has its own advantages and disadvantages. The needs and the condition of the patient should be considered in choosing the proper treatment. After the treatment, patient satisfaction should also be considered because objective criteria do not always reflect the efficacy of the treatment. The long-term efficacy of the three alternative treatments of BPH (TURP, TUIP, TUBDP) were compared in a total of 60 men with obstructive symptoms. TUIP was found to be the method of treatment we recommended in young patients with a small and symptomatic adenoma, whereas TURP is still the 'gold standard'.
PURPOSE: A second generation temporary stent (ProstaCoil*) was inserted into the prostatic urethra of patients with obstruction due to prostate cancer to allow spontaneous voiding during hormonal therapy given to decrease the size of the prostatic mass. MATERIALS AND METHODS: The stent was inserted under fluoroscopic guidance using topical anesthesia in 27 patients (mean age 77 years) who presented with urinary retention due to advanced carcinoma of the prostate. All patients underwent operative or nonoperative hormonal therapy shortly after insertion of the stent. RESULTS: Followup of our patients was 3 to 48 months after stent removal and 15 void spontaneously. In 6 patients the stent was removed 9 to 19 months after insertion due to slow regression of the prostatic mass. Two of these patients required transurethral resection of the prostate and in 3 a new stent was inserted because of recurrent obstruction. two recently treated patients await stent removal and 3 died before removal of the stent. During followup no patient had urinary infection, either with the stent indwelling or after its removal. CONCLUSIONS: Temporary internal stenting of the prostate should be the treatment of choice for relieving obstruction during hormonal therapy given for prostate cancer.
OBJECTIVE: To determine the benefits of a new self-expanding and self-retaining large calibre temporary intraprostatic coil stent in patients with bladder outflow obstruction due to benign prostatic hypertrophy. PATIENTS AND METHODS: Sixty-five patients with bladder outflow obstruction have been studied with a follow-up period of 3-28 months (mean 16). RESULTS: Thirty patients became eligible for surgery and had their stent removed without difficulty 3-12 months after stent insertion. Only one stent was removed because of urgency and incontinence. Stent repositioning was required in five patients and 14 complained of temporary dysuria or perineal pain. Twenty-seven patients continue to pass urine through their stent without difficulty. CONCLUSION: Because of its large diameter and its temporary nature this new stent allows endoscopic examination of the bladder and has few side effects. This stent should be considered as an alternative to a urethral catheter or other temporary stents in patients who are unfit for surgery.
To determine the incidence of congenital penile curvature a group of 500 consecutive male neonates at our institution were examined for this anomaly. In this group there were 3 cases of congenital penile curvature, for an incidence of 0.6%.