Early postoperative outcome of bipolar transurethral enucleation and resection of the prostate.

OBJECTIVES: To report the early postoperative outcome of bipolar transurethral enucleation and resection of the prostate. Our results were compared with those published from various centres. SETTING: Regional hospital, Hong Kong. PATIENTS: A total of 28 consecutive patients who had undergone bipolar transurethral enucleation and resection of the prostate by a single surgeon between January and June 2014. All patients were evaluated preoperatively by physical examination, digital rectal examination, transrectal ultrasonography, and laboratory studies, including measurement of haemoglobin, sodium, and prostate-specific antigen levels. Patients were assessed perioperatively and at 4 weeks and 3 months postoperatively. RESULTS: The mean resected specimen weight of prostatic adenoma in 28 patients was 48.2 g with a mean enucleation and resection time of 13.6 and 47.7 minutes, respectively. There was a mean decrease in serum prostate-specific antigen by 85.9% (from 6.4 ng/mL to 0.9 ng/mL) postoperatively. Prostate volume was decreased by 68.2% (from 71.9 cm(3) to 22.9 cm(3)) at 4 weeks postoperatively. The mean postoperative haemoglobin drop was 11.5 g/L. The rate of transient urinary incontinence at 3 months was 3.6%. Patients who underwent bipolar transurethral enucleation and resection of the prostate had a short catheterisation time and hospital stay, which is comparable to conventional transurethral resection of the prostate. CONCLUSIONS: Bipolar transurethral enucleation and resection of the prostate should become the endourological equivalent to open adenomectomy with fewer complications and short convalescence. The technique of bipolar transurethral enucleation and resection of the prostate can be acquired safely with a relatively short learning curve.

Giant urethral diverticulum calculus presenting as scrotal abscess.

We report herein a patient with a urethral calculus associated with urethral diverticulum. A 39-year-old man presented with scrotal swelling and acute retention of urine. Computed tomography of the pelvis and cystoscopy demonstrated a giant calculus in the proximal penile urethra. Emergency in-situ lithotripsy was performed. Complete stone clearance was achieved and a large urethral diverticulum was encountered. The rare occurrence of urethral diverticulum and associated stone disease were discussed.

Surgical treatment of penile curvature.

OBJECTIVE: To review long-term efficacy and complications of surgical treatment of penile curvature in a Chinese population. DESIGN: Retrospective review. SETTING: Regional hospital, Hong Kong. PATIENTS. Patients who underwent surgical treatment of penile curvature between January 1997 and March 2005 inclusive. INTERVENTION: Penile curvature corrective surgery. MAIN OUTCOME MEASURES: Penile curvature recurrence, early and late complications. RESULTS: Of 22 patients who underwent surgical treatment of penile curvatures, 19 had congenital and three had acquired diseases. The mean angle of deformity was 52.5 (range, 20-90) degrees. Ten patients had Nesbit procedures, ten had modified Nesbit procedures, and two underwent vein grafting. Twenty patients had residual or recurrent penile curvatures at a mean follow-up of 50.9 months. Fifteen patients had less than 30 degrees curvature and five had 30 to 60 degrees curvature. Early complications included wound infection (n=3), penile skin necrosis (n=1) treated by skin graft, and urethral injury (n=1). Three patients had erectile dysfunction; four complained of glans paraesthesia. Penile shortening (mean, 1.4 cm) and palpable knots were common late complications. A total of 19 patients were satisfied with the final outcomes. CONCLUSIONS: Surgical treatment of penile curvature produces long-term patient satisfaction. Preoperative counselling on potential recurrence and common minor complications is crucial to produce favourable outcomes.

Single-layer continuous anastomosis in gastrointestinal surgery: a prospective audit.

BACKGROUND: Single-layer intestinal anastomoses have been constructed conventionally using an interrupted suture technique. It is however, increasingly popular to perform such anastomosis using a continuous suture. METHODS: One hundred and eighty consecutive patients with 254 continuous single-layer anastomoses performed over a 4 year period were included in the study. Sixty-one patients underwent oesophagectomy, oesophageal bypass or gastrectomy, 32 underwent biliary bypass, hepatic, biliary or pancreatic resection and 88 had colorectal operations. The median age was 67 years. RESULTS: There were 254 anastomoses of which four leaked (1.6%). Fifteen patients (8.3%) died in hospital. CONCLUSION: These results show that the single-layer continuous suture technique is safe in gastrointestinal anastomoses.