Catheter-assisted transurethral resection of the prostate: a novel approach.

INTRODUCTION: The aim of the study was to compare the safety and efficacy of catheter-assisted transurethral resection of the prostate (TURP) with traditional TURP in the treatment of benign prostatic hyperplasia. MATERIALS AND METHODS: A total of 61 men were randomized to either catheter-assisted TURP (30 patients) or traditional TURP (31), both performed with a monopolar device. Measurements included the duration of Foley catheterization, length of hospital stay, symptom score and urinary flow rate. All patients were followed for at least 1 year after surgery. RESULTS: The catheter-assisted group had a significantly shorter operative time, duration of postoperative catheterization and length of stay. There were no significant differences in changes in serum sodium and hemoglobin level on postoperative day 1. At 1 year postoperatively, none of the patients suffered from urethral stricture and the 2 groups did not differ significantly in terms of prostatic volume, peak flow rate or International Prostate Symptom Score. CONCLUSIONS: Catheter-assisted TURP is safe and produced results at 1 year similar to traditional TURP. This new method for TURP appears to be a better and more effective approach than the traditional method, although a longer period of observation is needed to assess the durability of the results.

Prophylactic intravesical instillation of epinephrine prevents cyclophosphamide-induced hemorrhagic cystitis in rats.

The objective of this study is to investigate the potential protective effects of intravesical instillation of epinephrine in cyclophosphamide-induced hemorrhagic cystitis. In an earlier study, we have shown that epinephrine promotes hemostasis on established hemorrhagic cystitis induced by cyclophosphamide. Female Sprague-Dawley rats were divided into seven groups as follows: group 1: positive control (150 mg/kg, cyclophosphamide, i.p.), group 2: negative control (10 microg/ml, epinephrine, intravesical), co-administration of cyclophosphamide (150 mg/kg, i.p.), group 3: saline (intravesical), groups 4-6: epinephrine (2.5, 5, and 10 mu g/ml, intravesical), and group 7: mesna (50 mg/kg, i.p.). Rats were sacrificed on 3 consecutive days and the urinary bladders were removed, weighed, and evaluated. The vesical vascular permeability was determined by wet bladder weight and Evan's blue dye absorbance. After 24 hours of cyclophosphamide administration, severe hemorrhagic cystitis was induced with marked edema, hemorrhage, and inflammation. In the epinephrine-treated groups, symptoms of hemorrhagic cystitis (such as edema, inflammation, and hemorrhage) were reduced significantly. Intravesical instillation of epinephrine prevents edema, hemorrhage, and inflammation in rats with cyclophosphamide-induced hemorrhagic cystitis.

Epinephrine promotes hemostasis in rats with cyclophosphamide-induced hemorrhagic cystitis.

OBJECTIVES: To evaluate the hypothesis that intravesical instillation of epinephrine would attenuate bladder hemorrhage in a rat model of cyclophosphamide (CYP)-induced hemorrhagic cystitis. METHODS: Female Sprague-Dawley rats were divided into seven treatment groups: positive control (CYP, 150 mg/kg), negative control (epinephrine, 10 microg/mL), intravesical instillation of normal saline (vehicle) and epinephrine (2.5, 5, and 10 microg/mL), and intraperitoneal administration of mesna (50 mg/kg). Rats were killed on days 1, 2, and 3, and the urinary bladders were removed, weighed, and evaluated by gross and histologic analysis. Vesical vascular permeability was determined by wet bladder weight and Evan's blue dye absorbance. RESULTS: Cyclophosphamide administration induced severe hemorrhagic cystitis with marked edema, hemorrhage, and inflammation. All three epinephrine-treated groups had marked attenuation of hemorrhagic cystitis compared with the positive and negative control and mesna-treated groups. Epinephrine was also associated with significant inhibition of tissue edema, indicating decreased vesical vascular permeability. CONCLUSIONS: In this rat model of CYP-induced hemorrhagic cystitis, intravesical instillation of epinephrine inhibited edema, hemorrhage, and inflammation.