One-session bilateral ureteroscopy: is it safe in selected patients?

The aim of this study was to investigate the possibility to perform bilateral ureteroscopy in one session and to determine the procedure's indications and complication rate. Twenty-two patients underwent bilateral ureteroscopy in one session. Eighteen patients had bilateral lithiasis of the lower ureteral third, three patients had unexplained haematuria and one had unexplained bilateral hydronephrosis. The rigid ureteroscope was used in cases with stones and the flexible one in cases with haematuria and hydronephrosis. Ureteral catheters were placed in all patients. The overall stone-free rate was 83.3%. The procedure failed to confirm a diagnosis in 2 patients with unexplained haematuria. Follow-up included IVU and retrograde cystogram 3 months after the procedure and a renal scan one year later. No major complication was observed. It is concluded that bilateral ureteroscopy in one session can be performed safely in selected patients. The method does not yield major complications and saves patients from a second procedure and a second anaesthesia.

Influence of prostate size on terazosin efficacy.

BACKGROUND: While the rationale for the use of alpha1-adrenoreceptor antagonists in the treatment of bladder outlet obstruction is well established, not all patients have either objective or subjective improvement. The aim of this study was to evaluate the influence of prostatic size on the changes of peak flow rate, average flow rate and residual urine in symptomatic BPH patients undergoing terazosin treatment. METHODS: Thirty-five patients with symptomatic BPH received terazosin, 5 mg once a day for 3 weeks after a 2-week dose escalation period. Peak and average flow rates as well as residual urine were assessed before and after treatment. The patients were stratified in 3 groups by prostate size, which was estimated by transabdominal ultrasonography and a digital rectal examination. RESULTS: The baseline characteristics for age, peak flow rate and average flow rate did not vary between the 3 groups, however, the pretreatment volume of residual urine was greater in patients with large prostate adenomas. Terazosin treatment resulted in significant changes in flow rate and residual urine, however, changes in flow rates were not influenced by prostate size, while a marked decrease in residual urine was found in patients with large prostates. CONCLUSION: Patients treated with terazosin obtained similar improvement in peak and average uroflow, independent of the size of the prostate.