Symptomatic lymphocele after kidney transplantation a single-center experience

In a retrospective study, we evaluated the frequency, clinical presentation, and management of lymphocele in kidney transplant recipients operated on in a single center. Between September 1984 and June 2005, we had 2147 kidney transplantations from living donors. During the follow-up period, ultrasonography was performed in symptomatic patients and those with elevated serum creatinine level postoperatively. Other radiological procedures were done in complicated cases. Patients with lymphocele were treated by percutaneous drainage with or without injection of sclerotizing agent [povidone iodine]. If recurrence occurred, surgical intraperitoneal drainage was performed. In cases with multiloculated collection or inappropriate access for percutaneous drainage, the primary approach was surgical intraperitoneal drainage. Symptomatic lymphocele collection was seen in 17 kidney recipients of our series [0.8%; 95% confidence interval, 0.4% to 1.2%]. It presented with elevation of serum creatinine concentrations [47.1%], pain and abdominopelvic swelling [29.4%], and lower extremity edema [23.5%]. Percutaneous drainage was used for the treatment of lymphocele in 11 patients, but recurrence occurred in 7 [63.6%]. These cases were treated with open surgical drainage. In 6 patients, the primary approach was surgical intraperitoneal drainage, because of multiloculated collection or inappropriate access for percutaneous drainage. All of the patients were treated successfully and no graft loss occurred during the follow-up period. Symptomatic lymphocele is an uncommon complication after kidney transplantation. Surgical intraperitoneal drainage is the most effective approach for the management of symptomatic lymphocele

Radiofrequency-induced thermotherapy in benign prostatic hyperplasia

We evaluated the efficacy and safety of radiofrequency-induced thermotherapy of the prostate in patients with benign prostatic hyperplasia [BPH]. Radiofrequency-induced thermotherapy of the prostate was performed under local anesthesia in 24 patients [median age, 67 years] with BPH. The International Prostate Symptom Score [IPSS] score, maximum flow rate, postvoid residual urine volume, and prostate volume were measured preoperatively and 4 months postoperatively. Nine patients [37.5%] had urinary retention preoperatively. One patient [4.2%] required transurethral resection of the prostate due to retention despite improved symptoms, and 2 [8.3%] needed an alpha-blocker, postoperatively. The success rate was 87.5% after 4 months follow-up. All patients were catheter-free after the procedure. The mean IPSS score decreased from 26.08 +/- 3.9 to 13.33 +/- 4.69 [P <.001], and the mean maximum flow rate increased from 4.63 +/- 4.4 mL/s to 13.21 +/- 4.28 mL/s [P <.001]. The mean prostate volume and mean residual urine volume were 46.38 +/- 16.8 mL and 160 +/- 57 mL, which decreased to 39.6 +/- 16 mL [P =.009] and 61.46 +/- 17.45 mL [P =.003], respectively. Fever, dysuria, and perineal pain [in 9 patients; 37.5%] were improved with conservative therapy. Retrograde ejaculation, erectile dysfunction, and urinary incontinence were not reported. Radiofrequency-induced thermotherapy of the prostate is a new, safe, and effective treatment for BPH. This technique is carried out under local anesthesia and mild sedation with little bleeding. It is especially appropriate for patients who present as high risk for general anesthesia