A good alternative to indwelling catheter owing to benign prostate hyperplasia in elderly: Memotherm prostatic stent.

OBJECTIVE: To evaluate the long-term results of using Memotherm (Angiomed Gmbh & Co.) prostatic stents in the treatment of bladder outlet obstruction from benign prostatic hyperplasia (BPH) in patients with high anesthetic risk for surgery. METHODS: A total of 29 patients with BPH, who were ruled unfit for surgery, underwent a prostatic stenting procedure between 1998 and 2005 at our hospital, with a mean age of 75 years (range, 65-87) and a mean symptomatic period of 62.5 months (range, 7-180). All patients had previous failed medical treatment for severe lower urinary tract symptoms and evaluated as high risk for anesthesia. Mean follow-up period was 6.8 years (range, 60-125 months). Preprocedural, first year, and fifth year postprocedural values for peak flow rates, residual urine volumes, Turkish symptom scores, and quality of life index scores were compared and evaluated. RESULTS: Memotherm prostatic stent placement was successful in treating 25 patients with BPH (86%) at high risk for surgery who had prostate-related urinary obstruction. For the remaining 4 patients (13.8%), stent migration into the bladder prompted removal of the stents. Marked improvement in residual urine volume, Turkish symptom score, quality of life index scores, and peak flow rates were observed 1 and 5 years after the procedure. CONCLUSION: The results of our study suggest that placement of Memotherm prostatic stents is an effective treatment option in elderly patients with BPH at high anesthetic risk. And by this way, the possible unwanted results of continuous catherization and patient discomfort might be prevented.

Stone compositions in Turkey: an analysis according to gender and region.

OBJECTIVE: To evaluate the compositions of the kidney stones obtained from different regions of Turkey and to present the gender and regional differences. METHODS: The study included 6453 kidney stones obtained from patients from different parts of Turkey. All of the stones were obtained using ureterorenoscopy, percutaneous stone surgery, laparoscopic or open stone surgery, or extracorporeal shock wave lithotripsy. X-ray diffraction crystallography method was used for analysis. RESULTS: At the end of the analysis, 11 different stone types including calcium oxalate (Ca-ox) monohydrate (whewellite, COM), Ca-ox dihydrate (weddellite, COD), uric acid, cystine, struvite, biurea, xanthine brushite, quartz, whitlockite, and dahlite were determined either in pure or mixed conditions. Of the stones, 80.4% were Ca-ox (55.7% COM, 5.9% COD, 18.8% COM + COD), 4.8% uric acid, 3.1% cystine, and 3.3% were phosphate stones (dahlite, brushite, struvite, whitlockite). The remaining 8.4% of the stones were in mixed form with different combinations. Of the patients, 4411 were men (68.3%) and 2042 were women (31.7%). CONCLUSION: Ca-ox was the most frequently encountered stone type in our country as it is worldwide. The distribution of the other stone types is different than the other countries. The information about the structure of the stone has significant contribution to the understanding of the stone formation etiology, programming of the treatment process, and prevention of the recurrences. The study is significant in presenting the stone profile of Turkey.

Comparison of uni-and bilateral buccal mucosa harvesting in terms of oral morbidity.

OBJECTIVE: To evaluate the intraoral morbidity associated with uni- or bilateral buccal mucosa graft harvesting in the treatment of urethral stricture. MATERIAL AND METHODS: Forty-two men with anterior urethral stricture who were treated with dorsal onlay buccal mucosal graft urethroplasty were enrolled in this study. The graft was harvested from both cheeks in patients with a stricture length of ≥7 cm and from one cheek, if the stricture length was <7 cm. The postoperative pain scores, the time required both to return to a regular diet, and also to achieve full mouth opening, intrtaoral numbness and the salivary changes were compared between two groups. RESULTS: The bilateral buccal mucosal graft harvest group was disadvantaged in terms of the 7(th) day pain score, the time required both to return to a regular diet also to achieve full mouth opening (p<0.05). No significant intergroup differences were found in the terms of salivary changes and intraoral numbness. CONCLUSION: Although, intraoral morbidity of bilateral buccal mucosa graft harvesting is more marked than that of the unilateral harvesting, in the short term, it is well tolerated by the patients in the long term.