Transurethral resection of Prostate(TURP0 is the current optimal therapy for benign prostatic hypertrophy. But in some cases of BPH patients, TURP cannot be performed because the patients have medicl disorders not to be operated. Thus several
alternatives have been used in the management of BPH patients, especially who had anesthetic contraindications to an operation. We experienced 12 cases of BPH patients applied with Intraurethral Cath(r)(IUC) from April 1991 to september 1995.
Eleven
patients became able to void atter IUC insertion. The maximal flow rates were 5.1 to 15.7 ml/sec and average value was 11.8 m1/sec. Almost all patients showed irritative voiding symptoms such as urgency, urge incontinence, frequency, and dysuria
at
first. In 7 patients, these symtoms disappeared spontaneously within 2 to 5 days and oxybutynin chiloride was used orally in 2 patients. Suprapubic cystostomy was done in three patients because two patients had severe irritative voiding symptoms
and one
one patient had persistent urinary retention. The stent was changed every 3 to 6 months. Stone formation around the device was noted in 2 patients and migration of device into the bladder was found in 2 patients. In 4 patients, TURP was performed
when
patient's condition improved enough to be operated under epidural anesthesia.
In conclusion, the use of IUC is thought to be a valid, cost effective and safe alternative to TURP in the treatment of highly operative risk patients with benign prostatic hypertrophy.
|