Larsen Eh

3-Year Followup of Urinary Symptoms after Transurethral Resection of the Prostate

A total of 84 patients underwent detailed symptom analysis and urodynamic study preoperatively, and 3 and 12 months after transurethral resection of the prostate. In addition, 69 patients were contacted 3 years postoperatively for a detailed symptom analysis. These 3-year data then were compared to earlier evaluations. At 3 years 75 per cent of the patients claimed to have improvement, while 13 per cent stated that they were the same symptomatically. At the 1-year evaluation 84 per cent of the patients believed that they were improved and 10 per cent stated that they were unchanged. At 3 years 18 per cent of the patients had urge incontinence (an increase from 6 per cent at 1 year), while none complained of marked nocturia or frequency. Mean total irritative and obstructive symptoms were minimal and unchanged from the 1-year evaluation. Of the patients 33 per cent noticed decreased or absent erections and most blamed the surgery. One patient required another prostatic resection, while stricture developed in 3 and bladder neck contracture occurred in 6. We conclude that prostatic resection results in reasonable 3-year symptomatic improvement but it is hampered by other complications, including bladder neck contracture and, possibly, impotence.

Fibrosis of Corpus Cavernosum After Intracavernous Injection of Phentolamine/Papaverine

Intracavernous self-injection with vasoactive drugs is a new treatment for impotence. Although few reports of side effects have been published complications such as priapism and fibrosis of the spongy tissue are of concern. We report a case of penile fibrosis after intracavernous self-injection of a combination of phentolamine and papaverine.

Intracavernous self-injection with phentolamine and papaverine for the treatment of impotence.

To evaluate the efficacy and safety of intracavernous self-injection of phentolamine and papaverine for the treatment of impotence, 30 patients were enrolled in a prospective, randomized, double-blind, placebo-controlled cross-over study of papaverine and phentolamine versus normal saline. A total of 29 patients completed the study. The phentolamine plus papaverine combination resulted in erection in 24 patients (82.8 per cent) and no erection occurred after injection of saline. Of the patients 12 (41.4 per cent) experienced technical difficulties with the injection. Ecchymosis of the penis at the site of injection was common and 1 patient experienced priapism that resolved spontaneously. No other side effects occurred. Intracavernous self-injection with phentolamine and papaverine appears to be a safe and effective treatment of impotence but long-term effects must be determined.

Quinolone penetration into canine vaginal and urethral secretions.

Four newer quinolones (amifloxacin, ciprofloxacin, enoxacin, norfloxacin) were administered to female dogs by intravenous infusion. Drug concentrations in plasma, urine, and vaginal and urethral secretion were determined by bioassay. All four quinolones penetrated into vaginal and urethral secretion in concentrations several times higher than the MIC against common urinary pathogens, ciprofloxacin and norfloxacin reaching concentrations exceeding the simultaneous plasma concentrations. Because of their favorable antibacterial spectra, new quinolones should be investigated clinically for the treatment of recurrent urinary tract infection and bacterial vaginitis.

The Influence of Various Body Fluids and pH on E. Coli MIC of Quinolone Derivatives

Great efforts have been made to treat chronic bacterial prostatitis but the results have been disappointing, possibly due to poor drug penetration in the prostate (9, 10).

Uroxicillin/clavulanate in urinary tract infection

Abstract A new beta-lactamase-stable oral antibiotic (Augmentin) has been found and to be effective in the treatment of urinary tract infections (uncomplicated and complicated. recurrent, and nosocomial) and bacteriuria. The literature is reviewed.

Improved survival of patients with prostate cancer in northern Denmark, 1985-2004.

Objective. In 2003 prostate cancer was the commonest non-cutaneous cancer among men. In general, the prognosis for men with prostate cancer is less favourable in Denmark than in neighbouring countries. We aimed to examine possible changes in the long-term survival of patients with prostate cancer in four counties in Denmark during the period 1985–2004. Material and methods. From four Danish counties (population 1.6 million) we included all patients (n=8928) with an incident discharge diagnosis of prostate cancer, as recorded in regional hospital discharge registries. We determined age-stratified survival and mortality rates, and used Cox proportional hazards regression to assess changes over time while controlling for age. Results. The median age was 75 years (range 43–99 years). The number of patients increased during the four time periods, especially for those aged <70 years. The overall survival rate improved over time, in particular for the period 2001–04. One-year survival increased from 71% (1985–89) to 77% (2001–04). Overall 5-year survival was unchanged (26% and 28% for 1985–89 and 2001–04, respectively), whereas 5-year survival in patients aged <70 years improved from 35% in 1985–89 to 41% in 1995–99. Compared with the period 1985–89, the age-adjusted 1-year mortality rate ratio (MRR) was 0.79 (95% CI 0.70–0.89) (2000–04) and the age-adjusted 5-year MRR was 0.95 (95% CI 0.88–1.02 (1995–99). Conclusions. The survival of prostate cancer patients has improved in Denmark over the time period 1985–2005, and this change was most pronounced in men aged <70 years. These results may suggest a benefit from increasing use of prostate-specific antigen testing leading to an earlier diagnosis of prostate cancer, in some cases with a lower tumour burden.