ObjectiveTo evaluate the clinical efficacy as well as long-term clinical outcomes of superselective microcoil embolization for lower gastrointestinal bleeding (LGIB).Materials and MethodsBetween 1997 and 2009, 26 patients with intended transcatheter embolotherapy for LGIB were retrospectively reviewed. Embolization was performed only when the catheter could be advanced to or distal to the mesenteric border of the bowel. The main purpose of our study was to assess technical success, recurrent bleeding rate and complications. We also evaluated the long-term clinical outcome, including late recurrent LGIB, bowel ischemia and the survival rate.ResultsTwenty-two bleeding sources were in the territory of superior mesenteric artery and four in the inferior mesenteric artery. Technical success was achieved in 22 patients (84.6%). The target vessel of embolization was vasa recta in seventeen patients and marginal artery in the remaining five patients. Early rebleeding occurred in two patients (7.7%) and bowel ischemia in two patients, of whom the embolized points were both at the marginal artery. Delayed recurrent bleeding (> 30 days) occurred in two angiodysplasia patients. Five patients (19.2%) died within the first 30 days of intervention. Long-term follow-up depicted estimated survival rates of 58.2 and 43.1% after one, and five years, respectively.ConclusionTranscatheter embolotherapy to treat LGIB is effective with low rebleeding and ischemic complications. Considering the advanced age and complex medical problems of these patients, the minimal invasive embolotherapy may be used as both a primary and potentially definitive treatment of LGIB.

This study demonstrated that ultrasound diathermy may produce an osseous injury. The abnormality itself was usually mild and transient, with apparent full recovery after termination of therapy.

Purpose:   Transurethral Resection of the Prostate (TURP) is widely considered to be the gold‐standard treatment for Benign Prostatic Hyperplasia (BPH). More recently, bipolar diathermy TURP has been used in preference to monopolar diathermy due to various technical benefits. This retrospective audit has been conducted to determine whether this technique has had any discernable effects on regional centres. Methodology:   All monopolar and bipolar TURP charts within a six month period were reviewed and consecutive cases of each were analysed to obtain the objective data presented. All TURPs were performed by the same consultant surgeon in the same hospital. The parameters to be defined were: Patient age, operation duration, duration of catheterisation post‐operatively, length of stay, weight of prostatic resection + histology and complications. Results:   21 consecutive monopolar TURP cases and 22 consecutive bipolar TURP cases were reviewed and the data collated. It was observed that bipolar TURP had advantages including a reduced length of stay (1.3 days vs. 2.4 days) and a reduced post operative catheterisation period (1.3 days vs. 2.1 days). Other parameters remained comparable and no difference was noted in complication rates. Conclusion:   Within the limitations of a retrospective audit, the above data can be said to demonstrate significant benefits for bipolar diathermy in TURP procedures in a rural setting. Long term cost benefits could be inferred, given reduced lengths of stay for individual patients. The authors would recommend regional hospitals conducting TURPs to consider a transition to the bipolar TURP system if possible, given that complication rates were unchanged.