Objective:To demonstrate a benefit in diminished adverse events such as hypotension and hematuria with gradual drainage of the bladder when compared to rapid decompression in patients with acute urinary retention (AUR) due to benign prostatic hyperplasia in a case–control study.Methods:Sixty-two patients matched our selection criteria presenting with AUR. They were divided into two groups – the first was managed by rapid drainage of the bladder, the second was managed by gradual drainage through a urethral catheter (The first 100 mL immediately evacuated, then the rest evacuated gradually over 2 h).Results:The mean age was 64.4 and 63.2 years in the first and second group, respectively. Diagnosed cause was benign hyperplasia of the prostate. Hematuria occurred in two patients in the first group and none in the second group. The two cases of hematuria were mild and treated conservatively. After the relief of the obstruction, the mean blood pressure was noticed to decrease by 15 mmHg and 10 mmHg in the first and second group, respectively, however, no one developed significant hypotension. Pain relief was achieved after complete drainage in the first group and after the evacuation of 100 mL in the second group.Conclusions:We conclude that there is no significant difference between rapid and gradual decompression of the bladder in patients with AUR. Hematuria and hypotension may occur after rapid decompression of the obstructed urinary bladder, but these complications are rarely clinically significant.

Objectives: To evaluate the factors that affect the success rate of ESWL for treatment of renal stones and to estimate the prevalence of stone recurrence during a 1-year period. Materials and Methods:During the period of January, 2010 and December, 2010, prospective study of 142 subjects with single or multiple renal stones (<30 mm, largest diameter) undergone ESWL monotherapyby Siemens-LITHOSKOP lithotriptor. The results of treatment were assessedafter a follow-up period of 3 months. Treatment success was a complete clearance of the stones or presence of insignificantresidual fragments<4 millimeters. Correlation of the success rate with the characteristics of the subjects, conditionsof the urinary tract and features of the stone was done.Results: During the 3-months follow-up period, the success rate was 111/142 (78%). Re-treatment was needed in 75 patients (52.8%). Post-treatment procedures were done in 12 subjects (8.4%). Post-ESWL complications were observed in 5 subjects (3.5%). Out of 10 prognosticfactors studied, 5 had a powerful influence on the success rate, which are: renal morphology, presence of congenital anomalies, size of stone, site of stone and treated stones number. Other factors including age, sex, nationality, stonenature (de novo or recurrent) and ureteric stenting had no significant impact on the success rate. Conclusions:Prediction of success of treatment with ESWL and the recurrence depends and may be predicted by renal morphology, presence of congenital anomalies, size of stone, site of stone and treated stones number.

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