Whilst prostatectomy remains the "gold standard" for the treatment of outflow tract obstruction due to benign prostatic hyperplasia, medical treatment--if only for symptomatic relief--appears to be an attractive alternative. Most of the pharmacological agents in use block the hormonal or the sympathetic neurological pathways that influence prostate growth and function. All of these drugs are known to have side effects. Sixty patients with outflow obstruction due to benign prostatic hyperplasia (BPH) were entered into a double-blind, placebo-controlled study to evaluate the effect of a 6-month course of the pollen extract, Cernilton. There was a statistically significant subjective improvement with Cernilton (69% of the patients) compared with placebo (30%). There was a significant decrease in residual urine in the patients treated with Cernilton and in the antero-posterior (A-P) diameter of the prostate on ultrasound. However, differences in respect of flow rate and voided volume were not statistically significant. It is concluded that Cernilton has a beneficial effect in BPH and may have a place in the treatment of patients with mild or moderate symptoms of outflow obstruction.
The results of colonic conduit urinary diversion have been reviewed in 41 children with an average follow-up of 13.2 years. There was a high incidence of stomal stenosis (61.5%), ureterocolic stenosis (22%), ureteric reflux (58%) and upper tract deterioration (48.4%). Comparison with results of ileal conduit diversion in children show no advantage in the use of colon.
Chronic abacterial prostatitis and prostatodynia are notoriously difficult both to diagnose and to treat. These patients tend to have received several courses of antibiotics, antiinflammatory agents or adrenergic blockade and various other therapeutic manoeuvres with little success. The pollen extract, Cernilton, is reported to be effective in the treatment of this condition and we present the results of an open trial with Cernilton in a group of 15 patients with chronic prostatitis and prostatodynia. In 13 patients there was either complete and lasting relief of symptoms or a marked improvement; 2 patients failed to respond. Cernilton was found to be effective in the treatment of chronic prostatitis and prostatodynia. Its precise mode of action is not known, although experimental studies suggest that it has anti-inflammatory and anti-androgenic properties.
A method of measuring residual urine volume using ultrasound is described. The volume is computed from serial parallel sections of the bladder. This method is found to be significantly more accurate than previously reported techniques and is quick and easy to perform.
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