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Objectives To investigate the eCectiveness and reliabilityResults The mean duration of surgery, hospital stay and urethral catheterization were significantly longer with of the combination of optical mechanical cystolithotripsy (OMC) and transurethral prostatectomy (TURP) combined OMC and TURP than with OMC alone (P<0.05). Stone-free rates were 94% after OMC alone for the treatment of bladder calculi and obstructive benign prostatic enlargement (BPE).and 93% after combined OMC and TURP. The postoperative mean peak flow rates were 14.3 mL/s after Patients and methods From December 1990 to December 1996, 61 patients who had bladder stones the combined procedure and 15.2 mL/s after TURP alone. The complication rates were 21% for the comand BPE or bladder neck contracture were treated with combined OMC and TURP; 32 patients who had bined procedure and 13% for OMC alone. The complication rate of TURP was 5%, significantly lower than bladder stones with no infravesical obstruction were treated with OMC alone. The records of a random that for the combined procedure (P<0.05). Conclusion Bladder stones were associated with infravselection of 97 patients with obstructive BPE who were treated with TURP only in the same period were esical obstruction in two-thirds of patients. Simultaneous treatment with OMC and TURP did not used as the control. The operative duration time, the length of hospital stay, the duration of urethral cathchange the eCectiveness of these procedures, but caused additional morbidity. eterization, outcome and complications of the procedures for each patients were reviewed. The MannKeywords Bladder calculi, lithotripsy, transurethral prostatectomy Whitney U-test and chi-square tests were used for statistical analysis.posing condition for vesical calculous disease. Although

The significance of simulation modeling at multiple levels, scales, and perspectives is well recognized. However, existing proposals for developing such models are often application specific. The position advocated in this paper is that generic design principles for specifying and realizing multiresolution, multistage models are still lacking. Requirements for simulation environments that facilitate multiresolution multistage model specification are introduced. A multimodel specification formalism based on graph of models is suggested along with design precepts to enable flexible dynamic model updating. The notion of multisimulation is introduced to enable exploratory simulation using various types of multimodels.

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