Transrectal elastographic monitoring of the transurethral balloon pressure in urethral dilation for catheter-dependent patients with benign prostatic hyperplasia

Abstract

Background: Foley's catheter indwelling gives temporary relief for lower urinary tract obstruction, especially in case of severely symptomatizing benign prostatic hyperplasia (BPH). Several complications of long-term or frequent catheter indwelling have been reported in catheter dependent patients, specifically to those who are unfit for operative intervention. Objectives: Our aim was to find a safe, non-invasive relief from symptom severity, as well as, incapacitating complications of Foley's catheter in catheter-dependent patients. Methods: A total of 107 catheter-dependent men, or who had frequent Foley's catheter indwelling in case of BPH, participated in the present study. Preliminary estimation of the post-micturition residual urine was obtained. Ultrasound elastography was used to assess the transurethral balloon pressure of the double balloon silicon-coated catheter, adjudicated by ureteromat, and maintained in situ for 6 days in all patients. Basic follow up once-a-month has been performed up to 6 months. Results: Effectual urethral patency was noted in 89.7% patients at the end of the third month. The procedure was repeated for 11 patients shortly after 3 months, for 7 patients after 4 months and for 28 patients after 5 months, with no reported prostatic urethral injury. No stricture recurrence was noted in 61 patients up to 6 months. Conclusions:Preliminary results indicate that prostatic urethral balloon dilation in BPH catheterdependent patients is inexpensive, safe, and would be a potentially effective option in maintaining the prostatic urethral patency. Elastographic justification of the transurethral balloon has proved to be helpful.

Effect of transurethral split of the prostate using a double-columnar balloon catheter for benign prostatic hyperplasia

“…Unlike the traditional TUDP procedure, during which the spherical balloon only expanded the urethra at the transitional and central prostatic zones, almost within the proximal 1/2 of the prostatic urethra, [ 3 ] we developed the TUSP with the new improved double-columnar balloons catheter, which would not only expand the bladder neck and prostatic urethra with a proximal balloon, but also expand the membranous urethra with a distal balloon. The re-expansion of urethra by hyperbaric water sac coincided with the spit of the prostate capsule at the 12 o’clock position (the ventromedian circumference of the prostate capsule).…”

“…Benign prostatic hyperplasia (BPH), a common problem in ageing male, [ 1 ] is a histologic diagnosis that refers to abnormal proliferation of stromal and epithelial cells within the prostatic transition zone. [ 2 ] It has been the most responsible reason for urinary outflow obstruction [ 3 ] as the enlarged gland could directly result in bladder outlet obstruction (BOO, static component) or enhance smooth muscle tone and resistance (dynamic component). [ 4 ] Although the lower urinary tract obstruction secondary to BPH is not usually life-threatening, it is more often associated with poor quality of life.…”