The aim of the trial was to study factors predisposing to acute urine retention (AUR) in patients with prostatic adenoma (PA). The trial was made in Perm Center for Urgent Urological Care. This allowed registration and analysis of all cases of AUR in the city with population of 1 million people. For 11 years there were 1504 episodes of AUR in 1130 PA patients. One AUR episode was registered in 888 (78.6%) patients, two to four--in 242. Questioning of the patients, the disease histories analysis provided information on the factors predisposing to AUR. The following factors provoked AUR: alcohol intake (25.9%), water loading (11.5%), medication (atropin, belladonna, efedrin, aminasin, tizercin, phenobarbital, imisin, promedol, lazix, etc.; 11.4%), acute inflammation of the adenomatous nodes (7.4%), cold (6.7%), spicy food (5.5%), flebitis of the hemorrhoidal veins (5.5%), fatigue (5.1%), emotional stress (3.9%), forced urine retention (3.1%), bed rest (2.8%), sexual excesses (2%), surgical interventions (2%), etc. AUR occurred more often in the morning (at 4 to 8 o'clock a.m.), in the holidays and after them (92.5% of these patients took alcohol), on days with acute fluctuations of atmospheric pressure, temperature, air humidity. A complex of meteoprophylaxis of AUR is proposed.
This paper presents results of implementation (1993) of extracorporeal shock wave lithotripsy (ESWL) in Perm region, in which nephrolithiasis is endemic. Results achieved with ESWL using two Dornier lithotripters in 6054 patients were analyzed in detail. 93% of the patients had complete and 6,2% partial stone destruction and clearance, therefore positive results were achieved in 99,2% patients. In only 0,8% of the patients ESWL did not result in stone destruction. ESWL complications were registered in 0,64% of patients and included: subcapsular kidney hematoma (0,03%), intense hematuria (0,15%), acute pyelonephritis (0,46%). Over the past 22 years since implementation of ESWL in Perm region with the use of 4 Dornier lithotripters the number of open surgeries for nephrolithiasis fell by 11 times (4% of all nephrolithiasis patients), nephrolithiasis mortality and length of treatment decreased by 5,4 and 4,1 times, respectively.
The implication of meteorological factors in the incidence of acute urinary retention (AUR) were studied in prostatic adenoma patients. The trial was performed in the city of Perm (population 1.1 million) situated in the temperate zone with continental climate. The only center for emergency urological aid registered all AUR cases observed in the city throughout 1980-1990. All 1504 episodes of AUR were recorded with reference to meteorological conditions on the day of admission (temperature, atmospheric pressure, etc.). The original data obtained after mathematical processing of the material indicate that AUR frequency goes up in day-to-day temperature fluctuations (5 degrees C and more), changes in atmospheric pressure (9 GPa and more) and in humidity (20% or more); in moderate and strong winds, cloudy wet weather, thunder storms. A complex of general and pharmacological measures is proposed to prevent AUR episodes in patients with prostatic adenoma.
