Wednesday, January 25, 2006

New (half-)training session in Barcelona

Today I took a flight to Barcelona to participate in a training session on PVP - Photoselective vaporization of the prostate. We had programmed two patients, the first case was straightforward, the second was very complex. The second patient in the list had morbid obesity and respiratory problems, and we planned to operate him in the sitting position, to increase the chances for him to tolerate the operation. His prostate was relatively big, weighing 100 g. The first case was uneventful, the second case was cancelled because the patient did not respect the "nil per mouth" instruction and he had had breakfast consisting in coffee and cookies. The anaesthesiologist thought we could not operate him with a full stomach, so we have rescheduled him for another date and I went back to Madrid.

As this blog entry is not very exciting, I will use the oportunity to show the kind of effect PVP has on flow rates. Below I show how a flow rate measurement looks like, this test measures urinary flow (volume of urine passed in mL per unit of time in seconds) and represents it on a graph. For the patient, a flowmetry consists in passing water into a funnel connected to the registry equipment, so it is a painless test. It gives very useful information.

Here I show the preop and postop flowmetry of a patient. Initially the flow was very low and bladder emptying was incomplete. After PVP, the flow improved more than threefold. The patient was able to empty his bladder completely and very quickly after the operation.

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