The practical assessment and management of bladder outflow obstruction

The initial management of bladder outflow obstruction typically related to benign prostatic hyperplasia (BPH) falls to a large extent within the remit of general practice. Referral onwards to secondary care typically arises following the failure to respond to conservative measures or when complications have supervened; the most significant of which is urinary retention. In the hospital setting, anaesthesia, constipation and immobility are the common precipitants. What follows is a practical guide to the management of these situations and provides an overview of the conservative, medical, minimally invasive and surgical treatments available.     

Biodegradation of polydioxanone in bone tissue: effect on the epiphyseal plate in immature rabbits.

Implants of polydioxanone (PDS), 1.3 mm in diameter, were operatively fixed in the juxta-epiphyseal area of the right proximal tibial metaphysis in six rabbits and were driven into a drill hole of equal bore through the right proximal tibial epiphyseal plate in ten rabbits. The PDS implants had biodegraded almost completely in cortical bone at 16 weeks without any significant sign of inflammation or foreign body reaction. The PDS implants did not cause any growth disturbance. Histologic studies, however, showed that seven of 10 rabbits demonstrated significant osseous bridge formation across the epiphyseal plate.     

ARTHROSCOPIC REMOVAL OF ACRYLIC CEMENT FROM UNREDUCED HIP PROSTHESIS

A case is reported in which entrapped polymethylmethacrylate following traumatic dislocation of a total hip replacement prevented complete reduction. A combined arthroscopic and fluoroscopic technique was used to remove the entrapped polymethylmethacrylate. Manipulation of the total hip prosthesis was done after removal of polymethylmethacrylate to minimize mechanical abrasion. This technique allows direct visual assessment of the articulating surfaces as well as the mechanical stability of the prosthesis. The morbidity related to the procedure is minimal and a short rehabilitation period is the major advantage.     

Measuring maternal mortality: An overview of opportunities and options for developing countries

Background  

There is currently an unprecedented expressed need and demand for estimates of maternal mortality in developing countries. This has been stimulated in part by the creation of a Millennium Development Goal that will be judged partly on the basis of reductions in maternal mortality by 2015.