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To evaluate the efficacy and safety of 120 W potassium titanyl phosphate (KTP) in the treatment of urinary retention (UR) due to benign prostate hyperplasia in high-risk patients. Forty-six male patients with mean age of 73.78 ± 9.82 years who اhad UR and underwent 120 W KTP laser vaporization of the prostate between January 2015 and June 2017 were included. We evaluated perioperative parameters including serum prostate specific antigen, prostate volume, period of postoperative catheterization, vaporization time, delivered energy, hospitalization period, as well as intraoperative and postoperative complications. In the follow-up protocols, International Prostate Symptom Score and quality-of-life questionnaire (IPPS-QoL) and postvoid residual volume (PVR) were also assessed. The mean follow-up period was 15.57 ± 9.26 (1-42) months. All patients get rid of UR, except 1 patient (2.1%) remained on Foley catheter and standard TURP was done. Mean vaporization time was 8.57 ± 4.19 min, and mean energy delivered was 51.7 ± 29.9 kJ. No intraoperative complications were observed and no blood transfusion was done. The mean postoperative IPSS at the last follow-up was 9.64 ± 6.65 and the QoL score was 1.61 ± 1.31. Green light laser prostatectomy is a safe, simple, and effective procedure for the treatment of UR secondary to BPH in high-risk patients. Short hospitalization, low rate of intra operative and postoperative complications with rapid improvements in the objective, and subjective voiding parameters are important considerations of this procedure.

Purpose To define the efficacy of standard androgen deprivation therapy (ADT) in the treatment of metastatic prostate cancer (PCa). Materials and methods Fifty patients with mean age of 70.48 ± 9.95 years old (range 52–87) who had metastatic PCa and received ADT between 2014 and 2019 were retrospectively evaluated. Median values of pre-therapeutic PSA and Gleason scores were 50 ng/ml (range 8–1201) and 8 (range 6–9), respectively. All patients received luteinizing hormone-releasing hormone (LHRH) analogue and anti-androgen. The patients were evaluated in terms of age, pre-therapeutic PSA serum levels, Gleason scores, presence of metastasis, number and percentage of cores involved, nadir PSA, time to nadir PSA, duration of ADT, and PSA at last follow-up. Multivariate analysis was used to define the factors which have impact on ADT response. The mean follow-up period was 13.87 ± 7.78 months, (range 2–32). Results All patients showed reduction in serum PSA level after initiation of ADT, and the median value of nadir PSA was 1.12 ng/ml (range 0.02–50). The mean value of time to nadir PSA was 3.85 ± 1.57 months (range 2–7). The median value of PSA at last follow-up was 2 ng/ml (range 0.02–50.21). Multi-variant analysis showed that nadir PSA have a significant correlation with pre-therapeutic PSA, PSA at last follow-up, age, and Gleason scores (p < .05). Conclusion Standard ADT is a feasible option in the treatment of metastatic PCa. Gleason scores, age, pre-therapeutic PSA, and PSA at last follow-up have significant impact on outcomes of ADT. Further studies of high number of patients with long-term follow-up including other chemo-hormonal therapy and androgen receptor blockers should be carried out to confirm and improve efficacy of ADT.

Objective To evaluate the results of novel modifications on tension-free vaginal tape (TVT) in the treatment of female stress urinary incontinence (SUI). Methods In all, 16 female patients with a mean (range) age of 49.29 (31–78) years, who underwent anti-incontinence surgery to correct their SUI between June 2010 and August 2014, were included. An in situ anterior vaginal wall sling was prepared, and monofilament polypropylene tape passed below the in situ sling and the standard TVT procedure was performed. Both ends of the mesh in the suprapubic region were labelled with polyglactin 910 (Vicryl®, Ethicon Inc., Somerville, NJ, USA) sutures and left outside the wound. The middle of the mesh in the vaginal region was labelled with a similar suture and left outside the vagina. The Foley catheter was removed on the third postoperative day. The mean (range) follow-up was 8 (5–17) months. Results All patients benefited from the surgery; 15 (94%) of them were completely cured and one patient clinically improved. Urinary retention occurred in one patient, where the tension of the tape was reduced using adjustment sutures. No vaginal mesh erosion was detected during the gynaecological examination postoperatively. No significant post-voiding residue was detected after catheter removal. Conclusion This technique provides a feasible option for adjusting the tension of the mesh in the early postoperative period in case of urinary retention. The presence of the intervening in situ sling reduces the risk of vaginal erosion. Long-term success is expected because dislocation of the mid-urethral sling is less likely.

Aim To evaluate the efficiency of therapeutic Ultrasound, low level laser and compression therapy for healing of venous Leg ulcers and Compare the effect of modalities on the ulcers. Subjects and methods Three groups were included in the study. Group I: 20 patients with leg ulcers treated with low level laser therapy. Group II: 20 patients with leg ulcers treated with ultrasound therapy. Group III: 20 patients with leg ulcers treated by compression therapy (four layer bandage) were used in this study. All patients were subjected to detailed history, clinical evaluation in addition to X-ray of legs and feet, and Doppler ultrasound of both legs. The main variables for follow up were the measurement of the area of the lesions under aseptic conditions at 0, 1, 2, 3 months and qualitative clinical evaluation of the ulcers by physician and by the patient. The Results from group I, group II and group III were obtained and then compared with each others. Results According to the size of the ulcer, some ulcers heal within 1 month which is (15.6%) in group I, (10%) in group II, and (28.5%) in group III. Some ulcers heal within 2 months which is (28%) in group I, (23.3%) in group II and (37%) in group III. The remaining ulcers heal within 3 months or more which are (56%) in group I, (66.6%) in group II and (34.2%) in group III. Thus the percentage of healing denoting that compression bandage technique used in group III is the most efficient in healing of chronic venous leg ulcer followed by laser therapy and lastly US therapy (P = 0.04 at the end of the first month and P = 0.03 at the end of the third month). Conclusion Compression therapy is the most efficient treatment of venous leg ulcers. Low level laser therapy and Ultrasound therapy are useful methods as a conservative treatment of venous leg ulcers and can be used in ulcers of small size.

Crossed Renal Ectopia (CRE) is a relatively rare congenital renal anomaly. Management of stones formed within such anomalous renal architecture is a challenge for urological surgeons especially in the fused form of the anomaly (CFRE). There is an increasing trend for using percutaneous nephrolithotomy (PCNL) in such complicated cases. However, certain anatomical variants of this anomaly will make PCNL technically difficult especially when the path to the diseased kidney is blocked by the normal one. In this clinical report, we present a case of renal pelvis stone in a CFRE patient whose target pelvis position was technically difficult to reach by the fluoroscopy guided PCNL technique alone. To circumvent this difficulty, we successfully made use of the laparoscopic technology to visually navigate our way while creating the tract for the PCNL scope sheath in to the target renal pelvis.

We determined whether the gravity effect of radiographic anatomic features on the preoperative urography (IVP) are enough to predict fragments clearance after shock wave lithotripsy (SWL). A Total of 282 patients with mean age 45.8 ± 13.2 years (189 male, 93 female), who underwent SWL due to renal calculi between October 2005 and August 2009 were enrolled. The mean calculi load was 155.72 ± 127.66 mm². The patients were stratified into three groups: patients with pelvis calculi (group 1); patients with upper or middle pole calculi (group 2) and patients with lower pole calculi (group 3). Three angles on the pretreatment IVP were measured: the inner angle between the axis of the lower pole infundibular and ureteropelvic axis (angle I); the inner angle between the lower pole infundibular axis and main axis of pelvis-ureteropelvic (UP) junction point (angle II) and the inner angle between the lower pole infundibular axis and perpendicular line (angle III). Multivariate analysis was used to define the significant predictors of stone clearance. The overall success rate was 85.81%. All angles, sessions number, shock waves number and stone burden were significant predictors of success in patients in group 1. However, in group 2 only angle II and in group 3 angles I and II had significant effect on stone clearance. Radiographic anatomic features have significant role in determining the stone-free rate following satisfactory fragmentation of renal stones with SWL. The measurement of infundibulopelvic angle in different manner helps to predict the stone-free status in patients with renal calculi located not only in lower pole, but also in renal pelvis and upper or middle pole. Gravity effect is not enough to justify the significant influence of the radiographic anatomic features on the stone clearance and fragments retention after SWL.

Objective: To assess the effect of the gravity-related radiographic features on the success rate of extracorporeal shock wave lithotripsy (SWL) in renal stones. Materials and methods: A total of 79 patients (mean age 47.34±12.9 year) who underwent SWL due to renal pelvis stones (mean area 162.58±130.31 mm²) between 2005 and 2008 were enrolled. Three angles on the pretreatment excretory urography were measured; the inner angle between the axis of the lower pole infundibular and ureteropelvic axis (angle 1), lower pole infundibular axis and main axis of pelvis-ureteropelvic junction point (angle 2), and lower pole infundibular axis and perpendicular line (angle 3). Age, number of session, stone burden, numbers of shock waves, and presence of hydronephrosis were defined for all patients. The significant predictors of stone-free rate after the application of SWL was defined. Results: The success rate was 53.2%. All angles, number of sessions, stones burden, and number of shock waves were significant predictors of stone free rate. However, age, sex and the presence of hydronephrosis did not show similar effects. Conclusions: Gravity-related factors have significant role on the stone-free rate in patients treated with SWL for renal pelvis stones. These radiographic parameters may be used to determine the patients who will benefit from SWL.

Purpose To evaluate the validity of the standard tubularized incised plate (TIP) urethroplasty technique for different kinds of hypospadia. Materials and methods From June 2002 to December 2003 and from March 2006 to October 2007 38 patients aged 1–22 years (average 7.34) were operated using the concept of TIP urethroplasty. The hypospadiac meatus were subcoronal in 28 patients (73.68%), midshaft in six (15.78%), and penoscrotal in four (10.52%). Standard TIP urethroplasty in conjunction with double-layer covering of the neourethra with dorsal dartos flap were used in the primary cases (28 patients). In the secondary cases (four patients) and in boys who were circumcised before admission (six patients), modified TIP urethroplasty was used. The mean periods of hospitalization and follow-up were 0.92 days and 4.19 months, respectively. Results No fistulas were observed in boys who underwent primary reconstruction using standard TIP urethroplasty. Fistulas were observed in two patients (5.26%)—one patient with penoscrotal hypospadias who underwent two-stage repair and another who was circumcised before admission. One patient had meatal stenosis at the early postoperative period which was corrected by dilatation of the external meatus at intervals up to 2 months postoperatively. Conclusion Standard TIP urethroplasty with double-layer covering of the neourethra with dorsal subcutaneous tissue is the procedure of choice for treatment of primary cases of distal/midshaft hypospadias. This technique seems suitable for reconstruction of proximal, secondary, and even complicated hypospadias.

Since the first report on the efficacy of sextant biopsy under transrectal ultrasound guidance, there have been many modifications related to the total number of cores and the localization of biopsies to improve the prostate cancer (PCa) detection rate. The 2010 National Comprehensive Cancer Network Early PCa Detection Guidelines noted the 12-core biopsy scheme as the standard. However, this extended biopsy scheme still fails to detect 20% of high-grade PCa that can be detected by detailed pathological evaluation of radical prostatectomy; therefore, there is need for saturation biopsies. The existence of suspicions of PCa after previous negative biopsy or biopsies represents a valid indication for saturation biopsy. There has been no significant increment in morbidity or in insignificant PCa detection rates when a saturation biopsy scheme was used with an extended biopsy scheme. Along with the improvement in the PCa detection rate, accurate oncological mapping of PCa is another important consideration of saturation biopsies. The ideal number of cores and the diagnostic value of saturation biopsy after the failure of initial therapy are some of the issues that need to be addressed. Preliminary reports have shown that magnetic resonance imaging can improve the PCa detection rate, save patients from unnecessary biopsies, and decrease the need for a high number of cores; however, multiple limitations continue to exist.

Secondary to Pyriform Sinus Fistula: An Underlying Pathology for an Uncommon Introduction: Thyroid gland is very resistant to microbial infection, and whenever this happens, the presence of underlying pathology should be raised, especially with recurrent thyroid abscess. Presentation of Case: We report a clinical case of a 10 year old male child presented with recurrent thyroid abscess and diagnosed as a pyriform sinus fistula on the clinical grounds confirmed by esophagography and Computed tomography. The patient was treated by excision of the fistulous tract along with the involved thyroid tissue after an inflammation-free period. Surgery resulted in complete resolution and cure. Discussion: Although rare, there are a few reported cases in the literature discussing the entity of pyriform sinus fistula as a cause of recurrent thyroid abscess or suppurative thyroiditis. Strong clinical suspicion is the key to the diagnosis. Fistulogram could be confirmative especially when performed in an inflammatory-free period, and helps the surgeon to direct the plan of management. Surgical excision of the fistulous tract with hemithyroidectomy or lobectomy is the management of choice. Conclusion: Pyriform sinus fistula should be kept in mind as an underlying cause of n cases of recurrent thyroid abscess or suppurative thyroiditis.

The vesical stone formation due to intravesical mesh erosion of tension-free vaginal tape (TVT) is rare. In this report, a case of 48-year-old patient who underwent (TVT) elsewhere is discussed. The patient was presented with vesical stone and persistent stress urinary incontinence. Intravesical stone was detected by non-contrast computed tomography and cystourethroscopy. Stone fragmentation was done by pneumatic lithotripsy and transurethral resection of the mesh was performed. The postoperative control cystoscopy demonstrated complete healing of bladder mucosa.

Purpose: To evaluate the efficacy of a simple and economic procedure using a placard-shaped in situ anterior vaginal wall sling for the treatment of stress urinary incontinence, with or without cystocele repair. Methods: From July 2003 to July 2004, 14 female patients (mean age 45.21 years, range 37–57) were operated upon because of stress urinary incontinence (SUI) with the placard-shaped in situ anterior vaginal wall sling technique. The average follow-up period was 11 months (range 4–14.5 months). Twelve patients were operated primarily with this technique and only two patients had undergone previous surgeries for the treatment of SUI (one patient had had two previous surgeries and the other had had one previous surgery). In all patients urethral hypermobility or/and bladder prolapse were observed. Filling cystometry showed sufficient bladder capacity with no detrusor overactivity. Results: No urinary retention was observed in any patient in the postoperative period. While 11 patients have 100% cure of incontinence, three patients started leakage of urine after 1–2 months after the operation (one patient had been operated upon twice before (and who was diabetic and obese) and two patients were primarily repaired by our technique). In two patients, suprapubic tenderness and redness were observed, and were treated by oral antibiotic and anti-inflammatory drugs. Conclusion: The placard technique is simple, cost-effective and has low incidence of urinary retention in the post-operative period. The success rate seems to be satisfactory and it can be applicable to patients who are primary cases of SUI with average body mass index. Yet longer term follow up and larger number of patients are needed before final conclusion can be drawn.

Intrauterine contraceptive devices have been in use for more than 30 years. Although perforation of the uterus by an intrauterine device is not uncommon, intravesical migration with secondary stone formation is a rare complication. A 46-year-old women is described in whom intravesical migration of the intrauterine device was complicated by bladder stone formation. Endoscopic management was applied with an excellent outcome.

Objective To prospectively define the role of the double J-stent placement following ureteroscopic stone therapy in providing a pain-free postoperative period for patients with persisting loin pain and documented hydronphrosis. Material and methods The study cohort consisted of 27 patients (mean age: 38.59 years; range: 22–60 years) who had undergone ureteroscopic intervention due to ureteral stone. All of the patients reported loin pain which did not respond to medical therapy associated with various degrees of hydronephrosis documented by ultrasound and/or an excretory urogram. The patients were randomized to either a stented (18 patients) or stentless (nine patients) group following semirigid ureteroscopy (7.5/12 Fr) for the treatment of ureteral calculi (pneumatic lithotripsy). The mean diameter of the stones was 7.7 mm (range: 3–13 mm). Intra-operative balloon ureter orifice dilatation was routinely performed. All patients were evaluated between 0 and 6 days postoperative for loin pain and lower urinary tract symptoms. Results Nine patients had loin pain in the first few days following the operation and were in need of intramuscular and/or intravenous analgesics. Of these, four were stented patients (4/18; 22.2%) and five were stentless patients (5/9; 55.5%). Lower urinary tract symptoms were not clinically significant and did not affect the quality of life in terms of loin pain, with the exception of one patient in whom the stent had dropped into the bladder. Conclusion We believe that stenting in patients with documented hydronephrosis manifesting in persisting renal colic is recommended. As ureteroscopic therapy may aggregate the edema of ureter mucosa, double J-stent placement may play an important role in offering patients a postoperative period free of loin discomfort. However, further prospective trials should be designed to evaluate the criteria for stentless ureterorenoscopy.

Purpose We sought to evaluate the feasibility and safety of open or robotic radical prostatectomy (RP) after rectum, sigmoid, or colon surgery. Materials and Methods Sixty-four patients with a median age of 65 years (range, 46-73 years) who underwent RP after previous pelvic surgery were included. Twenty-four patients (38%) underwent robotic RP and 40 patients (62%) underwent open RP. Bilateral lymph node dissection and nerve preservation were performed in 50 patients (78%) and 35 patients (55%), respectively. Variables evaluated included demographic characteristics, perioperative complications, and functional and oncological outcomes. The median hospitalization and follow-up periods were 2 days (range, 1-12 days) and 21 months (range, 1-108 months), respectively. Results No conversions from robotic to open surgery were performed and there were no intraoperative complications. Surgical margins were positive in 13 patients (20%), seminal vesicle involvement was detected in 6 patients (9%), and lymph node involvement was found in 2 patients (3%). Postoperative complications included lymphocele in 1 patient, urethral stricture in 1 patient, and bowel obstruction and persistent bladder leakage in 2 patients. Eighty-eight percent of the patients were continent at 7 months and 80% of patients were able to achieve erection with or without medical aid. Conclusions Open or robotic RP can be done safely and effectively in patients who have previously undergone pelvic surgery. Although prior pelvic surgery of the large intestine was associated with increased morbidity, it should not be considered a contraindication for robotic or open RP.

Purpose To investigate the implication of topical urethral anesthetic gel on the evaluation of retrograde urethrography (RGU) Material and methods In this prospective study, 20 patients with a mean age of 46 years were enrolled. All these patients were subjected to RGU because of suspecting a urethral stricture. Of these 13 had a history of open or endoscopic urethral manipulation, while seven had no such history. In all patients 10 ml of Gelicain gel 2% (lidocainhydrocloride) was used as local anesthetic gel at temperature of 22C. The injection was made gradually over 10 s. The first set of RGU was done without local anesthesia and the second image was taken after 10 min of instillation of 2% gelicain gel. All images were evaluated by the same radiologist. The diameter of the urethra was measured by capture screen during fluoroscopy immediately distal to the stricture site in case of urethral strictures and at the middle of the bulbous urethra in other cases. Results In all patients, the mean diameter of the urethra at the selected site was 8.7 ± 2.5 mm before and 9.4 ± 2.9 mm after instillation of local anesthetic gel (P = 0.005). The stricture was diagnosed in 13 cases while seven patients had no stricture. The clinical diagnosis of a possible stricture was the same before and after instillation of the local agent in all patients. Conclusion Instillation of the local anesthetic gel before RGU produces a slight but statistically significant increase in the diameter of the urethra at the selected sites. However, neither the radiologic reading of RGU nor the clinical diagnosis of a possible stricture was changed because of this increment.

Purpose: Using the concept of tubularized incised plate (TIP) urethroplasty technique for proximal, distal, primary, secondary and complicated cases of hypospadias. Material and methods: From June 2002 to December 2003 TIP urethroplasty was performed in 15 patients between the age of 1–18-year-old with penosecrotal, mid shaft and subcoronal hypospadias. In 13 of them TIP urethroplasty used as the primary repair while in two of them as secondary repair. Results: No clinically important complications were observed in those boys who underwent primary reconstruction. One of them had meatal stenosis at the early postoperative period which was corrected by dilatation of the external meatus by feeding catheter at intervals up to 2 months postoperatively. Three boys had very narrow fistula which just allow leak of few drops of urine through urination. One boy with penoscrotal hypospadias who underwent two-stage repair had fistula. Conclusion: The concept of TIP urethroplasty is the procedure of choice for the treatment of proximal hypospadias and, it seems to be suitable for distal, secondary and even complicated hypospadias reconstruction. The advantages of this procedure include its simplicity, low complication rates and very good appearance of the glance with normal meatus.

Aberrant vessels is the most common cause of extrinsic uretero-pelvic junction (UPJ) obstruction. Due to the left flank pain, 18-year-old male patient with UPJ obstruction due to aberrant vessels in left malrotated kidney and right renal cross ectopia without fusion, had been operated. Ureter was reconstructed and anastomosed anterior to the aberrant vessels after the Double-J-Stent has been placed. At the postoperative period there were improvements in the clinical symptoms and renal function. So, even in the later childhood surgical choice is still the acceptable treatment modality in such cases. To the best of our knowledge, although there are some papers about aberrant vessels which cause UPJ obstruction, there is no such a case with ipsilateral renal hydronephrosis due to aberrant vessels associated with contralateral renal cross ectopia without fusion.

Purpose Modest long-term success is one of the most disappointing issues facing patients undergoing anti-incontinence surgery. Herein we introduce a novel surgical modification of the vaginal sling to address the mechanisms that may lead to a reduction in the success rate at the long-term follow-up. Materials and Methods Twenty-three female patients with mean age of 48.2 years (range, 22-73 years) underwent anti-incontinence surgery to correct their stress urinary incontinence (SUI) between August 2006 and January 2008. The in situ anterior vaginal wall sling, reinforced with equi-size monofilament polypropylene tape, was used as an anti-incontinence surgical procedure. The mean follow-up period was 30.2 months (range, 24-38 months). Results The surgical technique was successful in 22 patients (95.65%); 20 of them were cured and 2 patients showed clinical improvements. Urinary retention was observed in one patient (4.34%), which was resolved after decreasing the tension of the suspension sutures. No significant post-voiding residue was detected postoperatively. Conclusions Cost-effectiveness and a low risk of urethral erosion, due to the presence of intervening vaginal mucosa, are important advantages of this technique. Long-term success is expected, because relaxation of the non-tension-free suspension sutures and dislocation of the midurethral sling are less likely.

Objectives: To prospectively evaluate the role of double J (DJ) stent in enhancing the passage of fragments in patients undergoing extracorporeal shockwave lithotripsy (SWL) for renal stones with diameters less than 2.5 cm. Methods: Between November 2005 and January 2007, 38 patients with an average age of 47.05 years (range 16-73) were included and underwent SWL for renal stones. The inclusion criteria were radio-opaque renal stone not located in the lower pole, complete disintegeration of the stone, normal renal function, no met abolic abnormalities, no major renal abnormalities and no symptomatic urinary tract infection. The patients were randomized to either a stented (11 patients) or stentless (27 patients) group. The average stone diameters in stentless and stented groups were 1.54 cm and 1.77 cm, respectively (p > 0.05). Double J stent was removed when there was no further passage of the fragments for 6 weeks after stone disintegration. All patients were given non-steroidal anti-inflammatory drugs for one week after ESWL treatment. Stone passage and the data of DJ were determined with plain X-ray of the urinary tract (UTP). The severity of lower urinary tract symptoms, loin pain and the need for intravenous or intramuscular analgesics were recorded. Results: The overall stone-free rate at 3 months was 92.1%. Two patients in the stented and one patient in the stentless group were partially free of stones. Steinstrasse were observed in two patients (5.3%); one patient in the stentless group and another one after the removal of DJ stent. Only one patient in the stented group had severe lower urinary tract symptoms which responded neither to oral nor to other forms of analgesics, and therefore DJ stent was removed. The remaining patients were in no need for analgesics other than the oral therapy. Conclusion: Placement of DJ stent for the purpose of improving free stone rate or enhancing the passage of the fragments during SWL is unnecessary in renal stone with diameters less than 2.5 cm. However, further prospective trials should be designed to define the criteria for stented SWL (JPMA 59:141; 2009).

Background The aim of the study was to assess the morbidity and efficacy of repeat cryoablation (CA) in the treatment of localized prostate cancer. Methods Twenty-seven patients with median age of 71 years (range 48–80) who underwent repeat CA between April 2003 and April 2011 at a single institution were included. The median initial prostate-specific antigens (PSA) and Gleason values were 6.2 ng/ml (range 4–23.6) and 7 (range 6–9), respectively. Twenty-four patients underwent two CA treatments, and three patients underwent three CA treatments. Pre- and perioperative parameters and oncological and functional outcomes were evaluated. Results No intraoperative complications occurred. After the first CA, PSA was undetectable in 10 patients, and the median nadir PSA value was 0.65 ng/ml (range 0.1–4.9). After the second CA, 4 patients had undetectable PSA, and the median nadir PSA value was 1.25 ng/ml (range 0.2–7.9). For patients who underwent a third CA treatment, no patients had undetectable PSA, and the subsequent median nadir PSA value was 1.6 ng/ml (range 0.4–4.5). Two patients had incontinence (1 pad per day) following repeat CA. One patient had urinary retention after the third CA treatment, and one had urethral stricture. The mean hospitalization and follow-up periods were 1 day (range 0–2) and 51.5 months (range 11–96), respectively. Conclusions Repeat CA successfully reduced PSA levels, and complications were modest. We conclude that repeat CA is a feasible, safe, and effective treatment option for localized prostate cancer.