Intravenous paracetamol versus oral tramadol for pain control during shockwave lithotripsy: a prospective randomized comparative study

Abstract

Multiple system atrophy (MSA)  is similar to Parkinson’s di-sease but it is more severe, early onset neurodegenerative disease and has a higher morbidity and mortality. The symptoms of  the di-sease for lower urinary system may be seen before   symptoms of other systems develope. Because the disease causes a lot of comp-laints including  nocturia, frequency and incomplete emptying of the bladder  by means of its degenerative effect on lower urinary system, it has a particular  importance for urology. Due to simila-rities in respect of symptoms and findings to prostatic obstructi-on, some times the patients may be misdiagnosed as having  benign prostatic hyperplasia (BPH) and consequently undergo prostatic surgery when medical treatment suggested to be inadequate. This event may cause the patients’ complaints worsen and result in  dist-ressing  outcomes for both patients and urologists. Therefore urolo-gist should  be sure if  obstructive symptoms that sometimes are the only and preceding symptoms of MSA, resulted from  BPH  or be sure the patient has no  MSA actually.

Key Words: Benign prostate hyperplasia, multiple system at-rophy, Parkinson’s  disease

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