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Biomedical subjects

D Yachia

Publications and source records attributed to D Yachia.

At least 37 records · Page 2Linked to original sources
PubMed1993

New, self-expanding, self-retaining temporary coil stent for recurrent urethral strictures near the external sphincter.

Strictures near the external sphincter are a cause for concern. They can be managed by manipulation (e.g. urethral dilatation) or by anastomotic urethroplasty. Permanently implanted metallic stents have recently been used to treat recurrent urethral strictures. This report presents the results of using a temporary metallic coil stent (UROCOIL-S) in 20 patients with recurrent bulbomembranous strictures. In 13 patients the stent was left in place for 10 months and was then removed by a simple manipulation. After a mean follow-up of 10 months (range 3-14), the stricture recurred in only 1 patient. The use of a temporary (but long-term) stent for the treatment of urethral stricture is a new approach and the results are encouraging.

Follow-Up Studies↗
PubMed1993

New treatment modality for penile urethral strictures using a self-expanding and self-retaining coil stent: UroCoil. Follow-up of 16 months after removal of the stent.

Twelve penile urethral strictures which were managed in the past (2-21 years) by dilatations, urethrotomies, or by urethroplasty, were treated by an insertion of a temporary but long-term metallic coil stent. In 9 cases, the stent was left in place 6-9 months; in 3 cases, the stent is still in place. During the time the stent was inside, 4 patients who were sexually active before insertion of the stent were able to continue sexual activity. During a mean follow-up time of 16 months (range 4-24 months) after the removal of the stent, in only 1 case did the stricture recur. At present, this new internal device is the only one which can stent the penile part of the urethra temporarily without interfering with the sexual activity of the patient, and without causing pain or the risk of urethral perforation.

Follow-Up Studies↗
PubMed1993

[Long-term temporary prosthesis in prostatic obstruction. ProstaCoil, an expanding, self-fixating implant of large caliber].

The spiral metallic stent for insertion into the prostatic urethra developed by Fabian a decade ago, and its various modifications have a fixed external caliber of up to 21F and does not allow passage of instruments larger than 5-6F through it. Thus, they cannot be used in patients who need frequent trans-urethral manipulations. Since all temporary prostatic stents, in the long term develop incrustations they have to be changed once a year, or earlier, if they become occluded by stone formation. Permanent stents cannot be used in patients who are temporarily unfit for surgery because their removal necessitate traumatic manipulations. In order to overcome these disadvantages, a new large caliber, self-expanding and self-retaining intra-prostatic stent was developed (ProstaCoil). This stent is inserted under fluoroscopic guidance using topical anaesthesia. During the last 36 months the ProstaCoil was inserted into 65 patients suffering from complete prostatic obstruction due to BPH. Follow-up of our patients was 3-28 months (mean 16 months). Forty-eight patients could void either immediately or within 48 hours after insertion of the stent. Thirty patients underwent TURP or open prostatectomy 3-12 months after insertion of the stent. In all these cases the stent was removed easily before surgery. Only in 1 case the stent was removed because of severe urge incontinence. Seven patients died during this period. Twenty-seven patients still are passing urine through their stents (the longest 32 months).

Follow-Up Studies↗
PubMed1993

The use of urethral stents for the treatment of urethral strictures.

Three types of urethral stents can be used in the treatment of recurrent strictures: Urolume/Wallstent is a self-expanding mesh which is incorporated into the urethral epithelium; the ASI Titanium stent is a short rigid mesh of Titanium wire which is also incorporated into the urethra; Nitinol is a flexible spring in one or two parts connected by a steel wire. It remains endoluminal. The Urolume/Wallstent has been used since 1987. It is indicated in iatrogenic strictures. No statistical results are presented. The ASI stent should be reserved for strictures of the prostatic and posterior urethra. The Niticol UroCoil system can be used at all levels of the urethra; two models are available: simple or twin. The author has inserted 65 stents in 56 patients. The stent was removed after one year in 41 patients. The use of these stents has considerably decreased the number of repeated dilatations and urethrotomies.

Alloys↗
PubMed1991

Colonic-type adenocarcinoma of male urethra.

A case of a rare primary urethral carcinoma is presented. The histochemical characteristics of this tumor are identical to those of colon tumors. The patient was treated with segmental urethrectomy.

Adenocarcinoma↗
PubMed1991

Temporarily implanted urethral coil stent for the treatment of recurrent urethral strictures: a preliminary report.

A new urethral stent developed for use in recurrent urethral strictures is presented. This metallic coil is self-expanding when released from its introducing catheter. The stent was used in 18 patients with recurrent strictures necessitating frequent dilation or urethrotomy. The stent is introduced under fluoroscopic guidance after internal urethrotomy or simple dilation. Strictures of 5 to 60 mm. were treated successfully with this device. All strictures were distal to the external sphincter. No serious complications attributed to the device were recorded. When necessary, the stent could be repositioned either under fluoroscopic control or endoscopically. This device can hold the stenotic area of the urethra open for long intervals allowing for complete healing. Even after 6 months the stent is not covered with urethral epithelium and does not become incorporated into the urethral wall. It can be removed easily without an operation by simple manipulation. The large internal caliber permits passage of endoscopes up to 17F in patients who require cystoscopy. The device can be removed before transurethral resections and then a new stent can be inserted at the end of the procedure. Mean followup of our patients with the stent indwelling was 8 months (range 4 to 11 months). Followup after removal of the stent (6 patients) was 3 to 8 months (mean 5 months). The patients voided well during followup and were fully continent. No incrustations were noted in the removed stents even after 6 months and no stent became obstructed due to tissue proliferation or incrustation. In 1 patient the stricture recurred after 3 months and a new stent was inserted. Urine sterilization was obtained in 7 patients with infected urine after relatively short courses of antibiotics. This stent seems to be a promising tool for the nonoperative treatment of recurrent urethral strictures.

Humans↗
PubMed1991

Early assessment of penile curvatures in infants.

A noninvasive office procedure was developed for evaluation of penile curvatures in infants, in whom photography of this erectile deformity at home is difficult. By applying negative pressure with 2, 60 ml. syringes, penile engorgement and rigidity that mimic a natural erection could be achieved in 16 infants.

Diagnosis↗
PubMed1990

Tuberculous cold abscess of the corpus cavernosum: a case report.

A rare case of tuberculous cold abscess of the corpus cavernosum is presented. The only presenting symptom was obstructive urinary symptoms caused by external compression of the urethra by the abscess. Diagnosis was reached after surgical drainage and specific antituberculosis therapy led to a satisfactory conclusion.

Abscess↗
PubMed1990

Spontaneous breakage of self-retaining intraprostatic stent.

An unexpected late complication was observed in a patient in whom the self-retaining intraprostatic stent was inserted. Among our 32 patients in whom the device was used, instead of a long-term indwelling catheter in high operative risk patients or in those awaiting a definitive operation, the success rate was 80%, with a 20% immediate failure rate. Spontaneous breakage of the device occurred 96 days after its insertion. This device was removed endoscopically and a new unit was inserted under sonographic guidance. After 6 months the device still functioned satisfactorily.

Aged↗
PubMed1990

Modified corporoplasty for the treatment of penile curvature.

A technique based on the Heineke-Mikulicz principle was used to straighten penile curvature instead of Nesbit corporoplasty. By horizontally closing the longitudinal incisions the longer portion of the tunica albuginea is made equal in length to the shorter side. This technique achieves the same results as Nesbit corporoplasty in a simpler manner. Because of the distance between the longitudinal incision and the neurovascular bundle or corpus spongiosum these structures become less susceptible to injuries during an operation and need not be mobilized. Our experience with 10 cases treated with this technique is presented.

Humans↗
PubMed1990

Self-retaining intraurethral stent: an alternative to long-term indwelling catheters or surgery in the treatment of prostatism.

The self-retaining intraurethral coil is a device to stent the urethra in men who have severe urethral obstruction. It allows them to empty their bladders and still remain continent and sexually active. The device can be used in place of long-term indwelling catheters or as an alternative to surgery. During 1 year, we inserted the stent in 26 men who were poor operative risks. The treatment was successful in 20 (77%). All 20 were able to void satisfactorily. Four of the 20 resumed sexual activity, which previously had been prevented by indwelling catheters. Two patients who had delayed prostatic surgery because of fear of impotence were able to empty their bladders properly and to remain sexually active. Three patients subsequently had surgery, two after anticoagulant therapy could be stopped and one after renal function improved. No difficulties caused by the stent were encountered during surgery. Follow-up was for 2-12 months. Four patients who had had the stent in place for 12 months had no difficulties. In 16 of the 18 patients who had indwelling catheters and infected urine before insertion of the stent, sterilization of the urine was obtained after relatively short courses of antibiotic treatment. Short-term complications associated with the stent were incontinence or urinary retention. These were treated by repositioning the stent. Frequency of urination after insertion of the stent either disappeared spontaneously or was treated with anticholinergic drugs. In six patients, frequency was so severe that removal of the stent and insertion of an indwelling catheter were necessary. Slight to mild dysuria occurred immediately after surgery in all patients but eventually disappeared. Our experience suggests that the self-retaining intraurethral stent has considerable promise for the treatment of prostatic obstruction of the urethra.

Aged↗