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E Belgrano

Publications and source records attributed to E Belgrano.

At least 55 records · Page 3Linked to original sources
PubMed1996

[Infrequent application of intraoperative ultrasonography in urology].

Among the usual indications of intraoperative ultrasounds, we describe four infrequent applications that show how useful and powerful this technique could be for interventive urologists. The first case regards a 66 years old male who was affected by a renal metastasis from thoracic cage chondrosarcoma. The use of intraoperative ultrasounds permits to highlight atypical sonographic features of the secondary lesion that were not seen in preoperative radiologic exams and that are completely different from the usual renal lesions. The second case regards the treatment of prostatic abscess performed by echoguided transperineal puncture in which the use of transrectal ultrasound probe permits a precise and correct placement of the needle and the drainage in order to obtain a fast relief of the symptomatology. The third case shows the role of intraoperative ultrasounds in the localization of a parathyroid adenoma in a 52 years old male affected by primary hyperparathyroidism and with recurrent renal colics. In this case the blind surgical exploration of the parathyroid gland and so the possibility of iatrogenic lesions to the recurrent laryngeal nerve were avoided by the use of the intraoperative sonography for the identification of the adenoma. At the same time the operation times were reduced. The last case underlines the importance of using intraoperative ultrasounds in the real-time monitoring for the creation of the neovagina in sex reassignment surgery in male-to-female transexualism in order to avoid a dangerous postoperative complication represented by the iatrogenic lesion of the rectum during the dissection of the perineal region.

Abscess↗
PubMed1994

The skin response in evaluation of the sympathetic chains after retroperitoneal lymphadenectomy. Preliminary report.

The sympathetic skin response (SSR) permits recording of the sympathetic amyelinic fibres activity in relation to the function of sudoriparous glands. We recorded the SSR to check the efficacy of "nerve-sparing" technique in surgery of the sympathetic retroperitoneal postganglionic fibres following lymphadenectomy in nonseminomatous testis cancer. The results showed that SSR can be used to verify the integrity of the lumbar sympathetic chains after retroperitoneal lymphadenectomy.

Adult↗
PubMed1994

[Single-blind study of the effect of doxazosin mesylate in benign prostatic hypertrophy].

The purpose of this single blind study was to verify the efficiency of Doxazosin Mesylate, an alpha-1 adrenergic blocker, in patients with benign prostatic hyperplasia (BPH). This study involved 20 patients non placebo responders. The duration of treatment was 45 days with administration of Doxazosin Mesylate increased every 15 days from 1 to 2 mg and from 2 to 4 mg respectively. At the end of each dosage cycle the following investigations were performed: a) peak urinary flow, b) residual urinary volume, c) funneling of the prostatic urethra by means of permictional transrectal echography, d) Boyarsky's score. The analysis of these data, applying a two way analysis of variance (ANOVA), showed that Doxazosin Mesylate resulted in improvements in both urodynamic and symptomatic parameters. The statistical analysis proved also that there was a good correlation between the dosage of the drug up until 2 mg and the results from each parameter considered.

Aged↗
PubMed1994

[Physiopathology of cervico-urethral obstruction in benign prostatic hypertrophy].

It's known that benign prostatic hypertrophy arise from the glands that surround the proximal prostatic urethra. In these cases voiding disorders may be due by detrusor instability alone or associated with cervical urethral obstruction. At first Griffiths and Schafer and subsequently Sarky have introduced some correlations that are able to differentiate the bladder outlet obstruction from the impaired detrusor contractility. On the contrary with regard to the behaviour of detrusor during obstruction, in connection with histological findings, several interpretations have been expressed. The theory more credited has been expressed by Gosling who has showed a reduction of the parasympathetic innervation of detrusor and consequent hypersensitivity due to denervation.

Humans↗
PubMed1994

[Semeiotic flowmetry in complex varicocele].

The Authors report on their specific experience on the funicular Doppler veocimetry, regarding the varicocele. In particular we enhance the semeiological spects of the C.W. Doppler velocimetry in the sub-clinical varicocele, in the bilateral one and in the characterization of the spermatic and cremasteric refluxes, and of the external pudenda vein. The Authors stress the utility of the definition of the amount of the reflux, so achieving an integration with the existing classification by degrees, that as it is now days expressed, it seems, to regard the elapsed time and the quantity of reflux caused by the Valsalva manoeuvre. In the practical velocimetry those elements have not been proved to have a parallel increment. Lastly, we report on some cases of veno-spermatic refluxes, uniquely observed in the clynostatism, along with a missing orthostatism. Moreover the Authors believe that some of these hemodynamical consideration could be revisited.

Humans↗
PubMed1994

[Urologic applications of intralaparoscopic echography].

The impossibility to palpate organs and tissues is probably the most important drawback of the laparoscopic approach: laparoscopic sonography represent the only real alternative to manual palpation. The laparoscopic approach in the field of urology was initially limited to the identification of the undescended testes in paediatric urology and to the laparoscopic ligation of varicocele. More recently, it took into account the pelvic lymphadenectomy for staging prostatic and bladder cancer. The upper urinary tract and the retroperitoneum were approached more recently. In a preliminary phase the indications for laparoscopic nephrectomy were limited to benign diseases, such as atrophic kidney in patients with renal hypertension, and scarred pyelonephritic kidney. At present some preliminary experiences are reported about nephrectomy performed for carcinoma of the urether or of the upper collecting system and for renal masses of unknown origin. Another indication for a laparoscopic approach to the kidney is represented by symptomatic renal cysts. These cysts have been usually treated with percutaneous aspiration and/or sclerosis, but a high rate of recurrence is reported. Laparoscopy may be used to approach renal cysts with the advantage that most of the cystic wall could be excised, reducing the change of recurrence. Another possible indication for laparoscopy and laparoscopic sonography is the retroperitoneal lymphadenectomy in testes cancer with staging or therapeutic purposes. Nowadays preliminary experiences in laparoscopic adrenalectomy have been reported in a limited series of cases. In this report the Authors present their initial experience using a 7.5 MHz rigid probe having 400 crystal which can be inserted into a 10 mm trocar.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1994

[Physiopathology of the pelvic elements of support in stress urinary incontinence in women].

Stress urinary incontinence (SUI) is called as the involuntary loss of urine without the presence of detrusor contraction with bladder pressure that is higher than maximum urethral pressure. The SUI may be caused either by hypermobility of urethra or by inefficacious intrinsic urethral sphincter activity. It is clear that female urinary continence is established by the balance of opposed forces in the pelvis. The elements that contribute to the maintenance of continence are: 1) maximum urethral closure pressure; 2) anatomical and functional length of urethra; 3) ability of perineum to increase the urethral pressure simultaneously with the Valsalva's manoeuvre; 4) appropriate localization of the sphincteric unit. The alteration of the above-mentioned elements may be caused from no functionally of pubo-urethral ligaments and the laxity of cardinal ligaments and of pubic-cervical fascia.

Female↗
PubMed1994

[Physiopathology of bladder-sphincter dysfunctions].

Bladder voiding implies activation of mictional reflex. The coordination of the latter is strictly dependent on center of miction situated in encephalo. The interruption of the nervous fibers linking pons with center of miction situated in sacral spinal cord causes the appearance of vesico-sphincter dyssynergia. On the contrary, the interruption of the fibers localized above the opns causes the loss of the voluntary control of miction. Finally the lesion of sacral spinal cord or of the nervous fibers connected with it is responsible for the appearance of detrusor areflexia with reduction of the smooth sphincter activity and paralysis of the striated one.

Humans↗
PubMed1994

[Role of diuretic dynamic echography in the study of the pyelo-ureteral junction: review of a caseload after the first 4 years of experience].

Diuretic ultrasound, described in Literature in the seventies from Rosenfield, is an effective technique if compared with the functional urodynamic study and the diuretic renography evaluation for the assessment of upper urinary tract obstruction. In our study we have compared the effectiveness of diuretic ultrasound with diuretic intravenous urography in the evaluation of obstructive pathology of ureteropelvic junction. The technique was performed on 47 patients 11 of whom were pediatrics making a total of 94 renoureteric units. Results show high sensibility of this technique either with severe obstructions (94%) or moderate obstructions (96%).

Adolescent↗
PubMed1994

[Current utilization and potential developments of echography in the urologic field].

The employment of ultrasonography in urology is not well established yet. On this purpose a survey of present situation in different medical setting was conducted. 200 questionnaires were filled by about 1000 physicians operating in various medical centers. The most of answers was provided by assistant head physicians (41%) and head physicians (30%), with a clear prevalence of urologists (64%) and nephrologists (32%). The number of beds reported by each centers ranged from 0 to 90, while the average doctor-patient ratio was 3.6. 72% he centers could avail of B-mode echography (22% of them owned an echo-Doppler velocimeter). The data obtained reveal the great heterogenety of present medical system and the necessity of finding a correct equilibrium between specialistic and primary care settings. It can be concluded that the correct use of ultrasonography depends both on good knowledge of its real indications and on the proper professional training of the echografist.

Health Facilities↗
PubMed1994

Transcutaneous electrical localization and reversible blockade of the sacral nerve in the diagnosis of the urge syndrome.

To date, conventional urodynamic evaluation is not able alone to distinguish motor urgency with uninhibited detrusor contraction from sensory urgency. Transcutaneous electrical localization and reversible monolateral blockade of the 3rd sacral root was performed in 3 women with interstitial cystitis and in 2 men with idiopathic detrusor hyperreflexia by intranerve injection of 6 ml 0.5% Bupivacaine solution. The paralysis of the detrusor was completely reserved in all patients within 6 hours of the blockade. Cystometry and cystography were performed at 10 min, 2 and 6 hour intervals after the injection. In patients with the urge syndrome resulting from interstitial cystitis, there was a small increase in bladder capacity during the blockade. In contrast, the bladder capacity increased considerably during blockade in patients with idiopathic detrusor hyperreflexia. These results allowed us to differentiate the forms of the syndrome described above.

Diagnosis, Differential↗
PubMed1993

[The role of echography in the intraoperative study of non-palpable testicular masses].

Intraoperative ultrasound localization of the non palpable testicular lesions allows to detect small gonadal tumors or to well study benign testicular masses. Several methods have been proposed to study non palpable testicular masses including CT and NMR. Prospective studies of the efficacy of CT vs spermatic venography in localization of cryptorchid testes have also been reported: spermatic venography proved to be the most accurate of the two modalities even if possible neoplastic degeneration of testicular tissue is very difficult to investigate with this method. Herein we describe our clinical experience and particularly four cases in which we adopted intraoperative ultrasonography of testes with different results. M.S. a 28 year old infertile patient underwent testicular ultrasound during a check-up and a little image localized at the level of right testis was found. Even if no mass was palpable we decided to operate on the patient; an intraoperative testicular ultrasound revealed the precise localization so that the little mass was excised and examined at once. Histologic study confirmed the presence of tumoral tissue and orchiectomy was performed: deeper hystological studies confirmed it was a leydigioma. D.C. 27 year old bilaterally cryptorchid patient had been already operated on twice but no testicular structure was encountered at the level of inguinal channels. Neither preoperative abdominal ultrasound nor CT revealed the presence of the testes. At abdominal exploration both testes were localized in the iliac region. Intraoperative testicular ultrasound allowed us to localize a right testicular tumor: right orchiectomy and left autotransplantation were performed.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1993

[Echo-guided puncture of intraprostatic cysts].

The occurrence of an obstruction of the ejaculatory ducts, in spite of its rarity, must be considered by the Urologists in the screening of the etiologic causes of obstructive azoospermia. Nowadays, the diagnostic approach, which includes the biochemical study of seminal plasma and prostatic ultrasound, often leads to the preoperative recognition of the site of obstruction. Various surgical and endoscopic techniques have been adopted for the treatment of ejaculatory duct obstructions in different historical periods. Herein we describe our experience that starts from 1979. 17 infertile patients with intraprostatic cysts and 2 with a stenosis of the veru montanum were treated by us following these criteria: 9 azoospermic patients underwent scrototomy and endoscopy; 10 patients with a severe oligozoospermia underwent echo-guided puncture of an intraprostatic cyst. The patients were placed in the lithotomy position, a 16 G needle was adopted and by means ultrasound was possible to follow the needle entering the cyst. When no spermatozoa was detected in the cystic liquid, sclerosing agents (Sodium-tetradecyl-sulphate 30 mg in 1 l.) was introduced. This easy procedure was carried out on outpatients in local anaesthesia. One out of ten oligozoospermic patients had to repeat the echo-guided puncture of intraprostatic cyst as the first attempt had been followed by recurrence. Eight out of ten subfertile patients who had undergone percutaneous echo-guided treatment had longer than 1 year follow-up: in seven cases an increase in sperms number and motility was obtained; in one case sperm count remained unmodified. In three cases the partners became pregnant.

Adult↗
PubMed1993

[Echo-flowmetric control 6 years after percutaneous treatment of varicocele].

Several Authors have discussed the long term efficacy of sclerotherapy; somebody supposes that percutaneous angiographic treatment of spermatic vein is not sure at all because the occlusion due to the sclerosing agents is not retained as long lasting. Studies have been done by other Authors about comparison of recurrent varicocele anatomy following surgery and percutaneous balloon occlusion: it is concluded that venous collaterals are identified easily by renal venography, and knowledge of these collaterals is helpful in planning further radiological treatment. Since 1980 we have always treated left varicocele by means of percutaneous sclerotherapy of the spermatic veins following renal phlebography: the treatment is done on an outpatient basis, in local anaesthesia. Sclerosing agents we usually adopt are: sodium-tetradecyl sulphate and alcohol. At our knowledge long-term results of this treatment have never been published; this is the reason for which long-term follow-up of 27 patients that 6 years ago underwent percutaneous sclerotherapy was done. Only 16 of them have accepted to repeat: a) physical examination; b) Doppler flowmetry; c) scrotal ultrasound. The presence of a varicocele was demonstrated in 2 out of 16 patients (12.5% of the case). These data confirms that percutaneous treatment performed following the procedures we adopted in 1986 has a long term efficacy in 87.5% of the cases.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1992

Evaluation of hematochemical parameters and renal echography after ESWL.

Evaluation of hematochemical parameters and renal echography after ESWL treatment with Tripter X1 was done on the first 95 patients treated and for whom we had a longer than 3-month follow-up. Creatinine phosphokinase values showed an increase in 24 patients. 12 patients demonstrated an increase in amylasemia. Echographic checks performed the day after treatment revealed the presence of perirenal lesions in 3 cases. As far as amylasemia is concerned, only 1 patient was treated with aprotinin. One of the patients who developed perirenal hematoma had hypertension; another was following an antiaggregant therapy that was temporarily suspended.

Adolescent↗
PubMed1992

[Testicular autotransplant and laparoscopic orchiectomy in a case of bilateral adult cryptorchism].

B.L. a 27 year old bilaterally cryptorchid patient underwent right testicular autotransplantation in the presence of a quite normal testis. After one year the patency of microsurgical anastomosis was confirmed by means Doppler flowmetry and scrotal echography demonstrated the presence into the scrotum of a testis provided of a normal echogenicity. Left laparoscopic orchiectomy was planned. A small semilunar skin incision was made just below the rime of the umbilicus. Veress needle was introduced: as soon as the needle pierced the parietal peritoneum, its spring mechanism was released allowing the sharp needle point to retract leaving only the blunt tip protruding. Carbon dioxide gas was insufflated through the side part of the Veress needle until adequate abdominal distension was achieved. After having removed the Veress needle, the laparoscope on its sharp-pointed trocar was introduced into the peritoneal cavity and left testis was easily localized. Four trocars were introduced up to proceed to laparoscopic orchiectomy. The patient was discharged two days after. In our opinion in the presence of a bilateral cryptorchism in the adult, is better to plan a monolateral autotransplantation. After having verified the long-term result of microsurgery we can decide if a contralateral orchiectomy has to be planned.

Adult↗
PubMed1992

[Impotence: introductory notes].

If we define erectile impotence as the inability to achieve and maintain a firm erection we can distinguish several pathogens of impotence: psychologic disorders, neurogenic sinusoidal disorders, arterial disorders, venous & sinusoidal disorders and systemic diseases and other disorders can cause erectile impotence. An etiologic screening of impotence must be carried out by Urologists in order to adopt the best surgical approach. Especially when surgery has to be planned, a complete, often invasive screening associated with a super-specialist diagnostic study is necessary at the beginning of any procedure. Different approaches to impotence can be adopted on the basis of patient's age, etiology and failure of other devices. The main methods of surgical correction of impotence may be divided as follows: a) percutaneous transluminal angioplasty (P.T.A.); b) revascularization; c) surgical treatment of "venous leakage", d) trans-luminal veno-occlusion (T.L.V.O.); e) correction of penile curvature; f) prostheses placement. The diagnosis of arteriogenic impotence depends upon the arteriographic demonstration of bilateral hemodynamically significant obstruction. In our experience the injection of papaverine during the test has provided a better visualization of cavernous arteries and helicine branches. Reduction of luminal diameter by more than 50% suggest a hemodynamically significant stenosis. Intracavernous injection of vasoactive agents has provided an attractive alternative to surgery. We have employed papaverine alone or with phentolamine or phenoxybenzamine. After short term treatment, some patients have achieved good erections without further injections. For P.T.A. of the distal internal pudendal arteries our approach has been via the ipsilateral or contralateral femoral arteries. Under local anesthesia a penile arteriographic catheter is placed in the internal pudendal artery.(ABSTRACT TRUNCATED AT 250 WORDS)

Alprostadil↗