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Biomedical subjects

F Bergamaschi

Publications and source records attributed to F Bergamaschi.

29 records · Page 2Linked to original sources

Prostatic spiral versus prostatic urolume wallstent for urinary retention due to benign prostatic hyperplasia. A long-term comparative study.

Thirty-eight high-risk surgical patients with urinary retention due to benign prostatic hyperplasia (BPH) were treated by placement of a prostatic spiral under local anesthesia (group 1: 20 patients) or a prostatic stent under intravenous sedation (group 2: 18 patients). At the 1-year follow-up, mean peak flow rate, residual urine volume and subjective symptoms scale were significantly better in the stent group (p < 0.01). The rate of postoperative urinary incontinence and dislocation of the device was greater in the spiral group. Cystoscopic manipulation and removal of the device were definitely easier with the spiral. Both the prostatic spiral and stent have specific roles in the treatment of urinary retention in the unfit BPH patient. The selection of the most suitable device depends on accurate patient assessment.

Aged↗

Long-term clinical reliability of transurethral and open prostatectomy for benign prostatic obstruction: a term of comparison for nonsurgical procedures.

To elucidate the long-term reliability of prostatectomy, we evaluated 92 benign prostatic hyperplasia patients who had been submitted to either transurethral or open surgery at the 5-year follow-up. Ninety-five percent of the patients were still nonobstructed and subjectively satisfied of their urinary status. Postoperative mortality was presumably not related to the previous operation. Until now, nonsurgical procedures did not guarantee the results achieved by surgical treatment and should thus be reserved for patients at high operative risk or refusing surgery.

Follow-Up Studies↗

Velocity and flow volume gradients along the cavernosal artery: a duplex and color Doppler sonography study.

Duplex and color Doppler sonography were used to assess 130 impotent patients and 8 potent controls. Cavernosal artery diameter, peak flow velocity and volume flow rate were evaluated at the level of the crura of the corpora cavernosa and 1 cm proximal to the corona penis. Potent controls and nonarteriogenic impotent patients showed a 20% reduction in hemodynamic parameters at the periphery of the cavernosal arterial tree. In patients with occlusive disease, involving either the upper arterial tree or the entire course of the cavernosal artery, the gradient was maintained. In patients with selective occlusive disease of the distal segment of the cavernosal artery the hemodynamic gradient almost doubled. Hemodynamic gradients can be identified along the cavernosal artery and provide additional information to arteriographic data for the selection of candidates for penile vascular reconstructive surgery.

Arterial Occlusive Diseases↗

Morphodynamic assessment of penile circulation in impotent patients: the role of duplex and color Doppler sonography.

Duplex and color Doppler sonography were used to assess the vascular status of 240 impotent patients. The tests were performed before and after intracorporal injection of a standard dose of a vasoactive mixture and measurements were done both at the crura and at the midshaft of the penis. Particular care was taken in the evaluation of cavernosal arteries diameter, wall pulsatility, morphology of spectral waveform, blood flow acceleration, systolic and diastolic flow velocity and flow volume. Resistance and pulsatility indexes of the cavernosal arteries were also measured. Flow along the deep dorsal vein was quantified when possible. Cavernosal artery peak systolic flow velocity, flow volume and acceleration were the best indicators of arterial penile circulation. Persistently elevated (> 10 cm/s) diastolic flow in the cavernosal arteries positively correlated with a diagnosis of venogenic impotence obtained by dynamic infusion cavernosometry--cavernosography in almost 80% of cases. Duplex and color Doppler sonography permit to thoroughly evaluate cavernosal arteries function and seem to have a promising role in the study of the veno-occlusive mechanism of the corpora cavernosa.

Blood Flow Velocity↗

Bladder outflow after radical prostatectomy.

Postoperative bladder outflow was assessed in 150 patients subjected to radical retropubic prostatectomy for clinically localized prostate cancer. The overall mean (+/- S.E.M.) postoperative peak flow rates and residual urine volumes were 16.9 +/- 1.3 ml/s and 11.4 +/- 2.1 ml. According to flow nomograms, 22% of the patients were still obstructed postoperatively due to stricture of either the anastomosis or the urethra (12%), or to partial bladder denervation (10%). Scoring of subjective symptoms was not reliable in detecting postoperative outflow obstruction, while uroflowmetry with flow nomograms identified all obstructed cases. Radical retropubic prostatectomy can induce both mechanical and functional alterations of the distal urinary tract and a strict assessment of postoperative bladder outflow is recommended.

Adenocarcinoma↗

[Doppler color echography in the diagnosis of impotence].

This study reports the experience achieved with duplex and color Doppler ultrasonography in 120 impotent patients. The following morphodynamic parameters of the cavernosal arteries were studies before and after intracorporal injection of a mixture of vasoactive drugs: arterial diameter, wall pulsatility, morphology of the spectral waveform, peak systolic velocity, end diastolic velocity and flow volume. The veno-occlusive mechanism of the corpora cavernosa was studied directly by determination of flow along the deep dorsal vein of the penis and indirectly by serial evaluation of the diastolic flow of the cavernous arteries.

Adult↗

Transrectal microwave hyperthermia for advanced prostate cancer: long-term clinical results.

Transrectal microwave hyperthermia was applied to 46 stages D1 and D2 prostate cancer patients to treat urinary symptoms and local pain unrelieved by total androgen ablation therapy. Hyperthermia was administered in 10, 60-minute sessions twice a week for 5 weeks. A calculated intraprostatic temperature of 43.5 +/- 0.5C was maintained throughout the treatment. At 2 years the mean residual urine volume was significantly decreased (p less than 0.05), while the mean peak flow rate and maximum flow nomogram were improved but not significantly. The majority of patients reported a notable amelioration of subjective symptoms and quality of life. The only complication was a prostatorectal fistula that was cured by leaving a urethral catheter in place for 4 weeks. Prostatic hyperthermia is a safe and effective palliative procedure for bladder outlet obstruction due to advanced prostate cancer.

Aged↗

[Use of ultrasonography in morphofunctional evaluation of orthotopic neo-bladder].

Seventeen patients submitted to radical cystectomy and orthotopic bladder replacement according to Reddy's technique were studied at the 1, 3, 6 and 12-month, then annually follow-up by physical examination, intravenous pyelogram, cystourethrography, suprapubic and transrectal ultrasonography and complete urodynamics. Sixteen patients (94%) reported day-time urinary continence and twelve patients (70%) day-time and nocturnal continence. Cysto-manometry showed a mean bladder capacity of 450 cc with a maximal endocavitary pressure of 40 cm. H2O and satisfactory peak flow rate. Vesico-ureteral reflux was never detected at roentgenography. Ultrasonography may be useful in the study of a possible reflux or stenosis of the neovesico-ureteral junction by detecting renal scars or dilatation of the renal cavities. Sovrapubic ultrasonography can quantify the capacity of the neo-bladder (300-600 cc), study its shape, walls and contractions that do not cause the involuntary opening of the neo-bladder neck. Transrectal ultrasonography studies the bladder neck shape and its dynamic function. Residual urine volume never exceeded 50 cc. Ultrasonography demonstrated its effectiveness and reliability and limited the application of more invasive roentgenographic procedures.

Cystectomy↗

Postpubertal cryptorchidism: review and evaluation of the fertility.

We assessed the fertility of 91 patients affected by unilateral cryptorchidism who were subjected to postpubertal orchidopexy in the last 15 years. All cases were clinically examined, evaluated by semen analysis and Doppler ultrasound of the spermatic artery. Twenty-two patients underwent testicular biopsy. The results indicate that orchidopexy is not the best treatment for postpubertal cryptorchid patients. After orchidopexy, 83.5% of patients were azoospermic or oligospermic, with or without asthenospermia.

Adolescent↗

[Comparison of rectal examination, transrectal echography, CAT and MRI in the local staging of prostatic carcinoma].

From January 1978 to June 1990, 120 prostate cancer patients were submitted to radical retropubic prostatectomy. Local pathological staging evidenced 70 patients (58%) in stage B of disease (intraprostatic disease) and 50 patients (42%) in stage C of disease (extraprostatic disease). Sensitivity of rectal examination, transrectal ultrasonography, CT or NMR for stage B was 61%, 75%, 54% respectively and for stage C 61%, 70%, 50%. This study underscores the effectiveness of transrectal ultrasonography in the diagnosis of prostate cancer non evidenced at rectal examination. CT and NMR are not valuable for local staging and are now used only in patients at risk for extraprostatic or systemic disease.

Evaluation Studies as Topic↗