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G Malossini

Publications and source records attributed to G Malossini.

At least 37 records · Page 2Linked to original sources

[Percutaneous, laparoscopic, and surgical treatment of idiopathic varicocele: analysis of costs].

Idiopathic varicocele can compromise the spermatogenetic function of the testicle and associate with alterations of the semen quality. The treatment of varicocele stops the progress of testicular damage and improves spermatogenesis and semen parameters. These are the main alternatives to the traditional surgical treatment of varicocele retrograde percutaneous occlusion of the internal spermatic vein using sclerosing agents and embolizing devices (either separately or in combination), microsurgical ligation via inguinal or sub-inguinal approach, laparoscopic ligation and, more recently, antegrade scrotal sclerotherapy. None of these techniques can be considered the "gold standard" therapy. Literature does not point out any significant difference between them, either considering the absence of reflux percentage, or the improvement of semen quality, or the pregnance rate. Therefore cost comparison may be a valid criterion in the choice of treatment for varicocele correction. The total cost of the surgical retroperitoneal unilateral ligation of the internal spermatic vein is 968,805 Lire, while for the bilateral ligation it is 1,118,285 Lire. The costs of sclerotherapy and percutaneous embolization are respectively of 698,750 Lire and 1,708,950 Lire. The combination of the two techniques amounts to 1,918,230 Lire. Laparoscopic bilateral ligation costs 2,437,935 Lire. Antegrade scrotal sclerotherapy costs 191,035 Lire if unilateral, 216,580 Lire if bilateral. After considering these data we can say that antegrade scrotal sclerotherapy is the first choice economically in the treatment of both unilateral and bilateral varicocele.

Cost Control↗

Renal staghorn calculosis: our experience with the percutaneous treatment with or without extracorporeal shock wave lithotripsy.

OBJECTIVES: In this paper we report our results in the treatment of renal staghorn stones by percutaneous lithotripsy (PCNL) with or without extracorporeal shock wave lithotripsy (ESWL). METHODS/RESULTS: Over a period of 5 years, 244 patients with renal calculosis were treated by PCNL in our Department. Seventy-four of these were cases of renal staghorn calculosis: 44 presented a partial staghorn stone and in 30 cases the stone formation completely occupied the pyelocalieal cavity. We performed first a PCNL via a rigid nephroscope. Stones were crushed using an ultrasonic lithotrite; an electrohydraulic probe was used when the calculus was resistant to ultrasound. The patients were submitted to one or more percutaneous treatments followed by extracorporeal lithotripsy to complete the operation, when required. The patients were divided into two groups according to the type of stone: the first group comprised 59 patients with a partial or complete simple staghorn stone and the second comprised 15 patients with a complete complex staghorn stone. Complete resolution was achieved in 55 of the 59 cases (93.2%) in the first group and in 9 of the 15 cases (60%) in the second. We had no complications. CONCLUSIONS: Our experience confirms that PCNL is the elective treatment for partial and complete staghorn stones and ESWL in these types of stones must be utilized only as ancillary treatment for residual fragments.

Humans↗

[Our experience in the conservative surgical treatment of megaureter in the adult].

Surgical treatment of the megaureter in adults is only indicated when important symptoms and/or complications occur. The Authors report their experience with eight adult patients affected by megaureter, undergone to conservative surgery. The average age of the patients was 36 years (range 21-52). The disease was unilateral in five cases (four on the right side and one on the left), bilateral in three. In five patients megaureter was primary (obstructed in four, refluxing in one). A case of megaureter with ectopic orifice in the prostatic urethra was observed. The remaining two cases, already operated in other hospitals, were a segmentary megaureter associated with vesico-ureteral reflux secondary to endoscopic incision of an ureterocele and a bilateral refluxing megaureter in a patient undergone to bilateral ureterocystoneostomy because of primary megaureter in his childhood. All patients underwent ureterocystoneostomy, performed with Politano-Leadbetter antireflux technique in six cases and with direct non-antireflux technique in two. A reductive Hendren ureteroplasty was also performed in 7 cases. The average length of follow-up is actually of 82 months (range 5-231). Satisfactory results were obtained in three primary obstructed megaureters, in the megaureter with ectopic orifice and in the segmentary megaureter associated with reflux. In two patients with refluxing megaureter surgery was unsuccessful and a new operation was necessary. Finally, one patient with primary obstructed megaureter underwent endoscopic dilatation of the strictured vesico-ureteral anastomosis two months after the ureterocystoneostomy.

Adult↗

[Long-term results of the veno-occlusive percutaneous treatment of erectile disorders of venous origin].

The treatment of impotence due to venous leakage is remedied by creating an increase in the resistance of the venous outflow in order to trap arterial blood within the corpora cavernosa of the penis during erection. The percentage of success reported in Literature after resection of the deep dorsal vein and ligature of the cavernous veins varies from a minimum of 12.5% to a maximum of 75%. Interventional radiology represents a valid alternative to traditional surgery in the non-prosthesis treatment of erectile dysfunction of venous origin due to the absence of complications and lack of intrusiveness and for the encouraging short and mid term results obtained. From May 1991 to February 1997, seventeen patients (aged between 24-54, average age 36 years) affected by venous leakage underwent embolisation of the principal veins of drainage of the corpora cavernosa. All patients were previously strictly selected in order to exclude those affected by arterial, neurological, endocrine or ++psychological disease. Pathologic venous drainage was shown by pharmacocavernosometry and pharmacocavernosography. The technique employed consisted in isolation and catheterization of the deep dorsal vein of the penis with a cannula needle of 14 G and subsequent ligature and simple section of the vein; venous leakage fluoroscopic evaluation; coils placement under radiological control, in the distal tract of each vein chosen to be occluded; and then at last, embolization of the deep dorsal vein. A fluoroscopic control performed after these procedures showed the correct vascular occlusion. The operation has an average duration of 120 minutes and requires two-day hospitalisation. In 12% (2/17) of the selected cases a technical failure was recorded due to difficult catheterization of the periprostatic plexus, therefore only surgical ligature and section was carried out in the penile deep dorsal vein. Only in one case (6%) there was a slight and transitory oedema of the penis observed. The average follow-up is 34 months (range 3-72 months). Up to now, 11 patients over 15 (73.4%) refer a good improvement of erectile dysfunction together with a satisfactory sexual activity. In two cases (13.3%) only partial improvement have been referred. Only 2 cases (13.3%) did not obtain any benefit from treatment.

Adult↗

[Spontaneous bladder perforation due to eosinophilic cystitis: a case report].

We report a case of eosinophilic cystitis the onset of which was characterized by acute peritonitis secondary to a spontaneous intraperitoneal rupture of the vesical cupula. The patient was treated with urgent partial cystectomy in another hospital and 3 months later he underwent endoscopic diathermic coagulation of a residual inflammatory lesion at our institution. After an 18 month endoscopic follow-up no further signs of recurrent eosinophilic cystitis have been pointed out. The non-traumatic bladder perforation and the absence of any other bladder pathology might indicate that eosinophilic cystitis can be responsible for complete bladder rupture.

Aged↗

[Leydig cell tumor of the testis].

It represents a rare and mostly unilateral pathology with benign istological patterns. However, since the biological behaviour of the tumor is not foreseable from the istological characteristics, the follow-up must be prolonged. The treatment of this cancer is orchidofuniculectomy, sometimes associated, in selected cases, with retroperitoneal lymphadenectomy. In presence of tumor of small dimensions, above all if bilateral ones, it may be indicated a conservative treatment. Authors report six cases of Leydig cell tumors of the testis observed in sixteen years. All patients had orchidofuniculectomy by inguinal approach. In only one case has been associated retroperitoneal lymphadenectomy for the suspect of lymphatic metastasis. Follow-up of 3 months to 15 years is available for all patients: no one has died for the tumor and all are without signs of disease.

Adult↗

A case of testicular metastasis from carcinoma of the prostate.

Authors report a rare case of testicular metastasis from carcinoma of the prostate in a patient treated with anti-androgen therapy. The report of this kind of testicular metastasis was more frequent in the past years, when the neoplasm was often treated with bilateral orchiectomy. Metastatic carcinoma of the prostate to the testis is commonly accepted as a sign of advanced disease and it is usually accompanied by multiple metastases to other organs. The prognostic significance of testicular localization is still unknown.

Aged↗

Vesicovaginal fistulas: our experience and review of literature.

Vesicovaginal fistulas (VVF) still represent a sad complication of surgery of the female genital system. In this article an extensive review of the literature was conducted, analyzing the etiological, pathological and clinical aspects, as well as the therapeutical problems. For this purpose, we have compared the many surgical techniques proposed for treatment of VVF and have also evaluated their results. Furthermore, we report on our series of 35 patients who had undergone treatment for VVF.

Adult↗

[Surgical repair of congenital penile curvature].

Congenital penile curvature is not such a rare pathology and it is responsible for important aesthetic and functional problems. This malformation, can render intercourse difficult and painful, but it can be cured with a simple surgical procedure that almost always guarantees excellent results. In this work we report on the treatment of 48 patients (aged 16-34) with congenital penile curvature with a follow-up of 6 months to 10 years. The aetiology is also briefly analysed. A discussion follows on the diagnostic criteria for better interpretation of the main characteristics of this problem in relation to its functional appearance. A comparison of different surgical techniques is also shown, focusing over the procedure we perform: plissettage of the tunica albuginea. This technique is performed through a penile skin incision opposite to the maximal curvature of the organ, exposure of the tunica albuginea and the positioning of one or more series of stitches. The overall results show that 44 out of 48 patients were fully satisfied both from the aesthetic and functional points of view, while 4 were partly satisfied from the aesthetic point of view alone.

Adolescent↗

[Continuous monitoring of nocturnal penile tumescence and rigidity in the evaluation of erection disorders. Preliminary data].

Nocturnal penile tumescence measurements continues to be an important step in the diagnosis of impaired erectile function. We present our experience with this technique employed on 65 patients who consulted at our andrologic center. Our results corroborate the importance of the NPR-R test with the Rigi-Scan in the evaluation of this pathology to ensure these patients receive the most appropriate treatment.

Adult↗

[Treatment of renal cysts by percutaneous drainage and alcoholization. Our experience].

Since many years renal cysts have been treated by percutaneous puncture and successive aspiration. The introduction of various sclerosing substances has been associated with this manoeuvre. In our study we examined 44 patients with renal cysts submitted to percutaneous puncture, aspiration and injection with 95% ethanol. We thought right to leave a small pig tail catheter so that the sclerosing substance could be easily and completely eliminated allowing the adhesion of the cystic walls in the following days, without any accumulation of cystic and/or exudative liquid. The follow up (12-24 months) has shown no relapsing in 40/44 cases. Only in 4 patients a cyst was present, but with dimensions lower than 30% of the original volume.

Administration, Cutaneous↗

The vesicosigmoidal fistula: diagnosis and surgical treatment.

The authors report their experience in the diagnosis and treatment of 10 cases of vesicosigmoidal fistula. In accordance with the literature the most frequent presenting symptoms were of urinary origin. For the diagnosis urography was helpful, cystography and cystoscopy allowed the observation of a fistulous orifice, while barium enema confirmed, or removed probable doubts about the nature of the intestinal pathology. Surgical treatment varied from one-stage to multi-stage procedures.

Aged↗

[Protein-sparing peripheral parenteral nutrition in urologic surgery].

The use of parenteral nutrition in patients operated on for cystectomy is a basic post-operative therapeutic aid used for maintaining an adequate state of nutrition. In the present paper, the authors report the results of a study conducted for the purposes of comparing the efficacy of protein-sparing parenteral nutrition versus TPN.

Aged↗

[Parapyelic cysts].

The Authors present four cases of major pyelocaliceal obstruction secondary to parapelvic cyst. The treatment was surgical in all four cases and consisted in the cruentation of the wall of the cyst.

Adult↗

Considerations regarding a case of leiomyoma of the urinary bladder.

In spite of its rarity, leiomyoma of the bladder deserves to be better known as its diagnosis is not always obvious, depending as it does mainly on urography confirmed by anatomo-pathological examination, and particularly because its treatment is simple and the prognosis always favourable, a fact worthy of note in dealing with a tumour of the bladder.

Adult↗