[Percutaneous sacral rhizotomy using radiofrequency in the treatment of hyperspasticity of the central neurogenic bladder (proceedings)].
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Biomedical subjects
Publications and source records attributed to G Rossignol.
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Following spinal cord lesions, signs of spasticity may be observed on bladder with decreased capacity and urinary leaks. We have attempted to associate the inocuity of anesthetic blocks and the selective precision of microsurgical rhizotomies by percutaneous thermocoagulation of sacral roots. Bilateral 53 root coagulation, under Rx control, vesical pressure monitoring and stimulation tests, is ususally efficient. Authors report the technic and the results of this simple method about the first nine cases with more than one year of follow up.
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Presentation of theee procedures of experimental revascularization of the renal artery under microscopically controlled surgered (study of 19 dogs): --10 dacron velvet grafts, --6 hypogastric autografts, --3 spleno-renal autografts. Results obtained by three means of investigation: selective angiography, measurement of renal flow using radioactive xenon, microscopic study of the anastomoses and the grafts: --10 dacron 10 failures, --6 hypogastric autografts, 4 successes 2 failures, --3 spleno-renal autografts, 3 successes. Comparative study of the different experimental and clinical works on these subjects. Dacron grafts must be banned for calibers less than 4 mm in diameter. Hypogastric autografts give good congruence of the anastomoses, poses no problems with preservstion, but necessitates two sutures which spoil the results. Spleno-renal autografts, when possible, seem to be an ideal means connnection. A single suture, no nutritional problems and rapidity of execution.
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Since male impotence may be caused by a variety or non vascular factors, more precise techniques for identifying potential operative candidates must be developed. Our protocol includes nocturnal penile plethysmography, Döppler velocity at 8 levels, penile systolic pressure, electromagnetic blood flow measurement, penile reactive hyperemia. This non-invasive protocol applied on 21 patients aims to select those who would benefit from direct penile revascularization procedures. We are studying the venous emptying rate for more complete physiologic approach.
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