Biomedical subjects

M Sutorý

Publications and source records attributed to M Sutorý.

9 recordsLinked to original sources

PubMed2005

[Erectile dysfunction after traumatic pelvic injury].

UNLABELLED: Erectile dysfunction is a serious consequence of pelvic injuries. The aim of the study was to review and assess erectile dysfunction rates in mono and polytraumatized males with the pelvic injury, and to highlight the impotence-type of the pelvic injury relation and to evaluate the therapeutic response of the patients. METHODS: In total, 231 mono- or polytraumatized males with the pelvic injury were mailed a private letter including the HEF-5 International Index of Erectile Function questionnaire. The AO classification was used to assess the relation of the pelvic injury type and the onset of the erectile dysfunctin. The c2 test was used to assess the statistical significance. The peroral treatment with the phosphodiesterase 5 (PDE5) inhibitors was the therapeutical method of first choice. The therapeutical effect was assessed using the IIEF 5 questionnaire. RESULTS: We concluded that the erectile dysfunction affects nearly a third (31.5%) of the males who suffered pelvic injuries. The fact, whether the patient suffered an isolated pelvic injury or a pelvic injury in a polytrauma, has no influence on the erectile dysfuntion onset (p = 0.218), however, the onset of impotence has a significant connection to the type of the pelvic injury. We confirmed a statistically significant increase in the erectile dysfuncion rates in patients with the pelvic ring injury type B and C (p = 0.023). The mean IIEF-5 score prior to the treatment initiation was 11.5. In 85% of the patients the peroral treatment of the erectile dysfunctin using the PDES inhibitors was successful and resulted in achievement of the pair sexual satisfaction. The score of the IIEF-5 questionnaire reached physiological values 23 (22-25) following the treatment. Based on the findings, the authors recommend, during their hospitalization, to inform the males who suffered the type B and C pelvic ring injury about a possibility of their sexual dysfunction, and to advise them to contact a sexual disorders specialist.

Aged↗

PubMed2003

[Personal experience with injuries of the rectum and anus].

Authors analyze some new knowledge in treatment of rectal and anal injuries proceeded from own clinical experience in comparison with studies of a range of foreign authors published recently. During last ten years together 24 injured patients with this diagnose were operated in Traumatological Hospital Brno, primary reconstruction was performed in 10 patients, secondary reconstruction after precise examination of pelvic fundus pathophysiology in 14 patients, mostly transferred from other clinics. Authors prefer primary treatment in 3 hours after injury. This opinion is supported by control examinations after performed reconstructions.

Anal Canal↗

PubMed2001

[Carcinoma of the lower half of the rectum].

Authors analyze the group of patients surgically treated for rectal carcinoma during ten-years long period. While the surgical tactic in upper part of the rectum is solved by the resection with straight anastomosis, in carcinomas of lower part of the rectum there is an open question there, to use the deep pelvic anastomosis after radical resection or to perform the rectal extirpation with saving of sphincters and using the coloanal anastomosis. The necessary requirement is complex preoperative examination of the tumor and of pelvic fundus physiology. For application of coloanal anastomosis the rigid indications are determined. Authors used this method in 107 patients of the monitored group. Early and delayed complications of these interventions are analysed, indication for temporary stomy and application of pouchs. In the group of patients with coloanal anastomosis no local recurrence was noted, in the group with deep pelvic anastomosis the locoregional anastomosis was found in 8% of patients.

Anastomosis, Surgical↗

PubMed2000

[Does a pelvic compartment exist? Personal experience].

The authors analyze a group of 7 patients transferred to their hospital for instable fractures of the pelvic circle and lumbar spine. The pelvic compartment was manifested 24-48 hours after injury. Early diagnostics are based on the use of new imaging techniques, spiral CT examination is preferred, and angiography in stabilized patients. Early surgical intervention is aimed at evacuation of haematomas, revision of vessels, release of the ureters and temporary nephrostomy.

Compartment Syndromes↗

PubMed1999

[Our concept of defecography. Methods and reproducibility of results].

Defecography is used in the Czech Republic only exceptionally. Since 1988 the authors made 402 defecographic examinations. They submit a detailed description of hitherto assembled experience and their own modification of the examination. As contrast material they use at present Micropaque susp. thickened by means of wheat bran. They administer it by means of a modified press for dough preparation. The X-rays are taken on a modified ordinary stool made from soft timber. For screening of uncovered places in the visual field they use individually placed copper plates 2 mm thick. For better evaluation of the X-rays the authors place during examination an X-ray contrasting net behind the patient. Pictures are taken at rest, during contraction, during modified Valsalva's manoeuvre and during all stages of defecation. The authors mention the most interesting pathological pictures they encountered so far--internal prolapse, levator hernia, rectocele, sphincter defect, various forms of prolapses and dyskineses of the pelvic floor. In the authors opinion the basic quantifiable parameters are the magnitude of the anorectal angles. They used the assessment method described by Mahieu, as well as the mediorectal angle which in their opinion is a reflection of the patient's somatotype and levator function. More than the absolute values of the angles they emphasize the difference of the two angles and change of the latter during contraction and defecation. In their opinion enlargement of the difference during contraction and diminution to values close to zero is normal. Converse values are according to the authors evidence of dyssynergy of the pelvic floor. Independent assessment of the angles and magnitude of the lift of the pelvic floor by three subjects are subjected to statistical analysis. They provide evidence of complete reproducibility of results of anorectal angles according to the authors' definition. The results of assessment can be used to investigate relations with parameters of anorectal manometry (AM) or transrectal sonographyy (TRS) in subsequent investigations.

Contrast Media↗

PubMed1997

[Problems with continence after deep pelvic anastomoses in rectal carcinoma].

Based on the complex evaluation of the continence by anorectal manometry, EMG examination of sphincters, transrectal sonography, defecography and Colonic Transit Time examination, the analysis of the group of 15 patients partially incontinent after operation of carcinoma of the lower part of the rectum has been done. In these patients the deep pelvic anastomosis or coloanal anastomosis was performed. In none of the patients any serious organic damage of sphincters was manifested, the causes were dominantly extrasphincteric and functional, solvable well by conservative methods.

Anastomosis, Surgical↗

PubMed1996

[Associated injuries of the pelvis].

In last three years 27 injured patients were operated in Traumatological hospital Brno for associated pelvic trauma. This trauma was associated with injury of urinary tract in 8 patients, with traumatic lesion in area of the colon in 6 cases and with injured big vessels of the retroperitoneum in 8 patients. The urgent operation was performed in 44%. Authors put stress in diagnostic analysis and early indication of surgical operation on careful anamnestic clinical examination, they utilize the contribution of the sonographic and CT examination with contrast, in indicated cases the selective angiography and retrograde urethrocystography, too. Authors prefer early reconstructional operations.

Abdomen↗

PubMed1996

[Problems with continence in rectal injuries].

Authors analyse the group of 17 patients operated for rectal and anal injury. In this group 7 patients were operated primarily after injury and in 11 patients the secondary reconstruction was performed. Authors called the attention to the high diagnostic difficulty before the planned and indicated secondary reconstruction. Based on assessment of own clinical material and conforming with literature, authors conclude that secondary reconstruction are more difficult, and this difficulty is the higher, the less qualified the primary treatment was performed.

Fecal Incontinence↗

PubMed1994

An alternative in surgical treatment of post-irradiation vesicovaginal and rectovaginal fistulas: the seromuscular intestinal graft (patch).

The excellent results experienced with the use of seromuscular intestinal grafts in certain types of urological plastic operations encouraged us to use it (as a patch) also in the surgical management of vesicovaginal and rectovaginal fistulas. With this method, we treated 4 patients with post-irradiation fistulas who had previously undergone 1 or 2 operations. The seromuscular intestinal graft served as a direct partial wall replacement of the bladder or rectum. At the same time, it also supported the nutrition of the compromised tissues surrounding the fistula. There were no complications with epithelialization of the denuded muscular surface of the seromuscular intestinal graft (patch) facing into the bladder.

Adult↗