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Biomedical subjects

M Wisard

Publications and source records attributed to M Wisard.

At least 19 recordsLinked to original sources
PubMed2002

[Role of the urologist in the management of infertile men at the time of sperm intracytoplasmic injection].

Although intracytoplasmic sperm injection (ICSI) revolutionized treatment and prognosis of male infertility, checkup (case history, clinical and paraclinical examinations) practiced by urologist in infertile man keeps all its place. Varicocele, congenital or acquired seminal duct obstruction, urogenital tract infection, or ejaculation disorder must be sought, because these affections remain accessible to treatment.

Humans↗
PubMed2001

A large bullet in the bladder.

All manner of foreign bodies have been extracted from the bladder. Introduction into the bladder may be through self-insertion, iatrogenic means or migration from adjacent organs. Extraction should be tailored according to the nature of the foreign body and should minimise bladder and urethral trauma. We report a case of a bullet injury to the bladder, which finally presented as a gross hematuria after remaining asymptomatic for four years. We present here an alternative to suprapubic cystostomy with a large bladder foreign body treated via a combined transurethral unroofing followed by removal using a grasper passed through a suprapubic laparoscopic port.

Adult↗
PubMed2000

Diclofenac and NS-398, a selective cyclooxygenase-2 inhibitor, decrease agonist-induced contractions of the pig isolated ureter.

Non-steroidal anti-inflammatory drugs (NSAIDs) are currently considered a first-line treatment of renal colic. Their action has been ascribed to the inhibition of renal prostaglandin synthesis, which decreases renal blood flow and diuresis, and consequently lowers the pressure in the renal pelvis and ureter. However, the effects of NSAIDs on induced contractions of ureteral smooth muscle have received little attention. Also, there is a lack of clinically relevant spasmolytic drugs for the ureter. Therefore, we studied the influence of the non-selective cyclooxygenase (COX) inhibitor diclofenac, a NSAID drug customarily used in the treatment of renal colic, and of NS-398, a selective COX-2 inhibitor, on induced contractions of the pig ureter. Serotonin (0.1-30 microM), norepinephrine (0.1-30 microM) and neurokinin A (0.03-10 microM) induced reproducible concentration-dependent contractions, which were inhibited by diclofenac and NS-398 (10-300 microM) in a concentration-dependent manner. The sensitivity of neurokinin A-induced contractions to diclofenac was 3-4 times greater than that of the amines. Depending on the concentration, inhibition ranged between 25 and 96% of the initially induced contractile activity. In the presence of inhibitors, supramaximal concentrations of agonists were unable to trigger recuperation of the initially induced contractions. Prostaglandin F2alpha did not reverse the effect of diclofenac on agonist-induced contractions. Removal of diclofenac or NS-398 from the organ baths showed that the inhibition was totally reversible. Thus, the non-selective COX inhibitor diclofenac and the selective COX-2 inhibitor NS-398 are almost equipotent in reducing agonist-induced contractions in the isolated porcine ureter. Although the clinical relevance of this spasmolytic effect remains to be demonstrated, the data suggest that patients suffering from renal colic may benefit not only from the anti-diuretic and analgesic effects of diclofenac, but also from its potential spasmolytic properties. Moreover, selective COX-2 inhibitors may have clinical potential, as they may cause fewer side effects.

Animals↗
PubMed1999

[Assisted fertilization in azoospermic men: results of CHUV from 1994 to 1997].

In vitro fertilisation (IVF) and intracytoplasmic sperm injection (ICSI) have revolutionised the treatment and prognosis of oligo-terato-asthenozoospermia (OTA). Sperm extraction in the vas deferens, the epididymis (MESA: with epididymal sperm aspiration) or the testicles (TESE: with testicular sperm extraction), associated with ICSI, can achieve pregnancy in cases of excretory or secretory azoospermia. We report the results of the use of MESA and TESE in 42 patients with an average age of 37 (age range 24 to 58). Of these, 26 have excretory azoospermia, 11 secretory azoospermia and 5 a problem linked to ejaculation. Of the 506 oocytes that were inseminated, 270 zygotes were obtained, giving a fertilisation rate of 53.4%. 85 embryo transfers were carried out (55 with fresh embryos and 30 with cryo-preserved embryos). Three spontaneous abortions and one extrauterine pregnancy were reported. Six pregnancies are developing normally. To date, 13 children have been born (9 boys and 4 girls) in 10 deliveries (7 single children and 3 sets of twins). The limits of male infertility need to be revised to take these new forms of therapy into account and patients should be advised on the new possibilities available.

Adult↗
PubMed1997

[Endoscopic treatment of pyelo-ureteral junction disease].

The advent of "minimal invasive surgery" with the development of new endoscopic techniques modified many therapeutical concepts in urology as in other fields. The treatment of the ureteropelvic junction obstruction reserved in the past to open surgery can nowadays be successfully realized with endopelvic or endoureteral techniques under visual or fluoroscopic guidance. The authors present their experience with two new techniques: antegrade endopyelotomy under visual control or retrograde fluoroscopic endopyelotomy. Based on experimental and clinical studies which demonstrated the extraordinary capacity of the incised ureter to regenerate and regain a peristaltic activity, these treatments offer a cure rate nearly as high as open pyeloplasty.

Adolescent↗
PubMed1997

[Diagnostic and therapeutic approach to male sterility].

The new techniques of medically assisted procreation allow to approach most of the male infertilities. Their complexity and cost call for a precise diagnosis prior to treatment initiation and a multidisciplinary investigation of the sterile couple is mandatory. We demonstrate the urological side of these investigations.

Diagnosis, Differential↗
PubMed1997

[First evaluation of a year of ambulatory surgery in urology].

Day surgery in urology is in full growth actually. The present report is based on our first 120 patients. Low post-operative complication rate, patients' satisfaction and economical savings are the main factors for the important increase in this type of surgery.

Ambulatory Surgical Procedures↗
PubMed1996

Oral fleroxacin prophylaxis in transurethral surgery.

PURPOSE: A prospective trial was done to test the efficacy of antimicrobial prophylaxis in patients undergoing transurethral surgery. MATERIALS AND METHODS: A total of 75 adults with preoperatively sterile urine was randomized to receive either 400 mg. oral fleroxacin once daily or placebo as long as the catheter was in place. Urine cultures were obtained preoperatively and after removal of the catheter just before hospital discharge. Growth of 10(4)/ml. or more bacteria was considered a positive urine culture. RESULTS: Postoperative urinary tract infection rates were significantly lower in the fleroxacin group (3%) than in the placebo group (23%). Our study demonstrated the benefit of antimicrobial prophylaxis in preventing urinary tract infection after transurethral surgery, including resection of the prostate, in patients with sterile urine. CONCLUSIONS: The oral administration of 1 daily tablet of fleroxacin for the duration of catheterization is a safe, efficacious and clinically feasible regimen.

Administration, Oral↗
PubMed1994

[PSA: a new prostatic marker. A help or an added factor of confusion?].

In patients with a normal digital rectal examination and serum PSA levels under 18.4 ng/ml Yang (i.e. under 10.0 ng/ml Hybritech or under 14.4 ng.ml with the Basel Cantonal Hospital assay), twice yearly then yearly follow-up examinations are sufficient. More closely spaced examinations and a transrectal ultrasound scan are appropriate in patients with abnormalities upon digital rectal examination, especially when serum PSA levels are consistently elevated.

Diagnosis, Differential↗
PubMed1993

The Swiss Lithoclast: a new device for endoscopic stone disintegration.

Even in the presence of extracorporeal shock wave lithotripsy there is still the need for endourological treatment of stones in the urinary tract. Stone fragmentation usually is achieved with either ultrasonic, electrohydraulic or laser lithotripsy. We report our early experience with a new, simply constructed machine at a reasonable cost for endoscopic stone disintegration--the Swiss Lithoclast. The principle of this lithotriptor is based on pneumatic shock waves induced by the central compressed air system of a hospital or by a compressor. This device was used to treat 151 patients with stones in the kidney, ureter, bladder or a Kock pouch continent urinary diversion. Endoscopic fragmentation was successful in all patients. Independent of the composition, all stones were disintegrated within a short period, indicating that the device may well represent an attractive alternative to standard endoscopic lithotriptors.

Adolescent↗
PubMed1993

[Quantification of the intra-penile smooth muscle with a fuzzy logic algorithm].

We have developed a new computer program for tissue segmentation designed for the quantification of smooth muscle in the corpus cavernosum. The program uses digitalized images of stained histological sections taken with a CCD camera. The recognition of the different tissues is based on the examination of absorption of monochromatic light. The section is successively illuminated with light of three different wavelengths and the three absorption values and texture parameters are used for the identification of the tissue using a fuzzy algorithm.

Absorption↗
PubMed1993

[Urethral trauma: retrospective study of 15 years].

In urethral traumas are included pendulous, bulbar and prostatomembranous injuries generally associated with a pelvic fracture or a symphysis diastasis. Because of the possible sequelae concerning potency and urethral stricture of prostatomembranous disruptions in peculiar, treatment remains controversial. Authors present a retrospective series of 27 patients (26 males, 1 female) treated during these last 15 years to try to modify or redefine their strategy and to choose the harmless method of treatment by a multidisciplinary approach between the anaesthesiologist, the traumatologist and the urologist.

Adolescent↗
PubMed1993

[Neurophysiologic evaluation of erectile dysfunction].

The bulbocavernosus reflex and pudendal evoked responses were obtained in a group of 12 healthy male subjects and in 38 impotent men. The dorsal nerve of the penis was stimulated electrically. Responses were recorded over the bulbocavernosus muscle by a percutaneous method and over the cerebral cortex from the Cz-2 point.

Adult↗