Propofol is an anesthetic characterized by specific pharmacologic qualities, conditioning compliance of the clinical picture with the drug infusional rate, high-degree safety and facilitated anesthesia conduction--qualities by which it bears resemblance to inhalation anesthesia. This is an assessment of the qualities of TIVA with Propofol in poor-risk patients according to ASA, operated on an emergency basis. Proceeding from the obtained results, the inference is reached that continuous Propofol infusion provides for adequate anesthesia control and safety of the patients with heightened anesthesiologic and operative risk.

Adolescent↗

PubMed1996

[Prolonged propofol (Diprivan) infusion for sedation in the critically ill].

Continued sedation has important practical implications on overcoming the physical and psychic stress which in turn, has important practical implications on the well-being of patients in conditions of intensive care unit. It is the purpose of the study to assess the quality and characteristics of sustained sedation with constant propofol (Diprivan) and fentanyl infusion. As a result of the study the inference is reached that sedation with Diprivan and fentanyl, administered as constant infusion, lends itself readily to control, and what is more, it is free of noteworthy side effects. To secure permanent sedation it is necessary to adapt the infusional rate to the clinical signs in compliance with the concrete patient and individual needs.

Aged↗

PubMed1996

[Benign prostatic hyperplasia--its treatment with Proscar].

Benign prostate hyperplasia is a potentially serious condition affecting men in advanced age. The treatment is conservative and operative. Proskar of Msd is one of the drugs yielding encouraging results. It is a synthetic 4-azosteroid compound, and represents a new class of specific inhibitors of 5-alpha reductase, promoting stabilization of testosterone and the more active androgen dihydrotestosterone (DHT). A total of 35 patients undergo treatment with Proskar at 5 mg daily dose (one tablet) over a 6-month period. The study includes six patients with complete urinary retention. The results are assayed by the change in prostate gland volume, residual urine and maximal urinary flow, 6 PsA. Completely responsive to treatment are 71.44 per cent of patients, partial effect is recorded in 22.85 per cent, and no effect whatsoever--in 5.71 per cent.

Adult↗

PubMed1996

[The gastrointestinal tract as the possibility for a reservoir for the urinary system. A modification of the Mainz pouch technic].

Experience accumulated over the past decade with utilization of the gastrointestinal tract in the formation of a reservoir of the urogenital system shows that the Mainz-pouch technique contributes greatly to obtain a continent reservoir, mainly by Bauhin's valve reconstruction. A procedure is suggested enabling retroperitoneal implantation of the reservoir, formed by the original Mainz-pouch technique, in the lower right quadrant of the posterior abdominal wall, instead of suspending it in the abdominal cavity where it anastomoses with the umbilical anulus and augments the hazard of ileus. The 63-year-old woman with urinary bladder carcinoma, operated according to the modification described, tolerates the intervention free of complications with very good immediate outcome in terms of continence.

Carcinoma↗

PubMed1996

[The 1st steps in the surgical treatment of transsexualism in Bulgaria].

This is a report on the early results of the first cases of physical sex reconstruction in female to male transsexualism, and vice versa. Phalloplasty using an abdominal skin flap is applied in three cases of female to male transsexualism. Initially, in one of the patients the technique of Baumann for labia majus reconstruction is employed, with ensuing necrosis. Full-thickness flaps are taken with maximal removal of fatty tissue at a 7-to-14 ratio. Transfer and insertion of a penile silicon implant is forthcoming.

Bulgaria↗

PubMed1996

[The need for an Otis urethrotomy in transurethral resection of the prostate].

Transurethral prostate gland resection is performed in a series of 103 patients divided in two groups. Group one is made of 51 patients where preliminary urethrotomy after Otis is not done. These patients are compared by incidence rate of urethral strictures with 52 cases (group two) where urethrotomy is done. The postoperative results point to a substantially higher rate of anterior urethra strictures in patients not subjected to Otis urethrotomy. Urethrotomy prior to transurethral prostate gland resection is recommended as a procedure contributing to reduce the hazards of this postoperative complication.

Adult↗

PubMed1995

[Cysts of the kidney--the clinical picture and diagnostic possibilities].

Malformations associated with the differentiation of kidneys are characterized by a great number of morphological sequels, most of them relating to cyst formation (A. Someren 1989). Over the period 1983 through 1992, a total of 400 patients presenting solitary cysts, multiple cysts and polycystic condition of the kidneys undergo treatment in the Clinical Center of Urology--Alexandrovska University Hospital. The symptomatology involves 19 single and combined symptoms, and independent and combined investigations, with echographies ranking first--400 exams. Not a single of the symptoms is typical of cysts (with the exception of pain) with of the examinations the greatest diagnostic relevance is ascribed to echography and CAT.

Adolescent↗

PubMed1995

[Cysts of the kidney--their therapeutic management].

In patients presenting pain syndrome, hypertension obstruction of the pyelocaliceal system or kidney-cyst-induced ureteral compression, operative intervention should be by all means considered (A. Gelet 1990, L. Kavoussi 1991). Over the period 1983 through 1992, 400 patients with solitary and multiple cysts and polycystic condition of the kidneys (polycystosis) representing 1.13 percent of the total number of admissions, are subjected to treatment in the Clinical Center of Urology--Alexandrovska University Hospital. The series includes 196 men and 204 women; percutaneous puncture is performed in 245 cases, and operative intervention--in fifty-four. Twenty-five patients are reoperated, eight undergo three operations, and two--manifold repeated operations. Recurrent cysts are recorded in 35 instances. One patient of the contingent, admitted with ruptured cyst of the only kidney and peritonitis, dies after the operation.

Female↗

PubMed1994

[Subvesical obstruction following chronic bacterial prostatitis].

Twenty-eight men below 50 years of age, presenting obstructive miction complaints subsequent to chronic bacterial prostatitis cure, are subjected to operation and follow-up study over a 6-year period. The test of Meares (1991) is used as a diagnostic method to rule out chronic bacterial prostatitis. The patients are distributed according to microbiological findings in the ejaculate in the stage of prostatitis treatment. Obstruction of the lower urinary tracts is diagnosed on the ground of past history data, uroflowmetry, residual urine assessment, miction cystourethrography and urethrocystoscopy under regional anesthesia. In nine cases (32.1 per cent) transurethral resection of the neck of the urinary bladder is performed, and in the remainder (19 cases or 67.9 per cent)--transurethral incision of the cervix vesicae at 5-7 hours. In the postoperative period, 75-89 per cent of patients are free of any miction complaints.

Adult↗

PubMed1994

[Vascular complications in kidney transplantation (a review of the literature and the authors' own experience)].

Vascular complications following renal transplantation are by no means rare. Usually they are multifactorial in nature, and eventually require operative management. Arterial and venous thromboses, arterial stenosis and hemorrhages are among the most frequently encountered vascular complications. In 1994, in the renal transplantation department of the Clinical Center of Urology three patients presenting vascular complications after renal transplantation are observed and treated. Two of them undergo surgery: resection of the stenotic segment of arteria renalis is done in one of them, and explantation-in the second. In the third case it is a matter of tense terminoterminal anastomosis due to technical reasons with ensuing venous thrombosis-here no operative correction is considered owing to intercurrent ischemic attack. In patients with transplantation the timely made diagnosis of vascular complications, and their surgical management prolongs the survival term.

Adolescent↗

PubMed1994

[Accidentally discovered kidney carcinoma during autopsy].

Explore the source record for details and available documents.

Aged↗

PubMed1994

[The characteristics of ureteral lithiasis].

The study covers 2630 patients with ureteral concrements, eliminated operatively, through extracorporeal lithotripsy (ESWL), or spontaneously as the result of drug treatment. Attention is called to the left-side location of ureteral concrements, regardless of the mode of elimination, with the clinical symptomatology of the disease being comprehensively discussed. Clinical and chemical characterization of ureteral concrements (type, size and the like) is also done separately with a special reference to the method of removal employed. In concrements eliminated spontaneously a correlative dependence with the annual season is sought; in the winter months a rather elevated frequency of elimination is recorded, irrespective of the type of concrements.

Adult↗

PubMed1994

[The restoration of urinary tract continuity in kidney transplantation].

In 1994, fourteen kidney transplantations are done in the Clinical Center of Urology--FAH over a 4-month period. The patients are with age ranging from 11 to 44 years. In twelve cases the kidneys are obtained from living related donors, and in the remainder--from cadavers. The surgical techniques used to restore urinary tract continuity include: ureteroneocystostomy--in 7 cases, pyeloureterostomy--six, and ureteroureterostomy--one. The choice of a surgical method in transplantation depends on the state of the urinary tract. Assessment of the efficacy of these surgical procedures is practicable after long-term follow-up with a view to eventual late urological complications development.

Adolescent↗