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Biomedical subjects

R O Parra

Publications and source records attributed to R O Parra.

69 records · Page 4Linked to original sources
PubMed1991

A simplified technique for continent urinary diversion: an all-stapled colonic reservoir.

A simple continent colonic reservoir was constructed in its entirety with the aid of surgical stapling techniques in 17 men and 10 women. In 5 men an orthotopic pouch was created and in the rest a continent stoma was designed. Detubularization of the entire colonic segment assures a low pressure system with disruption of directional peristaltic activity. The ureters are implanted by simply burying them in a mucosal furrow. Operative time required for the creation of the reservoir (excluding time for cystectomy) has ranged between 70 and 140 minutes (mean 95.4 minutes). With a followup of 9 to 60 months (mean 22.8 months) continence has been achieved in all but 1 patient with no ureteral reflux or obstruction. Urodynamically the pouch has achieved a large capacity (mean 750 cc) with low filling pressures (8.1 cm. water) because of technical ease of construction together with a shortened operative time due to the stapling techniques. This form of bladder replacement offers an option for select patients in whom continent urinary diversion is contemplated.

Adult↗
PubMed1991

Testicular seminoma in a long-term survivor of the prune belly syndrome.

Patients with the prune belly syndrome have cryptorchidism as a constant feature of the constellation of anomalies. Testes that do not spontaneously descend represent a well-known risk factor for the development of testicular cancer. In this paper, we present the second case of a primary testicular germ cell tumor in a long-term survivor with prune belly syndrome.

Adult↗
PubMed1990

The use of transrectal ultrasound in the detection and evaluation of local pelvic recurrences after a radical urological pelvic operation.

Transrectal ultrasound was performed in 20 patients with suspected local pelvic recurrence after a radical pelvic operation: 9 had undergone radical prostatectomy and 11 had undergone radical cystoprostatectomy. Transrectal sonography verified the presence of recurrence in 19 of 20 patients (95%) and this was confirmed by biopsy of the visualized lesions. Analysis of the sonographic echo patterns encountered revealed that in 14 of 19 recurrent neoplasms (71.5%) the echogenic pattern was hypoechoic. In the remaining 6 patients (31.5%) the echo pattern was isoechoic. No hyperechoic lesions were noted. Based upon our findings and because of the low costs compared to other diagnostic modalities transrectal ultrasound represents an ideal technique to compliment the digital rectal examination in evaluation of patients suspected of harboring a local pelvic recurrence after a radical pelvic operation.

Carcinoma, Transitional Cell↗
PubMed1990

Treatment of post-orchiectomy hot flashes with transdermal administration of clonidine.

The occurrence of hot flashes in men after bilateral orchiectomy for prostatic carcinoma can be bothersome and difficult to treat. Transdermal clonidine was administered to 7 patients with such symptoms. In 3 patients the hot flashes were ablated and in the remaining 4 the number and frequency of attacks were considerably reduced. No significant side effects were encountered. We suggest that transdermal clonidine (0.1 mg.) administered weekly can safely control undesirable hot flashes in men after bilateral orchiectomy.

Administration, Cutaneous↗
PubMed1990

Experience with a simplified technique for the treatment of female stress urinary incontinence.

Over a 9-year period a simple procedure for the correction of stress urinary incontinence was performed in 86 consecutive patients, 31 of whom had failed a previous anti-incontinence procedure. Success was achieved in 81 cases (94%). Of the 5 failures, 2 were successfully treated with a repeat procedure. Operative time ranged from 14 to 49 min (median 27). The average hospital stay was 2 days. Because of its simplicity and reliability, this technique is recommended for the surgical correction of female stress urinary incontinence.

Adult↗
PubMed1989

Transrectal ultrasound in stage A1 prostate carcinoma.

Transrectal ultrasound of the prostate was employed on 6 patients found to have Stage A1 carcinoma of the prostate after transurethral resection in order to identify those patients with residual tumor. Two patients were found to have residual tumor by transrectal ultrasound; this was confirmed by ultrasonic guided biopsy of the prostate. Of the remaining patients, an additional 2 on whom the ultrasound did not detect the tumor had tumor less than 1 cm in size, and in 1 patient no residual disease was found in the pathologic specimen. We conclude that ultrasound of the prostate offers another dimension in the staging of patients with Stage A1 carcinoma of the prostate.

Adenocarcinoma↗
PubMedDate not supplied

Laparoscopic surgery for bladder carcinoma.

Recent utilization of laparoscopy in urology has led to the performance of several pelvic procedures. The successful performance of laparoscopic diverticulectomies and cystectomies for benign pathology has led to speculation about, and utilization of, the laparoscopic approach in the treatment of bladder cancer. Herein, we relay our experience with the laparoscopic approach for bladder surgery and discuss the pros and cons of its current status in the treatment of bladder cancer.

Carcinoma↗
PubMedDate not supplied

Prostatic titanium urethral stents. A new treatment option for obstructive uropathy: early clinical results and indications.

An expandable titanium stent was used as an alternative to standard treatment for urinary obstruction in 20 men. Six patients had recurrent urethral strictures. Fourteen patients had obstruction secondary to benign prostatic hyperplasia (BPH) and were considered high risk surgical candidates. Complete results with a mean follow-up of 12 months are available for 11 patients. Four of the six stricture patients are currently unobstructed. All seven of the available men with BPH are voiding well. No side effects have been related to the stents, and no encrustations or calculi have formed.

Adolescent↗
PubMedDate not supplied

Surgical implantation of the artificial urinary sphincter.

The surgery necessary for sphincter placement is much more difficult than that required during the placement of penile prostheses, and there is definitely an associated learning curve. The risks of complications are present, but for a patient with the severe social and psychological disability of urinary incontinence, these risks are generally acceptable.

Female↗