Biomedical subjects

R Ravalli

Publications and source records attributed to R Ravalli.

12 recordsLinked to original sources

PubMed1996

Nursing assessment and management strategies for urinary incontinence.

The promotion of continence is a multidisciplinary responsibility, with the nurse specialist's focus being on management, education, and ensuring a team approach. The patient's cognitive and functional abilities, general medical condition, and informed choice will ultimately determine the management plan. Behavioral techniques, supportive devices and intermittent catheterization are among the low risk interventions available to treat patients.

Female↗

PubMed1995

Nursing management of the laser prostatectomy patient.

The focus of nursing management for the patient having a laser prostatectomy is preoperative preparation and education. Patients often equate an ambulatory procedure with rapid symptom relief and may be discouraged and distressed postoperatively if they have unrealistic expectations. Training in clean intermittent self-catheterization will enable the patient to be catheter free while minimizing postvoiding residual volumes.

Humans↗

PubMed1994

Reasons for high drop-out rate with self-injection therapy for impotence.

One hundred and eighty patients, average age of 58 years (range 24-75) were evaluated for impotence and were advised to undergo pharmacologic self-injection therapy with either papaverine/Regitine (90%) or prostaglandin E1 (10%). Follow-up was available from 2 months to 3 years (average 11 months). The cause of impotence was determined by hormonal testing, Rigiscan and psychological testing. The etiology of impotence was organic (70%), psychogenic (20%), and mixed (10%). After the initial test injection 22% of patients did not enroll in the self-injection program or were lost to follow-up. The group with psychogenic impotence had the highest satisfaction/usage rate at 42%. Overall only 20% of patients were satisfied long-term and were actively using self-injection therapy. Of the 140 patients available for follow-up, 112 patients (80%) discontinued self-injection therapy. The reasons for discontinued usage were alternate treatment (prosthesis or vacuum device) 15%, return or improvement of erections 8%, partner dissatisfaction or loss of partner 10%, or complications of injection therapy 10%. Cost was not a factor for discontinued use. Loss of interest caused 57% of patients to stop using self-injection therapy. Although pharmacologic self-injection therapy is initially promising there is a high drop-out rate at long-term follow-up.

Adult↗

PubMed1993

Use of multiple Wallstents in treatment of bladder outlet obstruction.

Of 23 patients being treated with the Urolume Wallstent for bladder outlet obstruction, 4--3 with anterior urethral strictures and 1 with benign prostatic hyperplasia--required two to four stents. When placing multiple stents, there should be enough overlap to prevent the opening of a gap as the stents expand and shorten over the ensuing weeks. Use of more than 1 stent is indicated when the stricture or the prostatic urethra is longer than 3 cm or when stricture recurs beyond the end of a previously placed stent.

Aged↗

PubMed1991

Intracavernous pharmacotherapy in psychogenic impotence.

Twenty-five men with psychogenic impotence but without serious psychopathology were considered for intracavernosal therapy with papaverine hydrochloride and phentolamine mesylate. A total of 20 proved suitable and began self-injection in conjunction with sex therapy; 8 patients had return of spontaneous erections without pharmacotherapy, although one of them needs to keep the medication in his refrigerator. The other 12 patients are continuing self-injection therapy. Psychotherapy with self-injection may be helpful in the management of psychogenic erectile impotence.

Adult↗

PubMed1990

Biochemical evaluation of calcium stone patients: how soon can it be done after stone surgery/passage?

Biochemical evaluations were done two times for 29 outpatients with calcium stone disease, the first time within one month after surgical extraction or passage of stones and the second time two months or more later. Classification of the etiologic basis for the stone disease was the same after both tests in 27 patients. In the other 2 patients the diagnosis was changed from renal to absorptive hypercalciuria. Both of these patients had creatinine clearance rates less than 60 percent of normal during the first test. One also had multiple residual stones during both evaluations, and the second had a urinary tract infection during the first test that resolved with a normal creatinine clearance by the second test period. When nephrogenous cyclic adenosine monophosphate (cAMPn) assays were done on fasting specimens in these patients, the results were consistent with absorptive hypercalciuria. Almost all patients can be evaluated and placed in management programs within a few weeks after surgery. If cAMPn assays are not done, patients with decreased renal function secondary to residual stones or infection can be tested at a later time.

Adolescent↗

PubMed1990

Intermittent self-catheterization.

The geriatric population is a challenge to those health professionals who are willing enough to give them a chance. Growing old is just that, a growth process. We should break the pattern of neglecting growth and promoting regression. In 1916, Cabot and Crabtree had foresight into the future of intermittent catheterization when they said, in reference to urinary tract infections, that "there is no subject in which there is so little uniformity of opinion and so much confusion." Through continued education and research, we hope to reverse negative attitudes. With more uniformity in their care, the geriatric population can continue to live a comfortable, socially acceptable life.

Aged↗

PubMed1987