[Minimally invasive surgical procedures for female urinary stress incontinence].
Explore the source record for details and available documents.
Female↗
Biomedical subjects
S Madjar
Publications and source records attributed to S Madjar.
[Transurethral microwave thermotherapy for benign prostatic hypertrophy in patients with high risk for surgery].
The effectiveness of transurethral microwave thermotherapy (TUMT) for benign prostatic hypertrophy in poor surgical risk patients (ASA class IV) with indwelling catheters, was assessed. All had had an indwelling catheter for 1-12 months. Removal of the catheter was possible in 14 out of the 24 (58.3%). Urinary peak flow rates were 12.2 +/- 3.5 ml/sec at 3 months of follow-up and post-voiding residual urine volumes of less than 50 ml were recorded in 13 catheter-free patients. Our data suggest that TUMT is an effective procedure for management of high risk patients with indwelling catheters in whom surgery or anesthesia are contraindicated.
Follow-Up Studies↗
Pubic bone anchoring in the treatment of women with stress urinary incontinence: new applications to an old concept.
The concept of using the pubic bone as a support for the bladder neck and urethra in the treatment of women with genuine stress urinary incontinence is well established, and is applied in traditional procedures such as Marshall-Marchetti-Krantz and the Burch colposuspensions. Recently, minimally invasive techniques, including the use of laparoscopic surgery and pubic bone anchoring systems, have been introduced. These new techniques, attempt to combine the advantages of retropubic procedures while remaining minimally invasive. A search of the English literature was carried out, traditional and new procedures using the pubic bone as a support for the bladder neck and urethra are described, and their efficacy and complications are reviewed and discussed. Traditional procedures have proved to be highly effective and well tolerated, with good long-term outcomes. The early results of innovative minimally invasive techniques are promising, but further experience and longer follow-up is needed to establish their role in the treatment of female stress urinary incontinence.
Female↗
Low inguinal approach for correction of recurrent varicocele.
The purpose of this study was to evaluate the efficacy of low inguinal (or subinguinal) approach in the treatment of recurrent or persistent varicocele after surgical treatment. Recurrent varicocele was diagnosed in 23 patients who previously underwent surgical treatment. The technique used consisted of low inguinal incision at the level of the external inguinal ring without opening the external oblique aponeurosis. External spermatic veins (cremasteric veins) were dissected and selectively ligated. Then the spermatic fascia was incised and the internal spermatic veins were identified and ligated individually. Postoperative radioisotope scan, scrotal examination and sperm analysis were used for treatment evaluation. Twenty-one (91.3%) had negative postoperative scan and no signs of varicocele on physical examination. A marked improvement of sperm analysis was noted in 19 patients (p<0.05), while two had only minor improvement. Two patients had positive postoperative scans without improvement of semen analysis. Neither atrophy nor azoospermia were detected on follow-up examination in any of these men, however, one patient developed hydrocele. This study indicates a good surgical outcome and improvement of semen quality without significant complications.
Adolescent↗
Clinical significance of tumor angiogenesis in patients with localized renal cell carcinoma.
OBJECTIVES: To determine the relationship between angiogenesis and various histopathologic features as well as clinical outcome in patients with localized renal cell carcinoma (RCC). METHODS: Microvessel density was quantified by using immunocytochemical staining of endothelial cells for factor VIII-related antigen of 36 specimens taken from patients with pathologic Stage pT1 or pT2 RCC. All patients underwent radical nephrectomy and were followed for a mean time of 97.3 months. RESULTS: No association was noted between microvessel count (MVC) and either cell type, architecture, or tumor size. Inverse correlation was noted between MVC and nuclear area (P = 0.006), nuclear elipticity (P = 0.016), nuclear roughness (P = 0.039), and histologic grade (P = 0.047). Patients having tumors with low MVC had significantly better survival rate compared with those with high MVC neoplasms (P = 0.0014, by Cox proportional hazards method). CONCLUSIONS: Despite lack of correlation with known predictors of survival, MVC provides independent prognostic information for patients with localized RCC.
Adult↗
Minimally invasive pervaginam procedures for the treatment of female stress incontinence using a new pubic bone anchoring system.
The purpose of this ongoing study is to evaluate the safety and efficacy of new minimally invasive pervaginam cystourethropexy and sling procedures for the treatment of female genuine stress urinary incontinence. A total of 75 women (mean age, 52.8 years) underwent either a cystourethropexy or a sling procedure. A miniature bone anchor and a staple-like bone anchor driver were used for the fixation of periurethral tissue or a xenogenic sling to the pubic bone. With a mean follow-up of eight months, 61 patients (82%) were completely cured of stress incontinence, 10 (14%) reported a more than 50% decrease in pad usage, and 4 patients showed failure early following surgery. The exclusively pervaginam cystourethropexy and sling procedures are minimally invasive, safe, and effective. Further experience and longer follow-up are necessary to establish their role in the treatment of women with stress urinary incontinence.
Adult↗
Incisionless per vaginal bone anchor cystourethropexy for the treatment of female stress incontinence: experience with the first 50 patients.
PURPOSE: We evaluated the safety and efficacy of a new minimally invasive surgical procedure for the treatment of women with genuine stress urinary incontinence. MATERIALS AND METHODS: A total of 50 women (mean age 51 years) was treated for type I or II stress urinary incontinence. A miniature bone anchor and a staple like bone anchor driver were used for fixation of periurethral tissue to the public bone. RESULTS: The procedure was successfully performed in all patients without intraoperative bleeding. No significant persistent postoperative pain was noted and only 1 patient had urinary tract infection. Concomitant vaginal hysterectomy, cystocele repair or perineoplasty was performed in 33 cases. At 12-month followup 41 patients (82%) are completely continent, 7 patients (14%) reported more than 50% decrease in pad usage and 2 cases are considered surgical failures. Mean operative time was 28 minutes. CONCLUSIONS: Data suggest that our new minimally invasive procedure provides a safe, effective and easy to learn alternative for treatment of women with anatomical stress incontinence.
Adult↗
The impact of tumor size on clinical outcome in patients with localized renal cell carcinoma treated by radical nephrectomy.
PURPOSE: We investigated the influence of tumor size on clinical outcome in patients with localized renal cell carcinoma treated with radical nephrectomy. MATERIALS AND METHODS: We reviewed retrospectively the records of 54 patients with pathological T1, T2 renal cell carcinoma for age, sex, histological grade, cell type, architecture, deoxyribonucleic acid ploidy pattern, nuclear morphometry and vimentin expression. Variables found to predict outcome were correlated with tumor size, which was further tested for its prognostic value. RESULTS: The best predictors of prognosis were grade, ploidy pattern, nuclear morphometry and vimentin expression. Small (less than 5 cm.) and large (larger than 5 cm.) tumors had similar distribution of prognostic variable subgroups. No differences in progression rate or survival were noted between the tumor size categories. CONCLUSIONS: These results suggest that small renal tumors may follow unfavorable courses and require aggressive treatment.
Adolescent↗
[Diagnostic and therapeutic approach to sexually transmitted diseases].
In an ongoing study we evaluated 71 males and 32 females attending our sexually transmitted diseases (STD) clinic. Intraurethral or endocervical swab specimens were cultured for Neisseria gonorrhea (NG), Ureaplasma urealyticum (UU), Mycoplasma homines (MH), Herpes simplex virus (HSV) and Chlamydia trachomatis (CT), using an ELISA technique and the polymerase chain reaction (PCR). HIV antigen, hepatitis B (HBV) and Treponema pallidum (TP) seropositivity were tested by ELISA. Mean age was 33.4 and range 15-72 years. 83 patients (81%) used condoms only rarely, 35 (35%) had multiple sexual partners and 83 (81%) were treated empirically prior to evaluation. Dysuria and urethral discharge were found in 47 (45.6%), of whom 34 (33%) were males; the majority of females were asymptomatic. A specific etiology for STD was found in 53 patients (51.4%) and 1/3 had more than 1 pathogen. CT, UU, MH, HSV, NG and TV were found in 27, 24, 5, 3, 2 and 1, respectively. 8 patients were seropositive for HBV and 1 for TP; all were seronegative for HIV. CT was the most prevalent pathogen found. All patients with STD symptoms should be screened for all sexually transmitted pathogens, since many of them have more than 1 pathogen. STD clinics in Israel should be developed in conjunction with microbiology laboratories for better management of STD in the community.
Adolescent↗
Anuria and acute renal failure caused by multiple bladder calculi.
A rare case of multiple bladder stones (more than 300) is described. Acute renal failure and anuria complicated by urosepsis were the presenting symptoms.
Acute Kidney Injury↗
Three-dimensional imaging using spiral computerized tomography prior to tumor enucleation in a patient with a solitary kidney.
The authors present a case of renal cell carcinoma in a man with a solitary kidney. Three-dimensional computerized tomography instead a selective renal angiography was used preoperatively as a noninvasive technique for visualization of the renal tumor and renal vascularization.
Aged↗
Transthoracal approach for the removal of adrenal tumors. Early experience with 10 cases.
OBJECTIVES: To evaluate the early results of a transthoracal approach for the removal of various adrenal tumors. METHODS: Between May 1994 and March 1995, 10 patients with adrenal masses underwent transthoracal adrenalectomy. Operation time, blood loss, the use of parenteral analgesia, duration of thoracal drainage, time to oral intake, ambulation and hospitalization period were assessed. RESULTS: All tumors were excised successfully, with a short operation time (mean 91.5 min), minimal blood loss (mean 35 ml), limited use of parenteral analgesics (mean 1.4 days), early ambulation (mean 1.9 days to ambulation) and shorter period of parenteral nutrition (mean 2 days) leading to a reduced hospital stay (mean 6.7 days). CONCLUSIONS: The transthoracal approach provided excellent exposure and is a quick and safe procedure even for large, malignant and hormone-producing tumors. At present this is our preferred method for the removal of adrenal masses.
Adolescent↗
[Nonmalignant proliferative lesions of the urinary bladder].
Explore the source record for details and available documents.
Adenoma↗
Retrosternal goiter.
BACKGROUND: Retrosternal goiter is a common cause of compression of adjacent structures, and it may harbor cancer. METHODS: During a 22-year period, we treated 44 patients with intrathoracic multinodular goiter. RESULTS: The goiter was resected in 40 patients; 4 patients were rejected because of prohibitive risk. There were three minor complications and no deaths. CONCLUSIONS: The specific indications for resection include compression of adjacent structures, prevention of future complications, and obtaining a diagnosis. Fine-needle aspiration for diagnosis is not always possible and rarely reliable, and there is no effective medical therapy. Cervical incision is nearly always adequate, with few exceptions, such as very large posterior goiter, mediastinal blood supply, or carcinoma necessitating mediastinal dissection.
Aged↗
Neglected lung cancer.
Pulmonary nodules of unknown nature may be cancerous and are best treated by early resection. During the past 20 years we have seen 65 patients in whom asymptomatic pulmonary nodules from 5 to 20 mm in diameter were discovered on routine roentgenograms between 1 and 4 years prior to their referral to surgery. These patients have not been investigated for cancer. Instead, they had been 'observed' or treated with antibiotics while their nodules increased in size. At the time of referral, 29 patients had widespread metastases, 28 had locally invasive State III lung cancer, eight had Stage I or Stage II lesions. Only 16 patients had their tumors resected. Sixteen patients (24.6%) survived 1 year or longer; six patients (9.3%) survived more than 2 years. Early resection of all undiagnosed pulmonary nodules is essential. 'Expectant' or antibiotic treatment of these lesions should be condemned. Educational programs for family physicians are urged.
Adenocarcinoma↗
Thoracic splenosis.
BACKGROUND: Thoracic splenosis is an uncommon side effect of thoracoabdominal trauma involving injury to the diaphragm and spleen. Only 20 patients with a similar problem have been reported previously. METHODS: Two patients with thoracic splenosis were studied. RESULTS: One of the patients had undergone thoracotomy for resection of a "pulmonary nodule". The other remains under observation. CONCLUSION: Presence of a pulmonary nodule in a patient with history of injury to the diaphragm and spleen should arouse suspicion of splenosis. Appropriate investigation may prevent an unnecessary and potentially harmful operation.
Adult↗