Archivio italiano di urologia, andrologia : organo ufficiale [di] Società italiana di ecografia urologica e nefrologica / Associazione ricerche in urologia
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Arch Ital Urol Androl · Sep 2011
Incidence of ureteral stricture after ureterorenoscopic pneumatic lithotripsy for distal ureteral calculi.
We investigated the incidence of ureteral stricture in patients treated with ureterorenoscopic pneumatic lithotripsy for distal ureteral calculi. ⋯ The results of our study have demonstrated that the success rate was not related to the stone dimension, but the time of operation was found to be increased with larger stones. Main risk factors for formation of ureteral stricture were impacted ureteral calculi and reasons which merits double-J catheter placement like mucosal damage, perforation, impacted calculi and high stone burden.
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In recent years, echographic studies of the kidney have improved radically due to new technologies which have recently become available. Among these, perhaps the most useful one is the ultrasonographic (US) procedure for the simultaneous laboratory and clinical workup of patients affected with acute nephropathic syndromes. However, traditional B-mode ultrasonography lack of sensibility and specificity in identifying and evaluating Acute Kidney Injury (AKI) is well known. ⋯ Similarly, measurement of RI in patients with liver disease and normal renal function may help in early detection of latent hepato-renal syndrome. Although the IR is not, strictly speaking, a measure of renal function it may nevertheless be correlated with it especially if elevated arterial resistivity is accompanied by a reduction in renal function itself. Thus, IR may be considered a useful predictive index in specific clinical settings.
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Arch Ital Urol Androl · Sep 2010
30 minutes high energy transurethral microwave thermotherapy (30 minutes TUMT) for the treatment of chronic urinary retention in patients with ASA II-III-IV.
To investigate if 30-Minutes-TUMT was useful and safe in the treatment of chronic urinary retention due to BOO in patients with ASA II-III-IV. ⋯ 47.4% of the patients responded positively to the new 30 minutes TUMT removing the urethral catheter, without needing surgical procedure avoiding the operation risk. 68.4% also improved their QoL. Local anaesthesia and oral/intravenous analgesia were sufficient during treatment. TUMT seems to have no anesthesiological risk. It is an option in patients with high risk of operation.
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Stone disease in children differs in pathogenesis, presentation and in treatment from adults. In recent years, big changes on its management have occurred. We reviewed our experience on upper tract urinary calculi in paediatric age. ⋯ Stone treatment in children is changing dramatically, thanks to progressive transfer of procedures from adult patients and recent advances in miniaturized new technologies. Surgical approach to renal and urinary tract stones in childhood was recently moving from open surgical procedures (nephrolithotomy, ureterolithotomy, cystolithotomy), to less invasive procedures, such as ESWL and endoscopic approaches, as ULT and PCNL. Mini-invasive procedures present high efficacy and safety, also in young children, but require appropriate instrumentation and specific experience.
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Arch Ital Urol Androl · Dec 2009
Randomized Controlled TrialPeriprostatic nerve block before ultrasound-guided prostate biopsy: a comparison of two local anesthetics.
The objective of the present study was to evaluate the efficacy of the periprostatic nerve block (PNB) of the prostate-vesicular junction with low volume and high concentration of anesthetics in relieving pain during prostate biopsy. Two hundred and twenty patients were enrolled and randomized to receive PNB with 5 ml 2% lidocaine (group 1110 pts) and PNB with 5 ml 2% mepivacaine (group 2, 110 pts). The anesthetic was administered through a single puncture on each side at the prostate-vesicular junction using a 22-gauge needle. ⋯ No general or local adverse effects were observed between the anaesthetics. The use of a low volume (2.5 ml on each side) and high concentration (2%) of local anesthetics (lidocaine/mepivacaine) almost completely suppresses pain and discomfort associated with prostate biopsy. The anatomy of neurovascular bundle regions appears favourable to the administration of small amounts of anesthetic.