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Athanasios Dellis

Publications and source records attributed to Athanasios Dellis.

4 recordsLinked to original sources

Bladder lithiasis: from open surgery to lithotripsy.

Bladder calculi account for 5% of urinary calculi and usually occur because of bladder outlet obstruction, neurogenic voiding dysfunction, infection, or foreign bodies. Children remain at high risk for developing bladder lithiasis in endemic areas. Males with prostate disease or relevant surgery and women who undergo anti-incontinence surgery are at a higher risk for developing vesical lithiasis. Open surgery remains the main treatment of bladder calculus in children. In adults, the classical treatment for bladder calculi is endoscopic transurethral disintegration with mechanical cystolithotripsy, ultrasound, electrohydraulic lithotripsy, Swiss Lithoclast, and holmium:YAG laser. Novel modifications of these treatment modalities have been used for large calculi. Open and endoscopic surgery requires anesthesia and hospitalization. Alternatively, extracorporeal shock wave lithotripsy has been demonstrated to be simple, effective, and well tolerated in high-risk patients. Recently, simultaneous percutaneous suprapubic and transurethral cystolithotripsy has been tested as well as percutaneous cystolithotomy by using a laparoscopic entrapment sac.

Humans↗

Is there a role for alpha1-blockers in treating double-J stent-related symptoms?

OBJECTIVES: To evaluate the effect of alfuzosin in improving symptoms in, and quality of life of, patients with indwelling double-J ureteral stents. METHODS: A total of 100 patients, 50 men and 50 women (mean age 54.2 years), with unilateral ureteral stone-related hydronephrosis, who had opted for conservative management with insertion of a double-J ureteral stent, were prospectively randomized into two groups. Group 1 included 50 patients who received 10 mg of alfuzosin, once daily for 4 weeks, and group 2 consisted of 50 patients who received placebo for the same period. All patients completed a validated Ureteral Stent Symptom Questionnaire (USSQ) 4 weeks after stent placement. RESULTS: The mean urinary symptom index score was 21.6 in group 1 and 28.1 in group 2 (P < 0.001). Stent-related pain was reported by 44% of patients in group 1 and 66% of patients in group 2 (P = 0.027). The mean pain index score was 14.6 in group 1 and 17.4 in group 2 (P = 0.047). The mean general health index score was statistically greater (P < 0.001) in group 1 compared with in group 2 (8 versus 11.4, respectively). Among sexually active patients, the mean sexual score was 2.3 in group 1 and 2.9 in group 2 (P = 0.017). CONCLUSIONS: Stent-related symptoms were present in 66% of the controls (group 2). Alfuzosin improved a subset of stent-related urinary symptoms and pain. Patients receiving alfuzosin had their sexual function and general health better preserved.

Adrenergic alpha-Antagonists↗

Does the management of bladder perforation during transurethral resection of superficial bladder tumors predispose to extravesical tumor recurrence?

PURPOSE: We evaluated the impact of a bladder perforation during transurethral resection of superficial bladder tumor on extravesical tumor recurrence and patient prognosis. We also defined potential risk factors for extravesical recurrence prospectively giving emphasis to the management of the perforation. MATERIALS AND METHODS: The medical records of 3,410 patients were reviewed. Parameters recorded included patient age and sex, tumor stage, grade, number, size and location at the time of perforation, the type of bladder perforation (extraperitoneal vs intraperitoneal) and the way the perforation was managed (open surgical repair vs conservative treatment). Logistic regression analysis was used to identify risk factors for extravesical recurrence. Cox regression analysis was used to compare cancer specific survival. RESULTS: A total of 34 cases of bladder perforation were recorded, 4 patients were treated with open surgery and 30 treated conservatively. The 4 patients who underwent open surgery presented with extravesical recurrence after a mean followup of 7.5 months. The remaining 30 patients had no evidence of extravesical recurrence after a mean followup of 60 months (p <0.001). Of the patients with extravesical relapse 3 died of disease. The surgical management of bladder perforation was the best predictor of extravesical recurrence (p <0.001, r = 1.13), followed by an intraperitoneal localization of the perforation (p =0.0003, r = 0.67) and tumor size (p =0.01, r = 0.42). CONCLUSIONS: Surgical repair of a bladder perforation during transurethral resection of bladder tumor increases the risk of extravesical tumor cell recurrence and negatively affects patient prognosis.

Administration, Intravesical↗

Size of external genital organs and somatometric parameters among physically normal men younger than 40 years old.

OBJECTIVES: To estimate the sizes of the external genital organs in physically normal adult males younger than 40 years old, as well as to correlate the resulting values with age and a number of somatometric parameters, to provide data that could be clinically applicable by the practicing urologist. METHODS: Fifty-two physically normal men, 19 to 38 years old, underwent tape measurements of penile dimensions in the flaccid-stretched state (total, shaft, glanular lengths), penile shaft volume calculation, and ultrasonographic testicular volume estimation. The resultant values were correlated with age, height, weight, body mass index, waist/hip ratio, and index finger length. RESULTS: The mean testicular volume was 16.9 +/- 4.7 cm(3), with the right testis (17.5 +/- 5.8 cm(3)) measuring slightly larger than the left (15.85 +/- 4.9 cm(3); P = not significant). The mean total penile length was 12.18 +/- 1.7 cm, the mean penile shaft length was 7.76 +/- 1.3 cm, the mean glanular length was 4.4 +/- 0.4 cm, and the mean penile shaft volume was 46.5 +/- 17.2 cm(3). Among the various correlations performed, the penile lengths (total, shaft, glanular) to index finger length (P <0.05) and to penile shaft volume (P <0.001) were statistically significant. CONCLUSIONS: Data on the size of the external genital organs among physically normal young adult men were provided and a novel formula for penile shaft volume calculation was proposed. Age and somatometric parameters were not associated with the size of the genitalia, excluding the index finger length, which correlated significantly with the dimensions of the flaccid, maximally stretched, penis.

Adult↗