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Biomedical subjects

B Elman

Publications and source records attributed to B Elman.

14 recordsLinked to original sources
PubMed2001

Trans-rectal ultrasonography (TRUS) with lipiodol injection for localization of the prostatic apex before radiotherapy planning.

PURPOSE: To evaluate reliability of Trans-rectal ultra-sonography (TRUS) guidance with lipiodol injection for prostate localization before radiotherapy planning. MATERIAL AND METHODS: From October 1997 to March 2000, 31 patients with prostatic adenocarcinoma and six patients with anastomotic recurrence after radical prostatectomy had TRUS-guided injection of lipiodol. Two milliliters of lipiodol were injected into each side of the prostate and 1 ml into both seminal vesicles with a 22 Gauge CHIBA needle and US probe guide before radiotherapy planning. We had established a contrast quality index (0 for no prostate enhancement to 5 for efficient pacification without any diffusion). On simulation films, we had performed anatomic measurements for comparison with other anatomic studies. RESULTS: For all 37 patients, TRUS-guided injection was well tolerated. Among 31 patients with the prostate in situ, three had no apex opacification and 15 had no vesicle enhancement or peri-vesicle space diffusion. However, in 19 patients there was good contrast quality with an index score of > or =3. The majority of patients had prostatic apex between 1.5 and 3.5 cm from ischial tuberosities ligne (27 from 28 evaluable for apex). Among 19 evaluable patients, 15 had seminal vesicles 2-4 cm above the top of pubis. For six patients with anastomotic recurrence after radical prostatectomy, lipiodol was precious aid to locate it. We had only one failure because of a precocious bladder absorption relating to a delay which is too long between rectal probe locating and portal films. CONCLUSION: TRUS injection of lipiodol is a simple, inexpensive, relatively safe technique for localization of prostatic apex, but not appropriate for seminal vesicles enhancement. This is also an interesting method to locate anastomotic recurrence.

Contrast Media↗
PubMed1991

Kock pouch procedures: continuing experience and evolution in 135 cases.

Between April 1985 and January 1989, 135 consecutive patients underwent construction of a Kock pouch (to the skin in 72 patients, a urethral pouch in 45, an ileorectal pouch in 10 and a hemi-Kock pouch augmentation cystoplasty in 8). The operative mortality (30 days) rate was 4.4%. There were 16 early complications (12.4%) leading to 14 reoperations (11%), with a followup of 6 to 60 months. After Kock pouch to the skin, the late complication rate was 26.1% in the Kock-Skinner technique group and 7.4% in the simplified technique group, and 94.2% of the patients were continent. After a urethral Kock pouch daytime continence was achieved in 93% of the patients within 2 months and nighttime dryness was noted in 65% within 3 months. After an ileorectal Kock pouch all patients were continent day and night, as were those after hemi-Kock pouch augmentation, although 5 of the latter patients required intermittent catheterization.

Adolescent↗
PubMed1989

[Impotence in a urologic service].

In a recent experience we have studied 297 patients for impotence. 102 were considered psychogenic and 195 organic; 105 of the latter had isolated or associated arterial or venous lesions. The remaining 81 patients had preponderant organic pathology: Peyronie's disease, neurological disease, diabetes and pelvic trauma. All patients were explored by NPT (nocturnal penile tumescence), Doppler examination, intra-cavernous papaverine test, angiography and erectile flow associated with cavernography. We report our microvascular surgery results from the last seven years. 80 reconstructive vascular procedures were performed on a population of patients who averaged 50 years of age. 50 epigastric-cavernous by-passes were performed. Complete recovery has been observed in 14% with an average of 42 months follow-up. Erection improvement with possibility of vaginal intromission in 58%. Immediate or secondary thrombosis and priapism in 28%. 21 arterial epigastric-dorsal unilateral by-passes were performed with an average follow-up of 20 months. In 11 cases the arterial micro-revascularization was associated with deep dorsal vein ligature. Results are as follows: 10 excellent, 4 significant improvement, 3 failures and too short follow-up in three. 9 isolated venous ligature with a mean follow-up of 15 months. Complete recovery was observed in 3 patients, improvement in 3 and failure in 2. The author emphasizes the interest of a better selection of surgical indications, improvement of microsurgical techniques with epigastric-dorsal anastomosis associated with postoperative anticoagulant therapy whenever possible.

Erectile Dysfunction↗
PubMed1988

[An exceptional cause of renal colic. Castleman's tumor. Lymphonodular angiofollicular hyperplasia].

The case of a 38-year-old man with renal colic due to compression by an abdominopelvic mass is reported. Histologic examination of the mass led to the diagnosis of giant lymph node hyperplasia or Castleman disease. Surgical removal of the lesion ensured complete recovery with no recurrence after 32 months follow up. Giant lymph node hyperplasia usually develops in the mediastinum, but superficial and abdominopelvic forms are seen occasionally. Pathogenic hypotheses are discussed. Outcome is usually favorable following surgical excision but rare multifocal forms with a potentially poor prognosis have been reported.

Adult↗
PubMed1987

Endoscopic surgery under local anesthesia.

Transurethral resection for papillary tumors and benign prostatic hypertrophy was performed in 26 patients under local anesthesia, sometimes in association with neuroleptanalgesia. 14 superficial bladder tumors were so treated: 9 adenomas and 3 bladder neck obstructions were resected in elderly debilitated patients. No patient required general anesthesia. No complications due to local anesthesia were noted.

Anesthesia, Local↗
PubMed1987

[Value of teflon in recurrent stress incontinence in elderly women with urodynamic control].

Since 1981, 12 cases of stress incontinence in elderly, multi-operated women have been treated by one or several endoscopic injections of teflon. The definitive results, with a mean follow-up of 28 months, were as follows: 58% cures, 25% improvements and 16% failures. The urodynamic survey and cysto-urethrography revealed: unchanged urethral compliance, increased urethral tone and urethral length, improved abdomino-urethral transmission, increased bladder capacity, reduction in the posterior vesico-urethral angle and lifting of the bladder neck.

Aged↗
PubMed1986

[A pelvic tumor unusual in terms of its volume and clinical expression].

The authors report the case of an exceptionally large prostatic adenoma (800 g) with a misleading clinical presentation: haematuria, signs of vascular compression, raised acid phosphatase, with no signs of urinary obstruction. Only repeated biopsies were able to confirm the benign nature of this hyperplasia, which justified surgical treatment.

Aged↗
PubMed1985

[Use of netilmicin for antibiotic prevention of urinary infections after endoscopic surgery in urology].

We studied for one year 60 patients separated in 3 groups of 20: first reference group without treatment; second group receiving netilmicin in premedication; third group treated by netilmicin for 2 days postoperatively. This series clearly demonstrates the high urinary tract infection rate after transurethral surgery, the benefit of antibioprophylaxis with netilmicin and the efficiency of one dose of this aminosid given one hour preoperatively.

Aged↗