Biomedical subjects
C Sali
Publications and source records attributed to C Sali.
[Epidermoid cyst of the testicle: presentation of a case].
OBJECTIVE: To describe a case of epidermoid cyst of the testis, a rare lesion that warrants surgical exploration to confirm the diagnosis since its echo patterns are characteristic but not pathognomonic. METHODS/RESULTS: 10 years earlier the patient had noticed an asymptomatic swelling of the right testis which did not cause infertility since he had two children over the last 6 years. Tumor markers AFP, BHCG and LDH fell within the normal ranges. Ultrasound evaluation with a high resolution 7.5 Mhz transducer revealed a 4 x 3.5 x 3.2 cm testicular mass surrounded by atrophic parenchyma. The patient underwent radical inguinal orchidectomy. CONCLUSIONS: Epidermoid cyst is the benign variety of testicular teratoma. Two different forms exist: simple and mixed. Malignant components are present in the latter form. If the simple form is identified before substitution of the testicular parenchyma occurs, testis sparing surgery is justified; otherwise radical orchidectomy with inguinal exploration is indicated.
[pT1G3 tumor of the bladder].
The management of the superficial bladder tumor is commonly performed by transurethral resection (TUR) and a following chemotherapy or immunotherapy with exception of Tis. A lot of doubts and questions raise in the management of pT1G3 bladder tumor (BT) for the high grade of recurrencies and progressions. Our experience from 1984 to 1994 about 109 patients (pts) with pT1G3 BT undergone to radical cystectomy (47 pts) and TUR (62 pts) allows us to state that when Tis is present a radical cystectomy is mandatory, but the TUR option must be followed to frequent and accurate random biopsies in order to discovery foci of Tis. In the case of pT1G3 monofocal there is always a therapeutic disconcerting.
[Replacement bladders in Oltrepo].
In our Department we performed 269 radical cystectomies from January 1985 to April 1996. As regard the urinary diversion 64 patients were undergone to a cutaneous ureterostomy; in 137 we performed a Wallace uretero-intestinal anastomosis; in 6 a Mauclaire rectal diversion; in 12 patients a Mainz Pouch II and 50 selected patients (44 man and 6 ladies) we performed a Vesica Ileale Padovana (VIP). In these cases the stage was lowly, good renal function, no are hydronephrosis. The patients were motivated for a long follow-up and preoperatively undergone to urethral biopsies. We have had the following complications: an early bowel obstruction, 4 wound infections and for the long term follow-up 2 inguinal hernias, 1 laparocele, 5 patients with bilateral hydronephrosis. At the moment we cannot state a correct oncological report for the short follow-up: only 1 patient died after 18 months for a pelvic relapse. We can suggest that VIP is a good solution for the ladies: its mandatory to take care of the urethra and the pelvic floor for a good continence limiting the lymphadenectomy. We haven't any suggestions about the deep of the colpectomy and the opportunity of the vaginal suspension.
[Incision of the bladder neck].
Transurethral incision of the bladder neck (TUIBN) is a simple method of relieving bladder outflow obstruction producing similar results to transurethral resection of the prostate (TURP) when obstruction is caused by small prostate (< 40 gr). The complication rate is low and retrograde ejaculation has a far less degree than after TURP, so less bleeding. The major advantage of TUIBN are: short hospitalization, less bladder neck contractures. The drawback of the absence of prostate tissue for an earlier diagnosis of cancer can be balanced performing a biopsy before treatment.
[Intraurethral devices in the treatment of prostatic obstruction].
We describe our experience (started in 1988) about the use of urethral stents implanted into patients with prostatic outflow obstruction, unit for prostatic surgery. This technique has been applied successfully with few complications. The use of different stents (Fabian's spiral, mesh stent) allowed us to get the right choices in the different shapes of prostatic urethra and in the different expectancies of the patients. Lastly we can offer an useful recommendation about the patients evaluation and the stents selection.