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Biomedical subjects

G Passerini Glazel

Publications and source records attributed to G Passerini Glazel.

At least 19 recordsLinked to original sources

Reconstructive surgery of the urethra: a pilot study in the rabbit on the use of hyaluronan benzyl ester (Hyaff-11) biodegradable grafts.

We investigated the outcome of reconstructive surgery of the urethra through guides composed of a novel biodegradable and highly biocompatible polymer, Hyaff-11. A tract of about 1.5 cm of the rabbit pendulous urethra was totally resected and replaced by a Hyaff-11 tubular graft. Eleven animals were analysed at each of the time points ranging from 7 days to 4 weeks following surgery. Histological and radiological evaluation showed a satisfactory remodelling of the neo-urethra around the implant. The regenerated connective tissue connected both urethral stumps within the first 7 days. On postoperative week 3, the Hyaff-11 guide had disappeared. At the 4-week time point the retrograde urethrogram showed a good distensibility of the neourethra. The regenerated stroma consisted of fibroblastic cells, and collagenous and elastic fibres. The neo-epithelium was pluristratified and exhibited cells of the cuboidal type.

Animals↗

[Reconstructive surgery in complex hypospadias: therapeutic indications and technical considerations in 93 cases].

Perineo-scrotal hypospadias and the severe sequelae of a failed repair procedure are complicated cases. The present study describes our experience in the treatment of complex hypospadias, the new therapeutic possibilities, their indications and results. From 1981 to 1992, 93 children with complex hypospadias underwent surgery (53 underwent surgery for the first time and 40 for severe sequelae of a failed procedure). Excellent cosmetic results were achieved by surgery. For those undergoing hypospadias repair for the first time, we used a pedicled preputial flap following the Duckett (12 cases) or Standoli (41 cases) technique. For those with severe sequelae from a failed procedure, we utilized a pedicled skin flap (18 cases) or free flap of bladder mucosa or penile skin (22 cases). The overall complication rate was 50% (47 patients). Surgical repair of complex hypospadias is a relatively long and complicated procedure with a long learning curve and a high complication rate in the initial phase. Fistula is the most common complication, although closure is very simple due to the abundant, well vascularized, healthy tissue. Overall our results have been satisfactory, considering the severity of these cases.

Child↗

Ectopia of the vas deferens into the ureter. Case report and review of the literature.

Ectopia of the vas deferens into the ureter is a rare occurrence, frequently associated with anorectal anomalies. To date, 20 cases have been reported, accounting for a total of 26 vasoureteral communications, 6 of which are bilateral. Embryologically, ureteral ectopia of the vas deferens may be explained by an underlying defect in the proximal mesonephric duct or an abnormally cranial origin of the ureteric bud. We add the case of a newborn with an ectopic vas terminating into the ureter of a multicystic kidney.

Abnormalities, Multiple↗

[Neurogenic bladder caused by meningomyelocele in childhood: urodynamic pattern and treatment regimens].

The authors reviewed the records of 160 patients with neurogenic bladder secondary to myelomeningocele (MMC) treated at the Urology Department of the University of Padua during 1977-1988. All patients had been evaluated by excretory urography, urethrocystography and videocystomannometry (VCM). Urodynamic studies are fundamental in determining vesicosphincteric dysfunction and patients who are at high risk for early renal lesions. For this reason, the authors recommend urodynamic evaluation from the first year of the infant's life in order to institute treatment early. The therapeutic approach should aim at a) preserving renal function, b) achieving a socially acceptable degree of urinary continence, and c) protecting sexual function.

Adolescent↗

Vesical instillation of emepronium bromide in defunctionalized postobstructive noncompliant bladder: an alternative to intestinal augmentation surgery?

A contracted noncompliant bladder is an infrequent but severe complication of cutaneous ureterostomy. Recently, we effected a significant increase in bladder capacity by long-term, gentle hydraulic dilation with saline solution plus an anticholinergic drug (emepronium bromide). Based on this experience, we suggest a conservative approach like this before electing a patient for bladder augmentation or permanent diversion for any child with vesical contracture.

Administration, Intravesical↗

Stone formation in a female urethral diverticulum. Review of the literature.

A case of stone formation within a female urethral diverticulum is presented together with a brief literature review. Clinical diagnosis may be suspected if a stony hard mass is palpable on the floor of the urethra. The definitive diagnosis depends upon a plain X-ray film and a retrograde positive pressure urethrogram. Surgical excision of the diverticulum together with the calculus is best performed by the vaginal route.

Diverticulum↗

Acquired intravesical ureteral diverticulum: an unusual late complication of ureteroneocystostomy.

An unusual case of late ureteral obstruction following a Politano-Leadbetter ureteroneocystostomy performed 11 years previously is reported. Fibrosis of the distal ureter associated with vascular compression of the extravesical ureter presumably led to development of a ureteral intramural diverticulum. This case illustrates the necessity of careful ureteral placement and emphasizes the importance of close followup for many years, even in asymptomatic patients.

Adult↗

Congenital polyp of the prostatic urethra: report on 2 cases.

Congenital polyps of the prostatic urethra are an uncommon cause of obstructive uropathy, infection and/or hematuria in male children. A filling defect localized in the posterior urethra on the voiding cystourethrogram represents the peculiar diagnostic finding. Transurethral resection is the treatment of choice, according to the size of the polyp. Two cases of congenital posterior urethral polyps are reported and the main clinical and radiological features are discussed. This lesion has to be considered in the differential diagnosis of the voiding dysfunction in young boys.

Adolescent↗

Sarcomatous carcinoma of the kidney presenting as spontaneous retroperitoneal hemorrhage. Report of a case with immunocytochemical study.

A case of spontaneous perinephric hematoma due to a renal cell sarcomatous carcinoma in a 46-year-old woman is reported. Immunocytochemical analysis for the intermediate-sized filament proteins allowed a specific diagnosis of pseudosarcomatous renal carcinoma. Clinical, radiographic, sonographic and CT findings of spontaneous perinephric hematoma are discussed and the therapeutical modalities are briefly outlined.

Carcinoma↗

Bilateral single ectopic ureter.

A case of successfully treated bilateral single ectopic ureter with a follow-up of 13 years is reported. The genesis of the incompetence of the vesical sphincter and its treatment are discussed.

Choristoma↗

Blind ureterocele.

Ureterocele without corresponding renal tissue (blind ureterocele) represents a very rare malformation which is of special interest for the understanding of the embryogenesis of this anomaly. Two cases, the first without corresponding kidney seen in an adult and the second in connection with a small multicystic kidney observed in a boy, are considered. In light of the observation of the disappearance of antenatally diagnosed multicystic kidney, these lesions are considered to represent two different stages of the same anomaly. A somewhat functioning renal tissue is supposed to be necessary for the development of a ureterocele. In the case of blind ureterocele, it is supposed that the renal tissue might subsequently disappear. Ureterocele may result from a combined ureteral bud anomaly and obstruction during fetal development.

Adult↗

Upper urinary tract obstruction in children caused by Candida fungus balls.

2 children with upper urinary tract obstruction from Candida fungus balls are reported. A presumptive diagnosis, made on the basis of clinical and radiological findings, was confirmed by microscopic examination of urinary sediment. Medical treatment was successful in both patients. Since Candida infections can occur in patients with altered host resistance, this should alert clinicians to the possibility of fungal involvement when radiolucent filling defects are found in the renal pelvis. Such a presumptive diagnosis can then lead to a correct approach with conservation of renal function.

Candidiasis↗

[Diagnostic and therapeutic protocol in malformative uropathies prenatally diagnosed].

The increased frequency of prenatal detection of urinary tract abnormalities has brought to the attention of the pediatrician a high number of neonates and infants with asymptomatic hydronephrosis, which represents the most common form of uropathy. As it becomes clear that hydronephrosis does not necessarily mean obstruction, the purpose of the evaluation is to identify those infants in whom hydronephrosis will cause progressive renal deterioration, because of an ongoing restriction to urinary outflow. In the present paper, the discussion of the post-natal diagnosis and management focuses on the embryologic background, the pathophysiology of the obstruction and the rationale to utilise the different diagnostic techniques (ultrasonography, associated with the use of the Doppler; intravenous urography; avoiding cystourethrography; renal scintigraphy).

Clinical Protocols↗