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Biomedical subjects

G Savoca

Publications and source records attributed to G Savoca.

At least 19 recordsLinked to original sources
PubMed2001

Percutaneous ethanol injection of the prostate as minimally invasive treatment for benign prostatic hyperplasia: preliminary report.

OBJECTIVE: To evaluate the feasibility, safety and efficacy of a minimally invasive treatment for benign prostatic hyperplasia (BPH) consisting of percutaneous ethanol injection inside the prostate under ultrasound surveillance. MATERIAL AND METHODS: Transperineal ethanol injection into the prostate was performed in 8 patients who were affected by obstructive BPH according to AUA symptom score, impaired urinary flow, and volume of postvoiding residual urine. Injections were performed under transrectal ultrasound surveillance at four sites of the prostate for an overall amount of 6 ml of ethanol per patient. The procedure was performed under local anesthesia. RESULTS: The patients' median age was 69.7 years (range 57-83). No major intraoperative or postoperative complications were encountered. The median symptom score decreased from 21+/-5.2 (range 14-28) to 10+/-4.4 (range 1-14) at 3 months postoperatively (p<0.0001). The median peak flow rate increased significantly from 11 ml/s (range 7-17) before the procedure to 16 ml/s (range 12-20) after it (p<0.001). The median volume of post-voiding residual urine dropped from 130 ml (range 36-200) before treatment to 27 ml (range 11-42) after it (p<0.01). The same parameters were assessed at 6 months without significant differences. A mild side effect was observed in 1 patient who reported severe urge incontinence and moderate perineal pain the first month after the procedure. CONCLUSION: Percutaneous ethanol injection therapy of the prostate is a safe, easy and minimally invasive procedure for treating BPH, especially when there is an high operative risk.

Aged↗
PubMed2000

Sclerotherapy of hemangioma of the glans penis.

Penile hemangiomas are very rare, small lesions. Possible therapies include surgical excision, electrofulguration, cryotherapy, and sclerotherapy. We describe an extremely rare case of a large hemangioma of the glans that was treated by means of repeated injections of 2% polidocanol under local anesthesia (5% lidocaine-prilocaine cream). No complications were observed after the operation, and a satisfactory aesthetic result was obtained. No relapse was noted 18 months after the treatment. A therapeutic reference standard for the treatment of penile hemangiomas is still lacking because of the rarity of the disease. Sclerotherapy proved to be an effective, low-cost, and easy-to-perform procedure. Moreover, it is repeatable in case of failure.

Adult↗
PubMed2000

Long-term results with Nesbit's procedure as treatment of Peyronie's disease.

The objective was to assess sexual function at long-term follow-up after the Nesbit operation for Peyronie's disease. One hundred and fifty seven out of 213 patients treated between 1986 and 1998 using the Nesbit procedure were reassessed by means of IIEF-5 questionnaire together with two questions about residual deformity and treatment satisfaction. The results from this questionnaire together with the patient case records constitute the basis of this paper. After an average 72-month follow-up subjective patient determination of satisfaction indicated that 87.9% were satisfied with the results of surgery, 136 patients (86.7%) had good erectile function (IIEF-5 > 21). Shortening of the penis (from 1.5 to 3 cm) occurred in 22 patients (14%), but only in 2 (1.3%) was intercourse difficult because of excessive shortening. In conclusion, the Nesbit's operation results in the greatest amount of patient satisfaction about sexual function. When penile shortening occurs, it has not been a significant problem for patients who are properly counselled.

Adult↗
PubMed2000

Saphenous vein harvesting by 'stripping' technique and 'W'-shaped patch covering after plaque incision in treatment of Peyronie's disease.

Harvesting of the saphenous vein tract by means of leg stripping is proposed in the treatment of Peyronie's disease. The technique of W-shaped saphenous vein after plaque incision to correct severe penile deformity associated with Peyronie's disease is described. Graft material was obtained from the lower saphenous vein by means of distal 'leg short stripping' technique. The size and number of tunical incisions depended on the size of the plaque. A 15 cm venous segment is generally sufficient to cover the defect. The venous segment used was W-shaped, assembled with 6/0 polydioxanone (PDS) uninterrupted sutures and then sutured to the albuginea defect. In our preliminary series of eight patients, penile shortening and erectile dysfunction is absent. Complete correction of penile deformity was achieved in seven patients (87.5%). One patient had minimal residual curvature (<20 degrees ) which did not result in difficulty with intromission. Saphenous harvesting by the stripping technique is not an invasive procedure and is quick and simple to perform. The W-shaped assembling technique is safe because the piece of saphena is kept intact and may be suited properly to the albuginea defect.

Humans↗
PubMed2000

Comparison of single preoperative oral rufloxacin versus perioperative ciprofloxacin as prophylactic agents in transurethral surgery.

The aim of this prospective clinical trial was to compare the efficacy of rufloxacin, a once-daily fluoroquinolone administered as a single pre-operative dose versus the perioperative prophylaxis with ciprofloxacin in transurethral surgery. Two hundred and two patients undergoing transurethral resection of bladder tumors (132) or transurethral resection of the prostate (70) were selected for the study between January 1997 and June 1998. Patients were randomized to two treatment groups. Group A received a single oral 200 mg dose of rufloxacin three hours before surgery and group B was administered oral ciprofloxacin 250 mg bid until catheter removal. The two treatment groups were homogeneous with respect to patient characteristics. One hundred and seventy-three patients (89 rufloxacin and 84 ciprofloxacin) were assessed and 29 were excluded from the statistical analysis. The incidence of postoperative infection was similar in both treatment groups (5.7% rufloxacin, 4.7% ciprofloxacin). On the other hand, single-dose pre-operative prophylaxis with rufloxacin significantly reduced the cost of antibiotic prophylaxis. Results of the present study show that single dose oral rufloxacin may be used in routine clinical practice as a preoperative prophylactic antibiotic due to its low cost, its documented efficacy and its simple once daily dosage regimen.

Administration, Oral↗
PubMed2000

[Transrectal ultrasound-guided biopsy of the prostate].

The early detection of prostatic neoplasm is nowadays a primary need in the urological field. The availability of transrectal ultrasound equipment alongside with bioptic tools made possible that transrectal ultrasound-guided biopsy of the prostate became the standard procedure to achieve this goal. With this work we would like to confirm the efficacy of this method which is also associated with a good tolerance and low complications rate. 82 patients that came to our Department between 1997 and 1999 were submitted to this procedure, 25 resulted positive for prostatic adenocarcinoma. Only 2 of them did not tolerate the procedure while all the others referred only mild discomfort at the moment of the puncture; 9 patients afterwards had to be admitted to the hospital due to fever (1 patient), acute retention of urine (3 patients) and persistent macroscopic hematuria (5 patients). Transrectal ultrasound-guided biopsy of the prostate reveals to be a safe and accurate method to obtain tissue samples of the prostate along with high tolerance and low incidence of serious complications.

Biopsy, Needle↗
PubMed1997

Laparoscopically assisted penile revascularization for vasculogenic impotence: 2 additional cases.

PURPOSE: Microsurgical revascularization of the penis in vasculogenic impotence is an accepted surgical procedure in young men with a history of blunt pelvic or perineal trauma. Most penile revascularization techniques use the inferior epigastric artery in direct artery-to-artery revascularization or dorsal vein arterialization procedures. To obviate the wide pararectal incision laparoscopic mobilization of the inferior epigastric vessels has been recently proposed. We present 2 cases of successful laparoscopically assisted penile revascularization. MATERIALS AND METHODS: With the patient under general anesthesia the first trocar was inserted in the umbilical region and pneumoperitoneum was induced. Two other trocars were positioned laterally. As soon as the inferior epigastric vessels were accessed, dissection was initiated below the level of the arcuate line. The vessels were dissected cephalad en bloc to a point of bifurcation of the inferior epigastric artery above the umbilical level. The inferior epigastric pedicle was ligated with clips and transected at the cephalad edge of the dissection. It was then mobilized and tunneled through an infrapubic incision at the base of the penis for subsequent microvascular anastomosis with the penile vessels. RESULTS: The anastomosis was patent and hemostasis was satisfactory. Operative time in the 2 cases was 4.3 and 5.2 hours, respectively. At 3 months both patients reported complete erections. CONCLUSIONS: Our experience confirms the extremely practical use of laparoscopy which, due to its magnification power, makes it possible to perform fast, accurate excision of the epigastric bundle. Moreover, a wide pararectal incision, which is a frequent cause of postoperative complications, is avoided.

Humans↗
PubMed1997

Prevalence and incidence of enuresis before puberty.

OBJECTIVE: A mixed study of the prevalence and incidence of enuresis addressed to the schools of the province of Sassari was planned over a 2-year period. METHODS: School children aged between 3 and 11 years were considered. 734 children aged 3, 6, and 9, of 3 schools representative of the urban, suburban and rural areas of Sassari were selected by "cluster" sampling. In this first stage of the project a study of prevalence in children aged 3, 6, and 9 years was carried out. The second stage encompasses a 1-year longitudinal study of the cohort selected in the first stage and provides incidence data pertinent to children aged 4, 7 and 10 years. RESULTS AND CONCLUSIONS: Cross sectional study: In the 73 children aged 3 years who attended nursery schools, 7 cases of enuresis (9.6%) were identified. In the 306 6-year old children of the first year of primary school, 22 cases of enuresis (7.2%) were observed. In the 355 9-year-old students of the fourth year of primary school, 10 cases (2.8%) were reported. Follow up: No case of enuresis was observed among children of the nursery school (aged 4 years); 2 new cases (0.7%) were identified in the 7 year-old group and only 1 new case (0.57%) was encountered in the group of children aged 10. Prevalence of enuresis reached 5.3% in the overall sample and showed a progressive decrease from the younger to the older age group.

Child↗
PubMed1996

Intralaparoscopic ultrasound and Doppler sonography in urology.

Common practice with intraoperative sonography during open surgery has demonstrated that ultrasounds supply important information that can help the urologist in decision making; in addition, the growing popularity of laparoscopy has underscored the importance of laparoscopic ultrasonography. Laparoscopic ultrasound combines the advantage of diagnostic laparoscopy and intraoperative contact ultrasonography. The authors report their experience with intralaparoscopic ultrasonography using a 7.5-MHz transesophageal probe in several paradigmatic urologic applications, in which intraoperative ultrasonography was employed to provide anatomical information, to supply efficiency in confirming and excluding anticipated or unexpected pathology, and to solve diagnostic problems using high-resolution, real-time, B-mode ultrasound. Intralaparoscopic ultrasound proves to be a simple, efficient procedure that provides useful information in order to help the urologist in intraoperative decision making.

Adult↗
PubMed1996

[Calcifying giant-cell Sertoli tumor: description of a case with atypical echographic presentation].

Large cell calcifying Sertoli cell tumor of the testis is an extremely rare type of sex cord tumor with low malignant potential that occurs in the first and second ecades of life. Twenty-eight cases have been reported in the literature and, to our knowledge, only 2 had an aggressive behaviour. Patient age, tumor size, histological malignant patterns such as pleomorphism and high mitotic rate seem to heavy influence the future neoplasm malignancy. Ultrasonography imaging of the large cell calcifying has described in only 6 cases. We report an experience with a large cell calcifying Seroli cell tumor of the testis and point out the unusual sonographic findings. Moreover, if histologic examination suggests no malignant features, we suggest local excision as ideal therapy for the preservation of testicular parenchyma.

Adolescent↗
PubMed1996

[Color Doppler echographic monitoring of retrograde and anterograde sclero-embolization of a left varicocele: report of 76 cases].

Varicocele, which is the most common cause of infertility in man, is detected by means physical examination and color Doppler sonography. We analyzed the results of percutaneous sclerotherapy of the spermatic veins in 76 out of 103 patients with varicocele: antegrade sclerotherapy was performed in 11 patients while 92 men underwent retrograde scleroembolization. Color Doppler sonography was performed one month later and showed persistence of varicocele in 3 patients who underwent retrograde sclerotherapy. Retrograde percutaneous sclerotherapy of the spermatic vein represents, in our opinion, the gold standard in the treatment of primitive and recurrent left varicocele, because of its efficacy and minimal invasive nature. Antegrade sclerotherapy is an effective alternative treatment when retrograde access is not possible.

Adolescent↗
PubMed1996

[Echographic, MRI and CT features in a case of bladder endometriosis].

Endometriosis is relatively frequent in females of menstrual age and consists in the appearance of active endometrial tissue at site other than uterine cavity. Endometrial tissue has been described to colonise the urinary system, particularly the urinary bladder. The most common clinical features of vesical endometriosis are urgency and frequency, hypogastric pain and hematuria. We report on a case of vesical endometriosis whose presenting features were dysmenorrhea, stranguria and pelvic pain. MRI and CT did not provide different or more precise information than ultrasound scan: these findings were indistinguishable from an intrauterine lesion. On the contrary endovaginal sonography was more sensitivity than MRI and CT. Cystoscopy was negative. Nondiagnostic laparoscopy was performed. Patient underwent laparotomy and partial cystectomy. Histopatological findings demonstrated an endometriosis of the muscle layer of the bladder. The rarity of this condition prompted us to report on the problems encountered in making the differential diagnosis.

Adult↗
PubMed1994

[Role of echography in the diagnostic-therapeutic management of renal cysts].

Herein we report on the results of 171 out of 214 patients with renal cysts. In 127 cases diameter of cyst being less than < 6 cm, was monitored repeating renal ultrasound every 6 months: 78 patients underwent pecutaneous cyst echoguided puncture, while 9 patients were treated as follows: 4 by open surgery, 3 by laparoscopy and 2 by percutaneous treatment in general anaesthesia. Cysts are classified in 4 types and therapy is different according to Bosniak's classification. When the cyst is less than 6 cm in diameter and symptomatology is absent, we follow the patients up with yearly ultrasound. In our experience cyst sclerotization is carried out by injecting either ethanol or Trombovar or 50% glucose in water alone or associated with 2% Aethoxysclerol. The best results are obtained from the use of ethanol (30% of the volume of cyst). However some relapses are encountered after this kind of procedure. In these cases it is helpful to examine the cystic wall because of the presence of intracystic septa. Percutaneous treatment by means nephroscopy permits to visualize the cystic wall but it is not able to perform a biopsy of its wall. Laparoscopic treatment is performed by inserting 5 trocars with the patient under general anaesthesia. This technique is able to localize and biopsy the cystic wall without causing side-effects or complications. Open surgery was performed only in 4 patients affected with hidatid cyst. At present echoguided cyst puncture permits to approach the renal not complicated cysts, while laparoscopy constitutes a safe treatment in the case of benign recurrent and complicated cysts.(ABSTRACT TRUNCATED AT 250 WORDS)

Follow-Up Studies↗