Biomedical subjects

George Barbalias

Publications and source records attributed to George Barbalias.

5 recordsLinked to original sources

PubMed2005

"Angular percutaneous renal access". Multiple tracts through a single incision for staghorn calculous treatment in a single session.

PURPOSE: We herein describe the technique of a single subcostal skin incision with multiple angular punctures to approach the superior, middle and lower pole of the kidney for the management of staghorn calculi. MATERIALS AND METHOD: One hundred patients with staghorn calculi were managed between January 1997 and June 2000. The superior calyx was approached by a subcostal triangulation technique and the middle and lower calyces were approached by angular punctures. Correct advancement of the needle was monitored by biplane fluoroscopy. Maximum effort was made for complete stone clearance in a single session. RESULTS: : 87% patients were rendered stone free in a single session. The average number of tract dilation per renal unit was 2.4 with an average anesthesia time of 110 minutes and the average blood loss of 450 ml. The average hospital stay duration was 4.6 days. The secondary procedures required were 0.11 per patient and the complication rate totalled 7% with one case of excessive hemorrhage requiring embolization. CONCLUSIONS: We therefore propose the triangulation technique as a safe and appealing method for the percutaneous management of staghorn calculi.

Humans↗

PubMed2004

Clinical correlation of prostatic lithiasis with chronic pelvic pain syndromes in young adults.

OBJECTIVE: To investigate the incidence, morphology and clinical presentation of prostatic calculi in a selected population of young adults and to examine any possible correlation with chronic prostatitis/chronic pelvic pain syndromes (CP/CPPS). METHODS: A population of 1374 young adults was screened with ultrasound imaging of the prostate and 101 cases with prostatic lithiasis were selected. Patients were divided in two groups, according to the type of prostatic calculi (type A: small, multiple or type B: larger, coarser calculi). Further evaluation included history and physical examination, recording of lower urinary tract symptoms and the Meares-Stamey test. RESULTS: Calculi were type A in 71.3% and type B in 28.7% of cases. Localization (central/periurethral) was not correlated with other parameters. Age was closely related to calculus burden ( p =0.034 ). Type B calculi were more often associated with symptoms and chronic prostatitis/CPPS (chi(2)-test, p=0.007 and 0.018 respectively). CONCLUSIONS: Small, multiple calcifications are a normal, often incidental ultrasonographic finding in the prostate and represent a result of age rather than a pathologic entity. However, larger prostatic calculi may be related to underlying inflammation and require further evaluation and possibly, treatment.

Adult↗

PubMed2002

Effects of finasteride and cyproterone acetate on hematuria associated with benign prostatic hyperplasia: a prospective, randomized, controlled study.

OBJECTIVES: To evaluate the influence of two differently acting antiandrogens, finasteride (FIN) and cyproterone acetate (CPA), on the natural history of hematuria associated with benign prostatic hyperplasia (BPH) in a prospective, randomized, controlled study. METHODS: Forty-two patients with hematuria episodes due to BPH were randomly allocated to three subgroups of 14 patients each and treated daily with either 5 mg FIN or 100 mg CPA or were placed in a watchful waiting arm. Patients were evaluated at 3-month intervals, and 40 patients had at least 1 year of follow-up. RESULTS: Four patients in the FIN group (30%) and three in the CPA group (23%) presented with recurrent hematuria. In both groups, the bleeding episodes were treated conservatively and required no hospitalization. In the control group, 8 patients (57%) presented with recurrent bleeding; in 4, the bleeding was severe and required some form of intervention (catheterization or transurethral prostatectomy). When the frequency and severity of the hematuria episodes were analyzed over time, a statistically significant difference for FIN versus control was present at 9 and 12 months (analysis of variance, P = 0.035 and P = 0.009, respectively). A similar difference was evident for CPA versus control at 9 and 12 months (P = 0.028 and P = 0.008, respectively). No statistically significant difference was present between the FIN and CPA groups. Interestingly, no statistically significant effect in bleeding recurrence for both CPA and FIN over controls was present at 3 and 6 months of follow-up. CONCLUSIONS: Both FIN and CPA seem to exert a comparable control in hematuria recurrence in patients with BPH, thus confirming the rationale behind the use of antiandrogens for such a purpose. Our results support the hypothesis that any antiandrogen, irrespective of the mode of action, would alter the natural history of BPH-associated hematuria. Interestingly, our results indicate that the speed of action of FIN may not be as rapid as previously described.

Aged↗

PubMed2002

Retrocaval ureter and associated abnormalities.

OBJECTIVE: To investigate the association of retrocaval ureter with other congenital abnormalities. METHODS AND PATIENTS: Two new cases of retrocaval ureter are discussed and a detailed electronic search of the literature was mainly focused on the concomitant abnormalities. The first of our patients had also a glandular hypospadias and a supernumerary lumbar vertebra, while the second one had syndactylia (fixed toes) in both feet. Results. The review of the literature revealed that 21% of the cases of retrocaval ureter present with concomitant abnormalities mainly from the cardiovascular system and the genitourinary tract. CONCLUSION: Diagnosis of retrocaval ureter should increase the awareness of the responsible physician on the possibility of concomitant malformations where treatment could prevent future symptoms.

Abnormalities, Multiple↗

PubMedDate not supplied

Percutaneous rheolytic thrombectomy for treatment of acute renal-artery thrombosis.

PURPOSE: We present our experience with percutaneous rheolytic treatment with the AngioJet thrombectomy catheter for acute renal-artery thrombosis. CASE REPORT: A 63-year-old male patient with renal-artery thrombosis presented 48 hours after the onset of acute nonradiating flank pain. Thrombosis was documented by CT angiography, 99mTc-DTPA, and digital subtraction angiography. A percutaneous thrombectomy was performed with the AngioJet catheter. At the end of the procedure, the arterial lumen was patent, and no underlying stenosis or other deformity of the arterial wall was found. Thus, the cause of the obstruction was considered to be an embolus. After the procedure, urokinase was given to prevent distal occlusions from emboli that could have escaped mechanical thrombectomy. Heparin was also administered. The patient was released from the hospital with a patent renal unit and ameliorated serum creatinine concentration. CONCLUSION: We propose the use of the AngioJet thrombectomy catheter for the percutaneous treatment of acute renal-artery thrombosis.

Aged↗