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L Defidio

Publications and source records attributed to L Defidio.

9 recordsLinked to original sources
PubMed2001

[Flexible mini-ureteroscopy in diseases of the upper urinary tract: our experience].

OBJECTIVE: The aim of our work is to present our experience about the use of flexible mini-ureteroscope in the diagnosis and therapy of some upper urinary tract diseases. METHODS: We evaluated the data of 52 mini-ureteroscopy performed with 7.4 Fr instrument. The indications for ureteroscopy were: kidney stones (25 cases, 48.1%), filling defects (12 cases, 23.1%), positive cytology (5 cases, 9.6%), lateralising haematuria (8 casi, 15.4%), ureteropelvic junction obstruction (2 cases, 3.8%). RESULTS: There were no major complications during procedure. The stones were fragmented by 1.9 Fr electrohydraulic probe, by 200 and 365 m Holmium: YAG laser fiber or extracted by 0-Tip 3 Fr nitinol basket. The found papillary neoplasms were removed by basket or grasper and coagulated by laser fiber or 2 Fr electrode. The angiomas were coagulated by laser or 2 Fr electrode. The ureteropelvic junction was incised laterally by 365 m laser fiber or 3 Fr Rite-Cut. We interrupted the procedure only in 2 (3.8%) cases of lower pole kidney stones, because of lack of access with the laser fiber or other instruments. CONCLUSION: Today, the flexible mini-ureteroscopy is the gold standard in the diagnosis of filling defects and lateralising haematurias. This technique can be therapeutic also for the angiomas and the low grade tumours. In case of kidney stones, this technique is a less invasive alternative compared to percutaneous nephrolithotomy in the treatment of caliceal stones resistant to SWL and is the only therapy for the extremely obese patients with bleeding diathesis.

Equipment Design↗
PubMed1996

Prostate-specific antigen and prostatitis in men under fifty.

OBJECTIVE: To evaluate the occurrence of increased prostate-specific antigen (PSA) serum concentration in patients with prostatitis and low incidence of benign prostatic hyperplasia and prostatic cancer, PSA was measured in a selected population. METHODS: PSA levels were evaluated in 72 patients with prostatitis under 50 years of age. RESULTS: An increased PSA (> 4 ng/ml) was found in 5/7 (71%) patients with acute prostatitis, and in 2/13 (15%) and 2/32 (6%) patients with chronic bacterial and abacterial prostatitis, respectively. No patient with prostatodynia had an increased PSA. In patients with bacterial prostatitis PSA level decreased to normal value after effective antibiotic therapy in most cases. CONCLUSION: Prostatitis must be considered when using PSA as tumor marker.

Adult↗
PubMed1995

Bacillus Calmette-Guerin in the treatment of stage T1 grade 3 transitional cell carcinoma of the bladder: long-term results.

PURPOSE: We performed a retrospective long-term study to evaluate the results of immunotherapy in the treatment of high grade superficial bladder tumors. MATERIALS AND METHODS: Between 1981 and 1993, 593 patients with superficial transitional cell carcinoma of the bladder underwent transurethral resection. Of 64 patients with stage T1 grade 3 disease 50 received intravesical bacillus Calmette-Guerin after transurethral resection of all visible tumor. RESULTS: At a median followup of 42 months (range 12 to 112) 36 patients (72%) are disease-free and have not required further treatment. Superficial recurrence was noted in 8 patients (16%). Disease progressed in 6 patients (12%), including 5 with locally invasive and 1 with metastatic disease. Cystectomy was performed for progression in 4 patients and for recurrent stage T1 grade 3 disease in 1. There was 1 disease related death (2%). The overall survival rate is 94%. CONCLUSIONS: Intravesical bacillus Calmette-Guerin appears to be the most effective conservative treatment for patients with stage T1 grade 3 bladder cancer.

Adjuvants, Immunologic↗
PubMed1995

Chronic testicular pain. A workup and treatment guide for the primary care physician.

Chronic pain syndromes are encountered in every medical practice, and workup can be costly and frustrating. Patients with chronic testicular pain were once referred early to urologists but are now being seen and successfully treated in primary care offices. Referral is usually reserved for diagnosis of questionable testicular masses and for surgery. Antibiotic therapy, often combined with a nonsteroidal anti-inflammatory drug, may be useful--in some cases even when infection has not been identified. Spermatic cord block and transcutaneous electrical nerve stimulation may help relieve pain, although it often recurs. Antidepressants sometimes relieve pain and alleviate the psychogenic symptoms that may accompany it. Many patients benefit from a program at a multidisciplinary pain-management clinic and should complete one before opiate therapy is prescribed. When all conservative efforts have failed and testicular pain continues to diminish the patient's quality of life, orchiectomy may have to be considered. In general, however, we recommend that surgery be undertaken only when a pathologic condition is found and not for pain relief alone.

Algorithms↗
PubMed1993

Urethral stricture following transurethral resection of the prostate. The role of local anaesthetics.

In a multicentre prospective study, 261 patients undergoing transurethral resection of the prostate (TURP) in 17 urology departments were randomised to receive lubricating jelly containing either 3% tetracaine hydrochloride, 1% lignocaine hydrochloride, or no local anaesthetic. No patient had a history of urethral instrumentation or a previous urethral stricture. After 6 months' follow-up, 25/79 patients (32%) treated with 3% tetracaine jelly developed urethral strictures, as did 4/92 patients (4%) who received 1% lignocaine and 2/90 (2%) who received the jelly without anaesthetic. It was concluded that the use of 3% tetracaine jelly is associated with a high incidence of post-TURP urethral strictures.

Follow-Up Studies↗
PubMedDate not supplied

[Retroperitoneal liposarcoma].

Retroperitoneal soft-tissue sarcomas are a heterogeneous group of rare and peculiar mesenchymal tumors. They are locally invasive and have a peak incidence in the fifth decade of life. They account for 0.1-0.2% of all solid tumors and 15% of all soft-tissue tumors. Liposarcomas are usually large and occur most frequently in the lower extremities, in the retroperitoneal, perineal and mesenteric region. In the retroperitoneum they grow slowly due to the ability of the abdominal cavity to accommodate these slowly expanding masses. They don't produce symptoms until they are very large and have invaded local tissues. The case of a 61-year old man with a retroperitoneal liposarcoma is reported. The tumor was discovered due to the association of abdominal mass, weight loss and persistent fever. The fever, especially, is present due to a wide tumor necrosis. The diagnosis was suggested by computed tomography. Normally, the interval between start of symptoms and diagnosis is included within three weeks and one year. Surgical complete resection of the mass with splenectomy and local postoperative radiotherapy were performed. The weight of the mass was 8.56 kilograms and the pathological evaluation showed a pleomorphic highly undifferentiated liposarcoma. This histological type normally presents many tumor giant cells, some of which have the features of lipoblasts. The single most important prognostic factor in patients with soft-tissue sarcomas is the histologic grade of the primary lesion. In the last AJCC Staging System the grades are assigned from grade 1 (well differentiated) to grade 3 (poorly differentiated). The present case is grade 3. In the treatment of sarcoma of the retroperitoneum or genitourinary tract, the conventional chemotherapy does not seem effective, while radiotherapy has a little improvement on survival. Local recurrences are frequent, especially in the first three years, often in the absence of distant metastases. When the tumor recurs locally, the best therapy is still to remove the mass. Sometimes, two or more operations may be necessary for the patient. Generally, the prognosis is poor with overall 5-year survival of 15-50%. The patient was admitted in our division 4 months after the first operation with poor medical condition. The patient died nine months after surgery.

Follow-Up Studies↗