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L Musi

Publications and source records attributed to L Musi.

70 records · Page 4Linked to original sources
PubMedDate not supplied

[Varicocele: an epidemiological study and indications for treatment].

The varicocele is still the most common correctable cause of male infertility. The epidemiologic studies revealed a gradually increasing incidence of varicocele in patients 10 to 18 years old, as height at the end of puberty as that of the adult male population. The pediatric varicocele is often associated with smaller and hypotrophic testis which presents also histological and progressive changes. Surgical correction of a varicocele in the adult usually produces poor results. In order to improve the fertility rate in adulthood an early varicocelectomy has been suggested. On the basis of our own studies and after a review of the literature, we conclude that all grade III varicoceles and grade II associated with testicular hypotrophy must be early operated on. This hearing provides a higher fertility rate and can prevent the reduced fertility associated with delayed varicocelectomy.

Adolescent↗
PubMedDate not supplied

[Current trends in the treatment of varicocele].

A varicocele first develops in early adolescence and it can negatively affect testicular growth, histology and function. The use of early varicocelectomy to prevent severe testicular damage and sub-infertility in adulthood seems to be incontrovertible. However there is a difference of opinion as to the proper surgical procedure of varicocele ablation. To date, the inguinal and high retroperitoneal approaches are the most commonly accepted methods. However significant postoperative morbidity is common, with a recurrence rate ranging from 1 to 25% and return to normal activity often is prolonged. This considerations have prompted many to search for alternative techniques. The Authors performed laparoscopic clipping and division of the internal spermatic vein or the internal spermatic vessels in 55 adolescents to treat varicocele. Indications for the operation were third degree varicocele and second degree with testicular hypotrophy. At a mean 6 months follow-up, they did not observe either relapses or complications; no hydrocele was noted and testicular size did not decrease in any patient. In the Authors' experience and opinion, laparoscopic varicocelectomy is a simple, safe, effective and minimally invasive surgical procedure and it can be proposed as a viable alternative to open traditional surgical methods.

Adolescent↗
PubMedDate not supplied

[Recurrent facial paralysis in a child with renovascular hypertension].

Hypertension is rarely observed in childhood. The renal diseases are the most common causes of this condition. Headache, seizures, cranial nerve palsy and hemiplegia are the most frequent neurological manifestations. The Authors report on a patient with a severe involvement of central nervous system due to renal hypertension. The main clinical features were recurrent episodes of facial nerve palsy.

Child, Preschool↗
PubMedDate not supplied

[A flowmetric study after a Mathieu-Righini intervention in medial-distal hypospadias].

Uroflowmetric long-term data (mean follow-up 4.5 years) of 64 nonselected patients successfully treated for mid-distal hypospadias with Mathieu-Righini procedure were analyzed. None of our patients needed meatal dilation after primary procedure. Four patients (6.3%) presenting a plateau pattern and a maximum flow rate less than -2 standard deviations were considered to have meatal obstruction. These patients were successfully treated with meatoplasty. We conclude that functional characteristics of the neourethra are quite equivalent to a normal urethra in most of boys and adolescents after meatal based flap urethroplasty. On the other hand, in order to prevent the possibility of unknown strictures postoperative uroflowmetric controls are strongly recommended.

Child↗
PubMedDate not supplied

[Primary varicocele: a substimated pathology in pediatrico-adolescent age].

Idiopathic varicocele is a neglected entity in classic pediatric textbooks. Yet vast epidemiologic studies revealed that the incidence of varicocele gradually increases in patients between 10 and 15 years old and is comparable to that of the adult male population. Clinically, the pediatric varicocele is often associated with smaller and hypotrophic testis; histologically it also is associated with pathological and progressive changes of the testis. We report on the preliminary results of a personal epidemiologic study and a comparative follow-up to value the efficacy of surgical correction in two groups of adolescent and adult patients. Early recognition and treatment of a severe varicocele with testicular hypotrophy may help to prevent in adults the infertility associated with this condition.

Adolescent↗
PubMedDate not supplied

[Varicocele: epidemiologic study and indications for its treatment].

The varicocele is still the most common correctable cause of male infertility. The epidemiologic studies revealed a gradually increasing incidence of varicocele in patients 10 to 18 years old, as height at the end of puberty as that of the adult male population. The pediatric varicocele is often associated with smaller and hypotrophic testis which presents also histological and progressive changes. Surgical correction of a varicocele in the adult usually produces poor results. In order to improve the fertility rate in adulthood an early varicocelectomy has been suggested. On the basis of our own studies and after a review of the literature, we conclude that all grade III varicoceles and grade II associated with testicular hypotrophy must be early operated on. This hearing provides a higher fertility rate and can prevent the reduced fertility associated with delayed varicocelectomy.

Adolescent↗
PubMedDate not supplied

[Modern trends in the treatment of varicocele].

A varicocele first develops in early adolescence and it can negatively affect testicular growth, histology and function. The use of early varicocelectomy to prevent severe testicular damage and sub-infertility in adulthood seems to be incontrovertible. However there is a difference of opinion as to the proper surgical procedure of varicocele ablation. To date, the inguinal and high retroperitoneal approaches are the most commonly accepted methods. However significant postoperative morbidity is common, with a recurrence rate ranging from 1 to 25% and return to normal activity often is prolonged. This considerations have prompted many to search for alternative techniques. The Authors performed laparoscopic clipping and division of the internal spermatic vein or the internal spermatic vessels in 55 adolescents to treat varicocele. Indications for the operation were third degree varicocele and second degree with testicular hypotrophy. At a mean 6 months follow-up, they did not observe either relapses or complications; no hydrocele was noted and testicular size did not decrease in any patient. In the Authors' experience and opinion, laparoscopic varicocelectomy is a simple, safe, effective and minimally invasive surgical procedure and it can be proposed as a viable alternative to open traditional surgical methods.

Adult↗
PubMedDate not supplied

[Non-palpable testis: modern diagnostic and therapeutic trends].

Management of the nonpalpable testis is controversial and can be difficult as shown by the multiple modalities for evaluation and proposed treatment. In our opinion, laparoscopy is the ideal first step in the management of patients with a nonpalpable testis, having a great reliability in locating or confirming absence of an occult testis. Accurate preoperative assessment and localization will assist in selecting the appropriate surgical approach either laparoscopic, laparoscopic-assisted, or open procedure. Laparoscopy was performed on 74 patients with 86 nonpalpable testis. The technique has been demonstrated to be extremely safe and lead to diagnosis in 100% of cases. Surgical management of nonpalpable testis was directly performed by laparoscopy identifying intra-abdominal vanishing testis and locating an intra-abdominal or inguinal testis. The two-stage Fowler-Stephens orchiopexy was performed in 41 patients. The first stage consisted of laparoscopic clip ligation of the spermatic vessels. Of these, 32 underwent the second stage by vas-based orchiopexy; all testes, but one, showed a normal size and consistency. To conclude, we advocate the use of laparoscopy in all boys with nonpalpable testis.

Adolescent↗
PubMedDate not supplied

[Progress in the surgical treatment of congenital and acquired broncho-pulmonary pathology].

Surgery is the cornerstone in the management of congenital bronchopulmonary diseases. This term include a wide spectrum of malformative anomalies subdivided clinically into cystic and solid lesions. Bronchogenic cyst (BC), cystic adenomatoid malformation (CAM) and congenital lobar overinflation (CLO) are congenital cystic lesions. Pulmonary sequestration (PS) and pulmonary arteriovenous malformation (PAM) are congenital solid lesions. As a group, congenital bronchopulmonary diseases require removal in order to reduce potentially life-threatening infection and respiratory distress. Bronchopulmonary infections and neoplasms constitutes acquired bronchopulmonary diseases. Improvement in antibiotic therapy has reduced the place of surgery in the current treatment of bronchopulmonary infections. At present, the failure of medical therapy and the appearance of complications are the most common indications for operative treatment. Although these problems are not as common now, at times they required surgical intervention. Finally bronchopulmonary neoplasms are unusual in the pediatric age group. As a result, experience with the diagnosis, management and prognosis is limited. However, the complete surgical resection offers the best chance for survival in the large majority of cases.

Adolescent↗
PubMedDate not supplied

[Primary omental torsion in children: report of 2 cases and review of the literature].

The primary torsion of the omentum is a rare cause of acute abdomen. The clinic features may mimic closely acute appendicitis, with acute onset of right lower quadrant pain. The Authors, after reporting two cases recently observed, discuss the aetiopathogenetic aspects, point out the problems of diagnosis and finally suggest the most correct surgical approach.

Abdomen, Acute↗
PubMedDate not supplied

[The non-palpable testis: modern diagnostic and therapeutic approaches].

Management of the nonpalpable testis is controversial and can be difficult as shown by the multiple modalities for evaluation and proposed treatment. In our opinion, laparoscopy is the ideal first step in the management of patients with a nonpalpable testis, having a great reliability in locating or confirming absence of an occult testis. Accurate preoperative assessment and localization will assist in selecting the appropriate surgical approach either laparoscopic, laparoscopic-assisted, or open procedure. Laparoscopy was performed on 74 patients with 86 nonpalpable testis. The technique has been demonstrated to be extremely safe and lead to diagnosis in 100% of cases. Surgical management of nonpalpable testis was directly performed by laparoscopy identifying intra-abdominal vanishing testis and locating an intra-abdominal or inguinal testis. The two-stage Fowler-Stephens orchiopexy was performed in 41 patients. The first stage consisted of laparoscopic clip ligation of the spermatic vessels. Of these, 32 underwent the second stage by vas-based orchiopexy; all testes, but-one, showed a normal size and consistency. To conclude, we advocate the use of laparoscopy in all boys with nonpalpable testis.

Adolescent↗
PubMedDate not supplied

[Cystic-papillary neoplasm of the pancreas: a case report in childhood].

A solid and cystic tumor of the pancreas in a 11-year-old girl is reported. The child presented with abdominal pain and vomiting. A voluminous tumor, arising from the pancreas tail, was removed with distal pancreatectomy. These neoplasma occur predominantly in girls and young women, the prognosis is usually good in spite of histologic finding of apparent malignancy. The histochemical, immunohistochemical and electron examinations of this tumor show polymorphic differentiation, which means that part of the all can differentiate into duct epithelium, acinar or endocrine line. So up to, recently this tumor has been misclassified within other pancreatic tumors, and frequently has been managed with aggressive surgery. But as the neoplasm usually behaves like a very low grade malignancy, its complete removal is the treatment of choice for the tumors arising anywhere in the pancreas. The authors emphasize the importance of accurate diagnosis and of extirpative surgery in children with pancreatic malignancy.

Child↗
PubMedDate not supplied

[Cryptorchidism with didymo-epididymal dissociation and Robinow's syndrome: 2 case reports].

Two brothers of normal not consanguineous parents, with bilateral intrabdominal cryptorchidism, were admitted to our Institution. Both children had short stature, limb and hand malformations and craniofacial patterns of Robinow syndrome. During the orchidopexy, bilateral epididymal and vasal abnormalities were found in both of them. This anomaly associated with Robinow syndrome has never been reported before. These two cases provides the Authors with the opportunity of reviewing clinical features, genetics and radiological patterns of this rare syndrome.

Abnormalities, Multiple↗