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Biomedical subjects

P C Palma

Publications and source records attributed to P C Palma.

At least 19 recordsLinked to original sources
PubMed1997

Repeated lipoinjections for stress urinary incontinence.

A total of 30 women with stress incontinence underwent periurethral injection of autologous fat under spinal anesthesia. The fat was harvested from the abdominal wall by liposuction. Preoperative evaluation consisted of history, physical examination, and urodynamic evaluation. For study purposes, some patients also underwent bladder and urethral ultrasonography and magnetic resonance imaging studies. The first 13 patients received a single periurethral lipoinjection, and the following 17 patients received sequential injections when needed at 3-month intervals. Results were assessed by subjective questionnaire performed at 3 and 12 months. All patients had intrinsic sphincteric deficiency. Of the first group, there were only four patients (31%) cured after 1 year of follow-up. On the other hand, in the group that received repeated injections, there were 11 patients (64%) cured with a mean of two injections at 1-year follow-up. Our results show that this procedure warrants continued clinical investigation because it may be useful in selected cases of urinary stress incontinence.

Adipose Tissue↗
PubMed1996

[Meta analysis of diagnostic methods in urinary stress incontinence].

The analysis of existing diagnostic methods of urinary stress incontinence suggest that it is almost always clinical. Urodynamic evaluation has a place in special situations, as atypical symptom; neurologic disease; recurrent USI after surgery or when it is necessary to confirm the clinical diagnose.

Diagnosis, Differential↗
PubMed1994

Subureteric lipoinjection for vesicoureteral reflux in renal transplant candidates.

OBJECTIVE: Vesicoureteral reflux is a risk factor predisposing to infection after renal transplantation. Endoscopic correction of vesicoureteral reflux, a minimally invasive therapy, has been increasingly used with encouraging results. Although recent reports have described the successful use of Teflon paste in the endoscopic treatment of reflux, the choice of the material to be used is controversial. There is a need for finding an ideal substance for endoscopic injection for a simple and safe treatment of reflux. METHODS: Based on the good results of autologous lipoinjection in other situations, we performed lipoinjection for vesicoureteral reflux in 12 renal transplant candidates. There were 10 female and 2 male patients with grade III reflux or higher, accounting for 17 ureters treated by endoscopic lipoinjection. Voiding cystourethrography was performed in the operating room immediately after the procedure and again three months later. RESULTS: In 2 patients (16.2%) there was reduction of the grade of reflux, including the unique ureter that stopped refluxing. In the remaining 10 patients (83.3%) there was no change in the grade of reflux. CONCLUSIONS: These results suggest that although simple and attractive, lipoinjection alone is not a good alternative for endoscopic correction of vesicoureteral reflux.

Adipose Tissue↗
PubMed1993

Percutaneous treatment of bladder stones.

A total of 36 patients with bladder stones underwent percutaneous suprapubic cystolithotripsy. The successful rate was 89%. There were 11% failures due to nonfragmentation of the stones by the ultrasound probe. According to the presence of associated diseases 3 groups of patients were established. Two groups underwent concomitant treatments for benign prostatic hyperplasia and urethral stricture. No complications occurred even in patients with concomitant treatment. There was no statistically significant difference when these groups were compared (p > 0.05). Fluoroscopy was not necessary during the procedure. Since the technique is simple, safe and effective, it represents an alternative in the management of bladder stones.

Cystoscopy↗
PubMed1990

Massive intratubular hemorrhage with herniations into renal veins: report of a case.

A 24-year-old man had unilateral gross hematuria that required nephrectomy. Pathological examination revealed massive intratubular hemorrhage and frequent deposition of an amorphous and homogeneous material positive for periodic acid, Schiff stain in the corticomedullary junction. This substance had the characteristics of Tamm-Horsfall protein and frequently herniated into the lumen of thin-walled veins of arcuate size. There was no apparent cause for the bleeding. To the best of our knowledge this is the third reported case with these peculiar findings and no apparent cause. We discuss some hypotheses as to the etiopathogenesis of this rare and intriguing condition.

Adult↗
PubMed1990

Percutaneous nephrectomy in nonfunctioning kidneys: a preliminary report.

Nephrectomy is indicated for the removal of highly damaged kidneys. Several times patients are asymptomatic, and although the operation has a low morbidity rate they will refuse it. The development of new endourological techniques of percutaneous access to the kidney in experimental studies on liquefaction and aspiration of tissues, and the idea taken from the old resectoscope models using nonelectrical aids served to inspire our technique of percutaneous nephrectomy. Our patient presented with a nonfunctioning kidney due to ureteral obstruction and ultrasound demonstrated a severe decrease in renal parenchyma. Percutaneous access to the kidney was performed through the conventional manner and the remaining parenchyma was removed with biopsy and Lowsley forceps. Bleeding was minimum and a 22F nephrostomy Foley catheter was kept in place for 72 hours. As far as new instruments are developed, percutaneous nephrectomy represents a surgical option to remove nonfunctioning kidneys in highly selected patients.

Female↗
PubMed1988

Comparison between percutaneous nephrolithotomy and open stone procedures.

A total of 205 patients have undergone stone extraction surgery. Three groups were studied: in 70 patients the stones were removed by flank incision, in 20 patients by posterior incision and 80 patients were treated by percutaneous nephrolithotomy. Patients submitted to percutaneous nephrolithotomy had a shorter hospitalization, operative time and a significantly reduced period of recuperation, allowing earlier return to work and decreased disability. Narcotic drugs were demanded in a lower amount in the percutaneous nephrolithotomy group.

Adolescent↗
PubMed1988

Concentrations of norfloxacin in prostatic tissues following oral administration in patients with benign prostatic hyperplasia.

For assessing plasma and tissue concentrations of norfloxacin after oral administration, twelve patients with benign prostatic hypertrophy (BPH) were given two doses of 400 mg norfloxacin approximately 12 hours apart prior to transurethral resection of the prostate (TURP). Prostatic tissue samples and blood samples were collected and assayed for norfloxacin content by HPLC. The mean peak norfloxacin concentration in plasma was 1.63 micrograms/ml (range 0.63 to 3.38 micrograms/ml). The mean peak concentration in prostatic tissue was 1.63 micrograms/g (range 0.75 to 3.30 micrograms/g). The plasma and prostatic tissue levels of norfloxacin exceeded the MIC's of most urinary tract pathogens. The data suggest that norfloxacin may be useful in the treatment of chronic bacterial prostatitis.

Administration, Oral↗
PubMed1988

Endoscopic suspension of vaginal prolapse.

A new alternative for the surgical treatment of vaginal prolapse is presented in which the prolapse vagina is brought towards the abdominal wall using an extraperitoneal abdomino perineal approach with endoscopic control. The technique consists of a small suprapubic transverse incision to expose the abdominis rectus muscle aponeurosis. A Stamey needle is passed retropubically to the vagina and the extremity of a helicoidal suture previously made in the vaginal wall is introduced in the eye of the needle. It is then withdrawn to bring the thread to the suprapubic region. The maneuver is repeated on the other side and the threads are tied up over the aponeurosis of the rectus abdominis muscles, bringing the vagina to its original position. Endoscopic control is important to avoid bladder perforation.

Aged↗
PubMed1988

Approach for treatment of subcoronal meatus with excessively deep glanular groove.

We report on 9 children with subcoronal meatus and an excessively deep glanular groove who underwent a simple surgical repair. All the procedures were done on an outpatient basis, and there was no urinary diversion. The surgical results have been satisfactory, with no fistula formation, or urethral or meatal stenosis. The technique described is useful in selected cases.

Child↗
PubMed1988

Staghorn calculi: percutaneous versus anatrophic nephrolithotomy.

In a retrospective analysis percutaneous ultrasonic lithotripsy and anatrophic nephrolithotomy for staghorn stones were compared to evaluate morbidity. In 46 patients treated percutaneously and 29 patients treated by open surgery, the procedure time, success rate, complication rate, length of hospitalization, disability period, and amount of analgesics needed in the postoperative period were analyzed. 5 patients treated during the learning period were not considered for this study, no matter whether they were treated by open or percutaneous surgery. Complete removal of all stone fragments was achieved in 73.8% of the patients treated percutaneously. Calculi were removed successfully in 82.1% of the patients submitted to anatrophic lithotomy. The group treated percutaneously showed shorter procedural time (mean 120 versus 210 min), shorter hospitalization period (5 versus 7 days), less need for analgesics (mean 1.6 versus 4.7 doses per patient), and an earlier return to normal physical activities (9 versus 43 days). Among the patients who underwent open surgery, 14 (50.0%) required additional interventions to treat complications. Although in the percutaneous group 28.5% required more than one percutaneous intervention, the overall complication rate per surgery of 20.0% was significantly lower, with no need for open surgery. Percutaneous nephrolithotomy proved to be of significantly lower morbidity than anatrophic lithotomy.

Adult↗
PubMed1988

Comparison of the Stamey bladder neck suspension procedure with a modified endoscopic suspension for the treatment of stress urinary incontinence.

Endoscopic vesicourethral suspension is an acceptable procedure for the treatment of stress urinary incontinence and is associated with a high success rate and little morbidity. Classical endoscopic vesical neck suspension was performed in 93 patients with cure of incontinence in 89 (95.7%). Cost-effectiveness and simplification were introduced to Stamey's technique. Modifications introduced to the Stamey technique were found to be simpler and to provide cost savings with fewer complications. Eighty-six women were operated on by this method, with 84.9% of success. A total of 133 (74.3%) of the patients had previous surgical procedures to correct incontinence, demonstrating the indication of the endoscopic vesicourethral suspension in case of failures with other techniques.

Adult↗
PubMedDate not supplied

N-acetylcysteine in the prevention of cyclophosphamide induced haemorrhagic cystitis.

Cyclophosphamide, an alkylating agent used in the chemotherapeutic treatment of neoplasias, is metabolized into active substances capable of damaging the urothelium when in contact with some enzymes. Amongst several alternative proposals for the treatment and prevention of hemorrhagic cystitis induced by cyclophosphamide the use of a mucolytic agent, N-acetylcysteine is found. An experimental study performed in rats proved the efficacy of the drug in the prevention of hemorrhagic cystitis. Bladder protection was achieved in 33% of the animals with preventive treatment with N-acetylcysteine instead of 60% in the group which did not receive the drug.

Acetylcysteine↗