PubMed Health⌕ Search

Biomedical subjects

R Opsomer

Publications and source records attributed to R Opsomer.

At least 19 recordsLinked to original sources
PubMed1995

Laparoscopic nephrolithotomy: the value of intracorporeal sonography and color Doppler.

Laparoscopic nephrolithotomy was used as an alternative to open surgery in a patient who had failed extracorporeal shock-wave lithotripsy and whose anteriorly located stone-bearing calix precluded percutaneous extraction. Endocavitary ultrasonography and color Doppler render the procedure safe and effective; localization of the stone, selection of an optimal nephrotomy site away from large vessels and where cortical thickness is minimal, and control of fragment clearance are greatly facilitated.

Adult↗
PubMed1995

[PSA and anatomopathological stage of prostatic cancer].

Accurate preoperative staging is important for adequate selection of patients for radical prostatectomy. We reviewed the preoperative PSA levels of 214 patients who underwent radical retropubic prostatectomy and analysed the results in relation to pathological stage. 32 (15%) patients had a PSA level below 4 ng/ml; nevertheless 8 of them had already a extracapsular disease and one present with positive lymph nodes. Thus, although a specificity of 90%, the sensitivity is only 18%. 98 (46%) patients had PSA levels beyond 10 ng/ml of which 47 (48%) had extracapsular tumor; this gives a specificity of 62% and a sensitivity of 59%. Finally 35 (16%) patients had a PSA over 20 ng/ml of which 18 (51%) present a extracapsular disease thus the specificity is 87% but the sensibility remains low at 23%. We concluded that although PSA levels are grossly related to the pathological stage, that relation is not reliable to distinguish patients with organ-confined from those who have extracapsular tumor extension and for either definition of a positive PSA level many patients would be denied a curative operation. Therefore, PSA value cannot be used to decide whether to recommend radical prostatectomy for potential cure.

Aged↗
PubMed1995

[Epipadiac duplication of the urethra].

Urethral duplication is a less frequent malformation. The Williams classification, which is currently admit, classifies them in sagital, hypospadias or complex and collateral duplications. They can be complete, incomplete or reduced to an incomplete sinus. The most severe cases are often accompanied by multi-abnormality syndromes. Clinical manifestations are various: asymptomatic, urinary infection, incontinence, double urinary stream,... We will report two new cases of incomplete epispadias duplication. The first case presents a purulent flow from the fistula, the second a frank epispadiac status. In both cases, corrective surgical treatment was performed, after a complete balance-sheet. The embryological, diagnostical and therapeutical aspects of the different forms of urethral duplication will be studied based on data from literature.

Child↗
PubMed1994

Leydig cell tumor: estradiol level at different locations.

The authors report on estradiol levels at different locations in a patient with a Leydig cell tumor. The highest value was found in the testicular vein. The estradiol level was, however, ten times higher in the peritesticular vaginal fluid than in the peripheral veins.

Adult↗
PubMed1994

[Cholesteatoma of the upper urinary tract: endoscopic treatment].

We report here on a case of cholesteatoma of the upper urinary tract. This rare, but recurrent disease was managed successfully by means of repeated endourological treatment. Diagnosis was confirmed by histological examination of samples obtained by percutaneous extraction.

Aged↗
PubMed1994

[Immediate allergy to latex in urological practice].

Five cases of acute allergic reaction to latex are reported. Four of those were diagnosed during surgery and presented anaphylactic shock. One was suspected before surgery by systematic screening and dramatic presentation was avoided. Increasing frequency of latex allergy is reported in the literature and is usually seen in patients with extensive neurosurgical or urological histories, or by peoples currently exposed to natural rubber products (medical staff). Systematic screening in history before surgery is important so that exposure to latex should be avoided in suspected cases.

Anaphylaxis↗
PubMed1994

[Urethral stenosis in children. Apropos of 33 pediatric cases].

Urethral stenosis in children is rare. Between 1961 and 1993, only five specific retrospective studies were published. Between January 1987 and December 1992, thirty-three children, i.e. thirty boys and three girls, were observed in our institution for urethral stenosis. Their ages ranged from two and half months to seventeen years. Etiology was congenital in six, traumatic in two, inflammatory in two and iatrogenic in thirteen patients. In additions, ten stenoses were consecutive with hypospadias repair. Seventeen patients underwent first-line endoscopic internal urethrotomy. Success rate was ninety-one percent. Two patients underwent a successful second similar procedure. Repeating this procedure more than twice and second-line urethrotomy doesn't improve success rate. It appeared that internal urethrotomy proved to be more effective in short and recent stenosis. Fourteen patients underwent urethroplasty by using various techniques, of whom only five first-line urethroplasty. Its indication in case of multioperated or complicated stenoses may explain the poor global success rate of about fifty percent.

Adolescent↗
PubMed1992

[Obstructive urinary tract diseases and prenatal diagnosis. Timing of surgical correction].

The Authors are reviewing their experience of Obstructive Uropathies diagnosed and treated surgically in neonates, the last 8 years in their Institution. 67 cases were reviewed, in which 37 presented with ureteropelvic junction obstruction (UPJ). 13 with posterior urethral valves, 11 with primary megaureter and 6 with ureterocele. Prenatal ultrasonography allowed the diagnosis to be made in two third of the patients. UPJ is the most common obstructive uropathy observed. Posterior urethral valves the most severe because of high pulmonary and renal (dysplasia) complication rate. Surgery, when indicated, has no more complications to be expected than in general population, if oriented prophylactic measures are taken in the early peri- and postoperative period.

Female↗
PubMed1991

[Reversal of urinary diversion after radical surgery for rhabdomyosarcoma of the bladder].

The authors report a case of reversal of urinary diversion in a 14 year old boy who had presented, three years previously with an embryonal rhabdomyosarcoma of the base of the bladder. The initial treatment had consisted of preoperative and postoperative chemotherapy combined with radical cystoprostatectomy with urinary diversion via a colonic conduit. The principle of the technique of reversal of urinary diversion are discussed in the light of this unusual case.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1990

[The value of laparoscopy in the diagnostic evaluation of cryptorchism with non-palpable testicles].

From 1986 to 1989, diagnostic laparoscopy was performed in 12 boys, before operation of non-palpable testes. Cryptorchidism was unilateral in all but one case. Preoperative physical examination and ultrasonographic studies of the inguinal region had been performed in all of them and failed to localize the testis. Laparoscopy demonstrated six intra-abdominal testes in five children: five testes were brought down into the scrotum and one was removed because endoscopic diagnosis of complete epididymo-testicular dissociation. Four of the seven other boys were not operated on because of laparoscopic findings. In the last three cases, systematic surgical exploration of the inguinal region was performed and demonstrated total atrophy of the testis. Performed in good condition the procedure is very safe and simple to achieve. It does not increase significantly the duration of the operation and gives objective elements for the operative procedure.

Atrophy↗
PubMed1986

Coecocystoplasty: an evaluation of operative results.

Coecocystoplasty for substituting or augmenting the bladder is a relatively common operation in the United States, but not in Scandinavia. In order to focus the attention on this voiding-preserving operation we evaluated the late postoperative results of 8 patients. Median follow-up was 5 years. Seven of the patients had symptoms from a contracted bladder and 1 patient with epispadias was undiverted from a ureteroileocutaneostomy. There were some early postoperative complications. Two patients had a revision of the coecocystoplasty, 1 patient ended up with a ureteroileocutaneostomy and 1 patient needed a nephrectomy because of a perirenal abscess. The patient with epispadias later had an artificial urinary sphincter because of persisting incontinence. At follow-up time all patients found that they had a better life than prior to operation since the invalidating symptoms from the contracted bladder had disappeared. One patient with residual urine had chronic urinary tract infection. All patients were continent at daytime, 3 patients had nocturnal incontinence. Urodynamic studies showed no infravesical obstruction and bladder capacity between 75 and 380 ml H2O. Three patients had decreased renal function. Based on our limited material we conclude that coecocystoplasty is a reasonable, though not unproblematic, treatment in patients with severe symptoms from a small contracted bladder and a therapeutical alternative in patients with a previously defunctionalised bladder and that this method should always be taken into consideration before a urinary diversion.

Adult↗
PubMed1985

[Radio-urodynamic study of the lower urinary tract].

Radio-urodynamic examination of the lower urinary tract is the best method to study the complex functional problems involving those structures. It will very often provide a correct diagnostic orientation in a single session. The main indications are (1) urinary incontinence when symptoms are unclear, or recurring after surgical correction, (2) neurogenic bladder dysfunction, (3) incipient obstructive uropathy and (4) when it is necessary to ascertain that micturition is normal. The necessary investment in personnel, time and material is considerable, and the indications are therefore to be limited to complex problems and to certain centers that have a special clinical and research interest in urodynamics. It is nevertheless highly justified by the improvement in therapeutic results engendered by a correct and precise diagnosis.

Humans↗
PubMed1982

Serum prostatic acid phosphatase determination in prostatic diseases: a critical comparison of an enzymatic and a radioimmunologic assay.

A prospective study comparing a new radioimmunologic and a classical enzymatic assay for prostatic acid phosphatase was done to evaluate their respective roles in patients with prostatic diseases. We studied 50 patients with cancer of the prostate, 101 with benign prostatic hypertrophy and 17 with prostatitis as well as patients with nonprostatic malignancy, and various hematological and bone diseases. The results showed a low incidence of elevated values in patients with early cancer of the prostate and a high incidence of false positive values with the radioimmunoassay in patients with benign prostatic diseases, especially prostatitis. These data suggest that tests for serum prostatic acid phosphatase levels remain disappointing in the assessment of prostatic disease regardless of the technique used.

Acid Phosphatase↗