S Micali — Page 3 | PubMed Health

PubMed1996

Endoscopic ballistic lithotripsy in the treatment of bladder calculi in patients with neurogenic voiding dysfunction.

Bladder stones represent a troublesome complication in patients suffering from neurogenic voiding dysfunction, in whom prompt and effective therapy is required. A variety of endoscopic lithotripsy methods are available; however, current devices can be tedious to use. We have treated 17 patients affected by bladder calculi and spinal cord injury or multiple sclerosis by means of the ballistic lithotripter EMS Swiss Lithoclast. The mean diameter of the stones was 2.7 cm. The mean operative time was 27 minutes. There were five intraoperative complications, including crises of autonomic dysreflexia (three patients) and light hematuria (two patients). There was no malfunction of the lithotripter and no long-term complications. All the patients were stone free at 6 months postoperatively. In conclusion, endoscopic lithotripsy with the ballistic lithotripter proved to be a very effective, rapid, and safe method for treating bladder calculi in patients with neurogenic bladders.

Adult↗

PubMed1994

[Urethral diverticuli in patients with spinal cord injury: echographic study].

Urethral diverticula, a not infrequent complication in patients with spinal cord injuries, usually involve the bulbous urethra which is particularly exposed to the trauma of catheterism. Indeed, the frequent association of urethral trauma and infection is often the cause of diverticula in these patients. Diagnosis is made by ascending urethrogram, voiding cystourethrogram and urethroscopy. Eight patients between 20 and 45 years of age with spinal cord injuries who had used an indwelling catheter for periods ranging from 1 to 18 months and who presented urethral diverticula at conventional investigation, underwent transperineal and penile contact ultrasonography using 3.5 and 7.5 MhZ real-time scanners. Ultrasonography was performed during intraurethral injection of saline solution through a catheter positioned near the external urethral meatus. Before the scan all patients had undergone a neuro-urological physical examination, urine analysis and culture, renal and bladder ultrasonography, ascending urethrogram and voiding cystourethrogram, urethroscopy and urodynamic investigation. Ultrasonography identified all urethral diverticula, defined them morphologically, visualized the diverticula filling and emptying phases and evaluated urethral wall and periurethral tissue characteristics, without exposing patients to any dangerous gonadal irradiation. Ultrasonography cannot replace radiological investigation but is a valid alternative in cases of contrast medium allergy, when monitoring inoperable diverticula and in postoperative follow-ups.

Adult↗

PubMed1993

Mechanism for the T4 lymphopenia of AIDS.

I suggest that the T4 lymphopenia of AIDS may be caused by antibodies raised against the human immunodeficiency virus that block the generation of T4 cells.

Acquired Immunodeficiency Syndrome↗