PubMed · 957504
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L H Harrison, W H Boyce. 1976. Image intensification fluoroscopy.. https://doi.org/10.1016/s0022-5347(17)58810-2
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The specific disadvantage of the commonly used Vecchietti method for reconstruction of the vagina in cases of vaginal agenesis is the need for laparotomy. We now describe a successful endoscopically assisted construction of a neovagina by a variation of the Vecchietti method. The method causes relatively little stress to the patient.
We have been using the flexible cystoscope since 1987. Detailed information is given concerning the technique of flexible cystoscopy, its indications, advantages and disadvantages. A comparison is made with the results obtained using the rigid cystoscope in an initial series of 100 patients, yielding false negative results in only 8% of cases during the learning period. The flexible scope can be successfully employed for Neodymium YAG laser coagulation of superficial bladder tumours. The conclusion is reached that once the urologist has learned how to use it, he will consider the flexible cystoscope as a fundamental tool in his diagnostic armamentarium and false negative results will decrease almost to zero, especially if additional investigations, namely cytology, are routinely adopted.
The neodymium:YAG laser is now the most common type of laser applied in pediatric surgery. The bare fibres with diameter of 400 microns and 600 microns can be introduced through the side channel of #8 cystoscope thus the cystoscopic laser can be used even in newborns.--Generally accepted power settings are not yet available for laser therapy in pediatric urology. After 5 years of systemic laser application in children standard parameters have been established. They follow the principle of reaching the desired therapeutic goal using the least energy at the shortest exposure time possible. In the non-contact method 15-25 watts, 0.1-0.3 sec pulses and 0.3 sec intervals are recommended for coagulation, and 100 watts in continuous waves for cutting. The same pulses and intervals are advisable for the contact method using the bare fibre, but 10-12 watts are sufficient for coagulation and 20-25 for vaporization. With these settings all endoscopic procedures in pediatric urology such as the resection of urethral valves and structures, the ablation of ureteroceles and the treatment of hemangiomas can be performed.