ABSTRACT
The initial United States cooperative experience with the EDAP LT-01 second generation piezoelectric extracorporeal shock wave lithotriptor using ultrasonic guidance is presented. Particular to the machine are lack of radiation exposure, no need for anesthesia, a purely outpatient procedure, no electrocardiographic problems, a high degree of safety and a paucity of complications. The equipment is described briefly. The same machine currently is being used to destroy renal and biliary stones. The results are encouraging and highly comparable to the initial experience with the earlier machines. Fragmentation rates are approximately 86%, with destruction rates of 63.4% over-all. Ultrasound localization and monitoring proved surprisingly easy to learn and were increasingly less of a problem as experience was gained. No serious complications were observed, and there were no renal losses and no deaths. Only 3 cases of steinstrasse were noted among 461 with 633 stones targeted during 595 treatments.
Subject(s)
Lithotripsy/instrumentation , Adolescent , Adult , Aged , Aged, 80 and over , Child , Equipment Design , Evaluation Studies as Topic , Follow-Up Studies , Humans , Kidney Calculi/diagnosis , Kidney Calculi/therapy , Lithotripsy/adverse effects , Lithotripsy/methods , Middle Aged , Multicenter Studies as Topic , United StatesABSTRACT
During the last 2 1/2 years we have used the silicone gel prosthesis for 8 consecutive patients who were incontinent after prostatectomy. Although the prosthesis had to be replaced in 1 instance a satisfactory result has been obtained by each patient. We believe that with minimal patient selection successful results can be achieved in a large majority of such patients by implementing the evolved improvements in prosthesis placement: 1) use 4 serrated knee staples or George Washington modification to improve fixation, 2) release the urethral bulb from the central perineal tendon for better compression and 3) place the prosthesis higher on the ischiopubic rami. Avoidance of urethral erosion is the single most important aspect of the procedure and intraoperative urethral pressure profile may be helpful in this regard. Guidelines regarding the procedure, prosthesis injection and patient management are discussed briefly.
Subject(s)
Gels , Prostatectomy , Prostheses and Implants/methods , Silicones , Urinary Incontinence/therapy , Humans , Male , Postoperative Care , Postoperative Complications , Urinary Incontinence/etiologyABSTRACT
We present two cases of apparent congenital bladder diverticula in adult twins associated with progressive hearing loss.
