Laringectomia total associada à traqueostomia definitiva como tratamento da paralisia laríngea grave em cão

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Percutaneous ethanol injection of the prostate as minimally invasive treatment for benign prostatic hyperplasia: preliminary report.

OBJECTIVE: To evaluate the feasibility, safety and efficacy of a minimally invasive treatment for benign prostatic hyperplasia (BPH) consisting of percutaneous ethanol injection inside the prostate under ultrasound surveillance. MATERIAL AND METHODS: Transperineal ethanol injection into the prostate was performed in 8 patients who were affected by obstructive BPH according to AUA symptom score, impaired urinary flow, and volume of postvoiding residual urine. Injections were performed under transrectal ultrasound surveillance at four sites of the prostate for an overall amount of 6 ml of ethanol per patient. The procedure was performed under local anesthesia. RESULTS: The patients' median age was 69.7 years (range 57-83). No major intraoperative or postoperative complications were encountered. The median symptom score decreased from 21+/-5.2 (range 14-28) to 10+/-4.4 (range 1-14) at 3 months postoperatively (p<0.0001). The median peak flow rate increased significantly from 11 ml/s (range 7-17) before the procedure to 16 ml/s (range 12-20) after it (p<0.001). The median volume of post-voiding residual urine dropped from 130 ml (range 36-200) before treatment to 27 ml (range 11-42) after it (p<0.01). The same parameters were assessed at 6 months without significant differences. A mild side effect was observed in 1 patient who reported severe urge incontinence and moderate perineal pain the first month after the procedure. CONCLUSION: Percutaneous ethanol injection therapy of the prostate is a safe, easy and minimally invasive procedure for treating BPH, especially when there is an high operative risk.

[Transrectal ultrasound-guided biopsy of the prostate]. / Biopsia prostatica ecoguidata con accesso transrettale.

The early detection of prostatic neoplasm is nowadays a primary need in the urological field. The availability of transrectal ultrasound equipment alongside with bioptic tools made possible that transrectal ultrasound-guided biopsy of the prostate became the standard procedure to achieve this goal. With this work we would like to confirm the efficacy of this method which is also associated with a good tolerance and low complications rate. 82 patients that came to our Department between 1997 and 1999 were submitted to this procedure, 25 resulted positive for prostatic adenocarcinoma. Only 2 of them did not tolerate the procedure while all the others referred only mild discomfort at the moment of the puncture; 9 patients afterwards had to be admitted to the hospital due to fever (1 patient), acute retention of urine (3 patients) and persistent macroscopic hematuria (5 patients). Transrectal ultrasound-guided biopsy of the prostate reveals to be a safe and accurate method to obtain tissue samples of the prostate along with high tolerance and low incidence of serious complications.

[Minimally invasive treatment of intraprostatic cysts]. / Trattamento mininvasivo delle cisti intraprostatiche.

Prostatic cysts are rare; they are to be considered in the evaluation of obstructive azoospermia. A correct diagnosis is based on transrectal ultrasound of the prostate. Herein we describe our experience with perineal ultrasound cyst aspiration. During the last 10 years, 21 infertile patients underwent ultrasound puncture of an intraprostatic cyst. Patients were placed in the lithotomy position, a 16 G needle was adopted; by means of ultrasound was possible to follow the needle entering the cyst. The content was aspirated and, if no spermatozoa were detected in the cystic liquid, sclerosing agents were introduced. The technique was performed successfully in all patients with symptomatic cyst within the prostate. Follow-up prostatic ultrasound and semen analysis were performed in 17 patients. There was 1 recurrence that was aspirated again. In 12 cases an increase in sperms number and motility was obtained, in 3 cases oligoastenospermia remained unchanged and 2 patients are still azoospermic. In 3 cases the partners become pregnant.