Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 38
Filtrar
1.
Polymers (Basel) ; 14(9)2022 Apr 28.
Artigo em Inglês | MEDLINE | ID: mdl-35566967

RESUMO

The physical and mechanical properties of hemp-fibre-reinforced alkali-activated (AA) mortars under accelerated carbonation were evaluated. Two matrices of different physical and chemical properties, i.e., a low Ca-containing and less dense one with fly ash (FA) and a high Ca-containing and denser one with FA and granulated blast furnace slag (GBFS), were reinforced with fibres (10 mm, 0.5 vol% and 1.0 vol%). Under accelerated carbonation, due to the pore refinement resulting from alkali and alkaline earth salt precipitation, AA hemp fibre mortars markedly (20%) decreased their water absorption. FA-based hemp mortars increased significantly their compressive and flexural strength (40% and 34%, respectively), whereas in the denser FA/GBFS matrix (due to the hindered CO2 penetration, i.e., lower chemical reaction between CO2 and pore solution and gel products), only a slight variation (±10%) occurred. Under accelerated carbonation, embrittlement of the fibre/matrix interface and of the whole composite occurred, accompanied by increased stiffness, decreased deformation capacity and loss of the energy absorption capacity under flexure. FA-based matrices exhibited more pronounced embrittlement than the denser FA/GBFS matrices. A combination of FA/GBFS-based mortar reinforced with 0.5 vol% fibre dosage ensured an optimal fibre/matrix interface and stress transfer, mitigating the embrittlement of the material under accelerated carbonation.

2.
Mater Struct ; 55(3): 99, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35401024

RESUMO

Many (inter)national standards exist to evaluate the resistance of mortar and concrete to carbonation. When a carbonation coefficient is used for performance comparison of mixtures or service life prediction, the applied boundary conditions during curing, preconditioning and carbonation play a crucial role, specifically when using latent hydraulic or pozzolanic supplementary cementitious materials (SCMs). An extensive interlaboratory test (ILT) with twenty two participating laboratories was set up in the framework of RILEM TC 281-CCC 'Carbonation of Concrete with SCMs'. The carbonation depths and coefficients determined by following several (inter)national standards for three cement types (CEM I, CEM II/B-V, CEM III/B) both on mortar and concrete scale were statistically compared. The outcomes of this study showed that the carbonation rate based on the carbonation depths after 91 days exposure, compared to 56 days or less exposure duration, best approximates the slope of the linear regression and those 91 days carbonation depths can therefore be considered as a good estimate of the potential resistance to carbonation. All standards evaluated in this study ranked the three cement types in the same order of carbonation resistance. Unfortunately, large variations within and between laboratories complicate to draw clear conclusions regarding the effect of sample pre-conditioning and carbonation exposure conditions on the carbonation performance of the specimens tested. Nevertheless, it was identified that fresh and hardened state properties alone cannot be used to infer carbonation resistance of the mortars or concretes tested. It was also found that sealed curing results in larger carbonation depths compared to water curing. However, when water curing was reduced from 28 to 3 or 7 days, higher carbonation depths compared to sealed curing were observed. This increase is more pronounced for CEM I compared to CEM III mixes. The variation between laboratories is larger than the potential effect of raising the CO2 concentration from 1 to 4%. Finally, concrete, for which the aggregate-to-cement factor was increased by 1.79 in comparison with mortar, had a carbonation coefficient 1.18 times the one of mortar. Supplementary Information: The online version contains supplementary material available at 10.1617/s11527-022-01927-7.

3.
Int Urogynecol J ; 32(4): 967-974, 2021 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-32897460

RESUMO

INTRODUCTION AND HYPOTHESIS: The aim of the study was to evaluate hysterectomized and non-hysterectomized patients with prolapse and incontinence. Laparoscopic sacrohysteropexy (LSHP) and minimally invasive sacrocolpopexy (LMSCP) were done in combination with transobturator tape (TOT) and native tissue repair of the anterior and posterior vaginal compartments in patients with pelvic organ prolapse (POP) and occult, stress, or urinary incontinence (SUI). The hypothesis is that both methods are successful. METHODS: A total of 81 patients with POP were evaluated: 44 had vaginal vault prolapse (POPQ points Ba, C, and Bp were 1.2, 2.6, and 0.4, respectively) and 37 had uterine prolapse (POPQ points Ba, C, and Bp were 1.8, 1.7, and 1.3, respectively). LMSCP (which means less dissection of the vagina in its upper third and avoiding possible collision with the ureters anteriorly or the rectum posteriorly) was performed in patients with vault prolapse, whereas patients with uterine prolapse underwent LSHP. Transobturator tape (TOT) was placed in all patients to treat symptomatic and occult urinary incontinence. Systematic anterior and posterior colporrhaphy was performed in both groups. RESULTS: Both groups showed anatomic (p < 0.0001) and symptomatic improvement (p < 0.001-p < 0.05). Voiding was significantly improved after surgery without postoperative incontinence (p < 0.001). There was no significant difference between groups regarding duration of surgery (p = 0.06), hospital stay (p = 0.13), blood loss (0.83), Clavien-Dindo grade 3 (p = 0.87), and Clavien-Dindo grade 1-2 (p = 0.92) complications. CONCLUSION: Minimally invasive LSCP or LSHP combined with TOT and native tissue repair of the anterior and posterior vaginal compartment is a successful treatment for POP.


Assuntos
Laparoscopia , Prolapso de Órgão Pélvico , Slings Suburetrais , Incontinência Urinária por Estresse , Incontinência Urinária , Feminino , Procedimentos Cirúrgicos em Ginecologia , Humanos , Prolapso de Órgão Pélvico/complicações , Prolapso de Órgão Pélvico/cirurgia , Resultado do Tratamento , Incontinência Urinária por Estresse/cirurgia , Vagina/cirurgia
4.
Can J Physiol Pharmacol ; 97(5): 422-428, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-30730758

RESUMO

Acute kidney injury is a frequent disorder that can be mimicked by the application of different nephrotoxic agents, including carbon tetrachloride (CCl4), where kidney injury marker-1 (KIM-1) has been recognized as a highly specific marker. Melatonin is one of the most powerful natural antioxidants and has numerous beneficial properties. We evaluated the nephroprotective potential of 2 melatonin treatment regimens (pre- and post-intoxication) in a CCl4-induced acute kidney injury model based on the standard serum parameters, kidney tissue antioxidative capacity, KIM-1 levels, and kidney tissue morphological changes. The two treatment regimens were found to preserve kidney function, as judged from the evaluated standard serum parameters. Only when administered after the intoxication, melatonin preserved total kidney antioxidant capacity; pre-treatment melatonin only preserved reduced glutathione levels. An increase in tissue KIM-1 level was found to be prevented by both treatment regimens, which correlated with the morphological changes seen in the kidney tissues of animals treated with melatonin and CCl4. The findings of our study are in agreement with the known actions of melatonin in relieving kidney tissue oxidative burden, but also contribute to the understanding of its action by preventing an increase in KIM-1.


Assuntos
Tetracloreto de Carbono/efeitos adversos , Citoproteção/efeitos dos fármacos , Rim/efeitos dos fármacos , Rim/lesões , Melatonina/farmacologia , Animais , Biomarcadores/sangue , Rim/citologia , Masculino , Ratos , Ratos Wistar
5.
Int. braz. j. urol ; 44(6): 1265-1265, Nov.-Dec. 2018.
Artigo em Inglês | LILACS | ID: biblio-1040048

RESUMO

ABSTRACT Introduction: Distal urogenital fistulas (DUF) are usually iatrogenic and are uncommon in Europe. They occur in the urethra or near the bladder neck, and can be caused by vaginal hysterectomy, para-urethral cyst surgery, or erosion of the bladder or urethra from tension-free slings or meshes. The psychological and physical health consequences of DUF are devastating because most patients consider themselves "healthy" before surgery. Incontinence can appear after successful DUF closure due to previously occult incontinence or urethral incompetence. Additional surgery for incontinence is sometimes necessary to achieve satisfactory outcome. Materials and Methods: A Martius flap was used in 23 patients between 2000 and 2015. Patient age range was 38-75 years (mean, 58.7). DUF was due to gynecologic surgery for benign disease (15 / 23; 65.2%), mesh / sling erosion (2 / 23; 8.7%), and malignancy (6 / 23; 26.1%). The follow-up period was one year. Results: DUF was closed in 22 patients (95.6%). Satisfaction and complete dryness was achieved in 16 patients (69.6%) after the first procedure. Postoperative complications were: postoperative hematoma in 1 (4.4%), primary failure in 1 (4.4%), overactive bladder (OAB) syndrome in 3 (13.2%) and postoperative incontinence in 6 (26.4%) patients. A fascial sling was placed in patients with incontinence. All patients were dry after the secondary surgery. Anticholinergics were used for the treatment of OAB syndrome. Discomfort at the flap harvesting site was of minor importance. Finally, 22 out of 23 patients (95.6%) were satisfied. Conclusion: A Martius flap and additional fascial sling could be successfully used to optimize DUF treatment.


Assuntos
Humanos , Feminino , Adulto , Idoso , Fístula Vesicovaginal/cirurgia , Retalhos Cirúrgicos , Seguimentos , Resultado do Tratamento , Slings Suburetrais , Doença Iatrogênica , Pessoa de Meia-Idade
6.
Int Braz J Urol ; 44(6): 1265, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30088723

RESUMO

INTRODUCTION: Distal urogenital fistulas (DUF) are usually iatrogenic and are uncommon in Europe. They occur in the urethra or near the bladder neck, and can be caused by vaginal hysterectomy, para-urethral cyst surgery, or erosion of the bladder or urethra from tension-free slings or meshes. The psychological and physical health consequences of DUF are devastating because most patients consider themselves "healthy" before surgery. Incontinence can appear after successful DUF closure due to previously occult incontinence or urethral incompetence. Additional surgery for incontinence is sometimes necessary to achieve satisfactory outcome. MATERIALS AND METHODS: A Martius flap was used in 23 patients between 2000 and 2015. Patient age range was 38-75 years (mean, 58.7). DUF was due to gynecologic surgery for benign disease (15 / 23; 65.2%), mesh / sling erosion (2 / 23; 8.7%), and malignancy (6 / 23; 26.1%). The follow-up period was one year. RESULTS: DUF was closed in 22 patients (95.6%). Satisfaction and complete dryness was achieved in 16 patients (69.6%) after the first procedure. Postoperative complications were: postoperative hematoma in 1 (4.4%), primary failure in 1 (4.4%), overactive bladder (OAB) syndrome in 3 (13.2%) and postoperative incontinence in 6 (26.4%) patients. A fascial sling was placed in patients with incontinence. All patients were dry after the secondary surgery. Anticholinergics were used for the treatment of OAB syndrome. Discomfort at the flap harvesting site was of minor importance. Finally, 22 out of 23 patients (95.6%) were satisfied. CONCLUSION: A Martius flap and additional fascial sling could be successfully used to optimize DUF treatment.


Assuntos
Fístula Vesicovaginal/cirurgia , Adulto , Idoso , Feminino , Seguimentos , Humanos , Doença Iatrogênica , Pessoa de Meia-Idade , Slings Suburetrais , Retalhos Cirúrgicos , Resultado do Tratamento
7.
J Environ Radioact ; 168: 30-37, 2017 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-27686949

RESUMO

The present paper reports the results of a study on different types of fly ash from Serbian coal burning power plants and their potential use as a binder in alkali-activated concrete (AAC) depending on their radiological and mechanical properties. Five AAC mixtures with different types of coal burning fly ash and one type of blast furnace slag were designed. Measurements of the activity concentrations of 40K, 226Ra and 232Th were done both on concrete constituents (fly ash, blast furnace slag and aggregate) and on the five solid AAC samples. Experimental results were compared by using the activity concentration assessment tool for building materials - the activity concentration index I, as introduced by the EU Basic Safety Standards (CE, 2014). All five designed alkali-activated concretes comply with EU BSS screening requirements for indoor building materials. Finally, index I values were compared with the results of the application of a more accurate index - I(ρd), which accounts for thickness and density of building materials (Nuccetelli et al., 2015a). Considering the actual density and thickness of each concrete sample index - I(ρd) values are lower than index I values. As an appendix, a synthesis of main results concerning mechanical and chemical properties is provided.


Assuntos
Cinza de Carvão/análise , Materiais de Construção/análise , Monitoramento de Radiação , Álcalis/química , Centrais Elétricas , Sérvia
8.
Eur J Obstet Gynecol Reprod Biol ; 204: 117-21, 2016 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-27566193

RESUMO

OBJECTIVE: Stress urinary incontinence (SUI) is frequently associated with prolapse of the apical and anterior vaginal compartments. The standard treatment of SUI is transobturator tape (TOT). The usual treatment of prolapse (anterior colporrhaphy) has a high recurrence rate. The aim of this study is to evaluate the results of the treatment of SUI and concomitant anterior and apical prolapse with self-created transobturator tape and simultaneous laparoscopic anterior and apical support. STUDY DESIGN: A total of 36 patients with SUI and prolapse of the anterior and apical compartments were underwent operations. The mean follow-up was 18 months. Self-created transobturator tape and laparoscopical support of the anterior and apical compartment prolapse were performed in all patients. The most important symptoms of prolapse and incontinence, the anatomical outcome, and complications were evaluated before and after the surgery. RESULTS: Treatment of incontinence and anterior and apical prolapse was successful in 33/36 (91.7%), 30/36 (83.3%) and 31/36 (86.1%) patients, respectively (p<0.0001). There is a significant reduction of vaginal bulging and pelvic pressure (p<0.0001). Frequency and urgency were significantly reduced (p<0.0007 and p<0.03 respectively). There was no significant deterioration of the posterior compartment. The most important complications were bladder perforation in 2/36 (5.5%) patients and temporary urinary retention in 3/36 (8.3%) patients (Clavien-Dindo grade 3). CONCLUSION: Simultaneous laparoscopic anterior and lateral extraperitoneal support and transobturator tape are effective in the treatment of patients with both conditions.


Assuntos
Laparoscopia/métodos , Incontinência Urinária por Estresse/cirurgia , Prolapso Uterino/cirurgia , Adulto , Idoso , Terapia Combinada , Feminino , Seguimentos , Humanos , Pessoa de Meia-Idade , Slings Suburetrais , Resultado do Tratamento , Incontinência Urinária por Estresse/complicações , Prolapso Uterino/complicações , Vagina/cirurgia
9.
Srp Arh Celok Lek ; 143(5-6): 284-9, 2015.
Artigo em Inglês | MEDLINE | ID: mdl-26259400

RESUMO

INTRODUCTION: The development of effective medications makes pharmacological therapy of BPH the dominant mode of treatment today. It improves urinary symptoms and prevents disease progression while producing side effects on male sexual function. OBJECTIVE: The aim of the study is to present the effects of BPH pharmacological treatment on the occurrence of sexually adverse effects in men: changes in sexual desire, erectile, ejaculatory and the orgasmic function. METHODS: A prospective study involving 156 BPH patients.The average age was 61.16 ± 2.97. Four groups of 39 patients each were formed.The 4 groups were administered tamsulosin (alpha-blocker), finasteride (5-alpha reductase inhibitor), combination therapy (tamsulosin and finasteride) respectively, while the control group received no treatment. PSS-QoL, IIEF and MSHQ-EjD questionnaires were used to evaluate the symptoms of voiding and sexual function. Follow-up examinations were performed 3 and 6 months into treatment. RESULTS: Voiding symptoms improved in all groups receiving therapy. The side effects on the sexual function in all these groups include significant disorders of ejaculation and the orgasmic function. Ejaculation disorders: tamsulosin (-4.38 ± 2.55; p < 0.001), combined therapy (-3.89± 2.84) and finasteride (-1.49 ± 2.52). Orgasmic function disorders: tamsulosin (-1.03 ± 1.94), combined therapy (-0.76 ± 2.07) and finasteride (-0.54 ± 1.68). Complete absence of ejaculation was experienced by 23% of patients on combined therapy, 15% on tamsulosin and 5% on finasteride. CONCLUSION: Pharmacological therapy of BPH improved voiding symptoms producing different effects on male sexual function. The main adverse effect on sexual function in men is the deterioration in ejaculation or the absence thereof. Clinical consideration of BPH should include the elements of male sexual function, patients' age, the characteristics and effects of each group of drugs.


Assuntos
Antagonistas de Receptores Adrenérgicos alfa 1/administração & dosagem , Disfunção Erétil/induzido quimicamente , Finasterida/administração & dosagem , Sintomas do Trato Urinário Inferior/tratamento farmacológico , Hiperplasia Prostática/tratamento farmacológico , Sulfonamidas/administração & dosagem , Idoso , Estudos de Casos e Controles , Progressão da Doença , Esquema de Medicação , Quimioterapia Combinada , Disfunção Erétil/prevenção & controle , Humanos , Sintomas do Trato Urinário Inferior/etiologia , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Hiperplasia Prostática/complicações , Tansulosina
10.
Srp Arh Celok Lek ; 143(3-4): 162-8, 2015.
Artigo em Inglês | MEDLINE | ID: mdl-26012125

RESUMO

INTRODUCTION: lItrogenic ureteral injuries can occur during various abdominopelvic and retroperitoneal surgical procedures including gynecological, urological, colorectal and vascular. OBJECTIVE: The aim of our study was to examine the incidence and types of iatrogenic ureteral injuries occurred over the period of 16 years, as well as to evaluate the values of applied diagnostic and therapeutic procedures. METHODS: A retrospective analysis of clinical data (medical records and operative reports) of 55 patients (11 male and 44 female; mean age 54.5 years) with verified iatrogenic ureteral injury from 1998 to 2014, was performed. RESULTS: latrogenic ureteral injuries occurred during gynecological procedures in 55%, urological in 25%, colorectal in 15% and vascular in 5% of cases. Mechanisms of injury were incomplete transection (n=23), complete transection (n=1), ligation (n=7), partial perforation (mucosal abrasion) (n=1 3) and total perforation (n=1). The most frequent diagnostic procedures for postoperative identification of ureteral injuries were abdominal ultrasonography, excretory urography, antegrade pyeloureterography and retrograde ureteropyelography. Early therapeutic procedures were applied in 35 (64%), while delayed in 20 cases (36%). Early (<30 days) or late (>30 days) postoperative complications were verified in 14 cases (25%). CONCLUSION: Among different surgeries that may lead to the development of iatrogenic ureteral injury, gynecological procedures represent the most common cause. Rapid diagnosis enables immediate ureteral repair and is associated with low morbidity rates, representing a major factor contributing to the treatment success and ultimately preserving the renal function.


Assuntos
Previsões , Doença Iatrogênica , Centros de Atenção Terciária/estatística & dados numéricos , Ureter/lesões , Doenças Ureterais/etiologia , Procedimentos Cirúrgicos Urológicos/métodos , Adulto , Idoso , Feminino , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Sérvia/epidemiologia , Resultado do Tratamento , Ureter/cirurgia , Doenças Ureterais/epidemiologia , Doenças Ureterais/cirurgia , Adulto Jovem
12.
Eur J Obstet Gynecol Reprod Biol ; 182: 76-80, 2014 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-25262290

RESUMO

OBJECTIVES: The purpose of this study was to evaluate and compare the results of tension free self-created transobturator tape (SCTOT) with the standard industrially created transobturator tape (ICTOT) in the treatment of stress urinary incontinence (SUI). STUDY DESIGN: A prospective study of the treatment of SUI with SCTOT (67 patients) and ICTOT (47 patients) was performed. SCTOT was created from polypropylene mesh and monofilament sutures. The symptoms were evaluated before and after the surgery with the following: the Incontinence Impact questionnaire (IIC-7), the urogenital distress inventory (UDI-6), and the International Continence impact questionnaire short form (ICIQ5-SF). The overactive bladder symptom score (OABSS) was used to classify patients in the SUI or the mixed urinary incontinence (MUI) group. The follow up period was 18 months. Cure was defined as a negative stress test and no need for additional surgery. RESULTS: Objective cure was achieved in 56/67 (83.5%) participants in the SCTOT group and in 40/47 (85.1%) participants in the ICTOT group (p>0.05). There was a significant improvement in IIC-7, UDI-6, ICIQ5-SF and OABSS in both groups. Improvement was better in the group with pure SUI than in patients with MUI, but this difference was not significant. Postoperative infection occurred in 5/67 (7.4%) participants and in 5/47 (10.6%) patients in the SCTOT and the ICTOT group, respectively. De novo overactive bladder symptoms occurred in 4/67 (5.9%) of the participants in the SCTOT group and in 3/47 (6.3%) of the patients in the ICTOT group. Operating time was longer in patients with SCTOT compared to those with ICTOT. CONCLUSION: The results of the treatment with SCTOT are not inferior to the results of the treatment with ICTOT and other results reported in the literature.


Assuntos
Slings Suburetrais , Infecção da Ferida Cirúrgica/etiologia , Incontinência Urinária por Estresse/fisiopatologia , Incontinência Urinária por Estresse/cirurgia , Procedimentos Cirúrgicos Urológicos/instrumentação , Adulto , Idoso , Idoso de 80 Anos ou mais , Humanos , Pessoa de Meia-Idade , Duração da Cirurgia , Polipropilenos/efeitos adversos , Estudos Prospectivos , Slings Suburetrais/efeitos adversos , Telas Cirúrgicas/efeitos adversos , Inquéritos e Questionários , Suturas/efeitos adversos , Resultado do Tratamento , Bexiga Urinária Hiperativa/etiologia , Urodinâmica
14.
Urol J ; 11(3): 1660-5, 2014.
Artigo em Inglês | MEDLINE | ID: mdl-25154056

RESUMO

PURPOSE: To compare urethral reconstructions in patients after several years with or without blind urethral dilatation. MATERIALS AND METHODS: A retrospective study of 107 patients with urethral reconstructions was performed. Sixty patients with a long history of blind urethral dilatation (group 1) were compared with 47 patients without prior dilatations (group 2). RESULTS: The type of surgery planned according to urethrography and endoscopy findings was appropriate in 37/60 (61.6%) patients in group 1 and in 39/47 (83%) patients in group 2(P < .03). Anastomotic repairs were more frequent among the patients in group 2 (P < .001).Eighty five out of 107 patients were available for the 24 months follow-up. The success rate was higher in group 2 (91.4%) than patients in group 1 (70%) (P < .04). The greatest improvement in symptoms and quality of life occurred three months after the surgery (P < .05).Postoperative infection was persistent in 20/107 (18.7%) patients. CONCLUSION: Urethral strictures with a long history of blind dilatation are separate entity.They are more difficult to image, require more augmentation and staged procedures and have a lower success rate.


Assuntos
Dilatação/métodos , Estreitamento Uretral/terapia , Adulto , Idoso , Idoso de 80 Anos ou mais , Anastomose Cirúrgica/efeitos adversos , Sobrevivência de Enxerto , Humanos , Pessoa de Meia-Idade , Qualidade de Vida , Estudos Retrospectivos , Resultado do Tratamento , Estreitamento Uretral/cirurgia , Adulto Jovem
16.
Acta Chir Iugosl ; 61(1): 41-4, 2014.
Artigo em Inglês | MEDLINE | ID: mdl-25782224

RESUMO

INTRODUCTION: Reconstruction of the long urethral strictures is a difficult task in urology. The most frequently usedmethod is augmentation with the free buccal mucosal graft. MATERIAL AND METHODS: Restrospective analysis of 57 patients with the long urethral stricture was performed. All patients were evaluated endosco- pically and radiologically before the surgery. Buccal mucosal graft harvested from the inner side of the cheek (unilateral or bilateral) was used for the urethral reconstruction in all patients. Follow-up was one year. RESULTS: Complete follow up is achieved in 44/57 (77.2%) patients. The most important etiology of the strictures was previous iatrogenic trauma (instrumentation). The strictures were the most frequently located in the bulbar urethra. Preoperative exact evaluation of the stricture length was possible in only 35/57 patients (61.4%). Overall success rate of the surgery was 38/44 (86.3%). Complications occurred in 6/44 (13.7%) of patients--primary graft failure and urinary fistula. Mean preoperative IPSS was 19.2 ± 5.2, and postoperative 10.3 ± 3.2 (p < 0.0001). IPSSQOL was 4.9 ± 3.7 before the surgery, 2.9 ± 1.1 after the surgery (p < 0.001). Persistent urinary infection was present in 12/44 (27.2%) patients. CONCLUSION: Buccal mucosal free graft could be successfully used in the reconstruction of long urethral strictures. However, complications are not uncommon, and residual symptoms still exist after the surgery, and could not be neglected.


Assuntos
Mucosa Bucal/transplante , Procedimentos de Cirurgia Plástica , Complicações Pós-Operatórias/diagnóstico , Uretra , Estreitamento Uretral , Fístula Urinária , Infecções Urinárias , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Radiografia , Procedimentos de Cirurgia Plástica/efeitos adversos , Procedimentos de Cirurgia Plástica/métodos , Recidiva , Estudos Retrospectivos , Sérvia , Resultado do Tratamento , Uretra/diagnóstico por imagem , Uretra/cirurgia , Estreitamento Uretral/diagnóstico , Estreitamento Uretral/etiologia , Estreitamento Uretral/cirurgia , Fístula Urinária/diagnóstico , Fístula Urinária/etiologia , Infecções Urinárias/diagnóstico , Infecções Urinárias/etiologia
17.
Acta Chir Iugosl ; 61(1): 81-4, 2014.
Artigo em Inglês | MEDLINE | ID: mdl-25782232

RESUMO

BACKGROUND: Stress urinary incontinence (SUI) is managed with both TVT and TOT. The TVT route of placement could result in a higher com-plication rate. The aim of this study is to analyze and compare outcomes and complications of TVT and TOT in SUI treatment. METHODS: Prospective study in 64 women with isolated SUI was validated through Urogenital Distress Inventory (UDI-6), Incontinence Impact questionnaire (IIQ-7) and International Continence Impact Questionnaire (ICIQ5-SF). Intraoperative and postoperative complications were noted. Patients were considered cured when negative on stress test and with no need for additional surgery during follow up, after one and three months. RESULTS: The cure rates for both TVT 26/30 (86,6%) and TOT 30/34 (88,2) were comparable. Higher rates of bleeding, bladder perforations, pain and dyspareunia are recorded in TVT group. Quality of life graded on the questionnaire basis proved significant improvement in both procedures. CONCLUSION: Both TVT and TOT have comparable cure results in the treatment of SUI. The TOT is equally effective in the SUI treatment with significantly lower complication incidence.


Assuntos
Complicações Pós-Operatórias , Implantação de Prótese , Qualidade de Vida , Slings Suburetrais/efeitos adversos , Incontinência Urinária por Estresse , Procedimentos Cirúrgicos Urológicos , Idoso , Pesquisa Comparativa da Efetividade , Feminino , Humanos , Pessoa de Meia-Idade , Complicações Pós-Operatórias/diagnóstico , Complicações Pós-Operatórias/etiologia , Complicações Pós-Operatórias/cirurgia , Estudos Prospectivos , Implantação de Prótese/efeitos adversos , Implantação de Prótese/instrumentação , Implantação de Prótese/métodos , Reoperação , Inquéritos e Questionários , Resultado do Tratamento , Incontinência Urinária por Estresse/psicologia , Incontinência Urinária por Estresse/cirurgia , Procedimentos Cirúrgicos Urológicos/efeitos adversos , Procedimentos Cirúrgicos Urológicos/instrumentação , Procedimentos Cirúrgicos Urológicos/métodos
18.
Acta Chir Iugosl ; 61(1): 95-101, 2014.
Artigo em Inglês | MEDLINE | ID: mdl-25782235

RESUMO

OBJECTIVE: to analyze complications and clinical outcome of Camey-Le Duck ureteral reimplantation technique in modified Mainz pouch II urinary diversion. PATIENTS AND METHODS: this retrospective study included a total of 110 patients (101 male and 9 female, mean age 59.2 years, SD = 10.2), who had underwent a modified Mainz pouch II urinary diversion with Camey-Le Duck ureteral reimplantation technique, following total cystectomy, during the period 1995-2014. The mean follow-up, available for 90 (82%) patients period was 19 (1-74) months. Early and late postoperative complications were analyzed. RESULTS: early complications developed in 22 (20%) patients as follow: unilateral ureterohydronephrosis in 8 (7%) patients, bilateral ureterohydronephrosis in one (1%)-two RU (renoureteral units), urinary leakage in 8 (7%), and pyelonephritis in 5 (5%) patients. Late complications developed in 28 (25%) patients: pyelonephritis in 17 (15%), and ureteral reimplantation site stenosis in 11 (10%) patients with 12 RU. Balloon dilatation procedure was applied in all 12 RU, with additional metallic Strecker stent insertion in 5 RU. At 24-month follow-up, all patients with metallic Strecker stent had normal results of serum biochemistry, blood gas analysis and renal ultrasound. In the rest of six patients with 7RU, balloon dilatation has failed and restenosis of ureteral reimplantation site with consequent ipsilateral hydronephrosis was verified. In these patients, permanent percutaneous nephrostomy catheter was applied. CONCLUSION: Camey-Le Duck ureteral reimplantation technique following Mainz pouch II urinary diversion is simple, reliable and durable. It enables well upper urinary tract protection and is associated with relatively low major complication rates.


Assuntos
Anastomose Cirúrgica , Cistectomia/efeitos adversos , Complicações Pós-Operatórias , Ureter/cirurgia , Obstrução Ureteral/etiologia , Derivação Urinária , Coletores de Urina , Idoso , Idoso de 80 Anos ou mais , Anastomose Cirúrgica/efeitos adversos , Animais , Patos , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Complicações Pós-Operatórias/classificação , Complicações Pós-Operatórias/cirurgia , Reimplante/efeitos adversos , Reimplante/métodos , Estudos Retrospectivos , Sérvia , Obstrução Ureteral/cirurgia , Derivação Urinária/efeitos adversos , Derivação Urinária/métodos
19.
Vojnosanit Pregl ; 70(1): 68-71, 2013 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-23401933

RESUMO

BACKGROUND: Renal onkocytoma is a distinctive benign tumor derived from epithelial cells of the distal renal tubules. These tumors are often clinically asymptomatic, diagnosed accidentally and difficult to distinguish from renal cell carcinoma. CASE REPORT: We presented a giant renal onkocytoma in a man aged 64, without any signs or symptoms of the urogenital system disorder. The preoperative diagnosis described the tumor mass of the right kidney, size 16 x 14 cm, and indicated a malignant tumor of kidney. The patient underwent radical nephrectomy. The tumor was encapsulated at the intersection with the characteristic central hyaline scar. Microscopically, it was built of uniform polygonal cells with abundant eosinophilic cytoplasm. Immunohystochemiclly, tumor cells were immunoreactive to CK AE1/AE3 and CD 117, but showed negative immunoreactivity to CK 7, RCC marker and Vimentin. CONCLUSION: Giant renal oncocytomas are rare tumors with benign clinical course. As a rule, they are discovered by accident. Clinical differentiation from malignant tumors of the kidney is not possible. They are treated surgically, mainly by radical nephrectomy. A definitive diagnosis is made only by histopathological examination of tumors using immunohistochemical marker panels.


Assuntos
Adenoma Oxífilo , Neoplasias Renais , Adenoma Oxífilo/diagnóstico , Adenoma Oxífilo/patologia , Adenoma Oxífilo/cirurgia , Humanos , Neoplasias Renais/diagnóstico , Neoplasias Renais/patologia , Neoplasias Renais/cirurgia , Masculino , Pessoa de Meia-Idade
20.
Acta Chir Iugosl ; 60(1): 15-20, 2013.
Artigo em Inglês | MEDLINE | ID: mdl-24669558

RESUMO

Holmium laser enucleation of the prostate (HoLEP) represents a great potential alternative technique to standard transurethral resection of the prostate (TURP). We present 12-month follow up results of a randomized clinical trial, comparing HoLEP with TURP. A total of 40 patients with BPH and prostate volume < 50 g, have been randomized for HoLEP (n = 20) or TURP (n = 20). Urinary tract ultrasound with postvoid residual urine (PVR), International Prostate Symptom Score (IPSS) and Single Question Quality of Life (QoL) Score were evaluated preoperatively and during the follow-up period at 1, 3, 6, and 12 mo postoperatively. Intra- and perioperative data as well as early and late complications were assessed. Operative time was longer in the HoLEP group (p < 0.001); catheterisation time (p < 0.05) and hospital stay (p < 0.05) shorter. Hemoglobin levels drop (p < 0.001) was higher in the TURp group. Early and late postoperative complications were more frequent in the TURp group (p < 0.001). Follow-up data favored the HoLEP group, both regarding IPSS at 6-month (p < 0.05) and 12-month (p < 0.01), and single question QoL score, at 6-month (p < 0.01) and 12-month (p < 0.05). PVR was lower in the HoLEP group at 6-month (p < 0.01). HoLEP demonstrates superiority to TURp in regards to perioperative parameters and follow-up data and has a great potential to become the new gold standard in the surgical treatment of BPH.


Assuntos
Lasers de Estado Sólido/uso terapêutico , Prostatectomia/métodos , Hiperplasia Prostática/cirurgia , Ressecção Transuretral da Próstata , Idoso , Seguimentos , Humanos , Lasers de Estado Sólido/efeitos adversos , Masculino , Pessoa de Meia-Idade , Duração da Cirurgia , Prostatectomia/efeitos adversos , Qualidade de Vida , Índice de Gravidade de Doença , Ressecção Transuretral da Próstata/efeitos adversos
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA
...