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1.
J Reprod Med ; 45(11): 957-60, 2000 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-11127114

RESUMO

BACKGROUND: Retrograde ejaculation causes < 2% of male infertility but is the leading cause of aspermia. The incidence of retrograde ejaculation is increasing due to the aggressiveness of modern urologic cancer surgery and an increase in diabetes mellitus. Generally, the only adverse effect is on fertility. Various approaches have been proposed for treatment, ranging from insemination with sperm-rich urine obtained after masturbation to intracytoplasmic sperm injection (ICSI). We used a protocol involving bladder washing. CASES: Case 1 involved a man with retrograde ejaculation secondary to a successful right orchiectomy and retroperitoneal lymph node dissection for stage B1 embryonal cell carcinoma. He was treated with bladder washing and intrauterine insemination. He fathered three children from six insemination cycles. Case 2 involved a man with idiopathic retrograde ejaculation and a wife with ovulatory dysfunction. He received treatment similar to that in case 1 and fathered one child from two insemination cycles. CONCLUSION: Larger studies need to be done specifically comparing treatments. Our method resulted in four normal infants in two couples over eight total insemination cycles and, taken together with other results from the literature, seems a good choice for clinicians who are treating retrograde ejaculation for the first time. We agree with others who have recommended that in vitro fertilization/ICSI not be the first step for treating the usual couples with retrograde ejaculation.


Assuntos
Ejaculação , Inseminação Artificial Homóloga/métodos , Oligospermia/etiologia , Oligospermia/terapia , Irrigação Terapêutica/métodos , Bexiga Urinária , Adulto , Feminino , Humanos , Masculino , Neoplasias Embrionárias de Células Germinativas/cirurgia , Oligospermia/fisiopatologia , Orquiectomia/efeitos adversos , Gravidez , Resultado da Gravidez , Neoplasias Testiculares/cirurgia , Resultado do Tratamento
2.
Urology ; 49(1): 101-3, 1997 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-9000194

RESUMO

OBJECTIVES: There are a variety of open surgical and endoscopic approaches to the treatment of traumatic urethral injuries. The objective of our study was to evaluate the efficacy of early fluoroscopic realignment of the urethra following traumatic injury. METHODS: Seven patients with urethral rupture injuries (two anterior and five posterior urethral injuries) were treated. Follow-up ranged from 1 to 35 months. RESULTS: Six patients had successful early realignment of the urethra and catheter placement. Two of these required no further treatment, whereas 3 required another procedure or procedures following catheter removal. One patient is presently being treated. In 1 patient, realignment was unsuccessful and subsequent open urethroplasty was required. CONCLUSIONS: Early fluoroscopic realignment appears to be a safe and effective method of treatment for severe traumatic urethral injuries.


Assuntos
Uretra/lesões , Cateterismo Urinário , Adulto , Fluoroscopia , Seguimentos , Humanos , Ruptura/terapia , Fatores de Tempo
3.
Urology ; 48(1): 33-9, 1996 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-8693649

RESUMO

OBJECTIVES: To determine if 99mTc-sestamibi (technetium 99m-methoxyisobutylisonitrile) can be used preoperatively to differentiate renal oncocytomas from other renal masses. METHODS: We performed 99mTc-sestamibi scans on 6 patients with various renal masses, using a standard technique. The diagnosis in each patient was determined either by radiologic methods. RESULTS: There was significantly increased uptake in the patient with the renal oncocytoma, whereas the other lesions had decreased uptake in comparison to normal kidney. This was determined visually and by mean pixel analysis. CONCLUSIONS: Technetium 99m sestamibi scanning appears to have a potential role in the nonoperative diagnosis of renal oncocytomas, in combination with pathologic fine-needle biopsy confirmation. More definitive pathologic experience is required before recommending standard use.


Assuntos
Adenoma Oxífilo/diagnóstico por imagem , Neoplasias Renais/diagnóstico por imagem , Tecnécio Tc 99m Sestamibi , Adulto , Idoso , Diagnóstico Diferencial , Feminino , Humanos , Nefropatias/diagnóstico por imagem , Masculino , Pessoa de Meia-Idade , Cuidados Pré-Operatórios , Cintilografia
4.
Urology ; 42(6): 677-9, 1993 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-8256400

RESUMO

The role of ultrasound in the diagnosis of prostate cancer is still evolving. We used ultrasound to examine 202 patients with palpably abnormal prostates. Of 151 patients undergoing biopsy, ultrasound-guided biopsy was comparable to digitally directed biopsies in cancer detection (92% vs 90.7%). The two methods are complementary and should both be considered in patients with palpably abnormal prostates.


Assuntos
Adenocarcinoma/diagnóstico , Biópsia/métodos , Neoplasias da Próstata/diagnóstico , Adenocarcinoma/diagnóstico por imagem , Humanos , Masculino , Palpação , Valor Preditivo dos Testes , Estudos Prospectivos , Neoplasias da Próstata/diagnóstico por imagem , Reto , Sensibilidade e Especificidade , Ultrassonografia
5.
Urology ; 40(5): 435-7, 1992 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-1441041

RESUMO

Unilateral renal dysplasia in a horseshoe kidney is very uncommon. A case which was detected in utero is presented. The management of multicystic kidneys is reviewed.


Assuntos
Doenças Fetais/diagnóstico por imagem , Rim/anormalidades , Doenças Renais Policísticas/diagnóstico por imagem , Ultrassonografia Pré-Natal , Feminino , Doenças Fetais/epidemiologia , Humanos , Incidência , Recém-Nascido , Masculino , Doenças Renais Policísticas/congênito , Doenças Renais Policísticas/epidemiologia , Gravidez
6.
J Urol ; 147(6): 1599-601, 1992 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-1593695

RESUMO

An 11-year-old boy presented with bilateral testicular masses that consisted of hyperechoic centers with hypoechoic rims on ultrasound. Surgical exploration revealed bilateral epidermoid cysts. To our knowledge this is the first reported case of bilateral epidermoid cysts in a child. Recognition of this entity requires surgical confirmation but it may obviate removal of the testicle.


Assuntos
Cisto Epidérmico/diagnóstico , Doenças Testiculares/diagnóstico , Criança , Humanos , Masculino
7.
J Urol ; 140(1): 188-90, 1988 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-3379686

RESUMO

Superficial transitional cell carcinoma of the bladder has a 50 to 70% recurrence rate. Recurrences may be related to tumor cell implantation during transurethral resection which disrupts the glycosaminoglycan layer of the bladder. This study demonstrated decreased tumor formation in murine bladders which were pre-treated with sucralfate, a synthetic glycosaminoglycan, prior to tumor cell instillation. These results suggest a possible role for sucralfate as a glycosaminoglycan supplement.


Assuntos
Carcinoma de Células de Transição/prevenção & controle , Sucralfato/farmacologia , Neoplasias da Bexiga Urinária/prevenção & controle , Animais , Carcinoma de Células de Transição/patologia , Feminino , Camundongos , Camundongos Endogâmicos C3H , Transplante de Neoplasias , Pré-Medicação , Bexiga Urinária/patologia , Neoplasias da Bexiga Urinária/patologia
8.
J Thorac Cardiovasc Surg ; 86(3): 409-11, 1983 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-6411998

RESUMO

Massive hemoptysis occurs in 50% to 70% of patients with cystic fibrosis and carries an immediate mortality of up to 32%. Cystic fibrosis is regarded by many as a disease in which thoracic operations are ill-advised. A 21-year-old woman with mild cystic fibrosis presented with unrelenting massive hemoptysis, was not helped by medical management, and underwent a successful left upper lobectomy. We suggest that thoracotomy does have a role in the management of massive hemoptysis in selected patients with cystic fibrosis. On the basis of our case and all other cases reported in the English literature, we suggest criteria for determining which patients are suitable candidates for emergency thoracotomy.


Assuntos
Fibrose Cística/complicações , Hemoptise/cirurgia , Pulmão/cirurgia , Adulto , Antibacterianos/uso terapêutico , Emergências , Feminino , Hemoptise/complicações , Humanos , Infecções por Pseudomonas/tratamento farmacológico , Pseudomonas aeruginosa/isolamento & purificação , Testes de Função Respiratória , Escarro/microbiologia
9.
Arch Intern Med ; 143(2): 287-90, 1983 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-6824394

RESUMO

Massive hemoptysis occurs in 5% to 7% of patients with cystic fibrosis. Approximately 11% of these patients will die within 48 hours of manifestation because of uncontrolled hemoptysis and asphyxiation. If conservative medical treatment fails to control hemoptysis, fiberoptic or rigid bronchoscopy is the least risky and most accurate method of localizing the source of hemoptysis. Acute control of hemoptysis can be obtained in up to 100% of patients with endobronchial Fogarty balloon tamponade and in up to 88% of patients with bronchial artery embolization. Emergency thoracotomy can be performed if the above fail, but only in patients with mild cystic fibrosis and adequate pulmonary reserve.


Assuntos
Fibrose Cística/complicações , Hemoptise/terapia , Broncoscopia , Embolização Terapêutica , Hemoptise/diagnóstico , Hemoptise/etiologia , Hemoptise/mortalidade , Humanos , Pneumonectomia , Testes de Função Respiratória
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