A. Guarneri's research while affiliated with San Giuseppe Hospital and other places
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Publications (60)
Unlabelled:
Bulbourethral transobturator sling data from other investigators report a success rate from 53% to 85%. Since the degree of sling tension and its adjustment seems to be important for achieving complete urinary continence we present results on the first consecutive 12 patients, with mild post prostatectomy stress urinary incontinence--d...
Summary The authors describe their experience about a robotic system designed to perform prostatic biopsies, locally and tele-controlled. The system employs an industrial robotic arm with four degrees of freedom made up of a biopty gun and 18 gauge biopty needle. An ultrasound scanner with a trans-rectal probe 7.5 MHz is necessary to localize the t...
A new posterior urethroplasty is suggested for patients with pelvic fracture urethral distraction defect (PFUDD).
12 men, with PFUDD were treated with an anastomotic urethroplasty, using a transperineal-prerectal approach. All patients had a suprapubic tube in place and were impotent after pelvic trauma. The goal of this approach was to facilitate...
Most surgical therapies used to date for Peyronie's disease produce good results but cause penis retraction. The authors propose a personal surgical technique that makes use of an intracavernous cylinder, soft but axially rigid in consistency, in association with tunical relaxing incisions and saphenous vein grafting, in this exact sequence.
Betwee...
Partial or total penile amputation with resection of the corpora cavernosa and the urethra is a common and effective surgical procedure used to treat squamous cell cancer infiltrating the deep tissues of the penis. We describe an original method that allows for an aesthetic and functional restoration of the partially or total amputated penis.
Surg...
This study aims at comparing the oxygenation status of the cavernosal tissue after the direct action of the Vacuum device (VD) preceded or not by administration of Sildenafil. Patients and methods. We enrolled thirty patients who had undergone perineal radical prostatectomy. After four weeks from surgery we evaluated oxygen pressure (pO2), carbon d...
Surgical resection remains the cornerstone of treatment renal cell carcinoma. In the last 15 years a better understanding of tumor biology and the early diagnosis permitted an evolution of the surgical treatment towards a minimal invasive approach by nephron-sparing surgery. Together with absolute and relative indications, nephron-sparing surgery i...
The surgical therapy of the urethral strictures is still controversial as it interests the choice of an appropriate technique among many methods. In cases of complex urethral strictures, urethroplasties using genital or extragenital tissue for reconstruction are indicated. Scrotal in-lay was popular some years ago, but the complications rate was hi...
Transurethral resection of the prostate (TURP) is still the standard treatment of benign prostatic hypertrophy (BPH) but the surgical lasers recently introduced seem to offer the patient a very low perioperative complication rate, a short learning curve, the reduced operating time and the health care system a very low cost/benefit ratio. We report...
Penile lengthening and thickening techniques can be performed in different ways for treatment of congenital penile hypoplasia and dysmorphophobia in terms of aesthetics or function. Particularly for penile lengthening, a combination of surgery and stretcher device is suggested. Surgery for lengthening comprises three different stages: suture with p...
Eighteen years after the first clinical shock wave lithotripsy (SWL), no doubt remains as to its therapeutic efficacy in ureterorenal lithiasis. The advent of lithotriptors with a large shock wave energy range and integration of both ultrasound and radiologic imaging equipment at the shock wave source has meant that outpatients treatment of urolith...
We describe a select group of asymptomatic patients with fragments and dust 3 months after extracorporeal treatment, who were followed to evaluate the long-term outcome and therapeutic implications.
A total of 129 patients with dust and residual fragments (less than 4 mm.) at 3 months was re-examined at 12 months, and 95 were also evaluated at 24 m...
Extracorporeal shock wave lithotripsy is nowadays first choice treatment of ureteral stones. Shock wave generator technology has greatly advanced since the first electrohydraulic lithotriptor was introduced. Third generation lithotriptors combine all these advantages and integrate them into a multi-functional X-ray system. From January 1996 to June...
The treatment of ureteral stones has undergone a radical change in the last 15 years. First, the increased use of endoscopic procedures and then the introduction of extracorporeal lithotripsy relegated traditional surgery to a marginal role for this type of disorder. The best available treatment modality for ureteral lithiasis, particularly distal...
Post ESWL haemorragic complications are frequent and most patients experience temporary haematuria and focal intrarenal bleeding or perirenal haematoma are detected by NMR or US imaging. By tradition coagulation troubles have been a contraindication for ESWL but literature describes cases of coagulopathic patients treated with ESWL. From January 19...
The pathogenesis of benign prostatic hyperplasia (BPH) remains largely unresolved. The natural history of the disease involves two distinct phases, a pathological and a clinical one, whose pathogenesis is different. The pathologic phase is composed of two stages microscopic and macroscopic neither of which produces clinical dysuria. Nearly all men...
In male patients routine examination for urethral disease includes retrograde and anterograde urethrography and urethroscopy. In the patients underwent radical cystectomy, detection of cancerous cells in the urethral washing suggest cancer relapse. Nowadays we can achieve a sonographic study of the anterior male urethra, using a superficial high fr...
Laparoscopic surgery admits the retroperitoneal approach: the main restriction is the tight manoeuvring space that can be obtained with insufflation. The use of a dilatator balloon in the retroperitoneal cavity offers a solution to this problem. A cutaneous access and a dull parietal path is created, with blind positioning of the apex of the dihedr...
The main post uretero-sigmoidostomy complications are stricture of the anastomosis, chronic infection and urolithiasis. In our institution the patients with ureterosigmodostomy undergo a follow-up protocol in which blood chemistry, ultrasonography, intravenous pyelography and C.T. are periodically performed. The aim of the present paper is to compa...
Extracorporeal shock-wave lithotripsy (ESWL) is now applied as the treatment of choice in most cases of urinary stones. Its acceptance in pediatry, however has been only gradual despite numerous positive studies. We report on fourteen young patients (mean age: 9.7 years) who were all treated by ESWL with the MPL9000 lithotriptor for renal stones. E...
Hypertension has been reported to occur following extracorporeal shock wave lithotripsy (ESWL). Retrospective studies reported an incidence of new onset hypertension between 2.4 and 8.1%) and a significant rise in mean diastolic blood pressure was observed by some authors1-5. In order to assess the clinical impact of the potential risk of hypertens...
Infective complications following extracorporeal shock wave lithotripsy (ESWL) can be prevented using appropriate antibiotic therapy. However, in many cases antibiotic prophylaxy seem to be excessively precautionary1.
Undue acidity of the urine attributed to a deficiency in renal ammoniogenesis has been claimed to be prevalent in certain groups of patients who may form uric acid stones even in the absence of hyperuricosuria1.
Renoureteral anomalies can be seen as a pathogenetic factor of urolithiasis or simply as innocent bystanders revealed by symptomatic urolithiasis1. When ESWL was first attempted, these renoureteral anomalies were considered as absolute contraindications for this kind of treatment2. Nowadays, however, admission criteria for ESWL have been extended3....
It has been shown that shock waves can cause damage to the vascular structure of the kidneys and tubules and also to the renal glomeruli1. We undertook a study of the microscopic morphology of urinary erythrocytes in a group of patients who underwent extracorporeal shock wave lithotripsy (ESWL), to assess possible glomerular damage.
A therapeutical trial based on pelvic floor training, reduced evening fluid intake and a 3 hour nocturnal awakening has been performed by 12 adult primary enuretics. The aim of this study is to verify if diurnal pelvic floor training is useful to gain a nocturnal micturition control.
Perineal floor training and perineal biofeedback allow to reach a good improvement of clinical discomfort in the treatment of stress and urge urinary incontinence. The aim of this study is the real evaluation of the benefit due to a 6 week perineal biofeedback and pelvic floor training (PFT) versus PFT alone. 8 female patients have been treated wit...
A potential complication of prostatic adenomectomy and TURP is urinary incontinence. The incidence of this problem ranges from 0.1 to 1%. we reviewed our experience with 15 patients who were incontinent between 10 to 24 months after prostatectomy. We treated these patients with bladder training. At first, patients were evaluated for the type and ex...
A total of 64 treatments by the Dornier HM3 lithotriptor was performed on 52 solitary kidneys with stones. A slight increase but no significant variations in serum creatinine was noted in 15 patients without obstruction just after treatment (p greater than 0.05). No significant increases in serum creatinine were found even at the short-term, mid-te...
Thirty-five men and 33 women, mean age 45 years (range 15-67) treated with extracorporeal shock wave lithotripsy (SWL) for renal stones by a modified Dornier HM3 lithotripter, were followed in a 24- to 36-month prospective study to assess the risk of hypertension. No significant increase in the mean diastolic blood pressure was observed. No correla...
We evaluated the usefulness of percutaneous nephrostomy in 1700 patients treated for reno-ureteral stones by extracorporeal shock wave lithotripsy (SWL). Out of this group 81 patients (5.8%) underwent echo-guided percutaneous nephrostomy (EPCN): the procedure has been performed in local anesthesia in 38% of the cases (31 pts) before SWL and in 62%...
Throughout the world ESWL is nowadays the treatment of choice in renoureteral stones and ever smaller stones can be treated. We have undertaken the present study to evaluate post treatment infective complications in low-risk patients. A prospective study has been performed on 150 non-infected patients before ESWL treated for renal stones whose maxi...
A prospective study was performed to compare the efficacy of plain X-ray, renal tomography and renal ultrasound for the evaluation of the presence of residual fragments and the size of the fragments on 108 patients at 1 month follow-up after ESWL. Ultrasound appeared to be sensitive in identifying the residual fragments. Renal tomography more speci...
During a 15-year period (1977–1992) 2,000 consecutive patients with renal stones were studied. Fasting serum and 24-hour urinary samples were analyzed for calcium and phosphate. In 32 cases (1.6%) primary hyperparathyroidism was diagnosed on the finding of hypercalcemia associated with hypophosphatemia, hypercalciuria and hyperphosphaturia. At surg...
From January 1985 till June 1989, 222 patients with ureteral stones, underwent ESWL treatment. 109 patients were treated with the original Dornier HM3 under general or epidural anaesthesia and 113 patients were treated with the modified Dornier HM3 under anglosedation. 156 stones were in the upper ureter, 15 in the middle ureter, 51 in the lower ur...
Extracorporeal shock wave lithotripsy (SWL) treatment for renal stones has been proved safe and effective in the last 10 years. However, we needed to observe the patients for a longer period than a 3-month control to settle the fate of residual fragments. Two hundred fifty-four patients treated with SWL for different types of stones in solitary kid...
Dietary patterns have been implicated as major contributors to the high prevalence of upper urinary-tract stones in affluent countries (1, 2). Many studies have shown that a number of nutrients may influence the excretion of calcium (Ca), oxalate (Ox), citrate (Cit), and uric acid (UA) and predispose to Ca stone formation. Urinary Ca excretion is r...
Wstęp W zależności od rodzaju i metody implantacji beznapięciowe taśmy pochwo-łonowe albo unoszą bliższy i środkowy odcinek cewki moczowej albo podpierają szyję pęcherza. Jednak w zabiegach naprawczych wypadania przedniej ściany pochwy, przy współistniejącej nadmiernej ruchomości cewki moczowej, korzystne jest zastosowanie taśmy, która wykorzystywa...
Citations
... Sexual function is well preserved following glansectomy. A study of 39 patients found coital ability post-operatively in 84% of patients and orgasm feeling maintained in 78% of patients (55). Another study of 11 patients who had sexual function evaluation following glansectomy found 9 patients to be able to achieve erections and 6 patients to be sexually active (54). ...
Reference: Penile sparing therapy for penile cancer
... The stone-free rate was 78%, 73%, 43% and 30% for stones<5, 6-10, 11-15 and 16-20 mm insize, respectively. The authors concluded that stone size is more predictive of ESWL outcome than lower pole calyceal anatomy [12]. ...
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... Most of the preceding studies were retrospective and did not stratify patients into at-risk groups or exclude patients with pre-existing hypertension, renal disease, or other risk factors for renal injury after ESWL. Randomised controlled trials failed to reveal any evidence that ESWL causes changes in blood pressure [68,74,75]. Furthermore a recent study indicated that extracorporeal lithotripsy for kidney stones may be responsible for a drop in blood pressure, possibly because the intrarenal metabolism is altered. ...
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... Prostate ultrasound is deployed to generate images of the rectum and assist in biopsy for further diagnosis. Pisani et al. [63] presented a robotic system with the 4 DOF SCARA (Selective, Compliance, Arm, Robotized, Assembly) robotic arm to conduct a biopsy of the prostate aided by an ultrasound probe localisation system. The high-precision system has the potential to be controlled both locally and remotely from a distance for teleoperation and was demonstrated on over five hundred tests. ...
![[object Object]](https://i1.rgstatic.net/ii/profile.image/278675145674769-1443452740865_Q64/Alberto-Rovetta.jpg)
... The results of quality assessment were summarized in Table 2. Using the criteria that a study with 14 or more yes responses out of 18 (! 70%) of the Delphi checklist was considered to be of acceptable quality [45], 13/26 studies that evaluated the efficacy of the sling were not of acceptable quality [13,15,17,[22][23][24]28,29,[31][32][33][34][35]. None of the studies that assessed the artificial urinary sphincter had !14 yes responses indicating they were not of acceptable quality. ...
![[object Object]](https://i1.rgstatic.net/ii/profile.image/279323148865561-1443607236975_Q64/Davide-Abed-El-Rahman.jpg)
... hypertension rate of about 8%.Other institutions, however, showed new-onset hypertension rates of only 3.1-4% among patients receiving ESWL during 1-5 years of follow-up, which are similar to that among the general population. [11][12][13] Controversy about changes in BP after ESWL has continued ever since. ...
... with urinary incontinence, urinary frequency, and terminal dribbling [Paterson et al., 1997; Chang et al., 1998]. Some authors [Moulonguet et al., 1981; Ceresoli et al., 1993] reported their striking experience of the effectiveness of early functional treatment of urinary incontinence after prostatectomy. They showed that, with their treatment, improvement and cures in urinary incontinence after prostatectomy occur much earlier with the aid of functional treatment than spontaneously. ...
... The natural history of prostatic nodular hyperplasia (PNH) is a spectrum that encompasses an initial pathological phase, which may progress, to terminate in a clinical phase. [1][2][3] The pathological phase is devoid of any clinical symptom, and it is divided into two stages, the microscopic and macroscopic stages of PNH. [2,3] Microscopic PNH denotes microscopic confirmation of stromal and epithelial hyperplasia, while, macroscopic PNH, signify the increase in the size of the prostate gland secondary to stromal and epithelial proliferation. ...
... In clinical practice, relying on the feel of the implementer to control the depth of incision can easily result in deep wound incision until normal tissues and cause bleeding, urinary extravasation, and other complications. Ultrasound urethrography can provide a good display of stricture urethral scar thickness, which is conducive for guidance in surgical decision-making and implementation during the operation [9][10][11]. ...
... Systematic Reviews subjective outcomes (improvement in OAB symptoms) at 8 weeks, with no increase in adverse events. Biofeedback with pelvic floor muscle exercises was superior to pelvic floor muscle exercises alone, based on 1 nonrandomized, prospective comparative trial (1C) 24 for improvement in subjective (daily pad use) and objective outcomes (Visual Analog Scale scores) at 6 weeks, with no adverse event data reported. ...
