Science topic

Urologic Surgical Procedures - Science topic

Surgery performed on the urinary tract or its parts in the male or female. For surgery of the male genitalia, UROLOGIC SURGICAL PROCEDURES, MALE is available.
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I read about urethral stricture because there is often relapse after surgery, the stricture comes back.
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With the available Holmium Laser, it takes about 20 to 30 minutes to vaporize with no down time and no bleeding. Can be repeated easily with almost return of normal urethra. Please see several of my publications...google.
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42 years-old female very slim ( BMI = 18 kgs-m2) patient with recurrent carcinoid gastric type 1 into fundus-body about 1,5 cm previously resected by means eco-endoscopy. She presented recurrence after 4 months after full endoscopic resection. The lesion is moderate grade lesion - expression of Ki-67 = 10 %. Octreoscan is negative to distance spreading. What is the best approach to this case? New endoscopic approach? Subtotal distal or total laparoscopic gastrectomy? If total gastrectomy is choosen , Is whorthwilhe an esophago-jejunal anastomosis with interposed jejunal-pouch to decrease lost of weight? 
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Look there was very early recurrence. This patient is young and high levels of gastin will remain everytime. So new carcinoid tumors will always return.
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male post op bladder repair and partial cystectomy patients on tds tranexamic acid complain of pain and discomfort ( localized mostly at tip of penis) these patients are catheterized and complain of pain when clots pass through.. they also complain of a lot of pain when their bladder is irrigated via syringing to remove clots.
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I never use tranexamic acid in bladder surgery. Clot formation/organization in bladder can be dangerous for the patient.
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TURP remains a gold standard procedure for BPH in most centers. Preoperative short term Finasteride helps reducing intraoperative bleeding regardless of prostate volume in TURP.
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One month therapy reduces the risk of intraoperative bleeding but i don't think that the outcome is clinically relevant
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Intrascrotal 
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Trauma, inflammation, or necrosis in the scrotal cavity may lead to depositing of organic material in hydrocele fluid with consecutive calcification if the fluid is oversaturated.The appearance of scrotal calculi in hydrocele does not change the treatment or prognosis of hydroceles. However, if the calculous material is attached to the visceral or parietal part of the tunica vaginalis and does not change position during sonography with different postures, tumor growth may be a problem. 
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This is an atrophic testis with glanular structures showing in slides.
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what about his testosterone level?
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Some authors made a cut off value of 8 mm
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And how about the need for post operative urethral dilatation?
Do you do that? and if yes, how frequent?
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 I did not find the exact time to start sunitinib after nephrectomy in the guidlines
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Though sunitinib affects wound healing, the range of time to start it after nephrectomy is 14-80 days. On the other hand you can do nephrectomy post target therapy after a time range of 7-21 days.
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44 y/o man in London, UK. Horrific RTA. #pelvis, bladder neck and proximal urethal injury + more in 2010 . Embolisation coils placed in ureter to stop urine leak at the time. They now need to be removed. Unsuccessful attempts in one London Hospital. He is doing the rounds of London Urology units but does not want anyone else to have an unsuccessful attempt and is looking for experience. He will travel anywhere in the world.
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Personally I will suggest Cesare Scoffone who lives and works in Turin (scoof@libero.it). Please also consider an open access or at least a possible conversion... it can be very easy or a nightmare!
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No nocturia , No DM or HTN, he had P.H of surgically removed stone bladder 4-5 years ago. His urinalysis showed mild UTI . U/S showed Multiple stones in the UB and enlarged prostate 40cc.. his flowmetry was 20ml/ sec with no residual urine ,cystoscopy showed larger left lobe of the prostate than the mildly enlarged right one?,what should be next step...
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I would recommend pressure/flow study to determine if he is obstructed even with high flow rate, specially if he has high residual urine. Ultimately he may need bladder outlet reduction procedure plus cystolithotripsy. My preference would be Prostate Photovaporization and Holmium laser lithotripsy.