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  • S. Karger AG  (2)
  • 1
    In: Urologia Internationalis, S. Karger AG, Vol. 82, No. 2 ( 2009), p. 187-190
    Abstract: 〈 i 〉 Aims: 〈 /i 〉 Treatment of varicocele in children is a debated problem for which no validated guidelines exist. Several techniques have been proposed to solve this problem. The aim of this study was to evaluate the effectiveness and applicability of a modified Marmar technique in the treatment of varicocele in children and adolescents. 〈 i 〉 Methods: 〈 /i 〉 From April 2004 to September 2005, we evaluated 25 patients between the ages of 9 and 18 (mean 14.4) years, who suffered from left-sided varicocele with concomitant testicular hypotrophy. The diagnosis was ascertained clinically and with scrotal color Doppler ultrasound using the Dubin and Amelar classification. In 2 cases phimosis was also present. The operation was performed according to a modified Marmar technique, using embolization of the pampiniform plexus with 2 ml of 3% polidocanol. Patients underwent clinical evaluation and scrotal color Doppler ultrasound at 1 week and 3 and 6 months. 〈 i 〉 Results: 〈 /i 〉 The mean duration of the operation was 42 min. At 1 week after surgery no persistence of varicocele was found. In 1 patient, edema of the spermatic cord occurred for about 2 months with spontaneous regression, in 1 patient homolateral hydrocele was observed. At 6 months no other complications were reported. No case of testicular atrophy was observed. 〈 i 〉 Conclusions: 〈 /i 〉 The technique described has already been validated in the adult population, and although we present only a small number of cases, the operation proved easy to perform, safe, of low cost and can be considered a valid alternative to the microsurgical technique in children and adolescents.
    Type of Medium: Online Resource
    ISSN: 0042-1138 , 1423-0399
    RVK:
    Language: English
    Publisher: S. Karger AG
    Publication Date: 2009
    detail.hit.zdb_id: 1464417-4
    Library Location Call Number Volume/Issue/Year Availability
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  • 2
    Online Resource
    Online Resource
    S. Karger AG ; 2009
    In:  Gynecologic and Obstetric Investigation Vol. 68, No. 2 ( 2009), p. 88-103
    In: Gynecologic and Obstetric Investigation, S. Karger AG, Vol. 68, No. 2 ( 2009), p. 88-103
    Abstract: 〈 i 〉 Background: 〈 /i 〉 Deep endometriosis is usually associated with severe symptoms and constitutes a complex treatment challenge. 〈 i 〉 Methods: 〈 /i 〉 The available evidence has been revisited with the aim of defining an effective diagnostic workup and a safe surgical strategy based on pathogenetic findings. 〈 i 〉 Results: 〈 /i 〉 Vaginal, rectal, and bladder detrusor endometriosis appear to be caused by intraperitoneal seeding of regurgitated endometrial cells which implant in the posterior and anterior cul-de-sac and trigger an inflammatory process leading to adhesion of contiguous organs. Excision of posterior deep lesions implies removal of a fibrotic cast of the Douglas’s pouch which may involve the posterior vaginal fornix and the rectal muscular layer, with a not negligible risk of major complications. Removal of full-thickness bladder detrusor endometriosis entails excision of the bladder dome or posterior wall, generally well above the trigone. Transurethral resection is contraindicated. A radical approach to obstructive uropathy is suggested, with resection of the stenotic ureteral tract and reimplantation with antireflux vesicoureteral plasty. 〈 i 〉 Conclusion: 〈 /i 〉 Infiltrating endometriotic lesions appear to originate intraperitoneally sharing common pathogenetic mechanisms. Involvement of the intestinal and urologic apparatuses should be identified before surgery, in order to schedule intraoperative consultation and to inform the woman about the type of intervention required and its potential sequelae.
    Type of Medium: Online Resource
    ISSN: 0378-7346 , 1423-002X
    RVK:
    Language: English
    Publisher: S. Karger AG
    Publication Date: 2009
    detail.hit.zdb_id: 1482695-1
    Library Location Call Number Volume/Issue/Year Availability
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