Relevant bibliographies by topics / Genitourinary organs – Surgery – Complications

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Academic literature on the topic 'Genitourinary organs – Surgery – Complications'

Author: Grafiati
Published: 4 June 2021
Last updated: 19 February 2022

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Journal articles on the topic "Genitourinary organs – Surgery – Complications"

1

Alieva, K. Kh, N. A. Kokhreidze, A. A. Sukhotskaya, V. G. Bairov, and A. Yu Skripnik. "Herlyn–Werner–Wunderlich syndrome in the prepubescent period (literature review and clinical observations)." Andrology and Genital Surgery 21, no. 4 (February 12, 2021): 60–67. http://dx.doi.org/10.17650/2070-9781-2020-21-4-60-67.

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Herlyn–Werner–Wunderlich syndrome (OHVIRA syndrome) is a combined malformation of the genitourinary systeme, characterized by various combinations of uterus dydelphys with unilateral obstructed (or blind) hemivagina and ipsilateral renal agenesis. The causes of mistakes in diagnosis and treatment are common because of relative rarity of anomaly, insufficient awareness of practitioners about the syndrome and the lack of multidisciplinary approach. Untimely and tactically chaotic diagnosis of Herlyn–Werner–Wunderlich syndrome leads to a misconception about the clinical situation, wrong choice in treatment, and, as a consequence, to complications such as strictures, widespread adhesions and inflammation, as well as irreversible changes in the topography of organs of the small pelvis with a subsequent deterioration in reproductive status of patient. This article provides a review of the literature on the problem, considers the clinical cases of diagnosing this defect in prepubertal patients.
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Tsyganov, S. V., R. R. Safazada, and A. S. Sobolev. "Minimally invasive treatment of iatrogenic ureter injury after gynecological surgery." Experimental and Сlinical Urology 13, no. 5 (December 25, 2020): 120–24. http://dx.doi.org/10.29188/2222-8543-2020-13-5-120-124.

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Introduction. Iatrogenic trauma of the ureters accounts for 1-5.7% of all injuries to the organs of the genitourinary system, it is this that presents the greatest difficulty for diagnosis and the greatest danger in terms of the rate and frequency of development of severe, life-threatening complications (phlegmon of the retroperitoneal space, urinary peritonitis, sepsis. Description of the clinical case. Patient A., 47 years old. On June 17, 2019, laparoscopic uterine extirpation was performed for fibroids. 06/22/2019, iatrogenic injury of the lower third of the left ureter was diagnosed. Percutaneous puncture nephrostomy on the left was performed as the first stage for urine diversion. At the second stage, ureteroscopy on the left was performed, in which a burn zone was determined in the lower third of the left ureter, up to 0.5 cm in length with a defect of 1/3 of the ureteral circumference. Left kidney stenting was performed. After 2 months, the ureteral stent was replaced. At control computed tomography (4 months after surgery), the left ureter was contrasted along the entire length, no urodynamic disturbances were revealed. Discussion. Open surgical interventions for iatrogenic trauma of the ureter are long and traumatic, require a long rehabilitation period, accompanied by social maladjustment of patients, therefore the use of X-ray endoscopic methods of treatment is an effective and alternative method of treating this pathology. Conclusion. In this case, timely detection of iatrogenic damage to the ureter made it possible to perform an effective minimally invasive surgical treatment, which saved the patient from possible severe complications.
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Sparic, Radmila, Rajka Argirovic, Snezana Buzadzic, and Milica Berisavac. "Paravesical haematoma following placement of an isolated anterior mesh for cystocele repair." Vojnosanitetski pregled 70, no. 7 (2013): 697–99. http://dx.doi.org/10.2298/vsp1307699s.

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Introduction. Pelvic organ prolapse is a substantial health problem for women around the world. Given the limitations of traditional surgery in the reconstruction of normal vaginal anatomy and function in genitourinary prolapse, various synthetic implants have been developed for surgical repair. Mesh procedures are gaining in popularity, encouraged by preliminary data. Although minimally invasive and relatively safe, serious complications following these procedures have been described. Case report. We presented a patient who had underwent an isolated anterior mesh procedure and developed postoperative haematoma which required surgical intervention. Conclusion. This report suggests that minimally invasive urogynecological procedures could result in significant complications. Thus, surgeons should be familiar with effective interventions in order to manage them.
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Sood, Akshay, Hanhan Li, Jesse Sammon, Florian Roghmann, Michael Ehlert, Maxine Sun, Mani Menon, Humphrey Atiemo, and Quoc-Dien Trinh. "Utilization and perioperative outcomes of robotic vaginal vault suspension compared to abdominal or vaginal approaches for pelvic organ prolapse." Canadian Urological Association Journal 8, no. 3-4 (April 14, 2014): 100. http://dx.doi.org/10.5489/cuaj.1858.

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Objectives: Robot-assisted vaginal vault suspension (RAVVS) for pelvic organ prolapse (POP) represents a minimally-invasive alternative to abdominal sacrocolpopexy. We measured perioperative outcomes and utilization rates of RAVVS.Methods: RAVVS (n = 2381) and open VVS (OVVS, n = 11080) data were extracted from the 2009-2010 Nationwide Inpatient Sample. Propensity score-matched analysis compared patients undergoing RAVVS or OVVS for complications, mortality, prolonged length-of-stay, and elevated hospital charges.Results: Use of RAVVS for POP increased from 2009 to 2010 (16.3% to 19.2%). Patients undergoing RAVVS were more likely to be white (77.2% vs. 69.6%), to carry private insurance (52.8% vs. 46.0%) and to have fewer comorbidities (Charlson Comorbidity Index [CCI] ≥1 = 17.5% vs. 26.6%). They were more likely to undergo surgery at urban (98.2% vs. 93.7%) and academic centres (75.7% vs. 56.7%). Patients undergoing RAVVS were less likely to receive a blood-transfusion (0.7% vs. 1.8%, p < 0.001) or experience prolonged length-of-stay (9.3% vs. 25.1%, p < 0.001). They had more intraoperative complications (6.0% vs. 4.2%, p < 0.001), and higher median hospital charges ($32 402 vs. $24 136, p < 0.001). Overall postoperative complications were equivalent (17.9%, p = 1.0), though there were differences in wound (0.4% vs. 1.3%, p < 0.001), genitourinary (4.9% vs. 6.5%, p = 0.009), and surgical (6.6% vs. 4.9%, p = 0.007) complications.Conclusions: The increasing use of RAVVS from 2009 to 2010 suggests a growth in the adoption of robotics to manage POP. We show that RAVVS is associated with decreased length of stay, fewer blood transfusions, as well as lower postoperative wound, genitourinary and vascular complications. The benefits of RAVVS are mitigated by higher hospital charges and higher rates of intraoperative complications.
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Enikeev, Mikhail Elikovich, Dmitry Victorovich Enikeev, Dmitry Olegovich Korolev, Olesya Vyacheslavovna Snurnitsyna, Mikhail Vladimirovich Lobanov, Aleksandr Nikolaevich Nikitin, Leonid Mikhailovich Rapoport, and Petr Vitalievich Glybochko. "Repair of cystocele and apical genital prolapse using 6-strap mesh implant." Urologia Journal 87, no. 3 (December 16, 2019): 130–36. http://dx.doi.org/10.1177/0391560319890999.

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Objective: To assess the outcomes of surgical repair of anterior apical prolapse using the 6-strap mesh implant. Study Design: The prospective study included 100 patients with genitourinary prolapse. We used advanced 6-strap mesh implant. The results were assessed at 1 (n = 100) and 12 (n = 93) months after surgery. Maximum follow-up was over 4 years. The anatomical outcomes according to the Pelvic Organ Prolapse Quantification system and intraoperative and postoperative complications were assessed. Stage II and higher prolapse was considered to be a recurrence. The quality of life and sexual function were assessed using Pelvic Organ Prolapse Distress Inventory 20, Pelvic Floor Impact Questionnaire 7, and Pelvic Organ Prolapse/Incontinence Sexual Questionnaire 12. Results: Median age was 57 years (34–78 years (95% confidence interval)). All patients had stage III cystocele. The anterior vaginal wall descent in all the patients was associated with uterine descent: 37 (37%), stage II; 60 (60%), stage III; in 3 (3%), stage IV. In eight cases, postoperative de novo stress urinary incontinence developed. The quality of life improved in 93 (93%) women as judged by the Pelvic Floor Distress Inventory 20 data and in 87 (87%) women, according to the Pelvic Floor Impact Questionnaire 7 data. The desirable anatomical result (⩽stage I according to the Pelvic Organ Prolapse Quantification system) was achieved in 97 (97%) patients. With the exception of mesh fragment excision due to erosion (grade 3a), all the complications were classified as grade I according to the Clavien–Dindo classification. Conclusion: Genitourinary prolapse repair using 6-strap mesh is efficacious and relatively safe. The method demonstrates good anatomical results in relation to both anterior and apical prolapses with relatively short-term complications.
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6

Morgoshiia, T. Sh. "IN THE ORIGINS OF FORMATION OF DOMESTIC UROLOGY." Herald Urology 6, no. 2 (July 15, 2018): 69–75. http://dx.doi.org/10.21886/2308-6424-2018-6-2-69-75.

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The article notes that the problems of urology of the first half of the XX century were worked out by joint efforts of surgeons and urologists who distinguished their discipline as a narrow specialty from clinical surgery. Domestic medicine, improving and developing narrow specialties in those years, created the best conditions for improving the skills of the relevant specialists, but at the same time considered it necessary to proceed from the principle that a sharp delimitation of diseases and treatment by organs can not always serve the benefit of science and the patient. Special mention should be made of special methods of research – cystoscopy, catheterization of the ureters, pyelography, etc. – have become generally accepted for urologists and surgeons. Domestic urologists developed methods of operative access to the kidney, methods of intracapsular removal of it, methods of plastic restoration of the urino-genital organs. The author analyzes significant achievements in the treatment of congenital malformations of the genitourinary system in children, especially in the transplantation of ureters into the gut with ectopia of the bladder. When injuring the pelvic bones, rational surgical treatment of the wound at the first stages of evacuation, taking into account the anatomical features of the cellular spaces of the pelvis and the functions of the pelvic organs, was the main method of preventing subsequent complications. It is shown that in those years one of the important sections of the work of the urological departments of surgical hospitals was the treatment of gunshot injuries of the urethra. To treat these injuries, we used all sorts of developed ones before the Second World War. Domestic surgery in the first half of the XX century conducted an in-depth study of the main issues of theoretical and practical surgeons and urology. Surgical disciplines, including urology, began to approach the study of pathogenesis and the entire picture of the disease, guided by the teachings of Academician I.P. Pavlov on the role and significance of the central nervous system in the life of a living organism.Disclosure: The study did not have sponsorship. The author declares no conflict of interest.
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Rusina, Yelena Ivanovna. "The role of complex preoperative urodynamic testing of continent women when planning surgery for pelvic organ prolapse." Journal of obstetrics and women's diseases 63, no. 1 (December 15, 2014): 17–25. http://dx.doi.org/10.17816/jowd63117-25.

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Women with significant genitourinary prolapse may be continent in spite of a weak urethral sphincter because of kinking of the poorly supported urethra. After the surgery for prolapse 19-30 % of the patients identify “occult” urinary incontinence due to a weak urethral sphincter. The aim of this study is to evaluate the role of complex urodynamic testing to identify “occult” urinary incontinence, neuromuscular dysfunction of the bladder and urethra for adequate combined therapy. Methods: 257 female patients with no urinary incontinence at the age of 30-86 years old were examined, before the surgery the pelvic organ prolapse of II-IV stages was reduced by Simps vaginal speculum: 102 women were clinically tested, and 155 women were complexly (clinically and urodynamically) evaluated. In addition to clinical examination urodynamic testing was made. Complex examination was repeated to all of them after 1-3 and 12-36 months after the operation. Results: Decrease of values of abdominal pressure transmission (APT) of less than 100 % was found significantly more often (38 ± 3.9 %) compared to a positive cough test while clinical exami-nation(19.4 ± 3.2 %) P < 0.001. Preoperatively detrusor overactivity was diagnosed in 12.5 ± 3.5 % and 11.8 ± 4.2 % cases, urethral instability - in 3.1 ± 1.7 % and 5.1 ± 2.8 % cases, detrusor sphincter dyssynergy - in 3.1 ± 1.7 % and 1.7 ± 1.6 % cases, detrusor hypotonia in 9.4 ± 3.0 % and 13.5 ± 4.4 % cases of patients with APT of more than 100 % and less than 100 % respectively. Patients with detrusor overactivity, urethral instability, detrusor hypotonya got medical preoperation treatment during 3 months and longer. 6 patients with detrusor-sphincter dyssynergy, detrusor hypotension were contraindicated for sling operation. Patients who had clinically and urodynamically confirmed urinary incontinence underwent simultaneous sling operations (13 women in a clinical group and 51 - in a complex group). In 12-36 months after the surgery no patient with APT of more than 100 % showed urinary incontinence. Clinically examined patients revealed totally 7 out of 102 (7.14 ± 2.5 %) complications after 12-36 months after surgery (mixed urinary incontinence in 4 cases and difunctional urination due to hypotonia detuzor in 3 cases). There are no these complications in the group of complexly examined women. Conclusions: Urodynamic testing can identify those women at risk of developing postoperative urinary incontinence and difunctional urination so that prophylactic measures can be undertaken. In cases when neuromuscular dysfunction is corrected and values of APT are less than 100 % simultaneous sling operation is reasonable.
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Goldberg, Ilana, Steven Lee Chang, Shilajit Kundu, and Eric A. Singer. "Impact of inflammatory bowel disease on urologic oncology surgical outcomes and costs of care." Journal of Clinical Oncology 38, no. 6_suppl (February 20, 2020): 470. http://dx.doi.org/10.1200/jco.2020.38.6_suppl.470.

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470 Background: Recent studies suggest an association between genitourinary malignancies and inflammatory bowel disease (IBD). Our objective was to investigate clinical and financial impacts of IBD on common major urologic cancer surgeries: radical prostatectomy (RP), radical cystectomy (RC), radical nephrectomy (RN), and partial nephrectomy (PN). Methods: Using ICD9 codes, the Premier Hospital Database was queried for patients who underwent one of four surgeries: RP, RC, RN, or PN from 2003 to 2015. The cohort was segregated into IBD patients and non-IBD patients. Multivariable logistic regression models were used to determine the independent impact of IBD on complication rates (by Clavien-Dindo classification and organ system) and readmission rates. Hospital cost differences between the two cohorts, adjusted to 2016 US dollars, were examined with multivariable quantile regression models. Results: Our study population included 220,192 patients with urological malignancies, 5165 (0.4%) of whom had IBD. After controlling for clinicodemographic variables, there were significantly higher odds for any complication (Clavien ≥1) for IBD patients compared to non-IBD controls for RC (Odds ratio [OR]: 3.04, 95% confidence interval [CI]: 1.25-7.43), RN (OR: 1.57, 95% CI: 1.1-2.23), and PN (OR: 1.5, 95% CI: 1.02-2.22). Specifically, IBD patients had significantly more gastrointestinal, infectious, and soft tissue complications. Readmission rates were significantly higher for IBD patients who underwent RC (OR: 2.50, 95% CI: 1.17-5.35) and PN (OR: 1.81, 95% CI: 1.17-2.80). Hospital costs were significantly elevated for IBD patients, ranging from +$893 (95% CI: 108-1677) to +$6261 (95% CI: 1861-10660). Conclusions: There was a significantly higher overall complication rate for IBD patients undergoing RC, RN, or PN compared to the non-IBD cohort. Hospital readmission rates were significantly higher for the IBD cohort who underwent RC and PN. Hospital costs associated with surgery were also increased for IBD patients. These findings may be important when counseling IBD patients about surgical outcomes and during development of enhanced recovery pathways or bundled payment programs.
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Gong, Guoqing, and K. C. Wong. "Complications of genitourinary and gynecological surgery." Seminars in Anesthesia, Perioperative Medicine and Pain 15, no. 3 (September 1996): 212–23. http://dx.doi.org/10.1016/s0277-0326(96)80012-2.

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Peshekhonov, Kirill S., Eugene S. Shpilenia, B. K. Komyakov, Oleg O. Burlaka, and Natalia V. Morozova. "Comparative evaluation of clinical efficacy, safety, and economic expenses of two endoscopic techniques for treating prostatic hyperplasia in elderly patients." HERALD of North-Western State Medical University named after I.I. Mechnikov 12, no. 3 (December 20, 2020): 41–54. http://dx.doi.org/10.17816/mechnikov34052.

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Introduction. Rapidly developing highly specialized medical care and the emergence of new medical technologies determine the trend in surgical, minimally invasive treatment of patients with lower urinary tract symptoms due to prostatic hyperplasia. Drug therapy in elderly patients with somatic diseases poses a problem of poor compliance due to pronounced side effects caused by a drug. In this group of patients, surgical treatment of prostate hyperplasia is the most preferred solution. A doctors task is to choose the optimal method of surgery which will not only provide a long-term clinical effect, but also will minimize the economic costs of both surgical intervention and the postoperative period. The emergence of various types of energies for enucleating the prostate gland in urological practice has become an attractive alternative to transurethral resection of the prostate (TURP). However, when choosing surgical endoscopic intervention, it is important to consider the economic factor, which is considered to be a crucial problem in the medical care in Russia. Modern treatment options can not only prevent serious complications, and additional surgical interventions, but also improve the quality of patients lives. However, the introduction of new technologies is impossible without taking into account data on their cost-effectiveness. Purpose. To compare the results and evaluate cost-effectiveness of two types of BPH endoscopic surgical treatment (bTURP, HOLEP) in elderly patients (60 years old). Materials and methods. The study includes patients who underwent two different methods of endoscopic treatment of HPV (bTURP, HOLEP) from October 2017 to September 2018. The inclusion criteria were the presence of moderate or severe obstructive symptoms of the lower urinary tract, prostate volume 40 cm3, maximum urine flow 15 ml/sec. The exclusion criteria were the presence of cystostomy drainage, oncological process of the urinary system, active inflammatory process of the genitourinary system, previous surgical interventions on the organs of the urinary system, and symptoms of an overactive bladder. In each group of the patients the following indicators were evaluated the international system for the total assessment of prostate diseases (IPSS and QoL), the international index of erectile function, the dynamics of postoperative changes in prostate-specific antigen, the maximum urine flow, the residual volume, safety of the operation, intraoperative and postoperative economic expenses as well as socio-economic consequences. Cost-effectiveness analysis was carried out by calculating the indicators cost-effectiveness, cost-utility, net monetary benefit. 20-year prediction of the results was carried out by building the Markov chain model. Results. 150 patients operated within a year were examined. HOLEP has showed its clinical efficacy before bTURP in terms of the duration of surgery, the volume of tissue removed, the time of postoperative catheterization and the length of hospital stay which was significantly lower in the HOLEP group. However, the economic expenses associated with HOLEP were also higher compared to the bTURP group. Conclusions. Holmium laser enucleation is the preferred method for surgical treatment of prostatic hyperplasia in the prostate of more than 40 cm3, from the point of view of surgical safety, effectiveness, and also the length of the patients recovery period in elderly patients. Moreover, laser operations are considered to be economically reasonable in comorbid patients associated with a minimal risk of complications.
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Dissertations / Theses on the topic "Genitourinary organs – Surgery – Complications"

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Lord, Helen Elizabeth. "A randomised controlled equivalence trial comparing tension-free vaginal tape (TVT) with suprapubic urethral support sling (SPARC)." University of Western Australia. Faculty of Medicine and Dentistry and Health Sciences, 2008. http://theses.library.uwa.edu.au/adt-WU2008.0086.

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[Truncated abstract] Approximately 35% of women worldwide have stress incontinence, which is defined as involuntary leakage of urine on effort, exertion, or on sneezing and coughing. There are various surgical techniques for stress incontinence; however, minimally invasive operations are increasingly being chosen by surgeons and their patients. Of these procedures, tension-free vaginal tape (TVT) has a cure rate of approximately 90% and is now perceived as the standard technique for stress incontinence. Reported complications of TVT include arterial laceration, bladder perforation, bowel perforation, de novo urgency, dyspareunia, excessive blood loss, haematoma, nerve injuries, urethral erosion, urge incontinence, urinary tract infection, vascular injury, vaginal mesh erosion, voiding dysfunction and death. Suprapubic urethral support sling (SPARC) is a very similar minimally invasive operation and early indications suggested that the success rate for treating stress incontinence was expected to be identical or better than those obtained with the earlier TVT approach, with possibly fewer adverse perioperative events. Our trial sought to establish equivalence between TVT and SPARC in relation to short-term complications and efficacy. OBJECTIVES The primary outcome was bladder perforation. Secondary outcomes were blood loss, voiding difficulty, urgency, and cure of stress incontinence symptoms. METHOD A randomised controlled one-sided equivalence trial (RCT) was conducted in Perth, Western Australia during 2003 and 2004 by researchers in the School of Population Health, University of Western Australia (UWA) and King Edward Memorial Hospital (KEMH). Patients were recruited from the public Urology/Urogynaecology Clinic at the primary women's hospital and the consultant surgeons' private practices. ... However, acute urinary retention requiring a return to theatre to loosen the tape (TVT 0%, SPARC 6.5%; OR: [infinity], 95% CL: 2.2, [infinity]; p=0.002) and subjective short-term cure (TVT 87.1%, SPARC 76.5%; OR: 2.07, 95% CL: 1.13, 3.81; p=0.03) were statistically significantly different. CONCLUSIONS The results are consistent with clinical equivalence between TVT and SPARC in relation to the incidence of bladder perforation. No statistically significant difference was found between TVT and SPARC in blood loss, urgency or short-term objective cure of stress incontinence at the six week post-discharge visit to the surgeon. However, the tapes were more difficult to adjust correctly in SPARC procedures and a statistically significant number of patients required a return to theatre for loosening of the tape (TVT 0/147, 0% and SPARC 10/154, 6.5%, p=0.002). Compared with SPARC, TVT was statistically significantly higher for subjective short-term cure. In ii relation to vaginal mesh erosion, TVT was lower than SPARC, though not statistically significantly. Overall, voiding difficulty (loosening of the tape), urgency and vaginal mesh erosion were the most important clinical problems. This randomised controlled trial demonstrates the importance of testing new devices which appear to be similar, but which may have clinically relevant differences. A follow up study to assess the long-term efficacy of tension-free vaginal tape and suprapubic urethral support sling and associated complications is planned.
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"The use of levobupivacaine and ropivacaine in spinal anaesthesia for lower limb and urological surgery." Thesis, 2011. http://library.cuhk.edu.hk/record=b6075198.

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I found that 2.6ml of 0.5% levobupivacaine had similar clinical characteristics as the same volume of 0.5% bupivacaine in spinal anaesthesia. Both were effective for spinal anaesthesia in urological surgery, when a sensory block up to at least T10 dermatome was required. In comparing the use of levobupivacaine alone and levobupivacaine with fentanyl, there were no significant differences in haemodynamic changes and quality of sensory and motor block, when 2.6ml of levobupivacaine alone or 2.3ml of levobupivacaine with fentanyl 15mcg (0.3ml) were used in spinal anaesthesia. Both were effective for spinal anaesthesia in urological surgery. In comparing the use of ropivacaine 10mg and bupivacaine 10mg, both with fentanyl 15mcg in spinal anaesthesia for urological surgery, all the patients achieved adequate level of sensory block up to T10 dermatome or higher. The two drugs were similar in the onset time of motor block, the characteristics of sensory block and haemodynamic changes; however, the duration of motor block was shorter with ropivacaine. I concluded that both studied solutions, ropivacaine-fentanyl and bupivacaine-fentanyl, were effective for spinal anaesthesia in urological surgery and the duration of motor block was shorter with the ropivacaine-fentanyl solution. The dose-response relationship of ropivacaine in spinal anaesthesia for lower limb surgery requiring a sensory block up to at least the T12 dermatome was defined. Anaesthesia was successful in 0, 0, 42, 83 and 100% when ropivacaine at doses of 2, 4, 7, 10 and 14mg respectively were given. The derived values for ED50 and ED95 were 7.6mg and 11.4mg respectively. The cephalic level of sensory block and the degree of motor block increased with larger doses of ropivacaine. Finally, the median effective dose (ED50) of bupivacaine, levobupivacaine and ropivacaine in spinal anaesthesia for lower limb surgery were defined as 5.50mg (95% CI: 4.90--6.10mg), 5.68mg (95% CI: 4.92--6.44mg), and 8.41mg (95% CI: 7.15--9.67mg) respectively. The relative potency ratios were 0.97 (95% CI: 0.81--1.17) for levobupivacaine/bupivacaine, 0.65 (95% CI: 0.54--0.80) for ropivacaine/bupivacaine and 0.68 (95% CI: 0.55--0.84) for ropivacainellevobupivacaine.
In this series of studies, I have shown that levobupivacaine and ropivacaine are effective local anaesthetic agents for spinal anaesthesia in lower limb and urological surgery. This proved my hypothesis. Both are suitable alternatives to bupivacaine for spinal anaesthesia. Furthermore, these studies showed that ropivacaine is less potent than levobupivacaine and bupivacaine and the potency is similar between levobupivacaine and bupivacaine at median effective dose.
Levobupivacaine and ropivacaine are two relatively new local anaesthetics which were developed in view of their potential for less cardiotoxicity in comparison with bupivacaine, the most common local anaesthetic used in spinal anaesthesia for many years. Both are produced in pure S(-) enantiomer form in contrast to bupivacaine which is a racemic mixture. They have been shown to be effective in peripheral nerve blocks, and epidural analgesia and anaesthesia; nevertheless, experience of their use in spinal anaesthesia is limited. The objective of this thesis was to evaluate their use in spinal anaesthesia for surgery in non-obstetric patients. My hypothesis was that levobupivacaine and ropivacaine are effective local anaesthetic agents for spinal anaesthesia in lower limb and urological surgery. In order to test this hypothesis, I conducted five clinical studies on 269 patients who had urological surgery or lower limb surgery under spinal or combined spinal-epidural anaesthesia. First, I investigated the efficacy and clinical characteristics of levobupivacaine and the mixture of levobupivacaine with fentanyl in spinal anaesthesia. Next, I compared the use of ropivacaine-fentanyl with bupivacaine-fentanyl in spinal anaesthesia. Finally, I defined the dose-response relationship of ropivacaine in spinal anaesthesia using traditional dose-response methodology and defined the relative potency among levobupivacaine, ropivacaine and bupivacaine by comparing the defined ED50 in spinal anaesthesia using up-down sequential allocation method.
Lee, Ying Yin.
Source: Dissertation Abstracts International, Volume: 73-06, Section: B, page: .
Thesis (M.D.)--Chinese University of Hong Kong, 2011.
Includes bibliographical references (leaves 133-150).
Electronic reproduction. Hong Kong : Chinese University of Hong Kong, [2012] System requirements: Adobe Acrobat Reader. Available via World Wide Web.
Electronic reproduction. [Ann Arbor, MI] : ProQuest Information and Learning, [201-] System requirements: Adobe Acrobat Reader. Available via World Wide Web.
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Books on the topic "Genitourinary organs – Surgery – Complications"

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Gill, Inderbir S., and Ahmed M. Al-Kandari. Difficult conditions in laparoscopic urologic surgery. London: Springer, 2010.

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Complications of laparoscopic and robotic urologic surgery. New York: Springer, 2010.

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R, Newton Edward, ed. Complications of gynecologic and obstetric management. Philadelphia: Saunders, 1988.

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Mani, Menon, and SpringerLink (Online service), eds. Robotics in Genitourinary Surgery. London: Springer-Verlag London Limited, 2011.

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Manual of urologic surgery. Boston: Little, Brown and Co., 1990.

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C, Stempen Paul, ed. Atlas of urologic surgery. Philadelphia: Saunders, 1989.

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Atlas of urologic surgery. 2nd ed. Philadelphia: W.B. Saunders, 1998.

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Clayman, Ralph V. Laparoscopy. Bellaire, Tex. (6750 W. Loop Sout, #900, Bellaire 77401): American Urological Association, 1993.

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Atlas of robotic urologic surgery. New York: Humana Press, 2011.

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P, Hedican Sean, ed. Essential urologic laparoscopy: The complete clinical guide. 2nd ed. New York: Humana Press, 2010.

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Book chapters on the topic "Genitourinary organs – Surgery – Complications"

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Siddiqui, Sameer, Akshay Bhandari, and Mani Menon. "Complications of Robotic Prostatectomy." In Robotics in Genitourinary Surgery, 377–90. London: Springer London, 2011. http://dx.doi.org/10.1007/978-1-84882-114-9_33.

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Terry, Russell S., Mohit Gupta, and Li-Ming Su. "Complications of Robot-Assisted Radical Prostatectomy." In Robotics in Genitourinary Surgery, 493–505. Cham: Springer International Publishing, 2018. http://dx.doi.org/10.1007/978-3-319-20645-5_36.

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Lai, Weil R., and Benjamin R. Lee. "Complications in Robot-Assisted Partial Nephrectomy." In Robotics in Genitourinary Surgery, 615–23. Cham: Springer International Publishing, 2018. http://dx.doi.org/10.1007/978-3-319-20645-5_45.

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Crestani, Alessandro, Marta Rossanese, Valeria Lami, Francesco Esperto, Gianluca Giannarini, and Vincenzo Ficarra. "Outcomes and Complications of Robotic Kidney Surgery." In Robotics in Genitourinary Surgery, 677–84. Cham: Springer International Publishing, 2018. http://dx.doi.org/10.1007/978-3-319-20645-5_49.

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Castle, Erik P., Rafael Nuñez-Nateras, Michael E. Woods, and Paul E. Andrews. "Robotic Bladder Surgery Complications: Prevention and Management." In Robotics in Genitourinary Surgery, 553–67. London: Springer London, 2011. http://dx.doi.org/10.1007/978-1-84882-114-9_49.

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Linehan, Jennifer A., Michael Tyler, and Timothy G. Wilson. "Robotic Radical Cystectomy and Urinary Diversions: Complications and Outcomes." In Robotics in Genitourinary Surgery, 779–90. Cham: Springer International Publishing, 2018. http://dx.doi.org/10.1007/978-3-319-20645-5_57.

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Gadre, Kiran S., Balasubramanya Kumar, and Divya P. Gadre. "Panfacial Fractures." In Oral and Maxillofacial Surgery for the Clinician, 1283–302. Singapore: Springer Singapore, 2021. http://dx.doi.org/10.1007/978-981-15-1346-6_60.

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AbstractMost panfacial fractures occur with concomitant injuries to other organs. Management of panfacial fractures is challenging and requires proper planning and sequencing along with adequate knowledge of its anatomy and management.. Airway, breathing, circulation, disability and exposure (ABCDE) always remain the primary care in any trauma setting. Maxillofacial surgeons play a key role in initial stabilisation of fractures, control of local hemorrharage to facial areas and estlabishment of definitive airway in special situations. Definitive treatment is usually done after stabilisation of the patient and systematic evaluation of all systemic injuries. Panfacial fractures demand a lot more planning towards their management. The understanding of same is described in this chapter, in a methododical manner starting from the philosophy, indications, clinical findings to its management in adults and children including the commonly seen complications. This should give the reader adequate knowledge to learn from the authors experiences and comprehensively be able to manage these injuries after having achieved a level of experience and excellence in maxillofacial surgery.
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Renton, Tara. "Trigeminal Nerve Injuries." In Oral and Maxillofacial Surgery for the Clinician, 515–29. Singapore: Springer Singapore, 2021. http://dx.doi.org/10.1007/978-981-15-1346-6_25.

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AbstractThe trigeminal nerve constitutes the largest sensory cortex representation in the brain compared to any other sensory nerve. This is likely due to the fact that the trigeminal nerve underpins our very existence, as it protects, sensorially, our senses including the organs that provide sight, smell, taste, hearing, speech and meninges protecting our brain.Neurophysiologically, our affective and limbic systems in our brains are alerted before we even set foot in the dental surgery and the patient’s brain is anticipating and aligned for pain experience. Thus, when trigeminal nerve injuries occur, which in the main are preventable, the majority of patients experience mixed symptoms including ongoing and elicited neuropathic pain, numbness and altered sensation. These neuropathic features cause significant impact on the patients’ ability to function, for example, cold allodynia prevents the patient enjoying cold foods and drinks and undertaking outdoor activities or elicited pain on touch frequently interferes with sleep. The resultant chronic symptoms and functional impedance often result in significant psychological morbidity.There is no magic bullet to resolve these sensory nerve injuries, and our specialty is beholden to prevent nerve injuries where possible. The patient must have the appropriate consent, and their expectation is managed with understanding the potential benefits and risks for their chosen interventions.Prevention and management of nerve injuries related to local anaesthesia, implants and third molar surgery are outlined in this chapter. There is insufficient capacity to go in-depth for each area, but the author has provided up to date evidence base where it exists and some strategies to minimize and manage optimally these unfortunate complications.
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"Genitourinary Surgery." In Management of Laparoscopic Surgical Complications, 231–50. CRC Press, 2004. http://dx.doi.org/10.3109/9780203026205-15.

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"Genitourinary." In Complications in Surgery and Trauma, Second Edition, 469–70. CRC Press, 2013. http://dx.doi.org/10.1201/b16377-53.

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Conference papers on the topic "Genitourinary organs – Surgery – Complications"

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Barone, William R., Rouzbeh Amini, Spandan Maiti, Pamela Moalli, and Steven Abramowitch. "The Impact of Boundary Conditions on Surface Curvature Measurements of Polypropylene Mesh in Response to Uniaxial Loading." In ASME 2013 Summer Bioengineering Conference. American Society of Mechanical Engineers, 2013. http://dx.doi.org/10.1115/sbc2013-14598.

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Pelvic organ prolapse (POP) is defined as the descent of the pelvic organs into the vaginal canal. POP is a widespread condition among women, with a 7% lifetime risk for a single operation1. For surgical treatment, polypropylene mesh is often implanted to restore support to the pelvic organs. However, up to 20% of those who undergo surgery with mesh will require repeat operations for recurrent symptoms or complications2. One of the most common complications is mesh erosion3. Erosion is characterized by degeneration of the native vaginal tissue in contact with the mesh, resulting in the mesh migrating through the vagina. Though the cause of mesh erosion is undefined, surgeons have described this complication by the appearance of mesh “contraction”, “buckling”, “wrinkling”, and/or “bunching”. Some have even described this as an “accordion effect”.
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Feola, Andrew, Pamela Moalli, Suzan Stein, and Steven Abramowitch. "Comparison of the Tissue Response to 3 Distinct Polypropylene Prolapse Meshes in a Primate vs Rodent Model." In ASME 2012 Summer Bioengineering Conference. American Society of Mechanical Engineers, 2012. http://dx.doi.org/10.1115/sbc2012-80226.

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Each year, an estimated 225,000–280,000 women undergo surgery for repair of pelvic floor disorders in the United States, with many involving placement of a synthetic polypropylene (PP) mesh designed to restore direct support to the vagina and hence indirect support to the pelvic organs (1). In spite of high anatomical success rates, the use of synthetic meshes has been hampered by mesh related complications causing significant patient morbidity (2) and prompting two recent FDA warnings against the use of mesh (3). Thus, as the concern about the use of mesh increases, there is an urgent need to define the impact of mesh on host tissue and to understand how different material properties of the mesh may direct the host response.
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Feola, Andrew J., William R. Barone, Jon Shepherd, Pam Moalli, and Steven Abramowitch. "Characterizing the Ex-Vivo Properties of Prolapse Meshes." In ASME 2011 Summer Bioengineering Conference. American Society of Mechanical Engineers, 2011. http://dx.doi.org/10.1115/sbc2011-53841.

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Pelvic organ prolapse is a common condition that affects roughly 30–40% of women in their lifetime (1). Although not all women become symptomatic, 225,000 to 280,000 require surgery for prolapse each year (1). Prolapse occurs when the vagina can no longer support the pelvic organs. Thus, many urogynecological procedures use synthetic meshes to restore the supportive capacity of the vagina. However, a significant underreported proportion of women undergoing mesh procedures require a procedure to remove surgically placed mesh due to pain, exposure, erosion, and dyspareunia (2). It is suspected that these complications are related to mesh structural properties. However, since there are a wide variety of mesh products in use with little known about their properties before and after implantation, identifying the role of mesh in surgical failure has been difficult.
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Jallah, Zegbeh C., Pamela Moalli, Andrew Feola, William Barone, Stacy Palcsey, Naoki Yoshimura, and Steven D. Abramowitch. "The Impact of Mesh Implantation on Vaginal Smooth Muscle Innervation and Contraction." In ASME 2013 Summer Bioengineering Conference. American Society of Mechanical Engineers, 2013. http://dx.doi.org/10.1115/sbc2013-14008.

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Pelvic organ prolapse (POP) is a multifactorial disorder characterized by the descent of the pelvic organs into the vaginal canal. This disorder is associated with decreased quality of life, and even depression, yet 50% of women over the age of fifty are living with POP. The cost associated with the repair of POP exceeds one billion dollars annually, in the United States alone. This rather exorbitant figure includes the cost of surgery performed for symptom management, but does not include strategies which address the underlying cause of the disorder for which there are none. Because failure rates of native tissue repairs are as high as 30%, vaginal mesh is increasingly used in the surgical repair of POP. The procedure aims to reinforce the fibromuscular layer of the vagina and the paravaginal attachments, thus providing structural integrity to the weakened native tissues. However, the use of mesh is limited by mesh-related complications including exposure, erosion, pain contraction and infection.
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Pellet, Mathieu, Pierre Melchior, Youssef Abdelmoumen, and Alain Oustaloup. "Fractional Thermal Model of the Lungs Using Havriliak-Negami Function." In ASME 2011 International Design Engineering Technical Conferences and Computers and Information in Engineering Conference. ASMEDC, 2011. http://dx.doi.org/10.1115/detc2011-48095.

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This paper is about fractional system identification of a thermal model of the lungs. Usually, during open-heart surgery, an extracorporeal circulation (ECC) is carried out on the patient. In order to plug the artificial heart/lung machine on the blood stream, the lungs are disconnected from the circulatory system. This may results in postoperative respiratory complications. A method to protect the lungs has been developed by surgeon and anesthetist. It is called: bronchial hypothermia. The aim is to cool the organ in order to slow down its deterioration. Unfortunately the thermal properties of the lungs are not well-known yet. Mathematical models are useful and needed in order to improve the knowledge of these organs. As proved by several previous works, fractional models are especially appropriate to model thermal systems (model compacity, accuracy) and the dynamic of fractal systems. Thus, fractional models of the lungs have been determined using time domain system identification with the Havriliak-Negami function. A comparison with integer order models was also carried out. The aim of this paper is to present the results of this study.
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