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1.
Scand J Urol ; 52(5-6): 453-458, 2018.
Artículo en Inglés | MEDLINE | ID: mdl-30451054

RESUMEN

BACKGROUND: In contrast to treatment with oral or intramuscular analgesics, extracorporeal shock wave lithotripsy (E.S.W.L.) can be performed with patients under sedation too. Besides the advantage of increased shock energy, patients tend to have more constant breathing excursions and are more idle during treatment, potentially increasing the stone-free ratio (S.F.R.) after treatment. METHODS: This study presents the results of 310 patients who underwent 400 E.S.W.L. procedures under sedation, with a stationary lithotripter. RESULTS: After one procedure, the S.F.R. was 54.8% (170/310). A second treatment was successful in 42.1% (32/76), a third treatment in 21.4% (3/14). Therefore, 66.1% (205/310) of patients eventually became stone-free. Kidney stones were successfully treated in 65.4% (161/246), ureteral stones in 68.8% (44/64) of cases. Patients with stones ≤15 mm were successfully treated in 67.4% (194/288), patients with stones >15 mm in 50% (11/22) of cases. Considering each procedure individually, 45.3% (181/400) of procedures were successful after 3 weeks. Extending follow-up to 3 months is important, since 26.7% of stones (24/90) eventually still disappeared, increasing S.F.R. to 51.3% after one procedure. Complications occurred after 5.5% E.S.W.L.-procedures. CONCLUSIONS: E.S.W.L. is a well-tolerated, non-invasive procedure that produces reasonable stone clearance of both upper and lower urinary tract calculi. Performing the procedure whilst patients are intravenously sedated results in an acceptable S.F.R. Strong selection based on unfavourable factors could increase the chance on successful treatment and spare patients a pointless procedure. However, considering E.S.W.L.'s elegant nature, sometimes a more tolerant approach seems justifiable.


Asunto(s)
Sedación Profunda/métodos , Cálculos Renales/terapia , Litotricia/métodos , Cálculos Ureterales/terapia , Adulto , Anciano , Analgésicos Opioides/uso terapéutico , Anestésicos Intravenosos/uso terapéutico , Femenino , Humanos , Masculino , Persona de Mediana Edad , Propofol/uso terapéutico , Remifentanilo/uso terapéutico , Estudios Retrospectivos , Resultado del Tratamiento , Urolitiasis/terapia
2.
BJU Int ; 89(9): 901-4, 2002 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-12010236

RESUMEN

OBJECTIVE: To compare the acceptance of and satisfaction with intracavernosal injection (ICI) therapy with and without sexological counselling in men with erectile dysfunction (ED). PATIENTS AND METHODS: In a prospective randomized study, men were alternately assigned to ICI without sexological counselling (-SC) or with sexological counselling (+SC). In all, 70 patients were included, i.e. 35 in each group; 57 (28 -SC, 29 +SC) were interviewed by telephone after a mean follow-up of 11.3 months to determine their use of ICI and reasons for discontinuing. RESULTS: There were no differences between the groups in discontinuation of ICI (overall 30%), in reasons for discontinuing ICI (24% did so because of the return of spontaneous erections) or in sexual functioning. CONCLUSION: There was no positive contribution from additional sexological counselling but extensive information and support by the urologist seems to be sufficient, resulting in a high acceptance rate of ICI. The discontinuation rate (30%) is one of the lowest reported.


Asunto(s)
Disfunción Eréctil/tratamiento farmacológico , Papaverina/administración & dosificación , Fentolamina/administración & dosificación , Consejo Sexual/métodos , Adulto , Anciano , Actitud Frente a la Salud , Coito , Quimioterapia Combinada , Humanos , Inyecciones/métodos , Masculino , Persona de Mediana Edad , Satisfacción del Paciente , Estudios Prospectivos , Autoadministración
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