RESUMEN
INTRODUCTION: Testicular prostheses produced from various materials have been in use since 1941. The absence of a testicle has been shown to be a psychologically traumatic experience for males of all ages. The indications for insertion of a prosthesis include absence or following orchidectomy from a number of causes such as malignancy, torsion and orchitis. The most common substance used around the world in the manufacture of these implants is silicone; however, in the US, this material is currently banned because of theoretical health risks. This has led to the development of saline-filled prostheses as an alternative. PATIENTS AND METHODS: A Medline search was carried out on all articles on testicular prosthesis between 1966 and 2006. CONCLUSIONS: This review highlights the controversies regarding prosthetic materials, the complications of insertion and the potential benefits of this commonly performed procedure.
Asunto(s)
Prótesis e Implantes/normas , Implantación de Prótesis/métodos , Testículo/cirugía , Consejo , Predicción , Enfermedades de los Genitales Masculinos/cirugía , Humanos , Cuidados Intraoperatorios/métodos , Masculino , Prótesis e Implantes/tendencias , Diseño de Prótesis , Implantación de Prótesis/tendencias , Testículo/anomalías , Factores de TiempoRESUMEN
Phenytoin is often used to prevent postcraniotomy seizures, but is not always effective. We investigate changes in plasma phenytoin level ([phenytoin]) following craniotomy. The [phenytoin] in 28 patients who were receiving phenytoin (oral/ intravenous) and undergoing a craniotomy were prospectively measured 24 h preoperatively, immediately pre- and postcraniotomy, 24 and 48 h postoperatively. Factors examined included patients' age, sex, pathology, preoperative [phenytoin], operative duration and blood loss. Fifteen patients had [phenytoin] concentrations outside the therapeutic range. Twenty-five patients experienced a decrease in [phenytoin] immediately postcraniotomy: pre-, post- and 24 h postcraniotomy mean [phenytoin] were 13.4, 10.0 and 12.9 mg/l, respectively. Preoperative [phenytoin], operative duration and blood loss had significant correlation with the decrease in [phenytoin] (p < 0.05). In conclusion, < 50% of the patients had therapeutic preoperative [phenytoin]. In most patients, [phenytoin] decreases by 26% after craniotomy and returns to preoperative level within 24 h. These may contribute to early postoperative seizure development.
