scholarly journals Dializuojamų ligonių šlapimo takų ligų chirurginis gydymas

2005 ◽  
Vol 3 (4) ◽  
pp. 0-0
Author(s):  
Henrikas Ramonas ◽  
Asta Kantaravičienė ◽  
Audrius Rimas
Keyword(s):  
Renal Failure ◽  
Urinary Tract ◽  
Surgical Treatment ◽  
High Risk ◽  
Postoperative Complications ◽  
Obstructive Uropathy ◽  
Intraoperative Complications ◽  
Postoperative Bleeding ◽  
Dialysis Access ◽  
Infravesical Obstruction

Henrikas Ramonas, Asta Kantaravičienė, Audrius RimasVilniaus universiteto, Gastroenterologijos, nefrologijos,urologijos ir pilvo chirurgijos klinika,Vilniaus universiteto ligoninės Santariškių klinikosNefrologijos ir urologijos centras, 1 nefrourologijos skyrius,Santariškių g. 2, LT-08661, VilniusEl paštas: [email protected] Tikslas Nustatyti šlapimo takų ligų chirurginio gydymo rezultatus ligoniams, kuriems atliekamos hemodializės, ir operacinio gydymo įtaką hemodializės procedūroms. Ligoniai ir metodai Išanalizuoti chirurginio gydymo rezultatai 69 ligonių, kurie nuo 1999 iki 2004 metų operuoti ir gydyti hemodializėmis nuo ūminio inkstų nepakankamumo ir esant galutinei nepakankamumo stadijai. Vidutinis amžius – 57,07 ± 1,9 metų. Operuota dėl šių priežasčių: inkstų akmenligės – 26 (37,7%) ligoniai, inkstų policistozės – 7 (10,2%), obstrukcinės uropatijos – 13 (18,8%), infravezikinės obstrukcijos – 10 (14,5%), inksto vėžio – 5 (7,2%), dėl kitų priežasčių – 8 (11,6%) ligoniai. Dažniausiai atlikta nefrektomija – 46 (66,7%) pacientams, abipusė nefrektomija – vienuolikai. Rezultatai Intraoperacinių komplikacijų ir operavimo sunkumų buvo 21 (31,43%) pacientui. Pooperacinės komplikacijos diagnozuotos 14 (20,9%) ligonių. Pagrindinė komplikacija – pooperacinis kraujavimas. Mirė 5 (7,25%) ligoniai, trys iš jų – po abipusės nefrektomijos, pagrindinė mirties priežastis buvo pooperacinis kraujavimas. Analizuojant šiuos atvejus įsitikinta, kad operuojant per laparotominį pjūvį ir negalint gerai apriboti nefrektomijos zonos, komplikuotų operacijų atvejais sunkiai kontroliuojamas kraujavimas buvo pagrindinė mirties priežastis. Skubiosios hemodializės sėkmingiausiai integruotos su obstrukcinės uropatijos chirurginiu gydymu. Hemodializės procedūros komplikavosi 13 (18,84%) ligonių. Dažniausia komplikacija – arterinės-veninės jungties trombozė. Išvados Šlapimo takų ligų chirurginis gydymas ligoniams, kuriems lygia greta atliekamos hemodializės, susijęs su didele intraoperacinių, pooperacinių ir arterinių-veninių jungčių komplikacijų, dažniausiai okliuzinių, rizika. Jei šlapimo takų ligos komplikuotos, abipusės nefrektomijos nerekomenduojamos dėl didelės, sunkiai kontroliuojamo pooperacinio kraujavimo rizikos. Reikšminiai žodžiai: hemodializė, inkstų nepakankamumas, nefrektomija, obstrukcinė uropatija, infravezikinė obstrukcija Surgical treatment of urinary tract in haemodialysed patients Henrikas Ramonas, Asta Kantaravičienė, Audrius RimasVilnius University, Clinic of Gastroenterology, Urology andAbdominal Surgery, Center of Nephrology and Urology,Vilnius University Hospital "Santariškių klinikos",Vilnius, Santariškių str. 2, LT-08661, LithuaniaE-mail: [email protected] Background / objective To evaluate outcomes of urinary tract surgery in haemodialysed patients and determine the influence of surgery on haemodialysis procedures. Patients and methods We analysed results of urinary tract surgery in 69 patients with end stage renal impairment and acute renal failure in the period from 1999 till 2004. The mean age of patients was 57.07 ± 1.9 years. Operations were performed due to nephrolithiasis in 26 (37.7%) cases, polycystic kidneys in 7 (10.2%), obstructive uropathy in 13 (18.8%), infravesical obstruction 10 (14.5%), renal carcinoma 5 (7.2%), other causes in 8 (11.6%) cases. More frequently nephrectomy was done (in 46, or 66.67% of patients), and bilateral nephrectomy was performed in 11 cases. Results Intraoperative complications and surgery difficulties were defined in 21 (30.43%) patients. Postoperative complications were diagnosed in 14 (20,29%) cases, and the main complication was postoperative bleeding. Five (7.25%) patients died. Three patients died after bilateral nephrectomies, and the main cause of death was postoperative bleeding. Analysis of these cases showed that the laparotomic aproach and absence of the posibillity to isolate the renal area during complicated nephrectomies was the main cause of poorely controlled bleeding after operation. The urgent heamodialysis procedures were more successfully integrated with the surgical treatment of obstructive uropathy. Haemodialysis procedures were complicated in 13 (18.84%) patients. The common complication was thrombosis of arteriovenal dialysis access. Conclusions Urinary tract surgery in haemodialysis patients influences the high risk of intraoperative and postoperative complications, arteriovenal occlusive complications. Bilateral nephrectomies in complicated urinary tract diseases are not recommended due to a high risk of poorely controlled postoperative bleeding. Keywords: haemodialysis, renal failure, nephrectomy, obstructive uropathy, infravesical obstruction

New possibilities of the use of surgical lasers in obstetrics

1997 ◽  
Vol 78 (6) ◽  
pp. 434-438
Author(s):  
I. F. Fatkullin
Keyword(s):  
Surgical Treatment ◽  
High Risk ◽  
Postoperative Complications ◽  
Cesarean Section ◽  
Laser Welding ◽  
Comparison Group ◽  
Obstetrics And Gynecology ◽  
Septic Complications ◽  
Basic Group ◽  
Section Operation

The laser welding suture of peritoneum in pregnants and in women in labor with high risk of pyo-septic complications is used in cesarean section operation. In the basic group the postoperative complications are three times as little than in the comparison group. The promise of the use of the biological laser @welding@ in obstetrics and gynecology to improve technology and results of surgical treatment especially in delivery of women with high risk of pyo-septic complications is noted.

Assessment of the risk of complications in bariatric surgery

2019 ◽  
Vol 26 (2) ◽  
pp. 37-40
Author(s):  
L. I. Davletbaeva ◽  
K. A. Anisimova ◽  
D. I. Vasilevsky ◽  
S. G. Balandov
Keyword(s):  
Bariatric Surgery ◽  
Surgical Treatment ◽  
High Risk ◽  
Postoperative Complications ◽  
Metabolic Disorders ◽  
Obese Patients

Introduction. Surgical treatment of obese patients includes a high risk of complications.Material and methods. The article presents the analysis of the informativeness and reliability of OS-MRS, E. Livingston, P. Turner scores in predicting postoperative complications in patients with overweight and metabolic disorders.Results. According to the study, the OS-MRS score was the most reliable.

scholarly journals Feasibility and safety of radical cystectomy under combined spinal and epidural anesthesia in octogenarian patients with ASA score ≥3: A case series

2015 ◽  
Vol 9 (7-8) ◽  
pp. 500 ◽  
Author(s):  
Vassilios Tzortzis ◽  
Konstantinos Dimitropoulos ◽  
Anastasios Karatzas ◽  
Ioannis Zachos ◽  
Konstantinos Stamoulis ◽  
...  
Keyword(s):  
Bladder Cancer ◽  
High Risk ◽  
Postoperative Complications ◽  
Cancer Patients ◽  
Radical Cystectomy ◽  
Intraoperative Complications ◽  
Case Series ◽  
Surgical Trauma ◽  
Grade Ii ◽  
Grade Iii

Introduction: This study evaluated the feasibility and safety of open radical cystectomy (RC) under combined regional anesthesia (CRA) in high-risk octogenarian patients.Methods: We retrospectively evaluated the medical records of high-risk, octogenarian bladder cancer patients submitted to open RC with CRA. Demographic and clinical data, intraoperative parameters and perioperative and postoperative complications were recorded using the Clavien-Dindo classification.Results: In total, 14 male and 4 female patients, with a median age of 82.5 years were enrolled. Ureterocutaneostomy was performed in 15 patients and Bricker ileal conduit in the remaining 3. Operative time ranged from 97 to 184 minutes. Five patients were transfused and no major intraoperative complications occurred. Postoperative complications 30 days later included ileus (Grade II) in 3 patients, surgical trauma infection in 1 patient (Grade II), respiratory infection in 2 patients (Grade III), and hydronephrosis with concurrent urinary tract infection in 3 patients (Grade III). No deaths occurred.Conclusions: Our study showed that octogenarian, high-risk bladder cancer patients with indications for RC can safely undergo the surgical procedure under CRA, without apparent increase in major complications.

scholarly journals A successful delivery of giant bladder stone by obstetric forceps: a case report

2021 ◽  
Vol 8 (5) ◽  
pp. 1589
Author(s):  
Siti Fairus Che Ismail ◽  
Jamil Abdullah ◽  
Mohd Fadliyazid Ab Rahim ◽  
Mohammad Irsyadiee B. Mohd Saiful ◽  
Roziana Ramli
Keyword(s):  
Renal Failure ◽  
Acute Renal Failure ◽  
Case Report ◽  
Surgical Treatment ◽  
Medical Condition ◽  
Obstructive Uropathy ◽  
Bladder Stone ◽  
Bladder Stones ◽  
Rare Phenomenon ◽  
Obstetric Forceps

Giant bladder stone is a rare phenomenon. Surgical treatment which involves open vesicolithotomy and delivery of the bladder stone is usually straightforward. Herein, we report a 69-year-old gentleman with a neglected giant bladder stone complicated by obstructive uropathy and acute renal failure. After medical condition was stabilized, he underwent open vesicolithotomy. At surgery, delivery of the giant bladder stone was difficult both manually and with stone forceps. The stone was later delivered successfully by Wrigley’s obstetrics forceps. We report this case to highlight the rare cause of acute renal failure and the use of obstetrics forceps in the management of giant bladder stones.

scholarly journals Prevention of complications of transvesical adenomectomy with a blind suture of the urinary bladder

2012 ◽  
Vol 93 (1) ◽  
pp. 56-61
Author(s):  
E A Zubkov ◽  
M E Sitdykova
Keyword(s):  
Urinary Tract ◽  
Surgical Treatment ◽  
Postoperative Complications ◽  
Urinary Bladder ◽  
Postoperative Period ◽  
Early Recovery ◽  
One Stage ◽  
Analysis Of Results ◽  
Transvesical Adenomectomy ◽  
Prostate Adenoma

Aim. To determine the frequency and develop methods for prevention of possible complications of transvesical adenomectomy. Methods. Conducted was an analysis of results of surgical treatment of 492 patients with prostate adenoma. One-stage suprapubic transvesical adenomectomy with a primary blind suture of the urinary bladder and hemostasis of the adenoma bed was performed in 347 patients. Results. In the postoperative period inflammatory complications of the urinary tract were observed in 5 (1.4%) out of 347 operated patients. It was established that the frequency and nature of both early and late pyo-inflammatory and obstructive postoperative complications of the suprapubic adenomectomy depend on the method of hemostasis of the bed of the adenoma and on the time of urination recovery. Conclusion. The main measures of prevention of complications during suprapubic adenomectomy are hemostasis of the bed of the adenoma by temporary retriganization with removable hemostatic ligatures, early recovery of urethral voiding (2-4 days) and application of antibiotics to the bed of the adenoma via the drainages of the deference ducts.

scholarly journals Natyvinės nefrektomijos, atliktos rengiant pacientus inkstų transplantacijai, rezultatai

2014 ◽  
Vol 13 (1) ◽  
pp. 19-24 ◽  
Author(s):  
Henrikas Ramonas ◽  
Dalia Aleknienė ◽  
Kastė Mateikaitė ◽  
Rosita Bazarauskaitė
Keyword(s):  
Renal Transplantation ◽  
Postoperative Complications ◽  
Arteriovenous Fistula ◽  
Intraoperative Complications ◽  
Postoperative Bleeding ◽  
Stone Disease ◽  
Obstructive Nephropathy ◽  
Common Complication ◽  
Bilateral Nephrectomy ◽  
Kidney Transplantations

TikslasNustatyti natyvinės nefrektomijos, atliktos rengiant pacientus inkstų transplantacijai, efektyvumą.Ligoniai ir metodaiRetrospektyviai išanalizuoti 49 pacientai, kuriems inkstų ligų baigčių stadijoje nuo 1999 iki 2009 metų atliktos natyvinės nefrektomijos rengiant recipientus inkstų transplantacijai. Pacientų vidutinis amžius 44,9 metų. Nefrektomijos atliktos dėl inkstų policistozės 23 (46,9 %), inkstų akmenligės – 13 (26,6 %), obstrukcinės nefropatijos – 8 (16,3 %), kitų priežasčių – 5 (10,2 %) pacientams. Vienmomentė abipusė nefrektomija atlikta 24 ligoniams. Tyrimo metu natyvinių nefrektomijų efektyvumas vertintas analizuojant intraoperacines, artimąsias pooperacines, arterioveninių jungčių komplikacijas bei išnagrinėjus inkstų transplantacijos atlikimo dažnį bei neatlikimo priežastis iki 2012 metų.RezultataiIntraoperacinės komplikacijos nustatytos 3 (5,4 %) pacientams. Pooperacinės komplikacijos diagnozuotos 8 (14,3 %) atvejais ir dažniausia komplikacija buvo pooperacinis kraujavimas. Mirė 3 (6,12 %) pacientai. Analizuojant šių komplikacijų priežastis paaiškėjo perireninės fibrozės, išsivysčiusios po buvusių chirurginių manipuliacijų bei dėl šlapimo takų infekcijos, lemiamas vaidmuo. Hemodializių procedūros komplikavosi 9 (18,4 %) pacientams įvykus arterioveninės jungties trombozei. Atlikus natyvinę nefrektomiją recipientais išliko 46 pacientai ir iš jų 28 (60,9 %) atlikta inkstų transplantacijos operacija.IšvadosNatyvinių inkstų šalinimo operacijos rengiant recipientus inkstų transplantacijai yra susijusios su intraoperacinių (5,4 %), ankstyvų pooperacinių komplikacijų (14,3 %), artrioveninių jungčių trombozės (18,4 %) rizika. Atliekant natyvines nefrektomijas, pagrindinis tikslas – paruošimas inksto transplantacijai – buvo pasiektas 69,6 %: transplantacija atlikta 60,9% pacientų, o 8,7 % pacientų išlieka aktyviame inksto transplantacijos laukimo sąraše.Reikšminiai žodžiai: ikitransplantacinė nefrektomija, inkstų policistozė, arterioveninė jungtis, inkstų transplantacijaResults of native nephrectomy before planned renal transplantation ObjectiveThe goal of this paper is to establish the efficiency of pretransplant native nephrectomies performed in the patients being prepared for renal transplantation.Patients and methodsA retrospective study has been performed with 49 patients who had native nephrectomies in the period 1999–2009. The average age of the patients was 44.9 years. Nephrectomies were performed in 23 patients (46.9%) due to a polycystic kidneydisease, in 13 patients (26.6%) due to a kidney stone disease, in 8 patients (16.3%) due to an obstructive nephropathy, and in 5 patients (10.2%) for other reasons. Simultaneous bilateral nephrectomy was performed in 24 patients. The effectiveness was evaluated by analysing intraoperatve postoperative complications of native nephrectomies, complications of haemodialysis assess, and the rate of kidney transplantations before the year 2012 was assessed.ResultsIntraoperative complications were diagnosed in 3 patients (5.4%) and postoperative complications in 8 (14.3%) cases. The most common complication was postoperative bleeding. Perirenal fibrosis was the most common cause of these complications.Nine patients (18.4%) had a thrombosis of the arteriovenous fistula. After pre-transplant native nephrectomies, 28 patients (60.9%) underwent the renal transplantation surgery.ConculusionsPretransplant native nephrectomies associated with intraoperative complications occurred in 5.4%, postoperative complications in 14.3%, and thrombosis of arteriovenous fistula in 18.4% of cases. When performing native nephrectomies, the maingoal – preparation for renal transplantation – was reached in 69.6% : 60.9% of patients had a transplantation, whereas 8.7% of patients remained on the active list of those waiting for renal transplantation.Key words: pretransplant nephrectomy, renal polycystosis, haemodialysis assessment, renal transplantation

scholarly journals COMPARATIVE CHARACTERISTICS OF DIFFERENT METHODS OF TREATMENT OF CHRONIC COMPLICATED HEMORRHOIDS

2021 ◽  
pp. 36-42
Author(s):  
A. V. Makukha ◽  
M. A. Kashtalyan ◽  
V. Yu. Shapovalov ◽  
R. V. Enin
Keyword(s):  
Surgical Treatment ◽  
Postoperative Complications ◽  
Postoperative Bleeding ◽  
Stage Ii ◽  
Group Iii ◽  
Early Postoperative Complications ◽  
Group I ◽  
External Component ◽  
Group Ii ◽  
Methods Of Treatment

Abstract. Introduction. In recent years, a method of surgical treatment of hemorrhoids by the method of ligation of hemorrhoidal arteries under Doppler control (THD technique), as well as with additional rectoanal reconstruction (HAL-RAR) has been developed and widely used. The aim of the study. The aim of our study was to compare methods of treatment of chronic complicated hemorrhoids stage II-III: classical Milligan-Morgan surgery, staple mucopexy according to Longo, as well as a combined technique: Doppler desarterization by HAL-RAR with additional removal of the external anodermal component. Materials and methods. In the clinic of coloproctology of Military medical: Clinical Center of the Southern Region of Odessa performed an analysis of three groups of patients for the period from 2011 to 2021, who underwent hemorrhoidectomy for complicated forms of hemorrhoids (bleeding, nodular prolapse, mucosal prolapse, anal fissure). All patients suffered from chronic complications of stage II or III hemorrhoids, with one or more of the above complications. Selected cases are divided into three groups: Group I (control) operations on Milligan-Morgan — 240 patients, including -64 women and 176 men; Distribution by age from 18 to 75 years; Group II staple hemorrhoidopexy for Longo — 276 patients, including 89 women and 115 men. Distribution by age from 18 to 72 years; Combined interventions using the wireless Doppler surgical complex Wi-3 HAL-RAR and additional removal of excess anoderm (from January 2019 to May 2021) operated on 53 patients, including 31 (58%) men and 22 (42%) women . Distribution by age from 28 to 62 years. Results and discussion. According to our data: bed day ranged from 1 to 8 days, mostly it was lower in group III — 1.3 (± 0.4) bed per day compared to 3.1 (± 0.8) in group II and 4.8 (± 1,7) in group III resorptive fever was not observed; the highest pain syndrome for VASH (average 7 points) in the group of patients of group I — compared with patients from group II (average 4 points) and patients of group III (average 2 points); the highest number of early postoperative complications was found in the group of patients operated on Milligan- Morgan: 1) acute urinary retention was observed in 43 cases (18%) of group I, compared with 38 cases (14%) of group II. The lowest number of cases of urinary retention was observed in group III — 2 cases (4%) (p <0.05). 2) postoperative bleeding from the wound was significantly more common in group I — 9 cases (3.75%), compared with group II — 6 cases (2.5%). No postoperative bleeding was observed in group III. 3) resorptive fever was most common in group I — 43 cases (18%) compared with group II - 33 cases (12%). Resorptive fever did not occur in group III (p<0.05). In all patients using the combined intervention HAL-RAR + excision of the external component of the anoderm, the pain was acquired by taking nonspecific anti-inflammatory drugs without the use of narcotic analgesics. No complications were observed. All patients noted no reduction in quality of life in the postoperative period. Conclusions. 1. Surgical treatment of hemorrhoids by the combined method of HAL-RAR + excision of the external component is a simple and effective method that in the postoperative period reduces the patient’s stay in the hospital, relatively lower in pain and the frequency of early postoperative complications. 2. HAL-RAR technology with excision of the outer component of the anoderm can be the operation of choice in the surgical treatment of chronic complicated hemorrhoids stage II-III.

La patologia traumatica del rene: Nostra esperienza in tema di stadiazione e di indicazione chirurgica: Renai trauma: Our experience in clinical staging and surgical treatment

1995 ◽  
Vol 62 (2) ◽  
pp. 240-244
Author(s):  
A. Meazza ◽  
V. Nebulone ◽  
F. Franzoso ◽  
G. Sorboli
Keyword(s):  
Urinary Tract ◽  
Surgical Treatment ◽  
High Risk ◽  
Renal Parenchyma ◽  
Clinical Staging ◽  
Medical Facility ◽  
Radiological Assessment ◽  
X Ray ◽  
Risk Patients ◽  
Detailed Diagnosis

We studied in retrospect 144 patients suffering from blunt trauma of the kidney in order to better define the indications for radiological assessment and surgical treatment. If staging is fundamental, most of ail for high-risk patients, it is our opinion that urography must still be considered the decisive X-ray test to assess the renal parenchyma and the urinary tract of the kidney as well as the integrity of the adelph. In cases with micro hematuria and in absence of shock, ultrasound diagnosis is used in place of urography, whereas computerized tomography of the abdomen must be restricted to the cases of renal autoamputation, urohematic extravasation and suspected intraperitoneal injuries. We adopt conservative treatment for all those injuries to the renal parenchyma which respect the urinary tract, whereas we recommend emergency surgical treatment in those cases involving traumatism of the pedicle or kidney fragmentation. We instead postpone surgical treatment in all other cases, following spontaneous haemostasis of the renal space. We believe that both the rate of death and invalidating consequences from traumatic pathology of the kidney can be significantly reduced where there is qualified pre-hospital assistance and cooperation with a medical facility offering rapid detailed diagnosis and specific medicosurgical treatment.

scholarly journals Postoperative rendezvous endoscopic retrograde cholangiopancreaticography as an option in the management of choledocholithiasis

2019 ◽  
Vol 34 (11) ◽  
pp. 4883-4889 ◽  
Author(s):  
Eva-Lena Syrén ◽  
Gabriel Sandblom ◽  
Staffan Eriksson ◽  
Arne Eklund ◽  
Bengt Isaksson ◽  
...  
Keyword(s):  
Postoperative Complications ◽  
Intraoperative Complications ◽  
Postoperative Bleeding ◽  
Bile Leakage ◽  
Endoscopic Retrograde ◽  
Endoscopic Retrograde Cholangiopancreaticography ◽  
Referral Hospitals ◽  
Feasible Alternative ◽  
Intraoperative Ercp ◽  
Over Time

Abstract Background Rendezvous endoscopic retrograde cholangiopancreaticography (ERCP) is a well-established method for treatment of choledocholithiasis. The primary aim of this study was to determine how different techniques for management of common bile duct stone (CBDS) clearance in patients undergoing cholecystectomy have changed over time at tertiary referral hospitals (TRH) and county/community hospitals (CH). The secondary aim was to see if postoperative rendezvous ERCP is a safe, effective and feasible alternative to intraoperative rendezvous ERCP in the management of CBDS. Methods Data were retrieved from the Swedish registry for cholecystectomy and ERCP (GallRiks) 2006–2016. All cholecystectomies, where CBDS were found at intraoperative cholangiography, and with complete 30-day follow-up (n = 10,386) were identified. Data concerning intraoperative and postoperative complications, readmission and reoperation within 30 days were retrieved for patients where intraoperative ERCP (n = 2290) and preparation for postoperative ERCP were performed (n = 2283). Results Intraoperative ERCP increased (7.5% 2006; 43.1% 2016) whereas preparation for postoperative ERCP decreased (21.2% 2006; 17.2% 2016) during 2006–2016. CBDS management differed between TRHs and CHs. Complications were higher in the postoperative rendezvous ERCP group: Odds Ratio [OR] 1.69 (95% confidence interval [CI] 1.16–2.45) for intraoperative complications and OR 1.50 (CI 1.29–1.75) for postoperative complications. Intraoperative bleeding OR 2.46 (CI 1.17–5.16), postoperative bile leakage OR 1.89 (CI 1.23–2.90) and postoperative infection with abscess OR 1.55 (CI 1.05–2.29) were higher in the postoperative group. Neither post-ERCP pancreatitis, postoperative bleeding, cholangitis, percutaneous drainage, antibiotic treatment, ICU stay, readmission/reoperation within 30 days nor 30-day mortality differed between groups. Conclusions Techniques for management of CBDS found at cholecystectomy have changed over time and differ between TRH and CH. Rendezvous ERCP is a safe and effective method. Even though intraoperative rendezvous ERCP is the preferred method, postoperative rendezvous ERCP constitutes an acceptable alternative where ERCP resources are lacking or limited.

Erectile Dysfunction: Surgical Treatment (Vascular and Prosthetic Surgery)

2019 ◽  
Author(s):  
M Ryan Farrell ◽  
Laurence A Levine ◽  
George A Abdelsayed
Keyword(s):  
Surgical Treatment ◽  
Postoperative Complications ◽  
Intraoperative Complications ◽  
Penile Prosthesis ◽  
Pelvic Trauma ◽  
Effective Treatment Option ◽  
Prosthesis Implantation ◽  
Inflatable Penile Prosthesis ◽  
Arterial Insufficiency ◽  
Prosthetic Surgery

Surgical treatment oferectile dysfunction (ED) can be considered in men who either fail or elect to avoid further nonoperative modalities. For patients with an organic etiology of ED, a penile prosthesis can be placed. There are multiple approaches available for penile prosthesis implantation including penoscrotal, infrapubic, and subcoronal. Furthermore, the location of reservoir placement should be considered, either within the space of Retzius or at an ectopic submuscular location according to patient factors. Potential intraoperative and postoperative complications of penile prosthesis implantation are also reviewed. Alternatively, for young and otherwise healthy men with ED secondary to focal arterial insufficiency often in the setting of pelvic trauma, penile microarterial bypass surgery is an effective treatment option. This review contains 6 figures, 2 tables, and 48 references.  Key words:erectile dysfunction, inflatable penile prosthesis, malleable penile prosthesis, surgical technique, intraoperative complications, postoperative complications, arterial revascularization

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