scholarly journals Venous leakage treatment revisited: pelvic venoablation using aethoxysclerol under air block technique and Valsalva maneuver

2015 ◽  
Vol 87 (1) ◽  
pp. 1 ◽  
Author(s):  
Ralf Herwig ◽  
Salvatore Sansalone

Objective: We evaluated the effectiveness of pelvic vein embolization with aethoxysclerol in aero-block technique for the treatment of impotence due to venous leakage in men using sildenafil for intercourse. The aim of the procedure was to reduce the use of sildenafil. Methods: A total of 96 patients with veno-occlusive dysfunction, severe enough for the need of PDE5 inhibitors for vaginal penetration, underwent pelvic venoablation with aethoxysclerol. The mean patient age was 53.5 years. Venous leaks were identified by Color Doppler Ultrasound after intracavernous alprostadil injection. Under local anesthesia a 20-gauge needle was inserted into the deep dorsal penile vein. The pelvic venogram was obtained through deep dorsal venography. Aethoxysclerol 3% as sclerosing agent was injected after air-block under Valsalva manoeuver. Success was defined as the ability to achieve vaginal insertion without the aid of any drugs, vasoactive injections, penile prosthesis, or vacuum device. Additionally, a pre- and post- therapy IIEF score and a digital overnight spontaneous erections protocol (OSEP) with the NEVA™-system was performed. Results: At 3 month follow-up 77 out of 96 patients (80.21%) reported to have erections sufficient for vaginal insertion without the use of any drug or additional device. Four (4.17%) patients did not report any improvement. Follow up with color Doppler ultrasound revealed a new or persistent venous leakage in 8 (8.33%) of the patients. No serious complications occurred. Conclusions: Our new pelvic venoablation technique using aethoxysclerol in air-block technique was effective, minimally invasive, and cost-effective. All patients were able to perform sexual intercourse without the previously used dosage of PDE5 inhibitor. This new method may help in patients with contra-indications against PDE5 inhibitors, in patients who cannot afford the frequent usage of expensive oral medication or those who do not fully respond to PDE5-inhibitors.

2016 ◽  
Vol 2016 ◽  
pp. 1-3 ◽  
Author(s):  
Rohit Dewan ◽  
Anil K. Dasyam ◽  
Henke Tan ◽  
Alessandro Furlan

Vascular torsion is a rare renal transplant complication which requires prompt diagnosis and surgery to salvage allograft function. We report here a case of renal allograft torsion with interesting imaging findings on unenhanced CT and color Doppler ultrasound. A 60-year-old woman with a history of pancreas and kidney transplant presented to the emergency room with nausea, vomiting, abdominal pain, and minimal urine output. Unenhanced CT of the abdomen demonstrated an enlarged and malrotated renal allograft with moderate hydronephrosis. Color Doppler ultrasound demonstrated lack of vascularity within the allograft. The patient was taken urgently to the operating room where the renal allograft was found twisted 360 degrees around the vascular pedicle. After the allograft was detorsed, the color of the kidney returned and the Doppler signals for arterial flow improved. Intraoperative biopsy showed no evidence of infarct or acute cellular rejection. The detorsed kidney was surgically fixed in position in its upper and lower poles. Follow-up ultrasound 1 day later demonstrated normal blood flow to the renal allograft and the serum level of creatinine returned to normal.


2016 ◽  
Vol 22 (4) ◽  
Author(s):  
Ahmad Imran ◽  
Amna Tariq ◽  
Abid Ali Qureshi

<p><strong>Objective:</strong>  The objective of the study is to calculate the frequency of portal vein thrombosis in pediatric patients presenting with hematemesis and to estimate the frequency of acute and chronic portal vein thrombosis in these cases.</p><p><strong>Patients and Methods:</strong><strong>  </strong>Pediatric patients of 1 – 15 years of age of either sex, presenting to emergency or gastroenterology department with complaint of hematemesis were included. Informed consent was taken from parents/guardians. This is a Descriptive cross sectional study conducted in department of pediatric radiology, Children Hospital and Institute of child Health Lahore from 11-12-2012 to 10-6-2013. Doppler ultrasound of these patients was performed at Core Vision pro SSA 350-A Doppler machine (Toshiba, Japan) using standard imaging protocols. The data was analyzed using SPSS version 17.0 (SPSS Inc., IL, Chicago, USA)</p><p><strong>Results:</strong><strong>  </strong>In this study, 41% (n = 41) between 1 – 5 years, 38% (n = 38) between 6 – 10 years and only 21% (n = 21) between 11 – 15 years of age, 64%( n = 64) were male and remaining 36% (n = 36) were females, frequency of portal vein thrombosis in pediatric patients presenting with hematemesis reveals in 37% (n = 37) while 63% (n = 63) had no findings of PVT, frequency of acute and chronic forms in patients positive for portal vein thrombosis was 40.54% (n = 15) had acute and 59.46% (n = 22) had chronic portal vein thrombosis.</p><p><strong>Conclusion:</strong><strong>  </strong>We concluded that the frequency of portal vein thrombosis in pediatric patients presenting with hematemesis and frequency of acute and chronic forms in patients positive for portal vein thrombosis is in accordance with other studies while color Doppler ultrasound is a useful diagnostic modality being noninvasive and cost effective.</p>


Author(s):  
Suraj Mathur ◽  
P. Rajan ◽  
Dr. Jaya Kumar E. K

Method: A sample size of 40 kidney allograft recipients undergoing color Doppler Ultrasonography evaluation included in the study. Result: Corticomeduallry differentiation of kidney allografts within 24 hours post transplant period: There was no significant difference between CMD of kidney allorgrafts with complication and kidney allografts without any complication within 24 hour because the standard deviations of both groups were 0. Corticomeduallry differentiation in all kidney allografts, all were shows maintained corticomedullary differentiation. Conclusion: This study is aimed to assessing the role of CDUS in kidney allograft recipients to evaluate the graft perfusion immediate after anastamosis, within 24 hours and follow up period after engraftment of kidney allograft. Analyse the Color Doppler Ultrasound (CDUS) indices changes in parenchymal, and vascular cause of allograft dysfunction at follow up periods, to evaluate the uroloical, surgical and vascular complications in kidney recipients by using gray scale and color Doppler US at follow up periods and compare the results with biochemical parameter (serum creatinine). Immediate Doppler ultrasound is highly useful in the diagnosis of primary graft dysfunction and in follow-up of the transplanted patient. Keywords: Graft Perfusion, Anastamosis, Color, Doppler, Ultrasound


2020 ◽  
Vol 104 (11-12) ◽  
pp. 884-890
Author(s):  
Marco Pensabene ◽  
Maria Rita Di Pace ◽  
Fabio Baldanza ◽  
Maria Sergio ◽  
Marcello Cimador

<b><i>Purpose:</i></b> Undetected refluxing venous systems could cause persistence/recurrence of varicoceles in patients undergoing varicocelectomy. Color Doppler ultrasound (CDUS) is an important tool in the diagnosis and follow-up of varicocele, and could be successfully used to detect a venous reflux in the iliac-deferential district, usually involved in the recurrence/persistence of varicocele. <b><i>Materials and Methods:</i></b> We compared 2 historical series of patients treated with Palomo laparoscopic varicocelectomy between 1994 and 2018. In group 1, preoperative scrotal CDUS was obtained, while in group 2, additional inguinal CDUS was performed in order to detect a refluxing deferential vein (DV). When a deferential reflux was found, the DV and internal spermatic vein were interrupted during the same Palomo laparoscopic varicocelectomy. <b><i>Results:</i></b> A total of 449 patients underwent left laparoscopic varicocelectomy; 146 of them were not studied for deferential reflux with CDUS (group 1), while in the remaining 303, routine CDUS research of deferential reflux was obtained (group 2). The persistence/recurrence rate was significantly higher in group 1 (13.7 vs. 1%, <i>p</i> &#x3c; 0.000). <b><i>Conclusions:</i></b> The research of a refluxing DV revealed a useful, cost-effective, and simple tool, allowing a better comprehension of the vascular anatomy of varicocele and, thus, a significant reduction of varicocele persistence/recurrence rate.


2017 ◽  
Vol 19 (1) ◽  
pp. 59 ◽  
Author(s):  
Murat Akand ◽  
Mustafa Koplay ◽  
Necat Islamoglu ◽  
Emre Altintas ◽  
Ozcan Kilic ◽  
...  

Aim: The present study evaluated the effect of differences in the peak systolic velocity (PSV) and resistive index (RI) in the testicular artery (TA), capsular artery (CA), and intratesticular artery (ITA) after microscopic subinguinal varicocelectomy (MSV) on postoperative pain and semen parameters. Patients and Methods: Scrotal color Doppler ultrasound (CDUS) measurements were made in 33 patients (age 18-31 years) prior to MSV and 3 and 6 months after MSV. Pain was recorded using a visual analog scale and sperm concentration was determined to analyze the predictive value of the CDUS parameters regarding surgical outcome. Results: A significant decrease in pain scores was observed in most patients at both follow-ups. The first postoperative CDUS revealed a significant increase in the TA-PSV (p<0.001) and a decrease in the TA-RI (p=0.002) and CARI (p=0.006). The second postoperative CDUS also revealed a significant increase in the TA-PSV and a decrease in the TA-RI, and the PSV in the ITA and CA and RI in the ITA and CA were significantly different from the values obtained pre-operatively and at the first follow-up. A negative correlation was found between the pain level and TA-PSV (r=-0.433, p=0.012), whereas sperm concentration positively correlated with both the TA-PSV and CA-PSV (r=0.534, p=0.001 and r=0.455, p=0.008, respectively).Conclusions: The PSV and RI are useful parameters for detecting changes in testicular microhemodynamics after MSV. In addition, the TA-PSV and CA-PSV can be used to predict improvements in pain and sperm concentration.


2015 ◽  
Vol 32 (4) ◽  
pp. 468-475 ◽  
Author(s):  
Ana M. Kutz ◽  
Ligia Aranibar ◽  
Nelson Lobos ◽  
Ximena Wortsman

Author(s):  
Badreldeen Ahmed ◽  
Sanja Kupesic ◽  
Jose Maria Carrera

Abstract Ultrasound examination has become the “golden standard” in follow-up of the development and complications in early pregnancy. With introduction of transvaginal sonography a possibility for early morphological and biometrical ultrasound examinations has been significantly improved. The essential aim of an early pregnancy ultrasound is not only to diagnose a pregnancy, but also to differentiate between normal and abnormal pregnancy. Application of color Doppler ultrasound has enabled functional hemodynamic presentation and evaluation soon after implantation.


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