Objective To validate the application of the bacterial cellulose (BC) membrane as a protecting barrier to the urethra.Materials and Methods Forty female Wistar rats (four groups of 10): Group 1 (sham), the urethra was dissected as in previous groups and nothing applied around; Group 2, received a 0.7cm strip of the BC applied around the urethra just below the bladder neck; Group 3, received a silicon strip with the same dimensions as in group 2; Group 4, had a combination of 2 and 3 groups being the silicon strip applied over the cellulosic material. Half of the animals in each group were killed at 4 and 8 months. Bladder and urethra were fixed in formalin for histological analysis.Results Inflammatory infiltrates were more intense at 4 months at lymphonodes (80% Grade 2), statistically different in the group 2 compared with groups 1 (p=0.0044) and 3 (p=0.0154). At 8 months, all samples were classified as grade 1 indicating a less intense inflammatory reaction in all groups. In group 2, at 8 months, there was a reduction in epithelial thickness (30±1μm) when com-pared to groups 1 (p=0.0001) and 3 (p<0.0001). Angiogenesis was present in groups 2 and 4 and absent in group 3. In BC implant, at 4 and 8 months, it was significant when comparing groups 4 with 1 (p=0.0159).Conclusion BC membrane was well integrated to the urethral wall promoting tissue remodeling and strengthening based on morphometric and histological results and may be a future option to prevent urethral damage.
Abbreviations and Acronyms3G = third generation VoIP = voice over internet protocol ABSTRACT INTRODUCTION:The field of telemedicine has expanded over the past few decades. Remote operation of various devices enables physicians to provide off-site assistance in different areas of medicine. The purpose of the present report was test the use of hand-held smartphones for remote-access urodynamic telementoring. METHODS:Telementoring was performed using the Teleurodynamics software program (www.urodyn.net). The program was downloaded and installed at the testing site. Simultaneous use of voice over internet protocol (VoIP) software through smartphones allowed: (1) visualization of the tests for individuals at all settings, and(2) dialogues between the person performing the test, observers, and patients. Mentors participated during the test or helped interpret stored data. Password-protected access provided patient privacy. Urodynamic tests were performed between January, 2008 and August, 2010. The tests were conducted by residents at one center and by a technician at a second center. A recording of the procedure is available from the author on request. RESULTS:The authors remotely monitored over 1000 urodynamic studies, using 50 different examiners in various locations. They were able to analyze the urodynamic tests and reports in the same way as when the examiner was in situ, because all participants were using the same software programs. Occasional loss of the signal was eliminated by using an optional portable 3G connection. CONCLUSIONS:Telementoring urodynamic examinations by using computers and smartphones facilitates teaching and consultation. The technology adds very little cost to equipment and operating procedures. Hand-held smartphones can make the procedure available to a large number of users.UroToday International Journal ® UI J
Introduction: Percutaneous approach to the kidney is a very useful alternative in renal surgery which minimizes the morbidity of a variety of procedures. Objectives: To evaluate the efficacy, practicity of a reusable system of metallic coaxial dilator coupled to a special puncture needle to perform lumbar puncture and dilation of the percutaneous tract. Methods: A randomized experimental study was carried out involving 50 individuals. These patients were randomized as follows: Group 1 had the procedure performed with the conventional disposable Amplatz set traditionally used for this procedure. Patients in Group 2 were operated utilizing the new reusable coaxial set specially designed for this purpose. The following parameters were measured to compare the 2 groups: sex Corporeal Mass Index (CMI), Pre and postoperative hematocrit and hemoglobin. Time interval between the puncture, dilation and access to the renal pelvis and insertion of the nephroscope were also analyzed. Results: There was no statistical difference between the 2 groups concerning hematocrit and hemoglobin changes when comparing pre-with postoperative period. Patients in Group 2 required a significant lower time between puncture and final access to the upper collecting system. Conclusion: The new coaxial dilator set showed to be as safe as the conventional Amplatz set with the advantage of reusability and decrease of tract dilation time.
Contextualization: Emptying the bladder is a challenging problem for the urological community. Intermittent catheterization is the most widely used method to restore bladder emptying mechanism. However, this procedure can have a negative impact on self-image and result in a decline in the quality of life of patients. In this context, the use of a bladder emptying device (SVCATH3D) proposes to be effective and have a positive impact on the quality of life of different patients. Objective: The objective of the study was to evaluate the functionality of a new device for both intermittent and controlled emptying of the bladder in both sexes and ages. Materials and methods: A randomized clinical trial was conducted with 251 patients, with different bladder problems, from March 2013 to January 2023. After randomization, the patients were divided into two groups: Group I (SVCATH3D) and Group II (Clean Intermittent Catheterization). The primary outcome was defined as the impact on quality of life. Data on episodes of urinary tract infection, adverse effects, number of diaper use and treatment costs were analyzed. Results: The apposition of the SVCATH3D was performed on an outpatient basis, with no complications during the procedures. The patients were followed up for 10 years. There was a significant improvement in quality of life when comparing the moments before and after the use of SVCATH3D (p < 0.001), as well as there was a significant reduction in the number of episodes of urinary tract infection (p < 0.001), absent serious adverse effects and a reduction in the number of diapers or daily protectors. Conclusion: The study using SVCATH3D showed promising results in relation to functionality, showing improvement in quality of life with a reduction
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