Browsing by Author "Saavedra, Alvaro"

Now showing 1 - 4 of 4
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    Female urethral reconstruction: dorsal buccal mucosa graft onlay
    (2020) Gomez, Reynaldo G.; Segura, Fernando J.; Saavedra, Alvaro; Campos, Rodrigo A.
    Purpose Female urethral stricture (FUS) is an infrequent entity, but may cause significant morbidity. Despite a rising interest in recent years, there is still scarce published information. In this article, we review FUS with a special attention to the use of dorsal buccal mucosa grafts (DBMG). Methods A literature search was conducted summarizing information about etiology, anatomy, diagnosis, and management. A detailed description of our technique for DBMG urethroplasty is given, with a summary report of our experience and results. Results FUS accounts for about 1% of all women consulting for lower urinary tract symptoms (LUTS). Diagnosis is suspected in front of persistent LUTS suggestive of obstruction. Confirmatory tests are uroflowmetry, endoscopy, and urethrography; true anatomic strictures must be differentiated from functional or physiological obstructions. Initial management may include dilations, but recurrence is frequent. On the contrary, reconstructive surgery is highly efficient, with overall curative rates around 90%. For reconstruction, DBMG has gained popularity, because it would maintain intact the ventro-lateral urethral supporting structures, important for continence. The pathology of female strictures is unknown and neither the pre nor the intraoperative assessment allows determining the precise location and extent or the urethral damage; therefore, we advise extensive grafting of the entire urethra. Collected success of DBMG is 86% at a mean follow-up of 21 months. Morbidity is very low and de novo stress incontinence has not been reported. Conclusions Because of its many advantages, DMBG currently represents a prime choice for FUS reconstruction.
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    Sacral neuromodulation therapy for urinary and defecatory disorders: experience in a Latin American public hospital
    (2024) Mass-Lindenbaum, Marcelo; Arevalo-Vega, Diego; Aleuanlli, Isidora; Santis-Moya, Fernanda; Maluenda, Andrea; Dines, Eitan; Cohen-Vaizer, Miriam; Saavedra, Alvaro; Raby, Trinidad; Blumel, Bernardita; Cuevas, Rodrigo; Pohlhammer, Simone; Alarcon, Gabriela; Albornoz, Marco Arellano; Pizarro-Berdichevsky, Javier
    Objective: To To show the experience of a Latin American public hospital, with SNM in the management of either OAB, NOUR or FI, reporting feasibility, short to medium-term success rates, and complications. Methods: A retrospective cohort was conducted using data collected prospectively from patients with urogynecological conditions and referred from colorectal surgery and urology services between 2015 and 2022. Results: Advanced or basic trial phases were performed on 35 patients, 33 [94%] of which were successful and opted to move on Implantable Pulse Generator [GG] implantation. The average follow-up time after definitive implantation was 82 months (SD 59]. Of the 33 patients undergoing, 27 (81%]reported an improvement of 50% or more in their symptoms at last follow-up. Moreover, 30 patients (90%] with a definitive implant reported subjective improvement, with an average PGI-I "much better" and 9 of them reporting to be "excellent" on PGI-I. Conclusion: SNM is a feasible and effective treatment for pelvic floor dysfunction. Its implementation requires highly trained groups and innovative leadership. At a nation-wide level, greater diffusion of this therapy among professionals is needed to achieve timely referral of patients who require it.
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    Ureteroscopic Lithotripsy for Distal Ureteral Calculi: Comparative Evaluation of Three Different Lithotriptors
    (MARY ANN LIEBERT INC, 2012) Salvado, Jose A.; Mandujano, Rodrigo; Saez, Ivan; Saavedra, Alvaro; Dell'oro, Arturo; Dominguez, Javier; Trucco, Cristian
    Introduction and Objectives: We report the results of a randomized controlled trial comparing three different lithotriptors using semirigid ureteroscopy (URS) for distal ureteral stones.
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    Urodynamic and clinical features in women with overactive bladder: When to suspect concomitant voiding dysfunction?
    (2021) Santis-Moya, Fernanda; Calvo, Carlos Ignacio; Rojas, Tania; Dell'Oro, Arturo; Baquedano, Paulina; Saavedra, Alvaro
    Aim The aim of this study is to describe the prevalence and type of female voiding dysfunction (FVD) in patients with overactive bladder (OAB) who were studied by urodynamics and its relationship with voiding symptoms.