Objective:The aim of this study was to evaluate the efficacy and safety of ultrasound guided percutaneous sclerotherapy of symptomatic simple renal cysts with n-butyl cyanoacrylate (NBCA) and iodized oil mixture as an outpatient single session procedure.Materials and Methods:A total of ninety two patients with 100 symptomatic simple renal cysts (larger than 5 cm) were treated by ultrasound (US)-guided percutaneous aspiration and injection of NBCA and iodized oil mixture. The patients (68 men and 24 women, mean age, 42.4 ± 10.5 years) were treated with as out-patients. The volume of the treated cysts was calculated with periodic noncontrast enhanced CT examinations 3, 6 and 9, months after the procedure. The procedure was considered successful at follow-up CT when there was total ablation or greater than 80% reduction of size with resolution of symptoms, respectively. Failure was defined as less than 80% reduction and/or persistent symptoms.Results:The sclerotherapy was technically successful in all patients. The diameter of the cysts ranged between 5.5 and 13.5 cm (mean, 8.8 ± 1.4 cm), and 1.5 and 3.8 cm (mean, 2.1 ± 0.4 cm) before and after sclerotherapy, respectively (P < 0.001). Average diameter reduction was 83.7% during the follow-up period. The mean follow- up lasted 7.1 months (3–11 months). Flank pain resolved in 86 of 92 symptomatic patients (93.48%). In six patients, the symptoms decreased slightly. The procedure was successful in 98 of 100 cysts (98%), demonstrated by follow-up CT. The only two failed cyst was larger than 10 cm in diameter and don’t required any further treatment. We did not observe any procedure related complications.Conclusion:Ultrasound guided percutaneous sclerotherapy with NBCA and iodized oil mixture for management of symptomatic simple renal cysts was found to be a real time, effective, safe, well tolerated, alternative and simple technique that can be carried out by urologists as an outpatient procedure.
Background: the sacroiliac joint (SIJ) is the largest axial joint in the body, with an average surface area of 17.5 cm 2 , it is an accepted source of low back and/or buttock pain with or without lower extremity pain. Based upon history and physical examination findings, the prevalence of sacroiliac joint pain in chronic low back pain population has been shown to range from 22.5% to 62.8%. Aim of this work: to evaluate the therapeutic benefit of intra articular corticoid injections into the sacroiliac joints in a standardized fashion. Patients and Methods: This study included 20 adults with SIJ pain due to different reasons and who were scheduled to undergo SIJ injection of corticosteroids and local anesthetic. Demographic data to consider includes sex, age, weight, occupation, affected side, co morbidity and suggested pathology of the examined SIJ. Results: there is significant decrease of the inflammatory back pain in 85% of patients; on mean post 2.00±1.86 compared to pre 7.50±1.24 according to VAS of patients after 6 months follow up (p-value <0.001 HS). Its minimally invasive procedure & good result by single injection to all patients during 6 months follow up. Conclusion: CT guided sacroiliac joint minimally invasive, short time, very accurate and good results obtained. Intra articular SIJ injection is an effective method for alleviating pain in patients suffers from SIJ pain at least in short term.
Purpose: To evaluate effect of PRGF intra articular injection in patients with internal derangement of TMJ using CT guided versus conventional puncture technique. Materials and methods: Twenty patients with internal derangement without improvement by conservative treatment were divided into two groups: Group I: ten patients underwent arthrocentesis followed by PRGF injection using conventional puncture by anatomical landmarks. Group II: ten patients underwent arthrocentesis followed by PRGF injection using landmark and confirmed by CT. All patients were assessed preoperatively and postoperatively at 1week, 3 and 6 months for pain level, maximum interincisal opening, lateral, protrusive movements, joint tenderness and disk position with MRI after 6 months. Results: In both groups, all clinical variables showed statistical significant discrepancy postoperatively, the discrepancy between both groups was not statistically significant and MRI showed no statistical significant change in disc position. Conclusion: CT confirmed accurate position and depth within TMJ upper compartment in different views, allowed correction with less puncture trials and decreased learning curve of TMJ puncture but it is expensive, time consuming and not available in clinics. Anatomical landmarks is easy and representable method for TMJ puncture but blind technique and needs skill. Single injection of PRGF found efficient in the treatment of internal derangement of TMJ.
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