To compare examination adequacy and patient discomfort during retrograde urethrography (RUG) performed by using the conventional balloon method versus those of RUG and voiding cystourethrography (VCUG) performed with the clamp method of using drip infusion for the administration of contrast material. This prospective study was approved by the institutional review board; written informed consent was obtained from all patients. Eighty men (mean age, 64.3 years +/- 16 [standard deviation]; range, 18-85 years) suspected of having urethral stenosis were randomly distributed into two groups for urethrography: a control group (n = 36) and a clamp group (n = 44). In 11 of the 36 patients in the control group, the conventional balloon method could not be used, so these patients were transferred to the clamp group. Drip infusion was used to administer contrast material for RUG, and, except in cases where a suprapubic catheter was used (n = 8), for VCUG. The pain levels reported by patients were recorded by using a verbal descriptor scale (VDS) and a visual analogue scale (VAS). In the control group, RUG was successfully performed in 69% of patients (25 of 36), and mean pain levels recorded on inflation of the balloon were distressing according to the VDS and 4.8 +/- 1.4 (range, 2.3-7.5) according to the VAS. In the clamp group, RUG was successfully performed in all cases; in 69% of patients in this group (38 of 55), the pain level recorded at external compression was no pain according to the VDS and 0 according to the VAS, while mean values in the remaining 31% of patients (17 of 55) were mild pain on the VDS and 0.6 +/- 0.3 (range, 0.3-1.2) on the VAS. Bladder filling for VCUG was achieved with drip infusion in 96% of patients (69 of 72) in an average time of 11 minutes. The conventional balloon method of performing RUG is painful and, in some cases, not effective. The clamp method is a simple, well-tolerated procedure that allowed diagnostic evaluation in all cases. Drip infusion enables RUG and VCUG to be performed without the need for syringes or bladder catheters, thus increasing patient comfort.

Objective:To describe a new technique to prevent skin laceration during ultrasound-guided vacuum-assisted breast biopsy with the insertion of a spinal needle between the mass and the skin.Methods:The study includes 118 patients with 118 breast imaging-reporting and data system Category 3 masses located very close to the skin or areola, which were excised using the mammotome system with a spinal needle inserted just above the site of insertion of the probe.Results:The mean distance between the most superficial portion of the mass to the under surface of the overlying skin was 1.3 ± 0.4 mm. The average procedure time was 13.5 ± 4.2 min. A complete excision was achieved in 100% of the cases, and the procedure was well tolerated by all the patients. No patient experienced serious adverse events such as a skin laceration.Conclusion:This is the first study to prevent skin laceration during vacuum assisted breast biopsy.Advances in knowledge:The method described in this study is simple, safe and well tolerated b...

The aim of this study was to investigate the efficacy of the vacuum-assisted biopsy (VAB) system in evacuating symptomatic haematomas after VAB excision of benign breast lesions. We retrospectively analysed the data of eight patients with symptomatic and large haematomas who were treated with VAB evacuation between 10 and 14 days after VAB excision. Only one case underwent the procedure 24 h after VAB excision, due to the patient reporting intense pain, which was relieved after application of the technique, even though it had to be done twice. This new clinical application of the VAB system for evacuating symptomatic breast haematomas was successful in all the cases in the present study. No technique-related complications were observed. Conclusions: To the best of our knowledge, this is the first study to reveal that VAB evacuation of symptomatic haematomas is safe, effective, quick and well-tolerated by patients.

Background: Retrograde urethrography is considered the gold standard for evaluating stenosis or urethral disease. Purpose: To describe the clamp method for optimizing retrograde urethrography (RUG) using a perfected device and a drip infusion system. Material andMethods: RUG was performed in 42 patients with a mean age of 63.4±16.5 years suspected of having urethral stenosis. The modifications to the device are shown, and the steps of the technique described. The intensity of pain from both catheterization and external compression was measured on a visual analog scale (VAS). Results: All the RUG examinations were conducted satisfactorily. The use of the drip infusion system enabled visualization of the posterior urethra in 97.6% of cases, and bladder repletion was achieved in 95.2% of cases. The urethrograms revealed images of stenosis in 31 patients. With catheterization the mean pain intensity registered by VAS was 0.7±0.6 (SD), whereas with external compression the mean pain intensity was 0.06±0.02 (SD). Conclusion: The clamp method and drip infusion system used in this study are efficient and reduce patient discomfort. The procedure makes it possible to assess cases with stenosis close to the meatus that are difficult to manage with the conventional method.