Browsing by Author "Saavedra, Álvaro"
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Publication Magnetic resonance imaging of paraurethral and paravaginal lesion: relevant diagnoses, key findings and surgical correlation(https://doi.org/10.21037/tau-2024-726, 2025) Labra, Andrés; Cocio, Rolando; Saavedra, Álvaro; Schiappacasse, Giancarlo; Blaskovic, FernandaParaurethral and paravaginal lesions are uncommon entities that often present diagnostic challenges due to their anatomical complexity, varied etiologies, and overlapping clinical presentations. Accurate identification and characterization of these lesions are essential for appropriate management and surgical planning. A structured diagnostic approach, based on clinical history, lesion location, and imaging features, is critical to avoid misdiagnosis and unnecessary interventions. Magnetic resonance imaging (MRI) has emerged as the modality of choice due to its excellent soft-tissue contrast, multiplanar capabilities, and non-invasive nature, offering superior delineation of lesion extent and relationship with adjacent pelvic structures. This pictorial review seeks to support radiologists and clinicians by offering a comprehensive yet practical guide to the imaging evaluation of paraurethral and paravaginal lesions. Through high-resolution MRI images and original anatomical illustrations, we aim to reduce the gap between imaging interpretation and clinical decision-making. We summarize the primary MRI indications for evaluating female urethral pathology, provide an overview of common and rare differential diagnoses, and highlight relevant MRI protocol considerations. Additionally, we include correlations with surgical findings when available, to enhance clinical applicability. Rather than providing an exhaustive catalog of entities, our focus is to promote standardized imaging assessment and highlight key anatomical and diagnostic considerations that may facilitate a more confident and informed multidisciplinary approach to these often-overlooked pelvic pathologies.Publication Sacral neuromodulation therapy for urinary and defecatory disorders: experience in a Latin American public hospital(2024) Mass, Marcelo; Arévalo, Diego; Aleuanlli, Isidora; Santis, Fernanda; Maluenda, Andrea; Dines, Eitan; Cohen, Miriam; Saavedra, Álvaro; Raby, Trinidad; Blumel, Bernardita; Cuevas, Rodrigo; Pohlhammer, Simone; Alarcon, Gabriela; Arellano, Marco; Pizarro, JavierObjective: 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.