BRUNO CAMARGO TISEO

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Instituto Central, Hospital das Clínicas, Faculdade de Medicina - Médico
LIM/55 - Laboratório de Urologia, Hospital das Clínicas, Faculdade de Medicina

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  • article 3 Citação(ões) na Scopus
    Renal pseudoaneurysm after core-needle biopsy of renal allograft successfully managed with superselective embolization
    (2016) ANTONOPOULOS, Ioannis M.; YAMACAKE, Kleiton Gabriel Ribeiro; TISEO, Bruno C.; CARNEVALE, Francisco C.; JUNIOR, Enio Z.; NAHAS, William C.
  • article 21 Citação(ões) na Scopus
    Comparison of the learning curves and frustration level in performing laparoscopic and robotic training skills by experts and novices
    (2015) PASSEROTTI, Carlo C.; FRANCO, Felipe; BISSOLI, Julio C. C.; TISEO, Bruno; OLIVEIRA, Caio M.; BUCHALLA, Carlos A. O.; INOUE, Gustavo N. C.; SENCAN, Arzu; SENCAN, Aydin; PARDO, Rogerio Ruscitto do; NGUYEN, Hiep T.
    Robotic assistance may provide for distinct technical advantages over conventional laparoscopic technique. The goals of this study were (1) to objectively evaluate the difference in the learning curves by novice and expert surgeons in performing fundamental laparoscopic skills using conventional laparoscopic surgery (CLS) and robotic-assisted laparoscopic surgery (RALS) and (2) to evaluate the surgeons' frustration level in performing these tasks. Twelve experienced and 31 novices in laparoscopy were prospectively evaluated in performing three standardized laparoscopic tasks in five consecutive, weekly training sessions. Analysis of the learning curves was based on the magnitude, rate, and quickness in performance improvement. The participant's frustration and mood were also evaluated during and after every session. For the novice participants, RALS allowed for shorter time to task completion and greater accuracy. However, significant and rapid improvement in performance as measured by magnitude, rate, and quickness at each session was also seen with CLS. For the experienced surgeons, RALS only provided a slight improvement in performance. For all participants, the use of RALS was associated with less number of sessions in which they felt frustrated, less number of frustration episodes during a session, lower frustration score during and after the session, and higher good mood score. The advantages of RALS may be of most benefit when doing more complex tasks and by less experienced surgeons. RALS should not be used as a replacement for CLS but rather in specific situations in which it has the greatest advantages.
  • conferenceObject
    A scoring system for testicular torsion: Decreasing costs and therapeutic delay
    (2012) BARBOSA, J. A. B. A.; OLIVEIRA, C. M.; TISEO, B. C.; PASSEROTTI, C. C.; SROUGI, M.; NGUYEN, H. T.; RETIK, A. B.
    NTRODUCTION & OBJECTIVES: Testicular torsion is a surgical emergency requiring prompt intervention to prevent testicular loss. Differential diagnosis is not easily done with clinical evaluation, and imaging studies are usually required, especially ultrasound, causing therapeutic delay. Our objective was to create a scoring system for clinical diagnosis of testicular torsion, thus eliminating the necessity of ultrasound (US). MATERIAL & METHODS: Patients presenting with acute scrotum at a tertiary care center were prospectively evaluated and physical examination was performed by the first urologist to see the patient. Scrotal ultrasound was performed in all patients after visit. Single variate analysis was performed and clinical variables associated with testicular torsion were identified. A scoring system was created based upon logistic regression with relevant variables from univariate analysis. Retrospective validation of the scoring system was performed including all patients seen with suspicion for testicular torsion at this institution up to 2 years prior to the beginning of the prospective evaluation. RESULTS: Two hundred and thirty one patients were enrolled in the first phase of the study. Mean age of patients was 12.1 years and mean duration of symptoms was 40.2 hours. Thirty-three patients had a final diagnosis of torsion. Clinical variables associated with torsion were scrotal swelling, nausea and vomiting from history and testicular swelling, high-riding test icle, horizontal lie of the testicle, increased consistency of the testicle to palpation, presence of a thickened spermatic cord, negative Prehn's sign, absent cremasteric reflex and fixed scrotal skin to testis on physical examination (p<0.05). A scoring system was created with 5 variables, and patients were stratified in low, intermediate and high risk for torsion. Twenty-two patients were at high risk for testicular torsion, all of which had a final diagnosis of torsion, and 170 patients were at low risk for torsion, none of which had a diagnosis for this condition. Low and high risk groups comprised 82% of all patients seen. Retrospective validation was performed for 116 patients and 83% of cases fell within low or high risk categories; all patients in the high risk category had a final diagnosis of torsion and none in the low risk group. CONCLUSIONS: The present scoring system is a valuable tool for diagnosis of testicular torsion, eliminating the necessity of ultrasound in 80% of cases. Prospective validation of this score is necessary.
  • bookPart 0 Citação(ões) na Scopus
    Evaluation of men with unexplained infertility
    (2015) COCUZZA, M.; TISEO, B. C.
    Infertility affects approximately 15 % of couples desiring conception and male infertility underlies nearly half of the cases. However, despite the diagnostic advances in male infertility field, approximately 30 % of patients still have no apparent cause for their infertility problem. Although it is anticipated that future developments will allow identification of the etiology for subfertility in these patients, at present they are considered unexplained disorders that challenge specific treatment recommendations. The use of assisted reproductive techniques (ART) to overcome male infertility is increasing, and due to its effectiveness, this treatment modality has been suggested by some to be used as the treatment of choice in the majority of the cases of male factor infertility regardless of etiology. Although the use of ART may allow infertile couples to achieve pregnancy rapidly, the fear of transferring the unnecessary burden of invasive treatment on healthy female partners weigh down this treatment option heavily. The true litmus test for male fertility remains the ability to generate pregnancy in vivo. Although seminal parameters are used as a surrogate measure of a man’s fertility potential, it is definitely not a direct measure by any means. Seminal parameters between the reference ranges not reflect defects in sperm function. Thus, the assessment of sperm structure and function has gained interest and resulted in the development of the new techniques that are presented in this chapter. © Springer Science+Business Media, LLC 2015.
  • article 19 Citação(ões) na Scopus
    Impact of body mass index, age and varicocele on reproductive hormone profile from elderly men
    (2016) YAMACAKE, K. G. R.; COCUZZA, M.; TORRICELLI, F. C. M.; TISEO, B. C.; FRATI, R.; FREIRE, G. C.; ANTUNES, A. A.; SROUGI, M.
    Objectives: To study the impact of obesity, age and varicocele on sexual hormones fof adult and elderly men. Materials and Methods: 875 men who were screened for prostate cancer were enrolled in this study. Data recorded comprised age, body mass index (BMI), serum levels of total testosterone (TT), free testosterone (FT), sex hormone-binding globulin (SHBG), luteinizing hormone (LH) and follicular stimulating hormone (FSH). Patients were divided in groups according to their BMI in underweight, normal weight, overweight and obese grades 1, 2 or 3. First, it was studied the association between age, BMI, and hormone profile. Then, clinical varicocele was evaluated in 298 patients to assess its correlation to the others parameters. Results: Obese patients had lower levels of TT, FT and SHBG (p<0.001) compared to underweight or normal weight patients. There were no differences in age (p=0.113), FSH serum levels (p=0.863) and LH serum levels (p=0.218) between obese and non-obese patients. Obese grade 3 had lower levels of TT and FT compared to obese grade 1 and 2 (p<0.05). There was no difference in the SHBG levels (p=0.120) among obese patients. There was no association between varicocele and BMI; and varicocele did not impact on testosterone or SHBG levels. Conclusions: Men with higher BMI have a lower serum level of TT, FT and SHBG. The presence of clinical varicocele as well as its grade has no impact on hormone profile in elderly men.
  • article 2 Citação(ões) na Scopus
    Infrared Thermometer: an accurate tool for temperature measurement during renal surgery
    (2013) MARCHINI, Giovanni Scala; DUARTE, Ricardo Jordao; MITRE, Anuar Ibrahim; TISEO, Bruno Camargo; CASSAO, Valter Dell'Acqua; TORRICELLI, Fabio Cesar Miranda; ARAP, Marco Antonio; SROUGI, Miguel
    Purpose: To evaluate infrared thermometer (IRT) accuracy compared to standard digital thermometer in measuring kidney temperature during arterial clamping with and without renal cooling. Materials and Methods: 20 pigs weighting 20Kg underwent selective right renal arterial clamping, 10 with (Group 1 - Cold Ischemia with ice slush) and 10 without renal cooling (Group 2 - Warm Ischemia). Arterial clamping was performed without venous clamping. Renal temperature was serially measured following clamping of the main renal artery with the IRT and a digital contact thermometer (DT): immediate after clamping (T0), after 2 (T2), 5 (T5) and 10 minutes (T10). Temperature values were expressed in mean, standard deviation and range for each thermometer. We used the T student test to compare means and considered p < 0.05 to be statistically significant. Results: In Group 1, mean DT surface temperature decrease was 12.6 +/- 4.1 degrees C (5-19 degrees C) while deep DT temperature decrease was 15.8 +/- 1.5 degrees C (15- 18 degrees C). For the IRT, mean temperature decrease was 9.1 +/- 3.8 degrees C (3-14 degrees C). There was no statistically significant difference between thermometers. In Group 2, surface temperature decrease for DT was 2.7 +/- 1.8 \degrees C (0-4 degrees C) and mean deep temperature decrease was 0.5 +/- 1.0 degrees C (0-3 degrees C). For IRT, mean temperature decrease was 3.1 +/- 1.9 degrees C (0-6 degrees C). No statistically significant difference between thermometers was found at any time point. Conclusions: IRT proved to be an accurate non-invasive precise device for renal temperature monitoring during kidney surgery. External ice slush cooling confirmed to be fast and effective at cooling the pig model.
  • conferenceObject
    CAN WE TRUST IN VARICOCELE CLASSIFICATION AND TESTICULAR VOLUME MEASUREMENT BY PHYSICAL EXAMINATION?
    (2014) COCUZZA, Marcello; TISEO, Bruno; SROUGI, Victor; WOOD, Guilherme; RICARDO, Jose; SROUGI, Miguel
  • bookPart
    Incontinência urinária
    (2015) TANNO, Fabio Yoshiaki; TISEO, Bruno Camargo; LUCON, Marcos; BRUSCHINI, Homero
  • article 27 Citação(ões) na Scopus
    Bariatric Surgery Impact on Reproductive Hormones, Semen Analysis, and Sperm DNA Fragmentation in Men with Severe Obesity: Prospective Study
    (2020) WOOD, Guilherme Jacom Abdulmassih; TISEO, Bruno C.; PALUELLO, Davi V.; MARTIN, Hamilton de; SANTO, Marco Aurelio; NAHAS, William; SROUGI, Miguel; COCUZZA, Marcello
    Purpose Growing evidence in the literature suggests that obesity is capable of altering reproductive hormone levels and male fertility. Effects on classic semen parameters and sperm DNA fragmentation (SDF), however, have not been properly established. Additionally, the impact of bariatric surgery (BS) on those parameters is still controversial. Materials and Methods In Phase 1, 42 patients with obesity and 32 fertile controls were submitted to reproductive hormone evaluation, semen analysis, and SDF testing. In Phase 2, patients with obesity were submitted to BS or clinical follow-up and were invited to 6-month revaluation. Results Phase 1: Men with obesity have higher levels of estradiol, LH, and FSH and lower levels of total testosterone (TT) when compared with eutrophic fertile men. Additionally, they present worse semen parameters, with reduction in ejaculated volume and sperm concentration, worse sperm motility and morphology, and higher SDF. Phase 2: 32 patients returned to revaluation. Eighteen were submitted to BS (group S) and 14 were not submitted to any specific therapeutic regimen (group NS). In group S, TT more than doubled after surgery (294.5 to 604 ng/dL,p < 0.0001). Worsening of sperm concentration and total ejaculated sperm count were also noticed, and 2 patients became azoospermic after BS. SDF, however, improved after the procedure. No changes in the variables studied were observed in non-operated patients. Conclusion In this prospective study, we have found that BS results in improvements in reproductive hormone levels and SDF after 6-month follow-up. Sperm concentration, however, reduced after the procedure.
  • article 95 Citação(ões) na Scopus
    Development and Initial Validation of a Scoring System to Diagnose Testicular Torsion in Children
    (2013) BARBOSA, Joao A.; TISEO, Bruno Camargo; BARAYAN, Ghassan A.; ROSMAN, Brian M.; TORRICELLI, Fabio Cesar Miranda; PASSEROTTI, Carlo C.; SROUGI, Miguel; RETIK, Alan B.; NGUYEN, Hiep T.
    Purpose: Testicular torsion is a surgical emergency requiring prompt intervention. Although clinical diagnosis is recommended, scrotal ultrasound is frequently ordered, delaying treatment. We created a scoring system to diagnose testicular torsion, decreasing the indication for ultrasound. Materials and Methods: We prospectively evaluated 338 patients with acute scrotum, of whom 51 had testicular torsion. Physical examination was performed by a urologist, and all patients underwent scrotal ultrasound. Univariate analysis and logistic regression were performed, and a scoring system for risk stratification of torsion was created. Retrospective validation was performed with 2 independent data sets. Results: The scoring system consisted of testicular swelling (2 points), hard testicle (2), absent cremasteric reflex (1), nausea/vomiting (1) and high riding testis (1). Cutoffs for low and high risk were 2 and 5 points, respectively. Ultrasound would be indicated only for the intermediate risk group. In the prospective data set 69% of patients had low, 19% intermediate and 11.5% high risk. Negative and positive predictive values were 100% for cutoffs of 2 and 5, respectively (specificity 81%, sensitivity 76%). Retrospective validation in 1 data set showed 66% of patients at low, 16% intermediate and 17% high risk. Negative and positive predictive values for cutoffs of 2 and 5 were 100% (specificity 97%, sensitivity 54%). The second retrospective data set included only torsion cases, none of which was misdiagnosed by the scoring system. Conclusions: This scoring system can potentially diagnose or rule out testicular torsion in 80% of cases, with high positive and negative predictive values for selected cutoffs. Ultrasound orders would be decreased to 20% of acute scrotum cases. Prospective validation of this scoring system is necessary.