Biomedical subjects
Publications and source records attributed to A M Kwart.
We describe a method to remove papillary transitional cell carcinoma of the bladder using an adapted colonoscopic snare for transurethral electroresection. This method permits safe and accurate resection of papillary bladder tumors without the complications associated with the use of the resectoscope.
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Bladder replacement after radical cystectomy offers the cancer patient the possibility of restoration to a functional level not possible with the standard means of urinary diversion. Herein we present our experience using a detubularized right colonic segment to create functional reservoirs in 2 male patients and a continent reservoir in a female patient. Cystometric analysis reveals capacious reservoirs, low basal pressures, and a tendency toward pressure spikes at higher filling volumes. All 3 patients are continent at volumes up to 400 cc with preservation of the upper urinary tracts and the absence of reflux. We believe the simplicity of this technique and the encouraging results will contribute to more widespread application of continent and functional reservoirs.
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In this study, the cytologic diagnosis obtained by transrectal fine needle prostatic aspiration was compared to the histologic diagnosis obtained by prostatic needle biopsy or transurethral prostatic resection. Confirmation of all diagnoses occurred 91 per cent of the time: 96 per cent with benign prostatic hyperplasia, 77 per cent with carcinoma, and 100 per cent with prostatitis. Inadequate sampling for cytologic diagnosis occurred at the initiation of this study. False positive cancer diagnosis did not occur. False negative cancer diagnosis prompted appropriate follow-up. Fine-needle prostatic aspiration is a painless, simple to learn, minimally invasive, easily repeated, outpatient procedure for determining prostate pathology. The procedure should be part of each urologist's diagnostic capability.
Gynecologic diseases are a rare but easily detectable cause of complete urinary retention. Herein we describe a case of intermittent but complete urinary retention secondary to uterine fibroids and prolapse during the first trimester of pregnancy.
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A case of transitional cell carcinoma in a pyelogenic cyst is presented. The pathogenesis of pyelogenic cysts and the clinical management of avascular cystic renal masses are discussed.
A new bladder pump prosthesis has been designed and evaluated in the normal dog bladder. This encompasses a magnetic pump located subcutaneously with internal silicone catheters from bladder to the urethra. The pump is powered from a hand-held activator which is magnetically coupled externally across the skin. This pump was evaluated in 12 dogs for an average of 65 days and provided adequate emptying of the bladder without alteration of the normal urinary tract or pump malfunction. The potential and limitations of this new approach are discussed.
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The concept of vasculogenic impotence in humans is addressed by attempting to surgically create and correct vasculogenic impotence in healthy dogs. Initial experience reveals that only by extensive pelvic vascular interruption can such impotence be created and that, at best, it is only temporary because of collateralization. Microsurgical revascularization using both direct femoral artery implantation and femoral vein interposition into the corpus cavernosum penis yielded low patency rates. Further studies on this technique are needed before it can be recommended for widespread use in human beings.