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Biomedical subjects

B M Tolia

Publications and source records attributed to B M Tolia.

At least 19 recordsLinked to original sources
PubMed1989

Detection of testicular endocrine abnormalities and their correlation with serum antisperm antibodies in men following vasectomy.

We measured the serum gonadotropin response to gonadotropin-releasing hormone in 25 men who underwent vasectomy 2 to 64 months before the study. Ten age-matched fertile men were used as controls. Baseline serum follicle-stimulating hormone, luteinizing hormone and testosterone levels were not significantly different between vasectomized men and controls. However, mean serum follicle-stimulating and luteinizing hormone responses to an intravenous bolus injection of 100 mcg. gonadotropin-releasing hormone were significantly greater in the vasectomy group (p equals 0.008 and 0.003, respectively). There was no correlation between these responses and the interval after vasectomy. Serum antisperm antibodies were present in 13 vasectomized men (52 per cent) using enzyme-linked immunosorbent assay and microagglutination techniques. A significant correlation (p equals 0.003) was found between the presence of serum antisperm antibodies and a normal follicle-stimulating hormone response to gonadotropin-releasing hormone stimulation. Of 13 patients with demonstrable antisperm antibody titers 9 (69 per cent) had normal follicle-stimulating hormone responses, compared to only 1 of 12 (8 per cent) without identifiable antisperm antibody titers. Our data suggest that certain men following vasectomy have abnormalities in seminiferous tubule and Leydig cell functions of the testes. These abnormalities are unrelated to the interval after vasectomy and are not identifiable with routine static hormonal measurements. In addition, serum antisperm antibodies are most likely to be present in men who demonstrate normal seminiferous tubular activity after vasectomy.

Adult↗
PubMed1988

Urachal remnants in adults.

Urachal disorders are uncommon and present with varied appearances. Three cases of urachal disease, one congenital and two acquired, are reported. Each case is representative of the symptoms and findings of its respective category. A review of the literature is presented. A basic understanding of urachal development is necessary to suspect a diagnosis of urachal disease.

Adult↗
PubMed1988

Gonadal dysfunction after testicular torsion: luteinizing hormone and follicle-stimulating hormone response to gonadotropin releasing hormone.

We studied 14 postpubertal patients at an average of 33 months after treatment for testicular torsion. Of these patients 11 had been treated by detorsion and 3 by orchiectomy. Five normal male volunteers of the approximate age of the study group served as controls. The patients treated by detorsion were subdivided into 3 groups based on the degree of atrophy of the detorsed testicle: group 1--no testicular atrophy (5), group 2--25 per cent testicular atrophy (2) and group 3--greater than 90 per cent testicular atrophy (4). Mean duration of torsion was greatest in the orchiectomy group (161 hours) compared to 6, 16 and 29 hours for groups 1, 2 and 3, respectively. The serum luteinizing hormone and follicle-stimulating hormone response to an intravenous bolus of 100 mcg. synthetic gonadotropin releasing hormone was measured in all patients. All groups had a greater mean follicle-stimulating hormone response to gonadotropin releasing hormone stimulation than controls (p less than 0.05). Patients who underwent orchiectomy had the greatest follicle-stimulating hormone response to gonadotropin releasing hormone stimulation. Mean luteinizing hormone response to gonadotropin releasing hormone stimulation was normal in patients without atrophy (group 1) but it was greater than controls in patients who had atrophy (groups 2 and 3) or who underwent orchiectomy (p less than 0.05). Several conclusions could be made from our study. All patient groups treated for torsion had evidence of testicular dysfunction. Patients who underwent orchiectomy displayed more testicular dysfunction than patients who had atrophy after detorsion. Testicular dysfunction after torsion is more likely to involve spermatogenic before Leydig cell function.

Adolescent↗
PubMed1988

Continence mechanisms following transphincteric urethroplasty.

Urinary continence mechanisms were studied in 6 patients, 5 of whom had undergone end-to-end urethroplasty for membranous urethral strictures. All patients were able to interrupt the urinary stream on command by contracting the distal intrinsic sphincteric mechanism, despite an absent extrinsic sphincter. In 2 patients with prostatectomy and transphincteric urethroplasty, the intrinsic sphincteric mechanism was the sole remaining sphincter. These observations suggest that the intrinsic sphincteric mechanism is intramurally located, is also under somatic innervation and alone is capable of performing all of the sphincteric function required in the male.

Humans↗
PubMed1987

Unstable bladder: urodynamic diagnosis and observations in evaluating urinary incontinence in the female.

Unstable bladder in the female has been the subject of controversy with regard to its etiology, identification, and treatment. One hundred thirty consecutive female patients referred with incontinence were evaluated as to their symptoms and urodynamic findings. A stress cystometrogram, systematically done, was introduced and observations were made regarding certain findings on the urodynamic examination. These criteria were used subsequently for making a diagnosis of unstable bladder. Forty per cent of these patients were found to have an unstable bladder. History of frequency and urgency correlated best with a diagnosis in 70 to 80 per cent of our cases, and the new stress cystometrogram proved to be the most sensitive urodynamic test (78%) for detecting this condition. A systematic approach such as we describe is advocated as a first step toward gaining a better understanding of this puzzling entity.

Female↗
PubMed1986

Role of urodynamics in management of urethral diverticulum in females.

This report deals with 10 female patients with urethral diverticula, 8 of whom were also found to have findings of stress incontinence. This association was proved by urodynamic studies. Three patients were seen with incontinence postdiverticulectomy. Seven patients were evaluated prior to diverticulectomy, and of these 5 had anatomic changes of stress urinary incontinence. Those patients in whom the preoperative evaluation considered them to be at risk for development of stress incontinence postdiverticulectomy were treated with a prophylactic urethropexy. Patients so treated were continent and voided well and were probably spared having a postoperative problem with incontinence. The role of urodynamic techniques in the detection of any association between the diverticulum and a possible risk of postdiverticulectomy incontinence, and how to recognize the problem and its correction before it becomes clinically manifest are the stated purposes of this report.

Diverticulum↗
PubMed1985

On percutaneous drainage of retroperitoneal collections: when is primary surgical drainage preferable?

Percutaneous drainage of retroperitoneal collections is a method employed with an ever-increasing frequency. The indication for primary surgical drainage of these collections is rapidly decreasing. Herein we describe what we consider to be the indications for primary surgical drainage of retroperitoneal collections illustrated by the recurrence of the abscess in 3 of our patients following adequate primary percutaneous drainage.

Abscess↗
PubMed1985

Influence of indwelling urinary tract stones on twenty-four-hour urine chemistries.

Twenty-two patients with ureteral stones underwent twenty-four-hour urinary excretion studies of calcium, phosphorus, and uric acid before and after stone elimination from the urinary tract. Comparison of pre- and post-stone elimination studies showed no significant differences suggesting that the presence of stones in the urinary tract has little influence on the twenty-four-hour urinary excretion of calcium, phosphorus, and uric acid.

Calcium↗
PubMed1985

Androgen receptors in bladder tumors.

Cytosol androgen receptor content of transitional cell bladder cancer tissue was found to be substantially higher than its content in normal bladder mucosa and lower than in control benign prostatic hypertrophy tissue. Tumors arising in female patients had a lower androgen receptor content than those arising in male patients. High-grade tumors had a lower androgen receptor content than low-grade tumors.

Carcinoma, Transitional Cell↗
PubMed1985

Intraoperative profilometry.

Intraoperative profilometry measurements were done on 28 patients during various types of urethropexy to determine whether useful information could be provided to the operating surgeon. Successful Burch, Marshall-Marchetti and Stamey-Pereyra procedures resulted in a 50 per cent increase in urethral length. Closure pressure increases were noted only with the Stamey-Pereyra procedure (plus 49 per cent). Intraoperative profilometry measurements were considered to be informative and useful, particularly during the Stamey-Pereyra urethropexy in which case suture ties could be regulated to provide desired urethral elongation and closure pressure changes.

Female↗
PubMed1984

Is there a urodynamic equivalence to anterior urethra in the male?

To evaluate the role of the anterior urethra in the male in micturition dynamics, 9 patients with urethral strictures who were undergoing a two-stage Turner-Warwick urethroplasty were evaluated with flow and pressure flow measurements, pre- and post-second-stage urethroplasty. Any decrease in flow or increase in resistance after closure would suggest an anterior "urethral effect." None was found, indicating that the anterior urethra in the male functions as an inert conduit.

Humans↗
PubMed1984

Sex-dependent variations in natural history of transitional cell carcinoma of bladder.

The records of 196 patients with transitional cell carcinoma of the bladder diagnosed up to 1975 were analyzed for age, sex, tumor histology, and survival parameters. Analysis of the series as a whole showed it to be comparable to literature controls in the male to female ratio, average age at presentation, and in survival data. Sex stratification combined with parametric analysis showed that females had longer recurrence-free survivals and died less frequently of bladder cancer than their male counterparts. In addition, the incidence of high-grade tumors was lower in females. These facts and the comments that follow point to a probable less aggressive natural history of transitional cell carcinoma of the bladder in females.

Adult↗
PubMed1980

Xanthogranulomatous pyelonephritis: segmental or generalized disease.

Xanthogranul omatous pyelonephritis of the kidney usually occurs in association with urinary tract infection, obstruction and/or calculi. The diagnosis usually is made when a nephrectomy is performed for a non-functioning kidney and/or a mass indistinguishable from carcinoma on radiological as well as gross examination. Segmental excision of the kidney for focal xanthogranulomatous pyelonephritis has been used rarely in the past. Focal involvement of the kidney with xanthogranulomatous pyelonephritis was encountered in 4 instances at our institution. The diagnosis was made incidentally in 3 patients during segmental excision of the involved parenchyma and/or cyst wall. We believe that the xanthogranulomatous process probably starts as a localized involvement in some cases and, if excised during this stage, further destruction of renal parenchyma can be prevented successfully.

Adult↗
PubMed1978

Carcinoma of prostate presenting as retroperitoneal mass.

The pattern of dissemination of prostatic carcinoma varies, but skeletal metastasis is the single most common symptomatic mode of presentation. The clinical course and treatment of the 2 cases presenting with symptomatic metastases to the retroperitoneum are described in detail and pertinent literature is reviewed.

Adenocarcinoma↗
PubMed1978

Symptomatic renal angiomyolipoma: report of 8 cases, 2 with spontaneous rupture.

Of the 97 patients with symptomatic renal angiomyolipoma not associated with tuberous sclerosis reported in the literature 13 have presented with a clinical picture of shock because of spontaneous rupture and massive retroperitoneal hemorrhage. Eight new patients with symptomatic renal angiomyolipomas are described, 2 of whom presented with an acute abdomen. Renal angiomyolipomas are essentially benign tumors. Several angiographic and pyelographic characteristics have been described but none appears to be unequivocally diagnostic. Because of the inability to make a precise preoperative diagnosis and the possibility of massive hemorrhage, nephrectomy is indicated in patients with such unilateral solid tumors in the absence of the tuberous sclerosis complex.

Adult↗
PubMed1977

Testicular torsion in adults: plea for its consideration early in clinical evaluation of acute scrotum.

A case of a thirty-eight-year-old man with acute scrotum is presented. Past history of transient episodes of testicular pain, negative findings on urinalysis, and lack of symptomatic relief despite antibiotic therapy plus a high index of suspicion helped establish the correct diagnosis of testicular torsion. A long delay between onset of symptoms and surgical exploration resulted in testicular infarction. A plea is made to consider torsion of the testis even in the adult with scrotal pain when all of the classic clinical criteria of epididymitis are not present.

Acute Disease↗