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Biomedical subjects

B W Snow

Publications and source records attributed to B W Snow.

At least 37 records · Page 2Linked to original sources
PubMed1994

Repair of urethral diverticulum by plication.

OBJECTIVES: To develop a new technique to repair congenital and acquired megaurethra without opening the enlarged urethra. METHODS: A urethral plication similar to the Starr ureteral plication was developed, which allows the urethra to be plicated without opening into the lumen. This technique also allows the operation to be done in conjunction with hypospadias repairs. RESULTS: Eight of 10 patients had uneventful recoveries. One had obstruction and infection that resolved with drainage and antibiotics. A coronal margin fistula developed in a patient who had urethral plication as well as urethral advancement. CONCLUSIONS: This new urethral plication eliminates the need for opening the urethra and its associated complications while preserving urethral blood supply and allowing associated hypospadias repairs to be simultaneously performed.

Child, Preschool↗
PubMed1993

Urological manifestations of sacrococcygeal teratoma.

A review was done of 29 patients diagnosed with sacrococcygeal teratoma between 1978 and 1991. Urological disorders included total urinary retention (6 patients), hydronephrosis (6), hydrocele (4) and undescended testis (1). Ultrasonography and voiding cystourethrography were performed on the 6 patients in total urinary retention. These studies revealed cystic retrorectal lesions frequently with intralesional calcifications, and anterior and superior displacement of the bladder. Bladder wall trabeculation occurred in 2 of these 6 patients, and 4 had moderate or severe hydronephrosis. Upper urinary tract dilatation was found in 2 patients not in total retention. Hydronephrosis appeared to be related to poor bladder emptying and presumably high intravesical pressures, since each case resolved spontaneously after tumor resection. No primary upper tract anomalies were identified.

Female↗
PubMed1992

Tunica vaginalis urethroplasty.

Tunica vaginalis on a vascular pedicle was tubularized and used as a urethra to repair hypospadias in three difficult cases. This is the first report of tunica vaginalis utilized for a urethral reconstruction in humans. This new surgical technique is described.

Child↗
PubMed1991

Massive cystic ureteral diverticula in infancy.

We report 2 cases of massive abdominal distension due to a mid ureteral diverticulum. In a 1-year-old boy the mid ureteral diverticulum was associated with an atrophied chronically scarred kidney. In a female newborn the diverticulum was associated with an upper pole ureter of a completely duplicated system. To our knowledge this type of ureteral diverticulum has not been reported previously.

Diverticulum↗
PubMed1990

Techniques for outpatient hypospadias surgery.

With careful attention to patient selection and anesthesia, as well as easy-to-manage dressings and urinary diversions, outpatient surgery for all degrees of hypospadias can be performed safely and economically. By using these techniques over an eighteen-month period all hypospadias operations were performed in the outpatient department. This included thirty-four minor operations as well as twenty-five major hypospadias repairs. Seven complications were encountered in the fifty-nine operations.

Ambulatory Surgical Procedures↗
PubMed1989

Transverse corporeal plication for persistent chordee.

A technique is described wherein chordee which persists after resection of all evident fibrous tissue may be corrected. This technique involves a ventral midline incision and transverse dorsal plicating sutures which rotate the corporeal bodies to allow a straight erection.

Humans↗
PubMed1989

Bladder autoaugmentation: early clinical experience.

A surgical technique is described in which detrusor muscle over the entire dome of the bladder is excised while leaving the bladder epithelium intact. A large epithelial bulge is created, which functions to augment the storage properties of the bladder without using bowel, and it is referred to as "autoaugmentation". Seven patients have undergone autoaugmentation of whom 5 have excellent clinical results while 1 has modest improvement. The remaining patient was a technical failure. Postoperative urodynamics in 5 patients demonstrated improved bladder capacity in 3 and markedly improved bladder storage pressures in 4 compared to preoperative studies. The technical aspects of the procedure and patient management are discussed. Autoaugmentation offers potential advantages over enterocystoplasty, is simple to perform, does not preclude future enterocystoplasty if needed and may be a reasonable alternative to conventional augmentation in selected patients.

Adolescent↗
PubMed1989

Serial renal function in an ovine model of unilateral fetal urinary tract obstruction.

Renal tubular and glomerular function following ovine fetal urinary tract obstruction has been studied predominantly in anesthetized, exteriorized fetuses immediately after relief of obstruction. Since surgery and anesthesia may alter fetal cardiovascular and renal physiology, we developed a chronically catheterized, ovine model of unilateral fetal urinary tract obstruction to compare function of the unobstructed and obstructed kidneys repeatedly after relief of obstruction. Split renal function of the previously obstructed kidneys and unobstructed kidneys was measured serially in 7 fetal sheep after obstruction at 55 to 85 days per 147 days of gestation for 30 to 49 days. Seventy-five split clearances were determined on days 1, 2, 3 to 4 and 5 to 6 postoperatively. Not every fetus was studied each day. By 2-way ANOVA, renal function was stable on day 1 after surgery and did not change with time. Previously obstructed kidneys had lower creatinine clearance (0.16 versus 0.71 ml. per minute, p equals 0.0001), higher fractional sodium excretion (33.04 versus 6.02 per cent, p equals 0.0001) and higher urine sodium/creatinine ratio (4.80 versus 0.90 mEq. per mg., p equals 0.0001). Urine flow in the unobstructed kidneys did not differ significantly from that of the obstructed kidneys (0.122 versus 0.083 ml. per minute, p equals 0.35). Obstruction reduced kidney weight (4.7 versus 9.7 gm., p equals 0.0006), cortical thickness (-39 per cent) and nephrogenic zone (-59 per cent), and it increased collecting duct dilatation and medullary fibrosis. No cysts or dysplasia was noted. Fetal urinary tract obstruction for 39.7 days alters renal histology, glomerular function and tubular function. Renal function is stable by 1 day after catheterization and does not change from days 1 to 6 following relief of obstruction.

Animals↗
PubMed1989

Bladder autoaugmentation: partial detrusor excision to augment the bladder without use of bowel.

A surgical technique of partial detrusorectomy (autoaugmentation) for creation of a diverticular bulge of the dog bladder is described. The method is designed to serve as a bladder augmentation without using bowel. We describe the technique, results with dogs and its clinical application. Partial detrusorectomy appears to function as an autoaugmentation that can be performed reliably in dogs, offers potential advantages over bowel segments, and is a potential alternative to enterocystoplasty in selected patients.

Animals↗
PubMed1989

The versatility of the posterior lumbotomy approach in infants.

The versatility of the posterior lumbotomy approach to the upper urinary tract in infants is reviewed. A total of 32 procedures in 25 patients was performed. Nine different types of operations were performed ranging from upper pole heminephrectomy to ureterolysis. Surgical techniques and outcome are reviewed.

Back↗
PubMed1988

Deterioration of renal function in a conjoined twin: lack of compensatory renal hypertrophy.

The renal function of conjoined twin girls was evaluated by radioisotopic, radiographic, and laboratory techniques. The smaller of the twins was shown to have severe impairment of renal function, but due to the "auto-dialysis" by her normal twin, she was able to maintain a normal BUN and creatinine. Compensatory hypertrophy was not found in the normal twin, despite renal failure and loss of renal mass in the smaller twin.

Diseases in Twins↗
PubMed1988

Complications of pregnancy in women after reimplantation for vesicoureteral reflux.

The physiological changes of the urinary tract during pregnancy place women at increased risk of urological problems during that time. To evaluate how patients after ureteral reimplantation fared during this high risk period we contacted 67 women who had undergone ureteroneocystostomy with a minimum of 15 years of followup. Only those who underwent an operation for primary vesicoureteral reflux were included. Of the women 30 had been pregnant with 64 total pregnancies. During pregnancy 17 of the 30 women (57 per cent) had 1 or more urinary tract infections and 5 (17 per cent) had 1 or more episodes of pyelonephritis. There were 8 spontaneous abortions and 1 severe ureteral obstruction requiring cutaneous drainage until after delivery. There appears to be an increased risk of urinary infection and fetal loss in pregnant women who have undergone ureteral reimplantation as children. More frequent urinary screening and aggressive therapy during pregnancy are recommended in this high risk group.

Abortion, Spontaneous↗
PubMed1987

Compensatory renal growth: interactions of nephrectomy serum and urine antisera leading to a new theory of renal growth regulation.

Compensatory renal growth is mediated by a substance(s) found in the serum and in urine called renotropin. The interaction of nephrectomy serum and urine antisera upon compensatory renal growth was investigated by administering rat uninephrectomy serum and sham serum and urine to rabbits. The rabbit antisera was given intravenously to uninephrectomy and sham operated rats and kidney weight/body weight ratios were calculated. Antisera against sham serum and urine induced kidney growth as well as antisera against uninephrectomy serum and urine given to sham animals. These results suggest the presence of a circulating antigenic inhibitor to kidney growth and suggest that renotropin is made up of a inhibitory as well as a stimulatory substance.

Animals↗
PubMed1986

Use of tunica vaginalis to prevent fistulas in hypospadias surgery.

Tunica vaginalis was used to wrap around the neourethra at the time of hypospadias repair. This tunica vaginalis wrap prevented urethrocutaneous fistulas in 20 patients who underwent hypospadias repair. It also was successful when used in conjunction with urethrocutaneous fistula repair in 2 patients.

Humans↗