The management of acute scrotum pain.
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Biomedical subjects
Publications and source records attributed to C U Moisey.
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Thirty-eight patients with bladder neck obstruction were treated by unilateral bladder neck incision. Good subjective and urodynamic results were obtained in 33 patients. Retrograde ejaculation occurred in 16% of the patients on recommencing sexual activity. The value of combined videocystography and pressure flow studies is discussed. The technique is not recommended for patients presenting with acute retention.
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The results of a double-blind controlled trial using oxybutynin chloride in 30 patients are described. Twenty-three patients completed the study; 17 of these had symptomatic improvement and 9 patients had urodynamic improvement. Seventeen patients had significant side effects.
An inhibitor to procoagulant factor VIII (FVIIIC) developed in a patient three years after palliative resection of a bronchogenic carcinoma. The inhibitor was not active against ristocetin cofactor but possibly had some activity against factor XI. It responded to immunosuppressive therapy. This is apparently the first reported association of carcinoma and factor VIII inhibitor.
The results of colonic conduit urinary diversion have been reviewed in 41 children with an average follow-up of 13.2 years. There was a high incidence of stomal stenosis (61.5%), ureterocolic stenosis (22%), ureteric reflux (58%) and upper tract deterioration (48.4%). Comparison with results of ileal conduit diversion in children show no advantage in the use of colon.
Twenty-two patients with bladder outflow obstruction and a past history of cerebrovascular accident are described. Sixteen patients regained normal micturition control. Poor results occurred in the more handicapped patients, especially in those with additional neurological problems. Patients who present with bladder outflow obstruction should be treated surgically. To determine those patients who will have a poor result full clinical and neurological assessment must be made, together with urodynamic studies. In order to improve these results a team approach is required between the urologist, geriatrician, nurse and physiotherapist.
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