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Biomedical subjects

D M Essenhigh

Publications and source records attributed to D M Essenhigh.

12 recordsLinked to original sources
PubMed1988

Urethral dilatation compared with cystoscopy alone in the treatment of women with recurrent frequency and dysuria.

The relative merits of cystoscopy alone and cystoscopy plus urethral dilatation were compared in a randomised study of women with recurrent frequency and dysuria. One hundred women were studied before and at least 6 months after operation. A detailed questionnaire was completed, the severity of the symptoms was scored and patients underwent urodynamic investigation. Forty-eight patients underwent cystoscopy alone and 52 underwent urethral dilatation. The two groups were well matched with regard to age, parity, menopausal status, previous gynaecological surgery and severity of symptoms. A significant improvement in symptoms was observed in both groups after treatment: 30% had no residual symptoms, 50% were improved and 20% were no better. However, no difference in final outcome was observed between those who had undergone cystoscopy alone and those who had undergone urethral dilatation. Furthermore, 7 patients who underwent urethral dilatation experienced transient stress incontinence of urine, a complication not observed in women who underwent cystoscopy alone. No benefit was observed from the addition of urethral dilatation to cystoscopy alone in women with recurrent frequency and dysuria.

Adult↗
PubMed1985

The role of the ileal conduit in the development of upper tract dilatation.

The purpose of this study was to clarify the role of the conduit in the development of upper tract dilatation after ileal conduit urinary diversion. Twenty-seven patients with a normal upper tract were compared with 17 who had developed upper tract dilatation. Patients were studied by means of a technique to measure pressure and flow under "steady-state" conditions. Pressure activity was classified into two types. Type I pressure activity (frequency 6.2 +/- 3/min; amplitude 4.7 +/- 3 cm H2O) resulted in to-and-fro movement of contrast and the escape into the appliance of small volumes of contrast. In controls, most of the output from the conduit occurred during type I activity (73 +/- 14%). Type III/IV pressure activity resulted in vigorous aboral peristalsis and occurred infrequently in controls (frequency 5 +/- 4/h). In patients with upper tract dilatation, in contrast, type III/IV peristaltic activity occurred frequently (frequency 37 +/- 30/h; P less than 0.001: amplitude 72 +/- 34 cm H2O) and was responsible for most of the output (70 +/- 17%; P less than 0.001). The findings support the hypothesis that high pressure activity in the conduit is an important factor in the aetiology of upper tract dilatation, and they are compatible with the presence in such patients of functionally important obstructions of the distal conduit.

Dilatation, Pathologic↗
PubMed1985

Renovascular hypertension: ten years' experience in a regional centre.

In a unit serving a population of three million, 60 hypertensive patients with renovascular disease were identified over a 10-year period. The presence of renovascular disease was usually suggested by intravenous urography (IVU), although this was falsely negative in 21 per cent of cases; isotope renography (IR) was normal in a similar proportion of patients (25 per cent). Eight patients were treated medically and 52 underwent surgical procedures; nephrectomy in 32, autotransplantation in 10, by pass graft in six and percutaneous transluminal angioplasty in four. Twenty-three per cent of patients were cured, 37 per cent improved and 40 per cent unchanged one year after surgery, but the response could not be accurately predicted. Clinical features were of some value in that those patients most likely to benefit from surgery were younger, had less severe hypertension of shorter duration, smoked less, had less severe retinopathy and less cardiomegaly. There was also a trend for those with better renal function and less electrocardiographic evidence of left ventricular hypertrophy to benefit from surgery. The IVU and IR did not predict response to surgery but arteriographic appearances of fibromuscular dysplasia indicated there should be a favourable response. The renal vein renin ratio, basal or stimulated, was of no prognostic value since approximately two-thirds of patients with ratios above or below the threshold value had some benefit from surgery. We conclude that the surgical treatment of renovascular hypertension is worthwhile but the number of patients suitable for surgery is small. Clinical features and the results of simple investigations provided the best guide to surgical outcome in our patients.

Adult↗
PubMed1978

Indications for bladder transection.

Over the last 8 years 64 cases of bladder hyperactivity have been subjected to bladder transection. The patients seleced have been mainly adult enuretics, but have also included some others with daytime bladder hyperactivity without nocturnal incontinence who had failed to respond to medical and simple surgical procedures. A bladder capacity greater than 400 ml under general anaesthesia was used as a major criterion in selecting the cases for operation. The operation was very successful in the enuretic syndrome where the daytime symptoms or urgency and urge incontinence were severe. Other patients who had frequency, urgency and urge incontinence without demonstrable neurological or urological abnormalities also responded well.

Adolescent↗
PubMed1977

Bladder transection for adult enuresis.

45 patients with adult enuresis have been treated by bladder transection between 1969 and 1975 and followed-up from 6 months to 7 years. 24 patients are now asymptomatic. Bladder transection gave very worthwhile results in 53% of cases.

Adolescent↗