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Biomedical subjects

E Laor

Publications and source records attributed to E Laor.

17 recordsLinked to original sources
PubMed1990

Simplified gonadotropin-releasing hormone (GnRH) stimulation test.

Provocative gonadotropin-releasing hormone (GnRH) stimulation testing indirectly assesses testicular function with more sensitivity than determination of basal gonadotropin levels alone. Unfortunately, the drawbacks of multiple blood sampling and high cost have limited the clinical usefulness of this test. We herein present a simplified, two-point, thirty-minute GnRH stimulation test. Statistical analysis of data from 55 men with normal baseline gonadotropin levels, reveal that this simplified test is just as accurate as the traditional test (p less than 0.0001) without the latter's attendant difficulties. In addition, we found that normal basal gonadotropin levels had little correlation to the actual responses obtained from GnRH stimulation testing (r = 0.20 and r = 0.39 for luteinizing hormone and follicle-stimulating hormone, respectively).

Adolescent↗
PubMed1990

Paravesical granulomas masquerading as bladder neoplasms: late complications of inguinal hernia repair.

Paravesical granuloma formation after inguinal herniorrhaphy is a rare complication due to infected suture material. We present 8 cases of large paravesical granulomas masquerading as bladder tumors. Irritable symptoms predominate the symptom complex and accurate diagnosis can be obtained with multiple, sonographically guided, needle biopsies of the mass. An operation results in complete resolution of the symptoms, while nonoperative management may help to improve but not resolve the symptoms.

Diagnosis, Differential↗
PubMed1990

Unilateral testicular torsion: abnormal histological findings in the contralateral testis--cause or effect?

A histological review of testicular biopsies of the contralateral testis, obtained at the time of surgical intervention for testicular torsion, was performed in 20 post-pubertal men. Contralateral histological abnormalities were found in 12 specimens. The duration of torsion correlated well with the viability of the involved testis but not with the presence of contralateral abnormalities. The high incidence of contralateral histological abnormalities and their nature suggest that they existed prior to the torsion since they would be unlikely to appear at such an early stage. We believe that some patients who suffer testicular torsion probably have congenital anomalies of both testes. These abnormalities involve testicular parenchyma as well as the suspension system.

Adolescent↗
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

Use of Dacron patch graft in Peyronie disease.

A Dacron patch graft for surgical correction of Peyronie disease was used in 4 patients. Results were satisfactory as far as the correction of the penile deformity and resolution of the pain during erection were concerned. No change was found in the patients' potency except in 1 patient whose potency has improved postoperatively. A penile prosthesis was inserted subsequently in 1 patient with decreased potency preoperatively. We conclude that this is a useful and simple surgical treatment for Peyronie disease.

Adult↗
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↗