Search PubMed⌕ Search

Biomedical subjects

F B Scott

Publications and source records attributed to F B Scott.

At least 37 records · Page 2Linked to original sources
PubMed1985

Management of urinary incontinence in women with the artificial urinary sphincter.

This study concerns 39 women who underwent implantation of the artificial urinary sphincter for severe, persistent urinary incontinence following surgical correction of the anatomical deformity. The cause of incontinence was poor or absent function of the urethral sphincteric mechanism. The success rate in this series with the artificial urinary sphincter was 92 per cent. The condition of the tissues in the cuff area is crucial for success of the procedure. Some technical considerations of the procedure are discussed.

Adult↗
PubMed1985

The use of the artificial sphincter in the treatment of urinary incontinence in the female patient.

Data analysis of my experience with the implantation of the artificial sphincter shows an overall success rate of 84 per cent. These results are in 139 females ranging from 5 to 84 years of age. The surgery is difficult primarily because the urethral-vaginal septum is not a surgical plane. Even partial injury to these tissues can lead to failure with erosion of the device into the urethra or vagina. The use of a new surgical instrument, the "cutter clamp" (see Fig. 8) is expected to improve results because of the precision it offers in dissecting around the bladder neck. Infection occurred in 4 of 139 patients, or 3 per cent. In one infected patient, the cuff eroded into the urethra. The infection rate may actually be higher because infection might account for some of the other erosions that occurred. Once erosion occurs, secondary infection can obscure the fact that the device was contaminated at the time of the original implantation. The use of a surgical isolation bubble system may lower both the incidence of infection and erosions in the future. The relief to the totally incontinent female by the artificial sphincter cannot be overestimated. The patients are very grateful, especially because most have undergone multiple treatment methods in an effort to cure their incontinence. The effectiveness of the device, barring infection or erosion, is evident by a success of 91 per cent of such patients being socially continent and 66 per cent being completely dry.

Adolescent↗
PubMed1985

Use of the artificial sphincter in the treatment of urinary incontinence.

Data analysis of my experience with the implantation of the artificial sphincter shows an overall success rate of 84%. These results are in 139 females ranging from 5 to 84 years of age. The surgery is difficult primarily because the urethral-vaginal septum is not a surgical plane. Even partial injury to these tissues can lead to failure with erosion of the device into the urethra or vagina. The use of a new surgical instrument, the 'cutter clamp' (Figure 8A-F), is expected to improve results because of the precision it offers in dissecting around the bladder neck. Infection occurred in four out of 139, or 3% of the cases. In one infected case, the cuff eroded into the urethra. The infection rate may actually be higher since infection might account for some of the other erosions which occurred. Once erosion occurs, secondary infection can obscure the fact that the device was contaminated at the time of the original implantation. The use of a surgical isolation bubble system may lower both the incidence of infection and erosions in the future. The relief to the totally incontinent female by the artificial sphincter cannot be overestimated. The patients are very grateful, especially since most have undergone multiple treatment methods in an effort to cure their incontinence. The effectiveness of the device, barring infection or erosion, is evident by a success of 91% of such patients being socially continent and 66% being completely dry.

Adolescent↗
PubMed1984

Women's satisfaction with partners' penile implant. Inflatable vs noninflatable prosthesis.

We evaluated 49 women whose sexual partners were organically impotent and subsequently received either an inflatable or noninflatable penile prosthesis. The women comprised three groups, based on the type of prostheses their partners had received: inflatable (n = 34), noninflatable (n = 11), and a double implant group (n = 4). The comparisons made were (1) dimensions of sexual satisfaction, (2) emotional stability, (3) satisfaction with the prosthesis, and (4) relationship changes. Two special questionnaires and the Derogatis Sexual Functioning Inventory were utilized in this evaluation. Women in the inflatable prosthesis group were found to be significantly more satisfied with the quality of their sexual relations and with their partner's prosthesis than were the women in the noninflatable prosthesis group. There apparently is a general advantage to women whose partners have received an inflatable prosthesis compared with the noninflatable alternatives.

Adult↗
PubMed1984

Experience with inflatable penile prosthesis.

Prosthesis surgery for management of erectile impotence has become an increasingly important aspect of urology. The inflatable penile prosthesis (IPP) provides the impotent patient with a controllable, natural-appearing and physiologically functional penis. Major modifications in the prosthesis and in the surgical implantation technique have been made since its initial introduction. In this article we present a histologic review of the IPP and our ten-year experience with it.

Adult↗
PubMed1984

Total reconstruction of the lower urinary tract using bowel and the artificial urinary sphincter.

We report 3 cases in which the lower urinary tract was reconstructed using bowel. In each instance the cuff was placed around the bowel to provide a continence mechanism. The 2 patients in whom the sigmoid colon was used have sporadic diurnal incontinence with nocturnal enuresis. Urodynamic evaluation has shown that this is secondary to high pressures generated within the closed sigmoid loop. The ileocecocolonic segment is preferable for reconstruction of the lower urinary tract, since the pressure developed within the bowel is significantly lower. The use of the artificial urinary sphincter around the bowel extended the versatility of the device.

Adolescent↗
PubMed1984

The artificial urinary sphincter in children.

One hundred and thirty-two children underwent implantation of the AS792 artificial urinary sphincter over the past 5 years: 90% had an excellent result following the implantation. Thirty-one patients (24%) required further surgery to correct a malfunction of the device. The device was removed in 5.3% of the patients and the incidence of infection was 3.8%. The artificial urinary sphincter has been shown to be a reliable means of achieving urinary incontinence in children. With attention to patient selection and meticulous surgical technique, a high success rate can be expected.

Adolescent↗
PubMed1983

Treatment of urinary incontinence in children: the artificial sphincter versus other methods.

Urinary incontinence in children is a distressing problem that often is magnified during puberty, since the children then realize the full significance of the disorder. Although there are numerous methods of treatment described none offers the reliable combination of a normal body image and total urinary continence. We describe our experience with the AS792 artificial urinary sphincter in treating children with urinary incontinence of varying etiologies and compare it with other described methods.

Adolescent↗
PubMed1983

Use of the artificial urinary sphincter in spinal cord injury patients.

A total of 49 patients with neuropathic bladder dysfunction and urinary incontinence underwent implantation of the AS791/792 artificial urinary sphincter. Preoperative urodynamic evaluation allowed the bladder response to be categorized as hyperreflexia, areflexia and low compliance. The over-all success rate in obtaining total urinary continence in these patients was 70 per cent, although the type of bladder present did influence the degree of success. Although urodynamic evaluation is an essential prerequisite for sphincter implantation there were no clear-cut data that allowed an accurate prediction of the postoperative result. The only absolute contraindication to implantation of the artificial urinary sphincter is significant bladder fibrosis. Owing to the success in obtaining total urinary continence in this complicated group of patients, we believe that the artificial urinary sphincter should be considered in carefully selected patients with neuropathic bladder dysfunction secondary to spinal cord injury.

Adolescent↗
PubMed1983

Reactions to the implantation of an inflatable penile prosthesis among psychogenically and organically impotent men.

We evaluated 17 nondepressed and psychologically stable recipients of an inflatable penile prosthesis who had been either organically or psychogenically impotent and 12 of their sexual partners several months after surgical implantation. The men were evaluated for changes in general psychological adjustment, sexual satisfaction and sexual activity. The partners were assessed separately on similar instruments. Two scales of the Minnesota Multiphasic Personality Inventory were found to have potential for initially discriminating organic and psychogenic impotence. The hypothesis that psychogenic recipients would manifest more psychological difficulties and would be less satisfied was only partially supported. While neither group suffered significant disturbance in psychological adjustment a consistent pattern was noted in which psychogenic patients were somewhat less satisfied with the results and experienced more postoperative complications. However, over-all reactions were positive, including increases in frequency of sexual over-all reactions were positive, including increases in frequency of sexual intercourse and duration of sexual play for patients and their partners.

Coitus↗
PubMed1983

Use of the AS792 artificial sphincter following urinary undiversion.

Reconstruction of the urinary tract after diversion has been successful in patients with normal innervation of the lower tracts. However, the possibility of urinary incontinence after such major surgical procedures has dissuaded many surgeons from attempting urinary undiversion in patients in whom the continence status cannot be determined accurately before the operation or who were known to be incontinent before the original diversion. For this reason, the presence of neuropathic bladder dysfunction has been considered a relative contraindication to urinary undiversion unless it can be established preoperatively that the patient will obtain urinary continence. Eight patients are reported who had successful outcome with the use of the AS792 artificial urinary sphincter to control incontinence after urinary undiversion. Because of this successful experience it is now believed that patients with neuropathic bladder dysfunction or anatomically abnormal lower tracts are no longer precluded from urinary undiversion. A variety of methods has been used to reconstruct the urinary tract, including total reconstruction of the bladder and urethra with the sigmoid colon in 1 case. In the latter case the artificial sphincter was placed around the bowel segment to provide continence. The use of the artificial sphincter around a bowel segment offers many possibilities for reconstructive procedures involving bowel in the future.

Adolescent↗
PubMed1983

Treatment of the epispadias-exstrophy complex with the AS792 artificial urinary sphincter.

The AS792 artificial urinary sphincter was implanted in 11 incontinent patients with the epispadias-exstrophy complex. To date 10 patients (91 per cent) are totally continent of urine with normal renal function and intact urinary systems. The recent reports concerning success with bladder neck reconstruction in this syndrome are reviewed. Owing to the relatively poor success of this procedure in achieving total urinary continence it is recommended strongly that insertion of the artificial urinary sphincter be the initial anti-incontinence procedure for these patients. The success rate with the artificial sphincter currently is superior to any form of bladder neck reconstruction in patients with the epispadias-exstrophy complex.

Adolescent↗
PubMed1982

Bethanechol chloride and the traumatic cord bladder.

The effect of bethanechol chloride was evaluated in 28 men with neurogenic bladder disease secondary to traumatic spinal cord damage. Simultaneous measurements of bladder pressure, electromyography of the pelvic floor and flow rate were obtained to evaluate the effect on voiding. The results of these studies revealed that bethanechol chloride failed to improve voiding dysfunction in these patients in either the supine or sitting position. Functional bladder outlet obstruction was aggravated by bethanechol chloride. It was found that the effect of this drug on the bladder was unpredictable, as evidenced by some patients converting from a definite detrusor contraction to a wave type pattern. Bethanechol chloride failed to induce a detrusor contraction in patients with areflexia or wave pattern bladders.

Adult↗
PubMed1981

Management of neurogenic impotence with inflatable penile prosthesis.

The inflatable penile prosthesis was used to manage impotence of neurogenic origin secondary to spinal cord injury. The female partners were also interviewed. Analysis of the results indicated that this was an eminently satisfactory method of managing this distressing complication of spinal cord injury. Both men and women indicated satisfaction with the prosthesis. The incidence of complications was the same as in those patients with non-neurogenic impotence. Erosion of the prosthesis due to pressure necrosis of denervated tissue did not occur.

Adult↗
PubMed1980

Ultrastructural analysis of human penile corpus cavernosum. Its significance in tumescence and detumescence.

The erectile tissue from 15 normal and impotent male patients was studied by electron microscopy to determine if any ultrastructural features could contribute to the basic understanding of the physiology of penile erection and detumescence. It was found that the endothelium lining the cavernous lacunae contained both contractile elements and Weibel-Palade bodies which have a possible role in vasoconstriction. Within the trabeculae of the cavernous body there was an abundance of elastin as well as oxytalan and elaunin fibers around bundles of smooth muscle. With these elements affording an anchorage system for contraction of smooth muscles within the trabeculae, an alternate contraction of smooth muscles and endothelium could account for the erectile and detumescent states.

Adult↗
PubMed1980

An inflatable penile prosthesis for treatment of diabetic impotence.

Surgical results have improved considerably since the first implantation of the inflatable penile prosthesis in 1973. The incidence of infection appears to be less than 2% and the overall success rate greater than 95%. With strict attention to details of preoperative preparation and to asepsis, the incidence of infection is probably no greater in the diabetic patient. Although there will always be mechanical problems with this more sophisticated device, the ease with which these problems can be corrected and the advantages of having natural erections, as well as flaccidity, makes the inflatable prosthesis the most desirable treatment for organic impotence.

Adult↗