Search PubMed⌕ Search

Biomedical subjects

G E Leach

Publications and source records attributed to G E Leach.

At least 91 records · Page 5Linked to original sources
PubMed1987

Delayed bladder dysfunction after abdominoperineal resection: an indicator of local recurrence.

It is generally not appreciated that the delayed onset of voiding dysfunction after abdominoperineal resection for rectal carcinoma may be the first sign of local pelvic recurrence. We herein present a series of 5 patients who were referred for urodynamic evaluation of voiding dysfunction beginning nine to twenty-four months after the original operative procedure. Urodynamic evaluation revealed low bladder wall compliance in 4 patients, and detrusor hyperreflexia in 1 patient. Computerized tomography scans confirmed the local tumor recurrence in all cases. The delayed onset of voiding complaints after abdominoperineal resection should prompt a high index of suspicion that a local tumor recurrence may be present.

Adenocarcinoma↗
PubMed1987

Female urethral obstruction after Marshall-Marchetti-Krantz operation.

During the last 5 years 13 neurologically normal women were seen with urodynamically proved urethral obstruction after a Marshall-Marchetti-Krantz operation. These obstructed patients were treated by a simple transvaginal procedure consisting of complete urethrolysis followed by a needle urethrovesical resuspension procedure. Postoperatively, 12 patients experienced complete disappearance of the presenting symptoms, return to a normal voiding pattern and decreased residuals of urine to less than 50 cc. The remaining patient, although urodynamically unobstructed, had to remain on intermittent catheterization. The pathophysiology, diagnosis and treatment of this iatrogenic type of female urethral obstruction are discussed.

Female↗
PubMed1987

Incontinence after artificial urinary sphincter placement: the role of perfusion sphincterometry.

The systematic, objective evaluation of incontinence after artificial urinary sphincter placement is critically important in the direction of further therapy. The technique and application of perfusion sphincterometry in the evaluation of 9 men with various causes of incontinence after artificial sphincter implantation are described. The perfusion sphincterometry study, which does not require sophisticated urodynamic equipment, helped to define clearly the cause of the incontinence and, thus, facilitated appropriate therapy.

Aged↗
PubMed1987

Post-prostatectomy incontinence: the influence of bladder dysfunction.

The urodynamic studies of 38 patients referred for evaluation of incontinence after prostatectomy were reviewed. Only 15 patients (39.5 per cent) had pure sphincteric insufficiency as the sole cause of the incontinence. Of the 38 patients 16 (42 per cent) had sphincteric insufficiency combined with a significant component of bladder dysfunction (detrusor instability and/or low bladder wall compliance) as the cause of the incontinence. A total of 7 patients (18.5 per cent) had no evidence of sphincteric insufficiency but they had post-prostatectomy incontinence solely caused by detrusor instability and/or low bladder wall compliance. Of the patients referred for post-prostatectomy incontinence 60.5 per cent had bladder dysfunction as a major factor in the incontinence, which emphasizes the need for comprehensive urodynamic evaluation before treatment is recommended. Of 26 patients whose treatment was based on urodynamic findings and who were available for followup 23 (88 per cent) were adequately continent after treatment, with 35 per cent responding to pharmacological treatment alone and 54 per cent requiring placement of an artificial urinary sphincter with or without associated pharmacological therapy. The potential role of bladder dysfunction as a causative factor in post-prostatectomy incontinence must be considered to optimize the results of treatment and to avoid an unnecessary operation.

Aged↗
PubMed1987

Tubovaginal leakage: an unusual cause of incontinence.

Incontinence after hysterectomy may be caused by an abnormal fallopian tube draining into the vaginal cuff. We report 2 cases of this condition, which generally is known as hydrops tubae profluens. One patient also had genuine stress urinary incontinence and the other suffered persistent disease after 2 failed suspension procedures. This rare condition should be considered in the differential diagnosis of unusual causes of incontinence.

Fallopian Tubes↗
PubMed1986

Urologic and urodynamic evaluation of the elderly population.

The importance of a thorough history and physical examination in conjunction with appropriate laboratory, radiographic, endoscopic, and urodynamic studies is emphasized, with the goal of defining the cause of incontinence in the elderly. Once the pathologic process that is causing the symptom of incontinence is objectively identified, appropriate treatment can proceed logically.

Aged↗
PubMed1985

Cost-effective treatment of female stress urinary incontinence: modified Pereyra bladder neck suspension.

We herein report on the cost effectiveness of the modified Pereyra bladder neck suspension (MPBNS) compared with the Marshall-Marchetti-Krantz (MMK) retropubic suspension procedure. A total of 82 cases was reviewed retrospectively. The MPBNS was found to provide a 41 per cent cost savings with significantly shorter duration of intravenous fluid administration, shorter duration of postoperative indwelling catheter drainage, shorter operative time, and significantly shorter postoperative hospitalization. Early postoperative intermittent catheterization was a major factor in facilitating early discharge after MPBNS.

Cost-Benefit Analysis↗