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Biomedical subjects

G H Jordan

Publications and source records attributed to G H Jordan.

At least 55 records · Page 3Linked to original sources
PubMed1988

Transsexual surgery in the genetic female.

The increasing acceptance of the transsexual patient by society as well as a willingness of insurance companies to compensate for associated surgical procedures will result in an increase in patients presenting for sex reassignment. Data from gender identity centers suggest that the multidisciplinary approach leads to the best therapeutic results. Significant advances in phalloplasty techniques are yielding genitalia with more normal function and appearance.

Breast↗
PubMed1988

Management of urethral stricture disease.

With the advent of modern tissue transfer techniques, most cases of urethral reconstruction can be approached with confidence that an excellent functional and cosmetic result is probable. The authors present a logical approach to urethral stricture disease predicated on the anatomy of the stricture disease. Only those procedures believed to offer a maximal chance of success are offered to the patients. Should a patient present with complex stricture disease, initially a flap procedure would be employed.

Dilatation↗
PubMed1988

Use of the rectus abdominis muscle and fascia flap in reconstruction of epispadias/exstrophy.

Inferiorly based rectus abdominis muscle flaps and fascial flaps have been used to construct a firm abdominal wall without hernias and to provide coverage of the bladder, bladder neck, and proximal urethra in the secondary reconstruction of patients with epispadias/exstrophy complex. They have also been used to produce an elevation of the mons area, which is lacking in the typical exstrophy patient. Rectus fascial flaps have been the mainstay of abdominal closure when wide diastasis of the rectal muscles is present and when the lower abdomen lacks fascial support. We are pleased with the results of utilizing either the rectus muscle or rectus fascia in this complex condition. We have been using fascial flaps for over 10 years in our epispadias/exstrophy closures and abdominal wall strengthening procedures. We have been using bone grafts and the rectus muscle for the construction of a mons for the past 5 years. Although the rectus muscle procedure to cover the bladder and the bladder neck has been in use for only 2 years, we have seen patients with incontinence restored to a continent state; these patients have not been plagued with fistula problems when a neourethra has to be constructed to elongate the phallus. Previous attempts at urethral repair in this area have been successful in the main, but an occasional fistula at the junction between the penile skin and the abdominopubic skin has resulted. Since using the rectus muscle to cover the bladder and bladder neck area, we have not had this problem. Patients with epispadias/exstrophy remain such difficult problems that every advance in technique should be used to improve results.(ABSTRACT TRUNCATED AT 250 WORDS)

Bladder Exstrophy↗
PubMed1987

Segmental hemorrhagic infarct of testicle.

The seventh case of spontaneous hemorrhagic infarction of the testis is reported. Several mechanisms, including the likelihood that there are segmental watershed areas in some males, are explored as possible explanations for this rare finding.

Adult↗
PubMed1987

Reconstruction of the fossa navicularis.

Fossa navicularis strictures have troubled urologists for years. Although several flap procedures have been described none truly leaves a normal-appearing penis postoperatively. A new technique is described of the reconstruction of the fossa navicularis with a ventral transverse island flap on a broad, dependable pedicle. All 5 patients who have undergone the procedure have excellent cosmetic and functional results. The appearance of the penis postoperatively is normal, with a median followup of 17 months. Early reconstruction of fossa strictures may avoid the sequelae of more conservative attempts at management, thus, correcting the fossa stricture itself before the occurrence of penourethral stricture disease secondary to repeated dilations, meatotomy and internal urethrotomy.

Humans↗
PubMed1986

Extraperitoneal lymph node dissections with use of a midline incision in patients with female genital cancer.

Recent investigations have suggested that extraperitoneal, as compared to transperitoneal, lymph node dissections may result in significantly less morbidity in patients who later have external beam irradiation. Some incisions designed to perform such dissections do not afford easy access to the opposite side. With use of a midline incision carried down to the preperitoneal space, 30 patients underwent bilateral pelvic lymph node dissections. When necessary, access to the para-aortic nodes by an extraperitoneal approach was accomplished by use of a modification of this midline incision. Operating time to complete the pelvic dissection ranged from 35 to 90 minutes. The mean estimated blood loss for the dissection was 135 ml. The advantages of this extraperitoneal approach include easy access to lymph nodes on either side, ability to use the peritoneum as a pack, and an easier access to the obturator space nodes.

Adolescent↗
PubMed1985

Inadequate decompression of the upper tracts using a Foley catheter in the valve bladder.

Catheter drainage has been advocated for initial diversion in children who present with posterior urethral valves and concomitant urinary tract infection or metabolic derangement. We report a case in which a well placed and functioning Foley catheter provided inadequate upper tract decompression. However, excellent upper tract decompression was accomplished when the catheter was replaced with a feeding tube. It appears that physiological upper tract obstruction was promoted by the Foley catheter, which may have been a manifestation of the valve bladder syndrome.

Catheters, Indwelling↗
PubMed1985

Major rectal complications following interstitial implantation of 125iodine for carcinoma of the prostate.

From April 1975 through April 1983, 152 patients were treated for localized adenocarcinoma of the prostate with interstitial implantation of 125iodine seeds. In each case bilateral pelvic lymph node dissection was performed at implantation. Five rectal complications developed: 2 rectal ulcers and 3 prostatic urethrorectal fistulas. Our method to treat these problems is presented together with our technique of reconstruction in patients with persistent fistulas despite fecal diversion. While urethrorectal fistulas represent potentially devastating complications of the 125iodine implantation procedure, reconstructive techniques can minimize and have reduced their long-term effects.

Adenocarcinoma↗
PubMed1985

Ogilvie's syndrome developing after ethanol ablation of renal cell carcinoma.

Urological procedures frequently are implicated as a cause of Ogilvie's syndrome. We report the first case of Ogilvie's syndrome following ethanol ablation of a renal cell carcinoma. The urologist must be alert to the development of this complication. If recognized early and managed correctly long-term morbidity from this complication is minimal.

Adult↗
PubMed1985

Intraoperative consultation for the urethra.

The urologist is frequently summoned to the operating room to assist with urethral catheterization. This article presents the authors' method and techniques for dealing with the "impassible urethra." Oftentimes the patient has been traumatized. A sequential plan is presented that allows for maximal evaluation of the entire urinary tract along with eventual urethral catheterization. In the case of the disrupted urethra, diversion must be accomplished. The authors have found that the placement of a urethral catheter along with division of intact puboprostatic ligaments in the stable patient frequently limits the eventual morbidity of the trauma.

Female↗
PubMed1983

Pain control following renal infarction/ablation using continuous epidural combined anesthesia/analgesia.

A technique for anesthesia during pre-nephrectomy renal infarction or ablation using standard epidural anesthesia procedures is described. Additionally, post-infarction analgesia using epidural meperidine is discussed. This technique has been used successfully in 8 patients undergoing infarction or ablation of renal adenocarcinoma and shows promise as an adjunct to standard analgesia in other patients undergoing radical surgical procedures.

Adenocarcinoma↗
PubMed1983

Relationship of blood group to testicular carcinoma.

The hospital records of 48 patients undergoing retroperitoneal lymphadenectomy for testicular carcinoma between 1971 and 1980 were reviewed with respect to blood group. In contrast to a recent report which suggested an unusually high frequency of blood group A among patients with testicular carcinoma, no correlation between blood type and testicular carcinoma was noted in this group. The blood group frequencies observed in this study group were consistent with the reported blood group frequencies for the general population.

Blood Group Antigens↗