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Biomedical subjects

I M Thompson

Publications and source records attributed to I M Thompson.

At least 145 records · Page 8Linked to original sources
PubMed1989

Complete urinary obstruction following periurethral polytetrafluoroethylene injection for urinary incontinence.

We report a unique case of foreign body granulomatous reaction after periurethral polytetrafluoroethylene injection causing complete urinary obstruction. Urinary obstruction in the immediate postoperative period and granuloma formation following polytetrafluoroethylene injection are not unusual. To our knowledge delayed complete urinary obstruction after polytetrafluoroethylene injection has not been described previously in the urological literature.

Aged↗
PubMed1989

Carcinoma of the prostate: changing incidence associated with annual urologic screening.

The Urology Service at Brooke Army Medical Center has conducted routine screening rectal examinations for early diagnosis of carcinoma of the prostate since 1979. A review of the incidence of carcinoma of the prostate reveals that routine screening has yielded a significant increase in disease incidence. This incidence appears higher than national averages. It is apparent that a commitment to early diagnosis through screening for carcinoma of the prostate also requires a commitment in medical resources.

Carcinoma↗
PubMed1989

Periurethral polytetrafluoroethylene injections for post-prostatectomy incontinence.

Incontinence following prostatectomy is relatively common and produces well-known social and pathologic consequences. Previous reports have shown that periurethral injections of polytetrafluoroethylene (PTFE or Teflon) can provide continence in many patients with a variety of etiologies. Politano's group has shown about 50% of his incontinence radical prostatectomy patients to be cured or improved by these injections. Our experience with 10 patients found that overall, six of 10 were cured or improved. Five of six radical prostatectomy patients were cured or improved after radical prostatectomy and radiation therapy. One patient has subsequently undergone artificial sphincter placement without difficulty. PTFE injections may be a low morbidity procedure for the treatment of post-prostatectomy incontinence and still allow for later artificial sphincter placement if required.

Humans↗
PubMed1988

Efficacy of follow-up bone scans in carcinoma of the prostate.

Three hundred fifteen radioisotopic bone scans ranging from initial scan only to nine scans per patient, performed on 114 patients with adenocarcinoma of the prostate between 1979 and 1984, were reviewed. Seventeen patients had positive scans, ten on initial scan and seven at follow-up. Nine patients had bone pain at the time of the first positive scan and pain developed in two patients 6 months and 2 years later, respectively. The other six patients are still asymptomatic 1 to 4 years later. False-positive scans were found in six other patients. No patient with bone pain had a negative scan. We believe that routine bone scans for prostate cancer follow-up are not cost-effective unless the patient is symptomatic. Bone scans also are indicated for initial staging and to observe disease response to protocol treatment.

Adenocarcinoma↗
PubMed1988

Salvage radical prostatectomy for adenocarcinoma of the prostate.

Radiotherapy has been a major method of treating localized carcinoma of the prostate. It is becoming increasingly apparent that failures of radiotherapy do occur and can be predicted by postradiation biopsy. Salvage radical prostatectomy can be offered to these patients. The authors report on five patients with residual carcinoma after radiotherapy. Three patients had undergone external-beam radiotherapy and two had undergone interstitial plus external-beam radiotherapy. All salvage radical prostatectomies were uncomplicated technically. One patient had a myocardial infarction believed to be unrelated to the procedure. Two patients, observed for over 1 year, have mild residual stress incontinence but residual adenocarcinoma proved to be localized to the surgical specimen in all but one patient. One patient underwent nerve-sparing radical prostatectomy and has had return of sexual function. Salvage radical prostatectomy is a viable option for patients who have histologically proven residual carcinoma after definitive radiotherapy.

Adenocarcinoma↗
PubMed1988

Perineal recurrence of adenocarcinoma of prostate following radiation therapy.

Two cases of seeding of adenocarcinoma of the prostate to the perineum via biopsy tract are presented. Both patients had been treated previously with external beam radiotherapy. The dose of radiation to the perineum was calculated and, in both cases, was not tumoricidal. Treatment options for this uncommon site of recurrence are presented.

Adenocarcinoma↗
PubMed1988

Improvement in survival of patients with renal cell carcinoma--the role of the serendipitously detected tumor.

A review of 212 cases of renal cell carcinoma diagnosed during a 40-year period revealed an increasing number of cases detected during imaging studies performed for nonurological reasons. These so-called incidentally detected renal cell carcinomas are increasing in incidence, generally of low stage and associated with significantly improved survival, and they constitute the majority of the patients with improved prognosis during the recent 2 decades. The clinical course and disease stage in patients who continue to present with symptoms of the disease have not changed in the last 40 years. These data suggest that with currently available treatments for renal cell carcinoma a principal method to improve the prognosis of this disease would be through earlier detection. Low disease incidence would mitigate against morphological screening but case finding techniques may prove useful.

Carcinoma, Renal Cell↗
PubMed1988

An evaluation of serial digital rectal examinations in screening for prostate cancer.

The purpose of this review is to test the hypothesis that serial digital rectal examinations of the prostate lead to detection of prostate cancer at an earlier and more curable stage. The clinic records of 4,843 patients between 40 and 79 years old seen at the Brooke Army Medical Center prostate cancer screening clinic between January 1979 and September 1985 were reviewed. Of the patients with palpable nodules 122 were found on biopsy to have adenocarcinoma of the prostate. We compared the clinical and, when possible, pathological stage of disease diagnosed at the initial clinical visit to those from patients who had prior normal digital rectal examinations at the screening clinic and who were followed at our clinic. There was a numerically striking difference in the percentage of patients in each group with clinical as well as pathological stage B cancer. Due to the small number of patients in each group these differences were not statistically significant.

Adenocarcinoma↗
PubMed1988

Male fertility and the undescended testis in Down syndrome. How to counsel parents.

Evaluation of fertility in male patients with Down syndrome has generally revealed poor psychosexual adaptation and markedly abnormal semen quality, which have thus far been uniformly associated with sterility. Up to 50% of male patients with Down syndrome have undescended testes. Life-table analysis of survival among patients with Down syndrome, as well as the low incidence of testicular tumors, would suggest that orchidopexy may be unnecessary in some patients. In most patients, however, orchidopexy is appropriate to allow for subsequent testicular examination. Parents of children with Down syndrome must be appropriately counseled regarding the fertility of their children and the treatment options for cryptorchidism.

Counseling↗
PubMed1988

Bladder carcinoma presenting as exercise-induced hematuria.

Exercise-induced hematuria is becoming a common diagnosis for postexercise hematuria. However, a number of genitourinary tract diseases also may cause gross or microscopic hematuria in some physically active patients. Four cases of postexercise hematuria in patients with transitional cell carcinoma of the bladder are presented. The authors recommend urologic evaluation with excretory urography and cystoscopy for all patients with postexercise hematuria.

Adult↗
PubMed1987

The value of retrograde pyelography for fractionally visualized upper tracts on excretory urography in the evaluation of hematuria.

A 5-year retrospective study of 131 hematuria patients (23 with gross and 108 with microscopic hematuria) undergoing retrograde pyelography solely for fractional visualization of the upper tracts on excretory urography revealed no tumors or other significant pathological condition in the 187 renal units (56 bilateral cases) studied. A review of our cases of upper tract urothelial cancer since 1955 revealed 36 patients with complete records of the urological evaluations. None of the cases was diagnosed by retrograde pyelography for fractionally visualized excretory urography and 3 were within 9 months of a previously normal excretory urogram alone or with retrograde pyelography. We believe that retrograde pyelography done solely to evaluate a fractionally visualized upper tract may miss subtle lesions and it should not terminate the evaluation. We recommend that excretory urography, cystoscopy and voided urine cytology studies be performed initially and, if normal, they should be repeated in 6 and 12 months before upper tract urothelial tumors are ruled out.

Adult↗
PubMed1987

The evaluation of microscopic hematuria: a population-based study.

From 1979 until 1983, 2,005 men underwent routine urological examinations. Of these men 85 (4 per cent) had asymptomatic microscopic hematuria. All men underwent complete urological evaluation. Significant urological disease was detected in 22 per cent of the patients. Therefore, complete urological evaluation can be justified in a nonselected group of men with microscopic hematuria.

Cystoscopy↗
PubMed1987

Mechanical gastric outlet obstruction after continent urinary diversion.

A number of complications have been associated with complex continent urinary diversions. We report a case of postoperative mechanical gastric outlet obstruction after continent urinary diversion with distal ileum and ascending colon. Following adequate urinary reservoir drainage gastric outlet obstruction resolved. Such mechanical effects from distended urinary reservoirs must be considered in any patient undergoing continent urinary diversion.

Adult↗
PubMed1987

The impact of cigarette smoking on stage, grade and number of recurrences of transitional cell carcinoma of the bladder.

The records of 386 patients with diagnosed transitional cell carcinoma of the bladder were reviewed to determine a correlation between smoking history, and stage, grade and number of recurrences of transitional cell carcinoma. A significant association was detected between smoking history and all 3 variables. Within this military population 79 per cent of the patients were noted to have a smoking history, which is higher than most previously studied groups. These data further confirm the association between cigarette smoking and transitional cell carcinoma of the bladder, and suggest that cigarette smoking within the military population may portend a much higher cancer risk in this group.

Carcinoma, Transitional Cell↗
PubMed1987

Impact of routine screening for adenocarcinoma of the prostate on stage distribution.

The impact of routine screening with digital rectal examination for carcinoma of the prostate on stage distribution of the disease was assessed in the primary treatment population of our medical center. Two, 5-year periods were compared: 1974 to 1978--before the onset of routine screening and 1979 to 1983--during the period of routine screening of this population. The clinical stage distribution of prostatic cancer before the onset of routine screening was not significantly different from national averages. Routine screening during the latter period significantly increased the percentage of patients with clinically curable carcinoma of the prostate. Pathologically, the disease was upstaged in many patients in both series. Digital rectal examination can have a significant impact on early detection of carcinoma of the prostate within a given population but it cannot be interpreted as a panacea for this disease.

Adenocarcinoma↗
PubMed1987

Intravesical alum irrigation for intractable bleeding secondary to adenocarcinoma of the prostate.

We report on 2 patients in whom intractable hematuria was caused by carcinoma of the prostate. Since the hematuria failed to respond to conservative measures, intravesical 1 per cent alum irrigation was used. Hematuria resolved in both patients and no toxicity was observed. Intravesical alum irrigation should be considered in any patient with significant hematuria secondary to carcinoma of the prostate in whom conservative therapy has failed.

Adenocarcinoma↗