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Biomedical subjects

J B Hollander

Publications and source records attributed to J B Hollander.

At least 19 recordsLinked to original sources
PubMed1998

Multiple sclerosis and the neurogenic bladder.

Most patients with progressive MS will develop voiding dysfunction. In order to properly manage these patients, it is imperative to have a basic understanding of normal and abnormal bladder function. Based on history, physical examination, urinalysis, and renal function, diagnostic evaluation can be tailored to the individual. Empiric therapy without urologic consultation may be appropriate in some patients. In others, referral for full urodynamic evaluation will be necessary to best manage neurogenic voiding dysfunctions. Although there are many treatment options for patients with neurogenic bladders, it is imperative that therapy remain conservative and initially reversible because symptoms from MS tend to wax and wane over time. Long-term follow-up for patients with MS and neurogenic bladders is required to preserve renal function and avoid infections. A urologic program should be designed to promote continent, low-pressure bladder storage and controlled emptying while minimizing symptoms in a manner that promotes improved quality of life and self-esteem.

Follow-Up Studies↗
PubMed1996

Prostatism: benign prostatic hyperplasia.

This article is devoted to the most common cause of outlet obstruction in the male geriatric population, benign prostate hyperplasia (BPH). The prevalence, pathophysiology, and natural history of BPH is discussed, along with the work-up and indications for medical or surgical intervention. The authors also focus on medical and surgical options now available for management of BPH.

Aged↗
PubMed1995

First and second generation lithotripsy in children: results, comparison and followup.

During a 5-year period 32 children and adolescents 4 to 18 years old underwent 35 extracorporeal shock wave lithotripsy (ESWL*) treatments for 37 calculi. The unmodified Dornier HM3 lithotriptor was used in 21 cases (60%) while the remaining cases were treated with the Siemen Lithostar lithotriptor. The HM3 necessitated general anesthesia in 67% of patients and the Lithostar necessitated intravenous sedation in 86%. The majority of pediatric lithotripsy treatments were performed on an outpatient basis (24) or during an overnight hospital stay (3) while 8 were done on an inpatient basis. Of the 37 stones treated with 1 ESWL session 68% resolved, 19% had residual fragments less than 4 mm., 8% had residual fragments greater than 4 mm. and 5% required an endoscopic procedure for resolution. When success rates by lithotriptor were examined no significant difference between the 2 machines was identified although the HM3 treated larger stones (p = 0.0499). There were no statistical differences in regard to success and the use of stents, patient age or stone location between the 2 lithotriptors. Three patients required adjuvant procedures, and complications and morbidity developed in 2 and 5, respectively. All children or parents were contacted for followup (range 7 to 67 months). One child required ESWL for a new stone while another passed a stone without intervention. Only 1 child with a residual fragment less than 4 mm. became symptomatic but needed no intervention while 1 of 3 with fragments greater than 4 mm. needed intervention. No patients required open or percutaneous intervention.

Adolescent↗
PubMed1994

Technique for endoscopy of urinary diversion conduits.

Endoscopic evaluation of bowel conduits used for urinary diversion can be a cumbersome and untidy endeavor. We present a simple technique that facilitates this type of examination using an ostomy bag connected to a urinary drainage bag.

Cystoscopy↗
PubMed1993

Chronic priapism secondary to a traumatic arteriovenous fistula of the corpus cavernosum.

A 30-year-old man presented with a 7-month history of chronic partial priapism and sexual dysfunction following blunt perineal trauma. Duplex penile ultrasound confirmed high flow priapism and color flow Doppler ultrasound diagnosed an arteriovenous fistula within the left corpus cavernosum. This lesion was corrected via corporeal exploration and ligation of the artery feeding the fistula. The use of color flow Doppler ultrasound to diagnose this unusual condition obviated the need for angiographic studies. This rare condition of posttraumatic priapism may be diagnosed by noninvasive means. The pathophysiology, diagnosis and treatment of posttraumatic priapism and review of the literature are discussed.

Adult↗
PubMed1993

In vitro calcium oxalate lithotripsy: comparison of Dornier HM3 and Siemens Lithostar.

In vitro lithotripsy of round calcium oxalate stones retrieved from a patient at pyelolithotomy was used to compare the Dornier HM3 and Siemens Lithostar lithotripters. Similar stones were subjected to the same number of shock waves at similar kilovoltages and shock wave frequencies, and percent fragmentation was calculated. The numbers of shock waves required to fragment similar stones completely at the same kilovoltages were determined. Using 50 shock waves at less than 16 kV, the Siemens Lithostar produced little fragmentation of like stones, while at 16 kV and above, the Lithostar and the Dornier HM3 yielded similar stone fragmentation. The number of shock waves required to obtain complete fragmentation was similar for the HM3 and the Lithostar at greater than 16 kV. Using energy levels less than 16 kV, the HM3 needed markedly fewer shock waves to achieve fragmentation, although complete fragmentation could be accomplished with the Lithostar.

Aged↗
PubMed1993

Urinary diversion and reconstruction in the patient with spinal cord injury.

This article discusses surgical procedures that may be useful in the management of patients with spinal cord injury and is intended to be of practical use to those in general practice. In addition to a discussion of the pros and cons of indwelling Foley and suprapubic catheters, useful reconstructive and diversionary procedures are reviewed.

Catheters, Indwelling↗
PubMed1992

Patient satisfaction with pharmacologic erection program.

One hundred seventy-two patients on a pharmacologic erection program for male erectile dysfunction were sent a detailed questionnaire regarding their satisfaction using intracorporeal injection with vasoactive drugs. Sixty-seven percent of patients responded. Eighty-five percent of respondents said their sex life was improved. Eighty-eight percent would recommend penile self-injection to a friend whose complaint is impotence. Despite this, 49 percent of respondents were no longer using self-injections. The results from our detailed questionnaire suggest that the majority of the patients are quite satisfied with the erections achieved with intracorporeal injection of vasoactive drugs. The high dropout rate associated with such a program may be due to reasons other than the quality of erection achieved and sexual satisfaction derived from pharmacologic erections.

Adult↗
PubMed1992

A new technique for ureteral stent placement during pregnancy using endoluminal ultrasound.

Endoluminal sonography using the IVUS is a minimally invasive procedure performed using a flexible 6.2F catheter with a 20 megahertz transducer that can easily be passed endoscopically to image the urethra, bladder, ureter and renal pelvis. In the current study, a woman patient in her third trimester of pregnancy with a renal pelvic stone and persistent colic was safely treated with placement of an indwelling ureteral stent. Because it is minimally invasive and does not require the use of roentgenograms, we believe the IVUS will be a useful tool to assist with the management of ureteral colic in patients who are pregnant in whom intervention is required.

Adult↗
PubMed1987

Urographic and computed tomographic demonstration of ureteroarterial fistula.

Ureteroarterial fistulas are uncommon. We report a patient who developed a spontaneous fistula between the right iliac artery aneurysm and the right ureter. The diagnosis was made by a retrograde pyelogram and body computed tomography. The fistula was ultimately treated by simple transvesical ligation of the distal ureter. A brief description of the case is provided and the cause and management of ureteroarterial fistula are discussed.

Aneurysm↗
PubMed1987

Triamterene bladder calculus.

A case report of triamterene bladder calculus is presented. Triamterene containing antihypertensives should be used with caution in patients with predisposition to form stones.

Aged↗
PubMed1987

Artificial urinary sphincter for recurrent female urinary incontinence: indications and results.

A retrospective review of our experience with the artificial urinary sphincter in 32 women is presented. All patients had a history of recurrent urinary incontinence after failed bladder suspension procedures. Of 32 devices 31 were functioning, with an average followup of 2.5 years, and 91 per cent of the patients were dry without pads. Mechanical complications requiring surgical repair occurred in 21 per cent of the patients. Indications for artificial urinary sphincter implantation in the female patient and technical aspects of the procedure are discussed. The artificial urinary sphincter appears to be an acceptable treatment modality for urethral sphincter deficiency resulting in recurrent urinary stress incontinence in female patients.

Adult↗
PubMed1985

Scrotal fat necrosis.

A case of scrotal fat necrosis is presented. The clinical presentation usually is characteristic and the condition can be managed nonoperatively.

Acute Disease↗
PubMed1984

Success with penile prosthesis from patient's viewpoint.

This study is designed to explore the patient's point of view on success with penile prosthesis. Detailed questionnaires were sent to 57 penile prosthesis recipients, 38 of whom responded. Overall, 89 per cent claimed improved sexual satisfaction, and 76 per cent noted improved self-image with their prostheses. Seventy-six per cent claimed their partners approved of the prosthetic device. Prosthetic appearance was satisfactory to 87 per cent. Five patients, knowing what they now know, would not have had the prosthetic implantation. A significant factor in 4 of the 5 patients was lack of partner approval. We conclude penile prosthesis implantation is successful in returning satisfactory sexual intercourse to impotent men and their partners. Partners of those desiring penile prosthesis should be included in the preoperative evaluation process.

Consumer Behavior↗
PubMed1984

Bladder neck obstruction in women: a real entity.

Bladder neck obstruction in women is rare. Recently, we encountered 3 cases with similar findings. Clinically, the patients had chronic bladder symptoms of obstruction and irritation. The bladder showed trabeculation, diverticula and/or vesicoureteral reflux. Urinary flow rates were poor or absent. Endoscopy was unreliable in evaluating the outlet. The voiding pressure-flow cystourethrography study established the diagnosis. Specific operations to relieve bladder neck obstruction may be justified with proper urodynamic documentation.

Adult↗
PubMed1983

Fate of patients started on clean intermittent self-catheterization therapy 10 years ago.

We evaluated 60 patients placed on a clean intermittent catheterization program more than 10 years ago to determine their outcome. To date 27 patients still are performing self-catheterization, 18 have discontinued the procedure and 15 have been lost to followup. No patient has had deterioration in renal function. Prior incontinence was alleviated completely in 10 of the 27 patients still on the program and 10 of the 18 patients no longer on catheterization have returned to normal voiding. Clean intermittent catheterization is an effective treatment modality in properly selected patients, with few complications and excellent long-term results.

Adolescent↗