Search PubMed⌕ Search

Biomedical subjects

J Golomb

Publications and source records attributed to J Golomb.

At least 55 records · Page 3Linked to original sources
PubMed1992

[Management of neonatal testicular torsion].

Neonatal testicular torsion is rare, and is distinguished both clinically and anatomically from torsion in the older age group. We describe 2 cases of neonatal torsion treated in different ways, which reflect the current controversy regarding the timing of surgical exploration, the need for orchiectomy, as well as the indications for contralateral orchiopexy. The distinction between prenatal and the postnatal subgroups is emphasized and a policy of treatment is proposed.

Humans↗
PubMed1991

Effects of prostatectomy on sexual function.

We evaluated the effects of prostatectomy on sexual function in 210 patients, 49.6 percent of whom underwent transurethral resection of the prostate (TURP), and the remainder had suprapubic transvesical prostatectomy (SPP). Pre- and postoperative interviews with detailed questionnaires were utilized. Postoperative sexual dysfunction was reported by 18 of 152 patients (11.8%) who were functioning normally prior to surgery. The incidence of postoperative impotence was evenly distributed between the TURP and SPP groups and was age-related; it was highest among older patients. We further observed a strong correlation between the presence of a permanent sexual partner and the preservation of potency. We conclude that the risk of postoperative impotence is dependent on both the patient's age and the presence of a partner, and should be discussed with the patient preoperatively.

Aged↗
PubMed1991

Extended double-J ureteral stent.

Continent forms of urinary diversion using intestinal segments are becoming increasingly common. As this new treatment modality evolves, our instruments and mechanical devices are likewise evolving and adapting to the changing needs placed on them. We have used a new type of double-pigtail ureteral catheter in patients requiring continent urinary diversion. It allows stenting of the ureteral-intestinal anastomosis and safeguards against urinary leak or extravasation; at the same time the catheter is accessible to the outside for easy replacement, manipulation, and radiographic evaluation. The catheter has also shown to be useful for other purposes such as uretero-neo-cystostomy. This is particularly important in the pediatric population where repeated cystoscopy for stent removal or manipulation can be a significant drawback.

Equipment Design↗
PubMed1991

Kidney stone formed around refluxed surgical staple and removed by transureteral endoscopic manipulation.

We present a case of a kidney stone that developed around a surgical staple which refluxed up to the kidney following a Bricker urinary diversion and bilateral ureteroileal anastomosis. A GIA stapler had been utilized to construct the ileal conduit. The stone was retrieved by means of flexible ureterorenoscopy through the ileal conduit. To our knowledge, this is the first report of such a complication following construction of an ileal conduit with a stapling device.

Adult↗
PubMed1991

[Surgical treatment of urinary stress incontinence in women].

32 women with genuine stress urinary incontinence were operated on via the transvaginal approach during 1989-1990. They ranged in age from 27-72 years, with a mean of 55.7. In 26, in addition to the urine leakage, vaginal wall prolapse of various degrees was diagnosed. 6 underwent Raz modified Pereyra bladder neck suspension, 26 had Raz 4-corner bladder and bladder neck suspension, and in 17 rectocele and perineal repair were also performed. 2 with uterine prolapse also underwent vaginal hysterectomy. At follow-up 2-12 months later 29 of the 32 were completely cured of stress incontinence (90.6%). In 7 urge incontinence persisted in various degrees, and 3 had developed urge incontinence de novo. All but 1 of them responded favorably to anticholinergic medication. There were postoperative complications in 5 (15.6%), including wound infection that required removal of Prolene sutures in 2, urethrovaginal fistula requiring reoperation in 1, perioperative myocardial infarction in 1, and in 1 voiding dysfunction initially treated with self-intermittent catheterization, but later cured by removal of a pair of Prolene sutures.

Adult↗
PubMed1990

The anatomy of stress incontinence: magnetic resonance imaging of the female bladder neck and urethra.

Clinical, urodynamic, radiological and endoscopic evaluations as well as operative results on more than 800 cases of stress incontinence treated at our medical center have led to a better understanding of the pathophysiology of female stress incontinence. We attempt to correlate these physiological concepts with information obtained from magnetic resonance images of the paraurethral and bladder neck areas in patients with known stress incontinence and normal controls. All magnetic resonance images were compared to cadaver step sections of the female pelvis. Normal controls without stress incontinence were used to define normal anatomy by magnetic resonance imaging. Etiology of incontinence was divided into either intrinsic urethral damage or anatomical malposition of an intact sphincteric unit. Our findings not only provide valuable support to basic concepts of the pathophysiology of stress incontinence but also help to establish normal findings of female paraurethral and bladder neck anatomy as seen by magnetic resonance imaging.

Female↗
PubMed1990

Tapered intraluminal versus imbricated extraluminal valve: comparison of two continence mechanisms for urinary diversion.

One of the major limitations of continent intestinal reservoirs currently in use is failure of the efferent continence mechanisms. Unsatisfactory results have been reported in the literature in up to 40% of cases. While progress has been made toward better continence in urinary diversions, evolution of the actual continence mechanisms has been along two rather distinct paths: those with a valve mechanism placed inside the pouch (either by intussusception or surgical insertion), and those with the valve outside to the pouch (by imbrication of an externally located ileal segment). A canine experimental model was used to investigate a type of intraluminal continence mechanism and to compare it to an extraluminal imbricated ileocecal valve. In eight mongrel dogs a reservoir was made out of ascending and transverse colon with two different valve mechanisms--one intraluminal and one extraluminal--connected via separate stomas to the skin. Radiographic, sonographic, endoscopic and urodynamic studies of the pouch and its outlets were performed. Results showed that, in contrast to the extraluminal valve, continence in the intraluminal valve was volume dependent. The valve closing pressure of the intraluminal continence mechanism increased far beyond the values of the extraluminal valve (50.38 vs. 30.12 cm. H2O) at maximum pouch filling. Leakage of the intraluminal valve was observed at significantly higher pouch volumes than in the extraluminal valve (348 cc vs. 215 cc). In view of these results, the volume dependent intraluminal valve mechanism appears superior to an extraluminal type, especially at higher pouch volumes.

Animals↗
PubMed1990

Local hyperthermia of the prostate gland for the treatment of benign prostatic hypertrophy and urinary retention.

Local hyperthermia of the prostate was used to treat 72 patients who had an indwelling catheter because of urinary retention caused by benign prostatic hypertrophy. One month after completion of treatment 50% of patients were able to dispense with the catheter and 1 year later 40% remained catheter-free. The best results were achieved in patients who underwent 6 to 10 treatment sessions in conjunction with cyproterone acetate 50 mg tid administered during the treatment period only.

Aged↗
PubMed1989

Four-corner bladder and urethral suspension for moderate cystocele.

The classical approach to cystocele repair involves the approximation of lax pubocervical fascia through the anterior vaginal wall with narrowing of the bladder neck and proximal urethra by the Kelly-type plication. This procedure corrects the prolapse but when performed for the treatment of incontinence it has a high failure rate because the bladder neck and urethra are not placed into a high, supported, nonobstructed retropubic position. Furthermore, due to elevation of the bladder base without simultaneous elevation of the bladder neck and urethra, de novo stress urinary incontinence may occur. We developed a transvaginal needle suspension operation for the bladder and urethra that repairs anterior vaginal wall prolapse with excellent support of the bladder base and repositions the bladder neck in the high retropubic position, all during a simple and rapid operation that is tolerated well by the patient.

Female↗
PubMed1989

Incidence and pattern of bladder tumor recurrence following combined suprapubic prostatectomy and excision of a bladder tumor.

We studied retrospectively 36 patients who had undergone combined suprapubic transvesical prostatectomy for benign prostatic hypertrophy (BPH) and excision of a simultaneous bladder tumor. The follow-up period ranged from 1 to 7 years (average 3 years) and included periodic cystoscopy and voided urine cytology. Thirteen recurrences out of 60 (21.7%) occurred at the bladder neck, in 8 out of 23 patients (34.8%) with recurrent tumors. We relate the high recurrence rate located at the bladder neck to the concurrent prostatectomy. We conclude that combined surgery for BPH and bladder tumor is not recommended since it predisposes the bladder neck to tumor implantation at surgery.

Aged↗