Biomedical subjects
Publications and source records attributed to J L Lockhart.
Surgical repair of penoscrotal transposition usually leaves the urethral meatus in a perineal position. A Thiersch-Duplay skin tube created from perineal skin advances the urethral opening to the penoscrotal junction. This leaves the meatus in a more suitable position for definitive reconstruction.
Whether or not to treat bacteriuria (greater than or equal to 100,000 col/cc) in the asymptomatic patient has long been controversial. Fifty-two patients with uncomplicated neurogenic bladder disease secondary to spinal cord injury and bacteriuria were followed throughout their hospitalization. Antibiotics were reserved only for symptomatic patients. Our results indicate the value of no treatment for chronic bacteriuria as an alternative to chronic suppressive therapy.
Transurethral polytetrafluoroethylene (Teflon) injections were performed on 69 men with incontinence following prostatectomy. The etiology of incontinence was transurethral resection of the prostate in 27 patients (group 1), open prostatectomy in 15 (group 2) and radical prostatectomy in 27 (group 3). All patients had been incontinent for more than 1 year and had failed to improve with conservative management. Cure or improvement occurred in 85.1 per cent of the patients in group 1, 79.9 per cent in group 2 and 48.1 per cent in group 3. Reasons for failure included severe bladder instability, severe periurethral fibrosis and leakage of paste. Clinically significant particle migration was not observed.
Urinary incontinence in female subjects with bladder instability secondary to neurogenic bladder disease is difficult to manage. Many times pharmacologic manipulation and the standard anti-incontinence surgical procedures are unsuccessful. We have found that the urethral occlusive technique using polytetrafluoroethylene (Teflon) paste is highly effective in maintaining continence. We describe 6 patients who achieved complete urinary control and empty the bladder with the use of intermittent catheterization. All of the patients are extremely satisfied with the end results of urinary continence and have accepted self-catheterization well.
We report on 15 patients with massively refluxing megaureters in 28 renoureteral units. All had a history of urinary tract infections, and 14 were treated with initial vesical drainage. All had ureteral reimplantation, and half of those who initially underwent diversion did not require tailoring. Overall success was 87 per cent.
Explore the source record for details and available documents.
Mitomycin C has proved to be useful as prophylaxis against superficial bladder tumor recurrences. However, there is a significant incidence of prostatic urethral recurrences. Careful followup with urine cytology and cystoscopy, and bladder and prostatic urethral biopsies should be done at regular intervals.
We report a case of fibrosarcoma of the penis and review the literature. We believe that amputation is the most effective therapy and the role of lymphadenectomy is equivocal. All cases should be reported to better define the roles of various oncologic modalities of therapy.
Subtracted bladder pressure recording is the ideal method to diagnose bladder instability in supine and erect positions. Uroflowmetry demonstrated higher peak flow rates in our stable bladder group. Lateral cystourethrography showed a higher degree of urethral hypermobility in the same group. We believe that cystometry with subtraction is still the cornerstone in the evaluation of these patients. Uroflowmetry and lateral cystography may add some information and deserve further investigation in a large number of patients. Intravesical pressure alone, external urethral sphincter electromyography, and static urethral pressure profilometry were of no value in the evaluation of our patients.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
We are reporting on a 23 year old white male with neurogenic bladder disease secondary to spinal cord injury, who recently was discovered as having a primary transitional cell carcinoma of the posterior urethra. He is the youngest patient with neurologic involvement of the lower urinary tract presenting a malignant urethral tumor.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Bladder neck dysfunction has been evaluated in 16 male patients. The efficacy of the traditional investigative methods for this entity is questionable and the value of video-urodynamics for definitive diagnosis is presented. The ability of the condition to masquerade as prostatis is apparent and treatment by unilateral bladder neck incision is proposed.
Explore the source record for details and available documents.
This is the fifth family in the literature with siblings having the prune belly syndrome. It is the first with associated pulmonary stenosis, mental retardation, and hearing deficit. A genetic factor is suggested as the primary cause of the syndrome.