Oral cimetidine gives effective symptom relief in painful bladder disease: a prospective, randomized, double-blind placebo-controlled trial.
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Administration, Oral↗
Biomedical subjects
J R Parry
Publications and source records attributed to J R Parry.
Informed consent: an evaluation of patients' understanding and opinion (with respect to the operation of transurethral resection of prostate).
The ability of patients to understand and recall information given prior to obtaining written consent was assessed in 55 patients who were due to undergo the operation of transurethral resection of prostate. The patients were also asked their opinion on informed consent. Most patients knew the position of the prostate and the purpose of the operation. Some aspects of the postoperative management and complications were less well remembered. In particular, 18% of the patients could not remember the possibility of retrograde ejaculation despite efforts to emphasize this. Of the patients who returned their questionnaires, 41% did not mind what happened to them provided they were made better; 54% trusted their doctor to do the right thing and did not think detailed explanation was important; 62% felt that consent forms are to protect the doctor's right; still most patients felt that consent forms were necessary. Sub-groups comparison showed no relationship between patients' attitude and their ability to recall information.
Aged↗
Lower urinary tract reconstruction in patients with bladder exstrophy after failed primary treatment in early childhood.
The results of neonatal surgery for bladder exstrophy are not very satisfactory. A significant percentage of patients present in later childhood or adolescence for correction of their residual deformities. We have reconstructed 26 patients, correcting their entire urogenital and cosmetic deformity in a one-stage procedure. The results show that one-stage total reconstruction is possible and is preferable to serial correction of the various individual abnormalities. The principles of surgical reoperation in adolescence are the same as those now established for the primary correction in neonatal life.
Adolescent↗
Problems in the surgical treatment of interstitial cystitis.
Two series of patients with histologically proven interstitial cystitis that was unresponsive to hydrostatic bladder distension and intravesical chemotherapy with dimethyl sulfoxide have been studied. In the first series 24 patients were treated by subtotal cystectomy and substitution cystoplasty without further consideration; 8 of these 24 patients had persistent frequency due to active disease in the remaining trigone and/or urethra and in 2 cases this was severe. Because of this experience the second group of patients had routine biopsy of the trigone and assessment of urethral sensation as part of the initial assessment. In those in whom the trigone was unaffected, treatment was unchanged. If the trigone was affected, total cystourethrectomy was performed with substitution cystourethroplasty unless the patient chose or was advised to avoid surgery altogether or to have a simpler option such as conduit or continent urinary diversion. Trigonal biopsies should be part of the routine assessment of all patients being considered for surgery, since residual active disease is a major cause of dissatisfaction after subtotal cystectomy and substitution cystoplasty.
Adult↗
Surgical management of the congenital neuropathic bladder.
We have previously described 3 types of lower urinary tract dysfunction in the congenital neuropathic bladder--contractile, intermediate and acontractile--accounting for 35, 40 and 25% of patients respectively. Subsequent urodynamic and surgical experience has shown that the intermediate type is commoner and the acontractile type less common than was thought. The contractile group accounts for 31% of patients and rarely requires surgery (a "clam" ileocystoplasty). The acontractile group accounts for only 9% but more commonly requires surgical treatment, usually the implantation of an artificial urinary sphincter (AUS). The intermediate group accounts for 60% of patients and usually requires surgery. If there is no significant sphincter weakness incontinence, a "clam" ileocystoplasty alone is performed; if there is sphincter weakness, a "clam and a cuff" procedure is performed with implantation of the remainder of the AUS at a later date, if required.
Humans↗
Angiosarcoma of the penis.
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Hemangiosarcoma↗
Ureteric obstruction secondary to pelvic actinomycosis.
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Actinomycosis↗