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Biomedical subjects

K T Foo

Publications and source records attributed to K T Foo.

At least 73 records · Page 4Linked to original sources
PubMed1987

Transurethral ultrasonic lithotripsy for ureteric stones under direct vision.

With the development of the operating uretero-renoscope, and high frequency ultrasound generator, ureteric stones which otherwise would require open operative procedure can now be removed transurethrally with minimum morbidity and rapid recovery of patient. After preliminary cystoscopy, the ureteric orifice is dilated with flexible metal dilator or ureteric balloon dilator to size 15F. The rigid operating uretero-renoscope of 11F is then introduced and passed up to the stone. A 5F ultrasound probe is then passed through the uretero-renoscope to make contact with the stone. Stone disintegration with ultrasound is done under direct vision, and the fragments aspirated or removed with the help of forceps or Dormia basket. Of the first 70 patients done within 2 years from July 1984 to August 1986, 66 (94%) had their stones successfully removed by this procedure. It can be performed without radiological control and routine stenting of the ureter is not necessary. Serious complications included two perforation of the ureter and late development of ureteric strictures in another two patients. One patient had occlusion of the lower ureter requiring reimplantation.

Adult↗
PubMed1984

Endoscopic surgery of the lower urinary tract.

Endoscopic Surgery of the lower urinary tract was popularised in Singapore about a decade ago. Since then it has been established as the treatment of choice not only for obstructing prostates, but also for stones, carcinoma of the urinary bladder and management of neurogenic bladder, haemorrhagic chronic radiation cystitis, ureteric obstruction and urethral strictures. The main advantages of endoscopic surgery are lack of post-operative pain and minimum morbidity and mortality. Patients' recovery is rapid thus saving much needed hospital beds. However, endoscopic surgery requires special training and special equipment to get good results. If not properly done serious complications including the death of patients can occur. A plea is made for the setting up of a special division or department of Urology in Singapore to carry out this work and to train our young surgeons in this field.

Cystitis↗
PubMed1984

Transurethral resection of large obstructing prostates above the weight of 40 grams.

A series of 62 cases of transurethral resection of large obstructing prostates above 40 grams is presented. The weight of resected prostates ranged from 41 to 84 grams with an average of 54.5 grams. The average rate of resection was 0.7 gm/min. Though 74.2% of patients were in clinical grade II and III categories, no mortality occurred and serious complications were minimum. 71% of patients were discharged within a week. On the whole, the results were satisfactory although clot retention (11.3%) was a more common complication following transurethral resection of large prostate. Transurethral resection is a safe and acceptable alternative to open prostatectomy even for large prostates.

Aged↗
PubMed1984

Chemolysis of uric acid stones.

This paper illustrates one of the more satisfying aspects of the treatment of urinary calculous disease. A small series of 8 patients is presented to emphasize the possibility of dissolving uric acid stones by conservative measures thereby saving the patients extensive and often destructive surgical procedures. Patient selection is important for successful therapy. The stone must not be calcified and there must be sufficient function in the kidney. The regime consists of allopurinol 100 mg and sodium bicarbonate 2 to 4 grams given orally three times a day. Treatment period lasted up to six months, with dissolution of stones.

Adult↗
PubMed1984

Stone composition and metabolic study in urinary calculous disease.

A series of 178 urinary stones is analysed qualitatively during a three year period from 1980 to 1982. The majority (96%) of stones orginate from the upper tract. Calcium oxalate stones are the commonest entity seen in the western countries but less than 20% of such stones occur locally. A large proportion consists of mixed stones and one third are infective as triple phosphate is present. 20% contain urate as a constituent whereas relatively pure urate stones constitute 4%. The true incidence of pure urate stones is higher (about 10%) as we have been dissolving them with alkalinisation of urine without surgery. Idiopathic hypercalciura occurs in 11.8% and none has persistent hypercalcaemia. Hyperuricosuria which is commoner, occurs in 24% of patients. It is important to identify this group as it results in the formation of metabolically active stones, and they can be treated with allopurinol to prevent recurrence of stones.

Adult↗
PubMed1984

Haemorrhagic chronic radiation cystitis--following treatment of pelvic malignancies.

Haemorrhagic chronic radiation cystitis is not an uncommon clinical entity, and should be suspected in patients with painless gross haematuria who have a past history of radiotherapy to the pelvic region. A series of 29 patients with haemorrhagic chronic radiation cystitis were managed in the University Department of Surgery, Singapore General Hospital over a 5 years period from 1979 to 1983. Cystodiathermy was the mainstay of treatment and was successful in controlling haematuria in 27 patients. Two patients developed uncontrolled haematuria, urinary tract infection, septicaemia and died giving mortality of 6.9%. Excellent control of haemorrhage can be obtained with cystodiathermy in the majority of patients. Intravesical instillation of steroid or silver nitrate is used for the more intractable cases, after cystodiathermy. Urinary diversion with or without cystectomy are desperate measures to salvage the severe case and mortality is high.

Adult↗
PubMed1984

Optical urethrotomy for urethral strictures--a preliminary report.

24 patients with urethral strictures which were managed with the optical urethrotome are studied. These patients had developed strictures due to previous transurethral reaction of the prostate, and trauma or inflammation of the urethra. In some cases we have not been able to determine the aetiology of the problem. 58% of the patients responded satisfactorily to this mode of therapy. Although a high percentage develop recurrent stenosis, these can be treated by repeated urethrotomy under vision without much morbidity. Resistant cases would need urethroplasty.

Adult↗
PubMed1984

Genito-urinary tuberculosis--a local experience on its diagnosis and management.

Though the incidence of pulmonary tuberculosis has been on the decline, the incidence of genito-urinary tuberculosis has not decreased proportionately as the majority of patients have no associated pulmonary tuberculosis. Genito-urinary tuberculosis affects male and female equally and is commonest in the 4th decade of life. The most frequent presentation is that of persistent urinary tract infection in 2/3 of patients and gross haematuria in about 1/3 of our patients. A few may be relatively asymptomatic with loin ache. Though urine culture for acid-fast bacilli is important, diagnosis in most patients was established on histopathology and typical radiological features. The main stay of treatment is medical. The role of surgery is mainly reconstructive, to overcome strictures causing obstruction so as to preserve renal function. Close cooperation between physician and surgeon is important in the management of this disease.

Adult↗
PubMed1981

Renal cell carcinoma - a local experience.

A review of 23 cases of renal cell carcinoma was undertaken. The sex distribution was 3.6 males to 1 female, the male preponderance being higher than in most reported series. The tumour was most common in the 6th and 7th decades of life. Haematuria was the commonest presenting symptom (52.2%); however, all the features of the classical triad of haematuria, loin pain and swelling were not present in any of our patients; 26% of patients presented with non-urological symptoms. At the time of diagnosis, four patients (17.3%) had evidence of metastasis. Another four developed secondaries after nephrectomy. Our approach to renal cell carcinoma has been aggressive and all 23 patients including those with metastasis were treated by nephrectomy.

Adenocarcinoma↗