Search PubMed⌕ Search

Biomedical subjects

L Persky

Publications and source records attributed to L Persky.

At least 37 records · Page 2Linked to original sources
PubMed1988

Prevention of the development of a vesicovaginal fistula.

The cause of vesicovaginal fistulas after hysterectomy is not clearly understood. In an attempt to determine its cause, the records of 12 patients who had vesicovaginal fistula develop (after total abdominal hysterectomy) were compared with 12 consecutive patients who underwent total abdominal hysterectomy without fistula formation. Most of the patients who had vesicovaginal fistulas develop had excessive postoperative abdominal pain, distension or paralytic ileus, or both. Hematuria and symptoms of irritability of the bladder were also noted in the fistula group and prolonged postoperative fever and increased white blood cell count occurred more often. In contrast, the postoperative course was uncomplicated in the nonfistula group. The clinical course observed in many of the patients with vesicovaginal fistulas suggests that the patients had an unrecognized injury to the bladder resulting in urinary extravasation. It is postulated that the fistula develops when the urinoma drains into the vaginal cuff which is dependent and usually not closed. It may be possible to abort the development of many vesicovaginal fistulas by early recognition and treatment of an unsuspected bladder injury. It is suggested that patients with severe abdominal pain, distension, paralytic ileus, hematuria or symptoms of severe irritability of the bladder after abdominal hysterectomy be investigated early for a possible bladder injury.

Adult↗
PubMed1986

Staphylococcus epidermidis in diabetic urological patient.

We present 6 patients in whom prosthetic failure occurred because of sepsis owing to Staphylococcus epidermidis. Such failure occurs in grafts in other areas and is caused by the high resistance of the organism to conventional antibacterial measures. Therapy with appropriate antibiotics, that is aminoglycosides, vancomycin and rifampin, and the need for an early operation are stressed.

Adult↗
PubMed1986

Pattern of urinary symptoms in patients with metastatic bladder cancer.

In an attempt to assess the development or progression of symptoms in patients with metastatic bladder cancer we reviewed 41 patients who died of the disease but who did not undergo cystectomy. Therapy for the local tumor was used when indicated. Of the 41 patients 9 experienced worsening of symptoms, while the others were either stable or improved. Only 1 of 10 asymptomatic patients suffered symptoms during the course of the illness.

Adult↗
PubMed1986

Ileal and jejunal conduit urinary diversion.

The indications for urinary diversion have changed in recent years, and it is most often required in association with radical surgery for pelvic malignancies. Many patient with lower urinary tract dysfunction can be managed satisfactorily without diversion by use of intermittent catheterization, administration of specific pharmacologic agents, and, when necessary, implantation of artificial sphincters. For patients who require urinary diversion, the ureteroileal conduit remains the standard by which other methods should be judged. If satisfactory results are to be obtained, it is clear that meticulous attention to indications, operative technique, and careful follow-up are essential. As many of these patients have other disabilities, the management of the urinary tract must be integrated with other aspects of patient care. The introduction of the colonic conduit and recently the continent types of urinary diversion represent a search for the ideal method that has yet to be achieved.

Adenocarcinoma↗
PubMed1985

The management of civilian ureteral gunshot wounds: a review of 8 patients.

Ureteral injury is a rare consequence of abdominal gunshot wounds. We recently treated 8 patients with ureteral injuries. Failure to diagnose ureteral injury at presentation led to postoperative complications, necessitating additional operative procedures in 4 patients. However, in all 8 patients renal salvage was achieved.

Adolescent↗
PubMed1984

Incidental fetal hydronephrosis: clinical implication.

Maternal ultrasonography performed after twenty weeks of gestation is able accurately to identify and diagnose fetal hydronephrosis. We believe this finding should serve to alert the obstetrician as well as the pediatrician to potential complications which may arise at the time of delivery or immediately thereafter. Urologic evaluation and definitive surgical repair may then be performed when indicated.

Adult↗
PubMed1984

Fournier's gangrene: report of 20 patients.

Synergistic necrotizing fasciitis of the penis and scrotum was described first by Fournier and remains a rare but life-threatening disease. In Fournier's initial description the process was believed to be idiopathic. During the last 10 years we have treated 20 patients with Fournier's gangrene and a definite urologic or colorectal cause could be identified as the source of the infection in 19 (95 per cent). Despite the use of broad-spectrum antibiotics and aggressive surgical débridement the mortality rate was 45 per cent.

Adult↗
PubMed1983

Penile reconstruction with gracilis pedicle grafts.

Penile loss results from various external and self-inflicted catastrophic events. Many types of reconstructive efforts have been used successfully. Recently, bilateral pedicle grafts of the gracilis muscle have been successful and have provided serviceable results in our hands. Technique, complications and indications are discussed and illustrative cases are reported.

Humans↗
PubMed1983

Ureteral stones.

Ureteral surgery is complicated and technically difficult. Flexibility in operative procedures is necessary because the location of calculi can change intraoperatively. Complications occur, and a comprehensive understanding of corrective measures is required to address them adequately as they arise.

Humans↗
PubMed1982

Spectrum of bilateral ureteral ectopia.

Bilateral single ureteral ectopia is a rare occurrence. We have recently cared for 3 children (1 male, 2 females) with this congenital urinary tract anomaly. Their clinical courses and surgical treatment are presented. The embryology of ureteral ectopia is received with particular emphasis on distal ureteral and trigonal development. The surgical techniques employed to treat the associated hydroureteronephrosis, vesicoureteral reflux, and urinary incontinence are presented.

Female↗
PubMed1981

Acute scrotal pain and swelling in children: a surgical emergency.

The pediatric patient with acute scrotal pain and swelling can pose a difficult diagnostic problem. The therapeutic approach to these patients, however, need not be difficult. Despite the advent of Doppler ultrasonic equipment and technetium pertechnetate scanning to differentiate torsion of the testes from other causes of acute scrotal pain and swelling, the policy of emergency scrotal exploration in nearly all such pediatric patients seems to be most appropriate. The exception to this rule might be the rare child with frank pyuria and/or urinary tract infection in whom the diagnosis of epididymo-orchitis is suggested by all parameters.

Adolescent↗
PubMed1981

Radical perineal prostatectomy in patients over age of seventy.

Radical perineal prostatectomy remains at the forefront of the surgeon's tools for treatment of Stage A2 and Stage B adenocarcinoma of the prostate. In the past, generally the criterion for selection of patients excluded those patients over age seventy. In our series of radical perineal prostatectomies over the last thirteen years, we have operated on 8 patients between the ages of seventy and seventy-seven, with minimal postoperative morbidity and no operative mortalities. Radical prostatectomy can be well tolerated in the older age group and should be considered in selected patients seventy years and older.

Adenocarcinoma↗
PubMed1981

Effect of phenoxybenzamine (dibenzyline) on sexual function in man.

Phenoxybenzamine (Dibenzyline) has been extremely effective in treating patients with detrusor dyssynergia. Its minimal side effects include: mouth dryness, nasal congestion, drowsiness and fatigue, nausea and vomiting, palpitations, ejaculatory failure, and retrograde ejaculation. Nineteen men treated with phenoxybenzamine for detrusor dyssynergia reported ejaculatory failure during treatment; normal ejaculation returned after treatment was discontinued. Postmasturbation urine and semen samples were analyzed for sperm and fructose. The results of the study suggest that ejaculatory failure was due to the lack of seminal emission into the posterior urethra, rather than retrograde ejaculation. Some implications of this study are also discussed.

Adrenergic alpha-Antagonists↗