Biomedical subjects
Publications and source records attributed to M Eshghi.
A large solitary Brunn's cyst caused a ball-valve type of obstruction of the bladder neck in a 29-year-old man without endoscopic or histological evidence of bladder inflammation. Unroofing and drainage restored normal voiding. The histopathological features of Brunn's nests are reviewed.
The history of endoscopic ureteral dilatation began before the turn of the century, and many of those older methods are still in use with the aid of updated instruments. The recent development of controlled hydraulic dilatation promises to make ureteroscopy a one-step procedure.
Scrotal scintigraphy is nearly 100 per cent accurate in identifying testicular torsion and can distinguish that condition, which requires an operation, from torsion of testicular appendages, which often can be treated nonoperatively. The technique is 90 per cent accurate in distinguishing epididymo-orchitis, epididymitis, and testicular abscess and is valuable in the follow-up of testicular torsion or inflammation. It can screen patients for varicocele, identifying possible candidates for spermatic venography and embolization. However, it has nothing to offer in the differential diagnosis of painless testicular masses.
To prevent increasing renal pelvic pressure during ureterorenoscopy a 4F or 5F ureteral catheter can be inserted up into the renal pelvis via the working channel of the ureterorenoscope.
Calculi were removed from the upper urinary tracts and the distal ureter in single sessions in 2 patients with the aid of prone flexible cystoscopy and a through-and-through stone basket.
Two significant procedures, namely lithotripsy of staghorn calculus and dilatation of a stenotic calyceal infundibulum, were performed endourologically in a renal allograft drained by an ileal conduit. This is another example of the versatility of these minimally invasive urologic methods.
To overcome the problem of incontinence which failed to respond to standard measures, an animal model was designed for continent diversion without cystectomy. A tapered terminal ileal segment was implanted in a submucosal tunnel on the anterior aspect of the bladder, and the proximal end of the segment was brought out to the abdominal wall as a stoma that is catheterized intermittently. Ileocystostomy provided continent diversion in 10 dogs at intravesical pressures as high as 45 cm H2O, and there were no changes in serum electrolytes, creatinine, or urea nitrogen concentration.
We incised ureteropelvic junction obstruction in 31 patients with a cold knife direct-vision urethrotome inserted through a percutaneous nephrostomy tract. In 12 patients renal calculi were removed endourologically during the same session. There were no immediate complications and nephrostograms showed adequate drainage in all cases. Of these patients 8 had previously undergone open pyeloplasty without success. The longest followup is almost 2 years. There have been 4 failures and, thus, the success rate is 87.1 per cent.
Morphology and function of the kidney were studied before and after percutaneous stone extraction in 33 patients with unilateral calculus disease to assess damage secondary to the extraction procedures. Anatomic changes were studied using excretory urography before the procedure and at 3 to 6 months postoperatively, and using nephrostograms and noncontrast nephrotomograms several days after the procedure. Renal function was evaluated with radionuclide renography both before surgery and at either 4 to 6 weeks or about 1 year postoperatively. Six patients had early changes detected clinically and with nephrostograms, but only three of these had abnormalities on delayed excretory urography. Significant changes in renal function were found only in those patients who had clinically detectable complications (p less than 0.05), in one case before symptoms were manifest.