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Biomedical subjects

M Koraitim

Publications and source records attributed to M Koraitim.

15 recordsLinked to original sources
PubMed1995

Transurethral ultrasonographic assessment of bladder carcinoma: its value and limitation.

PURPOSE: We assess the value and limitation of transurethral ultrasonography in the diagnostic evaluation of bladder carcinoma. MATERIALS AND METHODS: A total of 115 patients underwent the procedure, either at the same setting as transurethral resection (76) or 2 weeks before radical cystectomy (39). The results were compared with the pathological findings of transurethral and cystectomy specimens. RESULTS: The correlation between transurethral ultrasonography and pathological staging was 100% in tumors without muscle invasion (stages Ta and T1), 95.7% and 96.8% in muscle invasive tumors (stages T2 and T3a, respectively), and 70% in tumors with extravesical spread. CONCLUSIONS: Transurethral ultrasonography is most valuable in determining the stage of tumor confined to the bladder wall. Also, it is of value in detecting tumors in a diverticulum, and monitoring the distensibility of the bladder wall and transurethral resection of disease. The main limitations are the inabilities to discriminate between stages Ta and T1 tumors, and to detect involvement of the pelvic lymph nodes.

Adenocarcinoma↗
PubMed1992

Preservation of urosexual functions after radical cystectomy.

Nerve-sparing radical cystectomy with ileocecal bladder substitute is highly recommended for male patients with schistosomal bladder carcinoma and for selected male patients with transitional cell carcinoma. Twenty-three patients underwent this procedure with preservation of the distal one third of prostatic capsule and inframontanal urethra, reinforcement of the ileocecal valve, and tightening of the two levator ani muscles over the cecourethral anastomosis. Urodynamic study revealed that the closed ileocecal segment is a highly compliant reservoir, and coupled with a reinforced ileocecal valve and distal urethral mechanism resulted in a low incidence of ureteral reflux (15%) and a high degree of urinary continence (100% by day and 40% by night). The procedure does not appear to undermine the principles of oncologic surgery, offers the psychologic and functional benefits of urethral micturition for all patients, and preserves erectile potency in half of them.

Cecum↗
PubMed1990

Treatment of primary nocturnal enuresis by oral androgen mesterolone. A clinical and cystometric study.

A double-blind clinical study of 30 boys, six to ten years of age, with primary nocturnal enuresis was undertaken to assess the role of androgens in treating enuresis. The oral synthetic androgen mesterolone was selected because of its minimal potential toxic effects. Twenty boys were treated with mesterolone and 10 received placebo. Fourteen boys (70%) became dry during treatment (20 mg daily for 14 days), and 5 (25%) remained dry for a follow-up period of four months. Increased cystometric bladder capacity and disappearance of uninhibited detrusor contractions were noticed in a significant number of cases after treatment. No side effects were recorded. Mesterolone has probably modulated the autonomic innervation of the vesical musculature with correction of the defective neural mechanism which is believed to be implicated in the pathogenesis of nocturnal enuresis.

Child↗
PubMed1986

Mechanism of continence after transpubic urethroplasty.

Urethral profilmetry was performed in seven continent patients with transpubic urethroplasty. The studies were repeated in the supine and upright positions, both at rest and under the stresses of cough, bearing down, and hold maneuvers. The urethral pressure tracing of these patients is characteristically bihumped in shape. The proximal hump with a mean height of 18 cm water at rest corresponds to the prostatic plateau of normal subjects. The distal hump with a mean height of 32 cm water represents the pressure inside that segment of the bulbar urethra which had been brought into the abdomen by the transpubic operation. The average functional urethral length is 4.6 cm and on standing increased to 6.7 cm, mainly due to elongation of the distal hump. Changes in intra-abdominal pressure by cough or bearing down are transmitted along the whole functional urethral length with augmented urethral closure pressure of 57 to 61 cm water in the proximal hump and 44 to 48 cm water in the distal hump. However, contraction of the perineal musculature by hold maneuvers has no effect on the urethra of these patients. We conclude that after transpubic urethroplasty, although the distal urethral mechanism is destroyed and excluded, the new intra-abdominal position of the transposed bulbar urethra provides a new factor that supplements the bladder neck in maintaining urinary continence.

Adolescent↗
PubMed1985

Anterior bladder tube: 4 forms for incontinence of different etiology.

We treated 20 male and 7 female patients with total urinary incontinence of variable etiology by construction of 4 different forms of the anterior bladder flap tube. The Tanagho procedure was used in 10 patients and 3 variants of the operation were fashioned to correct the particular defects present in the remaining 17. The high success rate of 85 per cent is due largely to the selection of the proper form of the tube for each case of urinary incontinence.

Adolescent↗
PubMed1985

A new retropubic retrourethral approach for large vesico-urethrovaginal fistulas.

Of all types of vesicovaginal fistula those affecting the trigone and bladder neck, and associated with urethral loss are the most difficult to repair. For these cases a retropubic retrourethral procedure is presented that offers a direct approach to close the vagina. A urethrovesical flap tube also can be fashioned to form a continent neourethra. Urodynamic studies showed that the proximal vesical and distal urethral components of the neourethra contribute to sphincteric function.

Adult↗
PubMed1985

Experience with 170 cases of posterior urethral strictures during 7 years.

Various types of urethroplasty and visual urethrotomy should not be regarded as competitive with each other for a particular case of urethral stricture. Rather, they should be regarded as complementary procedures available for the cure of different types of strictures, with each having its indications as well as limitations. In cases of post-traumatic strictures and disruption the best solution is complete excision of the pathological segment and bulboprostatic anastomosis, either through the perineum when prostatic displacement is absent or minimal, or by the transpubic route when the displacement is great. Post-inflammatory strictures should be corrected by a 2-stage urethroplasty with exteriorization of the diseased urethra. Internal visual urethrotomy is reserved for short post-traumatic strictures that are limited in length, circumference and depth. Free skin grafts are best suited to cover small defects after urethroplasty.

Adolescent↗
PubMed1982

Catheter as source of error in urodynamic study.

The effect of introducing a fine catheter on the urethral wall was studied by electromyography in rabbits. On introducing the catheter, increased electrical activity in the form of biphasic potentials was recorded from the external sphincter and bladder neck. This indicates active muscular contraction of these regions. The biphasic potentials persisted for about four minutes and then became less frequent and lower in voltage until they disappeared completely after fourteen minutes. We conclude that in urodynamic studies one must wait for at least fifteen minutes after catheter introduction before recording the results.

Animals↗
PubMed1977

Dynamic activity of bladder neck and external sphincter in ejaculation.

The bladder neck shows a typical electromyographic pattern in ejaculation. It consists of periods of heightened activity rhythmically alternating with intervals of reduced activity signifying muscular contraction and relaxation. This behavior of the bladder neck is confined to its ventral part. Concurrently, the external sphincter shows a short period of increased activity before the typical rhythmical pattern which corresponds to that of the ventral bladder neck.

Animals↗
PubMed1977

Vesicourethral continuity in bladder neck activity.

Electromyographic study of the bladder neck during vesical filling and emptying was performed in anesthetized dogs. Increased electrical potentials denoting active contraction of bladder neck were obtained on vesical filling. The bladder was then completely divided just above the vesical orifice, and the resulting apertures were closed to form two separate compartments. Still increased electrical potentials of bladder neck were recorded on filling the proximal compartment. We conclude that vesical neck activities are not directly dependent on the detrusor or on any anatomic continuity between bladder and urethral muscles.

Animals↗
PubMed1977

Urogenitodynamics of the male bladder neck. 1. During continence.

The dynamic behavior of the male bladder neck during urinary continence was studied by electromyography in dogs and rabbits. On vesical filling, increased electrical activity in the form of biphasic potentials was recorded from the anterolateral segment of the bladder neck. These biphasic potentials became more frequent and higher in voltage with further filling of the bladder. Concurrently, the posterior segment showed no significant electromyographic changes. These findings indicate muscular contraction of only the anterolateral part of the bladder neck during vesical filling. We conclude that the sphincteric function of the bladder neck during urinary continence is achieved by the active muscular contraction of its anterolateral segment. We postulate that the posterior segment is mainly concerned with the genital function of the bladder neck.

Animals↗
PubMed1977

Urogenitodynamics of the male bladder neck. 2. During voiding.

The dynamic activity of the male bladder neck during voiding was studied by electromyography in dogs and rabbits. On vesical filling, increased electrical activity in the form of high voltage biphasic potentials was recorded from the anterolateral segment of the bladder neck. With the onset of voiding these high voltage potentials disappeared completely and only a low voltage base line activity was recorded. This indicates muscular relaxation of the anterolateral bladder neck. Concurrently, the posterior segment of the bladder neck showed insignificant electromyographic changes. We conclude that opening of the vesical outlet during voiding is achieved by the muscular relaxation of its anterolateral segment. The dynamic activity of the bladder neck is reciprocally coordinated with the detrusor muscle to produce continence and voiding of urine.

Animals↗