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Biomedical subjects

P Coloby

Publications and source records attributed to P Coloby.

10 recordsLinked to original sources

Bladder reconstruction with ileum after cystoprostatectomy for bladder cancer: analysis of the micturition and continence of 44 consecutive patients.

From October, 1987, to August, 1990, 47 patients underwent an ileal low pressure bladder replacement using the Hautmann procedure after radical cystoprostatectomy for bladder cancer. The qualities of micturition and continence were evaluated from a questionnaire mailed to the patients and by urodynamic examinations in 44 consecutive patients over a follow-up period of more than 3 (mean 10.7) months. The 44 patients (100%) were perfectly dry during the daytime and voided every 4 (2-6) h with a micturitional volume of 357 (200-500) ml. Forty-two of the 44 patients had no residual urine. Thirty-three of the 44 patients (75%) were perfectly dry at night with a voiding frequency of 1.5 (0-3). Seven of the 44 patients (16%) were occasionally incontinent (spotting less than 2/week). Four of the 44 patients (9%) had night incontinence and used as external device. Only two patients showed high pressure waves of greater than 50 cm H2O. The maximum urethral pressure was 59.07 +/- 13.6 (30-80) cm H2O. The maximum flow rate was 17.2 +/- 9.7 (4.5-35) ml/sec. The different factors responsible for the new micturitional balance were discussed. With its very good functional results and its ease of performance, the ileal neobladder is, for us, the procedure of choice for bladder reconstruction after cystectomy.

Adult

[Functional analysis of micturition and continence after a Hautmann type enterocystoplasty (27 patients)].

Twenty seven patients treated by Hautmann enterocystoplasty completed a detailed questionnaire concerning the quality of their micturition and continence. The mean capacity of the neobladder was 250 cc with a diurnal interval between micturitions of about 3 hours. 79% of patients experienced an urge to micturate. The mean frequency of nocturnal micturition was 1.6. Diurnal continence was perfect in 100% of patients, while nocturnal continence was excellent in 78% of cases and good in 18% of cases, while one patient (4%) suffered from nocturnal incontinence. Hautmann enterocystoplasty is therefore an excellent technique for bladder replacement, ensuring diurnal and nocturnal continence for the great majority of patients.

Aged

Total androgen blockade with Zoladex plus flutamide vs. Zoladex alone in advanced prostatic carcinoma: interim report of a multicenter, double-blind, placebo-controlled study.

A double-blind, placebo-controlled, randomized, multicenter study was undertaken to investigate the effects of Zoladex plus flutamide vs. Zoladex plus placebo in patients with advanced prostatic cancer. Interim analysis has revealed no differences between the 2 groups in objective or subjective responses at 6 months' follow-up or in overall survival and time to disease progression at 15 months' follow-up.

Aged

[Hautmann enterocystoplasty. Clinical and urodynamic study in 24 patients].

Twenty-four patients with invasive bladder cancer underwent Hautmann enterocystoplasty. A study of the urinary continence revealed 100 per cent of good results during the day and 87.5 per cent of good results at night. Urodynamic investigation after 3 months revealed that only one patient presented with peristaltic waves and that the postmicturating residual urine volume was always less than 100 cc. There was no mortality in this series. The only uncertainty concerns the long-term outcome of these patients because of the risk of incomplete emptying and distension of the neobladder.

Aged

[Treatment of urethral stenosis using a pedicled flap of the scrotal skin. Long-term results in 16 patients].

The scrotal skin is vascularized in part by means of the superficial perineal branch of the internal pudendal artery. This nutrient pedicle, together with the scrotal skin dependent on it, can be isolated. The urethra is approached via the perineum. The stricture is incised longitudinally right down to the healthy area. The scrotal flap and pedicle are mobilized, and then anastomosed along the edges of the urethra. From March 1983 through April 1987, sixteen patients have been operated. Postoperative results: the mean follow-up for the 16 patients is 60 months with extremes of 24 and 66 months. 13/16 patients show good results (81%). 3/16 patients show poor results with recurrence of the stricture localized at the junction of the flap and healthy urethra. Such recurrences have yielded to treatment, in two cases, by optical urethrotomy and, in the other case, by means of a new scrotal flap.

Follow-Up Studies

Primary nonseminomatous germ cell tumor of the prostate.

We describe a case of a primary nonseminomatous germ cell prostatic tumor and discuss the problem of extragonadal germ cell tumors. Prognosis, staging and management of these tumors are similar to that of metastatic primary testicular germ cell tumors.

Adult

[What is the use of the radioimmunoassay of prostatic acid phosphatase?].

Radioimmunoassay (RIA) of prostatic acid phosphatases (PAP) using the Gammadab (R) PAP pack supplied by Clinical Assays in an effective method for determining extension of prostatic cancer. In patients with lymph node or metastatic invasion serum assay values are almost always elevated (sensitivity = 94%), especially with well differentiated cancer. Elevated levels of this variable are practically pathognomonic of external extension (specificity = 94%). This is of importance in therapy since the degree of invasion determines the choice between palliative and curative treatment. Strategy leading to this therapeutic choice can be greatly simplified and thus modified by RIA of PAP.

Acid Phosphatase