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Biomedical subjects

R Bihrle

Publications and source records attributed to R Bihrle.

82 records · Page 5Linked to original sources
PubMed1989

Construction of an antirefluxing urinary conduit using a plicated ileocecal segment.

A plicated ileocecal segment was used to construct an antirefluxing urinary conduit in 3 patients. Each patient had markedly dilated or shortened ureters that prevented conventional Leadbetter ureteral reimplantation into a colon conduit. Ascending colon was brought out as a cutaneous stoma, the ureters were anastomosed to ileum, and an antireflux mechanism was created from plicated terminal ileum and the native ileocecal valve. Significant reflux was prevented in all 3 patients. This technique provides a means to prevent urinary reflux into short or dilated ureters, and increases the versatility of the ileocecal segment for use in diversion and urinary tract reconstruction.

Adult↗
PubMed1989

Congenital genitourinary hemangiomas in a patient with the Klippel-Trenaunay syndrome: management with the neodymium:YAG laser.

The Klippel-Trenaunay syndrome is an unusual congenital anomaly characterized by cutaneous hemangiomas, multiple varicosities, soft tissue hypertrophy and, rarely, gastrointestinal or genitourinary hemangiomas. The large bladder as well as multiple penile hemangiomas in our patient were treated successfully with the neodymium:YAG laser with minimal morbidity.

Adult↗
PubMed1989

Creation of a transverse colon--gastric composite reservoir: a new technique.

All existing continent urinary reservoirs utilize cecum and/or varying lengths of ileum. In patients who have received prior pelvic radiation therapy, continent diversion has not been feasible because those segments of bowel lie within the field of irradiation. We describe a new technique of continent diversion utilizing only bowel outside the field of pelvic irradiation. A urinary reservoir is constructed from reconfigured transverse colon. A tubularized segment of stomach is implanted beneath the taenia of the reservoir to provide a continent, catheterizable stoma. We describe this technique in detail and report our results in five dogs followed for a mean of 59 days.

Animals↗
PubMed1989

Endoluminal radio-frequency electrocautery for permanent ureteral occlusion in swine.

An animal experiment was undertaken to assess the feasibility of using radio-frequency current-mediated thermal injury of the ureter to produce ureteral occlusion by means of an endoluminal approach. Through open pyelotomies, balloon angioplasty catheters coated with gold bipolar electrodes were introduced into the ureters. Doses (at 650 kHz) were delivered for specific energy totals in 13 of 15 ureters in eight pigs. Two ureters served as controls (balloon inflation without current application). In six experimental animals not killed immediately after the procedure, postoperative ureteral manometric studies and nephrostography were performed and nephrostomy drainage was maintained until death (1-8 weeks). Treatment with 200-400 J produced safe, reliable occlusion by 4 weeks. At histopathologic study at 4 and 8 weeks, necrotic muscularis propria had been replaced by fibrous tissue. Cardiac rhythm was not affected during treatment.

Angioplasty, Balloon↗
PubMed1989

Percutaneous transrenal endoureteral radio-frequency electrocautery for occlusion: case report.

In a patient with advanced cervical carcinoma who had a large vesicovaginal fistula, the authors applied radio-frequency (RF) current endoluminally to the ureter via a percutaneous nephrostomy tract to occlude the ureter. Perineal drainage was initially reduced and then stopped entirely. The procedure was relatively easy to perform and was successful in achieving occlusion until the patient's death 2 1/2 months later.

Adult↗
PubMed1988

Complications of retroperitoneal lymph node dissection.

In summary, the complications of retroperitoneal lymph node dissection for low-stage testis cancer appear to be minimal, especially with the advent of nerve sparing techniques. However, the approximate 30 per cent of patients who require primary chemotherapy and do not attain a complete remission are candiates for postchemotherapy retroperitoneal lymphadenectomy, and these patients are subject to a higher risk of intraoperative and postoperative complications. Maintaining awareness of these potential complications may aid in preventing morbidity in this group of patients.

Humans↗
PubMed1987

Indiana continent urinary reservoir.

Cecoileal reservoirs were created in 29 patients. Tunneled ureteral implantations along the tenia of the cecum provided the antireflux mechanism. Plication or tapering of the terminal ileal segment along with the ileocecal valve provided the continence mechanism. The tubular configuration of the cecum was disrupted with either an ileal or sigmoid patch, or it was re-configured in a Heineke-Mikulicz type of closure to avoid bolus (unit) contractions. Short-term followup examination with excretory urography showed no upper tract obstruction. X-rays of the pouch showed no reflux and interviews revealed satisfactory continence in 93 per cent of the patients.

Adult↗
PubMed1987

Alternative techniques for a continent urinary reservoir.

A modification of the Gilchrist procedure is used to create a continent urinary reservoir that provides reliable continence and antireflux mechanisms. The tubular form of the cecum is altered by a patch or reconfiguration to prevent bolus contractions of the reservoir. The procedure offers a choice of locations of the reservoir and stoma in most patients. Each step of the procedure uses techniques already familiar to urologists.

Cecum↗