Biomedical subjects

R Douenias

Publications and source records attributed to R Douenias.

7 recordsLinked to original sources

PubMed1992

New surgical approach for operative management of penile fracture and penetrating trauma.

We have seen 2 cases of penile fracture and 2 of penetrating penile trauma without urethral injury surgically managed with an incision originally described for the operative treatment of venogenic impotence. This incision afforded excellent exposure of all three corporeal bodies and facilitated operative repair. Postoperative results were excellent with return of normal erectile function, minimal edema, and a well-healed, barely visible scar. This incision represents another operative approach for the surgical management of penile fracture and penetrating trauma when urethral injury is not present.

Humans↗

PubMed1991

Predisposing factors in bladder calculi. Review of 100 cases.

One hundred patients, aged twenty to ninety-two years, underwent 111 procedures for removal of bladder calculi. Most patients (88) had some type of bladder outlet obstruction. Two types of stones were identified: those that had apparently formed in the upper tract and been trapped in the bladder (17 cases) and those that appeared to have formed in the bladder in the presence of various types of outlet obstruction. Stone analysis revealed uric acid stones in 50 percent, calcium oxalate stones in 19 percent, and stones of mixed composition in 31 percent. Five patients had metabolic abnormalities predisposing to stone formation; in 2 cases, these abnormalities were discovered during the evaluation for stone disease. Treatment depended on stone characteristics, associated pathology, and the general health of the patient. A review of the literature with regard to the morbidity and mortality of combining treatment of vesical calculi and bladder outlet obstruction secondary to prostatic obstruction is included.

Adult↗

PubMed1991

Endourology of lower urinary tract.

Two methods for obtaining percutaneous access to the bladder are described. Depending on whether or not urethral access is available an endoscopic or fluoroscopic technique may be applied. We have successfully performed suprapubic percutaneous cystolitholapaxy, antegrade fulguration of posterior urethral valves, antegrade cystourethroscopy as an adjunct for urethroplasty, and internal drainage of a bulbar urethral abscess. Endourologic techniques may be readily applied to the lower urinary tract and may be specifically indicated in certain situations.

Abscess↗

PubMed1990

Percutaneous bladder procedures.

Endourology must now include lower urinary tract pathology. The above techniques utilize equipment that is readily available in most centers performing percutaneous procedures. As with the upper tract endourology, the procedures performed in the bladder are likely to reduce morbidity and hospital stay, and in fact, many of these procedures are performed in the office setting under local anesthesia. Our experience was initially in the geriatric population but has now expanded widely, and we use this approach primarily in many bladder cases.

Abscess↗

PubMed1990

Advances in the percutaneous management of the ureteropelvic junction and other obstructions of the urinary tract in children.

In conclusion, endopyelotomy has been developed over the past several decades on the basis of sound laboratory and clinical research. The success rates have been similar to those of the standard open pyeloplasty, and the procedure is not associated with undue complications. Endopyelotomy has several distinct advantages over open surgery, including the decreased morbidity and associated expense of an open operation, minimal interference with the blood supply of the ureter, and avoidance of removal of the ureter from its natural sheath, preventing the tendency to adhere to adjacent structures and thus kink. As the instrumentation available for percutaneous renal surgery has improved and been miniaturized, the techniques developed in adults have been progressively applied to younger and smaller children. There seems to be little doubt that a comparison of morbidity and socioeconomic factors associated with a successful endopyelotomy versus an open pyeloplasty in adults heavily favors the percutaneous procedures, and judicious application to children would seem warranted. However, the changing presentation of ureteropelvic junction obstruction in children that has resulted from the widespread use of prenatal ultrasonography may make the question moot. Open infant pyeloplasty is a highly successful procedure, accompanied by minimal morbidity and accomplished in a 2- to 3-day hospital stay. The socioeconomic factors are obviated in the infant, who already requires constant maternal care. However, endopyelotomy deserves consideration in the older child, especially if the obstruction is secondary in nature after a previous open procedure.

Child↗

PubMed1990

Assessment of urinary dysfunction in the elderly.

This article discusses the significance of specific signs and symptoms in the history and physical examination as they apply to the lower urinary tract in the geriatric population. The relevant use of urodynamics, cystoscopy, and other innovative techniques that aid in the assessment of urinary dysfunction will be covered.

Aged↗

PubMed1979

[Coagulation and fibrinolysis proteins in nephrotic syndromes in children].

The main coagulation and fibrinolysis proteins have been studied in 22 children with nephrotic syndrome. Some anomalies such as the increase of fibrinogen and of Factors II, V, VII + X concentrations and the decrease of antithrombin III concentration could induce an hypercoagulability. Other anomalies such as the high alpha 2 macroglobulin concentration and the frequently low plasminogen concentrations could induce a decrease of the plasma fibrinolytic activity. The consequences of the low alpha 1 antitrypsin levels are probably less important. The fast alpha 2 antiplasmin levels have been found variable in the different patients. Practically, it appears that most children with plasma albumin levels less than 15-17 g/l have antithrombin III levels less than 23 mg/dl (70% of normal), which appears to result in a high risk of thrombosis (11).

Adolescent↗