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Biomedical subjects

R H Whitaker

Publications and source records attributed to R H Whitaker.

At least 19 recordsLinked to original sources
PubMed1992

Surgery for hypospadias fistula.

The results of 12 years' experience in the surgical treatment of hypospadias fistula are presented. Overall, there was a success rate of approximately 50% for each attempt at surgical closure of a fistula. The chances of success were not significantly influenced by the number of previous surgical procedures. The best results were obtained with fistulae on the shaft of the penis which were closed with mucosal inversion and advancement of a skin flap over the fistula.

Child↗
PubMed1992

Surgical outcome of orchiopexy. I. Previously unoperated testes.

A total of 1209 undescended testes in 961 boys who had no previous surgery for this problem have been reviewed with particular regard to the outcome of surgery in relation to the pre-operative and intra-operative assessment of the position of the testis. A third of impalpable testes were found at operation in the abdomen, a third in the inguinal canal and a quarter in the superficial inguinal pouch; 1% of all testes and 7% of impalpable testes were absent; 96% of all testes reached the scrotum at operation and this figure included 69% of abdominal and 94% of canalicular testes. In all 24 testes were excised--7 of which were abdominal, 8 canalicular and 9 were in the superficial inguinal pouch. The generalisation that the higher the undescended testis before operation the poorer the result, does not always hold true.

Adolescent↗
PubMed1992

Urological trauma.

Major urological trauma is life threatening and frequently associated with trauma to other organs. A conservative approach to lesser degrees of damage to the kidney is fully justified whilst a shattered kidney or a pedicle injury calls for surgical exploration. Renal injuries between these two extremes require careful assessment and clinical judgement to decide the best management. An intravenous urogram remains the mainstay of investigation but computed tomography, ultrasound and arteriography can be useful in some circumstances. The management of urethral trauma remains controversial and depends largely on the assessment of whether the posterior urethra is partially or completely ruptured. There remain two schools of thought concerning early or late intervention but all are agreed that suprapubic diversion is essential and that a urethral catheter should not be passed blindly in the initial stages. A ruptured bladder should always be repaired and early intervention is recommended for ureteric injuries. Severe trauma to the testis is best managed operatively to reduce the morbidity.

Angiography↗
PubMed1990

A new device for self-catheterisation in wheelchair-bound women.

The Deavin-Hunt device is designed to help paraplegic and incontinent women to catheterise themselves whilst in a wheelchair. Such patients with neuropathic bladder might otherwise be unable to use intermittent catheterisation, an effective method of controlling incontinence and preserving the kidneys.

Persons with Disabilities↗
PubMed1989

Genitoplasty for congenital adrenal hyperplasia: anatomy and technical review.

There is variable virilisation in female pseudohermaphrodities with congenital adrenal hyperplasia, but they always have normal ovaries, uterus and upper part of the vagina. The various anatomical stages of virilisation are outlined and a historical review is given. For psychological and practical reasons it is generally accepted that the operation should be performed when the patient is between 6 and 18 months of age. The aim is to reduce the size of the clitoris and to expose the vagina so that it opens onto the perineum. Operative procedures are described. The child is reviewed at intervals to determine the size and shape of the vagina and clitoris. Adjustments can be made around the time of puberty but are rarely necessary.

Adrenal Hyperplasia, Congenital↗
PubMed1979

Transurethral resection of large prostates.

A total of 102 men (mean age 70) underwent transurethral resection of the prostate. The weight of the resected prostate ranged from 40 to 152 g. Two deaths occurred in patients aged 85 and 92 years, both of whom were generally unfit. The average postoperative stay in hospital was 8.3 days. The proportions of patients with incontinence, infection, and stricture were similar to those in other series of resections and open prostatectomies, suggesting that resection of the larger prostate is safe and an acceptable alternative to an open operation.

Aged↗
PubMed1979

An evaluation of 170 diagnostic pressure flow studies of the upper urinary tract.

An analysis of 170 pressure flow perfusion studies reveals that they can be valuable in patients of all ages, but particularly so in children, and in a variety of clinical conditions. The complication rate is low and there are few patients in whom these studies do not provide a clear-cut answer on the degree of obstruction. They can be recommended as useful and, at times, invaluable clinical tools.

Adolescent↗
PubMed1979

Ureters that show both reflux and obstruction.

Eight ureters in 6 male patients have been shown radiographically and dynamically to exhibit both reflux and obstruction. The greater the degree of obstruction the more dilated the upper urinary tract. Reflux may be considerable, but in severely obstructed ureters it may be minimal. Both urologists and radiologists should be aware of this unusual association. When it occurs patients should not be managed conservatively, but should have their ureters reimplanted.

Adult↗
PubMed1979

The Whitaker test.

Since obstruction can be satisfactorily defined only in dynamic terms, it is not surprising that in a difficult case, a dynamic means of investigation is needed. The dynamic approach described in detail has been proved to be of great value in a variety of clinical situations. Further, both the apparatus and the technique are well within the scope of any urologist with access to radiologic equipment.

Humans↗
PubMed1977

Pressure-controlled nephrostography.

Nephrostomy tubes are often left in the kidney after renal operations. Radiographic studies with contrast medium via the tube post-operatively give anatomical information but little or sometimes even misleading information concerning the dynamics of the upper urinary tract. A pressure/flow-controlled nephrostogram allows not only the passage of medium to be watched but the significance of any hold-up or narrowing to be assessed in dynamic terms. In this way small degrees of obstruction can be identified. There are many situations in which this information is of considerable clinical value.

Female↗
PubMed1977

Hydronephrosis.

It is essential to distinguish between an obstructed and an unobstructed hydronephrosis as the management of the two types is quite different. Some of the radiographic and isotopic methods of distinguishing these two leave much to be desired and the place of dynamic studies is discussed. The aetiology of pelviureteric junction obstruction remains uncertain, but it is probable that one or more of several factors may be involved and these are discussed. The types of hydroenphrosis are classified as chronic, intermittent, unsuspected, equivocal, and reflux-induced.

Adolescent↗
PubMed1976

Investigating wide ureters with ureteral pressure flow studies.

A perfusion study is described and its usefulness in the diagnosis of ureterovesical obstruction is discussed. The study includes 31 children with either primary or secondary non-refluxing wide ureters or ureters that had been reimplanted previously.

Child↗