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Biomedical subjects

R H Whitaker

Publications and source records attributed to R H Whitaker.

At least 73 records · Page 4Linked to original sources
PubMed1982

Analysis of cord length obtained during steps of orchiopexy.

During 28 orchiopexies in 22 boys, an analysis was made of the increased length of cord that was obtained at the end of 3 aspects of the operation--after division of the cremaster, after excision of the sac and after retroperitoneal dissection. The mean gain in length of the cord was analysed in relation to the original position of the testis and was greatest in the ectopic testis and least in the testis in the inguinal canal. Each part of the operation produced worthwhile increases in length, but bore no relationship to the age of the child at operation.

Adolescent↗
PubMed1982

Diagnoses not to be missed. Torsion of the testis.

An acutely tender painful testis is likely to be a torsion, particularly in the boy before or at the time of puberty. In the older patient the lie of the other testis may give a clue to the diagnosis of torsion and at any age the history of previous "warning" episodes should be sought. Operation as soon as possible and always within 5 hours of the onset of pain is mandatory. The other testis should always be fixed. There is no place for treating small boys with antibiotics on the assumption of a diagnosis of epididymitis.

Adolescent↗
PubMed1981

Percutaneous upper urinary tract dynamics in equivocal obstruction.

Percutaneous pressure flow studies in the upper urinary tract remain the definitive method of distinguishing stasis from obstruction. They are not technically difficult and the results of 2 large series show minimal, minor complication rates. The results in over 200 studies show that a clear-cut answer as to whether or not an obstruction is present is obtained in over 95% of patients, the remainder showing pressures in an equivocal range.

Humans↗
PubMed1981

The use of danazol for ureteral obstruction caused by endometriosis.

We report 2 successfully treated cases of unilateral obstruction owing to endometriosis. Treatment consisted of danazol alone in 1 case and surgical freeing of the obstructed ureter in the other. Danazol alone can reverse completely ureteral obstruction caused by endometriosis but if secondary fibrosis has occurred surgical treatment may be necessary. This is the first case reported of complete resolution of unilateral ureteral obstruction owing to endometriosis using danazol therapy alone.

Adult↗
PubMed1981

Sensory level and renal prognosis in myelomeningocele.

Two hundred and fourteen cases of spinal dysraphism were studied to investigate the relationship of sensory level and renal damage. It was found that in 72 cases with a high sensory level of T12 and above, 45 cases (62%) had renal damage which was the cause of death in 12; in 142 cases with a low sensory level of L1 and below, 40 cases (28%) had renal damage which was the cause of death in only 2. A palpable bladder and reflux were associated with renal damage in the cases with a low sensory level but some additional factor appears to operate in those with a high sensory level. Other reasons for the poor prognosis in these cases are discussed. The critical level in the spinal cord at which the prognosis for renal damage sharply changes coincides with the sympathetic outflow to the renal tract (T12-L1). Disruption of the spinal cord at or above the renal outflow may be a determining factor in prognosis.

Adolescent↗
PubMed1981

Megacalices--how broad a spectrum?

Ten patients with a suspected diagnosis of megacalices have had pressure-flow studies to confirm or exclude obstruction. Eight had no evidence of obstruction and amongst these there were 2 patients with a non-obstructed megaureter. Two patients showed evidence of obstruction and remain a dilemma from a management viewpoint. If "megacalices" is used simply as a descriptive term, then the spectrum of disease is wider than previously suspected.

Adolescent↗
PubMed1981

Dynamic evaluation of the results of pyeloplasty using pressure-flow studies.

Dynamic assessment using pressure flow studies was made in 11 patients to assess the patency of their pyeloplasty. In 5 the study was in the immediate post-operative period and lead to a further exploration in 2 patients. In 6 the study was performed many years after the pyeloplasty and showed that despite symptoms only 2 patients needed a further procedure. Dynamic assessment is a useful technique in these difficult diagnostic problems.

Adult↗
PubMed1980

Peyronie's disease in a district general hospital.

Peyronie's disease can cause severe physical and psychological distress. Of 31 cases in this retrospective study, 12 underwent spontaneous improvement in their symptoms which makes the assessment of active treatment in other patients difficult. The indications and limitations of operative approach are discussed.

Adult↗
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↗