Biomedical subjects
Publications and source records attributed to R P Finney.
The 8F cystocath has been used as a temporary percutaneous nephrostomy. B-mode ultrasonography was used to determine the depth and direction of trocar placement after initial confirmation with a spinal needle. No immediate complications were noted in 10 successful insertions and there was only 1 failure of entry.
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Experience with a newly designed self-retaining silicone ureteral stent is presented. The stent is supplied in various lengths, has a J or hook molded into each end to prevent migration and has been designed specifically to be passed during an open operation as well as endoscopically. The device is used to provide free drainage to the bladder, reduce or eliminate urine leakage, provide stenting of the ureter and allow for earlier discharge from the hospital of patients without external catheters. In some cases the stent may be used instead of a nephrostomy tube to provide prolonged drainage with less chance of infection. It is removed easily in the outpatient facility by cystoscopy.
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Arteriosclerotic aneurysms of the abdominal aorta constitute a common clinical entity. Rarely are they associated with retroperitoneal fibrosis and ureteral obstruction requiring ureterolysis. Fifteen such cases have been reported, with resection successful in 5 of 7. A sixteenth case is presented complicated by the presence of a persistent left cardinal vein. It is the third aneurysm resected with such an anomaly, and to our knowledge the first to be associated with retroperitoneal fibrosis and ureteral obstruction. Ureterolysis with resection of the aneurysm was performed. The difficulties presented by these pathologic entities, as well as the anomalous venous pattern, are reviewed. Complete preoperative evaluation, including intravenous pyelogram, retrograde pyelography, aortography, and venacavography, for the definition of anatomic relationships and planning of the surgical approach is stressed.
A new paired hinged silicone prosthesis is described. The hinge allows the penis to move freely and hang in a dependent position without constrictive clothing and permits satisfactory coitus. A conical tip more nearly conforms to the distal corpus and the proximal end may be trimmed during the operation to fit the individual patient.
Embryonal rhabdomyosarcoma of the prostate is typically a rare mesenchymal tumor of young boys, presenting with obstructive urinary symptoms or an abdominal mass. The origin is probably in undifferentiated mesenchymal cells that persist into adult life. Histologically, the tumor cells resemble normal muscle development in a 7 to 10-week fetus. Treatment is combined radical surgery and chemotherapy, and usually radiotherapy as well. The prognosis is extremely poor in all patients. Our case is added to the few in the literature in which this disease occurred in a man more than 50 years old.
A self-retaining loop nephrostomy with an inflated balloon in the renal pelvis to prevent accidental extraction or displacement is described. An additional feature of this tube is a plug that may be positioned to promote maximal irrigation of the kidney with a stone solvent or to allow urine to flow from 1 or both ends of the loop.
A review of steroid management of urethral strictures is presented. The 96 patients were followed for a year or more after urethral injection with triamcinolone. Intralesional steroid may be used in many types of strictures but it is especially useful in those cases with strictures in the distal urethra or the meatus, those occurring after radical prostatectomy and in some cases when 1 or more urethroplasties have been done. Every practicing urologist can benefit from using stricture injection in selected cases.