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Biomedical subjects

R Shabsigh

Publications and source records attributed to R Shabsigh.

66 records · Page 4Linked to original sources
PubMed1989

The role of transrectal ultrasonography in the diagnosis and management of prostatic and seminal vesicle cysts.

Cysts in the region of the prostate and seminal vesicles are interesting because of their differential diagnosis and embryological relevance. We present our experience with 5 cases that include a müllerian duct cyst, diverticulum of the spermatic tract, seminal vesicle cyst and 2 prostatic cysts. Transrectal ultrasonography had a significant role in the diagnostic evaluation of these cysts. Ultrasonographically guided transperineal needle aspiration added significant diagnostic information and might have a therapeutic value. After a review of the literature, we propose an algorithm for the evaluation and management of prostatic and seminal vesicle cysts.

Aged↗
PubMed1988

Use of the AS800 device in exstrophy and epispadias.

Urinary continence is one of the more difficult goals to achieve in patients with exstrophy or epispadias. The artificial genitourinary sphincter provides an alternative to reconstruction of the bladder neck for management of this problem. Although excellent continence can be obtained with bladder neck reconstruction, results of a second procedure of this type seldom are reported. We used the AS800 device in 16 patients with exstrophy and epispadias, 13 of whom had undergone a prior bladder neck operation. We defined our results as total success and continence success, and have achieved over-all rates of 69 per cent (excludes those awaiting revision) and 90 per cent (those with an active device), respectively. Although the frequency of revision and erosion was significant, the ultimate outcome in this difficult patient group was satisfactory.

Adolescent↗
PubMed1988

Combined transrectal ultrasonography and urodynamics in the evaluation of detrusor-sphincter dyssynergia.

Thirty-one combined transrectal ultrasonographic and urodynamic studies were performed in 24 patients with spinal cord lesions at different levels between C4 and T12. Ultrasonography provided accurate real-time imaging of the bladder neck, prostatic urethra and external sphincter during the bladder filling phase as well as during the voiding phase. Bladder and rectal pressures, sphincter EMG and uroflow were recorded simultaneously. Transrectal ultrasonography contributed significantly to the accuracy of diagnosing detrusor-sphincter dyssynergia. Sphincter contractions were clearly visualised with ultrasonographic video monitoring. This imaging method was especially helpful in sorting out the problems of 3 patients with poor emptying of bladder after endoscopic sphincterotomy. One had a urethral stricture and the other 2 had sphincters that opened adequately but bladders that emptied poorly because of detrusor hypocontractility. Other problems, such as benign prostatic hyperplasia and false passage, were also easily recognised. Transrectal ultrasonography not only provides accurate information but also involves no exposure to radiation and thus precludes the need for costly lead-shielded examination rooms.

Adult↗
PubMed1987

Urinary undiversion and implantation of the artificial urinary sphincter in a 73-year-old man.

We report a case of successful urinary undiversion and implantation of an artificial urinary sphincter in a 73-year-old man, who had undergone ileal loop urinary diversion elsewhere for treatment of urinary incontinence secondary to transurethral prostatectomy. The rationale for our decision to perform undiversion is presented. Evaluation of patient history and physical examination are necessary, as well as delineation of the anatomy and function of the upper and lower tracts by laboratory, radiological and urodynamic examinations. Each undiversion case is unique. Treatment must be individualized and should be initiated only after meticulous weighing of the advantages and disadvantages of the different therapeutic alternatives. A complete explanation to the patient is important. Highly satisfying results can be expected in appropriately selected cases.

Aged↗
PubMed1987

The use of transrectal longitudinal real-time ultrasonography in urodynamics.

A total of 63 combined transrectal ultrasonographic and urodynamic studies was performed to evaluate the voiding dysfunction in 49 spinal cord injury patients and 7 other patients. Ultrasonography provided excellent real-time imaging of the bladder neck, prostatic urethra, prostate and external sphincter, and allowed for accurate diagnosis of detrusor-sphincter dyssynergia, detrusor-bladder neck dyssynergia, prostatic hypertrophy and bladder neck strictures. In addition to offering these capabilities, ultrasonography is less expensive than x-ray and it does not involve exposure of either the patient or examiner to radiation. However, it does not provide a means to detect vesicoureteral reflux.

Adult↗
PubMed1986

Lower urinary tract dysfunction after radical hysterectomy for carcinoma of cervix.

The charts of 22 consecutive patients who had undergone radical hysterectomy for carcinoma of the cervix were reviewed retrospectively. Uroflowmetry, gas cystometry, and postvoid residual measurements were performed pre- and postoperatively, and a questionnaire to evaluate urinary problems experienced postoperatively was mailed to all patients. Twenty responses were received and followed up by a telephone interview with the urologist. The number and kind of problems suggest that the cause of urinary dysfunction commonly reported after radical hysterectomy is disruption of nerve supplies to both bladder and urethra. Data on retention suggest that the characteristics of this dysfunction change with time but generally are stabilized by the end of the first postoperative year. It is noted that recurrent urinary tract infection may occur asymptomatically because of loss of bladder sensation. Because of the diversity of presentation, urodynamics played an important role in individualization of treatment and monitoring of progress.

Adenocarcinoma↗
PubMed1986

The impact of the artificial urinary sphincter in the neurogenic bladder on the upper urinary tracts.

The charts and x-rays of 120 neurogenic bladder patients who underwent artificial sphincter implantation for treatment of urinary incontinence between 1973 and 1984 were reviewed retrospectively. Patients were followed for 3 to 130 months (average 36.8 months). The upper urinary tracts remained unchanged in 108 patients (90 per cent). Renal growth in children was undisturbed. Transient hydroureteronephrosis occurred in 8 patients (6.7 per cent) and progressive hydroureteronephrosis occurred in 4 (3.3 per cent). A total of 26 patients with vesicoureteral reflux (39 ureters) underwent ureteral reimplantation. Our results indicate that implantation of the artificial urinary sphincter in neurogenic bladder patients has minimal adverse impact on the upper urinary tracts, followup should be long-term and should include an IVP, outflow obstruction should be eliminated preoperatively by means of external sphincterotomy in male patients and bladder flap urethroplasty in female patients, similarly, adequate emptying of the bladder always must be assured during followup, if hydroureteronephrosis is detected early appropriate treatment can restore normal upper tracts, the presence of previously damaged upper tracts without evidence of obstruction is not a contraindication for artificial sphincter implantation and an antireflux operation in combination with artificial sphincter implantation is feasible.

Adolescent↗
PubMedDate not supplied

The Female Sexual Function Index (FSFI): a multidimensional self-report instrument for the assessment of female sexual function.

This article presents the development of a brief, self-report measure of female sexual function. Initial face validity testing of questionnaire items, identified by an expert panel, was followed by a study aimed at further refining the questionnaire. It was administered to 131 normal controls and 128 age-matched subjects with female sexual arousal disorder (FSAD) at five research centers. Based on clinical interpretations of a principal components analysis, a 6-domain structure was identified, which included desire, subjective arousal, lubrication, orgasm, satisfaction, and pain. Overall test-retest reliability coefficients were high for each of the individual domains (r = 0.79 to 0.86) and a high degree of internal consistency was observed (Cronbach's alpha values of 0.82 and higher) Good construct validity was demonstrated by highly significant mean difference scores between the FSAD and control groups for each of the domains (p < or = 0.001). Additionally, divergent validity with a scale of marital satisfaction was observed. These results support the reliability and psychometric (as well as clinical) validity of the Female Sexual Function Index (FSFI) in the assessment of key dimensions of female sexual function in clinical and nonclinical samples. Our findings also suggest important gender differences in the patterning of female sexual function in comparison with similar questionnaire studies in males.

Adult↗