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Biomedical subjects

R Witherington

Publications and source records attributed to R Witherington.

At least 37 records · Page 2Linked to original sources
PubMed1984

Malacoplakia associated with vesicoureteral reflux and selective immunoglobulin A deficiency.

A case of malacoplakia involving the lower urinary tract of a young black boy, with associated bilateral vesicoureteral reflux, hydronephrosis and selective immunoglobulin A deficiency is reported. Reflux was caused by the malacoplakia. Reflux and hydronephrosis persisted despite elimination of bacterial infection and malacoplakia by drug therapy. These abnormalities were corrected by a conventional antireflux operation. Malacoplakia appears to be related to immunologic incompetence and diminished levels of intracellular cyclic 3',5' guanine monophosphate. Cholinergic agonists reverse or prevent the pathological changes of malacoplakia.

Anti-Infective Agents, Urinary↗
PubMed1984

Cryptorchism and approaches to its surgical management.

About 1 in 200 boys has cryptorchism, and orchiopexy remains the cornerstone of therapy. Inguinal orchiopexy is adequate for the palpable or low-lying testicle. The midline preperitoneal approach is particularly good for the high testicle, and it permits simultaneous orchiopexy in most instances of bilateral cryptorchism. For the very high testicle, microsurgical autotransplantation offers hope for functional and anatomic salvage.

Child↗
PubMed1983

An unusual case of anterior urethral injury.

We report an unusual case of straddle injury manifested by complete transection of the urethra without disruption of Buck's fascia and concomitant intussusception of the detached distal urethral segment through the external urinary meatus.

Adult↗
PubMed1982

The surgical management of acute bacterial epididymitis with emphasis on epididymotomy.

During the course of acute bacterial epididymitis of nonvenereal origin, severe epididymal inflammation and edema can produce compression of adjacent branches of the spermatic vessels, which can compromise the testicular vascular system. Scrotal fixation over the involved testicle heralds this event and indicates actual or impending epididymal suppuration. At this crucial moment either surgical decompression of the epididymis or epididymectomy is indicated to prevent ischemia of the testis and subsequent development of gangrenous epididymo-orchitis with testicular slough. Between 1956 and 1980, 14 epididymotomies were done, which resulted in salvage of 12 testicles (86 per cent). During the same period 10 patients with acute epididymitis had progression of the disease to gangrenous epididymo-orchitis, which necessitated orchiectomy. Epididymotomy can prevent progression of acute epididymitis to gangrenous epididymo-orchitis in many instances and is believed to have a role in the management of this troublesome affliction.

Acute Disease↗
PubMed1982

Ureteral splints: results of a survey.

The results of a survey concerning ureteral splints are reported. Of the respondents 70 per cent preferred the term splint to stent. There was general agreement that a splint should be used in any complicated pyeloplasty as well as in any patient undergoing an operation on the ureter or ureteropelvic junction draining a solitary kidney. Additionally, use of a splint after repair of ureteral injuries by a general urologist was believed advisable. Splints are not absolutely necessary in uncomplicated pyeloplasties and in most simple ureteroneocystostomies. Most urologists use ureteral splints, and believe that they do little or no harm and rather consistently terminate in a good postoperative result.

Humans↗
PubMed1981

Angiolymphoid hyperplasia with eosinophilia: report of a case with penile lesions.

A case of angiolymphoid hyperplasia with eosinophilia of the penis is reported. In addition to the proliferation of swollen endothelial cells with features of histiocytes ("histiocytoid endothelial cells"), the lesions also showed a remarkable proliferation of pericytes both in relation to formed vascular channels and away from them. The authors consider that the inflammatory component is associated with even the earliest stages in the development of the lesions and that it not be dismissed as secondary.

Adult↗
PubMed1981

Subcutaneous estradiol pellet implantation in management of advanced prostatic carcinoma.

Thirty patients with previously untreated Stage C and D carcinoma of the prostate were treated with subcutaneously implanted estradiol pellets in an effort to determine the efficacy of this mode of therapy in the control of advanced prostatic carcinoma. Serum levels of gonadotropins, testosterone, and estradiol were obtained prior to institution of therapy and at monthly intervals thereafter. Twenty-eight patients were followed for at least one year. Sixteen patients were hormonally castrate at six months following 1-pellet implantation. In these 16 patients the means serum testosterone level was 43.6 ng./dl. with a serum luteinizing hormone (LH) of 13.3 mlU/ml. and a serum estradiol of 19.2 ng./dl. Twenty-two patients were hormonally castrate at twelve months following 1 or more pellet implantations. In this group the mean serum testosterone level was 51.5 ng./dl. with a serum LH of 16.2 mlU/ml. and a serum estradiol of 22 ng./dl. Fifteen patients who were taking narcotics for pain relief either became pain free or had a marked decrease in need for analgesics. Increased weight improvement in over-all well-being was noted in 86 per cent of patients. pellet implantation intervals ranged from four to ten months, with a mean interval of 5.85 months between implantations. Complications attributable to this mode of therapy were no more apparent than with oral estrogens. In addition to better compliance, subcutaneously implanted estrogen pellets appear to provide a safe, reliable, and effective method of tumor control and palliation in advanced carcinoma of the prostate.

Acid Phosphatase↗
PubMed1981

Ureteropyelocalycostomy in the management of lower calyceal stone.

Side-to-side ureteropyelocalycostomy in 10 patients with lower calyceal calculi uniformly achieved good postoperative kidney drainage and has not been associated with stone recurrence during an average followup of 35.4 months. Five patients have maintained sterile urine postoperatively. Postoperative renal deterioration has been apparent in only 1 patient and it is unrelated to the operative procedure. This approach to the management of a lower calyceal stone has permitted excellent visualization of the collecting system for lithotomy and it has resulted in minimal renal tissue loss. The procedure is particularly appropriate for the management of lower calyceal calculi in kidneys in which there is medial parenchymal thinning over the calyx and preservation of all functioning renal tissue in deemed wise.

Adolescent↗
PubMed1981

Penile lesions: a generalist's guide.

Penile lesions are a discomfiting affliction demanding skillful diagnosis and management by the primary care physician. This article discusses and illustrates 14 common types, delineating characteristics, course, and treatment.

Chancre↗
PubMed1981

The midline preperitoneal approach to orchiopexy.

The midline preperitoneal approach has been used to facilitate delivery of 42 high undescended testicles into a suitable scrotal position. The gonads were situated preoperatively either within the abdomen (59.5%) or in a high inguinal position (40.5%). The technique described here has allowed marked lengthening of the spermatic cord and visibly shortened the distance between the spermatic vessel-great vessel juncture and the most dependent portion of the scrotum. It has virtually eliminated the necessity for staged orchiopexy in patients with heretofore difficult to manage cryptorchism. In this series an overall satisfactory anatomic result was achieved in 76.9 per cent of patients.

Adolescent↗
PubMed1980

Bladder hernias.

Six cases of bladder herniation are reported: 4 were associated with inguinal hernias, and 2 were situated in the lower midabdomen. In 1 patient a gangrenous intrascrotal ruptured bladder was found. In most instances simple fascial closure after reduction of the herniation sufficed for treatment. Bladder involvement in any low abdominal wall hernia should be suspected since failure to do so may lead to postoperative complications.

Aged↗
PubMed1980

Treatment of postoperative ureteral stricture by catheter dilation: a forgotten procedure.

Some postoperative ureteral strictures can be managed successfully by simple catheter dilations as shown in the cases presented herein. It appears that only one or two dilations may be necessary for prolonged resolution of the obstructive process. Internal ureteral splints may be used with equally good results. Operating intervention should be reserved for those cases in which either ureteral catheterization cannot be accomplished or dense fibrosis renders adequate long-term management by catheter dilation impossible.

Adult↗
PubMed1980

Improving the supracostal loin incisions.

After routine supracostal loin incisions the incised edge of the diaphragm may be sutured to the lateral pericostal tissues adjacent to the superior rib. This embellishment hides the pleura from view and protects it from intraoperative injury. Additionally, the procedure results in fixation of the incised edge of the diaphragm when the wound is closed.

Adrenal Glands↗
PubMed1979

A review of 117 partial nephrectomies.

In this review of 117 consecutive partial nephrectomies calculi associated with infection was the most common indication for the operation. Other indications included congenital anomalies, trauma, arteriovenous malformations and tumor. Partial nephrectomy has been shown to be a relatively safe procedure, with a mortality rate of 1.7 per cent. However, considerable morbidity occurred when stone and/or infection persisted postoperatively. We herein emphasize that total intraoperative removal of calcareous debris, appropriate treatment of associated infection and avoidance of nephrostomy tubes are important to a successful postoperative result. Partial nephrectomy as a method to remove stones confined to or originating in a diseases calix appears unsurpassed.

Adolescent↗
PubMed1979

The Denis-Browne hypospadias repair revisited.

Sixty-four cases of hypospadias repair by the Denis-Browne technique are reviewed. A urethrocutaneous fistula was the most common postoperative complication. Other less frequent complications were urethral stricture, residual chordee and improper location of the urethral meatus. These complications were corrected adequately and the results were satisfactory in all patients. This technique is simple, sound and trustworthy.

Child, Preschool↗