The diagnosis of obstruction in experimental hydroureteronephrosis. Mechanisms for progressive urinary tract dilation.
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Animals↗
Biomedical subjects
S A Koff
Publications and source records attributed to S A Koff.
A practical approach to hematuria in children.
Bilirubin or excessive ingestion of carotene or other food pigments can cause discoloration of urine similar to that seen in hematuria. The "red diaper syndrome" is caused by Serratia marcescens colonization of the gastrointestinal tract. Neoplasms are unusual causes of hematuria in children. Hematuria in the neonate may represent renal vein thrombosis, renal artery thrombosis, renal cortical necrosis or tubular necrosis. The most common cause of hematuria in children is glomerulonephritis, especially the poststreptococcal type.
Child↗
Bladder calculi complicating intermittent catheterization.
Bladder calculi occurred as a late complication in 4 male patients who performed satisfactorily clean, intermittent catheterization. The mechanism for stone formation in each case was a hair introduced into the bladder, which served as a nidus for incrustation. Patients on intermittent catheterization, particularly male subjects with impaired tctile discrimination, should be instructed to observe diligently for and avoid adherence of hairs to the catheter to prevent this complication.
Adolescent↗
Urodynamic studies in anesthetized children.
Urodynamic study was done on 31 neurologically normal children with urinary infection and/or severe voiding disturbances. The evaluation was performed with the child under anesthesia because awake testing proved unsatisfactory. Detrusor contraction occurred in 29 children under anesthesia and sufficient data were obtained to identify accurately patterns of dysfunction and to initiate therapy. A method for anesthetic neurourologic study using enflurane is presented, which permits reliable and reproducible urodynamic observations to be made in patients in whom awake investigations are incomplete or unsatisfactory.
Anesthesia, Inhalation↗
Assessment of hydroureteronephrosis in children using diuretic radionuclide urography.
Diuretic radionuclide urography was developed as a safe, accurate and non-invasive method of assessing nephroureteral dilatation to distinguish between obstructive and non-obstructive hydronephrosis. The nuclear medicine gamma camera/computer system is used to monitor the washout pattern of an isotope from any locus of suspected obstruction in the upper urinary tract. This technique was used to study 62 children with hydroureteronephrosis of diverse causes. Our experience suggests that it is accurate in determining whether true obstruction exists in dilated systems and effective in predicting which patients will benefit from corrective operation.
Adolescent↗
Cystourethrography: the effect of reservoir height upon intravesical pressure.
The effect of infusion height upon intravesical pressure during cystography was studied in three dogs and three patients. Results indicate that during bladder filling the intravesical pressure is independent of the reservoir height.
Animals↗
Association of urinary tract infection and reflux with uninhibited bladder contractions and voluntary sphincteric obstruction.
We studied 53 neurologically normal children with recurrent urinary tract infection who were found to have bladder-sphincter incoordination characterized by voluntary sphincteric constriction during involuntary uninhibited bladder contraction. Increased intravesical pressure was documented during these events and was associated with vesicoureteral reflux in nearly 50 per cent of the children and with abnormalities of the ureteral orifice in 30 per cent of those without reflux. We hypothesize that increased intravesical pressure causes urinary infection in these children and produces a spectrum of intravesical anatomic distortion that predisposes to vesicoureteral reflux. In a prospective uncontrolled study treatment of the uninhibited bladder contractions allowed 58 per cent of the patients to maintain sterile urine without subsequent antimicrobial therapy after cure of the initial infection.
Adolescent↗
Diuretic radionuclide urography: a non-invasive method for evaluating nephroureteral dilatation.
The diuretic radionuclide urogram is a simple, rapid and non-invasive technique to determine whether true obstruction exists in dilated nephroureteral systems. The methodology, results and interpretation of 102 studies in 41 patients are presented and compared to the conventional methods of assessing hydroureteronephrosis.
Adolescent↗
Neurogenic bladder dysfunction.
The combined use of cystometry and perineal electromyography permits the physician to detect abnormalities in the synchronization of bladder contraction and urinary sphincter relaxation. With each pattern of neurogenic bladder disease, the coordination between bladder and sphincter determines whether urinary tract problems will develop. Treatment is tailored to specific bladder and sphincter defects.
Humans↗
The pseudo-obstructed bladder in enuretic children.
In a minority of enuretic children with severe day symptoms, and especially when there is urinary infection, there a bladder diverticula and trabeculation and possbily also harmful vesicoureteric reflux which suggest the presence of an infravesical obstruction. However, in 11 children with this syndrome who underwent urodynamic studies, no anatomical or functional obstruction was demonstrable. It is contended that the obstructive signs are the result of uninhibited detrusor contractions being voluntarily resisted by contraction of the external urethral sphincter so that abnormallay high intravesical pressures result. Management involves the use of detrusor-inhibitory drugs. Ureteric reimplantation may be needed for reflux. In the majority of cases symptoms improve with time but the bladder diverticula persist.
Child↗
Experimental assessment of graded ureteral obstruction utilizing liquid and gaseous perfusion techniques.
Ureteral perfusion studies (Whitaker's test) utilizing both saline and carbon dioxide were performed in nonobstructed canine ureters and in ureters subjected to a standardized partial and high grade obstruction to characterize the pattern of pressure response. Three separate ranges of pressure elevation were identified with each perfusate and a high degree of correlation between saline and CO2 pressures was observed. However, a significant overlap between the pressure range for nonobstructed and partially obstructed ureters was noted. This overlap must be carefully considered in human studies before defining clinically significant obstruction on the basis of an absolute perfusion pressure value.
Animals↗
Candida albicans "fungus ball" in bladder.
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Candidiasis↗
Patterns of neurogenic bladder dysfunction in sacral agenesis.
Patterns of neurogenic bladder disease were defined in 13 patients with sacral agenesis. Each patient demonstrated an individualized mixture of upper and/or lower motor neuronal deficits. The paucity of clinical parameters capable of identifying and assessing bladder dysfunction in these patients mandates complete neurourological evaluation and careful followup.
Adolescent↗
Covered cloacal exstrophy: another variation on the theme.
Two cases showing many of the visceral features of exstrophy of the cloaca are described. In addition, there were the typical pelvic skeletal deformity and lumbosacral spina bifida but the abdominal wall was intact, although thin and weak. The embryogenesis is discussed. It is considered that the condition resulted from the breakdown of an infra-umbilical membrane at the 5 mm. stage. Later, mesodermal infiltration led to secondary closure of the membrane but visceral development was halted.
Abdominal Muscles↗
Intermittent catheterization in the treatment of acute purulent urethritis: case report.
Acute purulent urethritis is a complication associated with an indwelling. Foley catheter in male patients. A refractory purulent urethral discharge, fever and the sequelae of urethral stricture, periurethral abscess and epididymitis are familiar problems to the urologist. The usual therapy is removal of the catheter, antibiosis and provision for another type of vesical drainage. Our recent successful experience using clean intermittent catheterization to treat an acute urethritis is presented.
Acute Disease↗
Renal malacoplakia.
Malacoplakia often is considered a benign disease. Our recent experience with renal parenchymal malacoplakia and a review of the literature have revealed the clinical and pathologic features as well as the prognosis of this renal disease. Upper urinary tract malacoplakia is neither benign nor self-limited, and bilateral renal parenchymal involvement has been uniformly fatal.
Abscess↗
Altered bladder function in staghorn calculus disease.
Disorders of the lower urinary tract that predispose to urinary infection were identified in 69 per cent of 62 patients with branched renal calculi. Within an average followup of 6.3 years control of these disorders was observed to reduce the rate of reinfection and the frequency of complications after operative stone removal.
Adolescent↗