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Biomedical subjects

S Raz

Publications and source records attributed to S Raz.

At least 181 records · Page 10Linked to original sources

Surgical treatment of Peyronie's disease: a new approach.

We treated 12 patients with intractable Peyronie's disease with a new approach based on simple incision of the fibrotic plaque(s) and stenting of the corpora with penile implants. Infection in 1 case necessitated removal of the prostheses, while the remaining 11 patients had satisfactory functional and anatomical results. The procedure is indicated for patients with 1) Peyronie's disease and impotency, 2) normal potency and extensive disease and 3) normal potency and localized disease in selective cases. In this series insertion of the penile prostheses did not change sexual prowess in previously potent patients.

Adult↗

Carbon dioxide-urethral pressure profile in female incontinence.

Herein we describe a method to assess urethral dynamics in women with urinary incontinence, using a carbon dioxide cystometer. The parameters evaluated are the maximum urethral closing pressure, functional urethral length, active continence, transmission of intra-abdominal pressure to the urethral pressure and changes when patients are in the supine and erect positions.

Carbon Dioxide↗

[Prosthetic management of urinary incontinence following prostatectomy with special reference to Kaufman's prosthesis].

Issuing from the pathophysiological fundaments of the incontinence after operative sanation of the outlet of the urinary bladder the principal surgico-prosthetic possibilities for the removal of this complication are describes: 1. artificial systems of the sphincter with arbitrary increase and decrease of the occlusion pressure of the proximal urethra, 2. permanent compression of the bulbar urethra. On the last mentioned principle is based the incontinence prosthesis after Kaufman, which in its rate of success corresponds to the artificial sphincter systems.

Humans↗

Parkinsonism and neurogenic bladder. Experimental and clinical observations.

In a group of patients suffering from Parkinson's disease, beside neurogenic bladder dysfunction, we have also found dysfunction affecting the external sphincter musculature. Treatment with L-Dopa probably improves the urethral symptoms by providing a relaxing effect on the urethral closure pressur together with better coordination of the pelvic floor and external sphincter Mechanism during micturition. The effect was parallel to the improvement in Parkinsonion symptoms. Experimental studies demonstrate the ability of L-Dopa to reduce urethral closure pressure and this effect was related to a central effect on the skeletal musculature.

Animals↗

Silicone-gel prosthesis in treatment of urinary incontinence secondary to neurogenic bladder dysfunction.

Patients with lower neuron lesion neurogenic bladder, with normal upper urinary tracts, poor closing pressure of the urethra, and absence of vesicoureteral reflux can be considered candidates for the insertion of the silicone-gel (Kaufman) prosthesis. Our results in 10 cases indicated that there is a place for passive urethral compression in the treatment of neurogenic bladder after a careful selection of patients and using objective methods to regulate the amount of urethral compression. The use of a combined operation (silicone-gel prosthesis and a Small-Carrion prosthesis) in some of the cases is also presented.

Adult↗

Carbon dioxide urethral pressure profile.

In an evaluation of patients with lower urinary tract symptoms, particularly incontinence, the role played by the urethra is crucial. One of the most important methods of evaluation of urethral dysfunction is the urethral pressure profile. From among the many simple and more sophisticated methods of urethral pressure profile measurements we have chosen to describe a simple office procedure and a reliable method of urethral pressure profile evaluation, using the carbon dioxide cystometer. Slow withdrawal of the special catheter connected to the carbon dioxide cystometer allows the determination of the resistance of the urehtral wall at sequential centimeter levels along the entire length of the urethra. Carbon dioxide urethral pressure profile is a safe office procedure that is easy to perform for immediate recording and interpretation of results. The cystometer is easy to calibrate. We have had no complications in 450 consecutive urethral pressure profile determinations. The shortcoming of the procedure is the compressibility of the gas (carbon dioxide), giving a lag in the register's response to pressure differential. The use of carbon dioxide urethral pressure profile is demonstrated in male incontinence, in female incontinence and in patients with neurogenic bladder dysfunction, and the results are discussed.

Carbon Dioxide↗

External sphincter spasticity syndrome in female patients.

The external sphincter spasticity syndrome is described with regard to diagnosis, etiology, pathophysiology and treatment. Use of urodynamic techniques (especially urethral pressure profile and diagnostic pudendal blocks) and adrenolytic agents and diazepam in the treatment of the dysfunction is discussed. We consider this clinical entity to be much more common than perviously reported.

Adult↗

Gelfilm and blowout fractures.

A variety of alloplastic and natural substances have been utilized for support of the orbital floor following a blowout fracture. The employment of Gelfilm is herein recommended for the smaller floor defects. Sterile Gelfilm is manufactured from denaturated collagen, is 0.075 mm. thick, and is known to be tolerated well by ocular tissues. Complete absorbsion of Gelfilm occurs in two to three months, obviating the need for removal of a prosthetic material or the lifetime presence of an alloplast in the orbit. In contrast to autografts no additional surgery is required for its preocurement.

Adult↗

Passive urethral compression with a silicone gel prosthesis for the treatment of male urinary incontinence.

Eighty-six patients who underwent implantation of the silicone gel prosthesis for post-prostatectomy incontinence are the subject of this study. The operation entails the implantation of a silicone gel prosthesis in the perineum to provide passive urethral compression. Several modifications of this operation have been implemented in the last 2 years, and analysis of our results indicates that lasting benefit can be achieved in about 70% of patients.

Humans↗

Use of implantable prostheses for the treatment of urinary incontinence and impotence.

Silicone-Silastic implants to restore continence and potency have been used in one hundred twenty and twenty-five patients, respectively, and in eight patients a combined anti-impotence and anti-incontinence operation has been performed. The results have been gratifying, the complication rate has been minimal with fewer than five patients in our series having infection and a draining perineal sinus after the incontinence implant, and in no patient have delayed problems with the penile implants developed. Because of the design of the penile implants, fracture is extremely unlikely to occur, and the rods can be replaced if necessary because of inadequate length or asymmetry.

Erectile Dysfunction↗

Clinical applications of a new uroflowmeter.

A transportable, easy to handle and accurate uroflowmeter was designed by using standard laboratory equipment. The satisfactory results of assessment of the diagnosis and effects of treatment for relieving obstruction of the lower urinary tract are described.

Humans↗

Adrenergic and cholinergic receptors in the human prostate, prostatic capsule and bladder neck.

The adrenergic and cholinergic receptors of the human prostatic capsule, prostatic "adenoma", and bladder neck, were investigated by the in-vitro isometric technique. The prostatic capsule was found to be very rich in both alpha-adrenergic receptors and cholinergic receptors. The prostatic adenoma was moderately rich in alpha-adrenergic receptors, but cholinergic receptors were absent. Beta-adrenergic receptors were absent in the prostatic adenoma, and there was an equivocal response in less than half the specimens of the prostatic capsule. An attempt was made to distinguish between the trigonal component at the posterior bladder neck, and the true bladder neck muscle both posteriorly and antero-laterally. The results indicat that the "posterior bladder neck" seen at operation is predominantly trigonal muscle, and is poor in cholinergic receptors. The adrenergic response is variable in the true bladder neck muscle, but is present and strong in the trigonal muscle. This response is characteristically gradual in its development. In view of the findings in this investigation, it is suggested that certain instances of acute retention of urine in prostatic patients are due to over-stimulation of the alpha-adrenergic receptors, particularly those in the prostatic capsule. Similarly, the accepted clinical contraindication to the use of cholinergic drugs for retention in the prostatic patient is supported by the distribution of the cholinergic receptors in the tissues examined.

Acetylcholine↗