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Biomedical subjects

S Raz

Publications and source records attributed to S Raz.

At least 145 records · Page 8Linked to original sources
PubMed1984

Needle bladder neck suspension for female stress incontinence.

A highly successful transvaginal bladder neck suspension for female stress urinary incontinence is described and illustrated. Precise lateral placement of sutures, maximum mobilization of the anterior vaginal wall and bladder neck, and ease of approach are keys to the technique. The procedure can be utilized in any setting with minimal complications and with neither obesity nor multiple previous surgeries as contraindications.

Female↗
PubMed1984

[Treatment of urinary stress incontinence by transvaginal suspension of the bladder neck. Peyreyra-Raz technic].

Results are reported of the use of the technique of suspension of paravaginal tissue from either side of the neck of the bladder to treat female stress incontinence. Conducted almost exclusively through the vaginal route, an inversed incision in U allows dissection of the total retropubic space and pre-urethral bladder neck adhesions from any previous surgery, and the passage of a solidly implanted non-absorbable thread from one side of the suprapubic incision involving skin and subcutaneous tissue is made down to the aponeurosis alone. A special long needle is then passed from above downwards from the lateral extremity of the suprapubic incision to the vaginal incision and the two ends of the non-absorbable thread clamped. One of the advantages of the retropubic dissection is the guidance of this needle without the risk of perforation of the bladder or urethra. The ends of the thread are brought from the vaginal incision to the lateral angles of the hypogastric wound and tied together or over a small square of Teflon. The tension of the thread is such that it will just allow ascension of the posterior lip of the neck. This ascension, as well as the absence of any vesico-urethral perforation, and the permeability of the ureteral meatuses is verified by endoscopy. The very wide safety margin inherent in this procedure is shown by the 96% of perfect results in patients not previously operated upon, and the 94% of successes in those operated upon previously on one or several occasions without practically any complications. These findings suggest that this technique should occupy a place of choice in the treatment of urinary stress incontinence in women.

Female↗
PubMed1984

[Vaginal approach to non-irradiated vesicovaginal fistula].

We herein report our experience in the transvaginal repair of 30 consecutive cases of non-radiated Vesicovaginal Fistulae. The new principles applied include: early surgery as soon as the fistula is recognized, no excision of the fistulous tract to avoid retraction and bleeding of the margins as well as to provide protection of the ureteric orifices, closure of the intact fistula in two layers, rotation and advancement of the vaginal flap to cover the fistula avoiding overlapping of suture lines, and finally assurance of adequate bladder decompression with both a suprapubic tube and an urethral catheter. In the followup period of 6 to 72 months, we experienced a 94% success rate at primary repair with only two failures which are now dry after subsequent trans-vaginal closure. In spite of size, location or proximity to the ureteric orifices, the vaginal approach has proved to be amenable in all cases with minimal discomfort for the patient, a shorter hospital stay and equal or even better results than the more extensive abdominal approach.

Female↗
PubMed1983

Augmentation cystoplasty in the treatment of neurogenic bladder dysfunction.

We report on the role of augmentation cystoplasty in the treatment of 18 patients with neurogenic bladder dysfunction and associated symptoms of severe urinary urgency, frequency and urinary incontinence. All patients failed to obtain any symptomatic improvement with a variety of treatments, including intermittent self-catheterization and pharmacologic manipulation. Preoperative evaluation helped segregate the patients into 3 groups: 1) those with extremely poor bladder wall compliance, 2) those with severe detrusor hyperreflexia and 3) those with a combined problem of poor bladder wall compliance and hyperreflexia. Bladder augmentation involved cecocystoplasty in 15 cases and ileocystoplasty in 3. In 5 patients an artificial urinary sphincter cuff was placed in an attempt to improve continence. Followup ranging from 12 to 120 months (mean 38 months) was available in 17 patients. An excellent surgical result was obtained in 82 per cent of the patients who became asymptomatic and continent after augmentation cystoplasty. Augmentation cystoplasty is a therapeutic modality that should be considered a viable treatment option in selected patients with neurogenic bladder dysfunction.

Adolescent↗
PubMed1983

Further experience with the artificial urinary sphincter.

Since December 1977, 78 patients with severe urinary incontinence have been treated by insertion of an artificial sphincter at our medical center. In 53 patients the device was inserted and activated at the same time. Of these 53 patients 21 (40 per cent) are perfectly dry, 8 (15 per cent) are improved but are occasionally wet and 24 (45 per cent) have failed. In 25 patients activation of the sphincter was delayed. Of this group 14 patients (56 per cent) are perfectly dry, 2 (8 per cent) are occasionally wet and 9 (36 per cent) have failed. The delayed activation technique has reduced the failure rate from 45 to 36 per cent and we recommend its use in high risk patients.

Adolescent↗
PubMed1983

Obstructing urethral valve in a woman: a case report.

We report on a woman with a urethral valve causing obstruction, hyperreflexia, vesicoureteral reflux and retention. The diagnosis of urethral valves in female subjects rests on endoscopy and radiographic studies. Transurethral resection of the valve is effective treatment. The literature is discussed briefly.

Aged↗
PubMed1982

Urodynamic manifestations of cerebellar ataxia.

The urodynamic findings in 15 patients with voiding dysfunction associated with various forms of the ataxia syndrome were reviewed. Urodynamic studies helped segregate the patients into 3 groups: group 1-detrusor hyperreflexia, group 2-normal bladder contractility and group 3-acontractile bladder. Pelvic floor electromyography demonstrated either coordinated or uncoordinated vesicosphincteric function. Although the neurologic findings associated with the ataxia syndrome have been studied extensively the urodynamic findings have not yet been recorded. We emphasize the importance of urodynamic evaluation in the treatment of patients with ataxia and voiding dysfunction.

Cerebellar Ataxia↗
PubMed1982

Complications of penile prosthesis surgery for impotence.

Complications and their management in 1,207 cases of semirigid rod prosthesis for erectile failure are presented. Major complications occurred in 7.8 per cent of the cases. Complications and management of 84 cases of impotence treated with inflatable penile prostheses also are discussed. Mechanical problems occurred in 44 per cent of the cases and medical complications occurred in 10 per cent.

Erectile Dysfunction↗
PubMed1981

Treatment of urinary incontinence with the artificial sphincter.

From December 1977 to November 1978, 21 American Medical System 742A artificial sphincters were implanted in 19 male and 2 female patients with a variety of etiologies for incontinence, including post-prostatectomy incontinence, female incontinence following unsuccessful bladder neck suspension and myelodysplasia. Urodynamic evaluation before sphincter placement is reviewed. Eight patients (38 per cent) had excellent or improved results, while 5 (24 per cent) remained unchanged and 5 (24 per cent) suffered urethral erosion. Between January and September 1979, 18 patients had placement of the 742B or 742C model of the sphincter. Again a variety of etiologies for incontinence was represented, including 11 patients with postoperative male incontinence (10 after prostatectomy). Over-all, 9 patients (50 per cent) had excellent or improved results, while 6 (33 per cent) suffered urethral erosion. Of the post-prostatectomy group 50 per cent had excellent or improved results, while 50 per cent had erosion. Failures occurred more frequently in women, in patients with recurrent urinary tract infections or neurogenic bladders, and after failure of previous anti-incontinence surgical procedures.

Adolescent↗
PubMed1981

Female urethral diverticula: double-balloon catheter study.

A double-balloon catheter was used to evaluate the female urethra in 51 patients. Six different radiographic appearances were identified. Three of the categories are considered variants of normal. One of the categories consisted of eight patients with urethral diverticula. All showed large rounded or lobulated collections of contrast material which were adjacent to the urethra and which persisted on postvoid films. Other abnormalities should be closely correlated with the clinical findings to determine their significance. The diagnosis of urethral diverticulum may be missed, as physical examination and endoscopy can be negative. Therefore, the optimal method for identifying its presence and extent includes both a double-balloon catheter study and a voiding cystourethrogram.

Adult↗
PubMed1981

Protective effect of hydrocortisone on the myocardium during anoxic arrest.

The protective effect of hydrocortisone on the myocardium during anoxic arrest was investigated in nonworking, isolated rat heart preparations subjected to cardioplegia. In control preparations (no cardioplegia) there was no inotropic effect of hydrocortisone. After both 60 and 120 min of anoxic arrest, recovery of contractility in hearts treated with cardioplegia and hydrocortisone was significantly better than that of hearts treated with cardioplegia only--98 vs. 85%, respectively, at 60 min, and 100 vs. 87% at 120 min. The addition of hydrocortisone to cardioplegia solution apparently results in better protection of the myocardium during anoxic arrest.

Animals↗
PubMed1980

Diabetes insipidus and nonobstructive dilation of urinary tract.

Two cases of diabetes insipidus (hypothalamic and nephrogenic) with massive nonobstructive trabeculation and dilation of the bladder and hydroureteronephrosis are reported. The cases are evaluated thoroughly--radiologically and urodynamically. Treatment options are discussed, including the use of an important new drug, dDAVP. The general subject of diabetes insipidus and its urologic implications is reviewed.

Adult↗