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Biomedical subjects

T M Boemers

Publications and source records attributed to T M Boemers.

27 records · Page 2Linked to original sources
PubMed1994

Urodynamic evaluation of children with the caudal regression syndrome (caudal dysplasia sequence).

A total of 50 children with the caudal regression syndrome (caudal dysplasia sequence) underwent urodynamic evaluation of lower urinary tract function. Of the patients 15 had isolated sacral agenesis, 13 had sacral agenesis in combination with an anorectal malformation and 22 had an anorectal malformation without sacral anomaly. Neurogenic bladder-sphincter dysfunction was observed in 11 of the 15 children with isolated sacral agenesis (73%) and in 10 of the 13 children with combined sacral agenesis and anorectal malformation (77%). The pattern of neurogenic bladder-sphincter dysfunction in both groups did not differ significantly. In the group of 22 children with isolated anorectal malformation only 1 had signs of neurogenic bladder-sphincter dysfunction. These results indicate that anorectal malformation per se does not influence lower urinary tract function and that the sacral anomaly is the determining factor for neurogenic bladder-sphincter dysfunction in children with anorectal malformation.

Abnormalities, Multiple↗
PubMed1993

[Peroperative anaphylactic reactions due to latex allergy].

A 10-year-old girl with spina bifida underwent surgery to increase the capacity of her neurogenic bladder using an isolated loop of intestine. During the operation serious circulatory and respiratory problems occurred after the peritoneum was opened, when the ileum was manipulated using gloves containing latex. Latex allergy can lead to potentially fatal anaphylactic reactions. A survey is presented of the risk groups, together with measures recently advocated in the literature to detect latex allergy and to avoid major reactions.

Anaphylaxis↗
PubMed1993

[Ascensus testis or acquired abnormality of testicular engagement in 14 boys].

We report the cases of 14 boys in whom the testes ascended from the normal scrotal position to an undescended position. In 10 of the patients the testes were fixed in the high position by surrounding adhesions or by a patent processus vaginalis. We advocate that all boys, even those born with normally descended testes, should be examined regularly with respect to the position of the testes until puberty. Especially boys with retractile testes are at risk for secondary ascent of the testis. Acquired ascent of the testes may be a more important reason for orchidopexy than is usually recognised and may explain the relatively large number of orchidopexies performed in boys after toddler age.

Child↗
PubMed1993

Neomycin toxicity in bladder irrigation.

Neomycin is known for its ototoxicity after many different methods of administration of the drug. Neomycin sometimes is used for bladder irrigation in patients with urinary tract infections when other treatments fail. To our knowledge toxicity after bladder instillation of neomycin has not been reported previously. We report a case of perception deafness in a boy with end stage renal disease who underwent neomycin bladder instillations following augmentation of the bladder with a megaureter.

Administration, Intravesical↗
PubMed1993

Improved Mathieu repair for coronal and distal shaft hypospadias with moderate chordee.

A modified Mathieu "flip-flap" technique is described for coronal and distal shaft hypospadias with moderate chordee. The first improvement is the creation of a well vascularised skin flap by leaving the dartos tunica attached to the mobilised skin, thus making it possible to bridge urethral defects up to 2.5 cm. The second improvement is the correction of congenital curvature by partial chordectomy and dorsal plication of the tunica albuginea without the need for circumcision. Preputial reconstruction is possible if required. Twenty patients underwent the procedure with a follow-up of at least 2.5 years; 96 patients had a shorter follow-up. Complications in the group of 20 patients consisted of 1 fistula, 2 meatal stenoses and 1 glanular dehiscence due to severe wound infection. There were no late complications.

Abnormalities, Multiple↗
PubMed1991

[Effect of intermittent catheterization on urinary tract infections and incontinence in children with spina bifida].

Although the primary objective of clean intermittent (self) catheterization (CIC) was to regain continence in (older) children with myelomeningocele (MMC), we used the method also in the very young with detrusor-sphincter dyssynergia, to prevent future damage from the combined effects of obstruction and urinary tract infection (UTI). The results, in terms of incidence of UTI and degree of incontinence before and during CIC, were assessed in 61 children with MMC who had started CIC between 1985 and 1988. Mean follow up was 45.3 +/- 27.3 months, mean age at the start of CIC was 6.9 +/- 4.6 years. The incidence of UTI during CIC proved significantly lower than before CIC (chi 2 = 20.92, p less than 0.001), and the improvement in incontinence was also statistically significant (chi 2 = 45.16, p less than 0.001). In children with MMC, CIC seems ideally suited to prevent damage to the kidneys from the life-long problem of recurrent UTI's. It will also help in preventing bladder wall fibrosis--an important cause of loss of detrusor compliance--secondary to repeated UTIs.

Adolescent↗
PubMed1987

Regulated high frequency diathermy for bipolar electrocoagulation--a new method for the treatment of carcinoma of the bladder.

In the endoscopic treatment of bladder cancer, especially for stages beyond T2, transurethral resection does not seem to be sufficient. The risk of bladder wall perforation, the possibility of incomplete resection, seeding of tumor cells and high recurrence rates support the former statement [6]. Results of a multicentre prospective randomised study have exemplified that irradiation with the Neodymium-YAG Laser has been a reasonable alternative in the therapeutic approach to bladder cancer [2]. Diathermy coagulation must produce a sufficiently deep, homogeneous and well demarcated tissue necrosis. The coagulation depth has to be adjustable and heat production during coagulation should not lead to bladder wall perforation and consequent damage to the bowel. These criteria were investigated using regulated bipolar high frequency diathermy. The innovation in this method is, that thermal side effects on the tissue, e.g. vaporisation and carbonisation are prevented by a protective relay with constant current flow. Animal experimental studies have shown that this method meets all postulated requirements and therefore clinical trials can proceed.

Animals↗