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Biomedical subjects

A Ashamallah

Publications and source records attributed to A Ashamallah.

8 recordsLinked to original sources
PubMed1995

Urovaginal fistulae: 20 years' experience.

During the last 20 years we treated 86 patients suffering from urovaginal fistulae. The highest incidence of fistulae occurred in the third and fourth decades of life (31 and 28 patients, respectively). The incidence was very low after the age of 50 (only 2 patients). Fistulae were either simple between the bladder and vagina (54 cases), urethra and vagina (13 cases) and ureter and vagina (7 cases) or complex connecting more than two organs in 12 cases. The causative trauma was difficult prolonged labour with trial forceps in 28 patients. Fistulae followed caesarean section with or without hysterectomy in 24 women. Hysterectomy, whether abdominal or vaginal, was followed by fistulae in 19 cases. Five cases refused operation and 1 was medically unfit. Ureterovaginal fistulae were successfully treated with ureteroneocystostomy. Vesicovaginal fistulae were met with in 54 cases (3 cases required diversion, 1 was medically unfit and 46 were successfully repaired and 4 failed). Simple repair was performed in 30 cases, repair and flap interposition in 12, ileocystoplasty in 7 and colocystoplasty in 1. Urethral fistulae were reported in 13 cases (simple repair in 11 cases and neourethra in 2), of these, 10 were successfully corrected. Complex fistulae were diagnosed in 12 cases (3 required diversion, 5 refused operation, 2 successfully repaired and 2 unsuccessfully corrected). The 2 successfully repaired case were 1 ureterovisicovaginal (treated with ileocystoplasty) and 1 cervicovesicovaginal (treated with repair and flap interposition). The 2 failures were ureterovesicovaginal and treated with simple repair.

Adolescent↗
PubMed1995

Orthotopic bladder substitutes: histopathologic risk factors.

Prostate glands from 150 patients with carcinoma of the bilharzial bladder who underwent cystoprostatectomy were studied histopathologically by step sections. Prostatic urethral involvement by urothelial carcinoma was noted in 13 out of 96 (13.5%) and 5 out of 40 (12.5%) squamous and transitional cell tumors, respectively. None of the 12 adenocarcinomas and the two undifferentiated tumors showed involvement. Prostatic urethral involvement was as high as 19% in basal tumors and 26.7% in multifocal tumors compared to only 6.5% when the tumors occupied the bladder body. There was a significant increase in the incidence of prostatic urethral involvement from 9.5 to 35% when the prostate gland was involved. Prostate gland was involved in 20 out of 150 (13.3%). The bladder tumor was basal and infiltrating the prostate in 18 such cases. Seminal vesicles were infiltrated in 6 cases from the adjacent basal bladder tumors. We conclude that patients with basal or multifocal tumors are risky regarding bladder substitution and we recommend routine diagnostic transurethral prostatic biopsies and frozen sections from the site of urethral transection during cystoprostatectomy whenever bladder substitution controlled by the urethral sphincter is considered.

Adenocarcinoma↗
PubMed1983

Ileal replacement of the bilharzial ureter: is it worthwhile?

Our 14-year experience with the use of isolated ileal segments for replacement of the bilharzial ureter is analyzed retrospectively. Of 52 patients subjected to this procedure followup data were available for 38, in whom 52 ureters were repaired. The results generally were unsatisfactory: the morbidity and mortality rates were high and the percentage of functional improvement was low. The risk was higher for patients with low creatinine clearance. Therefore, we recommend that this operation be avoided when possible. If the operation is unavoidable, tapering of the ileal segment with antireflux ileovesical anastomosis may improve the outcome. Further clinical study must be done.

Adult↗