Complete duplication of the bladder and the urethra with associated anomalies.
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Biomedical subjects
Publications and source records attributed to A G Toguri.
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An unusual form of crossed renal ectopia is presented. Both kidneys are at the same level on the same side with fusion throughout their entire lengths.
A simple, inexpensive pressure-recording balloon system to determine abdominal or rectal sphincter pressures without difficulty is described.
Carbon dioxide urethral pressure profiles were analyzed under the same conditions for 113 spina bifida and 87 non-spina bifida patients categorized by sex and age. Either duplicate or triplicate measurements were obtained from each patient for parameters of continence length, closure pressure and functional length. The degree of reproducibility of each parameter varied depending on age, sex and diagnosis. Except for 1 age-sex category closure pressure exhibited the smallest degree of relative variation for spina bifida patients. Results for non-spina bifida patients were mixed in that the measurement of no one parameter resulted in a uniformly smallest degree of relative variation. Reproducibility based on within patient variability generally was least for the continence length.
We have described two circumcised children who developed a urethral fistula caused by long hairs constricting and ulcerating the penis. These cases are presented to remind physicians to examine the infant's penis when he presents with a swollen glans, abnormal urinary stream, and a parent with long hair.
This study shows that the response time between an actual event and a recorded event on a urethral pressure profile is a function of gas flow rate and gas circuit volume. Response times varied from 1.8 to 10.8 sec. Considerable variation was noted between flow setting and actual gas flow; therefore, calibration of the instrument's gas flow meter is recommended.
A form-fitting glans condom has been developed for use in small uncircumcised males with neurogenic bladders to avoid the problems inherent with diapers. The method to make the glans condom and early successful use in 19 of 33 patients are noted.
Cystometry in 21 cases of closed continent bladder exstrophy revealed that 14 patients had a normal reflexic bladder. A simultaneous anal plug electromyogram showed an appropriate response in all patients when correlated with a cystometrogram.
The relationship of the onset of continence, staged surgical procedures and continence length was investigated in 21 patients with closed continent exstrophy. Continence occurred within a year of operation in 13 patients and 10 of these 13 patients had a Young-Dees urethroplasty and Marshall-Marchetti-Krantz suspension. In 11 of these 13 patients the continence length was greater than 1 cm. In the remaining 8 patients continence was delayed beyong a year. Only 1 of these 8 patients had undergone both bladder neck procedures and in 5 patients the continence length was greater than 1 cm.
The urethral pressure profiles for 36 patients were analyzed specifically for continence zone by 3 techniques: 1) triangle, 2) planimeter and 3) weight. Graphically, the best agreement was between the weight and planimetry methods but, statistically, there was a significant difference among techniques except for the subgroup that had the smallest continence area.
A case of Y-type urethral duplication is described with urethrograms showing the anterior and posterior channels arising from the prostatic urethra. Postmortem studies revealed the dominant posterior channel and its relationships to the stenotic anterior channel and anus.
A case of Y-type urethral triplication is reported. Urethrograms and urodynamics revealed the stenotic anterior urethras and a functional posterior urethral channel with a normal urethral pressure profile.