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Biomedical subjects

A M Giron

Publications and source records attributed to A M Giron.

9 recordsLinked to original sources

Incontinent epispadias: surgical treatment of 38 cases.

We review 38 cases of surgically corrected incontinent epispadias with a followup of 5 months to 18 years. In 20 cases the Leadbetter, in 8 the Tanagho and in 8 the Young-Dees techniques of bladder neck reconstruction were used. Of 3 patients with minimal (15 to 25 ml.) bladder capacity the Arap procedure was performed in 1, while small constriction of the bladder neck to improve the bladder capacity and compliance was done in 2. In 1 of the latter patients a 60 ml. capacity was achieved and a secondary Leadbetter operation provided an excellent result. Continence was attained after the initial operation in 18 patients, followup is too short to determine the result in 3 and 15 did not acquire urinary control. Revision of the bladder neck plasty was performed in 11 patients, which resulted in continence in 4 and partial continence in 2. Among 34 patients with an adequate followup 22 (73.3 per cent) are continent and 8 (26.4 per cent) are incontinent. The results were similar with the 3 techniques.

Adolescent

Duplicated exstrophy: report of three cases.

Three cases of duplicate exstrophy are described and the theoretical mechanisms of embryogenesis discussed. In all 3 cases there was classic pelvic skeletal deformity. Urinary control was normal in 2 of the 3 patients. The surgical approach consisted of plastic repair of the abdominal wall defect in all patients and correction of urinary incontinence in 1 patient.

Bladder Exstrophy

[Vesicostomy: a temporary urinary diversion in childhood].

The authors report on 21 pediatric cases of tubeless cystostomies (19 males and 2 females). 15 cases of posterior urethral valves (septic condition and very narrow urethra). 3 primitive vesico-renal refluxes (small bladder, severe impairment of renal function and extensive dilatation of the upper urinary tract). 2 prune-belly syndromes. 1 neurogenic bladder. (Impracticable intermittent catheterization). 19 of the 21 cases showed dramatic improvement (narrowing of the upper urinary tract, disappearance of infection and resumption of staturo-ponderal thrive). Only 1 child with valves had to be put on cutaneous ureterostomy. The improvement in the upper urinary tract, as seen on the IVP, is very rapid in valve cases without reflux. The improvement is visible earlier on isotopic renal scans than on IVP. 11 children suffered acute pyelonephritis during vesicostomy. There were no cases of cutaneous peristomal modification. Simultaneous closure of the derivation and surgery of the primitive disease were performed in 10 cases after a 1-3 year period of vesicostomy. Vesicostomy will succeed in those babies who have shown clinical and biological improvement after a short period of trans-urethral or suprapubic catheterization. The suprapubic endoscopis treatment of the valves becomes possible through the vesicostomy hole excluding urethral trauma.

Child, Preschool