PubMed Health⌕ Search

Biomedical subjects

Adam R Metwalli

Publications and source records attributed to Adam R Metwalli.

6 recordsLinked to original sources
PubMed2006

Controversial issues and optimal management of stage T1G3 bladder cancer.

The management of T1G3 bladder cancer is controversial. Diagnostic methods, such as bladder mapping or second-look transurethral resection are recommended to assess risk. Bacillus Calmette-Guérin intravesical therapy with a maintenance regimen is recommended for solitary T1G3 tumors. The timing of radical cystectomy for these patients is controversial, but early recurrence during intravesical therapy is an indication for radical cystectomy. Multifocal disease, concomitant carcinoma in situ and disease in the prostatic urethra and bladder neck also suggest aggressive disease and cystectomy should be considered in these patients.

Administration, Intravesical↗
PubMed2004

Congenital midureteral stricture in children diagnosed with antenatal hydronephrosis.

OBJECTIVES: Antenatal hydronephrosis is the most common genitourinary pathologic finding during gestational ultrasonography. Congenital midureteral strictures are an unusual cause of prenatal hydronephrosis, with 13 total previously reported and only 1 diagnosed as a result of antenatal ultrasonography. METHODS: We present 4 cases of midureteral strictures as the cause of antenatal hydronephrosis and review the published data on congenital midureteral obstruction. RESULTS: All midureteral strictures in our series and in the published reports were treated surgically after varying periods of observation. Retrograde pyelography was diagnostic in all cases. CONCLUSIONS: This atypical cause of antenatal hydronephrosis may provide additional insight into the controversy regarding preoperative retrograde pyelography before surgical intervention for ureteropelvic junction obstruction. Given the typical misdiagnosis of ureteropelvic junction obstruction in the setting of midureteral stricture disease, we believe that the threshold for retrograde pyelography should be very low.

Child, Preschool↗
PubMed2004

Visual impairment after laparoscopic donor nephrectomy.

Loss of vision after surgery is rare and has never been reported after a laparoscopic procedure. We describe a case of visual deficits secondary to posterior ischemic optic neuropathy after a laparoscopic donor nephrectomy. The potential etiologies of postoperative visual loss are reviewed, and recommendations for avoiding this complication are discussed.

Adult↗
PubMed2003

Tissue engineering in urology: where are we going?

Tissue engineering in urology is a broad term used to describe the development of alternative tissue sources for diseased or dysfunctional native urologic tissue. This article reviews the recently published techniques involving synthetic and natural biodegradable matrices alone, known as "unseeded" scaffolds, and the latest data on "seeded" scaffolds, which are impregnated with cultured cells from urologic organs. Recent discoveries in reporter gene labeling of urologic tissue are discussed as a new method to identify and track the fates of these transplanted cells in vivo. This article also investigates how these bioengineering techniques are applied to synthetic and natural scaffolds, such as polyglycolic acid and porcine small intestine submucosa, to increase bladder capacity, repair urethral strictures, and replace corporal plaques in Peyronie's disease. Furthermore, recently published reports that these materials have been seeded with chondrocytes to create corporal rods for penile prostheses and stents for ureteral and urethral stricture disease are discussed. With these latest developments as a foundation, the future directions of tissue engineering in urology are presented.

Animals↗
PubMed2002

The practice of urethral dilation for voiding dysfunction among fellows of the Section on Urology of the American Academy of Pediatrics.

PURPOSE: Review of the literature reveals little scientific evidence to prove or disprove the efficacy of urethral dilation for children with dysfunctional voiding and recurrent urinary tract infections. We ascertain the current practice of urethral dilation among pediatric urologists. MATERIALS AND METHODS: An anonymous questionnaire regarding the practice of urethral dilation was mailed to all fellows in the Section on Urology of the American Academy of Pediatrics. The questionnaire contained 14 questions and included biographical information. RESULTS: The questionnaire response rate was 64%. When asked how one would treat a typical female child with classic voiding dysfunction, 87% responded with timed voiding and relaxation techniques with or without anticholinergics. Only 2.5% would proceed directly to cytoscopy and urethral dilation. For patients who did not respond to initial treatment, 67% would proceed with either urodynamics or biofeedback and only 10% would then perform urethral dilation. Of responders 61% do not practice urethral dilation under any circumstance, 36% will use it when all other means of therapy have failed, while only 2% use urethral dilation regularly and 2% find it helpful and will occasionally use it. Among physicians who perform urethral dilation 63% believed that less than half of the patients experienced long-term improvement. Overall, there was no consensus as to mechanism of action of urethral dilation. CONCLUSIONS: Urethral dilation is rarely used as primary treatment for pediatric voiding dysfunction, is usually reserved until all other treatments have failed and appears to have long-term efficacy in less than 50% of patients. To define better the need for this treatment modality and its efficacy, a randomized prospective trial is mandatory.

Attitude of Health Personnel↗