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Biomedical subjects

C B Manley

Publications and source records attributed to C B Manley.

At least 19 recordsLinked to original sources
PubMed1996

Pediatric endopyelotomy: the Washington University experience.

PURPOSE: Endopyelotomy has gained acceptance as minimally invasive therapy for ureteropelvic junction obstruction in adults. Its role in the treatment of pediatric ureteropelvic junction obstruction remains controversial. We report our experience with antegrade endopyelotomy for treating pediatric ureteropelvic junction obstruction. MATERIALS AND METHODS: A total of 17 patients 3 months to 17 years old underwent endopyelotomy as primary treatment for ureteropelvic junction obstruction (8) and after failed open pyeloplasty with secondary endopyelotomy performed a mean of 12 weeks after open pyeloplasty (9). Standard antegrade percutaneous techniques were used. Electrosurgical incision of the ureteropelvic junction at a posterolateral orientation was done in each case. Internal ureteral stents remained in place for 4 to 6 weeks postoperatively. RESULTS: In 5 of the 8 patients (62%) treated primarily the outcome was successful at a mean followup of 38 months (range 25 to 53). Failures occurred at 6 weeks, 3 months. In all 9 patients treated secondarily outcomes were successful at a mean followup of 59 months (range 16 to 110). CONCLUSIONS: Endopyelotomy as primary treatment of pediatric ureteropelvic junction obstruction remains controversial but it may be appropriate in select cases. On the other hand, endopyelotomy is safe and effective for pediatric patients in whom open pyeloplasty fails.

Adolescent↗
PubMed1993

Transitional cell carcinoma of bladder in children and adolescents.

Transitional cell carcinoma of the bladder is rare in patients under sixteen years of age. A case is described in a ten-year-old boy, and the literature is reviewed. The diagnosis and treatment of this tumor is the same in childhood as in older patients. Recurrence as well as death have been reported in this age group; therefore, these patients warrant careful long-term follow-up.

Adolescent↗
PubMed1991

Prune belly syndrome in females: a triad of abdominal musculature deficiency and anomalies of the urinary and genital systems.

We describe seven female patients with deficient abdominal wall musculature and urinary tract and genital anomalies that represent the female equivalent of the prune belly syndrome. Urethral atresia, uterine duplication, and anorectal anomalies occurred frequently. The perinatal mortality rate was high; of the four surviving patients, renal failure developed in two and renal transplantation was required. The analysis of these cases suggests that urethral obstruction is an important factor contributing to the development of the prune belly syndrome in females.

Abdominal Muscles↗
PubMed1991

Ischiopagus tetrapus twins: urological aspects of separation and 10-year followup.

Conjoined twins occur once in 50,000 births. Only 6% of conjoined twins are of the ischiopagus type in which the twins are joined symmetrically at the pelvis and fusion begins at the level of the common umbilicus. The longitudinal axis extends in a straight line in opposite directions and the genitourinary and gastrointestinal tracts are shared. Tetrapus is a subtype in which all 4 lower extremities are present and oriented at right angles to the axis of the common trunk. Two sets of female ischiopagus tetrapus twins were born in 1977 and successfully separated at the St. Louis Children's Hospital in the following year. We describe the genitourinary and associated anomalies, surgical separation and long-term urological followup of these 2 sets of ischiopagus tetrapus twins.

Abnormalities, Multiple↗
PubMed1991

Endopyelotomy for secondary ureteropelvic junction obstruction in children.

Percutaneous endopyelotomy has been shown to be successful in treating ureteropelvic junction obstruction in adults. Little data have been published regarding this procedure in children. We describe 4 patients 6.5 weeks to 5.5 years old who underwent percutaneous endopyelotomy to treat ureteropelvic junction obstruction following failed open dismembered pyeloplasty. Preoperative obstruction was demonstrated by a nephrostogram, diuretic renogram and/or ultrasonography. Percutaneous endopyelotomy was successful in relieving the obstruction in all 4 patients, although 2 required secondary endoscopic procedures. One patient had persistent obstruction 40 days after endopyelotomy at the ureteropelvic junction and, subsequently, required percutaneous resection of a persistent flap of obstructing tissue. In another patient a ureterovesical stricture was noted at the time of stent removal, which was treated by endoscopic incision. All patients have been followed from 1.5 to 3 years postoperatively. Followup diuretic renograms, ultrasound and/or excretory urography demonstrated a patent ureteropelvic junction in all patients and all have remained asymptomatic. Endopyelotomy appears to be safe and effective in treating secondary ureteropelvic junction obstruction in children.

Child, Preschool↗
PubMed1990

Caudal epidural anesthesia reduces blood loss during hypospadias repair.

We studied 24 boys who were randomized to receive caudal epidural anesthesia with 0.33 ml.kg.-1 0.25% bupivacaine either before (group A) or after (group B) Mathieu repair of distal hypospadias. The 2 groups did not differ in regard to age or weight, and all boys received a standardized anesthetic with halothane and nitrous oxide in oxygen. Intraoperative blood loss was measured with sponge weights and microcalibrated suction canisters. Halothane requirements were reduced in group A (0.5 versus 1.1 plus or minus 0.1%, p less than 0.001). Measured blood loss was reduced in group A (16 plus or minus 10 ml. versus 31 plus or minus 17 ml., p less than 0.01). Operating time was reduced in group A (92 plus or minus 13 minutes versus 103 plus or minus 14 minutes, p less than 0.05). There was no apparent difference in postoperative pain relief between the 2 groups. We conclude that caudal epidural anesthesia can reduce blood loss and improve surgical conditions during hypospadias repair.

Anesthesia, Caudal↗
PubMed1987

Bilobed testicle.

Explore the source record for details and available documents.

Adolescent↗
PubMed1982

Acute urinary retention caused by vesical diverticula.

Two children with acute urinary retention due to obstructing bladder diverticula are presented. This is an extremely rare but significant complication of congenital bladder diverticulum. The possible mechanisms of this complication are discussed. Voiding cystourethrography can provide the correct diagnosis.

Child, Preschool↗
PubMed1982

Undiverting the ileal conduit.

From 1975 to 1981, 46 patients were evaluated for urinary undiversion. Of these patients 27 completed urinary reconstruction. The patients have been followed for 6 to 80 months, with a mean followup of 32 months and a median followup of 23 months. There has been no death and no rediversion has been necessary, although in 1 patient renal function has deteriorated significantly following urinary reconstruction. Postoperative bladder function was normal in patients diverted for dysfunctional voiding or bladder outlet obstruction but children with meningomyelocele required intermittent catheterization postoperatively. With careful patient selection, meticulous surgical technique and compulsive followup urinary undiversion is a safe procedure.

Adolescent↗
PubMed1979

Acute ureteral obstruction secondary to bullous cystitis of the trigone: report of 2 cases.

Two boys presented with acute bullous cystitis limited to the trigone and periureteral zone and producing marked but transient acute ureteral obstruction. One patient was anuric and likely would have died without intervention. Cystoscopy in both cases showed localized bullous edema of the bladder mucosa; biopsy showed acute inflammation, mucosal edema, and lymphangiectasis. Radiological findings included distal ureteral obstruction and numerous nodular filling defects in the bladder, caused by the edema. The etiology of the cystitis could not be determined in either case.

Acute Disease↗