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Biomedical subjects

C C Carson

Publications and source records attributed to C C Carson.

At least 73 records · Page 4Linked to original sources
PubMed1985

Priapism: etiology, treatment, and results in series of 35 presentations.

Of 35 cases of priapism a successful outcome with detumescence of the erection and preservation of potency was achieved in only 6 instances. Patients with sickle cell disease enjoyed a more optimistic outcome, and early presentation appeared to be the key factor. The different therapeutic approaches did not have great impact on the outcome, and we advise an initial conservative approach progressing to glans-cavernosa fistula creation and subsequently to cavernosum-spongiosum shunting for patients failing to respond.

Adolescent↗
PubMed1985

Implantation of penile prostheses in patients impotent after priapism.

Review of recent implantations of penile prostheses done at Duke University Medical Center reveals 6 patients implanted for impotence secondary to priapism. Of these 6 patients, 5 had sickle cell anemia-induced priapism and 1 had idiopathic priapism. One patient had implantation of an inflatable prosthesis later followed by a semirigid prosthesis, 3 had implantation of a semirigid prosthesis, and 1 had an unsuccessful attempt at implantation of a semirigid prosthesis. The 5 patients with successful implantation have obtained satisfactory postoperative coital function. We believe that penile prostheses are beneficial in patients with impotence secondary to priapism. The degree of fibrosis encountered suggests that a semirigid prosthesis is more favorable, since the inflatable prosthesis may not overcome corporeal rigidity.

Adult↗
PubMed1985

Oat cell carcinoma of lung masquerading as prostatic carcinoma.

We believe this is the second case of oat cell carcinoma metastatic to the prostate to be reported. The patient was treated for prostatic carcinoma diagnosed by rectal examination. Subsequent biopsy confirmed oat cell carcinoma and led to the discovery of pulmonary carcinoma. Tumors metastatic to the prostate are rare and are identified when they result in urologic symptoms. A review of tumors metastatic to the prostate is presented.

Aged↗
PubMed1985

Radiation therapy for Peyronie's disease: is there a place?

Peyronie's disease is a disabling condition, the treatment of which remains controversial. We evaluated 40 patients who underwent external beam radiation therapy for the treatment of chronic Peyronie's disease. While patients with penile plaque, penile curvature and impotence were treated little improvement was noted. Patients with penile pain or pain on erection responded well to radiation with rapid resolution of the pain. We conclude that external beam radiation therapy has only limited application in patients with Peyronie's disease. Patients with primary symptoms of penile pain or pain with erection may be improved through the use of external beam radiation therapy.

Adult↗
PubMed1985

Peritoneal extravasation during percutaneous lithotripsy.

Extravasation of irrigation fluid during percutaneous nephrostolithotomy is a major complication and can result in severe morbidity. We report 3 cases of peritoneal extravasation of irrigation fluid. Ventilatory difficulty and narrowed pulse pressure suggest intraperitoneal extravasation of irrigation fluid, which should be treated by rapid drainage of extravasated fluid and careful monitoring of electrolyte concentrations.

Adult↗
PubMed1985

Ejaculatory duct obstruction: the case for aggressive diagnosis and treatment.

Ejaculatory duct obstruction is considered a rare cause of infertility. Based on the results of treatment in our 5 patients and a review of 14 additional well documented cases we were able to classify these patients prognostically. Whereas congenital and acquired noninfectious obstructions are amenable to a transurethral operation in as many as 57 to 67 per cent of the cases, all obstructions secondary to genital infections failed treatment.

Adult↗
PubMed1985

Vasography: effect of various agents on vas deferens patency.

Vasography is a common diagnostic procedure utilized in evaluating the male genital tract for causes of azoospermia, for evaluation of persistent perineal pain and seminal vesiculitis, and recently used in the staging of prostate cancer. In order to evaluate the effects of injectable agents on the healthy vas deferens, 7 groups of 10 rats had the left vas deferens injected by vasopuncture with saline, 4 contrast agents, doxycycline and absolute alcohol. The animals were sacrificed 8 weeks later, and were examined for patency of the vas and inflammatory response. Results revealed that vasopuncture did not produce obstruction. Vasography with water-soluble contrast media does entail a low risk of inflammation in the rat, but produces no obstruction. Intra-vas injection of doxycycline, injected by some for treatment of chronic seminal vesiculitis and perineal pain, is not deleterious in the rat model.

Animals↗
PubMed1985

Complications of percutaneous nephrostolithotomy.

In 224 patients, renal stones were removed from the urinary tract using either direct extraction with a basket or forceps (59 patients), ultrasonic lithotripsy (164 patients), or infusion chemotherapy (one patient). Residual stone fragments were present more frequently in patients treated with ultrasonic lithotripsy (27%) than with direct extraction (5%). Other complications included hemorrhage (eight patients), catheter dislodgement (four patients), large amounts of urine extravasation (three patients), glycine ascites (three patients), infection (two patients), pneumothorax (one patient), and a prolonged ileus (one patient). More complications occurred among the first 50 patients than the last 50 patients, even though more difficult cases, including patients with staghorn calculi, were accepted during the latter period. Although a learning curve exists, complications can be minimized by attempting to treat more favorable cases during the initial experience.

Extravasation of Diagnostic and Therapeutic Materi↗
PubMed1985

Percutaneous approach to nephrolithiasis.

Percutaneous techniques were successful in removing stones from 101 (92%) of 110 kidneys attempted. Ultrasonic lithotripsy was used on 80 kidneys in 74 patients with stones 5-38 mm in diameter. The most common complication was incomplete disintegration with retained stone fragments. Twenty patients were treated by direct stone extraction, either by a stone basket or forceps. The average hospitalization for percutaneous stone removal of 10 days was not significantly different from that for open nephrolithotomy. However, patients undergoing percutaneous stone removal had only a 3-10 day convalescence after hospital discharge before returning to normal activity.

Adolescent↗
PubMed1985

Percutaneous lithotripsy of staghorn calculi.

Eleven cases of staghorn calculi managed by percutaneous lithotripsy were reviewed. Ten of 11 cases were successful, and 70% of the successfully treated patients were discharged free of any renal stones. The percentage of patients discharged with residual stone fragments was higher than those with either percutaneously managed nondendritic calculi or surgically treated staghorn calculi. The complication rate was higher than for nonbranched stones managed percutaneously and was comparable to that for surgically removed dendritic calculi. Hospital stay averaged 18 days, equal to that for staghorn calculi treated by conventional surgical approach, but considerably longer than for nonbranched stones. Overall results more closely approximated those for surgical removal of staghorn calculi than those for percutaneous removal of nonbranched calculi. However, the principal advantage of percutaneous lithotripsy of staghorn calculi over surgical management is the significant reduction in convalescence after discharge from the hospital.

Adult↗
PubMed1984

Xanthogranulomatous pyelonephritis in renal transplant recipient.

Xanthogranulomatous pyelonephritis is reported in the native kidney of a renal allograft recipient. Immunoglobulin deposition in the transplant kidney in the absence of cell-mediated rejection, accompanied by selective cultures showing Escherichia coli from the native kidney, led to the diagnosis. Native nephrectomy resulted in resolution of the patient's chronic bacteriuria and creatinine elevation.

Adult↗
PubMed1984

Modified Johnson basket for antegrade stone extraction.

A modification of a classic Johnson stone basket has been made, such that this basket can pass easily over an angiographic guide wire. With this modification, the Johnson stone basket is an excellent instrument for use in an antegrade or a retrograde fashion for retrieving impacted ureteral calculi. Eleven patients had ureteral calculi manipulated. Of the six ureteral calculi manipulated with standard retractable baskets, only three were successfully extracted from impacted positions. Of the five manipulated with the modified Johnson stone basket, however, four were successfully extracted. The modified Johnson stone basket is an essential instrument in percutaneous manipulation of ureteral calculi.

Humans↗
PubMed1984

Transurethral resection for ejaculatory duct stenosis and oligospermia.

Four patients with oligospermia were treated for ejaculatory obstruction after diagnosis by semen analysis and vasography. Ejaculatory obstruction was caused by urethral catheterization or infection in all cases. Transurethral resection of the posterior prostatic urethra produced fertile levels of sperm in the semen in one patient. While success rates are low, low morbidity and possible use of sperm for in vitro fertilization make investigation and treatment of these patients worthwhile.

Adult↗
PubMed1984

Surgical correction of Peyronie's disease: the Nesbit procedure.

Surgical therapy for the correction of Peyronie's disease is indicated in patients with severe and chronic penile curvature that does not respond to conservative therapy and that is severe enough to prevent sexual intercourse. The penile prosthesis has been shown to be an effective treatment in patients with associated erectile impotence. However, there is disagreement regarding the procedure of choice in patients with Peyronie's disease and adequate erectile function. Because of the inconsistent results reported for grafting techniques, we used the Nesbit procedure in 12 patients with adequate erectile capacity distal to the plaque. Eleven patients reported satisfactory intercourse postoperatively with excellent anatomical results.

Animals↗
PubMed1984

Percutaneous dissolution of renal calculi using ultrasonic litholapaxy.

The surgical treatment of renal calculi has been markedly changed by percutaneous manipulation and ultrasonic dissolution. The low morbidity and decreased cost of this procedure make it an obvious choice over classic surgical operations. We report our experience with percutaneous ultrasonic stone dissolution in 23 patients.

Adult↗
PubMed1983

Squamous carcinoma of urinary bladder.

The clinical course of 56 patients with squamous cell carcinoma of the urinary bladder and poorly differentiated transitional cell carcinoma with squamous metaplasia were compared. Survival was evaluated to compare treatments and biologic potentials of these neoplasms. Squamous cell carcinoma of the urinary bladder behaves as poorly differentiated transitional cell carcinoma with squamous metaplasia, and survival is significantly poorer than in poorly differentiated transitional cell carcinoma. While survivals are limited, only radical, surgical extirpation can be associated with significant patient salvage.

Aged↗
PubMed1983

Inflatable penile prosthesis: experience with 100 patients.

The experience with 100 consecutive patients in whom an inflatable penile prosthesis was implanted for the treatment of chronic erectile impotence over a two-year period is reported. Each patient was thoroughly evaluated by history, physical examination psychologic investigation, and appropriate laboratory testing. Of these patients, the most common indication for prosthesis implantation was diabetes mellitus of adult onset, followed by vascular disease and radical pelvic surgery. Restoration of erectile function was accomplished in 99 patients. Mechanical complications and malfunction occurred in 12 patients; all such complications were surgically corrected in subsequent operative procedures. One diabetic patient experienced infection of the prosthesis, requiring its removal. The implantation of an inflatable penile prosthesis in properly selected patients, with careful surgical technique by a skilled and experienced surgeon, can produce excellent functional results and return of normal sexual activity.

Adult↗