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Biomedical subjects

C E Horton

Publications and source records attributed to C E Horton.

At least 55 records · Page 3Linked to original sources
PubMed1988

Transsexual surgery in the genetic female.

The increasing acceptance of the transsexual patient by society as well as a willingness of insurance companies to compensate for associated surgical procedures will result in an increase in patients presenting for sex reassignment. Data from gender identity centers suggest that the multidisciplinary approach leads to the best therapeutic results. Significant advances in phalloplasty techniques are yielding genitalia with more normal function and appearance.

Breast↗
PubMed1988

Epithelioid sarcoma of the penis.

A case of epithelioid sarcoma of the penis is reported with a review of the current treatment modalities. A new method of reconstructing the penis involved with malignancy is presented. Pertinent literature is cited. Cases of epithelioid sarcoma should be published to improve the understanding of the potential of different treatments available. This case represents the fifth epithelioid sarcoma of the penis reported in the literature.

Adult↗
PubMed1988

Use of the rectus abdominis muscle and fascia flap in reconstruction of epispadias/exstrophy.

Inferiorly based rectus abdominis muscle flaps and fascial flaps have been used to construct a firm abdominal wall without hernias and to provide coverage of the bladder, bladder neck, and proximal urethra in the secondary reconstruction of patients with epispadias/exstrophy complex. They have also been used to produce an elevation of the mons area, which is lacking in the typical exstrophy patient. Rectus fascial flaps have been the mainstay of abdominal closure when wide diastasis of the rectal muscles is present and when the lower abdomen lacks fascial support. We are pleased with the results of utilizing either the rectus muscle or rectus fascia in this complex condition. We have been using fascial flaps for over 10 years in our epispadias/exstrophy closures and abdominal wall strengthening procedures. We have been using bone grafts and the rectus muscle for the construction of a mons for the past 5 years. Although the rectus muscle procedure to cover the bladder and the bladder neck has been in use for only 2 years, we have seen patients with incontinence restored to a continent state; these patients have not been plagued with fistula problems when a neourethra has to be constructed to elongate the phallus. Previous attempts at urethral repair in this area have been successful in the main, but an occasional fistula at the junction between the penile skin and the abdominopubic skin has resulted. Since using the rectus muscle to cover the bladder and bladder neck area, we have not had this problem. Patients with epispadias/exstrophy remain such difficult problems that every advance in technique should be used to improve results.(ABSTRACT TRUNCATED AT 250 WORDS)

Bladder Exstrophy↗
PubMed1988

Correction of high pelvic defects with the inferiorly based rectus abdominis myocutaneous flap.

The two inferiorly based rectus abdominis myocutaneous flaps are the most versatile and accessible flaps for high pelvic defects. Their primary contribution is in the obliteration of the pelvic "deadspace." At the present time, these useful flaps are generally considered only for massive defects of the perineum, groin, and pelvis, but improved flap designs will enhance their usefulness for smaller defects.

Female↗
PubMed1987

Chromosome abnormalities in Peyronie's disease.

Peyronie's disease is a localized and progressive fibrosis of unknown etiology that affects the tunica albuginea of the penis. We examined cytogenetically cell cultures derived from plaque, adjacent tunica, dermis and lymphocytes in patients with Peyronie's disease, and compared the results to cell cultures established from the tunica albuginea of control patients. Chromosomal abnormalities were detected in 9 plaque-derived cell cultures from 7 of 12 Peyronie's disease patients (58 per cent). Cells cultured from adjacent tunica, dermis and lymphocytes from the same patients were karyotypically normal, as were cultures derived from control (chordee and penile scar) patients. Chromosomal aberrations consisted of 5 numerical changes and 4 structural rearrangements, and included chromosomal additions (trisomy 7 and trisomy 8), deletions (45X,-Y), reciprocal translocations and inversions or markers. In 2 instances cultures derived from plaque tissue contained 2 independent chromosomal abnormalities. The apparently random chromosomal changes associated with Peyronie's disease suggests that karyotypic instability may be a common feature of cells within the plaque. It presently is unclear whether this finding represents multiple pathways for the development of Peyronie's disease or secondary consequences of Peyronie's disease.

Aged↗
PubMed1987

An early appraisal of the methods of tissue expansion and the transverse rectus abdominis musculocutaneous flap in reconstruction of the breast following mastectomy.

In a 2-year prospective study, the results of two methods of breast reconstruction were compared. The tissue expansion and implant method was found to offer an acceptable reconstruction, but it was associated with a high rate of complications and revisions. The transverse rectus abdominis musculocutaneous flap reconstruction provided a more satisfactory reconstruction, with fewer major complications as well as a higher degree of patient satisfaction and less patient dissatisfaction. The present study does not address the long-term results of either procedure.

Breast↗
PubMed1987

Peyronie's disease.

More than 16 years' experience with approximately 1,000 cases of Peyronie's disease and a review of 110 patients evaluated more than 1 year postoperatively are presented. Peyronie's disease is difficult to treat. There is no known etiological agent, and because occasional spontaneous disappearance of the lesion occurs, the assessment of therapy is difficult. Our operation has been successful in relieving penile curvature and pain in a substantial number of patients (84%). Therefore, we recommend that in all severe, sexually disabling cases of Peyronie's disease unresponsive to conventional therapy, excision of the diseased tunica albuginea and replacement with dermal graft be considered. Organic impotence, which is occasionally seen preoperatively in association with Peyronie's disease, requires thorough investigation, sex counseling, and consideration of a penile implant.

Erectile Dysfunction↗
PubMed1987

New concepts in phallic reconstruction.

Over the past four years we have performed total phallic reconstructions in 12 patients. Six patients underwent reconstruction following trauma, 3 were female-to-male transsexuals, and 3 had micropenis deformities. These reconstructions were one-stage microsurgical tissue transfers that included urethral reconstruction and coaptation of erogenous nerves. The surgical indications, techniques, and results are discussed.

Adult↗
PubMed1987

Current hypospadias techniques.

Hypospadias repairs must encompass straightening of the penis and construction of the neourethra at the tip of the penis. In addition to an outline of preoperative and postoperative management, five techniques of single-stage surgical repair are discussed. All hypospadias defects can be repaired using one of these five basic procedures.

Humans↗
PubMed1987

Hidden penis release: adjunctive suprapubic lipectomy.

We believe the hidden penis may be caused and concealed by a prominent suprapubic fat pad in addition to the restrictive fibrous bands of the dartos fascia fixing the shaft of the penis proximally while loose skin folds prolapse distally over the phallus. A penis of inadequate length or appearance may affect body image. Patients with this problem often require psychological support. Hidden penis may be distinguished from micropenis by palpating adequate corpora and showing a stretched penile length within 2 SD of normal. Excision of suprapubic fat with sectioning of the tethering dartos bands will release and increase the length of the penis. Suprapubic fat pad resection may also be helpful to elongate a short penis in cases of adult microphallus, or after partial penectomy because of trauma or cancer. Circumcision is contraindicated.

Adipose Tissue↗
PubMed1987

Refinements in combined chemical peel and simultaneous abrasion of the face.

DuPont and colleagues, in 1972, were among the first to describe the use of a chemical peel and dermabrasion on the same area at the same time for acne scars. The combined use of a chemical face peel and simultaneous mechanical dermabrasion for the treatment of fine facial wrinkling was reported by Horton in 1984. Since 1973, in more than 500 cases, we have found that combined peel/dermabrasion corrects fine facial wrinkling in a manner that is superior to either dermabrasion or chemical peel alone. The combined procedure takes advantage of the benefits of each and avoids many of the detrimental aspects of both.

Chemexfoliation↗
PubMed1987

Hypospadias.

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Humans↗
PubMed1987

Bent penis.

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Humans↗
PubMed1986

Microsurgical hypospadias repair.

Successful primary hypospadias repair depends on careful execution of surgical principles, particularly during the urethroplasty portion of the procedure. These principles include careful tissue handling, development of well-vascularized flaps, and avoidance of placing sutures in the uroepithelial surface. Despite meticulous repair, the complication rate requiring secondary surgery is 15 to 30 percent. For the past year, the authors have utilized an operating room microscope, microsurgical instruments, a specially designed microsuture, and a Biooclusive dressing to decrease the postoperative morbidity and subsequent complications requiring secondary surgery (6.5 percent). A comparison of 50 hypospadias patients on whom no microsurgical repair had been used was made with 62 patients on whom microsurgical techniques were employed. The nonmicrosurgical group had 17 complications, 12 of which required reoperation (24 percent). The microsurgical group had 8 complications, 4 of which required reoperation (6.5 percent).

Child, Preschool↗
PubMed1985

Penile curvatures.

Penile curvatures are common. They are caused by tethering inelastic tissues that can be from the skin externally, from the congenital fibrous tissue of hypospadias and epispadias, and from inelastic tunica albuginea as in fractures, trauma, or Peyronie's disease. At the present time, with sexual organs exposed in photographs, human sexuality talked about with more freedom, and sexual experiences more open, a great deal of mental stress and anxiety can be produced by penile curvatures. Adjunct to this are impotency and other sexual problems. Surgical treatment is generally curative with grafts, flaps, excision of tunica albuginea, or repositioning and coaptation of the corporal bodies. Also, the use of a sex therapist can offer additional aid to the physician and realistic acceptance by the patient. More attention should be given to the patient with this problem. It is not well recognized by most physicians, and therefore, patients may suffer needlessly in silence without adequate help.

Humans↗
PubMed1984

The treatment of psychogenic impotence after dermal graft repair for Peyronie's disease.

We studied 20 men who failed to resume coitus after a dermal graft repair for Peyronie's disease. Psychogenic causes were found in 15 men, 10 of whom were treated locally by the sex counselors who interviewed all the couples. Psychogenic dysfunction was related to waiting for healing or for a specified period, then approaching first coitus either with idealized expectations or as if it were a test. Of the 10 treated men 3 also had marital conflict and 5 others had lack of a partner or poor motivation, including 1 who also suffered some instability of erection possibly of structural cause. In most of the treated men relief of anxiety and conflict proved effective, and coitus was restored. We are now evaluating possible improved results in new operative candidates through preoperative and postoperative counseling, which emphasizes a less pressured approach to coitus postoperatively.

Coitus↗