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C M Yip

Publications and source records attributed to C M Yip.

24 records · Page 2Linked to original sources

Mechanism of continence after modified Pereyra bladder neck suspension. Prospective urodynamic study.

Twenty females with genuine stress urinary incontinence who underwent modified Pereyra bladder neck suspension were urodynamically studied pre- and postoperatively in an attempt to determine the mechanism by which continence was restored. Detailed analysis demonstrated no significant change comparing the pre- and postoperative cystometry findings, uroflow parameters, maximal voiding pressure, urethral resistance, maximal urethral closure pressure, or functional urethral length. The only significant change identified as a result of the surgical procedure was an alteration of proximal urethral pressure transmission during stress from negative to positive gradients. It is concluded that the modified Pereyra bladder neck suspension restores continence by restoring proper urethral support with restoration of positive pressure transmission to the proximal urethra without causing outflow obstruction, changing functional length, or altering maximal urethral closure pressure.

Adult↗

Delayed bladder dysfunction after abdominoperineal resection: an indicator of local recurrence.

It is generally not appreciated that the delayed onset of voiding dysfunction after abdominoperineal resection for rectal carcinoma may be the first sign of local pelvic recurrence. We herein present a series of 5 patients who were referred for urodynamic evaluation of voiding dysfunction beginning nine to twenty-four months after the original operative procedure. Urodynamic evaluation revealed low bladder wall compliance in 4 patients, and detrusor hyperreflexia in 1 patient. Computerized tomography scans confirmed the local tumor recurrence in all cases. The delayed onset of voiding complaints after abdominoperineal resection should prompt a high index of suspicion that a local tumor recurrence may be present.

Adenocarcinoma↗

Post-prostatectomy incontinence: the influence of bladder dysfunction.

The urodynamic studies of 38 patients referred for evaluation of incontinence after prostatectomy were reviewed. Only 15 patients (39.5 per cent) had pure sphincteric insufficiency as the sole cause of the incontinence. Of the 38 patients 16 (42 per cent) had sphincteric insufficiency combined with a significant component of bladder dysfunction (detrusor instability and/or low bladder wall compliance) as the cause of the incontinence. A total of 7 patients (18.5 per cent) had no evidence of sphincteric insufficiency but they had post-prostatectomy incontinence solely caused by detrusor instability and/or low bladder wall compliance. Of the patients referred for post-prostatectomy incontinence 60.5 per cent had bladder dysfunction as a major factor in the incontinence, which emphasizes the need for comprehensive urodynamic evaluation before treatment is recommended. Of 26 patients whose treatment was based on urodynamic findings and who were available for followup 23 (88 per cent) were adequately continent after treatment, with 35 per cent responding to pharmacological treatment alone and 54 per cent requiring placement of an artificial urinary sphincter with or without associated pharmacological therapy. The potential role of bladder dysfunction as a causative factor in post-prostatectomy incontinence must be considered to optimize the results of treatment and to avoid an unnecessary operation.

Aged↗

Tubovaginal leakage: an unusual cause of incontinence.

Incontinence after hysterectomy may be caused by an abnormal fallopian tube draining into the vaginal cuff. We report 2 cases of this condition, which generally is known as hydrops tubae profluens. One patient also had genuine stress urinary incontinence and the other suffered persistent disease after 2 failed suspension procedures. This rare condition should be considered in the differential diagnosis of unusual causes of incontinence.

Fallopian Tubes↗

Urologic and urodynamic evaluation of the elderly population.

The importance of a thorough history and physical examination in conjunction with appropriate laboratory, radiographic, endoscopic, and urodynamic studies is emphasized, with the goal of defining the cause of incontinence in the elderly. Once the pathologic process that is causing the symptom of incontinence is objectively identified, appropriate treatment can proceed logically.

Aged↗

Delayed diagnosis of voiding dysfunction: occult spinal dysraphism.

The recognition of spinal dysraphism as a potential cause of voiding dysfunction is of the utmost importance if appropriate treatment and followup are to be initiated. We present 2 women with prolonged voiding dysfunction who had spinal dysraphism, intradural lipoma and related urodynamic abnormalities. The importance of initial symptom recognition, physical examination, urodynamic evaluation, appropriate treatment and periodic re-examination to detect progressive neurological impairment is emphasized.

Adult↗