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C P Bates

Publications and source records attributed to C P Bates.

8 recordsLinked to original sources

Clam enterocystoplasty in general urological practice.

A series of 45 patients (31 female) underwent clam enterocystoplasty for urgency and incontinence. The majority had detrusor instability. Prolonged conservative treatment had failed in all cases. Improvement occurred in 71% and those younger than 30 years had better overall results; 29% remained incontinent, with 9% requiring a urinary diversion. Many patients did not achieve maximum benefit until 9 months post-operatively. Surgery had no statistically significant effect on any urodynamic parameter and post-operative complications were common. The operation was performed in either the coronal (19) or the sagittal plane (26); this did not influence results. In general, surgery was found to be technically simpler in the sagittal group and it is recommended that this becomes the standard procedure. We feel that this operation involves major surgery and should only be offered with reluctance.

Adult

The nature of the abnormality in bladder neck obstruction.

There is no dispute that there exists, in men, a condition of obstruction at the bladder neck in the absence of fibrous stricture or prostatic enlargement. The condition was clearly described by Guthrie (1836) and Young (1913) reported the results ff punch resection operation in over 50 cases. The large measure of success now achieved following resection of the bladder neck in these patients has perhaps been allowed to mask our ignorance of the nature of the abnormality and thus discourage studies of its cause. It is perhaps most often thought to result from fibrosis but a number of studies--for example Baadenoch (1949)--have shown no associated increase in fibrous tissue. Certainly the condition is in no way similar to the hard fibrous stricture seen more often in the distal urethra, or at the bladder neck as an occasional complication of prostatectomy. Our study shows that the obstruction if functional in nature and is due to the tightening of the bladder neck as the detrusor contracts.

Adolescent