Biomedical subjects

D M Gleason

Publications and source records attributed to D M Gleason.

8 recordsLinked to original sources

PubMed1991

Is eosinophilic ureteritis an entity? 2 case reports and review.

The characteristics of eosinophilic ureteritis and idiopathic segmental ureteritis are sufficiently overlapping and so uncommonly reported as to raise a nosological issue. In an attempt to address that question, we compared 2 new cases and 8 previous reports of eosinophilic ureteritis with a series of 21 idiopathic segmental ureteritis patients. One of our patients also had renal pelvic involvement, while 1 is the youngest (3 years old) patient reported and the first instance of bilateral eosinophilic ureteritis. Our review found that eosinophilic ureteritis largely occurs in atopic or hypereosinophilic syndromes, often with a traumatic history. Eosinophilic and idiopathic segmental ureteritis causes ureteral obstruction due to mural involvement. However, eosinophilic ureteritis never forms an intraluminal mass and is not associated with mucosal ulceration. In addition, we found no case reported with features that bridge the 2 conditions. We conclude that the clinical and pathological features of eosinophilic and idiopathic segmental ureteritis are sufficiently distinct to separate the 2 conditions.

Adult↗

PubMed1990

Identifying types of female incontinence with retrograde urethrocystography.

The most specific radiographic findings characterizing stress incontinence (SI) on upright retrograde urethrocystography include replacement of a flat or rounded bladder base with a concave funnelled base; patency of the bladder neck with contrast material pooling in the proximal urethra; the descent of the intravesical Foley balloon beyond the internal meatus and into the proximal urethra. We found that neither a cystocele nor the dependent position of the urethra at the bottom of the bladder were diagnostic of SI if the above stigmata were absent. On the other hand the defect of urgency incontinence (UI) is functional. The bladder can usually be filled by retrograde urethral infusion (though in severe UI this may not be the case). An alert technician can frequently obtain a film when the patient is experiencing uninhibited voiding. The finding of contrast material throughout the urethra, in the distal urethra alone, or in the parameatal area is strongly suspicious for UI, especially when trabeculation is also seen. These findings in association with the stigmata of SI give warning of combined SI and UI.

Diagnosis, Differential↗

PubMed1989

The effects of transurethral resection on the urodynamics of prostatism.

We studied 11 patients urodynamically before and 6 months after transurethral resection of the prostate. Bladder pressures were measured through a fine suprapubic catheter. Urinary stream force and flow rate were measured simultaneously. We calculated values for stream velocity, area of Schäfer's flow control zone, the vena contracta, stream energy loss, total bladder work, total stream power and the passive urethral resistance relationship. After prostatic resection improved voiding was documented in most physiological parameters. However, the total work capacity of the bladder remained constant and appeared to be a fixed property of the healthy bladder. An increase in the volume voided postoperatively was related to an increase in the bladder capacity associated with a decrease in detrusor instability, and was not related to a decrease in residual urine.

Energy Metabolism↗

PubMed1979

Does the conventional cystogram exaggerate reflux?

We studied 35 patients with anterograde and retrograde cystography. Many patients who had reflux on retrograde cystography either did not have reflux or the reflux was reduced significantly on anterograde cystography. Furthermore, when reflux was seen on anterograde cystography it appeared to have more prognostic value than when seen on retrograde cystography. The question is raised of whether much reflex seen on retrograde cystography is not actually an artifact of the examination and does not exist beyond circumstances of the test.

Adolescent↗

PubMed1979

New techniques for the evaluation of bladder function.

The various techniques available for the dynamic assessment of bladder function, including uroflowmetry, cystometrography, urethral closure pressure profiles, and sphincteric electromyography are presented. All of these approaches are discussed in terms of the indications for their use and their functions in evaluation.

Electromyography↗

PubMed1977

Comparison of cystometrograms and urethral profiles with gas and water media.

Twenty-five female patients were studied using both gas and water media for custometrograms and urethral profiles. The results showed that gas and water did not generate equivalent data in either cystometrograms or urethral profiles. The cystometrogram data showed a high correlation of data between gas and water, with gas values consistently lower than water values. Urethral profile data with gas were very difficult to interpret in terms of water-generated data, and correlations were tenuous at best.

Carbon Dioxide↗

PubMed1976

Urodynamics.

The urinary tract is a hydrodynamic system whose components are in precise balance with each other and whose functioning depends on mechanical equilibrium. Alteration of the delicate balance between bladder and urethra means dysfunction in voiding or continence. Of greatest clinical interest at present is the bladder-urethra matching mechanism, which controls normal or abnormal voiding or continence. Since the matching combination of bladder and urethra must obey the same hydrodynamic laws that govern all fluid systems, it is obvious that measurement of fluid quantities and fluid porperties should correlate with function and dysfunction in the system. Urodynamics is the art of developing standard fluid-mechanical techniques that will be useful in routine clinical evaluation. Increasing experience with diagnostic urodynamic tests nurtures non-invasive, precise diagnosis of voiding dysfunction. Inexpensive, readily available and convenient techniques have been developed and are in clinical use. We can look forward to many more.

Aged↗

PubMed1976

Vesical neck suspension under vision with cystotomy enhances treatment of female incontinence.

Failure to surgically correct incontinence usually results from inadequate screening of patients with hyperreflexic incontinence, improper fixation of the urethra or yielding of tissues that have supported the repair. A surgical approach is described which fixes the bladder neck to the rectus tendon and adjacent pubic periosteum, under direct vision, through a cystotomy incision. The procedure achieves good continence in more than 90 per cent of the cases. Temporary postoperative voiding dysfunction occurred in about half of the patients.

Adult↗