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Biomedical subjects

D M Raezer

Publications and source records attributed to D M Raezer.

At least 19 recordsLinked to original sources
PubMed1994

A unique fasciocutaneous flap for posterior urethral repair.

The anatomic restrictions produced by male to female gender reassignment surgery necessitated a new surgical solution to treat a traumatic posterior urethral stricture. Aesthetic considerations were of paramount importance to the patient. A unique use of the pudendal thigh fasciocutaneous flap is presented which satisfied the reconstructive needs of well-vascularized tissue for reconstruction of the posterior urethral segment, and addressed the patient's aesthetic concerns. Correction of the posterior urethral stricture was successful, and the flap donor site inconspicuous. This procedure has not been described previously for urethral reconstruction and is an additional regional source of vascularized tissue for urethral repair.

Adult↗
PubMed1986

Surgical treatment of reflux in neurologically impaired child.

Ninety-three consecutive patients with neurologically impaired bladders were evaluated for vesicoureteral reflux. Of 22 patients found to have reflux, 3 had spontaneous remission of reflux, 8 were maintained on suppressive antibiotic therapy, and 11 required ureteral reimplantation. A total of 14 refluxing renal units underwent ureteroneocystostomies. Twelve of 14 have had no postoperative reflux. The remaining two renal units are now free of reflux following augmentation cystoplasty. The modified Hutch ureteroneocystostomy is particularly suited for use in patients with neuropathic bladders, in that no submucosal tunnel is necessary. The operative technique is described.

Adolescent↗
PubMed1985

Augmentation ileocystoplasty in neuropathic bladder.

Augmentation cystoplasty is a viable treatment modality in patients with neuropathic bladder. Indications include incontinence despite pharmacologic manipulation, persistent hydroureteronephrosis, vesicoureteral reflux, and propantheline bromide intolerance. Eight patients have had augmentation cystoplasties, with all obtaining normal bladder capacity, intravesical pressure, and voiding frequency. Reflux and hydronephrosis have been eliminated or significantly reduced in those patients who had experienced those problems prior to augmentation. Four cases are presented.

Adolescent↗
PubMed1980

The effects of bethanechol chloride on urodynamic parameters in normal women and in women with significant residual urine volumes.

A 5 mg. subcutaneous dose of bethanechol chloride was given to 12 women with residual urine volumes equal to or greater than 20 per cent of bladder capacity but no evidence of neurologic disease, or anatomic or functional outlet obstruction and to 27 normal women wtih approximately the same mean age. The cystometric and some profilometric parameters did change, indicating that the drug was pharmacologically active. No improvement in voiding function was noted, as judged by residual urine volume and flow rate measurements. These results raise significant questions regarding the contemporary use of this drug, especially in the currently recommended oral dosages.

Bethanechol Compounds↗
PubMed1980

Failure of the bethanechol supersensitivity test to predict improved voiding after subcutaneous bethanechol administration.

Subcutaneous administration of 5 mg. bethanechol chloride did not change significantly either flow rates or percentage residual urine in 11 patients with a positive bethanechol supersensitivity test. Therefore, a positive response to this test cannot be used to predict improved voiding function after subcutaneous or oral administration of the drug. Studies that purport to show a long-term rather than a short-term facilitory effect of this agent on voiding must satisfy rigid criteria, which include totally excluding a change in any other factor affecting the lower urinary tract.

Bethanechol Compounds↗
PubMed1980

A clinical experience with the Scott genitourinary sphincter in the management of urinary incontinence in the pediatric age group.

We report our experience with 22 Scott genitourinary sphincters implanted in 19 patients during a period of 4 years. Patient selection was rigid. Incontinence must be unremitting and fail to respond to exhaustive efforts at control by pharmacologic manipulation with or without intermittent catheterization. The patient must be able to empty the bladder by Credé's or Valsalva's maneuver, and consider the incontinence intolerable. The artificial sphincter is considered as an alternative to urinary diversion. A second attempt at placement has been done in 3 patients. Removal was required in 32 per cent of the devices. However, 79 per cent of the patients did achieve our goal of continence. Therefore, we have found the artificial sphincter to be a valuable addition to the treatment of pediatric incontinence as an alternative to urinary diversion.

Adolescent↗
PubMed1979

The reproducibility and significance of carbon dioxide urethral profilometry.

Infusion urethral profilometry using carbon dioxide as a medium is an interesting study with a wide range of variability from day to day in a single individual, a fact that considerably reduces the value of a single measurement as a diagnostic tool. Presently, all forms of infusion profilometry must be considered to be interpretable only within the framework of the entire neurourologic evaluation. The study may be useful to make the clinician more secure about a particular diagnosis and as an objective measurement for medico-legal documentation. It also may be useful in predicting and objectively demonstrating treatment results if normal variability can be excluded. However, a high level of skepticism should be maintained regarding the value of the profile in those situations in which its interpretation does not correlate with the impression formed from the remainder of the neurourologic evaluation.

Adult↗
PubMed1977

Bladder muscle contractility. Comparative effects and mechanisms of action of atropine, propantheline, flavoxate, and imipramine.

The anticholinergic and antispasmodic activity of atropine, propantheline, imipramine, and flavoxate were judged by each drug's ability to inhibit bethanechol chloride and barium chloride-induced canine detrusor contractions. In this in vitro model, atropine and propantheline are pure anticholinergic agents. Imipramine significantly decreases both bethanechol and barium-induced contractions, while flavoxate only minimally inhibits the response to either stimulant.

Animals↗
PubMed1976

Innervation of trigonal area of canine urinary bladder.

Adrenergic and cholinergic histochemical staining techniques and in vitro muscle strip responses to adrenergic and cholinergic stimulation and blockade have failed to demonstrate any neuromorphologic or neuropharmacologic differences between the musculature of the canine trigone and that of the underlying detrusor. There is no evidence to suggest that a functional potential could be attributed to the trigone separate from that of the related bladder base.

Acetylcholine↗
PubMed1976

Management of neurogenic bladder dysfunction in the adult.

A review of the management of neurogenic bladder dysfunction in the adult is presented. The various modes of therapy are classified according to their effects on bladder contractility and outlet resistance, providing a logical framework for discussion.

Autonomic Nerve Block↗
PubMed1976

Adrenergic innervation and stimulation of canine urethra.

Sympathetic nervous innervation of the canine urethra was studied using catecholamine histofluorescent straining and the in vitro muscle bath. Morphologically, adrenergic nerves were found terminating on the urethral smooth muscle. Pharmacologically, urethral strips responded like muscle strips from the bladder base to adrenergic stimulation. This evidence supports the concept that the sympathetic nervous system supplies and modulates the function of the smooth muscle stimulation of the rich periurethral vasculature nerve supply.

Animals↗
PubMed1976

Effect of levodopa on urinary bladder.

Levodopa therapy enhanced the ability of the bladder to store urine in two parkinsonian patients. In vitro canine muscle bath studies with the two major metabolites of levodopa, dopamine and norepinephrine, indicate that the effects of the drug on the peripheral sympathetic nervous system may play a major role in the improvement of urinary symptoms observed with levodopa therapy.

Aged↗
PubMed1976

Oral methylene blue and the dissolution of renal calculi.

Oral methylene blue therapy was not effective in dissolving non-obstructive renal calculi in 26 patients but it may prevent new stone formation in patients with metabolically active urolithiasis. The use of methylene blue therapy in combination with other regimens having different mechanisms of stone inhibition is recommended to further improve results.

Administration, Oral↗
PubMed1976

Adrenergic and cholinergic stimulation and blockade of the human bladder base.

The response of muscle strips from the human anterior and posterior bladder base to autonomic stimulation and blockade was studied. The human bladder base, like that of the dog, possesses an abundance of cholinergic and alpha-adrenergic receptor sites. Neuropharmacologically, the musculature of the anterior base is similar to that of the posterior base (trigone plus detrusor musculature).

Acetylcholine↗