Re: The role of urinary potassium in the pathogenesis and diagnosis of interstitial cystitis.
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Cystitis, Interstitial↗
Biomedical subjects
H Fenster
Publications and source records attributed to H Fenster.
A psychophysiological evaluation of female urethral syndrome: evidence for a muscular abnormality.
This is a preliminary investigation into a recently defined urological disorder occurring in a subgroup of women with "urethral syndrome" suggestive of pelvic floor muscular (PFM) dysfunction. Symptoms include straining to void, urgency, frequency, hesitation, incontinence and/or retention, and subpubic pain. Finding neither bladder nor urological abnormalities, urologists may consider these women emotionally unstable without organic cause for their symptoms. However, their distress may be a consequence rather than a cause of their voiding problems. Sixteen female urological patients were matched with 16 asymptomatic controls to investigate PFM functioning, psychological status, and symptomatology. Results showed heterogeneity of symptomatology and little elevation of depression or anxiety when comparing patients with controls. Hypotheses of muscular abnormality were confirmed. Patients evidence poor control over testing and relaxing PFM, elevations of PFM activity under various conditions, and chronic pain as a prominent symptom. Treatment approaches specifically designed to address PFM dysfunction are discussed.
Adult↗
Female bladder neck reconstruction. Anatomic and physiologic approach.
Postoperative scarring of the bladder neck and urethra after failed anti-incontinence surgery in the female can seriously disrupt the normal mechanisms of bladder storage and emptying. We have analyzed and treated this problem in 10 selected female patients. A "wrap-flap" technique with omental support has been applied to reconstitute the normal anatomy and physiology of the bladder neck. Excellent results were obtained in all patients, with up to fifty-four months of follow-up. We recommend this procedure prior to the implantation of prosthetic material, with its inherent difficulties.
Female↗
Vasovasostomy--is the microscope necessary?
Many techniques for vasovasostomy have been described, with each author suggesting his technique as the most effective procedure. Theoretical considerations such as leakage of sperm, obstruction, and narrowing of anastomosis suggest that a stentless technique with exact approximation of mucosal edges results in improved success rates. Careful macroscopic surgery with loupes, fine suture material, and experience on the part of the surgeon will give good results and pregnancy rates of 50 per cent. The value of microsurgery, however, becomes obvious when the anastomosis is performed in the convoluted portion of the vas and the epididymis. The microscope allows more mobility in allowing one to determine if the patient had a block proximal to the vasectomy site and then bypass these blocks. The success of vasovasostomy depends greatly on the surgeon's experience with the actual surgical technique. Although technique is of paramount importance, there are factors other than technique that determine the pregnancy rate. Factors important in the success of vasovasostomy, macro- and microscopic techniques, basic concepts, principles and techniques of the various procedures, and the merits and limitations of each procedure, will be discussed.
Female↗
Pathogenesis of urinary infection in patients with acute spinal cord injury on intermittent catheterization.
In a small pilot study urinary tract infection in patients with acute spinal injury was preceded by the establishment of Enterobacteriaceae on the introitus, glans and urethra. Those patients who retain the normal flora do not become infected. The first infection most commonly is by Escherichia coli with universal antibiotic sensitivities. Female patients with a history of urinary infections and male patients with a history of bacterial prostatitis are at risk for suffering recurrent infections. Saline or chlorhexidine gluconate pre-catheter preparation does not appear to relate to a continual status free of infection.
Chlorhexidine↗
Vasovasostomy-microscopy versus macroscopic techniques.
Many different surgical techniques of vasovasostomy can be successful. Many factors, both technical and nontechnical, play a role in determining pregnancy. Theoretical considerations such as leakage of sperm, obstruction and narrowing of the anastomosis, suggest that a stentless technique with exact approximation of mucosal edges will result in a better success rate. Careful macroscopic surgery with the use of fine suture material, and experience on the part of the surgeon, will give good results and pregnancy rates of up to 50%. Microsurgery becomes quite important when the anastomosis is performed in the convoluted portion of the vas and epididymis. The microscope allows more mobility in permitting one to determine if the patient has a block proximal to the vasectomy site, and then bypass these blocks. Conventional macroscopic techniques do not allow for this freedom of choice. Factors other than technique are also important and are discussed.
Humans↗
Unusual case of urethral duplication.
We present a case of unique penile malformation, a child with common prostatic urethra with two normal, double urethras parallel to one another with a bifid glans penis. This case emphasizes how abnormal embryology can contribute to our knowledge of normal development.
Abnormalities, Multiple↗