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Biomedical subjects

J B Wheelahan

Publications and source records attributed to J B Wheelahan.

5 recordsLinked to original sources
PubMed2000

Prostate cancer in Victoria in 1993: patterns of reported management.

OBJECTIVE: To describe the management of newly diagnosed prostate cancer in 1993 during the early prostate specific antigen (PSA) era. DESIGN: Survey of medical practitioners involved in the management of a total sample of incident prostate cancer cases selected from a population-based cancer registry. The survey was conducted in 1996, and the sample was followed up until 1998, to obtain five-year survival data on all patients. SETTING: The State of Victoria, including both public and private health sectors. PATIENTS: All men who were newly diagnosed with prostate cancer in the six months January-June 1993. MAIN OUTCOME MEASURES: Reported management by method of diagnosis; staging investigations; and treatment by observation, hormonal therapy, radical radiotherapy or radical prostatectomy. RESULTS: 1048 of 1117 (94%) cases diagnosed were surveyed. Most of the men (858 [82%]) were older than 65 years: 117 (11%) cancers were detected by screening asymptomatic men, and a further 269 (26%) were found by testing of men with symptoms ("case-found"). The 259 (25%) men treated with definitive local therapies (prostatectomy and curative radiotherapy) were younger (< 75 years), and their disease was clinically more localised (clinical stage, T1-2) and they were often found by screening or case-finding. Men given hormonal therapy (407; 39%) or managed without treatment (373; 36%) tended to be older and more likely to have been diagnosed by transurethral resection of the prostate (TURP). The overall relative survival at five years was 86% and was decreased in men with cancers of higher histological grade or more advanced clinical stage, or who had higher PSA levels. CONCLUSIONS: Although a third of patients were detected by screening or case-finding early in the PSA era, definitive local therapies were used infrequently (25% of the total sample). Most received appropriate treatment.

Age Factors↗
PubMed1990

Long-term results of colposuspension.

A series of 102 patients were treated by a technique of colposuspension similar to the Pereyra operation, in which a pair of monofilament sutures were tied over the rectus muscle; 79% of patients (78/99) reviewed 1 year after the operation were continent. During further follow-up (mean 4.5 years) there were 7 late failures, all within 4 years. Kaplan-Meier lifetable analysis showed 69% probability of continence at 5 years. The main factors associated with recurrent or persistent incontinence were detrusor instability (60% incontinent: 9/15) and previous failed colposuspension or multiple vaginal repairs (55% incontinent: 11/20). In the absence of these risk factors 90% of patients maintained continence throughout the follow-up period. This technique has given results at least equal to those reported for the Burch and Marshall-Marchetti-Krantz techniques of colposuspension.

Female↗
PubMed1986

The pressure-volume plot and prediction of treatment outcome in female incontinence.

A graphic representation of the micturition cycle by a pressure-volume plot has been obtained in 120 women, both incontinent patients and normal controls. The pattern of contraction during voiding allowed prediction of the outcome of treatment. Patients with urethral sphincter incompetence and a sustained detrusor contraction had a good result from colposuspension even if detrusor instability was found during filling. Where the urethral sphincter was competent, patients with urge incontinence with or without detrusor instability during filling cystometry had a good response to drugs, providing a sustained detrusor contraction was present during voiding. Urethral sphincter incompetence was characterised by a low detrusor voiding pressure.

Adult↗
PubMed1979

"Undiversion" with colocystoplasty for neurogenic bladder. A report of 2 cases.

The encouraging success of partial replacement of the bladder for interstitial cystitis and for contracted bladder due to tuberculosis, and the relative success of total bladder replacement for carcinoma, prompted an attempt to reconstruct a bladder in 2 patients with neuropathic bladders, who had problems with their ileal conduit and, thus, "undivert" them. Bladder reconstruction in these patients was performed using a modified technique of colocystoplasty. One of the patients has had 2 normal pregnancies since colocystoplasty.

Adult↗