Biomedical subjects

J Bycroft

Publications and source records attributed to J Bycroft.

6 recordsLinked to original sources

PubMed2006

Long-term urological outcomes in paediatric spinal cord injury.

STUDY DESIGN: Retrospective review. OBJECTIVE: This retrospective review observes the evolution of bladder management by time and reports adult urological outcomes and complications in paediatric onset spinal cord injury (SCI). SETTING: Spinal Injuries Unit RNOH Stanmore. METHOD: In total, 10 traumatic SCI patients with mean age at injury of 13.6 years underwent treatment, for a mean period of 13.1 years. Characteristics of injury were noted. Two diagnostic subgroups, neurogenic detrusor overactivity (NDO), and acontractile detrusor were made. Complications, treatment changes, operative procedures with follow-up were noted. RESULTS: In group 1 (6/10 patients) with NDO, five had DSD. Initial bladder management was reflex/urge voiding (n=4), suprapubic catheterisation (SPC), (n=1) and self-intermittent catheterisation (SIC), (n=1). Two patients had multiple upper tract complications with decreased renal function, two recurrent symptomatic urinary infections and one; bladder calculus. In total, 12 operative procedures were performed to treat complications and change bladder management to, SIC+oxybutynin (n=3), ileal conduit (n=1), sacral anterior root stimulator implant (SARSI), (n=1), voiding on urge (n=1). In group 2 (4/10 patients) with a-contractile detrusor two had low compliance. Initial bladder management was SIC (n=3) and voiding on urge/straining (n=1). Two patients converted from SIC to permanent catheter drainage and reported complications. Incidental kidney stone was diagnosed in one. A total of four interventions were carried out with final management of SIC (n=2), voiding on urge/straining (n=1) and Mitrofanoff+ileocystoplasty (n=1). CONCLUSION: Bladder management in paediatric SCI is dependent on neurological level and type of injury; it changes with growth and is affected by changes in bladder management.

Adolescent↗

PubMed2005

Autonomic dysreflexia: a medical emergency.

Autonomic dysreflexia is an important clinical diagnosis that requires prompt treatment to avoid devastating complications. The condition may present itself to all members of medical and surgical specialties, who may not be accustomed to treating it. It is the clinician's responsibility to have a basic understanding of the pathophysiology of the condition and the simple steps required to treat it.

Acute Disease↗

PubMed2005

Stress urinary incontinence: current understanding.

Many new concepts were introduced in epidemiology, a etiopathology and treatment of stress urinary incontinence. This review gives a short account of these concepts and compares the results of commonly used treatment options with new ones recently introduced.

Female↗

PubMed2004

Writing and publishing case reports: the road to success.

Case reports, by virtue of their simplicity, are ideal for the novice writer. The temptation is to write up anything that is remotely interesting in the hope that you get your name in print. One soon discovers that this is a self-defeating exercise when rejections of a mediocre manuscript come a plenty. Choosing an appropriate case is the difficult first step and getting started remains a challenge for the uninitiated. This article outlines our systematic approach for busy junior doctors to write high-quality and meaningful case reports with relative ease.

Humans↗

PubMed2003

Penile erosion in spinal cord injury--an important lesson.

STUDY DESIGN: A case report of the complications of a spinal cord injury (SCI) patient alternating between indwelling urethral catheter and a condom drainage system for bladder management. OBJECTIVE: To highlight the importance of penile care for bladder drainage following SCI. SETTING: Spinal Injuries Unit, Stanmore, UK. SUBJECT: A 39-year-old male who sustained a lumbar level SCI in December 2000. He presented acutely with leakage of urine around his condom drainage device. MAIN OUTCOME MEASURE: The examination revealed an eroded area on the ventral aspect of the proximal penile shaft, which corresponded to the site of condom attachment. An indwelling urethral catheter was inserted as a temporary measure before reconstruction. RESULT: At operation, in addition to the preoperatively observed area of erosion, the penile urethra was found to be cleaved for almost its entire length. CONCLUSIONS: The patient had suffered two complications from a combination of two types of bladder management, and surgery was successful in treating both the urethral cleavage and the skin erosion.

Adult↗

PubMed2003

Screening cystoscopy and biopsy in patients with neuropathic bladder and chronic suprapubic indwelling catheters: is it valid?

PURPOSE: Screening for bladder malignancy in patients with neuropathic bladder and a chronic indwelling catheter by cystoscopy and biopsy is commonly performed. Despite this practice the test has not been fully validated to date. We analyzed our experience with this screening test and explored its validity when applied to our patients. MATERIALS AND METHODS: We performed a retrospective analysis of screening biopsies in 36 patients with neuropathic bladder and a chronic indwelling catheter who had undergone yearly screening from 5 years after catheter insertion. Mean time since suprapubic catheter insertion was 12.1 years (range 8.7 to 23.8). RESULTS: No tumors were ever identified in our screened group. However, histological findings were frequently abnormal, of which the most common are active chronic cystitis and squamous metaplasia. CONCLUSIONS: Our study reinforces the increasing body of evidence suggesting that screening cystoscopy and biopsy in this group of patients is not valid. As a screening test, it fulfils few of the necessary criteria.

Adult↗