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Biomedical subjects

J C Hammonds

Publications and source records attributed to J C Hammonds.

At least 19 recordsLinked to original sources
PubMed1998

Detrusor myectomy for detrusor overactivity: a minimum 1-year follow-up.

OBJECTIVE: To evaluate the clinical and urodynamic outcome of partial detrusor myectomy in patients with idiopathic detrusor instability and neuropathic hyper-reflexia. PATIENTS AND METHODS: Seventeen patients with idiopathic detrusor instability and 10 with hyper-reflexia and symptoms not responding to non-surgical treatment underwent partial detrusor myectomy. The clinical and urodynamic results before and after myectomy were compared and the patient's subjective assessment of the outcome documented. RESULTS: There was an overall improvement in 17 of 27 patients (63%) but the success rate was higher in those with idiopathic instability (12 of 17) than in those with neuropathy (five of 10). There was urodynamic evidence of reduced bladder contractility and an improvement in the storage characteristics of the bladder in most of the patients treated. CONCLUSIONS: Partial detrusor myectomy is relatively simple and is associated with minimum morbidity and an acceptable success rate. The procedure alters the urodynamic behaviour of the bladder and leads to symptomatic and objective improvement, giving better results with idiopathic than with neuropathic detrusor overactivity. Detrusor myectomy may be offered to patients with detrusor overactivity unresponsive to conventional management. The option of enterocystoplasty is still open to patients with an unsuccessful outcome. However, the long-term results and surgical variations of the technique should be evaluated further.

Follow-Up Studies↗
PubMed1994

Balloon rupture and stenting for pelviureteric junction obstruction: abolition of waisting is a prognostic marker.

Endoballoon rupture and stenting was performed on 26 patients with pelviureteric junction obstruction. Follow-up was for a mean of 21.4 months (range 3 to 44 months), during which 16 patients (64%) were asymptomatic and the symptoms of eight (30%) recurred; two were lost to follow-up. When waisting of the balloon was observed and seen to resolve during the balloon inflation, the outcome was successful in 75% of patients, compared to only 43% if this was not observed. Balloon rupture and stenting is a useful alternative to pyeloplasty, but has a lower success rate. Major complications were rare. The abolition of waisting is an important prognostic sign.

Adolescent↗
PubMed1992

The current status of embolization in renal cell carcinoma--a survey of local and national practice.

The current role of renal embolization in carcinoma of the kidney is uncertain. In order to assess surgeons' opinion of its usefulness a questionnaire was circulated to all general urologists practising in Britain and Ireland. Also, a series of cases in which the technique was employed (n = 35) was reviewed and compared with a similar group who were not embolized (n = 40). There was a 71% response to the survey. The principal findings were that all but five urologists believe that embolization should not be used routinely in the management of renal cell carcinoma. Thirty-five per cent stated that they felt it has a role in management of symptoms in metastatic or inoperable tumours. The review of both series of patients in our unit shows that embolization (using 95% ethanol infused via a balloon occlusion catheter) did not reduce peroperative blood loss and did significantly increase hospital stay. There were no deaths in this series, and morbidity was confined to 'post-embolization syndrome' in 16 cases. We believe that in those cases where embolization is indicated, alcohol infusion via a balloon occlusion catheter is a safe and efficient method.

Attitude of Health Personnel↗
PubMed1990

Quantification of prostatic cancer metastatic disease using prostate-specific antigen.

The serum prostate-specific antigen (PSA) of 58 men with benign prostatic hypertrophy (BPH) and 17 men with carcinoma of the prostate (CaP) was correlated with the weight of prostatic tissue resected at transurethral prostatectomy (TURP). A significant correlation was identified between the weight of resected BPH tissue and the serum PSA (p less than or equal to 0.001; r = 0.54). No such correlation was seen in the CaP patients. By arbitrarily dividing the serum PSA by the prostate weight, it was possible to devise an index. This index corrected PSA in relation to prostatic size and unlike PSA in isolation did not differ significantly between normal controls and those with BPH. The index in CaP was significantly greater than that of either controls or BPH (p less than or equal to 0.001). Furthermore the index of metastatic CaP (M1) was significantly higher than that of nonmetastatic disease (MO) (p = 0.05). The higher index found in CaP would seem to be related to the bulk metastatic tumor, either manifest or occult. Comparing the index of CaPs to that found in normal and benign disease (a constant) offers a possible means of estimating the extent of local and metastatic tumor mass.

Antigens, Neoplasm↗
PubMed1990

Histological and environmental changes in longstanding ileal conduits.

Seventeen patients with urinary diversions present for between 10 and 17 years were examined endoscopically. The region of the anastomosis was successfully biopsied in 13 cases. Biopsy specimens were examined both histologically and cytologically. Urine was aspirated from the conduits under sterile conditions and sent for qualification of bacterial flora. Histology revealed a variable degree of villous atrophy, mucosal metaplasia, crypt hyperplasia and in one case, antral type gland metaplasia. The finding of hyperplasia was corroborated by flow cytometry which demonstrated a high percentage of cells in G2 and metaphase. The majority of cases showed a colonic type of bacterial colonization and mucin histochemistry demonstrated a colonic type of mucin.

Colon↗
PubMed1989

Ultrasound assessment of local complications of percutaneous renal stone removal.

Ultrasound evaluation of 20 consecutive patients undergoing percutaneous renal stone removal demonstrated fluid collections around the kidney to be common, occurring in 12 (60%). One was intraperitoneal, 7 were perirenal, and 4 were in the track through the posterior abdominal wall. In only 1 were related clinical complications evident. At long-term follow-up, local capsular thickening related to a surface dimple was seen at the puncture site in 66%, and fine cortical scars were visible in 33%. Apart from one slightly larger local cortical scar related to a segmental infarction, no other change related to the procedure was demonstrated.

Cicatrix↗
PubMed1989

Histological changes in the urinary bladder secondary to urethral catheterisation.

The macroscopic and microscopic features of the urothelial response of the human urinary bladder to urethral catherisation are described. The catheter reaction is characterised by a predominantly eosinophilic inflammatory response producing, macroscopically, a papillary mucosal appearance termed polypoid cystitis. The severity of the epithelial inflammatory response correlates significantly with the duration of catheterisation. Urothelial dysplasia confined to the catheter reaction site was noted in 6% of cases. The possible implications of these findings are discussed.

Aged↗
PubMed1988

The effects of transurethral prostatectomy on serum prostate specific antigen.

Serum prostate specific antigen (PSA) was recorded in 75 patients immediately before and after transurethral resection of the prostate (TURP). Fifty-eight patients had benign prostatic hypertrophy (BPH) and 17 had prostatic carcinoma (CaP). In patients with BPH there was a statistically significant rise in PSA immediately following TURP. No such rise was seen in patients with prostatic carcinoma. A statistically significant correlation was identified between the weight of the benign hypertrophic prostate and the baseline pre-operative serum PSA. Because of the effects of TURP on serum PSA it is important to avoid PSA estimations immediately following such surgery. The failure of the malignant prostate to release PSA in significant amounts during TURP suggests that the elevated levels of PSA found in patients with prostatic carcinoma arise not from the local disease but from its metastases.

Antigens, Neoplasm↗
PubMed1987

Clean intermittent self-catheterisation in the elderly.

The results of teaching the technique of clean intermittent self-catheterisation (CISC) to 20 elderly patients (aged 65-81 years) are reported. The patients were followed up for a maximum of 4 years. The use of this technique in the management of selected elderly patients with lower urinary tract dysfunction is discussed.

Aged↗
PubMed1987

An in vitro study of intracavitary pressures during percutaneous nephrolithotomy.

Pyelorenal reflux and irrigant extravasation secondary to raised intrapelvic pressure during percutaneous nephrolithotomy account for a significant percentage of the operative morbidity. The effect of irrigant flow rate, height of irrigant reservoir, diameter of Amplatz sheath and lithotripsy on intracavitary pressures has been studied in an in vitro model. The elevation of pressures produced by these variables suggests that percutaneous techniques should be modified.

Models, Biological↗