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Biomedical subjects

J G Gregory

Publications and source records attributed to J G Gregory.

At least 19 recordsLinked to original sources
PubMed1990

Treatment of post-orchiectomy hot flashes with transdermal administration of clonidine.

The occurrence of hot flashes in men after bilateral orchiectomy for prostatic carcinoma can be bothersome and difficult to treat. Transdermal clonidine was administered to 7 patients with such symptoms. In 3 patients the hot flashes were ablated and in the remaining 4 the number and frequency of attacks were considerably reduced. No significant side effects were encountered. We suggest that transdermal clonidine (0.1 mg.) administered weekly can safely control undesirable hot flashes in men after bilateral orchiectomy.

Administration, Cutaneous↗
PubMed1989

Transrectal ultrasound in stage A1 prostate carcinoma.

Transrectal ultrasound of the prostate was employed on 6 patients found to have Stage A1 carcinoma of the prostate after transurethral resection in order to identify those patients with residual tumor. Two patients were found to have residual tumor by transrectal ultrasound; this was confirmed by ultrasonic guided biopsy of the prostate. Of the remaining patients, an additional 2 on whom the ultrasound did not detect the tumor had tumor less than 1 cm in size, and in 1 patient no residual disease was found in the pathologic specimen. We conclude that ultrasound of the prostate offers another dimension in the staging of patients with Stage A1 carcinoma of the prostate.

Adenocarcinoma↗
PubMed1987

Penile prosthesis: review of current models, mechanical reliability, and product cost.

A fifty-year experience with the modern penile implant has led urologists to conclusions as to the reliability, applicability, and cost of these devices. Product evolution has led to a more physiologic erection. However, with increased sophistication, further potential for failure must be considered. Each modification must undergo the test of clinical experience in addition to classic bench testing in order to predict reliability accurately.

Costs and Cost Analysis↗
PubMed1987

Followup of ureterosigmoidostomy diversion for bladder exstrophy--behavioral biofeedback as an alternative treatment for fecal-urinary incontinence: a case report.

A total of 6 children underwent primary ureterosigmoidostomy diversion between 1972 and 1979. Despite preoperative testing of rectal competence all 6 children now experience rectal leakage. Behavioral biofeedback has been used in a 7-year-old boy who had learned to isolate and to contract the perineal muscles appropriately by 12 months of followup. The incidence of incontinence has been reduced from 15 to 5 per cent of the total hours recorded. The amount of waking hours in which the patient is wet has decreased from 31 to 6 per cent. Satisfaction of the child and parents is high.

Behavior Therapy↗
PubMed1986

Failure of the Jonas prosthesis.

A total of 27 patients received the standard Jonas silicone-silver penile prosthesis. The procedure was done at 3 separate hospitals by 2 surgical teams. Four patients who were reported on previously presented consecutively to our clinic with failed penile rigidity and complete multiple wire fractures were found at reoperation. Therefore, the remaining 23 patients were reviewed and 7 had positive findings suggesting fracture, including decreased penile rigidity, crackling that was audible or palpable and/or evidence of fracture on an x-ray. Seven patients had completely negative evaluations and 9 were lost to followup. Two patients with suspicious x-ray findings and 1 with negative x-ray findings but who reported less rigidity have since had the prostheses removed, and all had multiple wire fractures. Radiographs of fractured prostheses, both in the penis and explanted, attest to the limited reliability of x-ray in the diagnosis of wire fracture.

Humans↗
PubMed1986

Urinary incontinence in the elderly. Ways to relieve it without surgery.

Few studies of incontinence have been done on the elderly as a specific population, although epidemiologic reports reveal that incontinence is a debilitating condition that affects 15% to 30% of the elderly population of the United States. In diagnosing the problem, we use the simplest procedure that can supply the required information. However, if the diagnosis is uncertain or the treatment being considered is risky, urodynamic testing is necessary. Several nonsurgical treatments are available and have varying degrees of success in reestablishing continence. Some, such as pharmacotherapy and intermittent self-catheterization, are effective for some patients and are replacing bladder drill and bladder distention in popularity. Less conventional techniques (electrotherapy, biofeedback, and periurethral injection) are useful only in select cases and have had fewer clinical trials. Clamps and external devices for men and pessaries for women are prone to complications and generally are avoided in our practice. Long-term use of indwelling catheters is a last resort, to be considered only when all other alternatives have been exhausted. Further clinical research that considers the particular problems of the elderly is needed so that practical, humane, and effective treatment becomes possible.

Aged↗
PubMed1984

Ventriculo-peritoneal shunt pseudocyst causing ureteropelvic junction obstruction in a child with myelomeningocele and retrocaval ureter.

We report on a boy with myelomeningocele and a ventriculo-peritoneal shunt, who presented with progressive ureteropelvic junction obstruction and an enlarging right upper quadrant mass. Exploration revealed a large pseudocyst around the distal portion of the shunt, causing obstruction of an unsuspected retrocaval ureter. To our knowledge this is the first reported case of an upper urinary tract complication due to a ventriculo-peritoneal shunt as well as the first case of a retrocaval ureter associated with myelomeningocele.

Abnormalities, Multiple↗
PubMed1984

Intermittent catheterization: evaluation of complete dryness and independence in children with myelomeningocele.

We studied 46 children in active followup who have been managed by nonsterile intermittent catheterization to achieve continence. All patients were given maximum therapeutic doses of supplemental medication to improve dryness. Of the patients 33 per cent were noncompliant and, therefore, wet, 30 per cent were wet despite full compliance with the program, and only 24 per cent were completely dry and wearing regular underclothing. Nine children experienced side effects from the supplemental medications that were severe enough to warrant discontinuation of the drug. Of the 46 patients 19 have been removed from the catheterization program and currently are being managed by other modalities. Only 11 of the remaining 27 patients currently managed by catheterization perform the procedure independently. Results suggest that intermittent catheterization does not provide independence or social continence in many patients.

Adolescent↗
PubMed1984

Torsion of the contralateral testis 5 years after orchiopexy.

We report a case of spermatic cord torsion in the contralateral testicle 5 years after surgical fixation. Since diagnosis of such a lesion is difficult a high degree of suspicion is necessary. If torsion is suspected exploration is mandatory. We strongly recommend the use of a nonabsorbable reaction-producing suture (for example silk) when an orchiopexy is performed, with the point of fixation being between the visceral tunica vaginalis and the dartos muscle.

Adult↗
PubMed1984

The inflatable penile prosthesis, reoperation and patient satisfaction: a comparison of statistics obtained from patient record review with statistics obtained from intensive followup search.

Of 179 patients who received the inflatable penile prosthesis 43 per cent have required reoperation, 60 per cent of which were performed for mechanical failure. An attempt to evaluate the adequacy of chart review in assessing current function and patient satisfaction was made by comparing reports obtained by chart review to those obtained by direct patient interview. Results showed that if chart review alone was used malfunction would have been underestimated by 13 per cent and patient satisfaction overestimated by 21 per cent. The importance of direct followup in evaluating patients with the inflatable penile prosthesis is demonstrated.

Adult↗
PubMed1982

The diagnosis and surgical management of vasculogenic impotence.

Thirty-two patients have been treated for organic impotence at our institution during a 16-month period. Of these patients 5 were found to have penile vascular insufficiency and underwent a femorocavernosal bypass with an autogenous saphenous vein graft. Initial results were excellent but late failures occurred. At 28 months all shunts were occluded. Microscopic examination of the cavernous tissue revealed fibrous thickening of the septa and loss of cavernous spaces. These findings suggested that late failure in direct revascularization may be associated with fibrotic changes that occur under high pressure inflow to the corpora cavernosa.

Erectile Dysfunction↗