Biomedical subjects

J M Sparks

Publications and source records attributed to J M Sparks.

4 recordsLinked to original sources

PubMed1991

Surgery for stress urinary incontinence.

Stress urinary incontinence is a common problem, with various degrees of disability. Its etiology may be defective external or internal urethral sphincter mechanisms. Evaluation of the patient with symptoms of stress incontinence requires objective testing for diagnostic accuracy. Patient management may be individualized to conservative measures or to one of the various surgical approaches, which produce success rates between 80% and 95%. Retropubic suspension or long needle procedures should be considered for patients with stress incontinence and evidence of bladder neck detachment. Sling procedures, artificial sphincters, and periurethral injections should be considered for patients with minimal bladder neck mobility or low urethral pressures and for those with a high risk of failing other procedures.

Adult↗

PubMed1991

Vaginitis.

Vaginitis is a prevalent disorder requiring a thorough understanding by primary care physicians. An in-depth understanding of candidiasis, trichomoniasis and bacterial vaginosis provides the basis for effective treatment. An accurate initial diagnosis is needed in the evaluation of recurrent, chronic vaginitis. A simple office evaluation is usually sufficient and should include a careful microscopic evaluation of the vaginal secretions for hyphae, budding yeast forms, clue cells, trichomonads and Lactobacillus forms; a quantitative assessment of the white blood cells and non-Lactobacillus organisms; and an assessment of the presence of the newly described Mobiluncus species. Assessing the vaginal pH is also important in the evaluation. Vaginal cultures are necessary when the microscopic evaluation does not provide a clear etiology.

Adult↗

PubMed1991

Ovarian cancer screening.

For populations in which preventive measures have been applied for the more common causes of death, the early detection of ovarian cancer becomes the next focus of efforts to reduce premature death among women. Data regarding the effectiveness of ultrasonography in detecting early-stage ovarian cancer are reviewed. Ultrasonography is more sensitive than pelvic examination in detecting ovarian abnormalities but lacks specificity in distinguishing benign from malignant ovarian lesions. Combined with serum CA 125 levels, ultrasonography may provide an effective screening tool, although cost-effectiveness has not been demonstrated and its effectiveness in reducing mortality from ovarian cancer has not been completely evaluated. Guidelines are presented for the use of ultrasonography in evaluating the postmenopausal ovary.

Antigens, Tumor-Associated, Carbohydrate↗

PubMed1991

Transvaginal sonography of the endometrium in postmenopausal women.

The purposes of this study were to compare transvaginal sonographic scanning of the uterus and endometrium with histology obtained by endometrial biopsy or curettage and to determine whether the sonographic technique might be useful in the evaluation of postmenopausal women. Eighty postmenopausal women were studied. Of these, 65 were asymptomatic (38 on no hormone therapy and 27 on hormone replacement). Fifteen women underwent evaluation because of postmenopausal bleeding. In both groups, endometrial thickness of 4 mm or less as depicted by sonography correlated well with endometrial characteristics of decreased estrogen stimulation. However, in women with measured endometrial thickness between 5-8 mm, proliferative endometrium could not be distinguished from hyperplastic endometrium or, in one case, low-grade carcinoma. Large polyps and invasive carcinoma with myometrial extension were easily recognized.

Aged↗