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Biomedical subjects

J N Corriere

Publications and source records attributed to J N Corriere.

At least 19 recordsLinked to original sources
PubMed1991

Intraoperative decision-making in renal trauma surgery.

Surgery for renal trauma requires three intraoperative decisions: Should the kidney be explored? Is pedicle control necessary? What procedure should be performed? In 85 explorations for penetrating (66) and blunt (19) trauma, we found that penetrating injuries, active hemorrhage, or major tissue destruction are reasons for mandatory renal exploration. This resulted in 26 nephrectomies, 9 partial nephrectomies, and 4 major renorrhaphies. Forty-six patients underwent minor renorrhaphy or needless exploration without complications. Formal pedicle control was carried out 33 times (39%), but it was never necessary to control parenchymal hemorrhage. Unless a wound overlies the great vessels, perirenal hematomas can be safely entered laterally without prior pedicle control using manual pedicle or parenchymal control if needed.

Adolescent↗
PubMed1989

Simple cyst of the testis.

We report 5 cases of simple cyst of the testis, the largest series to date, and review the literature. Included are 2 autopsy cases, a case of a multilocular simple cyst and 1 case treated nonoperatively. Based on our experience, simple cyst of the testis should be suspected particularly in an enlarged but otherwise palpably normal testis. High resolution real-time scrotal sonography revealing an anechoic mass in the testis with well defined walls, and enhanced posterior through transmission and edge shadowing is diagnostic for a simple cyst. An asymptomatic simple cyst of the testis may be treated with observation alone. The symptomatic simple cyst should be treated ideally with local parenchyma-sparing excision.

Aged↗
PubMed1989

Urethrography in the diagnosis of acute urethral injuries.

Urethrography has proved to be tremendously valuable in the evaluation of patients with suspected acute urethral injuries. The authors review the techniques of examination, the anatomy, and the urethrographic classification of acute injuries in the male patient.

Classification↗
PubMed1989

Management of extraperitoneal bladder rupture.

Extraperitoneal bladder ruptures secondary to blunt trauma are caused by fractures of the bony pelvis 95 per cent of the time. A static cystogram is the only way to diagnose the lesion definitely. We have treated our 41 patients successfully with catheter drainage alone despite extensive urinary extravasation. Eighty-seven per cent of the ruptures will be healed in 10 days, and virtually all will be healed in 3 weeks.

Drainage↗
PubMed1988

Mechanisms of injury, patterns of extravasation and management of extraperitoneal bladder rupture due to blunt trauma.

During the last 7 years we have managed more than 100 cases of bladder rupture, the majority owing to blunt trauma. Of these ruptures 62 were extraperitoneal, including 59 (95 per cent) with associated pelvic fractures. Twelve patients had an associated urethral injury and 5 had a concomitant intraperitoneal bladder rupture. Complex injuries with extravasation outside the confines of the perivesical space were noted in 42 per cent of the patients. Extravasation extended into the scrotum, thigh, anterior abdominal wall and penis, and through the obturator foramen. The 41 patients who were treated with catheter drainage alone did well.

Abdominal Injuries↗
PubMed1988

Interstitial gold and external beam irradiation for prostate cancer.

We treated 65 patients with prostatic cancer confined clinically to the prostate or periprostatic area during an 8-year period. Seven patients had stage A2, 38 stage B and 20 stage C disease. All 65 patients underwent staging pelvic lymphadenectomy and implantation of gold grains into the prostate (mean dose 3,167 rad). A total of 64 patients then completed a course of external beam irradiation to a mean total tumor dose of 6,965 rad. Complications of therapy were mild and limited (less than 3 months in duration) in most patients, and they included radiation cystitis (32 per cent), diarrhea (31 per cent), extremity lymphedema (7.7 per cent) and wound infection (3 per cent). Two patients suffered urinary incontinence after therapy and 2 (3 per cent) had diarrhea more than 3 months in duration. The actuarial 5-year survival rate for all patients was 87 per cent and the 5-year survival free of disease was 72 per cent.

Actuarial Analysis↗
PubMed1988

The etiology and management of genital injuries.

In a 10-year period, we have seen and treated 70 patients with trauma to the genitalia. There were 42 penile, 38 scrotal, and 16 testicular injuries. Patients with severe multisystem or extensive genital wounds were successfully managed by early conservative debridement with delayed definitive repair.

Adult↗
PubMed1988

Avoiding "overkill" in diagnosis and treatment of lower urinary tract infections.

Lower urinary tract infections are not procedure-related conditions. Genitourinary tract abnormalities are uncommon, and there are few indications for an extensive workup of women with urinary tract infections. To avoid overtreating and yet remain confident of providing the best possible care, it is important to recognize that urinary tract infections are a spectrum of diseases with different etiologies and different diagnostic and therapeutic requirements. In the vast majority of cases, the urologist's responsibility is to avoid unnecessary treatment, to educate the patient on her condition, and to provide treatment with a first-line, established antimicrobial. The excretory urogram is indicated when the patient presents with symptoms of upper tract infection or asymptomatic hematuria. Urodynamic studies are useful for the patient with an abnormal voiding pattern or suspicion of neurogenic bladder. Cystoscopy has a place only when there is suspicion of bladder tumor. The voiding cystourethrogram is the most useful study for patients with urinary tract infection when there is suspicion of urethral diverticula. Studies are not recommended during a period of acute infection. Procedures that manipulate the urethra are contraindicated.

Bacterial Infections↗
PubMed1986

Iatrogenic ureteral injury.

We treated 27 patients with iatrogenic ureteral injuries during a 6-year period. Gynecological operations were the most common antecedent surgical procedures (52 per cent). The diagnosis of ureteral injury was made immediately in 4 patients and was delayed 1 to 34 days in 23. Three of the 4 injuries recognized during an operation were repaired successfully at the time of injury; the primary repair in the remaining patient leaked and ultimately resulted in a nephrectomy. In the delayed diagnosis group retrograde ureteral catheterization was successful in only 1 of 20 attempts. Of the 23 patients with injuries recognized in the postoperative period 11 were managed successfully with percutaneous nephrostomy (with or without stenting) alone, 3 required surgical repair after temporary percutaneous nephrostomy drainage, 4 were treated surgically without prior nephrostomy drainage and 1 had spontaneous resolution of hydronephrosis. The remaining 3 patients required nephrectomy: 1 because of a urinary fistula in a previously irradiated field, 1 because of a concomitant (ipsilateral) renal cell carcinoma and 1 because of renal hypertension. Percutaneous nephrostomy or ureteral stenting was successful as primary therapy in 73 per cent of the patients in whom it was used.

Abdomen↗
PubMed1986

Management of the ruptured bladder: seven years of experience with 111 cases.

During a 7 year period, we have seen 111 patients with bladder rupture, 95 from blunt trauma and 16 due to penetrating injuries. All 16 patients with penetrating injuries, as well as an additional 34 patients with intraperitoneal injuries, nine patients with extraperitoneal injuries, and five with both intra- and extraperitoneal injuries from blunt trauma, had formal closure of the wound and urethral or suprapubic catheter drainage. All did well. A total of 39 patients with extraperitoneal bladder injuries were treated with only catheter drainage and all did well. Eight patients died before institution of therapy.

Adolescent↗
PubMed1986

Bladder injury in blunt pelvic trauma.

Clinical and radiologic findings in 97 patients with bladder injury secondary to blunt pelvic trauma were reviewed. Fifty-five patients had extraperitoneal bladder rupture; 35, intraperitoneal rupture; two, interstitial bladder injury; and five, combined intraperitoneal and extraperitoneal bladder rupture. Of the 61 of 97 patients with film studies available for review, two patients with surgically proved intraperitoneal rupture had false-negative cystograms. In two other cases of intraperitoneal rupture, the diagnosis was established with cystography but was not demonstrated with urography. All cases of extraperitoneal rupture were demonstrated cystographically; in 15 cases in this group, the injury was complex, with extravasation of contrast material beyond the confines of the perivesical space. In two additional patients, incomplete bladder injury termed "interstitial bladder rupture" was identified. A classification of bladder injury based on cystographic patterns of extravasation is proposed.

Female↗