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Biomedical subjects

K Arikado

Publications and source records attributed to K Arikado.

11 recordsLinked to original sources
PubMed1989

[The role of uninhibited bladder in antireflux surgery. Special reference to reflux recurrence and diverticulum formation].

A retrospective study on antireflux surgery for primary vesicoureteral reflux at Hokkaido University Hospital was performed. One hundred and seventy-nine patients (299 ureters) underwent antireflux surgery in these 17 years and 7 months. When the period was divided into 3, success rate was 96.5, 93.8 and 100 per cent, respectively. Overall success rate was 96.6 per cent. There was a combined failure or complication in 9 patients. The records of these 9 were reviewed in detail. Three were believed to be a technical error: 2 stricture and one persistent reflux. The remaining 6 were all children except one and had no clear reason for failure: 2 persistent reflux and 4 contralateral appearance of reflux ("missing VUR"). Four of these 6 patients were characterized by voiding dysfunction, namely uninhibited bladder. In 3 patients reflux disappeared spontaneously by administration of anticholinergic agent. In many of these, vesical diverticulum formation was also noted to precede or to coincide with recurrence or appearance of reflux. Thus other 3 patients with diverticulum formation after antireflux surgery were added and re-evaluated. All 3 children had voiding dysfunction with uninhibited bladder. Diverticulum formation was believed to be related to uninhibited bladder in at least one child. It seems that the child with uninhibited bladder and reflux is particularly at risk for failure or complication of antireflux surgery. Patients with symptoms of voiding dysfunction deserve a complete evaluation, including cystoscopy and urodynamics.

Child↗
PubMed1986

[Clinical effect of prostaglandin F2 alpha on postoperative bowel movement in transurethral and transretroperitoneal urologic surgery].

The clinical effectiveness of prostaglandin F2 alpha (PGF2 alpha) injection on postoperative bowel movement was studied in 455 patients who underwent transurethral and transretroperitoneal operation. The patients were divided into two groups, 417 patients with PGF2 alpha injection and 38 without injection. 1,000 micrograms of PGF2 alpha were infused twice a day postoperatively until the onset of active flatus. The onset of flatus was recorded in each group. The onset of flatus after operation was 15 hours and 47 minutes for the injection group of 194 patients operated transurethrally, which was shorter than the 21 hours and 50 minutes for the uninjected group (p less than 0.01), but the onset of flatus was not significantly affected by the injection in the patients operated transretroperitoneally. Postoperative PGF2 alpha infusion facilitated flatus in the patients undergoing transretroperitoneal urologic surgery which took 1 and a half hours or more in doing so (p less than 0.05). Generally, postoperative paralytic ileus was milder after urological surgery than after bowel surgery, but PGF2 alpha injection was effective clinically both in transurethral surgery and transretroperitoneal surgery.

Adult↗
PubMed1985

[Clinical and pathological study of renal pelvic and ureteral tumors].

This report is on 25 patients with primary urothelial tumor in the upper urinary tract who were admitted to our hospital from February, 1969 through January, 1983. The patients were 18 males and 7 females with a mean age of 66 years. The affected side was the right side in 11 cases, the left side in 12 and bilateral in 1 case (bilateral asynchronous ureteral tumor). The major symptoms were hematuria (69%) and flank pain (25%), with rare signs of fever. Total nephroureterectomy with bladder cuff was employed as the surgical method in 19 out of 25 cases. We performed conservative surgery in the case of non-infiltrating bilateral ureteral tumor. Pathologically, all 25 patients had transitional cell carcinoma. Over-all survival rate at 3 and 5 years was 64% and 51%, respectively. Our findings coincided with earlier reports by others that the prognosis of primary tumors in the upper urinary tract is related to the grade and stage of the tumor.

Aged↗
PubMed1982

Prostatic reflux: a simple radiographic sign in recognizing dysfunctioned voiding from external sphincter disorders.

Clinical and urodynamic studies of urethroprostatic reflux were performed in 15 of 40 paraplegics subjected to voiding cystourethrography in the last 5 years. Failure of the external urethral sphincter to relax was confirmed in all patients by either sphincter electromyography or documentation of sympathetic dyssynergia, and high pressure in the prostatic urethra was confirmed by measurement of voiding pressure. A shrewd search for this simple radiographic sign was suggested in the followup of paraplegics because it often served as an early indicator of exposure of the urinary system to the brunt of voiding under high pressure, which presently is believed to be more detrimental to the patients than residual urine. We discuss briefly an anatomical basis for its occurrence preferentially in the peripheral lobe as well as in the central lobe of the prostate in some advanced cases.

Adult↗
PubMed1982

Experience with electromyography of the external urethral sphincter in spinal cord injury patients.

Simultaneous recordings of electromyography of the external urethral sphincter and bladder pressure during voiding were done for 71 male patients with spinal cord injury. Discordant activities between the anal and the external urethral sphincters were noted in 39 per cent of the patients. The degree of bladder dysfunction was related more to the degree of dyssynergia of the urethral than the anal sphincter. This detrusor-sphincter dyssynergia was found in 67 per cent of our patients regardless of the differences in cystometric patterns and the level of spinal injury. The importance of electromyography of the external urethral sphincter in the diagnosis of neurogenic bladder dysfunction was stressed. The management of detrusor-sphincter dyssynergia is discussed briefly.

Anal Canal↗
PubMed1982

Relevance of sympathetic dyssynergia in the region of external urethral sphincter: possible mechanism of voiding dysfunction in the absence of (somatic) sphincter dyssynergia.

The genesis of the cystourethrographic appearance of external sphincter spasm in 11 paraplegics with complete lower motor neuron bladders was examined. By the demonstration of its close association with a postural increase in the urethral pressure and catecholamine release, and its responsiveness to alpha-adrenolytic drugs an external sphincter spasm was suggested to be a result of sympathetic dyssynergia in the region of the external sphincter. The smooth muscular component in this region is believed to be a responsible unit of this disorder, since its surgical ablation by means of radical transurethral resection of the prostate uniformly resulted in the relief of sympathetic dyssynergia. The clinical implication of this disorder in the management of vesical dysfunction of the lower motor neuron type is discussed.

Humans↗
PubMed1981

Radical transurethral resection of the prostate for neurogenic dysfunction of the bladder in male paraplegics.

We herein report our experience with radical transurethral resection of the prostate in 50 paraplegics refractory to conventional conservative therapy, including the use of alpha-adrenolytic drugs and clean intermittent self-catheterization. The operation was successful in 46 patients (92 per cent) and unsuccessful in 4 tetraplegics with complete high cervical lesions. We discuss the rationales of this procedure for neurogenic dysfunction of the bladder and present urodynamic changes in the successful and unsuccessful cases. This extensive and, yet, microsurgically anatomical resection of the urethral sphincter is recommended for all refractory paraplegics except for complete tetraplegics with high cervical lesions.

Adult↗
PubMed1980

Congenital anomalies in children with testicular germ cell tumor.

The incidence and type of congenital anomalies associated with childhood testicular germ cell tumors were studied retrospectively in 25 patients (20 cases of yolk sac tumor and 5 cases of teratoma). Congenital anomalies were observed in 3 patients with yolk sac tumors and in 1 patient who had a mature teratoma. The abnormalities observed included individual cases of retrocaval ureter, diverticulum of the bladder, Down's syndrome and an ipsilateral inguinal hernia. Children with a testicular tumor should be examined closely for congenital abnormalities.

Child, Preschool↗
PubMed1975

Transitional cell carcinoma of renal pelvis in an infant.

A case of transitional cell carcinoma of the renal pelvis in a 4-month-old japanese boy is reported. This patient is the youngest one described in the literature with a tumor of this type. The differential points of Wilms tumor and other types of neonatal renal tumors are discussed.

Carcinoma, Transitional Cell↗