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Biomedical subjects

K Waterhouse

Publications and source records attributed to K Waterhouse.

At least 19 recordsLinked to original sources
PubMed1985

Transverse ureteral advancement technique of ureteroneocystostomy (Cohen reimplant) and a modification for difficult cases (experience with 121 ureters).

We reimplanted 121 ureters by the Cohen technique. A modification is introduced for difficult cases, making the Cohen technique more adaptable for dilated ureters and small bladders. Radiographic studies obtained at least 6 months after reimplantation revealed only 1 case of persistent reflux (grade I), no case of contralateral reflux and no obstruction. Even though the series included 35 ureters with grade V primary reflux and 7 primary obstructive megaureters, only 7 ureters were tapered. This finding suggests that the Cohen method might require tapering in a smaller percentage of cases compared to other reimplantation techniques.

Adolescent↗
PubMed1984

Correction of adult penile curvature with a Nesbit operation.

Nesbit's technique of excising ellipses of tunica albuginea has been effective in correcting chordee in children. We have used this technique successfully in adults for the correction of 19 congenital and traumatic curvatures, as well as those resulting from stable Peyronie's disease. All patients retained potency and reported excellent correction of the deformities. We believe that Nesbit's operation is the procedure of choice for the correction of disabling adult penile curvature.

Adult↗
PubMed1983

When to use the Chevassu maneuver during exploration of intrascrotal masses.

As many as 50 per cent of explorations for intrascrotal masses result in orchiectomy for benign disease. The most common diagnoses are hydrocele, epididymitis and benign testicular tumors. Many of these diagnoses could be made before orchiectomy if the tunica vaginalis and, occasionally, the tunica albuginea were opened, and the lesion biopsied. However, violation of the testicular tunics traditionally has been considered taboo because of the dangers of tumor seeding. In 1906 Chevassu suggested inguinal exploration and occlusion of the testicular vessels before biopsy of suspicious lesions. We have added scrotal hypothermia, double ligation of the gubernaculum before its division and irrigation with distilled water to provide a procedure that adheres to the principles of good cancer surgery. Its use during inguinal explorations for suspicious intrascrotal masses in 5 patients led to a benign diagnosis and preservation of the testis in 3 instances without subsequent testicular atrophy. Its judicious use can decrease the incidence of orchiectomy for benign disease.

Adolescent↗
PubMed1982

Observations on persistently dilated ureter after posterior urethral valve ablation.

The persistent ureteral dilatation frequently seen months or even years after posterior urethral valve ablation, continues to present a dilemma to the urologist. We have classified these dilated ureters into 3 types: (I) unobstructed with either an empty or filling bladder, (II) unobstructed with an empty bladder but obstructed with a filling bladder, and (III) obstructed with either an empty or filling bladder. The majority of ureters with persistent dilatation were found to be of the type II variety where appropriate treatment is not obvious. Classic ureteral tailoring and reimplantation offers little advantage since in such cases a narrower ureter is passed through a new hiatus in an otherwise unchanged bladder. When high renal pelvic pressures are found only with bladder filling, then consideration must be given to not only reconstructing the ureter but also to affecting the dynamics of the bladder and the large urinary output characteristically found in these patients.

Child↗
PubMed1981

Renal failure induced by contrast material.

Transitory and occasionally irreversible renal failure secondary to parenterally administered iodinated contrast material is now well documented. Diabetes and pre-existing renal insufficiency are the two most important risk factors. Intravascular contrast examinations should be avoided whenever possible in high-risk patients, particularly diabetics with creatinine levels of 5 dl./ml. or higher. Alternative methods for the etiologic evaluation of renal failure or hematuria are suggested.

Contrast Media↗
PubMed1981

Evaluation of anterior extravesical ureteroneocystostomy in kidney transplantation.

We evaluated the anterior extravesical ureteroneocystostomy technique in 184 consecutive renal transplants done in 2 consecutive calendar years. Complications included 5 cases of ureteral and 1 of pelvic necrosis, and 2 of ureteral obstruction, with a ureteral complication rate of less than 4 per cent. All cases of pelvic or ureteral necrosis except 1 were seen in cadaver donor kidneys that were imported from other centers. No bladder complications were seen. Pelvioureteral obstruction, presumably of congenital origin in the cadaver donor, was discovered in the kidney after transplantation in 2 cases and was corrected successfully by pyeloureterostomy to the native ureter. The extraordinary simplicity of this technique, coupled with improvement in the complication rate, makes it our procedure of choice.

Adult↗
PubMed1981

Reminiscences.

Explore the source record for details and available documents.

Australia↗
PubMed1980

The surgical repair of membranous urethral strictures: experience with 105 consecutive cases.

We reviewed 105 patients with rupture of the membranous urethra in whom impassable strictures developed. With 16 years being the division between children and adults there were 73 adults and 32 children. We prefer to repair these strictures with the mobilized anterior urethra if this can be accomplished satisfactorily, rather, than using skin substitution urethroplasties. The mobilized anterior urethra was used in 90 patients: 63 adults and 27 children. The anterior urethra in the remaining 15 patients had been damaged either by a previous operation or by previous disease and needed skin substitution urethroplasty. Techniques, complications and results in the 3 types of repair are presented.

Adolescent↗
PubMed1980

Management of 18 difficult vesicovaginal and urethrovaginal fistulas with modified Ingelman-Sundberg and Martius operations.

Our experience in the management of difficult vesicovaginal and urethrovaginal fistulas is presented. The fistulas were secondary to radiation damage and extensive local fibrosis owing to previous attempts to repair surgically. Satisfactory surgical repair of the fistulas was obtained by interposition of viable gracilis muscle and labial fibrofatty tissue at the repair site. The patients have been followed for 1 to 2 years postoperatively.

Female↗
PubMed1979

Traumatic strictures of the prostatomembranous urethra in children: radiologic evaluation before and after urethral reconstruction.

Impassible strictures of the posterior urethra are frequent sequelae of injuries of the prostatomembranous urethra. To select the appropriate type of urethral reconstructive procedure, the surgeon must know the length of the stricture, whether local complications are present, and whether the anterior urethra is strictured or bound down by fibrosis. The authors describe the radiographic techniques they use to plan urethral reconstruction and evaluate the operative result. The principles of the one-stage transperineal and combined transpubic-transperineal repairs and the two-stage Turner-Warwick scrotal skin inlay urethroplasty are presented to enable radiologists and urologists to interpret contrast studies of the lower urinary tract in patients who have undergone these operation.

Adolescent↗
PubMed1979

Partial tears of prostatomembranous urethra in children.

Five boys having sustained a pelvic fracture were found to have incomplete tears of the prostatomembranous urethra. Three patients were treated with suprapubic cystostomy drainage alone and fared better than 2 who were treated with urethral catheter stenting and drainage. A recommendation is made for the "hands-off" approach to the evaluation and management of membranous urethral injuries.

Adolescent↗
PubMed1979

The radiographic approach to injuries of the prostatomembranous urethra in children.

We favor initial non-operative treatment (suprapubic cystostomy drainage only) for prostatomenbranous urethral injuries in children and adolescents. Non-operative treatment usually results in uncomplicated strictures that can be corrected by a 1-stage transperineal or transpublic operation 4 to 6 months later. A hands-off diagnostic approach, which relies on excretory urography and retrograde injection urethrography to demonstrate partial and complete tears, eliminates the need for blind passage of catheters, an invasive procedure that may lead to complicated strictures unsuitable for a 1-stage repair. If a 1-stage repair is planned it is necessary to determine the length of the stricture, whether there are local complications and whether the anterior urethra can be widely mobilized. The radiographic techniques used to plan a corrective operation and to evaluate the results are described.

Adolescent↗
PubMed1977

Complications of partial cystectomy in patients with high grade bladder carcinoma.

We herein analyze the results of partial bladder resection in 61 patients with stage A transitional cell carcinoma. Staging was based on preoperative evaluation, operative findings and postoperative microscopic study of the specimen. In 54% of the patients with high grade malignancies local recurrences were noted and the patients eventually died of the disease. There were no recurrences in patients with low grade tumors. Therefore, the grade of bladder carcinoma should be considered when patients are chosen for this operation.

Carcinoma, Transitional Cell↗
PubMed1977

The surgical repair of membranous urethral strictures in children.

Eighteen patients have been treated for membranous urethral strictures following rupture of the prostatomembranous urethra. In 16, satisfactory results have been attained, 1 patient has been diverted permanently, and the remaining patient has not yet undergone complete repair.

Adolescent↗