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M N Sulaiman

Publications and source records attributed to M N Sulaiman.

10 recordsLinked to original sources
PubMed2001

A 10-year experience of managing ureteric calculi: changing trends towards endourological intervention--is there a role for open surgery?

OBJECTIVES: To study changing practices in the management of ureterolithiasis with the introduction of newer technologies, the efficacy and safety of endourology, extracorporeal shock wave lithotripsy (ESWL) and open surgery, and to determine if any indication remains for open ureterolithotomy in a tertiary endourology unit. PATIENTS AND METHODS: A 12-year retrospective review (1987-1998) was conducted of all primary ureteric stones treated by ESWL, endoscopy, intracorporeal shock wave lithotripsy (ISWL) administered via ureteroscopy, and open surgery. RESULTS: In all, 1195 patients were treated for primary ureteric stones, 44% by ESWL, 37% by ureteroscopy and ISWL, and 20% by open surgery. At the 3-month follow-up the stone-free rates for ESWL monotherapy, ureteroscopy and open surgery were 95%, 85% and 97%, giving an efficiency quotient of 73%, 64% and 94%, respectively. The overall complication rate for ESWL was 13%, for ISWL 32% and for open surgery 13%, but the complications of open surgery were often serious and potentially life-threatening. CONCLUSIONS: With recent advances in endourology the indications for open surgery have decreased considerably, from 26% in 1987-95 to 8% in 1996-98. However, the remaining indications for open ureterolithotomy include failure of less invasive modalities, the presence of medical/anatomical abnormalities, a concomitant open procedure, and the presence of large impacted calculi for which patients prefer to avoid multiple procedures.

Adolescent↗
PubMed2000

Three techniques for simpler, safer, and cost-effective rigid ureteroscopy.

Postureteroscopy colic, accumulation of irrigant fluid in the bladder, and advancement of the ureteroscope through narrow ureters are some of the problems commonly encountered during ureteroscopy. Three methods to overcome these problems and to make ureteroscopy technically easy, safe and cost-effective are described.

Abdominal Pain↗
PubMed1999

The role of ureteral stent placement in the prevention of Steinstrasse.

BACKGROUND AND OBJECTIVE: Steinstrasse constitutes a potentially serious complication of extracorporeal shock-wave lithotripsy (SWL). Ureteral stent placement has been used to prevent Steinstrasse after fragmentation of larger stones. However, particularly more recently, its preventive efficacy has been questioned. The aim of this study therefore was to analyze the role of ureteral stent placement in the prevention of Steinstrasse. METHODS: We analyzed data of 1087 patients who had been treated with a Wolf Piezolith 2300 in the General Infirmary in Leeds/UK for stones ranging from 10 to 95 mm in diameter. RESULTS: The incidence of Steinstrasse was 6.3%. The likelihood was significantly correlated with the stone size and was significantly less in patients with stones >20 mm if a stent had been inserted prior to SWL. Moreover, in these patients, the risk of acute clinical symptoms in the event of Steinstrasse was greatly reduced, and the treatment could be continued safely in the majority of cases (86%). Treatments of the Steinstrasse itself with SWL resulted in its clearance in most of the cases (78%). It was always possible to clear even extended persistent Steinstrasse by laser lithotripsy. CONCLUSION: These results provide a clear indication for the pre-SWL insertion of a ureteral stent in patients with stones >20 mm in diameter. In the event of Steinstrasse, SWL of the collection should be tried before more invasive endourologic procedures are considered.

Adult↗
PubMed1998

Urolithiasis in pregnancy--a clinical challenge.

Symptomatic urolithiasis in pregnancy is a rare event. We present a series of 13 cases. Although controversial, we think that X-rays should be avoided if possible. Ultrasound may not be the perfect diagnostic tool in every case of stone disease, however in pregnancy it is the imaging of choice and led to an accurate diagnosis in all our cases. Thirty-eight percent of the patients were managed conservatively throughout their pregnancy, and another thirty-eight percent of our patients needed more extended treatment but could be managed by simple insertion of a double J ureteric stent (DJ). Therefore, in our series invasive treatment was not necessary in the majority of patients. Each one patient required a percutaneous nephrostomy (PCN) and a nephrectomy for a non-functional pyonephrotic kidney. Urolithiasis in pregnant women constitutes a challenge for the treating urologists since they are deprived of some of their essential tools, such as X-rays and extracorporeal shock wave lithotripsy (ESWL), and since normally tolerable complications of less invasive treatments can have disastrous consequences in pregnant patients. Therefore, decisions on any kind of treatment have to be made very prudently and critically. We present an algorithm for the management of stones in pregnancy which may be helpful in decision making.

Adult↗
PubMed1998

Persistent Müllerian duct syndrome.

Persistent müllerian duct syndrome (PMDS) is a rare form of male pseudohermaphroditism. We present 5 cases with PMDS (2 cases associated with testicular malignancy) and discuss the diagnosis and management. Management strategies of PMDS have changed. Whereas in the past, removal of the müllerian remnants was targeted together with orchidopexy or -ectomy, this is no longer recommended. However, testicles that cannot be descended at an early stage are at a high risk of malignancy and should, therefore, be removed. If this is necessary on both sides, there is the additional problem of lifelong testosterone substitution which requires efficient patient monitoring and good patient compliance. In cases where this cannot be achieved, compromises, such as temporarily delayed orchidectomy, may be considered.

Adult↗
PubMed1998

Carcinoma in a bladder diverticulum: the place of diverticulectomy.

A carcinoma within a vesical diverticulum represents a therapeutic challenge because it has generally a poor prognosis, and unambiguous guidelines for its therapy are not at hand. The authors report their experience with two low-grade single and confined tumours which were treated by simple diverticulectomy. Both patients remained tumour-free after 2 and 4 years of follow-up, respectively. The literature has been reviewed to assess the state of the art approach for such tumours. Whereas simple diverticulectomy may be indicated in selected, confined cases, an aggressive approach combining surgery and radio- and/or chemotherapy is recommended in the majority of vesical diverticulum tumours.

Aged↗
PubMed1996

Penile fracture.

Explore the source record for details and available documents.

Adult↗
PubMed1995

Total colonic mobilization and exteriorization facilitates intra-operative colonic irrigation.

Intraoperative colonic irrigation has become an accepted procedure in the management of left-sided bowel obstruction, making it possible to perform a safe primary anastomosis after resection. However, many surgeons raise objections to the technique because it is a complex procedure to perform on an acutely ill patient and, furthermore, the procedure is time consuming. A modification of the technique initially described by Dudley and his colleagues has already been reported from our hospital and utilizes an irrigation needle and a one-piece disposal sack. During irrigation, the colon requires to be manipulated to encourage the onward flow of faecal contents. Difficulty may be experienced because of the sharp angulation and fixity of the colon at both the hepatic and splenic flexures. Mobilization and exteriorization of the whole colon eliminates this problem.

Colon↗
PubMedDate not supplied

Nesbit's procedure for penile curvature.

Between January 1982 and June 1992 83 patients with penile curvature due to Peyronie's disease or congenital curvature underwent a modified Nesbit's procedure for coital difficulties. This represented approximately 23% of the total number of patients referred to the male sexual dysfunction clinic with penile deformity. A confidential postal questionnaire was sent to all of the operated patients in order to determine the longterm results of surgery. Seventy-eight of the 83 patients were contacted, aged 16-71 years (mean = 48 years). Sixty-two of the 78 (79%) were satisfied with the result of surgery and would be prepared to have the operation again. Twenty-two of the 78 were not having intercourse. As a result of this survey we have identified a group of people with initial satisfactory results who have since developed erectile failure. These have been offered either self injection therapy with a vasoactive agent or penile prostheses if they do not respond or do not wish to self inject.

Adolescent↗