Biomedical subjects
Publications and source records attributed to M R Butler.
We report a 5 1/2-year-old boy with preperitoneal ectopic testes. This condition has been reported only once before. Both testes were attached to the umbilicus and at operation were successfully placed in the scrotum.
We report on 4 men attending our infertility clinic in whom seminomas developed. A review of testicular biopsies performed for investigation of subfertility in 2 patients revealed in situ and early invasive carcinoma. Infertile men have a prevalence of carcinoma in situ in the range of 1 per 100 to 200, with a high risk of progression to invasive germ cell tumor (50 per cent within 5 years of diagnosis). Biopsy is the only method of detection of the in situ lesion and, therefore, is recommended in the investigation of oligospermic and azoospermic male subjects. The surgical approach to and diagnostic sensitivity of testicular biopsy are reviewed, and the management of carcinoma in situ is discussed.
In an 11-year period, 49 patients developed bladder neck contracture after prostatectomy--an incidence of 0.86%. This complication was found to be more common after resection of small fibrous hyperplastic prostates. The best results for treatment of the contracture were obtained after bladder neck incision, which gave a 9% incidence of recurrence; after transurethral resection of the bladder neck contracture the recurrence rate was 46%, and after bladder neck dilatation it rose to 100%.
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Much interest has been expressed in flexible cystourethroscopy, which has obvious potential advantages. In this study it was compared to rigid endoscopy in 25 patients. It was found to be a painless procedure, but not as accurate in diagnosing vesical lesions as the rigid endoscope.
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The results of serial urodynamic studies in spinal cord injury are presented. A number of signs which may be useful in the prediction of patients who will eventually establish spontaneous and satisfactory voiding are described. (1) Some patients with cervical high/thoracic lesions show evidence of synchrony between the external sphincter and the detrusor muscle in the phase of spinal shock. Spontaneous and efficient voiding usually occurs in this group. (2) Some patients, especially those with mild-thoracic lesions show marked dyschrony between the external sphincter/detrusor muscle in the phase of spinal shock. Early outlet surgery is indicated in this group since spontaneous and efficient voiding rarely occurs. (3) A zone of high pressure can be detected in the posterior urethra in the phase of spinal shock often within the first week after injury.
The intravenous urograms of 894 patients with acute retention were assessed. The total number of lesions demonstrated was less than 1 per cent; consequently the value of routine intravenous urograms in patients with acute urinary retention is questioned.
Two groups of aphasics were administered an auditory comprehension task under conditions of 0-, 5-, and 10-sec. imposed delay of response. The auditory-visual group received auditory and visual cues; the auditory group received only auditory cues. Comprehension for the auditory-visual group was significantly better than for the auditory group. Increase in delay time significantly improved comprehension for the auditory-visual group but not for the auditory group.
Over a ten-year period, 129 patients with idiopathic pelviureteric obstruction were randomly selected for splinted or unsplinted pyeloplasties. Of these groups, the patients with splinted pyeloplasties had a lower incidence of postoperative complications. The long-term results were similar in both groups.
Relapse occurred in 53 cases out of 838 consecutive cases of genito-urinary tuberculosis, followed for periods of 11 months to 27 years. Initial and recurrent disease is classified, and the treatment given is described. Length of inactivity is estimated, and correlated with the type of therapy given. Sensitivity of the organisms to chemotherapy is stated. Conclusions suggest that a life-long follow-up, at yearly intervals, of patients with genito-urinary tuberculosis is justified, as recurrences are diagnosed early, destructive changes are than unlikely, further surgery may be avoided, and a repeat course of chemotherapy is usually curative.
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