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Biomedical subjects

N L Constantinople

Publications and source records attributed to N L Constantinople.

8 recordsLinked to original sources
PubMed1996

Incidence of inguinal hernias following radical retropubic prostatectomy.

OBJECTIVES: During the last decade, the number of patients undergoing radical retropubic prostatectomy (RRP) has substantially increased. Over this same time period, we have noted that a significant number of these patients have developed postoperative inguinal hernias. We sought to identify the incidence of postoperative inguinal hernias after RRP and compared this with the stated 5% incidence in the general adult male population. METHODS: Ninety-two consecutive RRPs performed by three surgeons (I.J.S., N.L.C., S.W.D.) were retrospectively reviewed. The operative reports for each patient who subsequently underwent inguinal herniorrhaphy were analyzed to determine whether the hernias were direct or indirect. RESULTS: The overall incidence of postoperative inguinal hernias was 12% (11 of 92). All hernias were found within approximately 6 months of the prostatectomy. Ninety-one percent (10 of 11) of these hernias were indirect, and only 9% (1 of 11) were direct. CONCLUSIONS: We believe this to be the first report in the English literature describing postoperative inguinal hernias following retropubic prostatectomy. A significantly higher incidence (12%) of inguinal hernias was noted in the postprostatectomy population compared with the general adult male population (5%). This finding suggests that inguinal hernias can be a consequence of RRP. Urologists should be cognizant of this possibility in order to screen all patients carefully prior to surgery for subtle weakness in the inguinal canal, as well as to inform patients properly of the possibility of developing an inguinal hernia after surgery.

Hernia, Inguinal↗
PubMed1988

Cytologic diagnosis of prostatic carcinoma by fine-needle aspiration biopsy. Community hospital experience.

Transrectal fine-needle aspiration and transrectal or perineal core biopsies were simultaneously performed on 31 patients with suspected prostatic cancer over an eighteen-month period. Of the 29 aspirations that were adequate for cytologic diagnosis, there was histologic correlation in 24 (83%). The sensitivity of aspiration for the diagnosis for prostatic cancer was 92 per cent (11 of 12) compared with 85 per cent (11 of 13) for the core biopsy method. There were no apparent false negative or false positive diagnoses with the aspiration biopsy technique. Insufficient material was obtained by aspiration in 2 cases. A febrile urinary tract infection occurred in 1 patient after transrectal aspiration and core biopsy. Our results suggest that fine-needle aspiration may be utilized by the practicing urologist in conjunction with a pathologist trained in the interpretation of fine-needle aspirates as a safe, relatively inexpensive, and sensitive diagnostic procedure for suspected prostatic cancer.

Biopsy, Needle↗
PubMed1984

Urologic disorders after forty.

New trends have emerged in the management of urologic disorders that commonly present after 40. Surgical treatment of stone disease has largely been replaced by reliable nonoperative methods. Advances have been made in the design of penile prostheses. New concepts of the natural history of urinary tract infection and incontinence have made diagnosis and treatment more effective and less costly. Lack of progress in treating disseminated urologic cancer has reinforced the urgency of prompt diagnosis and treatment.

Age Factors↗
PubMed1983

Renal cell carcinoma extending into vena cava and right atrium.

We report on a patient who underwent complete removal of a renal cell carcinoma extending into the vena cava and the right atrium. A review of the literature confirms the rarity of vena caval obstructive symptoms. Emphasis is on preoperative diagnosis, thoracoabdominal exposure, and team approach. Survival rates warrant aggressive surgical treatment in these patients.

Adenocarcinoma↗
PubMed1981

Pyelocaliceal diverticulum presenting as a disappearing renal mass.

We report a rare case of a disappearing cystic mass of the kidney. Pyelocaliceal diverticulum has to be considered in the differential diagnosis of patients with pyelonephritis and a space-occupying lesion of the kidney. Initial conservative therapy with antibiotics helps to determine the definitive diagnosis. Surgical management is recommended to prevent sequelae of pain and infection.

Adult↗
PubMed1979

Operative versus non-operative management of patients with staghorn calculi and neurogenic bladder.

During the last 5 years 22 patients have been treated at our hospital for staghorn calculi and neurogenic bladder. In 17 patients an operation was done soon after discovery of the calculi, while 5 patients were followed non-operatively. The latter 5 patients had a rapid downhill course marked by sepsis and renal function deterioration and an operation was necessary in 4 of the 5 cases. Injudicious non-operative therapy only prolongs the relentless effects of staghorn calculi in patients with spinal cord pathology.

Adult↗
PubMed1977

Detrusor-urethral sphincter dyssynergia.

Inappropriate contraction or failure of relaxation of either the internal (smooth muscle) or external (striated muscle) urethral sphincter or both coincident with detrusor contraction results in a micturitional disorder known as detrusor-urethral sphincter dyssynergia. Based on our clinical experience with more than 200 spinal cord subjects and serial urodynamic observations on some of these individuals from the time of injury, various grades of dyssynergia (1 to 3) were recognized. The duration and completeness of suprasacral cord injury essentially determined the degree of dyssynergia. Internal sphincter dyssynergia was encountered less often in this group. A review in relation to pathophysiology and management of this micturitional dysfunction is presented.

Adolescent↗