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Biomedical subjects

P H Abrams

Publications and source records attributed to P H Abrams.

16 recordsLinked to original sources
PubMed1979

The results of prostatectomy: a symptomatic and urodynamic analysis of 152 patients.

There were 152 patients with prostatism investigated by inflow cystometry and pressure flow analysis of micturition before and after elective prostatectomy. Many symptoms attributed to obstruction were found to be owing to bladder instability, which was demonstrated in 60 per cent of the patients. The symptomatic improvement postoperatively was accompanied by a decrease in the incidence of instability to 25 per cent. The repeat urodynamic studies and symptom analysis demonstrated a surgical success rate of 88 per cent.

Aged↗
PubMed1979

The assessment of prostatic obstruction from urodynamic measurements and from residual urine.

One hundred and seventeen males over the age of 55 were investigated for possible prostatic obstruction. About half of the cases in this series could have been objectively classified as unobstructed or obstructed from the maximum flow rate alone. In about two-thirds of the cases obstruction could be satisfactorily assessed from the maximum flow rate together with the detrusor pressure at maximum flow. It was not helpful to combine these 2 measurements into a single urethral resistance factor. In the remaining one-third of the cases, obstruction could be objectively assessed only from a plot of detrusor pressure against flow rate throughout micturition. In many of these cases both the pressure and the flow rate were low and the main peculiarity was that the contractile power of the bladder was weak. Residual urine is a sign of an abnormality of bladder function rather than the direct result of urethral obstruction.

Humans↗
PubMed1979

The influence of prostatic anatomy on the differing results of prostatectomy according to the surgical approach.

An anatomical study of cadaver prostates has demonstrated that, in all cases, adenomatous tissue lies inferior to the verumontanum. The proportion of tissue distal to the verumontanum varies from less than 10 to 50%. In a series of 100 patients the post-operative urodynamic studies showed that in the tansurethral resection group the mean urethral length was longer, the flow rate lower and the residual urine higher than in the retropubic prostatectomy group. It is suggested that prostatectomy by the transurethral route is less complete due to residual sub-verumontanal prostatic tissue. However, it is likely that by restricting resection to supra-verumontanal tissue many patients are spared post-operative stress incontinence.

Aged↗
PubMed1979

A double blind trial of bromocryptine in the treatment of idiopathic bladder instability.

Fifty-one patients (aged 20 to 68 years) entered a 6-week double-blind trial of Bromocryptine, a dopamine agonist. All patients complained of the complex: frequency, nocturia, urgency and urge incontinence which was due to demonstrable bladder instability. No significant improvement in either symptoms or cystometric findings was seen in the Bromocryptine treated as compared with the control group. A high incidence of nausea was noted in the treated groups. The results of this study suggest that Bromocryptine does not have a therapeutic role in the treatment of idiopathic bladder instability.

Adult↗
PubMed1979

The synthesis and release of prostaglandins by human urinary bladder muscle in vitro.

Using the technique of bioassay the presence, production, and importance of prostaglandins (PG) in human bladder muscle have been investigated in vitro. Low basal tissue levels of PG were shown. E series PGs were released by isolated bladder muscle strips in organ bath experiments. The spontaneous activity and PG release of these strips could be markedly reduced by the addition of indomethacin. Incubation of bladder muscle with the PG precursor, arachidonic acid, resulted in the synthesis of substantial quantities of PGs.

Arachidonic Acids↗
PubMed1979

Chest disease presenting as an acute abdomen.

Four patients with primary disease in the chest are discussed, each coming to laparotomy. The final postoperative diagnoses were empyema, pulmonary tuberculosis, pulmonary embolism and bacterial endocarditis. These cases well illustrate the real risk of confusing an acute chest condition with an acute abdomen.

Abdomen, Acute↗
PubMed1978

Urodynamic findings in chronic retention of urine and their relevance to results of surgery.

Fifty-five consecutive male patients aged 18-77 with chronic retention of urine were investigated urodynamically. All were shown to have obstructed micturition. Inflow cystometry defined two groups, one with high-pressure and one with low-pressure filling. Recent-onset enuresis and upper-tract dilatation as seen on radiography were significantly associated with high-pressure bladder filling. Postoperative studies showed that patients with high-pressure filling on preoperative cystometryhad a better response to outflow-tract surgery. The poor response of the patients with low-pressure filling was due to a high incidence of inadequate detrusor contraction leading to persistent residual urine. Thus urodynamic studies may be used to indicate which patients are likely to benefit from prostatectomy and, after the operation, whether the obstruction has been relieved.

Adolescent↗
PubMed1978

The late symptomatic and functional results of enterocystoplasty.

A symptomatic and, where possible, urodynamic assessment has been made in 19 patients undergoing enterocystoplasty over a 16-year period. It is suggested that this operation should be considered in those cases of interstitial cystitis and irritable bladder syndrome in which all recognised medical and surgical treatment has failed.

Adolescent↗
PubMed1978

Endoscopic examination in children.

Cystourethroscopy is an uncomfortable and often painful investigation for children. It is distressing to the parents, and even when it is done on a day case basis it can cause considerable disruption to the family. It should therefore only be considered when it is felt that the examination will contribute to the management of the urinary problem in the child, and then only after routine assessment including physical examination, urine culture, renal function studies, excretion urography and, where indicated, micturating cystogram. In a study of 242 children who had cystourethroscopy, it was found to be of only limited value in children with enuresis, incontinence, haematuria, recurrent urinary infection and painful micturition. In some children it provided an opportunity for either indirect (from instrumentation) or formal urethral dilatation and this seemed to be associated with post-operative symptom relief in some children. Endoscopy appeared to be of most value in the management of vesicoureteric reflux, upper tract duplication and specific urethral abnormalities. In these situations the examination provided essential information which was helpful with further management of the children.

Adolescent↗
PubMed1977

Prostatism and prostatectomy: the value of urine flow rate measurement in the preoperative assessment for operation.

Urine flow rates were measured before and after elective prostatic operations in 53 patients. The over-all success rate was 72 per cent, as assessed by the changes in symptoms and urine flow rates. Patients with less than a satisfactory operative result had more frequency and urgency and higher preoperative urine flow rates than patients with good results from the operation. Since bladder conditions unassociated with bladder outflow obstruction may be responsible for the poor results it is recommended that urine flow rates be measured before an elective prostatic operation so that patients unlikely to benefit from an operation may be identified.

Aged↗
PubMed1977

The concept and measurement of bladder work.

The methodology for the calculation of bladder work from pressure volume traces has been described. Bladder work values have been calculated from the urodynamic data of 50 male patients. When bladder work values were related to the micturition time and the volume passed, a highly significant correlation was demonstrated with urethral resistance. Bladder work values may be a useful index in the diagnosis of bladder outflow obstruction.

Humans↗
PubMed1977

A double-blind trial of the effects of candicidin on patients with benign prostatic hypertrophy.

62 patients with benign prostatic hypertrophy, leading to bladder outflow obstruction, took part in a randomised double-blind trial. Those patients in the treatment group took 6 capsules of a polyene macrolide, candicidin, each day (300 mg daily dose). Subjective improvement was noted in both the treated and the control group. This improvement was not confirmed by pressure flow analysis of micturition. The results of this trial do not support the view that candicidin is a useful drug in the treatment of benign prostatic hypertrophy.

Aged↗
PubMed1977

Urethral closure pressure profiles in the male: an analysis of 280 patients.

The shape of the urethral closure pressure profile of 281 male patients has been analysed. 'Prostatic' length, 'prostatic' peak, 'prostatic' plateau height and 'prostatic' plateau area have been measured. Thist study has shown that these parameters have a significant relation to the diagnosis of bladder outflow obstruction made after urodynamic studies.

Adult↗