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Biomedical subjects

P J Puchner

Publications and source records attributed to P J Puchner.

9 recordsLinked to original sources
PubMed1987

Prognostic variables in patients with transitional cell carcinoma of the renal pelvis and proximal ureter.

Recent technological advances in urological endoscopic surgery of the renal pelvis and proximal ureter via ureteroscopy or percutaneous nephroscopy have made it possible to consider parenchymal-sparing procedures in patients with transitional cell carcinoma. To define the role of these procedures in the management of renal pelvic or proximal ureteral transitional cell carcinoma we analyzed retrospectively 31 patients who underwent nephroureterectomy for transitional cell carcinoma of the renal pelvis and/or proximal ureter. High grade upper urinary tract transitional cell carcinoma and a history of metachronous or synchronous bladder transitional cell carcinoma were independent adverse prognostic factors. However, patients with low grade upper urinary tract transitional cell carcinoma and no evidence of a urothelial field change had a 100 per cent 5-year survival rate. It would appear that parenchymal-sparing endoscopic techniques should be regarded with caution in patients with either high grade transitional cell carcinoma of the renal pelvis and proximal ureter or a history of bladder cancer.

Adolescent↗
PubMed1979

Delayed development of the scrotum in exstrophy.

Early attempts at orchiopexy should be avoided in children with exstrophy, since the testes will often descend spontaneously by puberty. In many cases the scrotum will grow much larger and will become pendulous by puberty. In a patient with a rudimentary scrotum orchiopexy will only result in fixing the testes in an abnormally high position owing to the lack of a sac into which to place them. If the scrotum develops later the testicles will probably be unable to descend further. Scrotal skin should not be used for urethroplasty operations in children with exstrophy and special techniques should be applied if it is necessary to repair hernias in these patients. In the child with partially descended testes but with only a small patch of wrinkled scrotum efforts may be undertaken to increase scrotal size by topical hormone treatment (or by injections) before the onset of puberty to help fertility and emotional development.

Adult↗
PubMed1978

Pregnancy in women with bladder exstrophy.

Little is known about pregnancies in women with bladder exstrophy. Of 28 women with bladder exstrophy who were evaluated 7 became pregnant and 5 delivered successfully. Problems seen during pregnancy, the long-term effects and the need for early, informed counseling by the urologist are discussed.

Adolescent↗
PubMed1978

Long-term followup after exstrophy closure: late improvement and good quality of life.

Now that we have observed the growth and development of 17 of our anatomically reconstructed exstrophy patients through 20 or more years of followup, we are convinced that reconstruction should be the preferred primary treatment. Most of these patients are healthy, attractive, well educated adults and have achieved emotional maturity and stability, despite their many problems. Anatomical reconstruction also has considerable advantages over other current treatments for exstrophy that were not apparent initially.

Bladder Exstrophy↗
PubMed1975

Urologic problems associated with imperforate anus.

A total of 120 children with both high, intermediate, and low types of imperforate anus were evaluated urologically. Genitourinary anomalies were associated with all types of imperforate anus but were found more often in children with high rectal deformities. Because the over-all incidence of genitourinary anomalies was high, early and complete urologic evaluation is necessary to achieve the best functional result.

Adolescent↗