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R D Oates

Publications and source records attributed to R D Oates.

30 records · Page 2Linked to original sources
PubMed1993

Unilateral absence of the scrotal vas deferens associated with contralateral mesonephric duct anomalies resulting in infertility: laboratory, physical and radiographic findings, and therapeutic alternatives.

Ten patients who presented for infertility had unilateral absence of the scrotal vas deferens and a contralateral mesonephric duct anomaly, including contralateral ejaculatory duct or epididymal/vasal obstruction. The details of the physical examination, semen analysis and transrectal ultrasound led to an accurate preoperative diagnosis in each case. Therapeutic manipulations appropriate in this group included transurethral resection of the ejaculatory duct, microscopic vasoepididymostomy and microsurgical sperm aspiration coupled with in vitro fertilization. Only 3 patients had ipsilateral renal agenesis or ectopia (30%), which is well below the stated percentage for patients with unilateral vasal agenesis (90%). An aberration in the proper sequence of mesonephric embryological development may partly explain this bilateral constellation of abnormalities.

Adult↗
PubMed1992

Congenital bilateral absence of the vas deferens. A primarily genital form of cystic fibrosis.

OBJECTIVE: Almost all males with cystic fibrosis (CF) have absent vasa deferentia. It has been suggested that otherwise healthy males with congenital bilateral absence of the vas deferens (CBAVD), previously considered a distinct genetic entity, have an increased frequency of CF gene mutations. This study examined the genetic commonality of these two disorders. DESIGN: We typed six common CF gene mutations in 25 patients with CBAVD. Additional rare mutations were sought using single-stranded conformation polymorphisms and direct DNA sequencing. When rare mutations were found, they were sought in a large sample of both CF patients and obligate CF carriers to exclude them as polymorphisms. SETTING: All the patients presented to a male infertility clinic of a teaching hospital. SUBJECTS: Twenty-five unselected, unrelated azoospermic men with CBAVD, most of them of Northern European ancestry. RESULTS: Sixteen (64%) of the 25 men with CBAVD had at least one detectable CF mutation, 16 times the expected frequency (P less than .001). Moreover, we have thus far determined that three of these 16 men are compound heterozygotes, one of whom has a mutation not previously described. Analyses continue on patients who have yet to yield a detectable mutation. CONCLUSIONS: Some, if not all, otherwise healthy men with CBAVD reflect a newly recognized, primarily genital, phenotype of CF. Prior to sperm aspiration to remedy infertility, CF mutation analysis should be recommended for them and their partners, as well as for their relatives.

Adult↗
PubMed1992

Microscopic epididymal sperm aspiration (MESA): a new option for treatment of the obstructive azoospermia associated with cystic fibrosis.

Cystic fibrosis is a life-threatening disease. Only recently has the prognosis improved. In the male patient there is an almost invariable absence or maldevelopment of the vas deferens, creating a situation of obstructive azoospermia. Consequently, their fertility potential has been considered nonexistent. Having gained experience in microscopic epididymal sperm aspiration coupled with the advanced reproductive technologies for the treatment of congenital absence of the vasa, we sought to extend this treatment option to the male cystic fibrosis population. An Indian male with clinically evident and genetically confirmed cystic fibrosis underwent microscopic retrieval of epididymal sperm. The anatomy of the epididymis and the quality of sperm obtained were similar to those patients with congenital absence of the vas deferens. After appropriate spousal genetic testing, superovulation, and transvaginal oocyte retrieval, in vitro insemination of sperm was performed. Fifty percent of the oocytes were subjected to partial zona dissection and a single embryo resulted. Subsequent to transfer, no conception was realized but the effort expanded the clinical usefulness of microscopic epididymal sperm aspiration. This should open up an avenue of treatment for couples in whom only the most dire predictions for fertility have been made to date.

Adult↗
PubMed1992

Use of a polytetrafluoroethylene tube graft as a circumferential neotunica during placement of a penile prosthesis.

Various techniques have evolved for augmentation of the tunica albuginea in cases when tunical tissue has been found deficient during penile prosthesis implantation. An intraoperative situation occurred in which the size of the tunical defect did not permit primary tunical closure or allow for approximation by placement of a tunical patch graft. In this case, to ensure satisfactory insertion of a penile prosthesis a polytetrafluoroethylene (Gore-Tex) tube graft was used as a circumferential neotunica.

Adult↗
PubMed1992

Male infertility: role of transrectal US in diagnosis and management.

Ultrasound (US) has become crucial in the assessment of infertility of couples, in 50% of whom the male partner is responsible. Male infertility is caused by many diverse conditions, from reparable obstructive disorders to noncorrectable intrinsic testicular failure. During the past 4 years, a select group of 70 young infertile men with azoospermia or oligospermia and low ejaculate volume were examined with transrectal US. Twenty-six patients had congenital bilateral absence of the vas deferens, 11 had congenital unilateral absence of the vas deferens and contralateral obstructive pathology, 15 had additional abnormalities thought to be directly related to semen deficiencies, and 18 patients with other causes for semen deficiency and infertility had findings that were either normal or showed minor abnormalities. The delineation of congenital and obstructive abnormalities of the distal urogenital tract with transrectal US enables an accurate diagnosis of certain cases of male infertility and helps guide appropriate clinical and surgical management.

Adult↗
PubMed1991

Disturbed sexual function in patients with spinal cord disease.

The normal neural pathways involved in erection and ejaculation and the various spinal cord and central nervous system disorders that can adversely affect these functions are reviewed in this article. Also outlined are treatment strategies currently being employed.

Female↗
PubMed1989

Expanded role for fine needle aspiration of the prostate. A study of 335 specimens.

In 279 patients, 335 cytologic samples were obtained from the prostate and correlated with histology obtained by core needle biopsy in 189 cases. Approximately 6% of the cytologic specimens were inadequate for diagnosis. The unconfirmed positive rate for malignancy was 1.6%, the false-negative rate was 27.9%, and the accuracy rate was 89.6%. Granulomatous inflammation was diagnosed in 19 cases, and three cases of tumors other than acinar carcinoma of the prostate were encountered. Based on our experience, cytologic criteria for the diagnosis of prostatic adenocarcinoma are described.

Adenocarcinoma↗
PubMed1988

Granulomatous prostatitis following bacillus Calmette-Guerin immunotherapy of bladder cancer.

Granulomatous prostatitis is a recognized complication of intravesical bacillus Calmette-Guerin immunotherapy of superficial bladder cancer. Of 32 patients receiving such therapy 13 underwent prostatic core biopsy and/or fine needle aspiration for clinical indications. Prostatic induration or nodularity developed in 12 patients and 1 underwent biopsy for staging of known prostatic carcinoma. Granulomatous prostatitis was found in 100 per cent of those patients who underwent biopsy or aspiration, indicating that the incidence of this finding is at least 41 per cent following bacillus Calmette-Guerin immunotherapy. Acid-fast bacilli were demonstrated within the prostate of 3 patients with granulomatous prostatitis. The mean interval between the initiation of therapy and diagnosis of granulomatous prostatitis was 11.5 months. Bacillus Calmette-Guerin related granulomas of the prostate may be differentiated histologically from nonspecific granulomatous prostatitis, allergic prostatitis and postoperative granulomas. The clinical implications of these findings are discussed.

BCG Vaccine↗