PubMed HealthSearch

Biomedical subjects

S B Morris

Publications and source records attributed to S B Morris.

14 recordsLinked to original sources

Superficial bladder cancer: for how long should a tumour-free patient have check cystoscopies?

OBJECTIVE: To determine the probability of a patient with superficial bladder cancer developing a recurrent tumour after having remained tumour free for 2 or more years. PATIENTS AND METHODS: One-hundred and seventy-nine patients with Ta or T1 tumours at diagnosis, a minimum follow-up of 3 years and a minimum of 2 years remaining tumour free were identified. Thirteen patients had more than one episode that was eligible for inclusion and there were therefore 192 tumour-free episodes for analysis. Survival curves of the probability of being recurrence-free against time were constructed for the whole group, for subgroups of Ta and T1 tumours and for subgroups with characteristics at diagnosis suggesting a good, intermediate and poor prognosis. RESULTS: The probability of a patient developing a recurrence after 2, 5 and 10 years of being tumour free was 43, 22 and 2% respectively. No patient had a recurrence after remaining tumour free for 12 years. No patient who had been tumour free for at least 2 years progressed to muscle invasion or metastases. There was no significant difference in the probability of recurrence between Ta and T1 tumours after 2 years of remaining tumour free. CONCLUSION: The optimum length of cystoscopic follow-up for patients with superficial bladder cancer is unknown, but patients continue to develop recurrences even after many years of being tumour free. If a patient is to discontinue cystoscopic follow-up, then alternative methods of assessment should be applied.

Adult

Shared care for benign prostatic hyperplasia: a feasibility study.

OBJECTIVE: To determine the proportion of patients with symptoms of urinary outflow obstruction secondary to benign prostatic hyperplasia (BPH) who could be managed in the community after assessment in a shared-care clinic (managed by nursing staff, supervised by a consultant) to which they had direct access. PATIENTS AND METHODS: A total of 127 men were referred to one consultant urologist in a 9-month period for assessment of possible urinary outflow obstruction. All were investigated using urine analysis, serum prostate-specific antigen level, urea and electrolytes, plain abdominal X-ray, renal ultrasonography and urinary flow rate. Additional investigations were undertaken as required. The proportion of men who could have been investigated in a shared-care clinic and then managed in the community was determined. RESULTS: Of 127 men, 88 (69%) were found to have uncomplicated outflow obstruction secondary to BPH; of these 49 (38%) could have been managed in the community after assessment in the shared-care clinic and a further 27 (21%) could have been managed in the community after additional investigation by a specialist. Twelve men (9%) were found to have uncomplicated outflow obstruction and chose to undergo transurethral resection of the prostate. CONCLUSION: Many men with uncomplicated outflow obstruction could be assessed in a shared-care clinic and then managed in the community. A shared-care protocol for the management of these men has now been introduced in this unit.

Adult

Rapid processing in the management of prostatic cancer.

OBJECTIVE: To carry out rapid histological processing of prostatic biopsies for the management of patients who present with urinary retention or other urological problems, or with a suspected diagnosis of prostatic cancer. PATIENTS AND METHODS: Biopsies were taken from each of 26 patients who presented with urinary retention or other urological problems, or with a suspected diagnosis of prostatic cancer. The biopsies were processed in a Shandon Hypercenter using a 3-hour programme and were stained on a Shandon Linistainer automatic staining machine. The slides were reviewed both immediately and at weekly histopathology audit meetings. RESULTS: Results were available within 4 h of receipt of the specimen in the laboratory. One false negative, due to a sampling error at the time of biopsy, was identified. CONCLUSION: We believe that this facility is of benefit to both surgeon and patient and should be more widely available.

Biopsy, Needle

Case report: ureteric obstruction secondary to contralateral hydronephrosis.

Giant hydronephrosis is a rare condition, defined in the adult as a kidney containing more than 1 l of fluid. It is usually secondary to pelvi-ureteric junction obstruction. We describe a case where giant hydronephrosis caused contralateral ureteric obstruction. The radiological findings are described and the literature is reviewed.

Adult

Superficial bladder cancer: timing of check cystoscopies in the first year.

We report a prospective study of 141 patients presenting for the first time with a small, solitary, non-invasive, moderately or well differentiated transitional cell carcinoma of the bladder. The pattern of recurrence in the first year was assessed and recurrence rates calculated; 80% of patients without recurrence at 3 months remained clear in the first year. There was a highly significant reduction in recurrence rates for those free of recurrence at 3 months. It has been suggested that this group should have the second check cystoscopy at 1 year and yearly cystoscopies thereafter. Our findings support that proposal.

Adult

Prostatic sarcoidosis. Review of genitourinary sarcoidosis.

Sarcoidosis is seen by the urologist only rarely but it may present a diagnostic and therapeutic dilemma. We describe a rare case of prostatic sarcoidosis. The literature relating to sarcoidosis throughout the genitourinary system is reviewed.

Adult

The distribution of physician extenders.

As part of the Medicare Physician Extender Reimbursement Study, a mail survey was conducted of 5,572 physician extenders (PEs) to identify potential study participants. Analysis of survey results indicates that PEs are distributed disproportionately more often than physicians to primary care practices and to rural low income areas. However, there are substantial differences among types of PEs with regard to practice location and practice arrangement. The relationship between these findings and the distribution of other medical manpower and innovations is then discussed.

Nurse Practitioners