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S M Upsdell

Publications and source records attributed to S M Upsdell.

13 recordsLinked to original sources
PubMed1998

An unusual foreign body in the bladder 7 years after a Stamey endoscopic bladder neck suspension.

Delayed migration of the suture and bolster after an endoscopic bladder neck suspension across tissue planes, with subsequent erosion into the bladder, is uncommon. We present a case of late migration of the suture and bolster occurring 7 years after a Stamey endoscopic bladder neck suspension. A 56-year-old woman had undergone a Stamey procedure in June 1990. In January 1997 she presented with discomfort in the left iliac fossa and the groin. A midstream sample of urine showed microscopic hematuria. Imaging and endoscopic examinations revealed a calcified lesion on the left lateral wall of the bladder, attached to the Stamey sutures. Cystolitholapaxy was attempted, but during the procedure it became obvious that there was a calcified cuff attached to the suture. This was removed endoscopically, along with its suture. Cystoscopy should be considered early in the evaluation of patients presenting with lower abdominal discomfort or irritative voiding symptoms after retropubic bladder neck suspension.

Endoscopy↗
PubMed1994

The radionuclide assessment of pre-natally diagnosed hydronephrosis.

OBJECTIVE: To determine if a pre-operative non-invasive radionuclide study can predict the results of surgery in infants with pre-natally diagnosed hydronephrosis. PATIENTS AND METHODS: Eight male infants with prenatally diagnosed hydronephrosis were treated by pyeloplasty within the first 4 months of life. All infants underwent a pre-operative diuresis renogram and a dimercapto-succinic acid (DMSA) scan, followed by a further renogram 6 months after surgery to assess renal function and drainage. RESULTS: There was a significant difference between the results of the relative renal function estimates obtained by the pre-operative renogram and the pre-operative DMSA scan (P = 0.001). In all patients the recovery in renal function following surgery was accurately predicted by the pre-operative DMSA scan. CONCLUSION: The results of this preliminary study suggest that a pre-operative DMSA scan could replace the use of invasive nephrostomy drainage to assess the potential for recovery in the poorly functioning neonatal kidney and give an indication of those kidneys most likely to benefit from reconstructive surgery.

Humans↗
PubMed1992

The importance of renal function in the interpretation of diuresis renography.

Interpretation of the diuresis renogram is dependent on a full understanding of the factors that contribute to the washout curve, a major determinant being the urinary flow rate induced by the diuretic. Frusemide-induced flow rates were measured in 86 patients over a 30-min period and related to creatinine clearance in 39, 99mTc-DTPA clearance (glomerular filtration rate (GFR)) in 27, and 123I-Hippuran clearance (effective renal plasma flow) in 20. The flow rates 3 to 6 min and 15 to 18 min after administration of the diuretic received specific attention because of their importance to F + 20 and F - 15 diuresis renography respectively. The mean urinary flow rate 15 to 18 min after frusemide was 3.5 ml/min greater than at 3 to 6 min (P less than 0.001), explaining the value of the F - 15 renogram in further evaluating equivocal F + 20 curves. Linear relationships were observed between each parameter of function and the 3 to 6 min and 15 to 18 min periods as follows: creatinine clearance r = 0.66, r = 0.77; 99mTc-DTPA clearance r = 0.66, r = 0.77; 123I-Hippuran clearance r = 0.59, r = 0.71. From regression analysis of the data presented it is possible, with knowledge of total and split function, to predict single-kidney flow rates. It is demonstrated that these may commonly exceed flow rates used for perfusion studies if function is normal, but a single-kidney flow rate of 10 ml/min is unlikely to be attained if the single-kidney GFR is less than 15 ml/min.

Adult↗
PubMed1992

The F-15 diuresis renogram in suspected obstruction of the upper urinary tract.

The results are presented of the first long-term follow-up study of patients with suspected obstruction of the upper urinary tract investigated by a modified form of diuresis renography (F - 15 renography). The incidence of equivocal results from diuresis renography is significantly reduced by the use of the F - 15 renogram. F - 15 renography provides a reliable assessment of the upper urinary tract in patients with suspected obstruction and is recommended in the investigation of equivocal upper urinary tract dilatation.

Adult↗
PubMed1988

Diuretic-induced urinary flow rates at varying clearances and their relevance to the performance and interpretation of diuresis renography.

Minute-by-minute urinary flow rates before and after the intravenous injection of 40 mg frusemide were investigated in 29 well hydrated adult patients with varying creatinine clearances. Total urinary flow rates 3 to 6 min after frusemide ranged from 1 to 42 ml/min (mean 19). At 15 to 18 min after the diuretic, flow rates ranged from 8 to 46 ml/min (mean 23). Flow rates were proportional to creatinine clearance (r = 0.73; r = 0.8) and decreased with falling clearance, although significant diuresis (4 ml/min/kidney) was achieved down to single kidney clearances of 10 ml/min. Where single kidney clearances were less than 31 ml/min, single kidney flow rates of 10 ml/min or more were not guaranteed. Below this clearance, diuresis renography remains completely reliable and unequivocal in the majority of cases. However, perfusion pressure flow studies will not necessarily be urodynamically comparable and it should not be expected that the results of the two tests will agree in individual cases of upper tract dilatation. Recommended timing for frusemide administration should be 20 min into the test, or 15 min before radiopharmaceutical injection.

Aged↗
PubMed1985

The erect abdominal radiograph in the acute abdomen: should its routine use be abandoned?

The value of erect and supine abdominal radiographs and erect chest radiographs was analysed prospectively in 102 consecutive patients admitted to hospital with acute abdominal symptoms. The radiographs were reported on initially by junior surgeons of the admitting team, special note being made of the value of the erect abdominal radiograph over the combination of the supine abdominal radiograph and erect chest radiograph. On the basis of information obtained from the erect abdominal radiograph alone no changes in patient management were recorded. A consultant radiologist reported on the same radiographs at a later date. In five cases the erect abdominal radiograph was thought to have contributed useful or additional information, although in four of these cases abnormal features were visible in the supine film. In three of the five cases important but subtle information was missed by junior surgeons. In five of the 102 patients information obtained from the erect abdominal radiograph was potentially misleading. The small yield of positive information, potentially misleading features, and lack of effect on surgical management suggest that the routine use of the erect abdominal radiograph in the acute abdomen should be abandoned.

Abdomen, Acute↗
PubMedDate not supplied

Urological myths.

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Chronic Disease↗