Biomedical subjects

T J Kinahan

Publications and source records attributed to T J Kinahan.

8 recordsLinked to original sources

PubMed1994

A modified extravesical technique for megaureter repair.

OBJECTIVE: To report on the use of extravesical detrusorraphy for megaureter repair. PATIENTS AND METHODS: Twenty-three children underwent an extravesical megaureter repair over a 25 month period. There were 17 boys and 6 girls with an average age of 4.4 years. Three children had bilateral megaureters for a total of 26 repairs. Ureters were defined as megaureters if the ureteric diameter exceeded 1.0 cm on pre-operative imaging. There were 14 obstructing and 12 refluxing ureters. Three of the refluxing ureters were tapered while five of the obstructing megaureters were tapered. RESULTS: Twenty-one of the 23 patients were successfully repaired using this method. Complications were minimal. CONCLUSION: The extravesical approach can be used to correct reflux or obstruction in dilated ureters with efficacy equivalent to transvesical repairs.

Adolescent↗

PubMed1992

The efficiency of bladder emptying in the prune belly syndrome.

From 1956 to 1991, 49 cases of the prune belly syndrome were seen at our institution. Voiding information and/or 1 or more urodynamic studies were available in 30 male and 4 female patients. Analysis of multiple urodynamic studies during long-term followup periods ranging from 6 months to 19 years, with particular regard to any reconstructive procedures performed, revealed that voiding in the prune belly syndrome is variable, with 44% of the patients achieving spontaneous voiding and 56% requiring clean intermittent catheterization. The ability to void or need for clean intermittent catheterization was by no means permanent, indicating the need for meticulous followup. The 3 distinct voiding patterns observed included an approximately normal pattern, prolonged voiding with a low peak and an intermittent pattern. These 3 voiding patterns did not correlate with residual volumes. Comparison of urodynamic voiding parameters between reconstructed voiding patients and nonreconstructed voiding patients did not show significant differences.

Adolescent↗

PubMed1992

Omeprazole in post-gastrocystoplasty metabolic alkalosis and aciduria.

The use of segments of stomach for bladder augmentation is gaining popularity in pediatric urology due to favorable muscular and secretory properties. However, in a renal failure patient who underwent gastrocystoplasty a high level of acid production within the bladder associated with persistent hypergastrinemia was noted leading to severe systemic metabolic alkalosis. This condition was unresponsive to standard acid-inhibiting or neutralizing therapies but it was treated successfully with omeprazole, a proton-pump inhibitor recently introduced for treatment of peptic ulcer disease.

Alkalosis↗

PubMed1992

Major vessel excision in retroperitoneal lymph node dissection.

Retroperitoneal malignant tumours, both primary and metastatic, may involve surrounding structures such as the aorta and vena cava, making complete tumour excision difficult. En bloc resection of major blood vessels should be considered in such cases. The authors describe three patients who underwent excision of major blood vessels with retroperitoneal lymph node dissection. Two patients had aortic resection with placement of a Dacron tube graft, and one had excision of the vena cava from above the renal vessels to the level of the common iliac veins with distal venous ligation. The low complication rate confirms the feasibility of excising major blood vessels to accomplish complete retroperitoneal lymphadenectomy.

Adolescent↗

PubMed1992

Tisseel in hypospadias repair.

Tisseel (Immuno AG, Vienna, Austria), a fibrin sealant, adhesive and hemostatic agent made up of sterilized human and bovine components, was used in hypospadias repairs. The incidence of fistula and significant edema and the duration of hospitalization were all reduced in 30 patients who underwent modified Mustardé repairs in which Tisseel was used when compared with a matched group of 30 repairs without Tisseel. In addition, the rate of complications in fistula repairs and complex revisions was reduced when Tisseel was used on urethral suture lines and under all skin flaps.

Edema↗

PubMed1991

Transurethral resection of prostatic abscess under sonographic guidance.

Transrectal ultrasound may establish the diagnosis of prostatic abscess in an ambiguous clinical setting. Transurethral resection (deroofing) is the treatment preferred by many clinicians, yet intraoperative complete abscess obliteration may be difficult to confirm endoscopically. We report on a patient with a complex prostatic abscess endoscopically resected under transrectal ultrasound guidance. Adequacy of treatment was proved pathologically.

Abscess↗

PubMed1991

Radical prostatectomy for localized prostatic carcinoma in the renal transplant patient.

Three renal transplant patients had prostatic carcinoma after transurethral prostatectomy at 2 weeks, 2 months and 12 years following transplantation. One patient had stage A1 disease, while 2 had stage A2 prostatic carcinoma. All patients underwent radical retropubic prostatectomy and pelvic lymph node dissection. All patients had residual cancer in the radical prostatectomy specimen but none had nodal or capsular involvement. The surgical technique and rationale for management are discussed.

Carcinoma↗

PubMed1990

Transurethral resection of the prostate in the outpatient setting.

Transurethral resection of the bladder neck (8 patients) or prostate (142) was performed in the outpatient setting. Of the patients 5 required hospitalization for post-prostatectomy hemorrhage. This method has proved to be safe and cost-effective in the treatment of patients with outlet obstruction.

Adenocarcinoma↗