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Biomedical subjects

W A De Sy

Publications and source records attributed to W A De Sy.

At least 19 recordsLinked to original sources

Colpopromontoriopexy.

This is a review article about the colposacropexy and the colpopromontoriopexy in the treatment of vaginal prolapse. We reviewed the literature through the eyes of a urologist dealing with genuine stress incontinence. The treatment of genuine stress incontinence without sphincterdeficiency consists in the correction of the anterior compartment prolapse. Preoperative it is important to examen the middle and the posterior compartment of the vagina in order to achieve good postoperative results. Most urologists cure genuine stress incontinence with an abdominal approach. The combination of a colposuspension and a colpopromontoriopexy is an operation that corrects anterior, middle and posterior compartment prolapse by the same approach without significant more complications or bloodloss.

Female

Undiversion after previous cystectomy and Bricker derivation.

A 45-year-old man operated in 1989 for bladder cancer by a Bricker diversion was suffering from intractable eczema and stoma problems. A undiversion was unavoidable. A 'Camey type' diversion having been performed, a simple ligation of the membranoprostatic urethra seemed impossible but was in fact surprisingly easy. After introduction of a Béniqué sound, a simple opening in a kind of diaphragm at the proximal end of the ligated urethra made it possible to anastomose the created pouch. The patient remained continent during day- and nighttime.

Cystectomy

[General considerations on and the role of internal urethrotomy in the treatment of urethral stricture].

After stressing the importance of a precise diagnosis, the author defines the place of internal urethrotomy, which is certainly not always the first-line treatment that some would claim, due to its poor success rate and because an endoscopic reoperation is sometimes much less harmless than it appears. The importance of perfect anaesthesia for urethral surgery is then emphasised in view of the particular demands of this surgery. Finally, the author reviews the various approaches to the urethra and opening of the stricture.

Adult

[Urethroplasty using a full-thickness free skin graft].

Full-thickness free skin graft urethroplasty is an excellent technique for the cure of urethral strictures. Based on his experience of 250 cases since 1977, the author describes the indications and limitations related to surrounding tissues and to the graft itself. A rigorous and precise technique, described in detail in this paper, is the key to success.

Humans

[Stricture of the urethral meatus and the navicular fossa].

A review of the literature concerning strictures of the meatus and fossa navicularis reveals that few techniques are entirely satisfactory, apart from major techniques which are difficult to perform. The author describes an easy technique which gave perfectly satisfactory results in the majority of 36 cases, 17 of which have a follow-up of more than 5 years.

Follow-Up Studies

Down-staging prostate cancer. Is it possible by androgen depletion and Mitomycin C therapy?

The study was carried out in order to investigate the possibility of tumor reduction in prostate cancer patients. As a reduction of the primary tumor was observed with hormonal treatment and complete response of soft tissue tumor markers with Mitomycin C, this combined treatment was given in seven patients to evaluate if it was able to down-stage those cases which were thought to be incurable (T3N1-2M0/T4N0-2M0). Although the clinical evaluation suggested a significant down-staging, the explorative lymphadenectomy was unable to confirm this. The proposed treatment is able to reduce the tumor bulk significantly of the primary cancer as well as of its metastases; progression during the treatment was not seen.

Aged

Ureteroneocystostomy in the neuropathic bladder associated with high-grade reflux.

Between 1976 and 1987, a total of 25 ureteroneocystostomies were performed in 17 patients with neuropathic bladder associated with high-grade reflux III-V. An overall success rate of 82.4% is reported. Special complications included postoperative renal deterioration, especially after tapering of megaureters. During follow-up, contralateral reflux was noticed in 44% after unilateral treatment of reflux. Preoperative cystoscopy to define trigone abnormalities is mandatory.

Adolescent

[Hypospadias: lessons from the past and future perspectives].

The author presents a technique for the surgical cure of distal hypospadias. The basic idea is a doubly infolded transversal vascularised skin flap, partially de-epithelialized to allow complete repair of the glans over it. Personal experiment.

Humans

[A study of the causes of staghorn calculi].

A thorough metabolic evaluation of all staghorn stone patients seems justified, considering the results obtained by the study of 27 such cases. Pak's ambulatory screening test, slightly modified, was used. This allowed the finding of a hypercalciuria in more than 50% of the cases, a hyperuricosuria in 63% of the cases and a hyperoxaluria in one case out of five. A metabolic anomaly was not detected in two patients. Although urinary tract infection, present in 75% of the cases is essential to the genesis of a staghorn stone, the question raises whether metabolic anomalies are not the primary cause of the stone formation.

Adolescent

[A transglandular tunnel in the treatment of hypospadias].

A technique and the results of the creation of a transglandular tunnel for the more aesthetic repair of hypospadias is reported. The tunnel is not trocardisized through the glans but really excised. This reduced considerably the risk of stenosis, as this occurred only 9 times in 112 cases. In only three of them a reoperation was necessary. Sensibility of the glans remains normal after the operation while the appearance is a nearly normal.

Humans

Enterocystoplasty after cystoprostatectomy for bladder cancer. Time-saving technical modifications.

Enterocystoplasty, to construct a functional and continent bladder in male patients following cystoprostatectomy, can be simplified and shortened by some modifications. Partial pubectomy will allow a precise and bloodless section of the membranous urethra preserving the external sphincter and a watertight anastomosis with 10 to 12 stitches between the urethra and the intestinal bladder. Use of automatic intestinal suture devices. Passing the ureteral stents through stab wounds in the intestinal wall and out to the skin. An easy method for bringing the urethral catheter in the right horn of the intestinal bladder. These modifications will reduce the operating time to seven hours.

Humans