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Biomedical subjects

Y Siegel

Publications and source records attributed to Y Siegel.

At least 19 recordsLinked to original sources
PubMed2001

Factors affecting tube dwelling time after percutaneous nephrolithotomy.

BACKGROUND AND PURPOSE: Little is known about the impact of nephrostomy tubes on morbidity and quality of life. PATIENTS AND METHODS: The tube dwelling time and the factors influencing it were determined in 165 patients undergoing percutaneous nephrolithotomy (PCNL). RESULTS: The mean tube dwelling time was 21+/-30 days. The duration of tube drainage after PCNL was 13+/-17 days. Most of this time was preoperative when the tube was inserted for urgent reasons--obstruction or sepsis (31+/-33 days). On multivariate analysis, the number of secondary PCNLs and postoperative complications were the most significant factors affecting tube dwelling time. Age correlated with intubation time but did not reach statistical significance (P < 0.09). Neither the stone's side and type nor the patient's sex had a significant influence. CONCLUSIONS: A significant factor affecting the duration of tube drainage is preoperative medical evaluation and patient preparation, and these steps should be completed expeditiously in order to minimize the time to PCNL. Completion of PCNL in one session should shorten the postoperative intubation time.

Adult↗
PubMed2001

The impact of prostate biopsy on patient well-being: a prospective study of voiding impairment.

PURPOSE: We studied the possible association of transrectal ultrasound guided prostate biopsy with voiding impairment. MATERIALS AND METHODS: A total of 211 consecutive patients were prospectively enrolled. International Prostate Symptom Score (I-PSS), subjective voiding complaints and retention were recorded in 3 personal interviews before biopsy, and on postoperative days 7 and 30. RESULTS: Of the 204 patients who voided via the urethra at biopsy 52 (25%) reported subjective voiding impairment on postoperative day 7, including 12% who defined difficult voiding as mild-1 to 2 points on a 0 to 5 scale, 8% as moderate-3/5 and 5% as severe-4 to 5/5. In 5 of the latter cases (2.5%) acute urinary retention necessitated urethral catheter insertion. Transition zone volume, which was 42 ml. or larger in all patients in urinary retention, was the only independent variable associated with patient report of subjective difficult voiding and acute urinary retention during week 1 after biopsy (p = 0.03). Baseline I-PSS greater than 20 points indicated a risk of an acute transient increase in I-PSS on postoperative day 7. CONCLUSIONS: Transient voiding impairment may be precipitated by ultrasound guided prostate biopsy. To decrease this morbidity appropriate evaluation and possible treatment for bladder outlet obstruction are justified in patients with a larger transition zone and in those with preoperative baseline I-PSS greater than 20 points.

Adult↗
PubMed2000

[Gastrointestinal hemorrhage of obscure origin].

Gastrointestinal bleeding of obscure origin consists of recurrent bouts of acute or chronic bleeding for which no definite source is discovered in routine endoscopic and barium contrast studies of the upper and lower gastrointestinal tracts. Usually its cause is angiodysplasia of the intestine, but many cases are due to tumors, mostly of the small bowel, which may be malignant. In patients under the age of 50, the proportion with malignancy is relatively high (up to 14%) as compared to older patients. We describe a 45-year-old woman who suffered from gastrointestinal bleeding for 3 years. The cause of bleeding was not found despite extensive work-up. In her last admission for acute gastrointestinal hemorrhage she was given a total of 30 units of blood. A tumor of the small intestine found by angiography was excised and found to be a stromal tumor of uncertain malignant potential. 1 year after operation she is asymptomatic without bleeding and her hemoglobin is stable without treatment.

Angiography↗
PubMed1997

A genetic sequence change in the 3'-noncoding region of the androgen receptor gene in prostate carcinoma.

OBJECTIVE: We intended to identify structural changes in the hormone-binding domain and C-terminal region of the androgen receptor (AR) gene in carcinoma of prostate specimens. METHODS: Twelve prostate cancer specimens from prostate resections were analyzed for the presence of mutations in the E-H exons and part of the 3'-untranslated region of the AR cDNA, using RT-PCR and direct sequencing. RESULTS: A polymorphic sequence spanning 17 nucleotides was identified in the 3'-untranslated region of the AR cDNA from one prostate carcinoma tissue, suggesting the presence of a somatic mutation. No mutations were identified in the coding sequence of the hormone-binding domain of the AR cDNA. CONCLUSION: These results suggest that AR mutations are probably uncommon molecular events in the early stages of prostate cancer.

Adenocarcinoma↗
PubMed1992

Variability and circadian changes in home uroflowmetry in patients with benign prostatic hyperplasia compared to normal controls.

We evaluated the variability and circadian changes in consecutive measurements of home uroflowmetry in 32 patients with symptomatic benign prostatic hyperplasia (BPH) and 16 healthy men. In the BPH group 476 uroflow measurements were recorded during 24 to 72 hours (mean 14.9 measurements per patient), and the controls produced 100 flow recordings (mean 6.25 measurements per participant). Great variability between consecutive peak flow rates was observed in the BPH group, ranging from at least 1 standard deviation in 28 of 32 patients (87.5%) to at least 2 standard deviations in 15 of 32 (47%). In 21 of 32 patients (65.6%) the highest recorded peak flow rate was greater than, while the lowest peak flow rate was less than the -2 standard deviations plot in voiding nomograms. In the control group variability between consecutive voiding episodes also was marked, namely at least 1 standard deviation in 8 of 16 men (50.0%) and at least 2 standard deviations in 2 of 16 (12.5%). However, in none of the control men was any peak flow rate measurement less than the -2 standard deviations line. Circadian changes in diurnal and nocturnal measurements of voided volume, interval to maximal flow, flow time, peak flow rate and adjusted peak flow rate were recorded in the BPH group, providing a urodynamic support to a well known clinical observation.

Adult↗
PubMed1991

Effects of prostatectomy on sexual function.

We evaluated the effects of prostatectomy on sexual function in 210 patients, 49.6 percent of whom underwent transurethral resection of the prostate (TURP), and the remainder had suprapubic transvesical prostatectomy (SPP). Pre- and postoperative interviews with detailed questionnaires were utilized. Postoperative sexual dysfunction was reported by 18 of 152 patients (11.8%) who were functioning normally prior to surgery. The incidence of postoperative impotence was evenly distributed between the TURP and SPP groups and was age-related; it was highest among older patients. We further observed a strong correlation between the presence of a permanent sexual partner and the preservation of potency. We conclude that the risk of postoperative impotence is dependent on both the patient's age and the presence of a partner, and should be discussed with the patient preoperatively.

Aged↗
PubMed1990

Local hyperthermia of the prostate gland for the treatment of benign prostatic hypertrophy and urinary retention.

Local hyperthermia of the prostate was used to treat 72 patients who had an indwelling catheter because of urinary retention caused by benign prostatic hypertrophy. One month after completion of treatment 50% of patients were able to dispense with the catheter and 1 year later 40% remained catheter-free. The best results were achieved in patients who underwent 6 to 10 treatment sessions in conjunction with cyproterone acetate 50 mg tid administered during the treatment period only.

Aged↗
PubMed1990

Local thermotherapy of the benign prostate: a 1-year follow-up.

Local hyperthermia to the prostate has initially been found to be of considerable beneficial value in cancer of the gland and later also in benign prostatic hypertrophy (BPH) and in chronic prostatitis. The Prostathermer has been especially developed and used for this purpose. 124 patients with BPH, who have been treated by this method, were reevaluated after 1 year. This thermotherapy was well tolerated, and no noticeable complications were encountered. A sustained definite improvement in objective and subjective obstructive symptoms and signs was seen in 51% of the cases. Such definite and persistent improvement was best obtained when treatments were performed twice weekly for 60 min over a period of 3 weeks. Those patients with the more severe obstructive symptoms fared best. A full explanation for the effectiveness of this treatment of BPH has yet to be found. Although local hyperthermia cannot, at this stage, be considered as a radical form of treatment of BPH, it may offer definite relief to about 50% of the cases, particularly to those unwilling or unsuitable for surgery.

Androgen Antagonists↗
PubMed1989

[Verrucous carcinoma of the penis].

Malignant tumors of the penis are rare, and constitute only 1% of all tumors in males. The disease is more common in the black population of the USA due to genetic links and the rarity of circumcision. Penile carcinoma is extremely rare in Israel, only 10 cases having been reported during a period of 20 years. Verrucous carcinoma, often called giant condyloma acuminata, constitutes a subgroup of squamous cell carcinoma of the penis. The first description was by Buschke in 1925, and was followed by that of Loewenstein in 1939. The tumor is usually limited to the penile glans and does not invade lymph nodes. We present a 44-year-old Arab with verrucous carcinoma treated by partial amputation of the penis. He had been circumcised 11 years previously. During 18 months of follow-up there was no recurrence.

Adult↗
PubMed1989

[Transurethral procedures with sacral anesthesia].

Sacral anesthesia is a safe and effective procedure which we have used in 28 resections for benign prostatic hypertrophy, and in 42 resections of bladder tumors, 7 of them in women. The average age was 69 years. Average time for prostatic resection was 49 minutes and for bladder tumors, 23. Recovery from anesthesia averaged 78 minutes in both groups. In 44.3% of the patients there was no need for other medication during operation. Hemodynamic changes were minor and were controlled by fluid replacement in a third of the patients. Complications included convulsions (2 patients), severe headache (2), arrhythmias (5) and skin rash (1). There were no late sequelae. 0.5% marcaine was the most effective drug. The success rate was 77.1% in both groups; failures were due to technical difficulties.

Aged↗
PubMed1989

[Renal colic and renal calculus].

A positive diagnosis of urinary stone was made in 183 of 407 patients (44.9%) with renal colic seen in the emergency room. 182 (44.7%) had normal intravenous pyelograms, 26 (6.4%) had evidence of dilatation of the urinary system, possibly due to the passage of a stone, and 16 (3.9%) had other pathological urinary conditions, such as double collecting system or cysts. Stones were located in the upper urinary tract in 28.4%, in the midureter in 21.9%, and in the lower ureter in 49.7%. There was a statistically significant correlation between recurrent episodes of left-sided renal colic, erythrocytes in the urine and the presence of a stone in the urinary tract. No ethnic differences were found, nor was there a difference in the rates of stones found in those who were hospitalized and in those who were not.

Colic↗
PubMed1989

[Traumatic fracture of the corpus cavernosum with urethral rupture].

Traumatic fracture of the corpus cavernosum with urethral rupture occurs rarely, mostly during intercourse. About 200 cases have been published. Some reports favor conservative treatment, but lately it has been shown that this results in longer hospitalization and to late complications in 29%. Cavernography should be used in the equivocal cases without hematuria or signs of fracture. We present a case of fracture of the corpus cavernosum and tear in the urethra. Treatment consisted of surgical repair of the tunica albuginea and stenting of the urethra. Long term results were excellent.

Humans↗
PubMed1987

Local hyperthermia of the prostate gland for the treatment of benign prostatic hypertrophy and urinary retention. A preliminary report.

The Prostathermer (TM), a system designed to deliver hyperthermic treatment to the prostate gland, was used to treat six patients with benign prostatic hypertrophy and urinary retention. The 99-D model consists of a microwave generator operating at 915 MHz, an applicator with a built-in water cooling system, temperature probes and an IBM PC-XT type computer. The treatment regimen differed from patient to patient in the number of treatments (range 5-10), frequency per week (range 1-2), and average radiofrequency (RF) transmission. Sustained controlled heating of the prostatic tissue up to 39.4 to 45.2 degrees C was carried out for 60 min in each session. Five patients were relieved of their indwelling catheters and at follow-up 6 months after termination of therapy they were well by objective and subjective criteria. No complications were encountered. This is preliminary report of our results of treatment with 47 hyperthermic sessions in six patients.

Aged↗