- Email: [email protected]
Urethral Overdilatation in Females With Lower Urinary Tract Symptoms
153:
Al\JDROLOG~f
relief of symptoms. ""'"'"''"v.q failure "'"'""'·"rn'" at 3 weeks but returned to normal after 2 more weeks. P. R. R. 10 references
The Pathophysiology of the Jejunal Conduit Syndrome and its Exacei"tiation by Parenteral Hypera!imentation
D. C.
BONNHEIM, N. J. PETRELLI, A. STERNBERG AND A. MITTELMAN, Department of Surgical Oncology, Roswell Park
Memorial Institute, Buffalo, New York J. Surg. Oncol., 26: 172-175 (July) 1984 A 52-year-old man suffered jejunal conduit syndrome (hyponatremia, hypochloremic acidosis, hyperkalemia and azotemia) following intravenous hyperalimentation. The pathophysiological features of the jejunal conduit syndrome are reviewed. The authors conclude that intravenous hyperalimentation should be used with extreme caution in patients with jejuna! conduits, and that the selection of the solutions, dosage and infusion rate should be determined by monitoring the daily serum electrolyte levels. D. K. M. 2 figures, 12 references
Urethral Strictu.:re Aftm.° Co:ro:na:ry Artery Bypass Grafting
B. G. FERRIE, R SETHIA AND D. KIRK, Departments of Urology and Cardiac Surgery, Royal Infirmary, Glasgow, United Kingdom J. Roy. Soc. Med., 77: 643-644 (Aug.) 1984 The authors report on 3 patients with urethral strictures following coronary artery bypass grafting. A similar unusually high incidence of urethral stricture has been reported in men from Finland and Australia who have undergone a cardiac operation, Some alteration in latex catheter composition, which would be of little consequence in general surgical ,,~,,,w,ou, might result in urethral stricture in a hypothermic patient, Strictures may occur up to 12 months after a cardiac operation. P.R. R. 7 references
SURGICAL TECHNIQUES, EQUIPMENT AND INSTRUMENT§ Urethral Overdilatation in Femafos With Lower U:rtina:ry Tract Symptoms
D. M.
EASTWOOD, IVL GOLDMAN AND D. J. ment of Urology, Selly Oali Hospital, Birmingham, United Kingdom
J. Roy. Soc. Med., 77: 639-642
1984
The authors report on the long-term results of the Otis urethrotome used as a dilator only in 103 women with lower urinary tract symptoms. Initially, 80 per cent of the patients were improved or cured symptomatically by urethral dilation (91 per cent of women with proved and 97 per cent with presumed recurrent urinary tract infections). A total of 84 patients responded to a questionnaire 18 months later. Overall, 62 per cent of the patients maintained symptomatic improvement or cure. Urethral dilation seems to offer an advantage over urethrot-
omy in that syimp,trnrna relief can be obtained but with a shorter hospital stay. The authors believe that the degree of dilation should be correlated with the presumed state of bladder neck function to reduce the risk of incontinence. Failures of treatment should be evaluated fully before further treatment is implemented. P. R. R. 3 tables, 4 references
A Three Year Expe:rieltl.ce With Needle Cathetei· Jejunostomy in a Community Hospital
R. W. FELDTMAN AND J.P. ARCHIE, JR., Department of Surgery, Memorial City Medical Center and the Carolina Cardiovascular Surgical Associates, Raleigh, North Carolina Surg., Gynec. & Obst., 159: 23-26 (July) 1984 The authors report on needle catheter jejunostomy in 61 patients who underwent various general surgical procedures in a community hospital. The needle catheter was placed 10 to 15 cm. distal to the ligament of Treitz and was anchored with a 4zero polygalactin purse-string suture. Needle catheter placement added 3 to 5 minutes to the operating time. An average of 2,094 calories per day was administered in the form of diluted high nitrogen Vivonex. Hepatic-Aid and Amin-Aid were used with the presence of associated liver or renal compromise. The authors observed no complications of needle placement. Eleven catheters (18 per cent of the total) were not used, since the postoperative course was uncomplicated. Diarrhea with enteral feeding was common and was treated easily by decreasing the rate and concentration of the enteral feeding. The only contraindication for this type of enteral hyperalimentation is the presence of inflammatory bowel disease. The authors believe that this technique should be accepted more widely. G. F. S. 1 figure, 2 tables, 12 references
ANDROLOGY Return of Gonadal Functfon in Men With Pl!."olactiirnSecreting Pituitary Tu.mm."§ F, T. D. F. CAMERON AND C. KETCHUM, Departments of Medicine and Anatomy, University of School of 11/8'"1.i.,('/YiiP u·u,uw.,,uu,t:. Florida
J. Clin. Endocr. Metab,, 59: 79-85
1984
can present with impotence this nypo1g011a(I1s1m is associated with low serum testosterone levels and high levels of serum Semen analyses regularly show oligospermia and abnormal "'"'"''·""' These findings were confirmed in 10 men with prolactin-secreting pituitary tumors. Additionally, the authors demonstrated significantly decreased nocturnal penile tumescence in 7 of 8 patients. Treatment of the prolactinomas included an operation, radiation and dopamine agonist administration. Eight patients were studied 6 to 13 months after treatment, and serum prolactin and testosterone had reached normal levels. Of 5 patients evaluated 4 had improved nocturnal penile tumescence readings at followup. Although the followup semen analyses remained distinctly abnormal, a moderate increase in sperm concentration was noted. Hyperprolactinemia, per se, may have a direct, irreversible effect on sperm production independent of testosterone values. G. F. S. 5 figures, 3 tables, 31 references ,~, ,mnn
Al\JDROLOG~f
relief of symptoms. ""'"'"''"v.q failure "'"'""'·"rn'" at 3 weeks but returned to normal after 2 more weeks. P. R. R. 10 references
The Pathophysiology of the Jejunal Conduit Syndrome and its Exacei"tiation by Parenteral Hypera!imentation
D. C.
BONNHEIM, N. J. PETRELLI, A. STERNBERG AND A. MITTELMAN, Department of Surgical Oncology, Roswell Park
Memorial Institute, Buffalo, New York J. Surg. Oncol., 26: 172-175 (July) 1984 A 52-year-old man suffered jejunal conduit syndrome (hyponatremia, hypochloremic acidosis, hyperkalemia and azotemia) following intravenous hyperalimentation. The pathophysiological features of the jejunal conduit syndrome are reviewed. The authors conclude that intravenous hyperalimentation should be used with extreme caution in patients with jejuna! conduits, and that the selection of the solutions, dosage and infusion rate should be determined by monitoring the daily serum electrolyte levels. D. K. M. 2 figures, 12 references
Urethral Strictu.:re Aftm.° Co:ro:na:ry Artery Bypass Grafting
B. G. FERRIE, R SETHIA AND D. KIRK, Departments of Urology and Cardiac Surgery, Royal Infirmary, Glasgow, United Kingdom J. Roy. Soc. Med., 77: 643-644 (Aug.) 1984 The authors report on 3 patients with urethral strictures following coronary artery bypass grafting. A similar unusually high incidence of urethral stricture has been reported in men from Finland and Australia who have undergone a cardiac operation, Some alteration in latex catheter composition, which would be of little consequence in general surgical ,,~,,,w,ou, might result in urethral stricture in a hypothermic patient, Strictures may occur up to 12 months after a cardiac operation. P.R. R. 7 references
SURGICAL TECHNIQUES, EQUIPMENT AND INSTRUMENT§ Urethral Overdilatation in Femafos With Lower U:rtina:ry Tract Symptoms
D. M.
EASTWOOD, IVL GOLDMAN AND D. J. ment of Urology, Selly Oali Hospital, Birmingham, United Kingdom
J. Roy. Soc. Med., 77: 639-642
1984
The authors report on the long-term results of the Otis urethrotome used as a dilator only in 103 women with lower urinary tract symptoms. Initially, 80 per cent of the patients were improved or cured symptomatically by urethral dilation (91 per cent of women with proved and 97 per cent with presumed recurrent urinary tract infections). A total of 84 patients responded to a questionnaire 18 months later. Overall, 62 per cent of the patients maintained symptomatic improvement or cure. Urethral dilation seems to offer an advantage over urethrot-
omy in that syimp,trnrna relief can be obtained but with a shorter hospital stay. The authors believe that the degree of dilation should be correlated with the presumed state of bladder neck function to reduce the risk of incontinence. Failures of treatment should be evaluated fully before further treatment is implemented. P. R. R. 3 tables, 4 references
A Three Year Expe:rieltl.ce With Needle Cathetei· Jejunostomy in a Community Hospital
R. W. FELDTMAN AND J.P. ARCHIE, JR., Department of Surgery, Memorial City Medical Center and the Carolina Cardiovascular Surgical Associates, Raleigh, North Carolina Surg., Gynec. & Obst., 159: 23-26 (July) 1984 The authors report on needle catheter jejunostomy in 61 patients who underwent various general surgical procedures in a community hospital. The needle catheter was placed 10 to 15 cm. distal to the ligament of Treitz and was anchored with a 4zero polygalactin purse-string suture. Needle catheter placement added 3 to 5 minutes to the operating time. An average of 2,094 calories per day was administered in the form of diluted high nitrogen Vivonex. Hepatic-Aid and Amin-Aid were used with the presence of associated liver or renal compromise. The authors observed no complications of needle placement. Eleven catheters (18 per cent of the total) were not used, since the postoperative course was uncomplicated. Diarrhea with enteral feeding was common and was treated easily by decreasing the rate and concentration of the enteral feeding. The only contraindication for this type of enteral hyperalimentation is the presence of inflammatory bowel disease. The authors believe that this technique should be accepted more widely. G. F. S. 1 figure, 2 tables, 12 references
ANDROLOGY Return of Gonadal Functfon in Men With Pl!."olactiirnSecreting Pituitary Tu.mm."§ F, T. D. F. CAMERON AND C. KETCHUM, Departments of Medicine and Anatomy, University of School of 11/8'"1.i.,('/YiiP u·u,uw.,,uu,t:. Florida
J. Clin. Endocr. Metab,, 59: 79-85
1984
can present with impotence this nypo1g011a(I1s1m is associated with low serum testosterone levels and high levels of serum Semen analyses regularly show oligospermia and abnormal "'"'"''·""' These findings were confirmed in 10 men with prolactin-secreting pituitary tumors. Additionally, the authors demonstrated significantly decreased nocturnal penile tumescence in 7 of 8 patients. Treatment of the prolactinomas included an operation, radiation and dopamine agonist administration. Eight patients were studied 6 to 13 months after treatment, and serum prolactin and testosterone had reached normal levels. Of 5 patients evaluated 4 had improved nocturnal penile tumescence readings at followup. Although the followup semen analyses remained distinctly abnormal, a moderate increase in sperm concentration was noted. Hyperprolactinemia, per se, may have a direct, irreversible effect on sperm production independent of testosterone values. G. F. S. 5 figures, 3 tables, 31 references ,~, ,mnn