Does sacral posterior rhizotomy suppress autonomic hyper-reflexia in patients with spinal cord injury?
Study of the occurrence of autonomic hyper-reflexia (AHR) after intradural sacral posterior rhizotomy combined with intradural sacral anterior root stimulation, performed to manage the neurogenic hyper-reflexic bladder, and to determine the pathophysiological basis of the uncontrolled hypertensive crisis after sacral de-afferentation.
Bladder autoaugmentation in the rabbit using de-epithelialized segments of small intestine, stomach and lyophilized human dura mater
The objective of this study is to develop an animal model of partial detrusorectomy (autoaugmentation) and thus avoid the consequences of the direct contact of intestinal mucosa with the urinary tract in bladder augmentation. The results of this experimental study suggest that a demucosalized segment of small bowel is the best material to increase bladder compliance in detrusorectomy (autoaugmentation) as applied in this animal model.
Detrusor myectomy for detrusor overactivity: a minimum 1-year follow-up
Partial detrusor myectomy is relatively simple and is associated with minimum morbidity and an acceptable success rate. The procedure alters the urodynamic behaviour of the bladder and leads to symptomatic and objective improvement, giving better results with idiopathic than with neuropathic detrusor overactivity. Detrusor myectomy may be offered to patients with detrusor overactivity unresponsive to conventional management. The option of enterocysto-plasty is still open to patients with an unsuccessful outcome. However, the long-term results and surgical variations of the technique should be evaluated further.
The cellular basis of bladder instability
The aim of this review is to describe changes to the cell physiology of detrusor smooth muscle in samples taken from abnormal bladders. There are two advantages to such an approach: first, a thorough investigation of the cellular basis of contractile activation will permit the development of more specific therapeutic agents to regulate detrusor function; second, if any functional alterations can be documented and the cause identified, a strategy of prevention will be easier to formulate.
A technique for ureterosigmoidostomy by direct interposition of an ileal loop with a valve
There may be problems with ureterosigmoidostomy in patients whose ureters have a thick wall, are short or very dilated and there may be difficulties if there is hydroureteronephrosis in continent patients after ureterosigmoidostomy, or in those with a rectal bladder with a terminal colostomy. A procedure was thus developed using direct interposition of an ileal loop with a valve.
A simple method for the treatment of lower-third ureteric stones in female patients with cystocele
If ESWL is the treatment chosen for these patients, superpositioning of the stone with the pubic bones can cause difficulty in focusing treatment on the lower-third ureteric stones, or the procedure may be painful when applied through the bones. We describe a simple method to overcome such problems during ESWL in female patients.
This technique improves the visualization of the stone under fluoroscopy and makes the ESWL procedure less painful for patients with lower-third ureteric stones and with a cystocele.
Constitutional chromosomal instability: a case with three primary and sequential cancers
A 74-year-old man had undergone radical cystectomy in September 1992 for a high-grade, invasive and multiple TCC of the urinary bladder (G2/pT2) and had an ileal neobladder constructed. He was a heavy smoker (600 packs per year) and had previously been healthy. There was no family history of malignancy. A cytogen-etic study of the tumour cells in culture showed many structural and numeric non-clonal abnormalities.