Upper urinary tract filling defects: flexible ureteroscopic diagnosis.

There were 62 patients referred to our institution for evaluation of upper urinary tract filling defects. These patients had undergone any of several diagnostic evaluations, including computerized tomography, B-mode ultrasound scanning and urinary cytology studies with or without upper tract brush biopsy. In all cases a conclusive diagnosis could not be formulated.

Removal of upper urinary tract calculi with flexible ureteropyeloscopy.

Flexible ureteropyeloscopy is an endoscopic technique which can give access to the entire intrarenal collecting system. Retrieval instruments or lithotriptors, electrohydraulic or pulsed dye laser, can be employed. In 70 patients, 72 procedures were used to treat 77 calculi.

Flexible ureteropyeloscopy in the diagnosis of benign essential hematuria.

Benign essential hematuria is an uncommon syndrome that constitutes a dilemma in diagnosis for the urologist. We studied 32 patients with flexible ureteropyeloscopy. Previous studies included renal arteriography, computerized tomography, ultrasound and urinary cytology.

Evaluation of sexual satisfaction in partners of men experiencing erectile failure.

The present study was designed to examine the impact of erectile failure on the partners of impotent men. Partners were sent detailed questionnaires to assess the impact of the erectile dysfunction on their relationship. Many women felt that their partners were withdrawing as a result of the sexual difficulties, and 41% felt that they were to blame for this.

The use of PotenTest in the multidisciplinary evaluation of impotence: is it a reliable measure? Jefferson Sexual Function Center.

This study compares the findings of multidisciplinary evaluation to the three-night use of the PotenTest, a standardized stamp test for the evaluation of nocturnal penile tumescence, in 174 patients. An organic etiology was diagnosed in 54% of those evaluated. The PotenTest proved accurate as a screening device for organic disease.

Snap-Gauge band vs multidisciplinary evaluation in impotence assessment.

This study compares the findings of multidisciplinary evaluation to the two-night use of the Snap-Gauge band in 100 impotent men. An organic etiology was diagnosed in 52 percent of those evaluated. The Snap-Gauge band proved accurate as a screening device for organic disease.

Reverse lithotomy: modified prone position for simultaneous nephroscopic and ureteroscopic procedures in women.

Occasionally there is need for nephroscopic and ureteroscopic access during the same surgical procedure. Patient positioning is problematic and usually the patient must be turned from supine to prone position or vice versa. Simultaneous access is possible by placing the patient in a prone position with the thighs and knees cradled laterally in a "boot" type stirrup.

Ureteroscopic diagnosis and treatment of urinary calculi during pregnancy.

Flexible ureteroscopy has been utilized in two pregnant patients. In one, the procedure was for diagnosis of symptoms simulating ureteral colic, and in the other for the removal of a distal ureteral calculus. The diagnostic procedure was completed with local anesthesia alone, and both procedures were performed without radiation to the mother or fetus.

Balloon dilation of the ureter for ureteroscopy.

Balloon dilation catheters have been used extensively for percutaneous transluminal dilation of vascular narrowings. A recent urological application has been the use of a balloon to dilate acutely the normal ureteral orifice and intramural ureter for the purpose of performing transurethral ureteroscopy. Complications of balloon dilation may result if over inflation and bursting of the balloon occur followed by ureteral injury.

Snap-Gauge band versus penile rigidity in impotence assessment.

We examined the ability of the Snap-Gauge band to differentiate rigid from nonrigid erections in men complaining of impotence. A total of 80 patients was measured by a Snap-Gauge band and via technician assessment of erectile rigidity while undergoing nocturnal penile tumescence testing. The Snap-Gauge band correctly diagnosed 77.

Ureteropyeloscopic removal of ureteral calculi.

Ureteroscopy has been used for the treatment of calculi throughout the ureter. The results of ureteroscopic stone removal were reviewed in 100 patients. Similar results were compared in 30 patients undergoing ureterolithotomy and 32 treated by basket manipulation.

Ureteroscopy under local anesthesia.

Ureteroscopy has been performed with local anesthesia with and without sedation in 30 patients. Flexible endoscopes were used in 18, rigid endoscopes alone in 7, and rigid and flexible instruments in 5 patients. The flexible instruments ranged in size from 4F to 10F, while rigid instruments were 10F to 12F.

Flexible ureteropyeloscopy: diagnosis and treatment in the upper urinary tract.

Flexible ureteropyeloscopy was performed on 59 patients with 2.7, 3.2 or 3.

Pharmacologic treatment of infection stones.

Hippocrates first wrote of the association of urinary tract infection with urinary calculi. Modern research has established the causal relationship between "infection stones" and the presence of urinary infection with urease-producing organisms. Treatment and preventive measures can be based on antimicrobial activity and urease inhibition as well as the eradication of the calculi.

Flexible ureteropyeloscopy with modular, "disposable" endoscope.

A flexible modular ureteropyeloscope has been utilized in 36 patients. The flexible tips of this instrument can be replaced and have been available in sizes 6.0F, 8.

Ureteral endoscopy with passively deflectable, irrigating flexible ureteroscopes.

Flexible, passively deflectable fiberoptic ureteroscopes were used in 18 selected patients. The flexible endoscope must be stabilized with a cystoscope, flexible introducer sheath, or guide wire for placement through the urethra and bladder into the ureter. Irrigation through the instrument is beneficial in clearing the visual field and distending the lumen.

Endoscopic management of the obliterated ureteroileal anastomosis.

Endoscopic restoration of a totally obstructed ureteroileal anastomosis was accomplished in 3 patients. The combined use of rigid endoscopy of the ileal conduit and flexible nephroureteroscopy provided full visualization of the blind-ending segments and allowed location of the shortest segment between the lumina. A guide wire was passed through intervening tissue with fluoroscopic monitoring to re-establish internal drainage.

Intrarenal dimensions. Guidelines for flexible ureteropyeloscopes.

Designs for flexible ureteropyeloscopes should be based on the configuration of the intrarenal collecting system. This study measured retrospectively the ureteroinfundibular angle and infundibular lengths of 30 patients treated for calculus disease. Recommendations are given for the design of flexible ureteropyeloscopes that could visualize the entire normal intrarenal collecting system.

Percutaneous antegrade flexible ureteroscopy.

A flexible endoscope has been used for antegrade percutaneous ureteroscopy after percutaneous lithotripsy. The instrument, the ACMI Flexiscope, is 2.5 mm in diameter and has fiberoptic bundles for illumination and visualization but no channel for irrigation.

Neonatal phenobarbital imprinting of hepatic microsomal enzymes in adult rats: modulation by neonatal testosterone presence.

The influence of neonatal androgen status on the ability of neonatally administered phenobarbital (PB) to program increases in adult rat hepatic microsomal enzyme activities was investigated. Male and female rat pups were injected with 30 mg/kg PB or 0.9% saline on Days 1 to 5 postpartum.

Cefoxitin concentration in wound fluid.

The concentration of cefoxitin was determined in fluid obtained from human surgical wounds during the first postoperative day. Intravenous administration of cefoxitin sodium at a dosage of 1 or 2 g every six hours rapidly produced wound-fluid concentrations greater than the minimal inhibitory concentration for most susceptible organisms. After three hours, wound-fluid concentrations surpassed the serum concentrations of cefoxitin.