Surgical management of stress urinary incontinence: Burch colposuspension, modified Pereyra and Stamey bladder neck suspension, and collagen injection--Toa Payoh Hospital experience.

A retrospective analysis was performed on 34 female patients who underwent corrective surgery for stress urinary incontinence over a 4-year period at the Toa Payoh Hospital. These patients were offered surgery only after an adequate trial of medical therapy, pelvic floor exercises and weight reduction. Bladder neck suspension operations were performed via the Burch, Stamey and modified Pereyra techniques.

Traumatic bronchial rupture--a case report.

Traumatic bronchial rupture is a rarity. Its incidence is about 1.5% to 3% in most series of blunt chest trauma.

Results of closed intra-articular calcaneal fractures treated with early mobilisation and without reduction.

Between January 1987 and December 1989, a retrospective study was done of 42 patients with 56 closed intra-articular calcaneal fractures treated with no reduction and early mobilisation at the Department of Orthopaedic Surgery, Toa Payoh Hospital. There were 12 left, 16 right and 14 bilateral fractures. Using the Creighton-Nebraska Health Assessment for calcaneal fractures, 38 (67.

Incidence of back pain after lumbar epidural anaesthesia for non-obstetric surgery--a preliminary report.

This prospective survey attempt to study the incidence of post-operative back pain after lumbar epidural anesthesia for non-obstetric patterns and the correlation of this symptom with various contributing factors. One hundred and five patients who were given lumbar epidural anaesthesia as the sole anaesthesia for non-obstetric surgery were studied. The choice of equipment, number of attempts at giving the injection, duration of surgery and position of patient during surgery were documented.

Venous ligation for cavernous leak impotence--a report on 30 cases.

We report our experience with the surgical treatment of 30 patients with venous leak impotence seen at the Division of Urology, Toa Payoh Hospital, over a period from April 1991 to August 1993. The patients were assessed by history, clinical examination, hormonal evaluation and intracavernosal injection of papaverine. Confirmation of venous leak impotence was obtained by pharmaco-cavernosography in all patients; dynamic cavernosometry was performed in the later part of the series.

Penile implant surgery--local experience with the semi-rigid, single component inflatable and the multi-component inflatable penile prostheses.

A retrospective analysis was performed on 26 men who underwent penile implant surgery using semi-rigid, single component inflatable, and multi-component inflatable penile prostheses over a five-year period. No intraoperative complications were encountered in our series. Major complications following discharge from the hospital were encountered in 6 patients (23.

Corporeal plication for correction of penile curvature.

A retrospective analysis was done on 15 men who underwent corrective surgery for penile curvature between December 1989 to March 1993. The period of follow-up ranged from 3 months to 3 years, with a mean of 16 months. All patients underwent corporeal plication, with sutures placed on the convex side of the penile curvature to straighten the penis.

A prospective trial with vacuum-assisted erection devices.

The effectiveness of vacuum-assisted erection devices was evaluated in a prospective trial involving 18 men with erectile dysfunction. The patients were reviewed at 1, 3 and 6 monthly intervals by the same interviewer using a standard questionnaire. Sixteen patients (88.

Roxatidine versus ranitidine in the treatment of duodenal ulcers: a randomized double-blind controlled multicentre study in Singapore.

Roxatidine acetate, a new H2 receptor antagonist, was compared with ranitidine in the treatment of duodenal ulcers in a double-blind multicentre study. Eighty-four patients with endoscopically proven duodenal ulcer were randomized to receive 150 mg roxatidine acetate or 300 mg ranitidine at bedtime. Repeat endoscopy was performed after 4 weeks (25-33 days) and if the ulcer had not healed, another endoscopy was performed after a further 4 weeks of treatment.

Endoscopic adrenaline injection in treatment of bleeding peptic ulcers.

This study aimed to compare the results of bleeding peptic ulcer treated by endoscopic adrenaline injection with controls treated conventionally. Between January 1991 and December 1993, 69 patients with actively bleeding peptic ulcers with visible vessel received endoscopic adrenaline injection. This group of patients was compared with 31 endoscopically similar patients treated conventionally, using H2 blockers with or without surgery, from October 1987 to December 1990 prior to the introduction of endoscopic injection therapy in this hospital.

Laparoscopic varicocelectomy: technique and results.

Objective: To determine the safety and efficacy of laparoscopic varicocelectomy in the treatment of symptomatic varicocele.

Patients And Methods: Indications for surgery were subfertility in 98 patients and pain in nine. All varicoceles were confirmed on Doppler ultrasound.

The effects of 2% lignocaine gel on incidence of retching with the use of the laryngeal mask airway.

This randomised, single-blind study investigated the incidence of retching during emergence from general anaesthesia with a laryngeal mask airway in place. Eighty four patients, ASA grade 1 and 2, aged 15 to 60 years, were randomly divided into two groups. Each patient received fentanyl 1 microgram.

Nodular skin tuberculosis with lymphatic spread--a case report.

An unusual case of tuberculosis paronychia with skin infection of the big toe was recently seen in a patient returning from Kalimantan. This was complicated by inguinal lymphadenitis and tuberculosis abscess formation. The diagnosis was made on culture of the pus from the abscess and upon biopsy and histological examination of the skin lesion from the toe.

Intra-articular morphine and bupivacaine for pain relief after therapeutic arthroscopic knee surgery.

This randomised, double-blind study compared the analgesic properties of intra-articular injection of morphine and bupivacaine during therapeutic arthroscopic knee surgery. Forty male patients were randomly divided into 4 groups of 10 patients each. Group A received intra-articular injection of 1 mg morphine sulphate in 20 ml saline, Group B received 20 ml of 0.

A case of tetanus mimicking acute abdomen.

A 47-year-old man presented with backache and signs of acute abdomen. An exploratory laparotomy was performed. Post-operatively he developed hypoxaemia in the operating theatre and was brought to the Surgical Intensive Care Unit for ventilatory support and further investigations.

Gastric ulceration with acute bleeding from tuberculosis of the stomach--a case report.

Tuberculosis of the stomach is a rarity. Its diagnosis is difficult as it is often unsuspected or unrecognised. This is a case report of an elderly man who presented with active upper gastrointestinal tract bleeding.

Torsional performance of canine femoral osteotomy union.

This study allows the establishment of a protocol for standardizing the technical methodology of canine surgery for mechanical testing. Twenty mongrels were divided into 4 groups of 5 dogs each. All dogs had one femur selected as the test bone and the contralateral as paired control.

The Beri-Beri Hospital, Singapore (1907-1925).

The high incidence of Beri-beri in the 1890s and 1900s coupled with the ignorance of its causation led to many forms of treatment, culminating in the establishment of a "specialised hospital" in Singapore. However, the "anti-beri-beri" factor in unpolished rice soon made this hospital redundant.

Early years of the out-patient services, Singapore (1880-1946).

This article traces the history of the Out-patient Services from its humble beginnings in the late 19th Century to just after World War II. The class of patients catered for, the disease pattern, the work done and benefits accrued are recorded.

Echocardiographic detection of mobile right atrial thrombus.

Mobile right atrial thrombus is a rare echocardiographic diagnosis with important implications on further management. We report a case of 50-year-old woman with deep vein thrombosis of her left lower limb, who was found to have a large mobile serpiginous right atrial thrombus on both two-dimensional echocardiography (2DE) and transoesophageal echocardiography (TEE). She developed acute pulmonary embolism within thirty-six hours of diagnosis and subsequently underwent successful pulmonary embolectomy.

Malignant large-cell non-Hodgkin's lymphoma of the spleen.

Primary malignant tumours of the spleen are rare, with non-Hodgkin's lymphoma being the most common. A case of malignant large-cell lymphoma of the spleen in a patient with unexplained splenomegaly, is presented. There are very few previous reports on this condition in the radiological literature.

Penile angiography in impotence: local experience.

Vasculogenic causes of impotence and especially venous leakage are now considered to be significantly worthwhile to be evaluated in the light of new developments and changes in the treatment of erectile dysfunction. The investigations of cavernosography and penile arteriography are gaining importance. In 32 months, from August 1990 to March 1993, 126 cavernosograms and 11 bilateral internal pudendal arteriograms have been performed on patients from Toa Payoh Hospital.

Experience with laparoscopic cholecystectomy at the Toa Payoh Hospital.

A retrospective analysis was done of 88 cases of laparoscopic cholecystectomy performed by the first author from November 1990 to March 1992 at the Toa Payoh Hospital. There were 61 female and 27 male patients; the average age was 47.1 years.

Cavernous transformation of the portal vein--sonographic findings.

Cavernous transformation of the portal vein may be seen following portal vein thrombosis. Ultrasound is a useful non-invasive procedure for demonstrating many abnormalities of the portal vein and surrounding structures. Two cases of cavernous transformation of the portal vein, diagnosed by ultrasonography, are presented.