Evaluation of a non-invasive method to determine bladder volume in children.

Although urethral catheterization is the "gold standard" for accurate bladder urine volume measurement in all patients, the discomfort associated with its use makes it less than ideal in pediatric urologic practice. Portable ultrasound scanners have been demonstrated to be an acceptable alternative in adults in several studies, but little data exists on their use in children. A portable ultrasound scanner that automatically calculates the bladder urine volume was used for 40 separate determinations and correlated with bladder urine volume measured by urethral catheterization (coefficient of correlation = 0.759). The scanner is reasonably accurate, well-tolerated and a useful alternative to urethral catheterization for measuring bladder urine volume.

Analyses of indications for and outcomes of epididymectomy.

PURPOSE: We analyzed the contemporary indications for epididymectomy, and quantified outcomes in terms of symptom resolution, complications and patient satisfaction. MATERIALS AND METHODS: The indications for surgery and outcomes for 57 patients who underwent epididymectomy between 1990 and 1994 were evaluated. RESULTS: A total of 30 patients (53%) underwent surgery for epididymal cysts and 27 (47%) for chronic epididymitis or epididymalgia. There was greater patient satisfaction among the cyst group (92%) compared to the epididymitis/epididymalgia group (43%, p < 0.001). Furthermore, more patients in the latter group complained of subsequent problems that they considered related to the procedure. CONCLUSIONS: The outcome of epididymectomy, is significantly more favorable in patients with epididymal cysts than with chronic epididymitis or intractable epididymal pain. Epididymectomy should be reserved for the former group but avoided in the latter cases unless they have been carefully counseled regarding the likelihood of poor results.

Posterior urthral valves in the Eastern Caribbean - abstract

To ascertain the distribution, incidence, management, morbidity and mortality of posterior urethral valves (PUV) in Barbados and the islands of the Eastern Caribbean. The data were obtained through retrospective chart review of cases presenting to Queen Elizabeth Hospital during the years 1981 to 1990 inclusive. Information on 27 cases was available. The majority of these cases (70.37 percent), were from Barbados, but cases came from a total of six territories. From the results, an incidence of 98 per 100,000 in Barbados was estimated. The majority of cases (62.9 percent) were diagnosed after the first year of life. A significant number (33.2 percent) were diagnosed after the age of 10 years. There was no follow-up in 51.85 percent of cases. Of the remainder, overhalf (7/13) suffered complications of PUV or its treatment, and there was one death recorded secondary to the complications of PUV. There is a need for earlier diagnosis to avoid high morbidity and mortality. Closer attention must also be paid to follow-up in order to assess the success of treatment. This also will serve to reduce morbidity and mortality (AU)

Peritonitis in acute peritoneal dialysis at the University Hospital of the West Indies (a five-year review).

The records of patients receiving acute peritoneal dialysis during the years 1983-1987 were retrospectively evaluated. Of a total of 59 patients receiving dialysis, 10 developed peritonitis. Staphylococcus aureus was the single most frequently isolated organism. However, gram-negative bacilli as a group were more common. We recommend the use of cloxacillin orally and gentamicin intra-peritoneally as empiric antibiotic coverage until results of culture reports are available.

Peritonitis in acute peritoneal dialysis at the University Hospital of the West Indies: a five-year review

The records of patients receiving acute peritoneal dialysis during the 1983 - 1987 were retrospectively evaluated. Of a total of 59 patients receiving dialysis, 10 developed peritonitis. Staphylococcus aureus was the single most frequently isolated organism. However, gram-negative bacilli as a group were more common. We recommend the use of cloxacillin orally and gentamicin intra-peritoneally as empiric antibiotic coverage until results of culture reports are available (AU)

A review of 292 patients with tubal ectopic pregnancy (1984-1988) - abstract

All case notes at the Queen Elizabeth Hospital from January 1, 1984 to December 31, 1988 were reviewed to identify all cases of tubal ectopic pregnancy and to determine trends and review management of this condition. All diagnoses were confirmed histologically. The age range was 15 to 42 years and the rate of tubal ectopic pregnancy was highest in the age groups 35-39 years (33.2/1,000) pregnancies and 30-34 years (26.0/1,000 pregnancies). Fifty-nine patients (20 per cent) had previous pelvic inflammatory disease, 64 (22 per cent) had o 1 previous abortion, and 22 (7.5 per cent) had a previous tubal pregnancy. Rupture of the tubal pregnancy occurred in 227 (78 per cent) patients and the commonest surgical procedure was salpingectomy (61 per cent). There were no deaths in this series (AU)