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James R. Porter - One of the best experts on this subject based on the ideXlab platform.
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Current experience with computed tomographic Cystography and blunt trauma.
World journal of surgery, 2001Co-Authors: Andrew J. Deck, Sarah Shaves, Lee B. Talner, James R. PorterAbstract:We present our experience with computed tomographic (CT) Cystography for the diagnosis of bladder rupture in patients with blunt abdominal and pelvic trauma and compare the results of CT Cystography to operative exploration. We identified all blunt trauma patients diagnosed with bladder rupture from January 1992 to September 1998. We also reviewed the radiology computerized information system (RIS) for all CT cystograms performed for the evaluation of blunt trauma during the same time period. The medical records and pertinent radiographs of the patients with bladder rupture who underwent CT Cystography as part of their admission evaluation were reviewed. Operative findings were compared to radiographic findings. Altogether, 316 patients had CT cystograms as part of an initial evaluation for blunt trauma. Of these patients, 44 had an ultimate diagnosis of bladder rupture; 42 patients had CT cystograms indicating bladder rupture. A total of 28 patients underwent formal bladder exploration; 23 (82%) had operative findings that exactly (i.e., presence and type of rupture) matched the CT cystogram interpretation. The overall sensitivity and specificity of CT Cystography for detection of bladder rupture were 95% and 100%, respectively. For intraperitoneal rupture, the sensitivity and specificity were 78% and 99%, respectively. CT Cystography provides an expedient evaluation for bladder rupture caused by blunt trauma and has an accuracy comparable to that reported for plain film Cystography. We recommend CT Cystography over plain film Cystography for patients undergoing CT evaluation for other blunt trauma-related injuries.
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COMPUTERIZED TOMOGRAPHY Cystography FOR THE DIAGNOSIS OF TRAUMATIC BLADDER RUPTURE
The Journal of urology, 2000Co-Authors: Andrew J. Deck, Sarah Shaves, Lee B. Talner, James R. PorterAbstract:Purpose: We present our experience with computerized tomography (CT) Cystography for diagnosing bladder rupture in patients with blunt abdominal and pelvic trauma, and compare the results of CT Cystography with those of surgical exploration.Materials and Methods: We identified all patients with blunt trauma diagnosed with bladder rupture from 1992 to September 1998. We reviewed the radiology computerized information system for all CT Cystography performed to evaluate blunt trauma during the same period. We also reviewed the medical records and pertinent radiographic studies of patients with bladder rupture who underwent CT Cystography as part of the hospital admission evaluation. Operative and radiographic findings were compared.Results: CT Cystography was performed in 316 patients as part of the initial evaluation of blunt trauma. Of the 44 patients with the ultimate diagnosis of bladder rupture CT Cystography revealed bladder rupture in 42, while 23 of the 28 (82%) who underwent formal bladder explorati...
Yves Aigrain - One of the best experts on this subject based on the ideXlab platform.
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Cystography after the Cohen ureterovesical reimplantation: is it necessary at a training center?
The Journal of urology, 1999Co-Authors: Alaa El-ghoneimi, Emmanuel Odet, Sylvie Lamer, Veronique Baudouin, Henri Lottmann, Yves AigrainAbstract:AbstractPurpose: Reimplantation by the Cohen procedure has a low rate of recurrent reflux, although postoperative Cystography is done routinely at most centers. According to the French training program for pediatric surgery and urology residents, reimplantation is the main pediatric urology procedure performed during residency. We determine whether it is necessary to perform post-operative Cystography routinely and whether the fact that the procedure is done by a junior surgeon modifies management.Materials and Methods: A total of 268 children with primary vesicoureteral reflux underwent ureteral reimplantation by the Cohen transtrigonal technique. Bilateral reimplantation was done in 97% of the cases. Reimplantation was performed by a surgery resident assisted by a clinical fellow or senior consultant surgeon in 37% of the cases. Routine Cystography and renal ultrasound were done in all patients postoperatively. Followup ranged from 6 months to 5 years (mean 10 months).Results: In 2 children (0.7%) with ...
Andrew J. Deck - One of the best experts on this subject based on the ideXlab platform.
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Current experience with computed tomographic Cystography and blunt trauma.
World journal of surgery, 2001Co-Authors: Andrew J. Deck, Sarah Shaves, Lee B. Talner, James R. PorterAbstract:We present our experience with computed tomographic (CT) Cystography for the diagnosis of bladder rupture in patients with blunt abdominal and pelvic trauma and compare the results of CT Cystography to operative exploration. We identified all blunt trauma patients diagnosed with bladder rupture from January 1992 to September 1998. We also reviewed the radiology computerized information system (RIS) for all CT cystograms performed for the evaluation of blunt trauma during the same time period. The medical records and pertinent radiographs of the patients with bladder rupture who underwent CT Cystography as part of their admission evaluation were reviewed. Operative findings were compared to radiographic findings. Altogether, 316 patients had CT cystograms as part of an initial evaluation for blunt trauma. Of these patients, 44 had an ultimate diagnosis of bladder rupture; 42 patients had CT cystograms indicating bladder rupture. A total of 28 patients underwent formal bladder exploration; 23 (82%) had operative findings that exactly (i.e., presence and type of rupture) matched the CT cystogram interpretation. The overall sensitivity and specificity of CT Cystography for detection of bladder rupture were 95% and 100%, respectively. For intraperitoneal rupture, the sensitivity and specificity were 78% and 99%, respectively. CT Cystography provides an expedient evaluation for bladder rupture caused by blunt trauma and has an accuracy comparable to that reported for plain film Cystography. We recommend CT Cystography over plain film Cystography for patients undergoing CT evaluation for other blunt trauma-related injuries.
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COMPUTERIZED TOMOGRAPHY Cystography FOR THE DIAGNOSIS OF TRAUMATIC BLADDER RUPTURE
The Journal of urology, 2000Co-Authors: Andrew J. Deck, Sarah Shaves, Lee B. Talner, James R. PorterAbstract:Purpose: We present our experience with computerized tomography (CT) Cystography for diagnosing bladder rupture in patients with blunt abdominal and pelvic trauma, and compare the results of CT Cystography with those of surgical exploration.Materials and Methods: We identified all patients with blunt trauma diagnosed with bladder rupture from 1992 to September 1998. We reviewed the radiology computerized information system for all CT Cystography performed to evaluate blunt trauma during the same period. We also reviewed the medical records and pertinent radiographic studies of patients with bladder rupture who underwent CT Cystography as part of the hospital admission evaluation. Operative and radiographic findings were compared.Results: CT Cystography was performed in 316 patients as part of the initial evaluation of blunt trauma. Of the 44 patients with the ultimate diagnosis of bladder rupture CT Cystography revealed bladder rupture in 42, while 23 of the 28 (82%) who underwent formal bladder explorati...
Loring W. Rue - One of the best experts on this subject based on the ideXlab platform.
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CT Cystography: radiographic and clinical predictors of bladder rupture.
American Journal of Roentgenology, 2000Co-Authors: Desiree E. Morgan, Lakshmi K. Nallamala, Philip J. Kenney, Matthew S. Mayo, Loring W. RueAbstract:OBJECTIVE. Our goal was to identify radiographic and clinical variables that correlate with bladder rupture that may then be used as selection criteria for CT Cystography in trauma patients. SUBJECTS AND METHODS. Hemodynamically stable trauma patients with hematuria were examined under standardized protocol with dynamic oral and IV contrast-enhanced CT of the abdomen and pelvis, followed immediately by CT Cystography. CT Cystography consisted of contiguous 5-mm axial scans of the pelvis after retrograde distention of bladder with 300-400 ml of 4% iodinated contrast material. Radiographic and clinical variables (pelvic fracture, pelvic fluid, intraabdominal visceral injury, degree of hematuria, hematocrit, units of blood transfused, base deficit, injury mechanism, seat belt use, sex, age) were assessed and statistically analyzed using the two-tailed Fisher's exact test and Wilcoxon's rank sum test. Positive and negative individual and multivariate predictors were analyzed. RESULTS. Of the 157 patients entered in our study, 12 (eight males and four females) had bladder rupture. One or more pelvic fractures were present in nine (75%) of the 12 patients (p < 0.001). Pubic symphysis diastasis, sacroiliac diastasis, and sacral, iliac, and pubic rami fractures were statistically associated with bladder rupture. Isolated acetabular fractures did not correlate with rupture. Eight (67%) of the 1 patients with bladder rupture revealed on CT Cystography had gross hematuria (p < 0.001). No ruptures were seen in patients with
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ct Cystography radiographic and clinical predictors of bladder rupture
American Journal of Roentgenology, 2000Co-Authors: Desiree E. Morgan, Lakshmi K. Nallamala, Philip J. Kenney, Matthew S. Mayo, Loring W. RueAbstract:OBJECTIVE. Our goal was to identify radiographic and clinical variables that correlate with bladder rupture that may then be used as selection criteria for CT Cystography in trauma patients. SUBJECTS AND METHODS. Hemodynamically stable trauma patients with hematuria were examined under standardized protocol with dynamic oral and IV contrast-enhanced CT of the abdomen and pelvis, followed immediately by CT Cystography. CT Cystography consisted of contiguous 5-mm axial scans of the pelvis after retrograde distention of bladder with 300-400 ml of 4% iodinated contrast material. Radiographic and clinical variables (pelvic fracture, pelvic fluid, intraabdominal visceral injury, degree of hematuria, hematocrit, units of blood transfused, base deficit, injury mechanism, seat belt use, sex, age) were assessed and statistically analyzed using the two-tailed Fisher's exact test and Wilcoxon's rank sum test. Positive and negative individual and multivariate predictors were analyzed. RESULTS. Of the 157 patients entered in our study, 12 (eight males and four females) had bladder rupture. One or more pelvic fractures were present in nine (75%) of the 12 patients (p < 0.001). Pubic symphysis diastasis, sacroiliac diastasis, and sacral, iliac, and pubic rami fractures were statistically associated with bladder rupture. Isolated acetabular fractures did not correlate with rupture. Eight (67%) of the 1 patients with bladder rupture revealed on CT Cystography had gross hematuria (p < 0.001). No ruptures were seen in patients with <25 RBC/HPF (red blood cells per high-power field). All patients with rupture had pelvic fluid revealed on standard contrast-enhanced CT (p < 0.001). CONCLUSION. Gross hematuria, pelvic fluid, and specific pelvic fractures were highly correlated with bladder rupture; identification of these findings may help in selection of trauma patients for CT Cystography.
Joachim Noldus - One of the best experts on this subject based on the ideXlab platform.
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Assessing the vesico-urethral anastomosis after radical retropubic prostatectomy: transrectal ultrasonography can replace Cystography.
BJU international, 2007Co-Authors: T Eggert, Juri Palisaar, P Metz, Joachim NoldusAbstract:OBJECTIVE To determine if transrectal ultrasonography (TRUS) is as reliable as Cystography in detecting vesico-urethral extravasation (VE) after radical retropubic prostatectomy (RRP). PATIENTS AND METHODS Between October 2005 and February 2006 we prospectively investigated 100 consecutive patients undergoing RRP. The vesico-urethral anastomosis was assessed 6 days after RRP by a combined investigation with TRUS and Cystography. RESULTS In most patients (79%), at 6 days after RRP the vesico-urethral anastomosis was watertight or showed minimal leakage (8%), so that the urinary catheter was removed. Different degrees of VE were detected in 21 patients. Because of small, moderate or marked VE, the indwelling catheter remained until 9, 14 and 21 days after RRP in five, three and five patients, respectively. Every VE documented by Cystography was detected by TRUS beforehand; therefore TRUS showed no false-negative results in detecting a leaking anastomosis. In two patients paraurethral fluid was detected by TRUS mimicking VE, with no confirmation by Cystography. CONCLUSIONS TRUS can safely replace Cystography for detecting anastomotic leakage after RRP. The decision to remove the catheter after RRP can be made without radiation exposure and use of expensive contrast medium.
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postoperative monitoring of anastomosis after radical retropubic prostatectomy transrectal ultrasound can replace Cystography
Urologe A, 2007Co-Authors: T Eggert, Juri Palisaar, P Metz, Joachim NoldusAbstract:OBJECTIVE We determined if transrectal ultrasound (TRUS) is as reliable as Cystography in detecting vesicourethral extravasates after radical retropubic prostatectomy (RRP). PATIENTS AND METHODS Between October 2005 and February 2006 we prospectively investigated 100 consecutive patients undergoing RRP. The vesicourethral anastomosis was proven 6 days after operation by a combined investigation with TRUS and Cystography. RESULTS In the majority of patients (79%) the vesicourethral anastomosis was watertight on postoperative day 6 (POD) or showed minimal leakage (8%) so that the urinary catheter was removed. Different degrees of paravasates were detected in 21 patients. Because of small, moderate, or marked paravasations the indwelling catheter was removed on POD 9, 14, and 21 in 5, 3, and 5 patients, respectively. Every paravasate documented by Cystography had been detected by TRUS before. Therefore, TRUS showed no false-negative result in detecting insufficient anastomosis. In two patients paraurethral fluid was detected by TRUS mimicking anastomotic paravasation, without confirmation by Cystography. CONCLUSIONS TRUS can safely replace Cystography to detect anastomotic leakage after radical prostatectomy.
