Continent reconstruction of the lower urinary tract using the appendicovesicostomy (Mitrofanoff p... more Continent reconstruction of the lower urinary tract using the appendicovesicostomy (Mitrofanoff principle) is an excellent means of managing many patients with altered bladder function, especially those with good bladder volume and low pressure. Motivated patients unable to perform urethral catheterization because of paresis or other reasons now have a method of urinary diversion free of an appliance, though additional procedures may be necessary if bladder volume is low and/or bladder pressure is high. We no longer routinely perform appendectomy during bladder substitution or bladder augmentation procedures. By removing the appendix, we may be discarding an appendage that might prove useful should future urinary reconstruction procedures be required.
Bilateral hydrocalycosis secondary to radiographically demonstrated bilateral infundibular stenos... more Bilateral hydrocalycosis secondary to radiographically demonstrated bilateral infundibular stenosis required a left nephrectomy in an 18-year-old young man. The infundibular narrowing was due to marked hyperplasia of the submucosal smooth muscle. Scattered within the hypertrophic smooth muscle were rare spindled CD117-positive interstitial cells, similar to the cells responsible for peristaltic pacemaker activity within the gastrointestinal tract. The admixture of CD117 cells suggests this is a true muscular hyperplasia rather than a leiomyomatosis. The stimulus to the hyperplasia is unknown.
Urachal anomalies are relatively uncommon and result because of incomplete obliteration of the ur... more Urachal anomalies are relatively uncommon and result because of incomplete obliteration of the urachus prenatally. In children, urachal cysts and sinuses constitute the common presentations, and these can sometimes become secondarily infected. Malignant involvement of the urachus in the pediatric population is rare, and primary urachal adenocarcinoma is reported exclusively in adults. Herein, we present the case of an adolescent girl with a low-grade mucinous neoplasm arising in a urachal cyst and discuss its significance.
The treatment of urolithiasis in children has changed dramatically in recent years. With the prov... more The treatment of urolithiasis in children has changed dramatically in recent years. With the proven safety and efficacy of extracorporeal shock wave lithotripsy (ESWL), percutaneous lithotripsy and ureteroscopy in adults, these modalities are now in the forefront of the treatment of pediatric urinary stones. Our research in the juvenile non-human primate with ESWL indicates that renal damage in most cases is neither significant or persistent. In addition, technological advances in instrumentation have cleared the way for the use of percutaneous lithotripsy and ureteroscopy in most pediatric patients. Today, open surgical procedures for stone disease in children should be a last resort.
... NEAL, JR., MD,*,t EDWIN HARMON, MD,* TIMOTHY HLAVINKA, MD,Í M. BERNICE KAACK, Ph.D.,t and RAJ... more ... NEAL, JR., MD,*,t EDWIN HARMON, MD,* TIMOTHY HLAVINKA, MD,Í M. BERNICE KAACK, Ph.D.,t and RAJU THOMAS, MD ... Prior to treatment, each animal underwent an excretory urogram, which documented the presence of anatomically normal kidneys without obstruction or ...
... DURWOOD E. NEAL, JR., MD,§ EDWIN HARMON, MD,§ TIMOTHY HLAVINKA, MD,t ANNE MORVANT, MRT,§ ELIZ... more ... DURWOOD E. NEAL, JR., MD,§ EDWIN HARMON, MD,§ TIMOTHY HLAVINKA, MD,t ANNE MORVANT, MRT,§ ELIZABETH RICHARDSON,§ and RAJU THOMAS, MD§ ABSTRACT ... One animal in the single-treatment group died from renal hemorrhage the day after treatment. ...
Bilateral hydrocalycosis secondary to radiographically demonstrated bilateral infundibular stenos... more Bilateral hydrocalycosis secondary to radiographically demonstrated bilateral infundibular stenosis required a left nephrectomy in an 18-year-old young man. The infundibular narrowing was due to marked hyperplasia of the submucosal smooth muscle. Scattered within the hypertrophic smooth muscle were rare spindled CD117-positive interstitial cells, similar to the cells responsible for peristaltic pacemaker activity within the gastrointestinal tract. The admixture of CD117 cells suggests this is a true muscular hyperplasia rather than a leiomyomatosis. The stimulus to the hyperplasia is unknown.
Extensive urethral defects in the presence of insufficient local skin can challenge the reconstru... more Extensive urethral defects in the presence of insufficient local skin can challenge the reconstructive urologist. We report a case of complete anterior urethral loss due to Fournier's gangrene that was successfully reconstructed using autologous buccal mucosa. A 17.5 x 2.5 cm tube graft was harvested, extending from the left to right buccal regions along the lower labial fold. At long-term follow-up, the patient had an acceptable cosmetic result with maintenance of potency and the ability to urinate. Buccal mucosal grafts are a viable alternative for cases of near-total urethral reconstruction.
Continent reconstruction of the lower urinary tract using the appendicovesicostomy (Mitrofanoff p... more Continent reconstruction of the lower urinary tract using the appendicovesicostomy (Mitrofanoff principle) is an excellent means of managing many patients with altered bladder function, especially those with good bladder volume and low pressure. Motivated patients unable to perform urethral catheterization because of paresis or other reasons now have a method of urinary diversion free of an appliance, though additional procedures may be necessary if bladder volume is low and/or bladder pressure is high. We no longer routinely perform appendectomy during bladder substitution or bladder augmentation procedures. By removing the appendix, we may be discarding an appendage that might prove useful should future urinary reconstruction procedures be required.
Bilateral hydrocalycosis secondary to radiographically demonstrated bilateral infundibular stenos... more Bilateral hydrocalycosis secondary to radiographically demonstrated bilateral infundibular stenosis required a left nephrectomy in an 18-year-old young man. The infundibular narrowing was due to marked hyperplasia of the submucosal smooth muscle. Scattered within the hypertrophic smooth muscle were rare spindled CD117-positive interstitial cells, similar to the cells responsible for peristaltic pacemaker activity within the gastrointestinal tract. The admixture of CD117 cells suggests this is a true muscular hyperplasia rather than a leiomyomatosis. The stimulus to the hyperplasia is unknown.
Urachal anomalies are relatively uncommon and result because of incomplete obliteration of the ur... more Urachal anomalies are relatively uncommon and result because of incomplete obliteration of the urachus prenatally. In children, urachal cysts and sinuses constitute the common presentations, and these can sometimes become secondarily infected. Malignant involvement of the urachus in the pediatric population is rare, and primary urachal adenocarcinoma is reported exclusively in adults. Herein, we present the case of an adolescent girl with a low-grade mucinous neoplasm arising in a urachal cyst and discuss its significance.
The treatment of urolithiasis in children has changed dramatically in recent years. With the prov... more The treatment of urolithiasis in children has changed dramatically in recent years. With the proven safety and efficacy of extracorporeal shock wave lithotripsy (ESWL), percutaneous lithotripsy and ureteroscopy in adults, these modalities are now in the forefront of the treatment of pediatric urinary stones. Our research in the juvenile non-human primate with ESWL indicates that renal damage in most cases is neither significant or persistent. In addition, technological advances in instrumentation have cleared the way for the use of percutaneous lithotripsy and ureteroscopy in most pediatric patients. Today, open surgical procedures for stone disease in children should be a last resort.
... NEAL, JR., MD,*,t EDWIN HARMON, MD,* TIMOTHY HLAVINKA, MD,Í M. BERNICE KAACK, Ph.D.,t and RAJ... more ... NEAL, JR., MD,*,t EDWIN HARMON, MD,* TIMOTHY HLAVINKA, MD,Í M. BERNICE KAACK, Ph.D.,t and RAJU THOMAS, MD ... Prior to treatment, each animal underwent an excretory urogram, which documented the presence of anatomically normal kidneys without obstruction or ...
... DURWOOD E. NEAL, JR., MD,§ EDWIN HARMON, MD,§ TIMOTHY HLAVINKA, MD,t ANNE MORVANT, MRT,§ ELIZ... more ... DURWOOD E. NEAL, JR., MD,§ EDWIN HARMON, MD,§ TIMOTHY HLAVINKA, MD,t ANNE MORVANT, MRT,§ ELIZABETH RICHARDSON,§ and RAJU THOMAS, MD§ ABSTRACT ... One animal in the single-treatment group died from renal hemorrhage the day after treatment. ...
Bilateral hydrocalycosis secondary to radiographically demonstrated bilateral infundibular stenos... more Bilateral hydrocalycosis secondary to radiographically demonstrated bilateral infundibular stenosis required a left nephrectomy in an 18-year-old young man. The infundibular narrowing was due to marked hyperplasia of the submucosal smooth muscle. Scattered within the hypertrophic smooth muscle were rare spindled CD117-positive interstitial cells, similar to the cells responsible for peristaltic pacemaker activity within the gastrointestinal tract. The admixture of CD117 cells suggests this is a true muscular hyperplasia rather than a leiomyomatosis. The stimulus to the hyperplasia is unknown.
Extensive urethral defects in the presence of insufficient local skin can challenge the reconstru... more Extensive urethral defects in the presence of insufficient local skin can challenge the reconstructive urologist. We report a case of complete anterior urethral loss due to Fournier's gangrene that was successfully reconstructed using autologous buccal mucosa. A 17.5 x 2.5 cm tube graft was harvested, extending from the left to right buccal regions along the lower labial fold. At long-term follow-up, the patient had an acceptable cosmetic result with maintenance of potency and the ability to urinate. Buccal mucosal grafts are a viable alternative for cases of near-total urethral reconstruction.
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Papers by Edwin Harmon