Shamael Elam

69 timestamped statements across 2 collections — auto-found in recorded discussions, each timestamp jumps to the exact moment.

Featured diaries

▶ Ep 24 · 32:05
I personally have no trouble dividing bladder necks and doing the reimplant, bringing down a vasicostomy, the time of flake repair for those 5 centimeter common channels because I really haven't seen any 5 centimeter common channels with volitional voiding that are very.
quote · Anorectal Malformation
▶ Ep 61 · 32:05
I personally have no trouble dividing bladder necks and doing the reimplant, bringing down a vasicostomy, the time of flake repair for those 5 centimeter common channels because I really haven't seen any 5 centimeter common channels with volitional voiding that are very.
quote · Colorectal / ARM & Hirschsprung
▶ Ep 61 · 32:05
I personally have no trouble dividing bladder necks and doing the reimplant, bringing down a vasicostomy, the time of flake repair for those 5 centimeter common channels because I really haven't seen any 5 centimeter common channels with volitional voiding that are very.
quote · Colorectal / ARM & Hirschsprung
▶ Ep 24 · 18:04
Implant the metrofenoff very carefully and then see where the malone goes. If you try and push the alone to the umbilicus after you've implanted the metrofenoff, you're limited by your blood supply, and there have been reports of it ripping.
quote · Anorectal Malformation

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Anorectal Malformation 23 entries

Urologic and Gynecologic Aspects in Anorectal Malformations: Pediatric...

▶ Ep 24 · 0:53
clinical A voiding cystourethrogram showing high-grade reflux with ureteral dilation, tortuosity, and renal pelvis dilation indicates a child at relatively high risk who should be followed closely and warrants urologic evaluation. ↗
▶ Ep 24 · 1:08
quote This is a child who is at relatively high risk, and this is a child that should be followed pretty, pretty closely and definitely it warrants a urologic evaluation. ↗
▶ Ep 24 · 4:33
clinical Solitary kidney patients are at higher risk for further injury of that solitary kidney, generally in the case of unrecognized or underdiagnosed neurogenic bladder. ↗
▶ Ep 24 · 7:05
clinical In ARM patients at risk with solitary kidney, height and weight growth and development are very important to track—a creatinine of 0.3 may be normal but a child at the 4th percentile for height and weight is not normal. ↗
▶ Ep 24 · 7:08
quote The creatinine may be 0.3 for the 1st 12 months of life or 18 months of life, but the child could be at the 4th percentile for height and weight. That's not a normal condition. ↗
▶ Ep 24 · 10:41
clinical A 12-year-old ex-cloaca repair patient who is voiding well, has urinary control, and no UTIs may still have underlying neuropathic bladder that could lead to renal failure by age 30. ↗
▶ Ep 24 · 10:58
quote The morbidity is the functional morbidity. The structural morbidity is something everyone in the room can see. ↗
▶ Ep 24 · 11:19
quote A neuropathic bladder doesn't mean that they leak. It doesn't always mean that they have urinary tract infections, and there's some subtleties. ↗
▶ Ep 24 · 11:19
clinical Neuropathic bladder does not always mean the patient leaks or has urinary tract infections—there are subtleties requiring renal function studies (cystatin C) to assess GFR and overall kidney health. ↗
▶ Ep 24 · 13:07
clinical ARM patients with bladder neck fistula, single kidney, reflux, and tethered cord are at high risk for neurogenic bladder, and expectations should not be set for volitional voiding. ↗
▶ Ep 24 · 13:18
quote Expectations should not be set in terms of volitional voiding in that patient population. It's nice to be wrong, and let's say they have volitional voiding and they're healthy, that's great, then we're wrong. ↗
▶ Ep 24 · 13:31
quote I can tell you based on the number of patients that are seeing me, especially in their 20s and 30s, um, I don't think we're right. ↗
▶ Ep 24 · 16:47
clinical The split appendix technique uses the proximal appendix (closest to cecum) for Malone and the distal appendix for Mitrofanoff. ↗
▶ Ep 24 · 17:09
guideline Even if a child has malrotation, the appendix should not be removed electively in ARM patients because it may be needed for Mitrofanoff or Malone. ↗
▶ Ep 24 · 17:25
opinion The appendix makes a better Mitrofanoff with longer durability than a tapered ileal piece. ↗
▶ Ep 24 · 17:25
quote The appendix makes a really nice metrofenoff that tends to have a little bit longer, uh, durability, so to speak, than a tapered, uh, ileal piece for uh metrofenov. ↗
▶ Ep 24 · 18:04
clinical When using split appendix technique, implant the Mitrofanoff first and then see where the Malone goes—pushing the Malone to the umbilicus after Mitrofanoff implantation can cause blood supply problems and reports of ripping. ↗
▶ Ep 24 · 18:04
quote Implant the metrofenoff very carefully and then see where the malone goes. If you try and push the alone to the umbilicus after you've implanted the metrofenoff, you're limited by your blood supply, and there have been reports of it ripping. ↗
▶ Ep 24 · 32:05
clinical Five centimeter common channel cloaca patients rarely have volitional voiding that is functional later in life. ↗
▶ Ep 24 · 32:05
quote I personally have no trouble dividing bladder necks and doing the reimplant, bringing down a vasicostomy, the time of flake repair for those 5 centimeter common channels because I really haven't seen any 5 centimeter common channels with volitional voiding that are very. ↗
▶ Ep 24 · 34:01
clinical A circle stent (small 6 or 8 French elastic catheter) that comes out of the urethral repair and bladder and ties to itself, protected with a suprapubic tube, allows 100% certainty about urethral healing and avoids a perineal catheter that can be pulled. ↗
▶ Ep 24 · 34:36
clinical Patients who need vesicostomy probably have some impairment in bladder function and may need intermittent catheterization. ↗
▶ Ep 24 · 34:36
quote You have to remember that patients who tend to get to the point where they need a vesicostomy probably have some impairment in bladder function, and there may be a risk that those patients would then need intermittent catheterization. ↗
Colorectal / ARM & Hirschsprung 46 entries

Urologic and Gynecologic Aspects in Anorectal Malformations: Pediatric...

▶ Ep 61 · 0:53
clinical A voiding cystourethrogram showing high-grade reflux with ureteral dilation, tortuosity, and renal pelvis dilation indicates a child at relatively high risk who should be followed closely and warrants urologic evaluation. ↗
▶ Ep 61 · 0:53
clinical A voiding cystourethrogram showing high-grade reflux with ureteral dilation, tortuosity, and renal pelvis dilation indicates a child at relatively high risk who should be followed closely and warrants urologic evaluation. ↗
▶ Ep 61 · 1:08
quote This is a child who is at relatively high risk, and this is a child that should be followed pretty, pretty closely and definitely it warrants a urologic evaluation. ↗
▶ Ep 61 · 1:08
quote This is a child who is at relatively high risk, and this is a child that should be followed pretty, pretty closely and definitely it warrants a urologic evaluation. ↗
▶ Ep 61 · 4:33
clinical Solitary kidney patients are at higher risk for further injury of that solitary kidney, generally in the case of unrecognized or underdiagnosed neurogenic bladder. ↗
▶ Ep 61 · 4:33
clinical Solitary kidney patients are at higher risk for further injury of that solitary kidney, generally in the case of unrecognized or underdiagnosed neurogenic bladder. ↗
▶ Ep 61 · 7:05
clinical In ARM patients at risk with solitary kidney, height and weight growth and development are very important to track—a creatinine of 0.3 may be normal but a child at the 4th percentile for height and weight is not normal. ↗
▶ Ep 61 · 7:05
clinical In ARM patients at risk with solitary kidney, height and weight growth and development are very important to track—a creatinine of 0.3 may be normal but a child at the 4th percentile for height and weight is not normal. ↗
▶ Ep 61 · 7:08
quote The creatinine may be 0.3 for the 1st 12 months of life or 18 months of life, but the child could be at the 4th percentile for height and weight. That's not a normal condition. ↗
▶ Ep 61 · 7:08
quote The creatinine may be 0.3 for the 1st 12 months of life or 18 months of life, but the child could be at the 4th percentile for height and weight. That's not a normal condition. ↗
▶ Ep 61 · 10:41
clinical A 12-year-old ex-cloaca repair patient who is voiding well, has urinary control, and no UTIs may still have underlying neuropathic bladder that could lead to renal failure by age 30. ↗
▶ Ep 61 · 10:41
clinical A 12-year-old ex-cloaca repair patient who is voiding well, has urinary control, and no UTIs may still have underlying neuropathic bladder that could lead to renal failure by age 30. ↗
▶ Ep 61 · 10:58
quote The morbidity is the functional morbidity. The structural morbidity is something everyone in the room can see. ↗
▶ Ep 61 · 10:58
quote The morbidity is the functional morbidity. The structural morbidity is something everyone in the room can see. ↗
▶ Ep 61 · 11:19
quote A neuropathic bladder doesn't mean that they leak. It doesn't always mean that they have urinary tract infections, and there's some subtleties. ↗
▶ Ep 61 · 11:19
clinical Neuropathic bladder does not always mean the patient leaks or has urinary tract infections—there are subtleties requiring renal function studies (cystatin C) to assess GFR and overall kidney health. ↗
▶ Ep 61 · 11:19
quote A neuropathic bladder doesn't mean that they leak. It doesn't always mean that they have urinary tract infections, and there's some subtleties. ↗
▶ Ep 61 · 11:19
clinical Neuropathic bladder does not always mean the patient leaks or has urinary tract infections—there are subtleties requiring renal function studies (cystatin C) to assess GFR and overall kidney health. ↗
▶ Ep 61 · 13:07
clinical ARM patients with bladder neck fistula, single kidney, reflux, and tethered cord are at high risk for neurogenic bladder, and expectations should not be set for volitional voiding. ↗
▶ Ep 61 · 13:07
clinical ARM patients with bladder neck fistula, single kidney, reflux, and tethered cord are at high risk for neurogenic bladder, and expectations should not be set for volitional voiding. ↗
▶ Ep 61 · 13:18
quote Expectations should not be set in terms of volitional voiding in that patient population. It's nice to be wrong, and let's say they have volitional voiding and they're healthy, that's great, then we're wrong. ↗
▶ Ep 61 · 13:18
quote Expectations should not be set in terms of volitional voiding in that patient population. It's nice to be wrong, and let's say they have volitional voiding and they're healthy, that's great, then we're wrong. ↗
▶ Ep 61 · 13:31
quote I can tell you based on the number of patients that are seeing me, especially in their 20s and 30s, um, I don't think we're right. ↗
▶ Ep 61 · 13:31
quote I can tell you based on the number of patients that are seeing me, especially in their 20s and 30s, um, I don't think we're right. ↗
▶ Ep 61 · 16:47
clinical The split appendix technique uses the proximal appendix (closest to cecum) for Malone and the distal appendix for Mitrofanoff. ↗
▶ Ep 61 · 16:47
clinical The split appendix technique uses the proximal appendix (closest to cecum) for Malone and the distal appendix for Mitrofanoff. ↗
▶ Ep 61 · 17:09
guideline Even if a child has malrotation, the appendix should not be removed electively in ARM patients because it may be needed for Mitrofanoff or Malone. ↗
▶ Ep 61 · 17:09
guideline Even if a child has malrotation, the appendix should not be removed electively in ARM patients because it may be needed for Mitrofanoff or Malone. ↗
▶ Ep 61 · 17:25
opinion The appendix makes a better Mitrofanoff with longer durability than a tapered ileal piece. ↗
▶ Ep 61 · 17:25
quote The appendix makes a really nice metrofenoff that tends to have a little bit longer, uh, durability, so to speak, than a tapered, uh, ileal piece for uh metrofenov. ↗
▶ Ep 61 · 17:25
quote The appendix makes a really nice metrofenoff that tends to have a little bit longer, uh, durability, so to speak, than a tapered, uh, ileal piece for uh metrofenov. ↗
▶ Ep 61 · 17:25
opinion The appendix makes a better Mitrofanoff with longer durability than a tapered ileal piece. ↗
▶ Ep 61 · 18:04
clinical When using split appendix technique, implant the Mitrofanoff first and then see where the Malone goes—pushing the Malone to the umbilicus after Mitrofanoff implantation can cause blood supply problems and reports of ripping. ↗
▶ Ep 61 · 18:04
quote Implant the metrofenoff very carefully and then see where the malone goes. If you try and push the alone to the umbilicus after you've implanted the metrofenoff, you're limited by your blood supply, and there have been reports of it ripping. ↗
▶ Ep 61 · 18:04
quote Implant the metrofenoff very carefully and then see where the malone goes. If you try and push the alone to the umbilicus after you've implanted the metrofenoff, you're limited by your blood supply, and there have been reports of it ripping. ↗
▶ Ep 61 · 18:04
clinical When using split appendix technique, implant the Mitrofanoff first and then see where the Malone goes—pushing the Malone to the umbilicus after Mitrofanoff implantation can cause blood supply problems and reports of ripping. ↗
▶ Ep 61 · 32:05
quote I personally have no trouble dividing bladder necks and doing the reimplant, bringing down a vasicostomy, the time of flake repair for those 5 centimeter common channels because I really haven't seen any 5 centimeter common channels with volitional voiding that are very. ↗
▶ Ep 61 · 32:05
clinical Five centimeter common channel cloaca patients rarely have volitional voiding that is functional later in life. ↗
▶ Ep 61 · 32:05
quote I personally have no trouble dividing bladder necks and doing the reimplant, bringing down a vasicostomy, the time of flake repair for those 5 centimeter common channels because I really haven't seen any 5 centimeter common channels with volitional voiding that are very. ↗
▶ Ep 61 · 32:05
clinical Five centimeter common channel cloaca patients rarely have volitional voiding that is functional later in life. ↗
▶ Ep 61 · 34:01
clinical A circle stent (small 6 or 8 French elastic catheter) that comes out of the urethral repair and bladder and ties to itself, protected with a suprapubic tube, allows 100% certainty about urethral healing and avoids a perineal catheter that can be pulled. ↗
▶ Ep 61 · 34:01
clinical A circle stent (small 6 or 8 French elastic catheter) that comes out of the urethral repair and bladder and ties to itself, protected with a suprapubic tube, allows 100% certainty about urethral healing and avoids a perineal catheter that can be pulled. ↗
▶ Ep 61 · 34:36
clinical Patients who need vesicostomy probably have some impairment in bladder function and may need intermittent catheterization. ↗
▶ Ep 61 · 34:36
quote You have to remember that patients who tend to get to the point where they need a vesicostomy probably have some impairment in bladder function, and there may be a risk that those patients would then need intermittent catheterization. ↗
▶ Ep 61 · 34:36
clinical Patients who need vesicostomy probably have some impairment in bladder function and may need intermittent catheterization. ↗
▶ Ep 61 · 34:36
quote You have to remember that patients who tend to get to the point where they need a vesicostomy probably have some impairment in bladder function, and there may be a risk that those patients would then need intermittent catheterization. ↗