0000000000116925
AUTHOR
M. Marberger
Hemodynamic effects of experimental testicular torsion.
Experimental testicular torsion must be used for certain studies of clinical relevance, but most experimental models either do not provide hemodynamic alteration comparable to the clinical situation or cannot guarantee reproducibility. Using a rat model arterial perfusion and hemorrhagic infarction were correlated to the degree of both intra- and extravaginal testicular torsion. Arterial inflow was measured sequentially with radiolabelled microspheres, hemorrhagic infarction was judged by the increase of testicular weight. Maximal hemorrhagic infarction and reproducible values were found when the spermatic cord was twisted together with the tunica vaginalis for 360 degrees-540 degrees.
Postersitzung 9: Therapeutische Alternativen beim Harnleiterstein
In der heutigen Therapie des Harnleitersteines dominiert eindeutig die ESWL. Bei erfolgloser ESWL oder bei speziellen Indikationen wie grose obere Harnleitersteine oder Steine in Projektion auf die Ileosacralfuge kommen die endourologischen Masnahmen zum Tragen. Die Indikationsbreite fur den Einsatz einer Schlinge ist insbesondere wegen der Gefahr der aufsteigenden Infekte nur noch sehr gering. Da selbst bei anatomischen Veranderungen diese haufig durch endourologische Masnahmen beseitigt werden konnen, steht die offene Schnittoperation im Rahmen der Therapie des Harnleitersteines an letzter Stelle.
The Lich-Gregoir antireflux plasty: experiences with 371 children.
AbstractThe Lich-Gregoir antireflux procedure is a simple and safe method for the treatment of primary reflux of all grades if the ureter is not grossly dilated on the excretory urogram. Reflux was cured in 97.7 per cent of 429 ureters in 371 children. A stenosis of the terminal ureter requiring reimplantation occurred in 0.5 per cent. The over-all rate of reinterventions was 3.7 per cent. This low complication rate makes surgical correction of reflux advisable if urinary tract infection and primary reflux cannot be eradicated by continuous antimicrobial therapy within 6 months.
Ballon occlusion of the renal artery in tumor nephrectomy.
AbstractA method of preoperative intraluminal occlusion of the renal artery in cases of kidney tumors using a 5F Swan-Ganz balloon catheter is presented. The procedure was used in 26 tumor nephrectomies without complications and resulted in marked facilitation of the operation in 70 per cent of the cases.
119. Zur Problematik der Verletzungen des Harntraktes bei Beckenfrakturen
Infolge Zunahme der Verletzungen der Harnwege im Rahmen von Beckenfrakturen sollte die urologische Diagnostik in den Untersuchungsgang mit einbezogen werden. Leitsymptome weisen auf eine Harnrohren- oder Harnblasenverlet zung hin. Anzustreben ist in jedem Falle die Durchfuhrung eines Infusionsurogrammes. Bei Harnrohrenverletzungen sollte zusatzlich durch ein Urethrocystogramm eine genaue Lokalisation der Rupturstelle ermoglicht werden. Mit der operativen Versorgung der urologischen Verletzungen sollte gleichzeitig eine Stabilisierung des vorderen Beckenringes erfolgen.
Transcatheter embolization of the kidney with butyl-2-cyanoacrylate: Experimental and clinical results
The technique and efficacy of therapeutic catheter embolization of the kidney with butyl-2-cyanoacrylate (Histoacryl) were studied in 80 rabbits (including control groups) and in 10 dogs. A mixture of butyl-2-cyanoacrylate, 50% glucose, and tantalum powder was used for the embolization. Complete and permanent vascular occlusion was found in nearly all cases. The main complication observed was a reflux of embolizing material into the lumbar arteries, which occurred in seven rabbits. Clinically, therapeutic embolization was performed in six patients with hypernephroma. The indication for embolization in these patients, as well as in two others with iatrogenic lesions, was pronounced hematuria…
Percutaneous Stone Manipulation
Percutaneous stone manipulation by direct ultrasound disintegration, extraction or chemolysis was done on 34 patients. A total of 15 patients presented with an operatively established nephrostomy, while percutaneous nephrostomy and subsequent dilation of the nephrostomy channel were done in 19. The rate of complete stone clearance was 19 of 20 stones after percutaneous nephrostomy and 8 of 16 stones in the group with an operatively established nephrostomy. The primary goal, to remove obstructing pelvic stones, was achieved in all cases. There were no untoward side effects, such as back pressure damage owing to flushing of the collecting system during ultrasound disintegration, or persistent…
Simultaneous Balloon Occlusion of the Renal Artery and Hypothermic Perfusion in in Situ Surgery of the Kidney
AbstractRenal ischemia and cooling may be achieved by intraluminal balloon occlusion and intermittent hypothermic perfusion using a double lumen, balloon-tipped catheter introduced into the renal artery percutaneously. This technique was used successfully in 26 of 31 extensive nephrolithotomies, eliminating the need for dissection and clamping of the renal artery and intricate surface cooling. Intrarenal operations could be performed as effectively as with clamp occlusion. Despite a mean ischemia time of 54 minutes the individual 131I-hippuran clearance of the operated kidneys was only reduced to a mean 78.4 per cent of the preoperative value 2 to 3 weeks postoperatively and increased to 92…
The impact of in-situ balloon occlusion of the renal artery and hypothermic perfusion on renal blood flow
Unilateral renal blood flow was evaluated in-situ in 13 dogs by cineangiodensitometry and microsphere distribution studies before and after intermittent balloon occlusion with and without hypothermic perfusion of one kidney. The contralateral kidney served as control. No significant difference in renal blood flow and vascular resistance was noted before, and 5, 30 and 60 minutes after unilateral intra-arterial manipulation. Compartmental flow distribution studies in 5 dogs revealed no evidence of alteration of intra-renal haemodynamics. In a clinical pilot study, unilateral renal blood flow measured by cineangiodensitometry showed no change of clinical significance 5 and 60 minutes after in…
Regional hypothermia of the kidney: surface or transarterial perfusion cooling? A functional study.
Hypothermia reduces ischemic damage if prolonged occlusion of the renal artery is required during an in situ kidney operation. Hypothermia may be achieved by external cooling or by transarterial hypothermic perfusion. External cooling may lower intrarenal temperature heterogeneously. Perfusion techniques via intra-arterial catheters introduced percutaneously are associated with minimal technical difficulties. The 95 patients who underwent extensive hypothermic nephrolithotomy had differential 131iodine hippuran clearance studies preoperatively, and 2 weeks and 6 to 46 months postoperatively. Sixty-three kidneys were cooled by transarterial hypothermic perfusion and 39 were cooled with topic…
Experimental Testicular Torsion: Effect on Endocrine and Exocrine Function and Contralateral Testicular Histology
In order to investigate whether unilateral testicular torsion exerts a negative influence on the previously undisturbed contralateral side, exocrine and endocrine testicular function were evaluated before and two months after torsion. A rat model with 6 hours', 12 hours' or permanent extravaginal 540 degrees torsion of the right testis was used; a sham operated group of animals served as controls. Ejaculates were collected by electrostimulation; LH, FSH and testosterone serum levels were determined by radioimmunoassays. Eight weeks after torsion sperm output had decreased by half in the experimental groups, and LH levels increased significantly, whereas the other hormone levels, as well as …