0000000000515076
AUTHOR
G. Voges
Postersitzung 6: Extrakorporale Stoßwellenlithotripsie (ESWL) bei komplizierter Urolithiasis
Die Nierensteinbehandlung hat sich mit Einfuhrung von PCNL und ESWL innerhalb weniger Jahre dramatisch gewandelt. Die Kombination von PCNL plus ESWL minimiert die Nachteile beider Techniken, die sie in ihrer alleinigen Anwendung bei der Behandlung von Ausgussteinen aufweisen. Uber unsere ersten Erfahrungen mit diesem Therapiekonzept haben wir bereits berichtet [1]. Bisher ist jedoch noch unklar, welche Spatergebnisse in diesen mit PCNL plus ESWL behandelten Patienten erzielt werden. In dieser Studie haben wir daher Patienten nachuntersucht, die 1984 und 1985 an unserer Klinik wegen Ausgussteinen kombiniert mit PCNL plus ESWL behandelt worden waren.
DNA Histogram of Invasive Bladder Carcinoma: Comparison of Flow Cytometry and Automated Image Analysis
Invasive bladder carcinoma is characterized by a considerable interindividual heterogeneity. The natural course of the disease as well as sensitivity of the tumors to various treatment modalities are thus unpredictable. Searching for more accurate characteristics of tumor biology than those presently available, the DNA histograms of 65 paraffin-preserved bladder carcinomas from cystectomy specimens were analyzed. Flow cytometry and automated image analysis, two competing methods, were compared.
Vergleich von Beckenangiographie, gepulster Dopplersonographie und penobrachialem Index in der Abklärung der erektilen Impotenz
Die Beckenangiographie galt bisher in der Abklarung der erektilen Dysfunktion zur Beurteilung der Penisgefase als Methode der Wahl [3]. Als Scree-ning-Untersuchung wird der penobrachiale Index (PBI) als nicht invasives diagnostisches Verfahren durchgefuhrt.
Lokale Stoßwellenlithotripsie des Harnleitersteins — Klinische Ergebnisse
Im Zeitraum zwischen dem 1.3. l986 und 31.10.1986 wurde in der Urologischen Abteilung der Universitat Mainz bei 134 Patienten mit Harnleitersteinen eine lokale Stoswellenlithotripsie (LS) mit dem Siemens Lithostar durchgefuhrt. Dies entspricht 30% aller in diesem Zeitraum behandelten LS-Patienten. Zweitbehandlungen waren in 7% der Falle, auxilliare Masnahmen in 6% erforderlich.
Computerized tomography: an unreliable method for accurate staging of bladder tumors in patients who are candidates for radical cystectomy.
A total of 164 patients with bladder tumors underwent preoperative staging by computerized tomography. All patients were previously untreated, or had undergone only transurethral biopsy or resection of the tumor before computerized tomography. The post-cystectomy histological stage was compared to the preoperative computerized tomography stage. Computerized tomography accuracy according to the tumor, nodes and metastasis classification was only 32.3%, whereas overstaging was found in 39.6% and understaging in 28.1% of the cases. In untouched tumors or after transurethral resection computerized tomography accuracy demonstrated no significant difference. Only 2 of 19 true positive lymph nodes…
Die perkutane Harnleiterokklusion
One hundred and nineteen transrenal occlusions of 77 ureters were carried out in 71 patients. Thirty-one ureters were occluded by means of glue and in 21 Gianturco coils were introduced at the same time. Forty-six ureters were occluded by means of disposable silicone-filled latex balloons. Seventeen out of 31 ureters treated with glue (55%) and 32 out of 46 ureters with balloons (70%) were permanently occluded. On 42 occasions, re-occlusions had to be carried out, the average period from the initial occlusion being 2.5 weeks for glue and 19.5 weeks for balloons. In nine out of the 119 ureteric occlusions (7.5%), there were mild complications; these were easily treated and were of no consequ…
Adjuvant polychemotherapy of nonorgan-confined bladder cancer after radical cystectomy revisited: long-term results of a controlled prospective study and further clinical experience.
A total of 83 patients with nonorgan-confined bladder cancer with or without lymph node metastases (tumor stages pT3b, pT4a and/or pN1, pN2) was evaluated in November 1993 for relapse-free and overall survival. All patients underwent radical cystectomy between 1987 and 1991, 38 underwent adjuvant polychemotherapy with methotrexate, vinblastine and cisplatin plus doxorubicin (M-VAC) or epirubicin (M-VEC). Of the 83 patients 49 had entered a prospective randomized trial comparing adjuvant to no adjuvant treatment. The protocol was activated in May 1987. Patient recruitment was concluded in December 1990 because an interim analysis of the 49 randomized patients revealed a significant prognosti…
Advanced Bladder Cancer (Stages pT3b, pT4a, pN1 and pN2): Improved Survival after Radical Cystectomy and 3 Adjuvant Cycles of Chemotherapy. Results of a Controlled Prospective Study
A total of 49 bladder cancer patients with tumor stages pT3b, pT4a and/or pelvic lymph node involvement without microscopic or macroscopic evidence of residual tumor was randomized into 2 comparative groups: the chemotherapy group was to receive 3 adjuvant cycles of methotrexate, vinblastine and cisplatin plus doxorubicin (M-VAC) or epirubicin (M-VEC) after radical cystectomy. The control group received no additional treatment. The protocol was activated in May 1987. Patient recruitment was concluded in December 1990 because an interim analysis of the 49 randomized patients revealed a significant prognostic advantage in favor of 26 patients randomized to the chemotherapy group compared to 2…
Probleme der Stadieneinteilung beim fortgeschrittenen Blasentumor
Eine bis zu 50% reichende Unterschatzung der Blasencarcinome in den Stadien pTa bis hin zum Stadium pT3a, eine uber 50% reichende Uberschatzung der Stadien pT3b und pT4 und eine richtige Aussage in nur 44% der Falle kennzeichnen die Problematik der exakten klinischen Stadienerfassung von Blasentumoren in der „Vor-CT-Aera“ [2].
Vergleich von Duplexsonographie und CT zur Beurteilung des Tumoreinbruchs in Vena renalis und Vena cava inferior bei Nierentumoren
Die praoperative Kenntnis der Tumorinvasion von Nierentumoren in Vena renalis und Vena cava inferior ist fur die Operationsstrategie von entscheidender Bedeutung.
Therapiekonzept bei kindlichen Doppelnieren
Im folgenden soll unser Therapiekonzept bei Doppelnieren mit Reflux, ektopem Harnleiter und ektoper Ureterozele aufgezeigt werden.
Epithelioid Leiomyoma of the Prostate
We report a case of an unusual mesenchymal tumor of the prostate. Rectal-digital palpation and transrectal ultrasound showed a circumscribed and inhomogeneous tumor within the right prostatic lobe. Surgical treatment consisted of transurethral resection of the right prostatic lobe. On the basis of morphology and immunohistochemical detection of desmin and smooth-muscle-type actin, the diagnosis of an epithelioid leiomyoma was made. This is the first report of this entity in the prostate. A definite prediction of the biological potential is currently not yet possible.
Analysis of Meatal Location in 500 Men
AbstractThe high incidence (70 percent) of anterior hypospadias, mostly without penile curvature, in our pediatric hypospadias patients led us to study the meatal location in normal men to investigate if meatal advancement in all patients with anterior hypospadias can be justified when the wide variation of meatal locations in normal men is considered. The location of the external meatus was analyzed in 500 men (mean age 57 years) with classification of the meatal position in relation to the tip of the glans and corona. Quality of erections and sexual intercourse, presence or absence of penile curvature, urinary stream and ability to void in a standing position were assessed in an interview…
Verwendung von Spalthauttransplantaten zur Rekonstruktion des äußeren Genitale
Das Hauptproblem bei der Rekonstruktion des auseren Genitale bei sog. Hypospadie- bzw. Epispadiekruppeln liegt im Mangel an lokal vorhandener, verwendungsfahiger Haut. Dasselbe Problem stellt sich bei der primaren Penisausgrabung bei Patienten mit Epispadie und Blasenexstrophie. In diesen Fallen mus auf freie Transplantate zuruckgegriffen werden. Zur Rekonstruktion der Urethra gewinnt der freie Blasenschleimhautlappen zunehmend weltweite Verbreitung [3, 6]. Zur plastischen Deckung des denudierten Penis bietet sich die Spalthauttransplantation an.
Tunica vaginalis Free Grafts for Closure of Urethrocutaneous Fistulas
In 32 patients a tunica vaginalis free graft was used for closure of urethrocutaneous fistulas (n = 26) or complicated hypospadias repair (n = 6). All patients had at least one operation (average 3.9) for urethral reconstruction prior to this procedure. 12 patients had recurrent fistulas (average 2.2). The technique proved to be very successful. Only 2 patients had to undergo subsequent reoperation for recurrent fistulas. The use of a free tunica vaginalis graft interposed between skin and urethra is our method of choice in the repair of recurrent or complicated urethrocutaneous fistulas.
Local Shock-Wave Lithotripsy of Distal Ureteral Calculi
Abstract Since the initiation of the clinical trial utilizing a second-generation lithotripor (Lithostar, Siemens, Erlangen, FRG), 96 patients with distal ureteral calculi (i.e. calculi below the pelvic brim) underwent local shock-wave lithotripsy. Routine treatment was conducted under intravenous sedation and light analgesia only. Complete stone disintegration was achieved in 84 patients (87.5%), 11 requiring two sessions and 1 patient, three. In 7 patients ureteroscopy became necessary after unsuccessful local shock-wave treatment. In 2 of these patients a 9-french flexible ureteroscope and the Storz Q-switched neodymium-YAG laser was used for stone disintegration. In 3 cases loop extract…
Therapiekonzept beim Sinus urogenitalis
Sinusanomalien lassen sich nach ihrem Schweregrad gemas Williams in Typ I und Typ II einteilen [5].
Comparison of selective internal iliac pharmaco-angiography, penile brachial index and duplex sonography with pulsed Doppler analysis for the evaluation of vasculogenic (arteriogenic) impotence.
AbstractBetween July 1987 and February 1988 selective internal iliac angiography was performed before and after intracavernous injection of papaverine plus phentolamine in 43 patients with erectile dysfunction. In 63% of the patients stenosis or occlusion of the pudendal artery was found. The penile brachial index was calculated and duplex sonography with pulsed Doppler analysis was performed in 23 patients. Angiography and penile brachial index correlated in only 39% of the patients, whereas selective internal iliac angiography and duplex sonography correlated in 91% (21 of 23). In 2 patients duplex sonography with pulsed Doppler analysis rendered better information about penile arterial p…
Ureterosigmoidostomy: an outdated approach to bladder exstrophy?
Long-term results among 46 children with ureterosigmoidostomy are presented. The indication for ureterosigmoidostomy had been bladder exstrophy in 40 patients, incontinent epispadias in 5 and neurogenic bladder dysfunction in 1. Of the 40 patients with bladder exstrophy 8 had undergone ureterosigmoidostomy after failure of other types of urinary tract reconstruction (6 had upper tract dilatation before ureterosigmoidostomy). Three patients with previously damaged upper urinary tracts required early postoperative conversion because of severely increasing kidney dilatation. Three other patients required conversion after a mean of 10 years to preserve kidney function. One patient died after 16…
Characterization of conservatively resected renal tumors using automated image analysis DNA cytometry
The DNA histograms of 57 conservatively resected renal tumors were studied using automated image analysis DNA cytometry (Leytas II). Forty-nine of the analyzed tumors were renal cell carcinomas, six were oncocytomas, one was an angiomyolipoma, and one was a renal cell adenoma. On the basis of their DNA histograms, diploid, tetraploid, and aneuploid tumors could be distinguished. Aneuploid tumors could be subtyped further according to the DNA content of the stem cell line as hyperdiploid, hypertriploid, or hypertetraploid. Eight of the tumors were characterized by a combination of diploid and hypertriploid stem cell lines. During a mean follow-up of 5 years, only the two patients with a pure…
Pheochromocytoma in the Pediatric Age Group: The Prostate—An Unusual Location
AbstractPheochromocytomas of the prostate are rare, with only 3 cases in adults reported in the literature. We present the case of an 8-year-old boy with a pheochromocytoma of the prostate and a second tumor in the region of the left internal iliac artery. (J. Urol., 144: 1219–1221, 1990)