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DerUrologeA.70360162.eng.abstr
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DerUrologeA.70360162.eng.abstr
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"id": "DerUrologeA.70360162.eng.abstr-passage-0",
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"The case of a 10-year-old boy with post-traumatic priapism after perineal trauma is presented . Interdisciplinary treatment using angiography and selective catheter embolization for juvenile high-flow priapism is demonstrated . The literature and the diagnostic possibilities resulting from color duplex sonography are discussed ."
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DerUrologeA.70360165.eng.abstr
|
DerUrologeA.70360165.eng.abstr
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"id": "DerUrologeA.70360165.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Between November 1993 and September 1995 , we carried out visual laser ablation of the prostate ( VLAP ) in 72 high-risk patients ( ASA 3-4 ; severe cardiovascular and/or pulmonary diseases ) aged 60-88 years ( mean 76.7 years ) ; the prostate volume was 22-136 ml ( mean 56 ml ) . The urinary peak flow rates ( Qmax . ) ranged from 2 to 15 ml/s ( mean 4.4 ml/s ) preoperatively ; 42 patients ( 58.3 % ) suffered from acute urinary retention for up to 2 weeks and had an indwelling catheter . The residual urinary volume ( RUV ) was 0-320 ml ( mean 142.3 ml ) in those 30 patients with spontaneous micturition . The International Prostate Symptom Score ( IPSS ) ranged from 10 to 33 ( mean 21.8 ) . In the first 37 patients , pressure-flow studies were carried out only in cases of doubt to verify obstruction . In the last 35 patients , pressure-flow studies were carried out in every case . Perioperatively , there was no appearance of blood loss of absorption of irrigation fluid . None of our patients needed transfusions or intensive care perioperatively . Further complications were not severe and could be handled without problems . In two patients with large benign prostate hypertrophy ( BPH ) a second operation ( VLAP , no conventional transurethral prostatectomy ) was necessary . After 6 weeks , 29.4 % of the patients suffered from symptomatic urinary tract infections ( UTI ) . After 6 months , only 7.1 % of the patients had symptomatic UTI . After 6 weeks ( n = 61 ) , Qmax . was 6-34 ml/s ( mean 15.3 ml/s ) , RUV was 0-230 ml ( mean 51.5 ml ) , and the IPSS was 12.3 ( 8-28 ) . After 3 months ( n = 54 ) , Qmax . was 9-45 ml/s ( mean 19.8 ml/s ) , RUV was 0-96 ml ( mean 31.6 ml ) , and the IPSS was 1-23 ( mean 7.4 ) . After 6 months ( n = 52 ) Qmax . was 12-33 ml/s ( mean 20.4 ml ) , RUV was 0-53 ml ( mean 26.4 ml ) , and the IPSS was 1-12 ( mean 4.1 ) . VLAP provided no further risks for our high-risk patients , while Qmax . , RUV , and IPSS were improved noticeably ( improvement of more than 75 % ) . It represents a step forward in the treatment of obstructive BPH in high-risk patients . Particularly in high-risk patients with cardiac diseases , this procedure lessens the perioperative risk . Despite the minimal appearance of UTI after 6 months , UTI seemed to be the most important complication during the first few weeks after VLAP by virtue of the bothersome symptoms ."
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DerUrologeA.70360177.eng.abstr
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DerUrologeA.70360177.eng.abstr
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"id": "DerUrologeA.70360177.eng.abstr-passage-0",
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"text": [
"Chronic testicular pain represents a challenging urological chronic pain syndrom in terms of adequate diagnosis and therapy . Reported success rates of 55-73 % and 10-40 % of conservative and surgical interventions are extremely low . We report on microsurgical testicular denervation as therapeutic option in patients with chronic testicular pain ( CTP ) . 12 consecutive patients with CTP were included in our study . After complete diagnostic workup and positive response to testicular nerve blockade , all patients underwent surgery : the cremasteric muscle was dissected by electrocautery , the periadventitial layer of the testicular artery was dissected over a length of 2-3 cm . After a median follow-up of 20.6 months ( 4-62 ) 11/12 patients ( 92 % ) are pain free . None of the patients suffered from intraa- or postoperative complications . Based on our experience microsurgical testicular denervation should be performed in patients with CTP and no underlying organic disease . However , the high success rate of our surgical procedure can only be maintained if the selection of suitable patients is performed very carefully and a specific organic origin of CTP has been excluded prior to surgery ."
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[] |
[] |
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DerUrologeA.70360181.eng.abstr
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DerUrologeA.70360181.eng.abstr
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DerUrologeA.70360194.eng.abstr
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DerUrologeA.70360194.eng.abstr
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DerUrologeA.70360209.eng.abstr
|
DerUrologeA.70360209.eng.abstr
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"After treatment of more than 3000 kidney and ureteral stones with the Siemens Lithostar Multiline the results of the first 1400 ureteral stone treatments using the \" Booster technique \" and 3-month follow-up findings are reported . There was a disintegration rate of 98 % directly after treatment ; 1 week after \" Booster technique \" treatment 96 % of the patients were free of stones and without any symptoms . The 3-month follow-up showed a stone-free rate of 97 % . Only in 13 % of the cases auxiliary procedures were neccessary , 7 % of them before extracorporeal shock wave lithotripsy ( ESWL ) and 6 % after ESWL . 43 % of the treatments were performed without any premedication , anaesthesia or sedoanalgesia . Our data even prove that in situ ESWL is a safe and effective method for the treatment of ureteral stones . In comparison to endoscopic procedures , it is superior in regard to invasivity , side effects , complications and neccessity of analgesia , while being just as efficient . Therefore it is recommended as first choice method in the treatment of ureteral stones ."
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DerUrologeA.70360222.eng.abstr
|
DerUrologeA.70360222.eng.abstr
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"text": [
"Questionnaires were mailed anonymously to 150 German shock wave centers . Twenty questions addressed the following areas of interest : - Facilities of the extracorporeal shock wave lithotripsy ( ESWL ) center ( technical , personnel , laboratory , etc. ) - Cooperation at ESWL center with referring urologists - Laboratory facilities versus actual metabolic work-up . The return rate was 114 of 150 ( 76 % ) . Surprisingly , at 58 % of the centers the average number of treatments is less than two per day . In 30 % of the centers only chemical stone analysis is done ! The final conclusion was that ESWL has largely replaced the causal metabolic work-up and subsequent metaphylaxis as a symptomatic measure against urolithiasis ."
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DerUrologeA.70360226.eng.abstr
|
DerUrologeA.70360226.eng.abstr
|
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DerUrologeA.70360233.eng.abstr
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"Extracorporeal shock waves have revolutionized urological stone treatment . Nowadays shock waves are widely used in orthopedics , too . This article reviews the applications of extracorporeal shock waves on bone and adjacent soft tissue . The osteoneogenetic effect of extracorporeal shock waves has been proven and can be used to treat pseudarthrosis with a success rate of around 75 % . Shock waves have a positive effect in tennis and golfer's elbow , calcaneal spur , and the complex called \" periarthritis humeroscapularis . \" The mechanism for this is not yet known , and results from large prospective and randomized studies are still lacking . However , the treatment has been performed many thousands of times . In patients in whom conservative treatment has failed surgery used to be the only choice , but its success rate barely exceeds that of shock wave therapy and surgery can still be done if shock wave therapy fails . Extracorporeal shock waves will have an impact on orthopedics comparable to its effect in urology . Scientific evaluations , professional certifications , quality assurance and reimbursement issues present great challenges ."
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DerUrologeA.70360239.eng.abstr
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DerUrologeA.70360239.eng.abstr
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[] |
[] |
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DerUrologeA.70360243.eng.abstr
|
DerUrologeA.70360243.eng.abstr
|
[
{
"id": "DerUrologeA.70360243.eng.abstr-passage-0",
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"text": [
"We performed a phase II trial with second-line chemotherapy in patients with refractory , metastatic cancer of the bladder . Second-line therapy consists of 2.6 cycles of mitomycin-C , 5-fluorouracil and folic acid . Two patients suffered from WHO grade III side effects ( nephrotoxicity , leukocytopenia ) . We did not find any complete or partial remission . Four patients had a stable disease ; 3.3 months after therapy , patients developed tumor progression with a median survival of 9 months . Four patients reported an improvement in quality of life . Since all patients received supportive care , improvement in quality of life cannot be related to chemotherapy alone . In conclusion , second-line chemotherapy with mitomycin-C , 5-fluorouracil and folic acid has no effect on refractory , metastatic cancer of the bladder and is no alternative for cisplatin and methotrexate-based chemotherapy ."
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] |
DerUrologeA.70360255.eng.abstr
|
DerUrologeA.70360255.eng.abstr
|
[
{
"id": "DerUrologeA.70360255.eng.abstr-passage-0",
"type": "abstract",
"text": [
"We investigated whether the free-to-total prostate-specific antigen ( PSA ) ratio ( f-PSA/t-PSA ratio ; i . e . percentage of free PSA ) represents a better discriminator for the detection of cancer of the prostate ( CaP ) . In a retrospective analysis , the persentage of free PSA was determined in the sera of 35 patients with histologically proven benign prostatic hyperplasia ( BPH ) and 35 patients with clinically localized CaP . Patients with urolithiasis ( n = 33 ) served as a control group . Serum levels of free PSA and total PSA were determined employing a chemiluminescent enzyme immunoassay . Patients with CaP demonstrated a lower percentage of free PSA ( median : 8.7 ) than patients with BPH ( median : 20.0 ; P 0.001 ) and those with urolithiasis ( median : 18.8 ; P 0.001 ) . Determination of the percentage of free PSA enhances the differentiation between BPH and CaP and may reduce the number of unnecessary biopsies in patients with an elevated PSA . Confirmation of our preliminary results is required ."
],
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1026
]
]
}
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DerUrologeA.70360259.eng.abstr
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DerUrologeA.70360259.eng.abstr
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"Epidermoid cysts are rare , benign tumors of the testis or , less frequently , the inguinal cord . Generally , they affect males between 10 and 39 years . In newborns they are rare . We report on a newborn with an epidermoid cyst of the right testis that had been diagnosed in utero and was removed with preservation of the testicle ."
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[] |
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DerUrologeA.70360313.eng.abstr
|
DerUrologeA.70360313.eng.abstr
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DerUrologeA.70360318.eng.abstr
|
DerUrologeA.70360318.eng.abstr
|
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{
"id": "DerUrologeA.70360318.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Nitric oxide ( NO ) is suggested as an important mediator for the regulation of biological processes . In the present study we tried to determine histochemically and immunohistochemically the localization and distribution of the constitutive NO-synthase isoforms ( bNOS and eNOS ) of 14 normal non-obstructive and 12 hyperplastic obstructive human prostates . Differentiated nitrinergic innervation was shown for the prostate glands , firbromuscular stroma and blood vessels by NADPH-diaphorase staining and immunohistochemically with specific NOS antibodies . In the specimens with benign prostatic hyperplasia nitrinergic innervation seems to be distinctly reduced . The vascular distribution of NOS provides evidence for segmental differentiation of NO-mediated vascular regulation . The NADPH-diaphorase reaction was not confirmed immunohistochemically by the specific NOS antibody in the glandular epithelium . The distribution of NO synthase shows the importance of nitric oxide in the regulation of smooth muscle tone , blood flow and secretory function in the normal and hyperplastic human prostate ."
],
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0,
1108
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]
}
] |
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] |
[] |
[] |
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DerUrologeA.70360327.eng.abstr
|
DerUrologeA.70360327.eng.abstr
|
[
{
"id": "DerUrologeA.70360327.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Therapeutic equivalence should be demonstrated in a randomised , reference-controlled multicentric double blind clinical trial with PRO 160/120 , a combination of Sabal- and Urtica-Extract , and Finasteride , respectively , in patients suffering from benign prostatic hyperplasia ( BPH , Stage I to II according to Alken ) . The study involved 543 patients , who were treated for 48 weeks with two capsules of PRO 160/120 or one capsule of Finasteride per day , in a double dummy design . Primary variable was the change of the maximum urinary flow after 24 weeks of therapy in comparison to therapy start . As secondary variables urodynamic parameters such as average urinary flow , miction volume and miction time were monitored . Urinary symptoms were recorded by the International-Prostate-Symptom-Score ( I-PSS , Paris 1993 ) . Additionally , the impacts of the symptoms on quality of life had been assessed by a quality of life questionnaire according to The American Urological Association Measurement Committee ( 1991 ) [ 9 ] . An increase of the urinary flow rate could be observed in both treatment groups ( 1,9 ml/s with PRO 160/120 ; 2,4 ml/s with Finasteride ) . During the trial , the average urinary flow increased , whereas the miction time decreased in both groups in a similar extent . The miction volume did not show any relevant differences after treatment with either PRO 160/120 or Finasteride . The I-PSS decreased from 11.3 at the therapy start to 8.2 after 24 weeks and 6.5 ( week 48 ) under PRO 160/120 and from 11.8 to 8.0 and 6.2 , under Finasteride , respectively . Accordingly , life quality improved between therapy start and therapy end from 7.5 to 4.3 with PRO 160/120 and from 7.7 to 4.1 with Finasteride . In terms of safety aspects less adverse events occured with the Sabal/Urtica-Extract as with Finasteride . Especially less cases of diminished ejaculation volume , erectile dysfunction and headache have been reported ."
],
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"For routine evaluation of ureteropelvic junction obstruction in children , sonography , voiding cystogram , IV pyelogram and a renal scan in combination with administration of furosemide are available . Furthermore , often preoperative antegrade or retrograde ureteropyelography is performed . However , the significance of retrograde ureteropyelography in the world literature remains controversial . Therefore , we reviewed the records of 41 children who underwent a pyeloplasty in our department . In 9 children the ureter was visualized by IV pyelogram , voiding cystogram or antegrade ureteropyelography ; a retrograde examination of the ureter was performed in 21 children before pyeloplasty in the OR . In 11 children the ureter was not visualized preoperatively . Retrograde ureterography neither gave additional information in any patient nor did it change the operative technique . In the children where the ureter was not visualized preoperatively , no ureteric abnormality was found in association with ureteropelvic junction obstruction . Hence , we conclude that retrograde ureteropyelography before pyeloplasty in children is not necessary , provided that sonography does not show ureteral dilatation ."
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DerUrologeA.70360339.eng.abstr
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"We present long-term results ( minimum follow-up 5 years ) in 145 patients with advanced non-seminomatous germ cell tumours , who underwent radical retroperitoneal lymphadenectomy ( RPLA ) after chemotherapy . We correlated patients ' outcomes ( death of disease ) to different kinds of chemotherapy and to intraoperative findings . We found that patients who were treated by a modified Einhorn scheme with cisplatin , etoposide and bleomycin have a good prognosis . In all , 90 % showed no evidence of disease ( NED ) . The NED rate was significantly lower in patients who were treated by sequential alternative chemotherapy ( DOD = 37 % ) . We determined the following prognostic factors which predict a poor outcome : ..."
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] |
DerUrologeA.70360343.eng.abstr
|
DerUrologeA.70360343.eng.abstr
|
[
{
"id": "DerUrologeA.70360343.eng.abstr-passage-0",
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"Twenty-five patients with locally advanced prostate cancer ( stage pT3pN0 ) underwent pelvic lymphadenectomy and radical prostatectomy and were followed up thereafter for at least 15 years . No hormonal treatment was given prior to tumor progression . Overall and disease-free 15-year survival rates were observed to be 44 and 24 % , respectively . These data suggest that a cure from prostate cancer by radical prostatectomy can be expected in a quarter of patients with capsular penetration . From our results , no justification can be derived to exclude radical prostatectomy from the spectrum of treatment options for patients with capsular penetration of prostate cancer . More detailed analysis of the results depending on the local extent of the tumor and histological grade revealed distinct differences with respect to the risk of progression . Histological grade was the single most predictive parameter of progression . Out of all subgroups of patients with capsular penetration of prostate cancer , those with a poorly differentiated tumor showed the shortest progression-free interval after surgery , the highest level of overall progression and the largest proportion of tumor-related deaths . By contrast , the prognosis was only slightly influenced by the presence or absence of seminal vesicle involvement . The role of adjuvant treatment after radical prostatectomy for patients with stage pT3pN0 prostate cancer or for subgroups of them remains to be determined within the scope of prospective randomized trials ."
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] |
[] |
[] |
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DerUrologeA.70360348.eng.abstr
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DerUrologeA.70360348.eng.abstr
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DerUrologeA.70360351.eng.abstr
|
DerUrologeA.70360351.eng.abstr
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{
"id": "DerUrologeA.70360351.eng.abstr-passage-0",
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"text": [
"Poor longterm success has been reported for penile vein ligation the last few years . Therefore , we decided to re-investigate our group of 147 patients who were operated on between 1987 and 1996. All patients showed a negative response to intracavernous injection therapy at the time of diagnosis and revealed a maintenance flow > 15 ml/min , as well as a pathological venous flow with pharmacocavernosometry or pharmacocavernosography . These patients underwent ligation of all superficial dorsal veins and resection of the deep dorsal vein of the penis . An up-to-date record of the success of the operation was kept either by a renewed clinical visit or by a standardized telephone interview or questionnaire . A total of 126 patients were available here for long-term follow-up . We divided the findings into three groups : complete spontaneous erection , postoperative response to cavernous auto-injection therapy and no changes in erectile competency postoperatively . The short-term success rate for these groups after 1-3 months was an outcome of 31 ( 24.6 % ) , 25 ( 19.8 % ) and 70 ( 55.6 % ) patients ; 86 % of the cases whose results deteriorated after the initial operation success rate had this happen within the first postoperative year ( p K 0.001 ) . Favorable prognostic factors were preoperative erectile dysfunction of K 7 years , a normal CC-EMG and a maintenance flow of K 45 ml/min . If all three parameters were present , the long-term success rate ( spontaneous erection plus response to intracavernous injection ) of 30 % of all patients was found to rise to 67 % in this selected group of patients ( p K 0.001 ) . This study reveals that long-term success for unselected patients undergoing penile venous surgery is disappointing ; however , careful selection of patients by certain prognostic factors can improve long-term results ."
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DerUrologeA.70360369.eng.abstr
|
DerUrologeA.70360369.eng.abstr
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{
"id": "DerUrologeA.70360369.eng.abstr-passage-0",
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"text": [
"We describe a patient with a primary renal plasmacytoma . In the literature available , only six clinical cases have been reported . A 64-year-old patient is presented who had the clinical signs of a renal cell carcinoma . Histological examination after nephrectomy , however , revealed a plasmacytoma . Based on this case , we discuss how one should proceed in this disease . Primary renal plasmacytoma can be tentatively diagnosed preoperatively only in the presence of paraproteinemia or Bence-Jones proteinuria , as it cannot be distinguished from other renal tumors by imaging procedures . Postoperatively , further staging procedures must rule out bone involvement ( solitary myeloma or multiple myeloma ) . Nephrectomy is required in patients with plasmacytoma only if renal complications occur ."
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DerUrologeA.70360400.eng.abstr
|
DerUrologeA.70360400.eng.abstr
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"Stress incontinence is the most frequent form of incontinence found in females . The usual method of surgery for this is to lift the bladder neck towards cranial and ventral . Two competitive techniques - bladder neck suspension in accordance with Stamey and colposuspension in accordance with Burch - were retrospectively investigated . A total of 95 women underwent surgery and it was possible to evaluate the postoperative course in 46 and 30 ( total 76 ) patients respectively . Initially , both surgical techniques demonstrated a very good success rate ( 91.3 % and 96.7 % resp. ) . However , the continence rate of the Stamey patients deteriorated after 6 weeks down to 78.3 % and after more than 2 years only 28.6 % of these patients were still completely continent ( mean follow-up 40.4 mths ) , whereas deterioration in the Burch patients was only 87 % ( mean follow-up 44.25 mths ) . The disappointing results with the Stamey technique did not correlate with the degree of initial continence . It was noted here that obese patients showed a greater tendency towards regression . The three cases of recurring incontinence after Burch colposuspension were already relapses at the time of surgery . With respect to long-term follow-up , our results with the Stamey method were distinctly poorer than with the Burch technique . Therefore , in our opinion , the Burch colposuspension procedure and fascioplasty should be the method of choice for the management of stress incontinence ."
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DerUrologeA.70360405.eng.abstr
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DerUrologeA.70360405.eng.abstr
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"Conservative treatment of genuine stress urinary incontinence in females gained more and more interest . The use of mini-devices is one of the newly developed therapeutical options however , its clinical relevance and longterm-results are still under debate . This review article gives a critical evaluation of the available urethral plugs and regulators and new developments as well according to the longterm-follow-up studies in the literature and own experience with those devices . The continence rates that can be obtained with the different plugs or regulators are dependent upon the degree of stress incontinence , ability to insert the plug and compliance of the patient . Reported longterm results vary between 48 % and 100 % . The most frequent side effects are urinary infection , haematuria and/or handling problems with the devices . According to the published material it is impossible to give therapeutical standards for treatment of female stress urinary incontinence with urethral mini-devices . Although proper Patient selection might give excellent longterm-results in patient continence rates ."
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DerUrologeA.70360420.eng.abstr
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DerUrologeA.70360420.eng.abstr
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[
{
"id": "DerUrologeA.70360420.eng.abstr-passage-0",
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"text": [
"We investigated the technical feasibility and clinical results of bone fixation techniques in combination with needle suspension for correction of female stress urinary incontinence . In our experience the screw-like bone anchor , which is drilled into the pubic tubercle , represents a minimally invasive but very stable and reliable technique . However , the needle suspension fixed to the bone anchor turned out to be critical . Even though the suspension was fixed in the paraurethral tissue with a deep Z-stitch between the bladder neck and the midurethra , the 1-year recurrence rate was 76 % . Our data showed that the suspension sutures pull through the paraurethral tissue because there is no paravesical scar formation as in open procedures . Modifications of the suspension technique ( four-point suspension , simultaneous laparoscopic or digital dissection of the paravesical space , combination with sling procedures ) revealed significantly improved short-term results . Therefore we conclude that after improvement of the suspension technique the bone anchor will represent a valid option for minimally invasive fixation of a bladder neck suspension ."
],
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DerUrologeA.70360426.eng.abstr
|
DerUrologeA.70360426.eng.abstr
|
[
{
"id": "DerUrologeA.70360426.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Indications , results and complications of 144 women who have undergone implantation of the current model AMS 800 since 1983 and remained in continuous follow-up in our department are presented . Included are 70 patients suffering from stress urinary incontinence ( SUI ) type III after 208 previously unsuccessful incontinence procedures , 54 patients with incontinence due to neurogenic bladder dysfunction ( NBD ) and 20 patients with congenital or acquired internal sphincter weakness of other causes . In the NBD group , apart from sphincter implantation a total of 113 additional operations were necessary due to complex malfunctions of the urinary tract : augmentation ileocystoplasty in 51 patients , ureterocystoneostomy in 23 patients and 43 operations at the bladder neck . One hundred and twenty-six patients ( 86 % ) achieved total continence and 5 patients ( 3 % ) were significantly improved . In 9 females ( 6 % ) incontinence persisted , and 4 patients ultimately underwent urinary diversion into a Kock pouch . With the implanted artificial sphincter 116 patients ( 81 % ) are able to empty their bladder spontaneously , without residual urine and without the necessity of intermittent self catheterisation . Under the aforementioned conditions implantation of the artificial urinary sphincter AMS 800 is the most effective therapy for complex female incontinence ."
],
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}
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DerUrologeA.70360432.eng.abstr
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DerUrologeA.70360432.eng.abstr
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"The methodology used to assess postoperative continence has a significant effect on the outcome of incontinence surgery . Retrospective chart review studies consistently report higher success rates than patient questionnaire-based outcome analyses . The purpose of this study was to evaluate the true long-term results of the Stamey bladder neck suspension procedure using an anonymous patient questionnaire . Of 172 consecutive patients , 138 ( 80.2 % ) returned a questionnaire on long-term continence , complications and subjective satisfaction with the operative result . With a mean follow-up of 66 months , 65 of 130 evaluable patients ( 50.0 % ) remained completely continent while 15 ( 11.5 % ) never became continent and 50 ( 38.5 % ) had recurrent incontinence 6-90 months postoperatively . Almost two-thirds of the patients felt either cured or substantially improved more than 5 years after surgery . Stamey bladder neck suspension leads to a persistently improved quality of life despite a considerable failure rate . Our study demonstrates the advantages of patient questionnaires for outcome analyses and emphasizes the need for standardisation and validation to allow comparisons between the results of different incontinence procedure in the future ."
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DerUrologeA.70360440.eng.abstr
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DerUrologeA.70360440.eng.abstr
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"Pure teratomas are considered to be less aggressive and less likely to metastasize than other nonseminomatous germ cell tumors . Therefore , patients with mature teratomas are considered to be candidates for surveillance protocols . We report on the clinical history and treatment of 44 patients with a primary pure testicular teratoma . In all , 35 patients ( 79.5 % ) presented with clinically low-stage disease [ n = 26 , clinical stage I ( 59.1 % ) ; n = 9 , clinical stage IIA/B ( 20.4 % ) ] and underwent radical orchiectomy followed by retroperitoneal lymphadenectomy ( RPLND ) ; nine patients ( 20.5 % ) presented with clinically advanced disease ( clinical stage IIC to stage IV ) . Archival tumor blocks were available for pathological reevaluation and serial sections were obtained in all cases . The frequency of lymph node metastases in patients with clinical stage I disease was 19.2 % ; in patients with clinical stage IIA/B the risk was 66 % . Pathohistological diagnosis of mature teratoma was confirmed in all cases ; however , 17/20 patients demonstrated scars or calcifications in the adjacent parenchyma , indicating a burned-out tumor and 3/20 demonstrated microfocal germ cell tumor elements . None of the clinical stage I patients relapsed during follow-up ; relapse rate among patients with stage IIA/B disease was 33 % . Our data demonstrate the malignant potential of pure testicular mature teratoma . Based on our results , metastases in testicular mature teratoma seem to result from metastazising non-germ-cell components undergoing early regression as demonstrated by the high frequency of burned-out tumors . We recommend serial sections of the orchiectomy specimen in all cases of pure mature teratoma for deciding on adequate management : RPLND in cases with associated scars , calcifications or microfocal malignant germ cell components , and surveillance in cases with pure mature teratomas ."
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DerUrologeA.70360445.eng.abstr
|
DerUrologeA.70360445.eng.abstr
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"We report on the eighth known case of a mature metastasis of a mature teratoma of the testis . In a 19-year-old patient who had undergone a pyeloplasty of the left renal pelvis 6 years before , a mature metastasis of an occult mature teratoma of the testis was found at the former operation site . This case - in addition to those published previously - emphasizes the fact that a mature teratoma of the testis has to be regarded as a malignant tumor in adults . It is supposed that the mature teratoma originates , as other testicular tumors , from carcinoma-in-situ-cells , which are responsible for metastasize and are not detected after lysis ."
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"After > 10 000 treatments - our HM3/4 and MPL 9000 have been replaced by the Siemens Lithostar multiline . As a ESWL center with ESWL as the primary treatment indication for all types of stones in kidney and ureter we report our initial experience with this new multifunctional lithotripter . The system consists of an electromagnetic shock-wave emitter ( Focus 80 x 5 mm ) and a digital fluoroscopy unit . Stone localization is achieved in a - 10 ° and + 30 ° position without movement of the patient . The treatment table itself allows most endourologic and percutaneous auxiliary procedures . Additionally , an intergrated inline ultrasound is available . From 10/94 to 08/95 , 204 male and 96 female patients with a mean age of 50.7 ( 4-92 ) years underwent ESWL with the Lithostar multiline . The mean stone diameter was 10.3 ( 2-20 ) mm with 53 % ureteral and 47 % renal stones . 300 patients underwent 480 treatments ( average shocks 3673 , range 793-8000 ; mean energy level 5.5 , range 1-9 ) . Stone localization was achieved after 5 ( 1-39 ) min ( mean fluoroscopy time 3.1 ( 0.5-16.2) min ) . In 92.7 % no analgesic premedication was done . 56 % of the patients needed no analgesics at all during ESWL . 44 % received 8.1 ( 2-15 ) mg Piritramid intravenously . Epidural anesthesia was performed in only 2.3 % for a second treatment . 95 % of the patients had complete stone disintegration . In 68 % disintegration was achieved in one session . ESWL was repeated for further disintegration in 18.5 % , because of an unsuccessful treatment in 11.5 % and because of technical interruption of the previous session in 2.5 % . We saw subkapsular haematomas in 2 % . Auxiliary procedures following ESWL were necessary in only 9.2 % of the patients . In situ ESWL with the new Lithostar Multiline seems to be as effective as the Dornier HM3/4. Analgesia-free treatment was performed in more than 50 % of the patients . Auxiliary procedures were less frequently necessary as compared to our previous experience with in situ ESWL ."
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DerUrologeA.70360456.eng.abstr
|
DerUrologeA.70360456.eng.abstr
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{
"id": "DerUrologeA.70360456.eng.abstr-passage-0",
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"text": [
"In recent years , mumps orchitis has become a rarely reported disease . However , since October 1994 a clear increase in the incidence of this disease has been observed . At four hospitals in the Saarland , Germany , 45 cases of mumps orchitis in adolescents and adults were diagnosed in this period . In addition to the case history and clinical findings , the diagnosis was confirmed by an increased IgM titer . None of the patients had been previously vaccinated . The main reason for this was a lack of parental knowledge of the necessity for this vaccination , one which has almost no side effects . The goal of this study is to describe the disease , present our own results , and indicate the need for vaccination . In addition to providing information , a further aim of the study is to increase the motivation of adolescents and adults for vaccination . Although many treatments for mumps have been published in recent years , the most successful therapy is still prophylactic vaccination ."
],
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[] |
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DerUrologeA.70360513.eng.abstr
|
DerUrologeA.70360513.eng.abstr
|
[
{
"id": "DerUrologeA.70360513.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Some of the most common lesions in patients with multiple traumas are injuries to the urinary system . A blunt trauma of the abdomen mainly leads to injuries of the kidney , ureter and/or bladder , whereas the external genitals are often damaged by contusions , decollements and even amputation . The multiply traumatized patient must necessarily be cared for and treated through an interdisciplinary cooperation . Thus , \" urologisation \" of the condition must be avoided , as must the non-recognition of urological injuries . Iatrogenic lesions are primarily observed in the context of urological , gynecological and surgical interventions . Immediate recognition may lead to early treatment , thereby avoiding possible , complications . The procedure for treating multiply traumatized patients will be shown using a plan of specific steps . Symptoms of injuries to the genitourinary system are usually not obvious . In most cases micro- and macro- hematuria are the leading symptoms , but they are not always demonstrable . In the acute phase the drainage of urine must be protected . It is mainly during the third step that urological lesions require surgical treatment . Catheterisation of the urethra may only be performed when the possibility of injury to it is excluded ."
],
"offsets": [
[
0,
1279
]
]
}
] |
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DerUrologeA.70360523.eng.abstr
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DerUrologeA.70360523.eng.abstr
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"A dynamic helical CT scan following initial ultrasound provides reliable radiological staging for kidney traumas and immediate diagnosis of most abdominal injuries . It also proves useful for pediatric traumas . Using mainly CT data we apply a classification system proposed by the American Association for Surgery of Trauma ( grade I-V ) . The diagnostic steps and subsequent management are demonstrated by flow-chart . Most renal traumas may be treated conservatively but persistent bleeding or persistent urinary extravasation may necessitate surgical intervention . In cases of exploration of the kidney , the use of fibrin adhesive , alloplastic mesh capsule and DJ stents enables the reconstruction of the kidney . Exploration of the renal injury should never be omitted if urgent laparotomy is indicated for associated injuries ."
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DerUrologeA.70360535.eng.abstr
|
DerUrologeA.70360535.eng.abstr
|
[
{
"id": "DerUrologeA.70360535.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Urodynamic examinations were performed in 82 patients with clinically localized prostate cancer before and after radical prostatectomy . A significant decrease in bladder capacity ( 396 ml to 331.9 ml ) , urethral closure pressure ( 89.6 cm H2O to 65. , 2 cm H2O) and functional profile length ( 61 mm to 25.9 mm ) was noted . The continence rate after radical prostatectomy was 33.4 % after 1 month , 69.4 % after 3 months , 84.7 % after 6 months , and 90.9 % after 12 months , respectively . A correlation was found between urethral closure pressure and functional profile length and continence . A second urodynamic examination was performed 6 months after radical prostatectomy . Functional profile length and urethral closure pressure increased . These data suggest that restoration of continence is based on sphincteric parameters ."
],
"offsets": [
[
0,
838
]
]
}
] |
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DerUrologeA.70360540.eng.abstr
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DerUrologeA.70360540.eng.abstr
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DerUrologeA.70360548.eng.abstr
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DerUrologeA.70360548.eng.abstr
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DerUrologeA.70360552.eng.abstr
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DerUrologeA.70360552.eng.abstr
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"We investigated in 17 children ( mean 7.1 years ) the continuous administration of tramadol following augmentation cystoplasty or exstrophy reconstruction . Mean duration of the tramadol administration on the pediatric ward was 3.8 +/- 1.1 days ( initial dosage 0.25 mg/kg/per hour , dose adjustment by the nursing staff ) . Mean tramadol consumption was 0.21 mg/kg/h on day 1 and was reduced to 0.08 mg/kg/per hour on day 4. Median pain score ( assessed with ten-step scales ) was 5 before treatment and between 2.5 ( day 1 ) and 0.5 ( day 5 ) during therapy . Lowest oxygen saturations ( mean ) ranged from 93.8 % to 95.2 % . Three patients ( 17.6 % ) suffered from nausea/vomiting on 3 of 64 treatment days ( 4.7 % ) . Pruritus and extreme sedation did not occur . The continuous administration of tramadol is a simple and safe procedure following major urological surgery in children ."
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DerUrologeA.70360561.eng.abstr
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DerUrologeA.70360561.eng.abstr
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DerUrologeA.80370002.eng.abstr
|
DerUrologeA.80370002.eng.abstr
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"The exact knowledge of the topographic anatomy of the urethra as well as the macro- and microcirculation of the penis [ 6 ] are the basics of reconstructive urethral surgery . Adherence to the fundamentals and principles of tissue transfer [ 5 ] are necessary to fascilitate conditions for successful treatment of the various disorders of the male urethra . Mutural description of the anatomy of the male urethra in conjunction with external male genitals is necessary because of developmental similarities as well as the close anatomical relationship . The arterial and venous blood supply of the urethra and the penis have to be taken into account if vascularized flaps from the penile skin or the prepuce are used in urethral reconstruction . The dual arterial and venous vascularity of the genital skin is of fundamental importance to a successful outcome of the operative treatment . The purpose of this article is , to summarize the relevant anatomical knowledge of reconstructive urethral surgery ."
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[] |
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DerUrologeA.80370008.eng.abstr
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DerUrologeA.80370008.eng.abstr
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"id": "DerUrologeA.80370008.eng.abstr-passage-0",
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"For therapy of strictures of the urethra several procedures are available . The choice of the adequate strategy requires a rational diagnostic , answering questions about localisation , length , shape and funktional effect of the stricture . The most important method is the miction-cyst-urethrography ( MCU ) . Statements about the dimensions of scarred alterations in the corpus spongiosum urethrae are to receive from urethral ultrasonic . In addition you can perform the retrograde urethrography . The functional effects of the urethral stricture should be investigated by uroflowmetry and examinations of the upper urinary tract ( ultrasonic/urography ) ."
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[] |
[] |
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DerUrologeA.80370010.eng.abstr
|
DerUrologeA.80370010.eng.abstr
|
[
{
"id": "DerUrologeA.80370010.eng.abstr-passage-0",
"type": "abstract",
"text": [
"This manuscript outlines the important points in the evaluation and treatment of urethral stricture disease . The algorithms described within are not presented as strict guidelines but rather are intended to give a logical thought progression which incorporates the basic principles of urethral reconstruction . It is important to determine the therapeutic goal before applying these principles . There are basically two arms of consideration , the first is to attempt to cure the patient of urethral stricture disease and the second is to simply manage the patient's urethral stricture disease without intent of cure . Applying the current knowledge of anatomy with modern tissue transfer techniques will achieve a highly successful , single stage reconstruction in most patients . Although approaching urethral stricture disease with the intent to cure is preferred , management may not be unreasonable in certain cases . Some patients have entensive co-morbidities or may prefer a trial of conservative measures before definitive treatment is undertaken . If the goal established is urethral reconstruction , the gold standard is to perform a single stage pocedure that is highly successful and durable . Excision of the urethral stricture with primary anastomosis ( EPA ) represents this gold standard . However , ist application is limited by stricture location or length . An accurate evaluation of the stricture location , length , and associated spongiofibrosis is mandatory in forming viable options for repair . By exploiting the advantages of differing techniques , the proper course of action can be chosen which generally will solve even the most complex problem in one stage . The reconstructive surgeon come to the operative suite armed with the full knowledge and understanding of the principals and techniques which will result in a favorable outcome . It is not uncommon for intra-operative findings to guide the decision for the best alternative for urethral reconstruction . We also offer some helpful hints regarding positioning , sutures , exposure , and retractors ."
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DerUrologeA.80370021.eng.abstr
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DerUrologeA.80370021.eng.abstr
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"Urethral dilatation and urethrotomy can be effective treatments of the stricture disease in selected patients when the spongy tissue is not severely damaged . In the few reports comparing urethrotomy and dilatation , results are not significantly different . A long term followup is mandatory in assessing the outcome of treatment of urethral strictures . Charcteristics of the stricture as location , length , caliber , number , and previous failed treatments allow to select the best therapeutical option . After the failure of the first instrumentation , repeated procedures are not curative ."
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[] |
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DerUrologeA.80370031.eng.abstr
|
DerUrologeA.80370031.eng.abstr
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"The posterior prostatomembranous urethral stricture or distraction defect has historically been the most formidable challenge of stricture surgery . This uncommon lesion occurs most often as the sequelae of pelvic fracture injuries , or straddle trauma , and is associated with serious urethral disruption and separation - an injury that is often complicted by inappropriate initial management using substitution skin flap techniques with the development of recurrent stenosis , irreversible impotence , and occasional incontinence . Management by endoscopic techniques may be possible in patients with short strictures or in those after prostatectomy , but they rarely play a role in resolving the complex obliterated urethra with a significant defect [ 1 ] . Resolution of post-traumatic posterior urethral distraction defects and other posterior urethral pathologic conditions has dramatically improved over the past two decades despite an inaccessible subpublic location involving exposed sphincter-active and erectile neurovascular anatomy . The contemporary , perineal , one-stage bulboprostatic anastomotic operation as popularized by Turner-Warwick [ 20 ] with selective scar excision is a versatile procedure with a high patent lumen success . Patients undergoing anastomotic urethroplasty have a substained patent urethral lumen success rate approaching 100 % versus those who have undergone urethral skin flap or patch repair , where the restricture rate in 5 and 10 years increases twofold to threefold [ 1 , 20 ] . A patent urethra after an anastomotic urethroplasty at 6 months is free from further recurrent stricture and gives credence to Mr. Turner-Warwick's admonition that \" urethra is the best substitute for urethra \" ."
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DerUrologeA.80370038.eng.abstr
|
DerUrologeA.80370038.eng.abstr
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"Single stage urthroplasty with an onlay patch graft of penile skin or buccal mucosa is an effective treatment for patients with complex anterior urethral stricture disease . Using buccal mucosa , operative time is substantially reduced by using a two-team approach in which one team harvests the graft from the mouth while a perineal team simultaneously exposes and calibrates the stricture . Excellent results can be expected using grafts urethral substitution in men with refractory bulbar strictures . Focal areas of severe stenosis may be excised from the graft bed . For patients with long or dense strictures , grafts may easily be combined with other tissue transfer techniques ."
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DerUrologeA.80370042.eng.abstr
|
DerUrologeA.80370042.eng.abstr
|
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"Between 1977 and 1996 we treated 176 patients suffering from complicated urethral strictures with the mesh-graft urethroplasty . This operation technique has replaced the Bengt-Johanson-Operation which had been used frequently until that date . The Cecil-Operation has been totally abandoned , because in our opinion the usage of scrotal skin in urethral reconstruction is obsolete today . The mesh-graft technique is based on the free transfer of meshed prepuce ( full-thickness skin or split-thickness skin ) in a two stage procedure . In 37 patients the inner layer of the prepuce was used , in 63 patients we only used split-thickness skin grafts and in 76 patients we applied a combination of both , the inner layer of the prepuce in addition to a split-thickness skin graft . After complete healing of the graft ( first stage ) the formation of the neourethra follows as the second stage procedure . The mesh graft procedure can be used to treat all kinds of strictures independant of the etiology or localisation . Hair growth , diverticula development and stone formation that are observed frequently as complications with scrotal skin substitutes can be avoided . Due to these advantages encouraging long term results could be obtained with the mesh graft urethroplasty . In 162 patients ( 92 % ) with a minimum follow-up of 7 years we achieved a successful result of the operations , a significant improvement could be obtained in 7 patients ( 4 % ) . Unfortunately in further 7 cases ( 4 % ) the operation method ultimately failed . In particular in patients with complicated and severe strictures after numerous unsuccessfull prior reconstructive attempts , extensive long strictures and strictures in paraplegic patients , mesh graft urethroplasty has been shown to be a safe and reliable treatment option ."
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DerUrologeA.80370056.eng.abstr
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DerUrologeA.80370056.eng.abstr
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DerUrologeA.80370066.eng.abstr
|
DerUrologeA.80370066.eng.abstr
|
[
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"Intraoperativ pulmonary embolism with acute cardiac arrest can successfully be managed by immediate open cardiac massage followed by rt-PA injection , an interdisciplinary approach is mandatory . The scheduled tumor nephrectomy was performed 6 weeks after the initial event . The tumor was embolised with intravascular coils placed in a supraselective manner by the radiologist . During the secondary procedure it was found to be necrotic . In the second case the event occurred at the end of a radical cystectomy . Instead of an ileal conduit cutaneous ureterostomies were used for urinary drainage after cardiac output had been restored and rt-PA had been administered ."
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[] |
[] |
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DerUrologeA.80370070.eng.abstr
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"The surgical management of vesicovaginal fistulae ( VVF ) is a matter of controversy . This study deals with our experience with transvaginally treated patients suffering from VVF . Between 1966 and 1996 , 64 patients with VVF were treated surgically . The VVF occurred in the course of hysterectomy in 54 patients , was due to radiotherapy in 7 , was a result of obstetric complications in 2 patients , and occurred after colporrhaphy in 1 patient . In 60 of these 64 patients closure of the fistula was carried out transvaginally . Fourteen of these 60 patients ( 23 % ) had undergone prior surgical attempts to close the VVF ( 1 to 3 procedures ) . Transvaginal surgery was successful at first attempt in 55 of these 60 patients ( 92 % ) . The other 5 patients were successfully treated by a second procedure ( again transvaginal : n = 3 ; transabdominal : n = 2 ) . In conclusion , the transvaginal approach to close VVF is of advantage , avoiding an abdominal incision and reducing postoperative morbidity . In the vast majority of the cases isolated VVF can be treated successfully by transvaginal repair ."
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DerUrologeA.80370075.eng.abstr
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"The influence of aspirin treatment on haemostasis is still under debate . There are doubts in emergency operations , especially in transplant patients , concerning dosage and change in medication . Our results are based on an analysis of the therapeutic approaches in German transplantation centres . The question of transplant suitability , dosage and haemostatic effects are discussed with respect to the literature . Some 92.11 % of the transplantation centres perform the operation even though the patient has been treated with aspirin . In these cases an increased bleeding tendency is tolerated and observed in 34.2 % of the centres . An increased mortality has not been reported . Most of the transplantation centres accept a dosage of 100 mg aspirin daily . Only 7.89 % of the transplantation centres refuse to operate on aspirin-treated patients . Correctly indicated aspirin treatment ( for cardiac arrhythmia , embolism , or thrombosis , for example ) does not contraindicate renal transplantation ( daily dosage up to 100 mg ) . In elective surgery , however , a preoperative change in medication is recommended , e . g . , the heparin instead of aspirin ."
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DerUrologeA.80370079.eng.abstr
|
DerUrologeA.80370079.eng.abstr
|
[
{
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"text": [
"We report on a complete longitudinal rupture of the urethra in combination with a rupture of the pubic symphysis and pelvic fracture during spontaneous vaginal delivery . Only after stabilisation of the pelvic fracture by external skeletal fixation adaptation of the urethra was possible . Three weeks later after removing of the transurethral catheter a mild stress incontinence could be observed . In the follow up one year later the patient was completely continent . The cosmetic result was satisfactory . There was no cystocele . An unclear haematuria after delivery needs a meticulous urological examination . Early repair of urethral disruption minimize the risk of severe incontinence . Coordinated care between the trauma surgeon and urologist is required for successful treatment of this rare combined injury after birth ."
],
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DerUrologeA.80370086.eng.abstr
|
DerUrologeA.80370086.eng.abstr
|
[
{
"id": "DerUrologeA.80370086.eng.abstr-passage-0",
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"text": [
"A report is given of two patients with a history of splenectomy many years previously due to traumatic rupture . No vaccination was given to either patient . From a state of good health , both patients developed fulminant , therapy-resistant sepsis with proof of Streptococcus pneumoniae in the blood culture . Autopsy findings were similar to Waterhouse-Friderichsen-syndrome . In conjunction with the history of splenectomy , the final pathological diagnosis was a so-called OPSI syndrome . This postsplenectomy sepsis is discussed further ."
],
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DerUrologeA.80370138.eng.abstr
|
DerUrologeA.80370138.eng.abstr
|
[
{
"id": "DerUrologeA.80370138.eng.abstr-passage-0",
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"text": [
"Improved diagnostic procedures prior to radical prostatectomy have led to a reduced rate of positive lymphnodes in patients with clinical stage T1-T2 prostate cancer . According to current datas prolongation of survival following radical prostatectomy alone in patients with positive lymphnodes is not certain . Whether the recurrence free interval is prolonged is not known due to the lack of prospective randomized trials . Since it is not possible to define the small group of patients who will develop pronounced local symptoms after radical prostatectomy has been abandoned because of positive lymphnodes , radical prostatectomy cannot be recommended in general . In summary there is rarely an indication for radical prostatectomy in patients with stage T1-T2 prostate cancer and pelvic lymphnode metastasis ."
],
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DerUrologeA.80370141.eng.abstr
|
DerUrologeA.80370141.eng.abstr
|
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"id": "DerUrologeA.80370141.eng.abstr-passage-0",
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"Few patients with prostate cancer metastatic to the lymphnodes can be cured by radiotherapy , radical prostataectomy or androgen deprivation . Inevitably serum PSA levels will rise after a few years whereas the clinical recurrence appears after 5 to 10 years . Prospective trials regarding adjuvant treatment of lymphnode positive prostate cancer do not exist . Retrospective studies involving adjuvant endocrine treatment reveal a prolonged disease free survival time . Scientific proof of the best treatment for prostate cancer with lymphnode metastasis does not exist . The decision how to treat is based on our personal experience and philosophy as well as on our knowledge and interpretation of the available lierature . The art of medicine is the feeling for the best treatment of each individual patient ."
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[] |
[] |
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DerUrologeA.80370149.eng.abstr
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DerUrologeA.80370149.eng.abstr
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"In a comparative analysis of 29 studies , maximal androgen deprivation ( MAD ) was not found to be superior to partial androgen deprivation . Thus , MAD cannot be regarded as the new gold standard . Most trials focus on quality of life which - given the palliative aim of the treatment - deserves special attention . This aspect has not yet been evaluated , however , in the largest multicenter study , Intergroup study 0105. In patients with advanced bone metastasis or severe pain , MAD treatment should be begun because of the flare phenomenon . The synergistic effects of LHRH agonists on the prostate are currently being investigated . Since no clear prognostic factors exist and reduction of serum-PSA levels under MAD does not delay progression , the patient must help to make the decision of whether or not MAD should be begun ."
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DerUrologeA.80370153.eng.abstr
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DerUrologeA.80370153.eng.abstr
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DerUrologeA.80370156.eng.abstr
|
DerUrologeA.80370156.eng.abstr
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"Since the mid-forties androgen deprivation is regarded the standard treatment of incurable prostate cancer . Antiandrogens can be given either as monotherapy or in combination with bilateral orchidectomy or gonadotropin-releasing-hormone analoga . Recently reports have been published that withdrawal of antiandrogens in patients with hormone-resistant prostate cancer caused reduction of PSA and clinical improvement . Thus , in patients who progress under maximal androgen blockade or antiandrogen-monotherapy the antiandrogen should first be withdrawn and - in case of monotherapy - be replaced by GnRH-analoga . In approximately 30-50 % of the cases a reduction of serum-PSA can be expected lasting for approx . 6 months . In some patients an improvement of symptoms and objective remission is observed ."
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DerUrologeA.80370159.eng.abstr
|
DerUrologeA.80370159.eng.abstr
|
[
{
"id": "DerUrologeA.80370159.eng.abstr-passage-0",
"type": "abstract",
"text": [
"In patients with hormone-resistant prostate cancer primary androgen deprivation eventually fails . The begin of secondary treatment is depending on clinical symptoms ; since survival cannot be prolonged in progressive disease improvement of quality of life is of paramount importance . Altering of endocrine treatment and antiandrogen withdrawal can cause a transient improvement of the sense of well being . Single agent chemotherapy with little side effects should be prefered as compared with polychemotherapy since response rates do not exceed 30 % . Although 2/3 of the patients benefit from chemotherapy there is however no proof that it is superior to symptom-related pain relief . The indication for surgical management such as TURP and spinal cord decompression is depending on clinical symptoms from local progression and systemic disease ."
],
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0,
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]
]
}
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DerUrologeA.80370162.eng.abstr
|
DerUrologeA.80370162.eng.abstr
|
[
{
"id": "DerUrologeA.80370162.eng.abstr-passage-0",
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"text": [
"For patients with advanced prostate cancer efficient therapy of painfull bony lesions is the primary goal of interdisciplinary treatment strategies . Preservation of quality of life appears to be the main aim rather than prolongation of life . Apart from oral pain relief and local irradiation systemic treatment with radionuclides offers low-risk radiotherapeutic strategies for the palliation of painful , multifocal osteoplastic bone metastases . Depending on the radiopharmaceutical substance chosen response and reduction of pain are described in 65-80 % . The duration of pain relief lasts between 6-12 weeks . During this time the morphine based medication can be reduced and in some cases withdrawn which positively effects quality of life . After improvement of myelosuppression treatment with radionuclides can be repeated . Patients have to be hospitalized for two days because of protection from radiation procedures ."
],
"offsets": [
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0,
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]
}
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[] |
[] |
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DerUrologeA.80370167.eng.abstr
|
DerUrologeA.80370167.eng.abstr
|
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"In the treatment of advanced hormone-resistant prostate cancer , the aim is an improvement in quality of life since treatment strategies are merely palliative and life cannot be prolonged . Therapy is based on medical pain relief for different aspects of pain without seriously affecting activity and quality of life . With respect to therapy of chronic pain , Germany can be regarded as a developing country . It is definitely in the interest of urological cancer patients that this situation will be finished ."
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DerUrologeA.80370170.eng.abstr
|
DerUrologeA.80370170.eng.abstr
|
[
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"Prostate specific antigen ( PSA ) is used in the follow-up of patients who underwent radical prostatectomy and radiotherapy or who have systemic disease . However , easy assessment and high diagnostic value of PSA should not lead to frequent and unnecessary testing . Following radical prostatectomy or radiotherapy intervals of 6 months appear to be sufficient whereas patients with metastatic disease should be followed symptom related ."
],
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DerUrologeA.80370175.eng.abstr
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DerUrologeA.80370195.eng.abstr
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DerUrologeA.80370195.eng.abstr
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"Four hundred and eighty-eight radical retropubic prostatectomies ( RRP ) were performed on clinically localized prostate cancer at one institution within 5 years ( 1992-1996 ) . These were then analyzed regarding the migration of pathological tumor stages towards more localized stages . Within the observation period , the annual rate of RRP increased by 81 % from 69 to 125 cases . The authors noted a decline in the occurrence of advanced tumor stages ( 65.0 % to 39.2 % ) and small cancers ( 0.5 cc : 7.2 % to 1.6 % ) and an increase in pathological T2 tumors ( 30.4 % to 55.2 % ) . The rate of positive surgical margins declined from 34.7 % to 12.8 % ( for all pathological stages ) . These data confirm trends which were observed in the USA with increasing detection and treatment of localized prostate cancer ."
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DerUrologeA.80370199.eng.abstr
|
DerUrologeA.80370199.eng.abstr
|
[
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"text": [
"Transforming growth factor-1 ( TGF-1) is a pleiotrophic growth factor in carcinogenesis and regulars multiple cell functions . We wanted to evaluate the diagnostic meaning of TGF-1 plasma levels in patients with a biopsy proven prostate cancer . The TGF-1 blood level was analysed in 394 patients . In 242 patients ( group I ) the blood was taken before any prostate manipulation and biopsy . The TGF-1 plasma concentrations were almost similar in the group of patients with a prostate cancer ( n = 157 ) and patients with a benign prostate hyperplasia ( n = 85 ; 14 258 pg/ml versus 14 658 pg/ml , SD 10 516 pg/ml ) . In 152 patients the blood was taken 6-12 months after radical prostatectomy ( group II ) . There was no significant difference between the patients with a PSA-progress and without PSA-progress after . Our results suggest that TGF-1 plasma levels can not be used to distinguish between patients with prostate cancer and benign prostate hyperplasia ."
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DerUrologeA.80370203.eng.abstr
|
DerUrologeA.80370203.eng.abstr
|
[
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"id": "DerUrologeA.80370203.eng.abstr-passage-0",
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"text": [
"Duplications of the bladder is uncommon and rarely occors as isolatet anomaly . Two cases of complex malformations from the VACTERL-assoziation are reported . The study of urogenital duplications in cases from the literature are described ."
],
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]
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[] |
[] |
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DerUrologeA.80370254.eng.abstr
|
DerUrologeA.80370254.eng.abstr
|
[
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"text": [
"Men suffering from varicocele have lower mean sperm counts and \" worse \" seminal parameters than those without a varicocele . Also in those with a varicocele , who already fathered a child , the mean sperm count is lower than in other fertile men . The observations , however , do not refer specifically to an existing varicocele , but are common also in other spermatogenic defects . This holds also true for the frequency of tapering forms ."
],
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DerUrologeA.80370265.eng.abstr
|
DerUrologeA.80370265.eng.abstr
|
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DerUrologeA.80370270.eng.abstr
|
DerUrologeA.80370270.eng.abstr
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"Since approximately 45 years subfertile patients with varicocele are treated with different techniques of a varicocelectomy if there are no ( other ) causes of infertility . In the meantime , a varicocelectomy is being applied prophylactically in adolescents , too . In this article , there should be investigated whether the conducted clinical trials provide evidence of the efficacy of a varicocelectomy . Due to the fact that there are only a few valuable trials concerning the therapy of varicocele , the meta-analysis is mainly a critical analysis of the considered biostatistical methods . It comes to the conclusion that there is no clinical evidence for efficacy as well as against , and this conclusion is valid for the treatment as well as for the prophylaxis of male factor infertility . To achieve evidence , intensification of cooperation in multicenter study groups is necessary and methodical quality of the clinical trials on varicocelectomy should be improved ."
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DerUrologeA.80370277.eng.abstr
|
DerUrologeA.80370277.eng.abstr
|
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{
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[] |
[] |
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DerUrologeA.80370282.eng.abstr
|
DerUrologeA.80370282.eng.abstr
|
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"1493 patients were enrolled in 55 centers in Europe , Canada , Australia and the USA comparing the efficacy of mycophenolate mofetil ( MMF ) in daily doses of 2 and 3 g with placebo/azathioprine ( PLA/AZA ) for the prevention of acute rejection in renal transplant patients . Acute rejections and graft loss and death at 1 year were measured per trial and these data were combined and analyzed in a pooled fashion . The three pooled treatment groups were well balanced regarding demographic characteristics and cause of renal failure leading to transplantation . At one year the graft survival rate was 90.4 % and 89.2 % in the MMF 2 g and 3 g groups compared with 87.6 % in the PLA/AZA-group . MMF 2 and 3 g were significantly better than PLA/AZA in reducing biopsy proven rejection at one year : 40.8 % placebo/aza vs. 19.8 % in the MMF 2 g group and 16.5 % in the MMF 3 g group ."
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[] |
[] |
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DerUrologeA.80370299.eng.abstr
|
DerUrologeA.80370299.eng.abstr
|
[
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"id": "DerUrologeA.80370299.eng.abstr-passage-0",
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"The independent prognostic value of neoplastic extension of renal cell cancer ( RCC ) into the vena cava inferior has been the subject of several investigations reported to date . However , the use of vena cava thrombosis as an independent prognosticator of a patient's long-term survival is still debated . We have therefore correlated the clinical course of 53 patients with RCC and vena cava thrombosis with a control group consisting of 47 patients with renal cell tumors without vena cava thrombosis ( follow-up : 1-154 months ) . The median long-term survival of patients with and without vena cava thrombosis was 32 and 35 months , respectively . Neither the propagation of the tumor into the vena cava ( P = 0.391 ) nor the cranial extension of the thrombosis ( P = 0.158 ) - even in case of propagation into the right atrium - could be identified as parameters of any prognostic value during univariate or multivariate statistical analysis ."
],
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},
{
"id": "DerUrologeA.80370299.eng.abstr-s5-r48-t7.1-t5.1",
"type": "analyzes",
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},
{
"id": "DerUrologeA.80370299.eng.abstr-s5-r49-t7.1-t4.1",
"type": "measures",
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"arg2_id": "DerUrologeA.80370299.eng.abstr-s5-t4",
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},
{
"id": "DerUrologeA.80370299.eng.abstr-s5-r50-t1.1-t3.1",
"type": "associated_with",
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},
{
"id": "DerUrologeA.80370299.eng.abstr-s5-r51-t6.1-t5.1",
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"arg2_id": "DerUrologeA.80370299.eng.abstr-s5-t5",
"normalized": []
}
] |
DerUrologeA.80370306.eng.abstr
|
DerUrologeA.80370306.eng.abstr
|
[
{
"id": "DerUrologeA.80370306.eng.abstr-passage-0",
"type": "abstract",
"text": [
"The excact pathogenesis of Peyronie's Disease ( PD ) is still unknown . Histopathological investigations suggest , that the metabolism of the collogenious tissue plays an important role . Therefore , we started a prospective study in order to evaluate the metabolic situation of 11 patients with PD and 11 healthy controls . We mesured biochemical parameters of penile and venous blood , wich correspond to the collagen metabolism ( procollagen III [ P III P ] , PMN-elastase [ PMN-E ] , fibronectin [ FN ] , fibronectinreceptor [ FN-R ] und -1-proteinase-inhibitor [ -1-PI]). There was no difference in PMN-E , P III P , FN and FN-R in all samples . There was no difference in penile and venous blood as well . But we found out a highly significant lower concentration of -1-PI in patients with PD ( 158,55 mg/dl ) than in controls ( 214,82 mg/dl ) ."
],
"offsets": [
[
0,
851
]
]
}
] |
[
{
"id": "DerUrologeA.80370306.eng.abstr-s1-t1",
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"pathogenesis"
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11,
23
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{
"id": "DerUrologeA.80370306.eng.abstr-s1-t2",
"type": "umlsterm",
"text": [
"Disease"
],
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38,
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"id": "DerUrologeA.80370306.eng.abstr-s2-t1",
"type": "umlsterm",
"text": [
"Histopathological"
],
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72,
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"id": "DerUrologeA.80370306.eng.abstr-s2-t2",
"type": "umlsterm",
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"metabolism"
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124,
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}
]
},
{
"id": "DerUrologeA.80370306.eng.abstr-s2-t3",
"type": "umlsterm",
"text": [
"tissue"
],
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155,
161
]
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"db_id": "C0040300"
}
]
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"id": "DerUrologeA.80370306.eng.abstr-s2-t4",
"type": "umlsterm",
"text": [
"role"
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181,
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"id": "DerUrologeA.80370306.eng.abstr-s3-t1",
"type": "umlsterm",
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"patients"
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282,
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"db_id": "C0030705"
}
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},
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"id": "DerUrologeA.80370306.eng.abstr-s3-t2",
"type": "umlsterm",
"text": [
"controls"
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314,
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]
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"db_id": "C0243148"
}
]
},
{
"id": "DerUrologeA.80370306.eng.abstr-s3-t3",
"type": "umlsterm",
"text": [
"prospective study"
],
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[
213,
230
]
],
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"db_name": "UMLS",
"db_id": "C0033522"
}
]
},
{
"id": "DerUrologeA.80370306.eng.abstr-s4-t1",
"type": "umlsterm",
"text": [
"blood"
],
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380,
385
]
],
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},
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"db_id": "C0005768"
},
{
"db_name": "UMLS",
"db_id": "C0005835"
}
]
},
{
"id": "DerUrologeA.80370306.eng.abstr-s4-t2",
"type": "umlsterm",
"text": [
"collagen"
],
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411,
419
]
],
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"db_id": "C0009325"
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]
},
{
"id": "DerUrologeA.80370306.eng.abstr-s4-t3",
"type": "umlsterm",
"text": [
"metabolism"
],
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420,
430
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}
]
},
{
"id": "DerUrologeA.80370306.eng.abstr-s4-t4",
"type": "umlsterm",
"text": [
"procollagen"
],
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433,
444
]
],
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}
]
},
{
"id": "DerUrologeA.80370306.eng.abstr-s4-t5",
"type": "umlsterm",
"text": [
"fibronectin"
],
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488,
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]
],
"normalized": [
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"db_id": "C0016055"
}
]
},
{
"id": "DerUrologeA.80370306.eng.abstr-s4-t6",
"type": "umlsterm",
"text": [
"fibronectinreceptor"
],
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509,
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],
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},
{
"id": "DerUrologeA.80370306.eng.abstr-s5-t1",
"type": "umlsterm",
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"blood"
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{
"db_name": "UMLS",
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}
]
},
{
"id": "DerUrologeA.80370306.eng.abstr-s6-t1",
"type": "umlsterm",
"text": [
"concentration"
],
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756,
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]
],
"normalized": [
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"db_id": "C0086045"
}
]
},
{
"id": "DerUrologeA.80370306.eng.abstr-s6-t2",
"type": "umlsterm",
"text": [
"patients"
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782,
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]
],
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]
},
{
"id": "DerUrologeA.80370306.eng.abstr-s6-t3",
"type": "umlsterm",
"text": [
"controls"
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[
824,
832
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0243148"
}
]
}
] |
[] |
[] |
[
{
"id": "DerUrologeA.80370306.eng.abstr-s2-r1-t2.2-t1.1",
"type": "location_of",
"arg1_id": "DerUrologeA.80370306.eng.abstr-s2-t2",
"arg2_id": "DerUrologeA.80370306.eng.abstr-s6-t1",
"normalized": []
},
{
"id": "DerUrologeA.80370306.eng.abstr-s3-r1-t1.1-t2.1",
"type": "performs",
"arg1_id": "DerUrologeA.80370306.eng.abstr-s6-t1",
"arg2_id": "DerUrologeA.80370306.eng.abstr-s6-t2",
"normalized": []
},
{
"id": "DerUrologeA.80370306.eng.abstr-s4-r1-t1.1-t6.1",
"type": "produces",
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"normalized": []
},
{
"id": "DerUrologeA.80370306.eng.abstr-s4-r2-t1.1-t2.1",
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"normalized": []
},
{
"id": "DerUrologeA.80370306.eng.abstr-s4-r3-t1.2-t2.1",
"type": "consists_of",
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},
{
"id": "DerUrologeA.80370306.eng.abstr-s4-r5-t3.1-t6.1",
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"arg2_id": "DerUrologeA.80370306.eng.abstr-s4-t6",
"normalized": []
},
{
"id": "DerUrologeA.80370306.eng.abstr-s4-r6-t1.1-t5.1",
"type": "produces",
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},
{
"id": "DerUrologeA.80370306.eng.abstr-s4-r7-t3.1-t1.2",
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},
{
"id": "DerUrologeA.80370306.eng.abstr-s4-r8-t3.1-t2.1",
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},
{
"id": "DerUrologeA.80370306.eng.abstr-s4-r9-t1.2-t6.1",
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},
{
"id": "DerUrologeA.80370306.eng.abstr-s4-r10-t1.1-t3.2",
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},
{
"id": "DerUrologeA.80370306.eng.abstr-s4-r11-t3.1-t5.1",
"type": "produces",
"arg1_id": "DerUrologeA.80370306.eng.abstr-s6-t3",
"arg2_id": "DerUrologeA.80370306.eng.abstr-s4-t5",
"normalized": []
},
{
"id": "DerUrologeA.80370306.eng.abstr-s4-r12-t1.1-t3.1",
"type": "location_of",
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"normalized": []
},
{
"id": "DerUrologeA.80370306.eng.abstr-s4-r13-t1.1-t1.2",
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"normalized": []
},
{
"id": "DerUrologeA.80370306.eng.abstr-s4-r14-t1.2-t5.1",
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"normalized": []
},
{
"id": "DerUrologeA.80370306.eng.abstr-s4-r15-t3.1-t3.2",
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"normalized": []
},
{
"id": "DerUrologeA.80370306.eng.abstr-s4-r16-t1.2-t3.2",
"type": "consists_of",
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},
{
"id": "DerUrologeA.80370306.eng.abstr-s5-r1-t1.2-t1.1",
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},
{
"id": "DerUrologeA.80370306.eng.abstr-s5-r2-t1.1-t1.2",
"type": "surrounds",
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"normalized": []
},
{
"id": "DerUrologeA.80370306.eng.abstr-s6-r1-t3.1-t1.1",
"type": "result_of",
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"arg2_id": "DerUrologeA.80370306.eng.abstr-s6-t1",
"normalized": []
}
] |
DerUrologeA.80370367.eng.abstr
|
DerUrologeA.80370367.eng.abstr
|
[
{
"id": "DerUrologeA.80370367.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Therapy of advanced renal cell carcinoma remains difficult . New therapeutic schemes besides cytokine treatment should be evaluated . The following study analyzes the in vitro toxicity of treosulfan on spheroids of 8 primary cultures of renal cell carcinoma cells . These data were compared to the toxicity of vinblastine . All investigations were performed in regard to the P-glycoprotein ( Pgp ) expression of the cells , which is one of the main causes of multidrug resistance . Four Pgp positive and four Pgp negative spheroids were incubated with the drugs in increasing doses . Toxicity was measured using the MTT toxicity assay as well as trypan blue exclusion . Significantly higher toxicity of treosulfan compared to vinblastine could be demonstrated . In addition , the effects of treosulfan were not related to Pgp expression . These results are encouraging and a phase II study analyzing the efficacy of treosulfan in patients with advanced renal cell carcinoma has been initiated in our institution ."
],
"offsets": [
[
0,
1013
]
]
}
] |
[
{
"id": "DerUrologeA.80370367.eng.abstr-s1-t1",
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"Therapy"
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0,
7
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"db_id": "C0039798"
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]
},
{
"id": "DerUrologeA.80370367.eng.abstr-s1-t2",
"type": "umlsterm",
"text": [
"cell"
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26,
30
]
],
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"db_name": "UMLS",
"db_id": "C0007634"
}
]
},
{
"id": "DerUrologeA.80370367.eng.abstr-s1-t3",
"type": "umlsterm",
"text": [
"carcinoma"
],
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31,
40
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],
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"db_name": "UMLS",
"db_id": "C0007097"
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},
{
"id": "DerUrologeA.80370367.eng.abstr-s1-t4",
"type": "umlsterm",
"text": [
"renal cell carcinoma"
],
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20,
40
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],
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"db_name": "UMLS",
"db_id": "C0007134"
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]
},
{
"id": "DerUrologeA.80370367.eng.abstr-s2-t1",
"type": "umlsterm",
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"therapeutic"
],
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65,
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]
],
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"db_name": "UMLS",
"db_id": "C0039796"
}
]
},
{
"id": "DerUrologeA.80370367.eng.abstr-s2-t2",
"type": "umlsterm",
"text": [
"cytokine"
],
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93,
101
]
],
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"db_id": "C0079189"
}
]
},
{
"id": "DerUrologeA.80370367.eng.abstr-s2-t3",
"type": "umlsterm",
"text": [
"treatment"
],
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102,
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"db_name": "UMLS",
"db_id": "C0087111"
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"db_name": "UMLS",
"db_id": "C0039798"
}
]
},
{
"id": "DerUrologeA.80370367.eng.abstr-s3-t1",
"type": "umlsterm",
"text": [
"toxicity"
],
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176,
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]
],
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"db_name": "UMLS",
"db_id": "C0600688"
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{
"db_name": "UMLS",
"db_id": "C0040539"
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]
},
{
"id": "DerUrologeA.80370367.eng.abstr-s3-t2",
"type": "umlsterm",
"text": [
"treosulfan"
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},
{
"id": "DerUrologeA.80370367.eng.abstr-s3-t3",
"type": "umlsterm",
"text": [
"spheroids"
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202,
211
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],
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"db_id": "C0282501"
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},
{
"id": "DerUrologeA.80370367.eng.abstr-s3-t4",
"type": "umlsterm",
"text": [
"cultures"
],
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225,
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]
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"db_id": "C0220814"
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"db_name": "UMLS",
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]
},
{
"id": "DerUrologeA.80370367.eng.abstr-s3-t5",
"type": "umlsterm",
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"cell"
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243,
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},
{
"id": "DerUrologeA.80370367.eng.abstr-s3-t6",
"type": "umlsterm",
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"carcinoma"
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248,
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]
},
{
"id": "DerUrologeA.80370367.eng.abstr-s3-t7",
"type": "umlsterm",
"text": [
"cells"
],
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258,
263
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DerUrologeA.80370372.eng.abstr
|
DerUrologeA.80370372.eng.abstr
|
[
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"id": "DerUrologeA.80370372.eng.abstr-passage-0",
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"Ureterneoimplantation ( unilateral in 6 cases ) was performed as palliative urinary diversion in 8 patients ( age 64-81 years ) due to locally advanced prostate cancer and bilateral ureteral obstruction ( serum creatinine 2.1 to 9.8 mg . per dl . ) between 1991 and 1995. In these cases the applipcation of a double-J-catheter had failed or a percutaneous nephrostomy was refused . Postoperative time of survival ( 237 days , 2 patients still living for 20 and 21 months after therapy ) , mortality ( 1 of 8 patients ) , morbidity and time to hospital discharge ( 26 days ) are compared to the results of the published retrospective investigations concerning percutaneous nephrostomy . The opportunity of a natural micturition without external urinary diversion could be gained for a longer period of time ( 5 and 20 months ) in 2 of 3 patients . The other patients with in situ double-j-catheters were drained sufficiently by a suprapubic cystostomy ( serum creatinine postoperatively 1.3 to 2.0 mg . per dl . ) . Bilateral ureterocystoneostomy being more invasive than unilateral diversion showed no benefits and was no more performed since 1991. Ureterneoimplantation with comparable postoperative results to percutaneus nephrostomy seems to be a sufficient therapeutic possibility in patients with natural micturition , repeated catheter complications , refusal or failure of alternative urinary diversion ."
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DerUrologeA.80370377.eng.abstr
|
DerUrologeA.80370377.eng.abstr
|
[
{
"id": "DerUrologeA.80370377.eng.abstr-passage-0",
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"text": [
"Matrix metalloproteinases ( MMP ) and their tissue inhibitors ( TIMP ) are involved in important processes of tumor invasion and metastasis . In the study presented , matrix metalloproteinase 1 ( MMP1) and 3 ( MMP3), the tissue inhibitor of metalloproteinase 1 ( TIMP1) and the complex MMP1/TIMP1 were measured by ELISA tests specific for these proteins in blood plasma . These components have been investigated in prostate cancer patients ( PCa ) with metastases ( n = 18 ; T2, 3 , 4 pN1, 2M1), prostate cancer patients without metastases ( n = 29 ; T2, 3 pN0M0), patients with benign prostate hyperplasia ( BPH ; n = 29 ) and in healthy men ( n = 35 ) . Mean values of MMP1 and of the complex MMP1/TIMP1 were not different among the four groups . The mean values of MMP3 and especially TIMP1 were significantly higher in prostate cancer patients with metastases compared with controls , BPH patients and prostate cancer patients without metastases . Ten of these 18 patients had TIMP1 levels higher than the upper reference limit . TIMP1 concentrations correlate to the tumor stage but not to the tumor grade . These results indicate , that TIMP1 could be an potential marker for metastases in prostate cancer patients ."
],
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DerUrologeA.80370382.eng.abstr
|
DerUrologeA.80370382.eng.abstr
|
[
{
"id": "DerUrologeA.80370382.eng.abstr-passage-0",
"type": "abstract",
"text": [
"In total malignant mixed tumors ( carcinosarcomas ) represent a very rare gynecological neoplasm . In accordance with the embryological genesis primary localizations are with descending probability the uterus , the ovarians and finally the tubes . We report on a 55 year old female patient , with a paraurethral mass , which was primarily diagnosed in 1994. Histopathological evaluation of a transvaginal biopsy did not demonstrate evidence of malignancy at that time . After painful enlargement the paraurethral mass was resected surgically and histopathological evaluation revealed a primary paraurethral malignant mixed tumor ( carcinosarcoma ) . Postoperatively , the patient underwent percutaneous ( 46,4 Gy ) and intracavitarv ( 2 x 6 Gy ) radiation . Twelve months postoperatively there is no evidence of disease ."
],
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]
}
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{
"id": "DerUrologeA.80370382.eng.abstr-s1-t1",
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"id": "DerUrologeA.80370382.eng.abstr-s3-t3",
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[] |
[] |
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DerUrologeA.80370386.eng.abstr
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"Recent reports have indicated the ribonucleoprotein enzyme telomerase to play an important role in tumorigenesis . Activation of this enzyme is known to prevent progressive shortening of the end of the chromosomes , or telomeres , and hence to be critical in maintaining chromosomal integrity . The telomerase expressing cells require immortality . Supported by recent findings which suggest that telomerase activity is expressed in virtually all cancers but not in normal tissues , except those of the germline , hope grew up toward a potentially important new therapeutic target in the fight against cancer . An emerging hypothesis is that the inactivation of telomerase results in the death of immortal cells . If telomerase activation represents a tumor-specific feature , ( gene ) therapeutic applications would become most promising in regard to an effective anticancer therapy , possibly with limited side-effects . However , most recent studies report on telomerase activity to be also expressed in normal , non-neoplastic tissues as well as in non-neoplastic hyperproliferative lesions . The questions whether telomerase activity is tumor-specific or associated with ( physiologic or pathologic ) hyperproliferation is intriguing and remains to be clarified ."
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DerUrologeA.80370395.eng.abstr
|
DerUrologeA.80370395.eng.abstr
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"id": "DerUrologeA.80370395.eng.abstr-passage-0",
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"Today the organ donor operation in brain dead donors is mostly projected as multiple organ procurement ( MOP ) . Not only the kidneys , but heart and liver or additionally lungs and pancreas are removed in MOP . A good synchronization between the collaborating transplantation groups ( thoracic and abdominal surgeon , urologist ) is essential to prevent loss of an organ because of technical problems . In Germany urologists perform more than 40 % of kidney transplantations . These urologic institutions perform the cadaver kidney retrievals and participate on MOP . If possible , an urologist experienced in renal transplantation should contribute to the care for quality of the kidneys . Since 1987 the transplant center of Bremen obtained 390 donor registrations . 202 organ donor operations have been performed ( 106 MOP and 96 exclusive kidney retrievals ) . 398 donor kidneys have been collected and 382 could be transplanted ."
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[] |
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DerUrologeA.80370401.eng.abstr
|
DerUrologeA.80370401.eng.abstr
|
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"id": "DerUrologeA.80370401.eng.abstr-passage-0",
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"The history of Cowper Gland is described . Next the clinical , radiological and endoscopical findings in 172 patients ( age 18 to 82 ) are evaluated with regard to the importance of these alterations in clinical practice . There was no tumor . In three cases , only the bulbourethral gland showed inflammation . Out of 169 syringoceles 9 were closed ( 3 perineal , 6 bulbar ) . Only one case of the urethral ( bulbar ) type of closed syringocele showed obstruction . There were 56 patients with various forms of dilatation and opening into the urethra . Only one case showed obstruction . Thirty-one out of 104 patients with so-called simple syringocele had mild dilatation of the duct , mainly normal gland and mild symptoms . Alterations of the urethral wall as well as clinical symptoms were noted in the remaining 73 men with irregular ducts and alterations of the gland ; all of them had local urethral signs ; in 42 there were extensive urethral strictures ."
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DerUrologeA.80370487.eng.abstr
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DerUrologeA.80370487.eng.abstr
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"In this paper the role of psychosocial factors in erectile dysfunction is examined in two different ways : ( 1 ) Current approaches to the causation of psychogenic erectile dysfunctions are reviewed and discussed . ( 2 ) Empirical results from a large unselected sample of sexually dysfunctional men are presented and compared to a sample of functional men . Concerning etiological models the traditional unidimensional dichotomous concepts ( psychogenic versus organic ) of erectile dysfunction have to be abandoned and replaced by twodimensional models that are able to take the clinical reality into account that many patients have both significant psychological and organic factors in their disorder . The main causes of psychogenic erectile disorders can be divided into three groups , each belonging to a different phase of time : ( i ) immediate factors ( performance anxiety ) , ( ii ) antecedent life events from recent history , ( iii ) developmental vulnerabilities from childhood and adolescence . The specific interplay as well as the importance of the different groups is different in primary and secondary erectile disorders . The empirical results presented here are based on a sample of 751 patients from our interdisciplinary outpatient unit for sexually dysfunctional men and a group of 55 sexually functional men . Both groups completed a self-developed , multidimensional questionnaire addressing a variety of psychosocial and descriptive factors concerning erectile disorders . The results prove the heterogeneity of patients and their respective erectile problems and show a number of highly significant group differences . The frequent comorbidity of erectile disorders and premature ejaculation and disorders of desire is worth mentioning as well as the high prevalence of depression and the extreme extent of performance anxiety in the patient group . The results are discussed with respect to future treatment strategies . The necessitiy of combined psychosomatic approaches optimizing the efficacy of all available therapeutic options is particularly stressed ."
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DerUrologeA.80370495.eng.abstr
|
DerUrologeA.80370495.eng.abstr
|
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"id": "DerUrologeA.80370495.eng.abstr-passage-0",
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"text": [
"In diagnostics of erectile dysfunction there are different simple or large-scale procedures available . Refering to a three-step-scheme that makes difference in the diagnostics in I. non-invasive , II . semi-invasive and III . invasive procedures the current diagnostic measures will be explained . To the non-invasive measures do account the extensive patients history taking including the sexual history and the psychological diagnostics , the physical examination and laboratory screenings . The semi-invasive procedures include the intracavernous injection test with vasoactice substances , the doppler sonography and duplex or color duplex sonography , the corpus-cavernosum-electromyogram ( CC-EMG ) and other neurophysiological examinations . The third invasive step contains the dynamic infusion pharmacological cavernosography and cavernosometry ( DICC ) and the selective pharmacological phallo-arteriography . The procedures of this step are essentially limited to patients with erectile dysfunction who are planned for surgical interventions ."
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[] |
[] |
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DerUrologeA.80370503.eng.abstr
|
DerUrologeA.80370503.eng.abstr
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"id": "DerUrologeA.80370503.eng.abstr-passage-0",
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"Pharmacotherapy of erectile dysfunction comprises oral and local application of drugs . Today , Yohimbin is the only drug listed for this indication . Yohimbin acts via central alpha-receptor blockade and showed a significant effect in a recent double blind study compared to placebo . The centrally acting substances Apomorphin and Trazodone were also tested for their potential use with Apomorphin showing promising results . The orally active phosphodiesterase-V inhibitor Sildenafil acts predominantly on the peripheral side ; broad clinical studies demonstrated a significant effect of the drugs compared to placebo . For local use , intraurethral ( MUSE ) and intracavernous applications are available with PGE1 being the drug the most widely used for the moment . Since many different drugs with various modes of action and different modes of application are being developped at the moment , future pharmacological treatments will allow a more refined approach towards an individually adapted regimen ."
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[] |
[] |
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DerUrologeA.80370509.eng.abstr
|
DerUrologeA.80370509.eng.abstr
|
[
{
"id": "DerUrologeA.80370509.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Vascular surgery or penile prosthesis implantation are the main surgical options for erectile dysfunction . In this category , penile revascularization is the only causal therapy for selected patients : males younger than 50 years of age at time of surgery , maximum of two risk factors , exclusion of diabetes mellitus . Long-term success decreased to 53 % to 55 % in comparison to first encouraging reports of 80 % success . Venous surgery resulted in an even more distinct decline of success the longer the elapse of time after surgery . Long-term success dropped under 40 % , leaving only a few indications for penile venous ligation . In contrast , penile prosthesis implantation results in high satisfaction rates . Despite this , it is not generally recommended as first choice surgical management as it is linked to irreversible damage of the cavernosal bodies . Among numerous types of penile implants , preference is nowadays mostly given to the three-piece hydraulic models . However , such complications as defective or perforated cylinders in up to 35 % after 5 years have arisen , depending on the type of implant . In a selected patient group , vacuum constriction devices with a mean patient acceptance of 75 % ( 50 % to 90 % ) seldom result in complications and are thus considered to be a well-established therapeutical option ."
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DerUrologeA.80370516.eng.abstr
|
DerUrologeA.80370516.eng.abstr
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"Hemorrhagic cystitis is a well known toxic and often life-threatening complication from high-dose chemotherapy with cyclophosphamide . The incidence is particularly high after allogeneic bone marrow transplantation . The morphologic bladder wall changes are associated with gross hematuria , clot formation in the bladder and problems to control the bleeding in up to 70 % without preventive measures . Prevention is routinely done and can reduce but not obviate the incidence of hemorrhagic cystitis . Treatment is initiated by forced diuresis and continous bladder irrigation . When necessary endoscopic cauterisation of bleeding mucosal areas is combined with the instillation of hemostyptic agents . Embolisation of the pelvic vessels or open surgery to control the bleeding is indicated in selected cases in a life-threatening situation ."
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DerUrologeA.80370522.eng.abstr
|
DerUrologeA.80370522.eng.abstr
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{
"id": "DerUrologeA.80370522.eng.abstr-passage-0",
"type": "abstract",
"text": [
"We observed two patients with stone formation in the renal pelvis two and five years after pyeloplasty . In both cases there was no obstruction of the pyeloureteral junction detectable . We consider the use of Polyglactin ( Vicryl ) for the pelvis suture as reason for the stone formation . For stone removal we favourite an endoscopic procedure , in which a removal of residuums of the suture is even possible as the verification of the pyeloureteral junction ."
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0,
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[] |
[] |
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DerUrologeA.80370526.eng.abstr
|
DerUrologeA.80370526.eng.abstr
|
[
{
"id": "DerUrologeA.80370526.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Adrenal lipomas are extremely rarely occuring benign tumors being hormonally inactive . The patient described in this report underwent surgical excision of an adrenal lipoma because of the associated hypertension . The blood pressure decreased postoperatively to normal levels . This case report and the review of the literature consider diagnosis and therapy of the adrenal lipomas ."
],
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0,
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}
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[] |
[] |
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},
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"id": "DerUrologeA.80370526.eng.abstr-s3-r1-t3.2-t2.1",
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"id": "DerUrologeA.80370526.eng.abstr-s3-r4-t3.1-t1.2",
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"id": "DerUrologeA.80370526.eng.abstr-s3-r5-t1.1-t3.2",
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"id": "DerUrologeA.80370526.eng.abstr-s3-r7-t1.1-t1.2",
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"id": "DerUrologeA.80370526.eng.abstr-s4-r2-t4.1-t3.2",
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{
"id": "DerUrologeA.80370526.eng.abstr-s4-r3-t3.2-t4.1",
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},
{
"id": "DerUrologeA.80370526.eng.abstr-s4-r4-t3.1-t4.1",
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"arg2_id": "DerUrologeA.80370526.eng.abstr-s4-t4",
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}
] |
DerUrologeA.80370593.eng.abstr
|
DerUrologeA.80370593.eng.abstr
|
[
{
"id": "DerUrologeA.80370593.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Aim of this review article was to critically analyse the recently described zytogenetic and molecular markers for testicular germ cell tumors with regard to their clinical utility . The isochromosome i ( 12p ) represents the most common and characteristic cytogenetic finding which already appears in testicular carcinoma in situ . A number of proto - oncogenes ( Cyclin D and PTHLH ) as well as putative tumor suppressor genes are localized on 12p ; however , their role in pathogenesis and prognosis of testicular germ cell tumors has not been defined yet . Clinical characteristics of patients with familial testicular germ cell tumors indicate a genetic background for the development of testicular tumors . Although a number of chromsomal loci encoding potential testicular tumor susceptibility genes have been identified , the genetic basis of testicular cancer pathogenesis is still unknown . With regard to molecular prognostic risk factors most of the reported data on proliferation markers , tumor suppressor genes , proteases and adhesion molecules have to be confirmed in prospective randomized trials prior to their widespread clinical use . Based on the available data on prospective studies percentage of embryonal carcinoma and vascular invasion appear to be the most significant prognosticators . Investigation and identification of those factors determining the aggressive biologic behavior of embryonal carcinoma compared to all other histological components appear to be most promising in research for prognosticators of metastatic disease ."
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}
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DerUrologeA.80370621.eng.abstr
|
DerUrologeA.80370621.eng.abstr
|
[
{
"id": "DerUrologeA.80370621.eng.abstr-passage-0",
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"text": [
"We analyzed 33 patients with disseminated germ cell tumors ( GCT ) who underwent residual tumor resection ( RTR ) during the period from 1991-1997 . The patients were markerpositive prior to surgery were analyzed . The histopathological examination of the resected masses , the marker dynamics and the relapse-free respectively the progressionfree survival , were evaluated . The status differed at primary diagnosis : minimal disease n = 1 , moderate disease n = 15 , advanced disease n = 17. The patients received at average 8,5 cisplatin-containing cycles of polychemotherapy . Only 11 patients underwent surgery after first-line-chemotherapy . The remaining received second- or third-line-chemotherapy prior to surgery . In 12 of 31 evaluable patients , a durable CR was achieved . The median follow-up for this group is 30 months ( 2-58 months ) . The histopathologic examination of the resected specimen and the tumor marker level prior to RTR do not permit determination of prognostic outcome . After operation 44 % of the AFP-positive and 30 % of the -HCG-positive patients had a durable remission . If tumor marker levels at time of RTR are within normal range , disease-free survival is 72 % ; in case of elevated markers 39 % will survive . If intensive chemotherapy fails to normalize markers , RTR remains the only option to change the fatal course of the disease ."
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] |
[] |
[] |
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DerUrologeA.80370629.eng.abstr
|
DerUrologeA.80370629.eng.abstr
|
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{
"id": "DerUrologeA.80370629.eng.abstr-passage-0",
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"text": [
"Between 1/1990-8/1997 two cources of single agent Carboplatin had been given to 36 patients with clinical stage I seminoma . Within an median follow up period of 52 months ( 17-88 ) 29 out of 34 patients were analyzed retrospectively . During this period no recurrences had been noted and nobody of our patients died ( 0 % relapsrate , 100 % survival-rate ) . The Carboplatin-therapy was well tolerated . Myelosuppression after chemotherapy was mild ( WHO grade I ) . The experienced acute toxic side effects ( max . grade II WHO ) during and after chemotherapy had been nausea ( 37 % ) , vomiting ( 14 % ) and mild hairloss ( 11 % ) . Until now no long term side effects were notized . A standardized questionaire had been used to evaluate the impairment of quality life after single agent carboplatin therapy . After a minimum of one year follow up averagly 79 % ( 62-92 % ) of the asked patients showed no impairment of their quality of life , wheras 19 % ( 8-38 % ) of the people experienced mild impairment of their quality of life . Because of the shown low recurrence rate , the minimal toxicity and no relevant impairment of the quality of life single agent carboplatin therapy will be an alternativ approach for clinical stage I seminoma ."
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DerUrologeA.80370635.eng.abstr
|
DerUrologeA.80370635.eng.abstr
|
[
{
"id": "DerUrologeA.80370635.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Improved survival in testicular cancer has been accompanied by concern about long-term side effects of chemotherapy or radiotherapy . Secondary malignant neoplasia represents one of the worst possible long-term complications , leading to death in patients cured of their primary malignancy . Patients with testicular germ cell tumors appear to have a 2-fold increased risk of developing any second cancer 25-30 years after the diagnosis , resulting in a cumulative incidence of 16-23 % at that time . The risk for secondary solid tumors can be mainly attributed to radiotherapy . There is strong evidence of an increasing risk for secondary solid tumors with time since treatment . Tumor-specific analysis of the risk for second cancers revealed statistically significant excesses for stomach , pancreas , bladder , rectum , prostate , and kidney cancer , as well as for cancer of the thyroid , melanoma , sarcomas , and non-Hodgkin's lymphoma . No significantly elevated risk for secondary solid tumors was observed after treatment with chemotherapy alone ."
],
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DerUrologeA.80370648.eng.abstr
|
DerUrologeA.80370648.eng.abstr
|
[
{
"id": "DerUrologeA.80370648.eng.abstr-passage-0",
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"text": [
"Laparoscopy and magnetic resonance imaging ( MRI ) are competetive tools in the diagnostic of non-palpable testis . Advantages and disadvantages of this methods will be demonstrate . 29 boys investigated for this indication with MRI . In case MRI failed to locate the testis laparoscopy was performed with a new miniaturized set of pediatric instruments ( 1.9 mm optic ) . The aim of laparoscopy was the identification of the spermatic duct and vessels and their topographic relation to the internal inguinal ring . All findings were verified by open surgical procedures . MRI revealed 10 inguinal and 7 abdominal testis . There was no false positive finding . In 12 boys MRI showed no testis . 4 cases were correct negative , 8 cases were false negative ( 32 % ) . In these 8 MRI-negative patients laparoscopy revealed 7 inguinal and 1 abdominal testis . The optical quality of the mini-telescope was sufficient for a 100 % correct diagnosis . Laparoscopy related complications did not occur . Laparoscopy proved to be a powerful low risk diagnostic method in non- palpable testis with high senitivity and specifity ( 100 % correct positive , 0 % false negative ) . Therefore lapraroscopy is recommended as primary diagnostic access for this indication . In the same anesthesia a optimal therapy is possible . Nevertheless a positive MRI-finding locates the testis reliably , whereas a negative finding always needs further exploration because testis might have been missed ."
],
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DerUrologeA.90380006.eng.abstr
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DerUrologeA.90380006.eng.abstr
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"Classification systems of bladder dysfunction are mainly based on functional and urodynamic characteristics . Under functional aspects classification relates to disturbances of storage and emptying function and the behaviour of its components , the bladder and the bladder outlet . The International Continence Society established a committee for the standardisation of terminology of lower urinary tract function and recommended worldwide accepted standards of terminology . These standards are the basis for any classification system and should be used to facilitate comparison of results . In addition , classification of bladder dysfunction should be completed by a clinical investigation to define the risks of underlaying disorder ."
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DerUrologeA.90380010.eng.abstr
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DerUrologeA.90380010.eng.abstr
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"Neurogenic bladder dysfunction in childhood is mostly caused by spinal dysraphism . The urologic diagnostic procedure tries to evaluate the underlying form of neurogenic bladder , dysfunction the associated disturbances at the upper tract and the development of changes by body growth . Therapeutic main aim is the conservation and protection of the kidney function and , secondly , the development of social dryness and a form of bladder emptying , that is related to the individual situation and associated disabilities . We report here about the diagnostic procedure and result of a group of 190 patients , that have been seen in our department since birth and for more than ten years continously . Developmental changes of neurogenic bladder dysfunction has been found in more than 25 % of the children . This figure shows the need of lofe-long close urodynamic follow-up ."
],
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] |
[] |
[] |
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DerUrologeA.90380014.eng.abstr
|
DerUrologeA.90380014.eng.abstr
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"Voiding dysfunctions secondary to failure of adequate relaxation of the striated urinary sphincter or the smooth bladder neck should be considered in children with urinary day time incontinence and/or enuresis and recurrent urinary tract infections . The urodynamic findings resemble to those obtained in neuropathic bladders , but only a minority of the children suffer from neurologic disorders or anatomical obstruction . In the majority of cases a developmental delay of the central nervous system responsible for urinary control is assumed . Behavioural disturbances play another important etiological role . Therapy is based on behavioural modification ."
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DerUrologeA.90380020.eng.abstr
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DerUrologeA.90380020.eng.abstr
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"id": "DerUrologeA.90380020.eng.abstr-passage-0",
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"Functional voiding disturbances can be due to failure of the detrusor or to discoordinated sphincter function during micturition . Therapeutical options are directed either to strengthening the contraction up to an adequate magnitude or to lowering the voiding resistance or can be aimed at influencing both . In a brief survey mechanical , pedagogical , electrotherapeutical , and surgical measures as well as drug treatment are critically examined . Conservative methods should always be attempted before surgical procedures are performed . Depending on the degree of severity and the etiology of the disease , a combined therapy can be useful . In the case of resistance to therapy , intermittent autocatheterism is to be preferred to permanent deviation via an indwelling catheter ."
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[] |
[] |
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DerUrologeA.90380030.eng.abstr
|
DerUrologeA.90380030.eng.abstr
|
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{
"id": "DerUrologeA.90380030.eng.abstr-passage-0",
"type": "abstract",
"text": [
"After unsuccessful medical treatment of a neurogenic hyperreflexive bladder dysfunction further treatment options are the ileal bladder augmentation , the detrusor-myectomy ( bladder auto-augmentation ) and the sacral root deafferentation . All techniques lead to a low-pressure bladder with enlarged storage volume . The authors here report about their personal experience with the detrusor myectomy in 62 patients with hyperreflexive neurogenic bladder dysfunction from 1989 until 1998. Indication , surgical technique , and long-time results are presented ."
],
"offsets": [
[
0,
560
]
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}
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[] |
[] |
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DerUrologeA.90380038.eng.abstr
|
DerUrologeA.90380038.eng.abstr
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"id": "DerUrologeA.90380038.eng.abstr-passage-0",
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"The requirement of blood transfusions was evaluated in a two compartment ( retrospective/prospective ) study in our renal transplantation program . Between July 1st , 1993 and December 31st , 1994 ( observation period I ) we retrospectively investigated 110 patients with end stage renal disease and anemia undergoing kidney transplantation . Between January 1st , 1995 and December 31st , 1996 ( observation period II ) the requirement of blood transfusions was followed prospectively in 134 patients after allogenic renal transplantation . The amount of blood drawn for preoperative diagnostic investigations was in observation period I significantly higher ( 280 ml ) than in observation period II ( 150 ml ) ( p = 0.02 ) . For postoperative diagnostic tests in observation period II significantly less blood ( 240 ml ) was needed than in observation period I ( 510 ml ) ( p = 0.01 ) . The intraoperative bloodloss was similar in both periods ( 170 ml vs. 190 ml ; p = 0.6 ) . The need for closer graft observation was the reason for significantly increased amount of blood transfusions in patients with delayed graft function . The number of blood transfusions was significant lower in patients with primary graft function ( p = 0.0001 ) . There was no correlation between blood transfusions and the use of ATG/OKT3, surgical complications and reoperations . With an improved management of blood drawing for diagnostic tests after allogenic kidney transplantation the number of perioperative blood transfusions can be reduced significantly ."
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DerUrologeA.90380046.eng.abstr
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DerUrologeA.90380046.eng.abstr
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"PET is a new method in nuclear medicine which examines the metabolism and not the morphology . Tumors show a higher rate of glycolysis than benign tissue and hence can be detected by radioactive glucose . This method has proved good for various tumors . In this study the lymph node staging of bladder cancer by PET was investigated . In 64 patients a PET of the pelvis after injection of fluorodeoxyglucose ( FDG ) was carried out preoperatively ; the PET-results were compared with the histology of the OR specimen after classical pelvic lymphadenectomy . For lymph node staging positive nodes were found in 14 patients which was correct ; a false-negative result was obtained in 7 patients . In 37 patients the PET-result was true-negative and in 6 patients false-positive resulting in a sensitivity of 67 % , a specificity of 86 % and an accuracy of 80 % . Therefore , our PET results are encouraging and seem to be better than those obtained by classical staging procedures such as CT or MRI ."
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DerUrologeA.90380051.eng.abstr
|
DerUrologeA.90380051.eng.abstr
|
[
{
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"text": [
"The intravesical instillation of BCG ( Bacillus Calmette-Guérin ) in cases of relapsed superficial bladder cancer is an acknowledged kind of prophylaxis . It is uncertainly up to now whether a verification of the immune systems competence is necessary . The recommendations in this problem are very different . In conclusion to the recent literature we think that a verification of the immune system before BCG installation in the urinary bladder has not a prognostic value . Additionally , the legal obligingness of this immunotest is doubtful ."
],
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0,
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]
}
] |
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DerUrologeA.90380056.eng.abstr
|
DerUrologeA.90380056.eng.abstr
|
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{
"id": "DerUrologeA.90380056.eng.abstr-passage-0",
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"text": [
"For patients with erectile dysfunction oral medication seems to be the most comfortable form of application . This can also be seen in the expectations looking forward to Sildenafil and other drugs in development . We present a prospective examination with the oral medication of 100 mg acecarbamol , 30 mg extract of cortex quebracho and 33 mg tocopherol acetate ( Afrodor ) in 100 patients complaining secondary erectile dysfunction . The patients were treated unselected with 3 x1 tablet/day during the diagnostic schedule . 14 % of the patients were able to perform satisfying sexual intercourse after 4 weeks of medication and another 15 % showed an increased libido . Therefore we suggest , that the application of an oral medication , might be useful , especially during the time of diagnostics . Especially for those patients who gain without invasive diagnostic tools as intracavernous injection ."
],
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0,
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{
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{
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{
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{
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{
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{
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{
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{
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{
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{
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{
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{
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{
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{
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{
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{
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{
"id": "DerUrologeA.90380056.eng.abstr-s5-r6-t4.1-t5.1",
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{
"id": "DerUrologeA.90380056.eng.abstr-s5-r7-t4.1-t5.1",
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{
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{
"id": "DerUrologeA.90380056.eng.abstr-s5-r9-t1.1-t2.1",
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{
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{
"id": "DerUrologeA.90380056.eng.abstr-s5-r11-t3.1-t6.1",
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{
"id": "DerUrologeA.90380056.eng.abstr-s5-r12-t2.1-t4.1",
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{
"id": "DerUrologeA.90380056.eng.abstr-s5-r13-t2.1-t4.1",
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{
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{
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{
"id": "DerUrologeA.90380056.eng.abstr-s5-r16-t4.1-t2.1",
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{
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{
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{
"id": "DerUrologeA.90380056.eng.abstr-s5-r19-t3.1-t5.1",
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{
"id": "DerUrologeA.90380056.eng.abstr-s7-r1-t1.1-t2.1",
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}
] |
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