摘要:

Screening for early cancer detection is of value if (i) appropriate tests are available, (ii) the detected tumor can be treated, and (iii) the treatment improves the quality of life or the mortality rate of the patients. It is demonstrated whether carcinomas of the prostate and urinary tract, renal cell carcinoma, penile carcinoma and testicular tumors satisfy these conditions. Screening for early cancer detection may be indicated in prostatic and urinary tract carcinomas. The clinical examination should include the male genitalia. The indication for sonography of the kidneys to detect renal cell carcinomas is investigated at the moment. Instruction to perform self-examination of the testes should be given to all males older than 20 years.

ISSN:0042-1138    

DOI:10.1159/000280790

出版商:S. Karger AG    

年代:1982

数据来源: Karger

摘要:

Ureteral strictures are serious and frequent complications of chronic bilharziasis of the urinary tract are seen. To determine which corrective surgical procedures are most successful, we compared the results of those most commonly done. We retrospectively analyzed our experience with mucosa to mucosa ureterovesical anastomosis (68 ureters), transvesical ureteral meatotomy (30 ureters) and submucosal tunnel ureteroneocystostomy (UNC; 10 ureters). Complete follow-up data are available for 102 patients (108 ureters); half of these cases were followed for 4 years or even more. It is to be noted that, in our series, only 10 ureters were suitable for submucosal tunnel anastomosis: bilharzial ureters are usually fibrotic, noncompressible, and the vesical mucosa is adherent to the muscular layer – which renders creation of a tunnel difficult or impossible. However, this procedure produced the best results. The conclusion was reached that, whenever possible, antireflux procedures suitable for the bilharzial bladder and ureter should be attempted. Based on this analysis, a prospective clinical trial was carried out, which compared Boari flap UNC (30 ureters), triangular flap ureterovesicoplasty of Girgis et al. (30 ureters), and ileal loop replacement of the pathologic segment (30 ureters). The average period of follow-up was 20 months. Triangular flap and Boari flap were found to be superior to ileal replacement. Ileal replacement is consistently followed by vesicoileal reflux and commonly by persistent urinary tract infection. In consequence, the latter operation must be reserved for cases with extensive ureteral loss or destruction. Anti-reflux procedures still remain the most desirable methods whenever technically possibl

ISSN:0042-1138    

DOI:10.1159/000280791

出版商:S. Karger AG    

年代:1982

数据来源: Karger

摘要:

The histotopographic localization of the nerves of the vas deferens was studied in dogs. The nerves of the vas are concentrated at two poles. A vasectomy with a nerve-sparing technique and a conventional vasectomy were performed in two groups of dogs. 5 months later all dogs underwent vasovasostomy. The intact nerve supply after vasectomy was controlled by electrophysical measurement. Sperm evaluation and morphological findings are compared and the advantages of a nerve-sparing technique demonstrated. The proliferative capacity of the epithelial layer of the vas deferens has to be considered in operations on the vas.

ISSN:0042-1138    

DOI:10.1159/000280792

出版商:S. Karger AG    

年代:1982

数据来源: Karger

摘要:

A urethral/bladder model was placed in a reservoir simulating the abdominal cavity. Increased ‘intraabdominaΓ pressure was transmitted to the urethra-like part of the model only when this was situated inside the ‘abdominal cavity’. The use of H2O or CO2 as filling medium was indifferent as only the relation between rise in urethral pressure and in bladder pressure is of practical importance. However, the increase in transmitted pressure was 25% lower when CO2 was used. Incompetent urethral closure mechanism is found in three categories of female patients: (1) patients with sensory urge who have an unstable urethra, (2) patients with genuine stress incontinence, and (3) patients who have a sphincteric insufficiency due to a low maximal urethral closure pressure and atrophy of the urethral mucosa. These categories can be separated urodynamically using simultaneous urethracystometry combined with transmission studies. Out of 20 patients with sensory urge 16 were found to have an unstable urethra. Transmission studies in 51 women with symptoms of stress incontinence revealed positive transmission, i.e. the increase in urethral pressure exceeded the rise in bladder pressure, in 23 patients. They were all elderly women and had a low maximal urethral closure pressure and their leakage of urine was due to an endourethral weakness. The remaining 28 patients had negative transmission and thus genuine stress incontinence. In conclusion: To classify the three different types of incompetent urethral closure mechanism it is necessary to perform a simultaneous urethracystometry, in which transmission studies are mandatory, as this is the most appropriate way to distinguish between patients who will benefit from operation and patients who wi

ISSN:0042-1138    

DOI:10.1159/000280793

出版商:S. Karger AG    

年代:1982

数据来源: Karger

摘要:

A new disposable device for measuring urinary peak flow rate is evaluated. Comparison with an electronic flowmeter revealed no significant difference in the results obtained. It provides a simple method of peak flow rate estimation where conventional uro-dynamic apparatus is not available.

ISSN:0042-1138    

DOI:10.1159/000280794

出版商:S. Karger AG    

年代:1982

数据来源: Karger

摘要:

Dilute solutions of formalin, surgically injected under direct vision into the cortex of the mouse kidney is soon attended by degeneration and necrosis of the proximal convoluted tubules for a distance around the injection site. After 4 weeks, regeneration and some attempt at repair become evident in the epithelium. Although this experimental model represents a direct approach to the kidney, it is suggested that repeated renal exposure to small amounts of formalin, employed in commercial and scientific endeavors, which gain entrance to the circulation through minute breaks in the epidermal surface or the respiratory mucosa may eventuate in similar alterations of the human kidney.

ISSN:0042-1138    

DOI:10.1159/000280795

出版商:S. Karger AG    

年代:1982

数据来源: Karger

摘要:

Inferior pyelocalycotomies for stag-horn calculi and multiple stones have been performed in 12 kidneys which had narrow or adhesive extrarenal pelvis. The efficiency of inferior pyelocalycotomy was improved by the use of a renal pedicle clamp and fibrin coagulum. The operative procedures are described and the advantages discussed.

ISSN:0042-1138    

DOI:10.1159/000280796

出版商:S. Karger AG    

年代:1982

数据来源: Karger

摘要:

A case of transient urinary retention secondary to genital herpes simplex virus infection is reported. The neuropathy of the bladder was documented by a full urodynamic investigation including a positive denervation supersensitivity test. Viral infection as an aetiology of transient bladder dysfunction is discussed.

ISSN:0042-1138    

DOI:10.1159/000280797

出版商:S. Karger AG    

年代:1982

数据来源: Karger

摘要:

In 40 patients with urinary bladder tumours we compared the results of the immune profile, obtained by means of cutaneous tests with dinitrochlorobenzene (DNCB), and the infiltration of immunocompetent cells in the histological pattern after transurethral tumour resection. It was noted that the more the tumour had infiltrated, the less was it possible to immunize with DNCB or to achieve an immunocyte infiltration in the tumour. According to the classification of the WHO there was a positive reaction in 56–67% and a correlating immunocyte infiltration in 50–

ISSN:0042-1138    

DOI:10.1159/000280798

出版商:S. Karger AG    

年代:1982

数据来源: Karger

摘要:

The pressure-flow relationship of the normal pyeloureter was investigated in 10 pigs. From a mean baseline pressure in the pelvis of 7.5 cm H2O, the pressure increased during perfusion. The pressure increase from baseline to 8 ml/min was significant. It was noticeable that a perfusion rate of 8 ml/min resulted in intrapelvic pressures of more than 27 cm H2O in 4 of the 10 pigs. A further increase in perfusion rate gave only a slight, additional increase in pressure with linear relationship between flow rate and pressure. The steep rise in pressure from baseline values to 8 ml/min and the slight additional increase in pressure hereafter was probably caused by a transformation of peristalsis to a continuous flow.

ISSN:0042-1138    

DOI:10.1159/000280799

出版商:S. Karger AG    

年代:1982

数据来源: Karger