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D H Zermann

Publications and source records attributed to D H Zermann.

44 records · Page 3Linked to original sources
PubMed1997

Diagnostic value of natural fill cystometry in neurogenic bladder in children.

OBJECTIVE: Investigation of the diagnostic value of natural fill cystometry (NFC) in children with neurogenic bladder in comparison to conventional videocystometry (CVC). METHODS: We investigated 20 children (aged 6-11; 15 girls and 5 boys) with the following diagnoses: 6 myelomeningocele, 2 tethered cord syndrome, 1 syringomyelia, 1 Vater syndrome, 1 suprasacral spinal cord injury, 9 suspected neurogenic bladder. We carried out a NFC after completing standard diagnostic including a slow-filling CVC. RESULTS: All investigations were completed successfully. The investigation lasted 6-20.5 h (mean 11:15 h). We registered phases of sleep, waking consciousness and micturition. CVC findings were confirmed in 45%: normal bladder function was confirmed in 2 patients (10%), bladder hyperactivity was confirmed in 7 patients (35%). In 55% we obtained different findings on NFC in comparison to the slow-filling CVC: bladder hyperactivity was not confirmed in 2 (10%), detection of bladder hyperactivity was found in 4 children (20%) with normal bladder function on CVC, detection of bladder hyperactivity on NFC was found in 5 children (25%) with low-compliance bladder on CVC. In 45% of all children, NFC detected new findings compared with CVC diagnoses. In 10%, possible artifacts (e.g. due to catheterization) of CVC were recognized. CVC findings were confirmed in 45%. CONCLUSION: These results are preliminary but they suggest that this is a new diagnostic method for improving the diagnostic standard in the childhood neurogenic bladder.

Child↗
PubMed1997

[EMG surface polygraphy of the pelvic floor--description of functional changes after radical prostatectomy].

Urinary stress incontinence after radical prostatectomy could be cured by physiotherapy in a high percentage. The authors developed an investigation procedure for description of myoelectrical activity of pelvic floor with surface electrodes. 10 patients were studied 1 day before, 10 days and 6 months after radical prostatectomy. Significant changes of amplitude and frequency characteristics could not be found in rest and during the stationary intervals of maximal contraction. But after the operation in all patients changed the activation pattern within the interval of increasing muscle contraction. The mean and median frequency decreased significantly (Friedman-test, p < 0.001). This was interpreted as a problem of intramuscular coordination. After physiotherapy urinary incontinence was cured or improved. The typical activation pattern of dyscoordination was not more evident after 6 months.

Aged↗
PubMed1996

[Possibilities of therapy and rehabilitation of patients with urinary incontinence].

Rehabilitation of incontinent patients is an interdisciplinary challenge. Many therapeutical options in gynecological urology reveal an optimal rehabilitation of these patients. In the last years, a great scientific progress in the area of neurourology offers patients with severe dysfunction of the lower urinary tract (e.g. spinal cord injury) new concepts to improve their urological problems.

Combined Modality Therapy↗
PubMed1995

[The high risk patient with symptomatic prostatic hyperplasia--a therapeutic dilemma?].

Since a few year, a lot of new methods in therapy of symptomatic benign prostate hyperplasia are available. Until now, none of these methods could reach the outcome of surgical therapy. Therefore, surgery is remaining the golden standard in the therapy of BPH. Alternative methods are of great importance in the treatment of "high risk patients". It may be possible to improve the quality of life. Laser therapy and intraurethral catheters are superseding transurethral and suprapubic catheters. The indication for the several methods has to been proven critically.

Aged↗
PubMed1995

[Injuries to the external male genitals].

Genital injuries are rare in comparison to other traumatologic injuries. Diagnostic and therapy demand a detailed urological knowledge and high abilities in the surgical and the microsurgical field. The emergency doctor/urologist, who firstly treats the patient, decides about the therapeutic outcome. Delays in the diagnostic procedures and false therapeutic indications may be followed by impairments in cosmetic and function of the genitale for the patient. Therefore, we demand an early consultation of an urologist.

Adolescent↗
PubMedDate not supplied

Fetal fibronectin: a new screening-marker for bladder cancer?

Early detection of transitional cell carcinoma (TCC) of the urinary bladder is essential for effective treatment. While several serum markers have been evaluated, none have been widely accepted for practical clinical use. Thus, urinary markers have been introduced and investigated to detect the evidence of bladder cancer. But sensitivity and specificity range around 80% respectively. In a prospective study we evaluated fetal fibronectin in the urine of patients with TCC of the urinary bladder. The positivity of oncofetal fibronectin was measured in morning urine samples by membrane immunoassay. This FFN membrane immunoassay is a qualitative test, a solid-phase immunogold assay. A positive sample will result in a single spot after binding of the oncofetal fibronectin-immunogold complex to the membrane containing a monoclonal antibody specific to oncofetal fibronectin (FDC-6, which specifically recognizes III-CS region). The morning urine samples were collected from patients with TCC before they underwent transurethral resection (n=40, 34 non-invasive and 6 invasive carcinomas) and healthy controls (n=20). Oncofetal fibronectin was investigated in the surgical samples by immunohistochemistry (antibody FDC-6, APAAP technique). We found a positive result for oncofetal fibronectin in 38/40 patients with transitional cell carcinoma of the urinary bladder. Two patients with a small pTaG1-TCC showed negative results. In the urine of healthy controls no positive results were detected. Thus, there is a sensitivity of 95% and a specificity of 100%. The TCC was demonstrated as a source of oncfn. To our knowledge this is the first study showing that patients with an evident TCC have a demonstrable amount of oncofetal fibronectin in the urine. We conclude that a positive result is common in TCC-patients. The sensitivity and specificity of this test seems to be extraordinarily high. Because of the small number of cases further studies are required.

Adult↗