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Biomedical subjects

D Hauri

Publications and source records attributed to D Hauri.

At least 37 records · Page 2Linked to original sources
PubMed1989

Management of ureteral stones by extracorporeal shock wave lithotripsy. 3 years of experience.

From April 1985 to March 1987 181 patients with ureteral stones were treated by means of extracorporeal shock wave lithotripsy (ESWL). Management for proximal calculi changed from in situ ESWL treatment (group n = 27) or placement of a ureteral catheter below calculi (group II, n = 30) to retrograde stone manipulation into renal pelvis (group IV, n = 52) or ESWL treatment under intraoperative irrigation of saline in cases where repositioning failed (group III, n = 50). The best stone-free rate for upper ureteral stones was obtained in group IV with 96% after 6 weeks, presenting also the shortest hospital stay (4.2 days) and lowest quota of postoperative auxiliary procedures (2%). Stones, not being dislodged into renal pelvis (49%), could be treated successfully in 86% by irrigation with saline during ESWL (group III). The stone-free rate decreased in patients with in situ treatment (group I: 67%) or ureteral catheter placement (group II: 83%). Treatment of these stones increased the need of postoperative ancillary procedures to approximately 30%. For distal ureteral stones ESWL and preoperative Zeiss placement achieved a stone-free rate of 95%.

Adult↗
PubMed1989

Radical prostatectomy in cases of prostatic carcinoma: the problem concerning erectile impotence.

It has become fashionable to perform radical prostatovesiculectomy for carcinoma of the prostate using the nerve-sparing method. In cases with a not too large prostate and a locally limited tumor, it is possible to preserve erectile potency. Our anatomic and radiologic preparation proved that postoperative impotence is not only due to lesions of the nerves but, almost as frequently, the consequence of obliterations of the vessels or a combination of both. If the lesion is purely arterial, revascularization surgery guarantees normal erections.

Erectile Dysfunction↗
PubMed1989

[The staghorn calculus: anatrophic nephrolithotomy versus percutaneous litholapxy and extracorporeal shockwave therapy versus extracorporeal shockwave lithotripsy monotherapy. A report of over 6 years' experience].

From 1982 to December 1987, 71 with incomplete (C4 by Rocco) and 37 with complete (C5 by Rocco) staghorn calculi underwent anatrophic nephrolithotomy (AN; n = 29), or combined percutaneous nephrostolithotomy and ESWL (PCNL + ESWL; n = 21), or ESWL monotherapy without or with preoperative JJ stenting (n = 37/21). The patients with incomplete staghorn calculi (C4) and preoperative ureteral stenting were free of stones after 6 months in 15 of 17 cases (88%), which is comparable to our results with AN (90%) and combined PCNL + ESWL (85%). ESWL without JJ stenting were free of stones in only 52%. The treatment of infected C4 calculi with JJ stenting was especially successful (92%). Complete staghorn calculi (C5) represented the best results after AN (78%) and combined PCNL + ESWL (75%), in contrast to ESWL without JJ stenting (44%). Four patients with C5 calculi were treated with ESWL and preoperative stenting, three of them were free of stones after 6 months. For incomplete staghorn calculi (C4), ESWL monotherapy with JJ stenting seems to be a justifiable noninvasive method which offers excellent results in stone elimination (88%), with lower costs than AN or PCNL + ESWL. More invasive procedures should be reserved for complete staghorn calculi.

Combined Modality Therapy↗
PubMed1989

[Continent ileum reservoir with anastomosis to the urethra].

We report our experience with the directly to the urethra anastomosed continent ileal reservoir. Our results suggest that the S-Pouch is superior to the proceeding suggested by Kock both from clinical and urodynamic view. Continence is to be expected at an anastomosis of this pouch with the bladder neck, whereas at an anastomosis with the posterior urethra occasional cases of nightly incontinence were registered. This always happened when the neurovascular bundle had not been preserved intraoperatively. If an ileal reservoir is installed metabolic acidosis has to be carefully avoided.

Anastomosis, Surgical↗
PubMed1989

[The effect of aminoglutethimide on steroid synthesis of the adrenal gland and its use in prostate cancer].

Following the hypothesis of depressing adrenal androgens in patients with relapsed prostatic carcinoma using Aminoglutethimide (AG), we performed a prospective study during three years, beginning in 1983. Twenty orchiectomized men aged 61-83 (mean 77) with progressive prostate carcinoma stage D2 (T0-4 Nx M1) were included. They received 4 x 250 mg AG and 50 mg cortisone daily. Overall response, according to NPCP-criteria, was 30% after 3 months (1 patient with partial remission and 5 patients stable), and at the end of trial 1 patient (5%) remained stable and 7 (65%) had progression. Laboratory controls of adrenal androgens did not show any significant change of androstenedione and DHEA-S within 3 months, and there was even an average rise of testosterone from 1 to 2 nmol/l. AG seems to be only of small advantage in secondary treatment of advanced prostatic carcinoma. But it is possible that aromatase inhibitors could be useful in treating BPH because of their influence on peripheral oestrogens.

Adrenal Cortex↗
PubMed1989

[Surgical possibilities in treatment of vascular-induced erectile impotence].

We are of the opinion that in most cases of erectile dysfunction morphological factors are involved. These have to be defined by means of adequate diagnostic procedures. When vascular disease is responsible it is necessary to distinguish between arterial, venous and arteriovenous conditions. Whereas arterial failure can often be corrected, the treatment of venous leakage is problematic, as the primary disease seems to affect the cavernous bodies directly.

Arterial Occlusive Diseases↗
PubMed1988

Arterially originated erectile disturbances: surgical possibilities and their alternatives--some personal thoughts.

The arterially originated erectile disturbances are the most common form of impotence due to morphological reasons. The concepts of therapy range from the surgical revascularization, to the intracavernous self-injection of vasoactive substances and to the implantation of penis prostheses. The advantages and disadvantages are discussed and weighed against each other.

Architecture↗
PubMed1988

[Retroperitoneal lymphadenectomy in non-seminomatous stage I, IIa and IIb testicular tumors].

Between 1961 and 1985, 190 retroperitoneal lymph node dissections (RLND) have been performed in the Urological Clinic of the University Hospital of Zurich in patients with low stage (I, IIa, IIb) non seminomatous germ-cell testicular cancer. Indication, operative technic, complications (8,9%, dry ejaculation in 27%) and the results of the operation are pointed out (relapse rate in stage I: 10%, IIa: 35%, IIb: 59% without and 14% with adjuvant chemotherapy). The question is analysed if this primary surgical approach in this primary surgical approach in these stages, simultaneously a diagnostic and therapeutic procedure, is still indicated in the era of efficacious chemotherapy.

Ejaculation↗
PubMed1988

[Bacteriology of the ejaculate--a useful study?].

In a retrospective study we analyzed the results of 318 bacteriologic tests of ejaculates from 175 patients with suspected infections of the prostate, epididymis and urethra. Only 55% of all bacteriologic tests were positive, and the bacteria most frequently found were those normally present in the anterior male urethra, enterococci and coagulase-negative staphylococci. These results indicate that bacteriologic testing of the ejaculate does not yield such reliable results as the segmented urine culture technique and the examination of expressed prostatic secretions.

Adolescent↗
PubMed1987

[An incidental finding of renal cysts: routine occurrence or a finding deserving clarification?].

Since the introduction of new non-invasive diagnostic techniques such as abdominal ultrasound and computerized tomography, simple renal cysts are diagnosed with increasing frequency. Over 30% of patients over 50 years of age are found to have simple renal cysts of different size. A cystic renal mass may represent a simple renal cyst without clinical relevance, a cystic renal carcinoma, early evidence of polycystic kidney disease in a young patient, a rare cause of renal hypertension, a source of infection in a symptomatic patient (infected renal cyst), or a manifestation of an infectious disease (renal abscess, echinococcus cyst). The differential diagnosis and management of a cystic renal mass therefore remain a clinical problem. In the past, surgical exploration of a cystic renal mass was frequently performed. Today, modern diagnostic techniques such as ultrasound-guided percutaneous cyst puncture with cytological analysis of the cyst content, or computerized tomography, are considered the methods of choice. They are particularly useful in case of doubt about the dignity of a cystic renal mass. The determination of renal venous renin levels may be useful in differentiating the causal role of a renal cyst in a patient with hypertension. The management of a cystic renal mass depends on the underlying disease.

Diagnosis, Differential↗
PubMed1987

[Angiographic, cavernosonographic and clinical differentiation of two forms of priapism with different prognoses].

Based on the findings upon arteriography, cavernosography and clinical features two different kinds of priapism are differentiated: Type I ("low flow priapism") is characterized by severe blood stasis within the corpora cavernosa and reduction of arterial perfusion through compression of the deep arteries of the penis. The penis is very hard and painful upon palpation. A delay of treatment over 48 hours will result in a damage of the corpora cavernosa and impotence. Type II ("high flow priapism") is characterized by arterial hyperperfusion. Outflow obstruction is absent. The penis is erected but of an elastic consistence, pain is absent. Even with a delay of treatment of up to 6 months the corpora cavernosa remain intact, normal erectile function is preserved.

Diagnosis, Differential↗
PubMed1979

[Experiences with a new method of surgery for incontinence].

Our new operation method against the prostatectomy-incontinence is only indicated, if the external urethral sphincter is intact. This possible in 90% of all incontinent patients after prostatectomy. In this situation we can guarantee a good chance of success. An interoperative lesion of the bulbi arteries, which enter in the urethra through the posterior portion of the bulbocavernosus muscle, must be prevented. A lesion of them leeds to a total necrosis of the posterior urethra.

Humans↗