[Conservative treatment of benign prostatic hyperplasia (author's transl)].
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Biomedical subjects
Publications and source records attributed to D Hauri.
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The diagnostic and predictive value of renal venous renin determinations was investigated in 73 patients who had various forms of hypertension associated with unilateral renal disease and who were operated upon. Patients with fibromuscular hyperplasia showed a markedly higher cure rate than cases with arteriosclerotic renal artery stenosis (64% vs. 25%) and were less frequently not improved (4% vs. 12%). Patients with unilateral (non-vascular) small kidney and patients with unilateral hydronephrosis showed comparable high cure rates (53% and 50%, respectively), whereas in no patient with a unilateral renal cyst did postoperative blood pressure return to normal. In the present study no statistically significant correlation was found between postoperative pressure reduction and PRA-ratios in either the whole group of patients or in the various subgroups. A negative PRA-ratio (less than or equal to 1.4) was found in 36% of all cured patients. In particular, cured patients with fibromuscular hyperplasia showed a high percentage (38%) of falsely negative tests. As expected, characteristic differences were observed in simple clinical data between cured and improved patients. Patients with normal postoperative blood pressure were significantly young (34.7 +/- 13.6 years) than improved cases (47.3 +/- 10.8 years; P less than 0.001) and cured patients showed lower preoperative blood pressure values (192 +/- 29/119 +/- 15) than improved ones (214 +/- 31/126 +/-117 mm Hg). Thus our results document a limited prognostic value of renal venous renin determination in patients with hypertension due to unilateral renal disease.
Results after internal urethrotomy under direct vision are comparable to the results after open plastic procedures for strictures of the urethra. Internal urethrotomy at present is preferred to plastic procedures because of its simplicity. But plastic procedures maintain their indication for some special types of strictures. Postoperative treatment after internal urethrotomy under direct vision varies with the etiology of the stricture. In iatrogenic strictures results are better using an indwelling catheter for a period up to 6 weeks after internal urethrotomy under direct vision.
Priapism is a pathological and mostly painful permanent penile erection. Typically only both corpora cavernosa and not the corpus spongiosum urethrae and the glans penis are involved. The vascular and nervous preconditions for a normal erection are discussed and a new concept presented. On this basis the conditions for a priapism are enumerated and the principles of therapy are discussed.
The congenital curvature of the penis occurs very seldom. The bow string curvature is caused by an asymmetry of dimension in the tunica albuginea, who covers the corpora cavernosa. The orifice of the urethra is normally located. The patients can not perform coitus. Often the diagnosis can be made only with a photograph of the erectile penis. 1965 Nesbit first described a surgical correction. Several vertical elliptical segments of the tunica albuginea were closed with silk sutures. All results were reported to be perfect. To spare the erectile tissue in 4 cases were only gathered up the tunica albuginea by u-silk sutures. With this technique the functional and cosmetic results are also perfect.
The prognosis of testicular tumors is largely depending on an early as possible tinning of the diagnosis. The present tumormakers do not bring a diagnostic security. However they are important for the continuing observation of the patients, especially of those with cytostatic chemotherapy. Today's acknowledged treatment of malignant testicular tumors is the high semicastratio, for Seninoms the additional highvoltage radiotherapy, for the Teratocarcinomas the additional retroperitoneal lymphnode extirpation and for the cases with retroperitoneal metastases the subsequent high-voltage radiotherapy and the adjuvant cytostatic chemitherapy. Between the alternative of the transperitoneal and the thoracoretroperitoneal lymphadenextomy we prefer the latter. The operation is radical, the thoracic complication are minimal and this technic besides advantages because the postoperative number of patients with a loss of ejaculation is much lower.
Cryosurgical technique as therapy of infravesical obstruction is of palliative character. Experience and results with patients from the years 1973-1978 are reported. The incidence and the rate of complications influence our technique and the precise indication for cryosurgery of the prostate to avoid failures in the future.
A retrospective study was conducted in 13 patients with phlebographically diagnosed tumor-induced renal vein occlusion to evaluate the incidence and extent of proteinuria and/or nephrotic syndrome. In 5 patients minimal proteinuria was found, but in none of the patients were the criteria of nephrotic syndrome fulfilled. These data can be used as additional evidence that renal vein occlusion is not the cause of nephrotic syndrome. They underline the hypothesis that, in cases of nephrotic syndrome associated with renal vein occlusion, the thrombic occlusion of the renal vein is a complication of the excessive renal protein loss and developing hypercoagulability.
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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.
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