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Biomedical subjects

D Hauri

Publications and source records attributed to D Hauri.

At least 163 records · Page 9Linked to original sources
PubMed1978

[Prostatectomy incontinence].

Urinary continence is guaranteed by the system of smooth urethral musculature, the so-called sphincter internus. The striated sphincter externus has primarily no responsibility for continence. One of its most important functions is the initiation of a voluntary micturition. Further functions are: the voluntary interruption of the urinary stream, the reflectory occlusion by elevated intraabdominal pressure (coughing, sneezing, laughing, heavy physical work), expression of the rest of urine in the urethra after micturition, stabilization of the proximal urethra in the urogenital diaphragm. To get an optimal function after prostatectomy an intact sphincter externus becomes important for the smooth urethral muscular system which is further responsible for the continence. About 90% of all patients with a postprostatectomy incontinence have an intact sphincter externus. In these cases we have a high incidence of incontinence cure. Only in 10% of incontinence after prostatectomy the sphincter externus is damaged. In those cases the incontinence operation is inadequate.

Action Potentials↗
PubMed1978

Post-prostatectomy incontinence.

Urinary continence is maintained by the smooth-muscled system of the "internal sphincter". The striated external sphincter is not primarily responsible for continence. One of the chief functions of the external sphincter is the initiation of voluntary micturition. Its other functions are: random interruption of the urinary stream, reflex control during an increase in intra-abdominal pressure (such as coughing, sneezing, larghing, lifting) complete emp;ying of the urethra after micturition and stabilization of the posterior urethra in the urogenital diaphragm. After prostatectomy an intact external sphincter is important in order to support the smooth-muscled system which continues to be primarily responsible for continence to function as efficiently as possible. In approximately 90% of all postprostatectomy incontinences the external sphincter is intact and this cames a good prognosis following our correcture surgery without the need for prostheses. Only in rare post-prostatectomy incontinence cases (aprox. 10%) is the external sphincter also injured. Incontinence surgery according to our method has not been satisfactory in these cases.

Electromyography↗
PubMed1978

[Urinary infection and vesicorenal reflux after renal transplant (author's transl)].

Worldwide experience shows that a urinary infection can endanger a renal transplant. Our experience with vesicorenal reflux and its possible complications led gave us to check randomly selected patients with renal transplant. In 3 out of 4 patients with chronic or relapsing infections, reflux was found. Four out of 23 patients with no reflux had a chronic urinary infection. In our opinion a ureter implantat with antireflux mechanism in the bladder should be given closest attention.

Chronic Disease↗
PubMed1978

[The value of uroflowmetry in the diagnosis of urethra strictures (author's transl)].

The urethrogram, possible combined with urethroscopy, is still the best way to diagnose urethra strictures. In follow-up checks of patients after urethrotomy, and especially in chronic urethral dilatation uroflowmetry is a valuable aid for the practical urologist, enabling him to estimate the course of a urethra stricture. We find essential that uroflowmetry makes it possible to fix the term of dilatation objectively, thus reducing the possibility of complications. The urethra pressure profile is not suitable for stricture diagnosis. Determination of the peripheral resistance, as the only objective parameter, is theoretically and experimentally very interesting, but not feasible in practice.

Chronic Disease↗
PubMed1977

Simultaneous measurement of absolute pressure values in the urethra and bladder. Experimental model for the construction of a new measuring device.

In order to improve the accuracy of bladder and urethral pressure recording, a measurement system has been tested experimentally. It is possible to measure absolute pressure values during withdrawal of the catheter only when the system is constantly perfused. The optimum relationship between catheter diameter, perfusion rate, withdrawal rate, measurement inertia and systemic resistance has been analysed.

Humans↗
PubMed1977

A new operation for post-prostatectomy incontineance.

A new surgical treatment for post-prostatectomy incontinence is described. The intact urogenital diaphragm and a peripheral elastic resistance are the two most essential factors to assure continence. In addition to stabilizing the urogenital diaphragm, an elastic peripheral resistance is created by this technique. Contience is achieved by imbedding the urethra between the two corpora cavernosa and followed by median rotation and adaptation of the ischiocavernosi muscles. The proof of continence is given urodynamically by the function urethral profile.

Humans↗
PubMed1977

[A new operation for postprostatectomy incontinence (author's transl)].

A new operation for incontinence is reported on. The prerequisites for continence are discussed, of which an intact pelvic floor and a flexible peripheral resistance are born essential. The operation leads additionally to stabilization of the pelvic floor and creates a peripheral flexible resistance. The regained sphincter function and its usefulness for continence is demonstrated radiologically and urodynamically.

Humans↗
PubMed1976

[The treatment of prostatic adenoma].

Prostatic hyperplasia is a benign disease of elderly men. In 30-40% of the men the prostatic adenoma causes obstruction which requires operative treatment. 75% of these patients consult the general practitioner. Stage I is treated conservatively. Early surgery is indicated only in those undergoing surgery for hernia and in cases of intermittent obstruction. Operation is definitely indicated in stage II. Stage III should be treated initially with an indwelling catheter for 3-4 months. Treatment with lifelong indwelling catheter is rarely indicated today.

Androgens↗
PubMed1976

[Complications after thoraco-retroperitoneal nephrectomy (author's transl)].

We are of the opinion that for large kidney tumors in the upper region as the afflicted venous portions, the most advantageous incision is a thoraco-retro- peritoneal one. It allows the surgeon total freedom of movement and ensures reliable radical tumor-nephrectomy, as well as reconstruction possibilities in the large vessels. Of course, use of this incision is not without complications. They appear, however, not as often as opponents of this method would suppose. There are other statistics to support our convictions (4). From the check-ups of our thoraco-retroperitoneal nephrectomy patients, we are able to surmise the following: - The post operative mortality rate is not increased with this method. The cause for the mortalities are, as far as one can tell, old age and/or a generally poor condition piror to nephrectomy. - Post operative complications due to access though the thorax are very few. Not one patient had to be re-operated, punctured, or treated using suction drainage. No respiratory difficulties were observed. - Post operative complications from the wound were naturally relative to the extent of the incision. It was also here unnecessary to perform a second operation except in one case of a retroperitoneal hematoma from heparinization. This complication was not the result of this particular incision.

Follow-Up Studies↗
PubMed1976

[Urinary continence after radical prostatectomy: the urodynamic proof of an anatomical hypothesis (author's transl)].

Prostatic carcinoma can be cured by a radical operation. In radical prostatectomy the whole so-called internal sphincter is removed. It is generally accepted and often proved that the external sphincter which is mostly somatically innervated cannot resume the funciton of continence. The postoperative urinary incontinence after radical prostatectomy is frequent and therefore the radical prostatectomy is not performed in many places. The problem of postoperative continence as well as incontinence after enucleation of the adenoma will be briefly discussed. In 1966, HUTCH described the so-called 'baseplate'. It is a bundle of smooth muscle fibers, circulary arranged around the bladder neck, which are also responsible for passive continence. He proposed that a certain sphincter function can be achieved by a tubular anastomosis of this anatomical substratum with the distal urethral stump. We were able to prove this anatomical hypothesis urodynamically. A specially constructed double-lumen perfusion catheter enabled us to register the so-called functional urethra profile and simultaneously register a new sphincter pressure wave in the transformed 'baseplate' which was responsible for the continence. We could observe this new sphincter region in all continent patients after radical prostatectomy whereas in the incontinent patients it was absent. Since 1972 we have employed the procedure proposed by HUTCH and have performed 20 radical prostatectomies. All these patients have been postoperatively completely continent. We are of the opinion that undue restraint concerning radical prostatectomy is no more justified.

Humans↗