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Biomedical subjects

H Marberger

Publications and source records attributed to H Marberger.

At least 19 recordsLinked to original sources
PubMed1993

Posterior hypospadias: long-term followup after reconstructive surgery in the male direction.

Posterior hypospadias with a scrotal or perineal meatus results from a defect in step 3 of male sexual differentiation. The different etiological factors underlying this condition result in a broad spectrum of presentations ranging from the isolated form to complex ambiguity of the external genitalia, such as male pseudohermaphroditism. Between 1952 and 1988 a total of 92 patients with posterior hypospadias underwent a 2-stage reconstruction at our department. A retrospective study was performed with the aim of evaluating the long-term results in these patients. Our special interest focused on the functional and cosmetic results, exocrine and endocrine functions, as well as the sexual lives of the patients. While satisfactory results were obtained in two-thirds of the 42 male patients available for long-term followup, there were 13 patients who at followup still presented with complex sexual ambiguity. In 6 of these patients androgen receptor defects were detected by means of biochemical as well as molecular-biological investigations. Our data emphasize the importance of androgen metabolism for male sexual development and underline the necessity of careful evaluation in these children.

Adolescent↗
PubMed1986

Excisional repair of urethral stricture. Follow-up of 90 patients.

One hundred five patients with urethral stricture of various causations were treated with excision of the stricture and oblique end-to-end anastomosis. Fifty-two patients (49%) had had one or more previous operations and dilatations, respectively. The immediate postoperative complication rate was 9 per cent. Ninety patients could be followed for one to eight years. The success rate was 93 per cent. Five patients had recurrent strictures. The failures were due to abscess formation, perineal hematoma, and excessive length of stricture.

Adolescent↗
PubMed1984

Topical doxorubicin hydrochloride therapy for carcinoma in situ of the bladder: a followup.

A total of 10 patients with histologically proved carcinoma in situ of the bladder had remission of tumor after topical chemotherapy with doxorubicin hydrochloride for 24 months. Of the 10 patients 3 suffered new areas of carcinoma in situ 9 to 12 months after termination of intravesical chemotherapy. Furthermore, 1 of these 3 patients had a distal ureteral tumor. Fibrosis of the submucosal tissue was observed in every patient but a decrease in bladder capacity was observed in only 1 with prior radiotherapy.

Administration, Topical↗
PubMed1983

Reconstruction of abdominal wall and mons pubis in females with bladder exstrophy.

We report on 3 patients with bladder exstrophy who had considerable scar deformities of the lower abdomen after primary closure of the bladder and/or urinary diversion. The scar tissue was excised, and augmentation of the abdominal wall and mons veneris was achieved by the use of a pedicled, vascularized groin flap with integrated bone from the iliac crest. This procedure is recommended for patients with faulty closure of the pelvic ring and severe defect of the lower abdominal wall.

Abdominal Muscles↗
PubMed1983

Exocrine and endocrine testicular function in patients with unilateral testicular disease.

Amongst 30 patients who had undergone untwisting and fixation for unilateral torsion of the testis, seminal analyses were normal in 15, equivocal in 3 and pathological in 12; and of 46 men with cryptorchidism who had had unilateral orchidopexy, seminal analyses were normal in 13, equivocal in 23 and pathological in 10. Follicle-stimulating hormone levels were found to be elevated in those with equivocal and pathological seminal analyses in both groups. Assessment of testicular function before orchidectomy in 36 patients with seminomas and non-seminomatous testicular tumours revealed only one (with a HCG-negative seminoma) with a normal seminal analysis. Men with HCG-positive testicular tumours were found to have decreased follicle-stimulating hormone levels and elevated 17-beta-oestradiol and prolactin levels.

Adolescent↗
PubMed1983

[Injuries of the posterior urethra].

Injuries of the posterior urethra are a result of a blunt trauma of the pelvic ring, lacerations of the perineum and iatrogenic perforations due to transurethral manipulations. Traumatic lesions of the posterior urethra in about 10% of these patients suffer also a bladder laceration. The diagnosis of a urethral injury is ascertained by i. v. urogram and urothrography. If a urethral trauma is suspected the insertion of a catheter should be avoided in any case. The treatment is divided in emergency treatment, which means evacuation and drainage of the haematoma and extravasation and suprapubic urinary derivation made by the surgeon and the primary realignment or delayed urethral reconstruction, both interventions being reserved for well trained urologists. Minimal lesions characterized by a preserved continuity in small extravasations in the urothrography are sufficiently treated by a suprapubic urinary diversion. Severe injuries are treated by realignment of the urethra over a splint, drainage of the perivesical space and urinary diversion. 63% of the patients treated by this modality had perfect results and there was no need for further therapy. The proper replacement of the fractured pelvic bones are an integrated part of our plan of treatment. About 12% of patients with pelvic fracture and injury of the posterior urethra experience loose their potency. These can be explained by neurovascular injury. Impotence does not seem to be caused by surgical treatment, since the rate of impotence is similar in patients treated by primary realignment and suprapubic urinary diversion only.

Erectile Dysfunction↗
PubMed1983

Combined cis-platinum and radiation therapy in patients with stages pT3 and pT4 bladder cancer: a pilot study.

A prospective study was done on 8 patients with advanced transitional cell carcinoma of the bladder to evaluate toxicity of an integrated treatment with cis-diamminedichloroplatinum (1.6 mg. per kg. body weight 3 times weekly) and 60 gray 60cobalt or 18 mev. photons. Local and systemic toxicity caused by this treatment schedule was minor. Late sequelae consisted of a contracted bladder in 1 patient. The rate of bladders free of tumor after a mean followup of 7.7 months was surprisingly high (6 of 8).

Aged↗
PubMed1982

[Urolithiasis in childhood].

Our experience with 95 pediatric stone patients in the years 1960-1979 is presented. 2/3 of all stones were diagnosed in the pre-school age. Leading symptoms were infection, hematuria and abdominal pain. 52% of the stones were composed of phosphate. 87.5% of the children up to the age of 6 had urinary tract infection. Phosphate stones were mostly accompanied by urea-splitting organisms. An underlying cause for the stone formation could be found in 62% (urodynamic disturbances 32%, metabolic derangements 21%, proteus infection 8%, foreign body 1%). In 76% of the children the stones had to be removed surgically. The recurrence rate was 22% in 6.2 years. From our experience we recommend to use only a crystallographic stone analysis, to perform an exact metabolic check-up and a long term follow-up of the children.

Adolescent↗
PubMed1981

Intracavitary doxorubicin hydrochloride therapy for carcinoma in situ of the bladder.

We treated 15 patients with carcinoma in situ of the bladder by intravesical instillation of doxorubicin hydrochloride. Different dose and interval schedules, that is 40 mg. biweekly and 80 mg. monthly, each resulted in a 66 per cent tumor remission rate. In no instance were undue systemic effects noted; the local side effects were negligible. Cold cup random biopsies were obtained before and during therapy. Light and electron microscopic evaluation revealed a gradual redifferentiation of the malignant urothelium in the course of treatment. In addition, A, B and H antigenicity was assessed and showed a recurrence of initially lacking surface isoantigens in patients with tumor remission.

Administration, Topical↗
PubMed1981

Orgotein, a new drug for the treatment of Peyronie's disease.

Twenty-three patients with Peyronie's disease have been treated with the new anti-inflammatory metalloprotein drug orgotein, which exhibits pronounced superoxide dismutase activity. Administration was done into the indurated areas of the penis by a special syringe. Evaluation of signs and symptoms included measurement of the induration size and consistency as well as the degree of the deviation of the penis. The patients responded well to orgotein therapy, especially regarding the loss of pain on erection. On long term results also a diminishment of the induration size and penis deviation on erection was observed; the drug administered intraplaqueally was of outstanding safety.

Anti-Inflammatory Agents↗
PubMed1980

Successful renal revascularization of unilateral traumatic renal artery thrombosis.

We report 3 patients with traumatic renal artery thrombosis treated successfully with revascularization. The diagnosis was made preoperatively in 2 cases and intraoperatively in 1. Treatment consisted of reanastomosis with a saphenous vein patch on the side of the arteriotomy in case 1, an aortorenal artery saphenous vein bypass in case 2 and a bypass graft from the aorta to the distal renal artery in case 3. Two patients had functioning kidneys and normal blood pressure, and 1 patient dies 24 hours after reconstruction.

Abdominal Injuries↗
PubMed1980

Testicular torsion: late results with special regard to fertility and endocrine function.

Late results were determined for 42 patients who had undergone detorsion and fixation for unilateral testicular torsion in the prepubertal and pubertal age. Exocrine and endocrine function for the testes was determined in 30 patients who had reached postpuberal age. Patients who underwent detorsion and fixation 8 hours or less after the onset of symptoms had normal-sized testicles and only slight changes in testicular morphology. When treatment was delayed and detorsion was done more than 8 hours later a marked decrease was observed in testicular size. The exocrine function in patients with torsion was reduced. The semen quality, as judged by 2 semen analyses, was normal in 15 patients, doubtful in 3 and pathological in 12. Even when detorsion was done 4 hours or less after the onset of symptoms the exocrine function of the testes was normal in only 50 per cent of the cases. In patients with doubtful and pathological sperm analyses higher follicle-stimulating and luteinizing hormone levels were observed.

Adolescent↗
PubMed1980

Hydrodynamic aspects of bladder-outlet obstruction: consequences of functional micturition disorders.

Functional disturbances of micturition lead to secondary structural changes. Both factors may change the physical properties--shape, elasticity and consistency--of the posterior urethra and of the bladder neck. In order to demonstrate their influence on urodynamics experimental studies were undertaken, elastic models, straight tubes of equal diameter throughout their length, were used. One model was a straight elastic tube of PVC material, three other models had nonelastic segments of different shape but with the same square area as the undeformed elastic parts. Perfusion was performed under equal conditions. The experiments showed firstly that nonelastic segments in an elastic system reduce the flow rate and secondly, that flow depends on cross section versus circumference, which is expressed by the so-called hydraulic diameter. Elasticity, consistency and shape of the bladder-outlet, frequently altered in patients with neurogenic bladder disease, are therefore important factors regarding loss of friction. Our results support the clinical experience, that a functional obstruction has to be eliminated before secondary structural changes occur which alter the physical properties of the bladder outlet and therefore make flow conditions even worse.

Elasticity↗
PubMed1980

[Carcinoma in situ of the urinary bladder: a diagnostic and therapeutic challenge].

Carcinoma in situ (Tis) of the urinary bladder means a challenge for the urologist, because of the uncharacteristic symptoms and the various treatment modalities. Early detection requires wide use of urinary cytology and multiple cold-cup biopsies. Cytology has proven to be sensitive in 95%. Histological grading of the Tis and the concomitant overt tumor is in accordance in 85%. A dedifferentiation of the tumor during the course of the disease was observed in only 14%. Modes of conservative treatment can achieve long-lasing tumor control or remission. Therefore, a cystectomy cannot be justified as the primary treatment in any case.

Adult↗