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Biomedical subjects

H Pflüger

Publications and source records attributed to H Pflüger.

At least 37 records · Page 2Linked to original sources
PubMed1998

Comparison of intraurethral liposomal and intracavernosal prostaglandin-E1 in the management of erectile dysfunction.

OBJECTIVE: To compare the intraurethral application of liposomal prostaglandin-E1 (PGE1) with intracavernosal injection of PGE1 in patients with organic or psychogenic erectile dysfunction (ED). PATIENTS AND METHODS: Penile tumescence and rigidity were classified by palpation in 25 patients (10 with psychogenic and 15 with organic ED: median age 45 years, range 23-67). All patients were undergoing primary treatment for ED, the median (range) duration of which was 2 3 (2-44) months. After administering PGE1 by each route (1 mg intraurethral and 0.02 or 0.01 mg intracavernosal), the degree of erection was assessed and duplex ultrasonography of the deep penile artery was performed. RESULTS: After the intraurethral application of liposomal PGE1, there was mild penile tumescence in 12 patients with organic ED, the others having no response. In contrast, intracavernosal injection produced sufficient rigidity in 13 patients with organic ED, while two only had a slight increase in tumescence. In patients with psychogenic ED, intraurethral application gave adequate rigidity in six, with four having little or no tumescence, and intracavernosal injection induced sufficient rigidity for intercourse in all. Duplex ultrasonography of the deep penile artery of the penis showed that intraurethral application induced lower flow rates than intracavernosal injection. No patient reported pain after intraurethral application but two of 25 reported severe pain after intracavernosal injection. CONCLUSIONS: The intraurethral application of liposomal PGE1 did not produce sufficient rigidity and was not effective in patients with organic ED. However, it did produce sufficient rigidity in six of 10 patients with psychogenic ED and may thus provide a therapeutic alternative in selected patients.

Adult↗
PubMed1998

Electromotive drug administration and hydrodistention for the treatment of interstitial cystitis.

Thirteen patients with interstitial cystitis diagnosed by the NIH criteria were treated with intravesical electromotive administration of lidocaine and dexamethasone followed by cystodistention. After a mean follow-up of 10 (range 3-22) months, 8/13 (62%) of the patients reported complete resolution of bladder symptoms lasting an average 4.5 (range 0.75-17) months. Partial or short-term improvement of bladder symptoms was observed in three patients, while two patients reported aggravation of pain for several days after therapy. A significant increase in bladder capacity, to an average 166% of the pretreatment capacity, was observed in all patients. Whenever symptoms recurred after initially effective therapy, retreatments were performed with equal efficacy in 11 patients. This promising new therapeutic approach, performed on an outpatient basis, may become first-line treatment for patients with interstitial cystitis.

Administration, Intravesical↗
PubMed1997

Intravesical electromotive drug administration for the treatment of non-infectious chronic cystitis.

Seventeen patients with non-infectious chronic cystitis (NICC) (9 with interstitial cystitis, 6 patients with radiation cystitis, 1 with chemocystitis and 1 with lupoid cystitis) were treated with electromotive administration of intravesical lidocaine and dexamethasone followed by hydrodistension of the bladder. Complete resolution of symptoms for an average of 7.5 months was observed in 11 patients (65%), partial improvement in 4 (23.5%). In this series no complications occurred. Electromotive drug administration (EMDA) and cystodistension were well tolerated by all patients. The treatment was performed on an outpatient basis, thus reducing therapeutic costs. The results presented demonstrate that the combination of EMDA and bladder hydrodistension is an effective first-line treatment for NICC patients.

Administration, Intravesical↗
PubMed1996

Laparoscopic implantation of temporary electrodes for bladder stimulation in dogs.

Five female mongrel dogs were used in an acute animal experiment. Under general anesthesia two monopolar wire electrodes armed with needles on either side were implanted into the bladder wall, the leads of both electrodes were then pulled through the abdominal wall. Filling of the bladder and intravesical pressure measurement were achieved through a suprapublic percutaneous cystostomy. Electrostimulation was carried out using the XEJ-2 experimental electroejaculator (biphasic pulses, pulse width 2.5 msec, approximately 70 mAmp, 50 Hz). The pressure changes within the bladder following electrostimulation were recorded, the effect of stimulation was observed endoscopically. Electrostimulation of the bladder wall resulted in micturition in all cases, showing an initial pressure peak at the commencement of electrostimulation followed by a decrease after onset of evacuation. We believe that laparoscopic implantation of temporary wire electrodes followed by percutaneous electrostimulation may open up new possibilities for bladder rehabilitation as well as for diagnostic investigations into the contractile capabilities of the bladder.

Animals↗
PubMed1996

Experience in renal autotransplantation: analysis of a clinical series.

OBJECTIVE: To determine the benefit of renal autotransplantation in selected patients with either renovascular lesions, renal or urothelial carcinomas or other disorders of the urinary collecting system. PATIENTS AND METHODS: Between 1977 and 1994, 12 patients underwent renal autotransplantation, six involving renovascular hypertension, two involving tumours of the renal parenchyma, two with urothelial tumours and two with long ureteric stenoses. Pre-operative renal function was normal in six patients and impaired in five. One patient was on haemodialysis. Five patients had a solitary kidney and four patients had functionally solitary kidneys. The follow-up period ranged from 1 to 93 months (mean 34.9). RESULTS: Post-operatively, six patients had normal kidney function (serum creatinine < or = 12 mg/L), five patients had impaired renal function (creatinine content < or = 26 mg/L) and one patient was on haemodialysis due to arterial graft thrombosis. Serum creatinine levels improved in four patients and were stable in another four. Renal function deteriorated in three patients and one patient required a graft-nephrectomy. Immediate post-operative complications included arterial thrombosis in one patient, perirenal haematoma in two, pulmonary oedema in one and severe intra-operative bradycardia requiring a transient cardiac pacemaker in one. CONCLUSION: Renal autotransplantation represents an effective alternative treatment with good long-term results for selected patients with long ureteric lesions and renovascular disorders. It is also an effective method for patients with urological malignancies, especially those with solitary kidneys where the maintenance of renal function is of major concern.

Adult↗
PubMed1995

Functional replacement of bladder and urethra after cystectomy for bladder cancer in a female patient.

We describe a new concept for female bladder replacement introducing an ileocecal pouch with the intact appendix vermiformis used as an orthotopic neourethra. Based upon the results of preceding experimental studies this procedure was performed on a woman with the diagnosis of focal invasive bladder cancer. Eight months after the operation the patient is completely continent and back to work. This new type of urinary diversion with improved body image can be offered to female patients undergoing cystectomy for bladder cancer.

Appendix↗
PubMed1994

Intracavernous injection of prostaglandin E1 plus procaine in the treatment of erectile dysfunction.

Despite the availability of prostaglandin E1 for more than 7 years as a diagnostic and therapeutic tool in patients with erectile dysfunction, the problem of penile discomfort after prostaglandin E1 application has remained unsolved. In a randomized, double-blind, crossover study we investigated the effect of 2 different prostaglandin E1-procaine concentrations on 24 patients suffering from pain following intracorporeal injection of prostaglandin E1 alone. Intracavernous injection of 20 micrograms. prostaglandin E1 with 10 mg. procaine (study 1) failed to improve local painful sensations. The combination of 20 micrograms. prostaglandin E1 with 20 mg. procaine (study 2) decreased the incidence of local pain significantly (p < 0.01). These preliminary results show that the combination of prostaglandin E1 plus procaine represents a beneficial alternative in patients with penile pain due to the single substance.

Adult↗
PubMed1994

Laparoscopic nephropexy.

Laparoscopic nephropexy was done in 10 women with the diagnosis of a mobile kidney. The indications for laparoscopic nephropexy were confirmed by 123iodine-hippurate renal scan with the patient in the supine and sitting positions, which revealed decreased renal perfusion in all cases. Via a laparoscopic approach, the kidney is fixed to the abdominal wall at a high position according to the desired axis using a polyglactin net, which is stapled to the abdominal wall. Tissue adhesive also is applied over the net. All procedures were uneventful. Early postoperative excretory urography showed the treated kidneys to be in the desired position with free drainage of contrast medium through the ureteropelvic junction. Postoperative renal scans demonstrated significant improvement in all cases. In our opinion, laparoscopic nephropexy represents a technique of adequate invasiveness in relation to the disease to be treated.

Adult↗
PubMed1993

[Preoperative monitoring of blood coagulation in urologic operations: diagnosis of familial factor XI deficiency within the scope of preoperative blood coagulation studies].

Presurgical coagulation diagnosis should--apart from coagulation monitoring in the laboratory based on a stepwise diagnosis for detection of coagulations disorders, starting with global tests (NT/APTT) followed by appropriate specific investigation in case of pathological findings--consist of an adequate hemostaseological anamnesis and physical checkup of the patient. This would allow detection of important signs of hemostaseological impairment during the pre-analytical phase already and permit subsequent initiation of more specific coagulation tests. The casuistics of a patient with factor XI-deficiency ("Minor Form"), a condition which is extremely infrequent in our country, demonstrates the coagulation diagnostic procedure which led to detection of his inherited factor XI-deficiency. In addition the pre-, peri- and postsurgical therapeutical management of this particular patient using an antifibrinolytic drug (tranexamic acid) is presented.

Blood Coagulation Tests↗
PubMed1991

Complete androgen deprivation prior to radical prostatectomy in patients with stage T3 cancer of the prostate.

Twenty-one patients with stage T3 cancer of the prostate underwent complete androgen deprivation (LH-RH agonist and flutamide) for 3 months prior to radical prostatectomy. Two problems were to be dealt with: the decrease in the volume of the prostate, and the possibility of downstaging (= pT less than pT3 according to the UICC 1987 classification) of the prostatic cancer. A decrease in the volume was noted in each case. A downstaging effect (pT in comparison to T stage) was noted in 33% of the patients. The downstaging effect was noted in 75% of grade 1 tumor, in 31% of grade 2 tumors, but not in grade 3 tumors.

Aged↗
PubMed1988

Urokinase-type plasminogen activator as a marker for the formation of distant metastases in prostatic carcinomas.

Plasma levels of urokinase-type plasminogen activator have been investigated in 80 patients with prostatic carcinoma by means of a radioimmunoassay. A total of 30 patients with disseminated prostatic carcinoma had significantly elevated levels of urokinase-type plasminogen activator, whereas the plasma levels in patients without metastases did not differ from a healthy age matched control group. Sensitivity of elevated urokinase-type plasminogen activator levels in patients with prostatic carcinoma for the presence of metastases was 80 per cent. Therefore, urokinase-type plasminogen activator appears to be a reliable marker for the formation of metastases in prostatic carcinoma.

Acid Phosphatase↗
PubMed1988

Plasma urokinase-type plasminogen activator correlates to bone scintigraphy in prostatic carcinoma.

Urokinase-type plasminogen activator (u-PA) levels in the plasma of 35 patients suffering from disseminated prostatic carcinoma have been determined. According to the grade of dissemination, found by bone scintigraphy, the patients were divided into three groups. Patients with a higher degree of dissemination revealed significantly higher levels of plasma u-PA compared to patients with a lower degree of dissemination. Therefore plasma u-PA seems to be a possible marker for progression in patients suffering from disseminated prostatic carcinoma.

Aged↗
PubMed1987

Effect of urokinase on the proliferation of primary cultures of human prostatic cells.

The effects of exogenously added urokinase type plasminogen activator, tissue type plasminogen activator, plasmin and thrombin on the proliferation of primary cultures of cells derived from prostatic hyperplasia or prostatic carcinomas were investigated by measuring the incorporation of 3H-thymidine into the cultures. Addition of urokinase type plasminogen activator (1.35 x 10(-9) M) or thrombin (10(-7) M) to the culture medium caused a two-fold increase of 3H-thymidine incorporation, regardless of the origin of the prostatic cells. Tissue type plasminogen activator did not alter the rate of 3H-thymidine incorporation, whereas plasmin caused a 25% decrease of 3H-thymidine incorporation in all cultures.

Cell Division↗
PubMed1986

[Spinal lipoma with a dural closure defect as a cause of neurogenic bladder and chronic renal failure].

It is reported on a 6-year-old boy, in whom 3 years after the appearance of a neurogenic disturbance of the urinary bladder a lipoma in the spinal canal of the inferior thoracic region was diagnosed myelographically. The operative removal of the growing and displacing fatty tissue which by a (congenital?) dural gap continued in epidural direction indeed resulted in a far-reaching regression of the paresis of the lower extremities, not, however, in an improvement of the urological picture of the disease. The renal insufficiency caused by the hydronephrosis was no more reversible, which emphasizes the importance of the early diagnosis of this relatively infrequent malformation.

Child↗
PubMed1985

Increased urokinase activity to antigen ratio in human renal-cell carcinoma.

Eighteen patients with renal-cell carcinoma have been investigated in an attempt to elucidate the ratio of active urokinase enzyme to urokinase antigen in the tumor and adjacent normal kidney. The tumor itself exhibited a significantly increased total fibrinolytic activity, an increase in the relative contribution of anti-urokinase IgG-inhibitable plasminogen activator activity and increased levels of urokinase antigen when compared to normal renal tissue. In tumor-adjacent tissue total fibrinolytic activity was also, but not significantly, increased, this increase being completely due to tissue-type plasminogen activator. Correlation of active urokinase-type plasminogen activator with urokinase antigen revealed that in tumor tissue the enzyme was present to more than 70% in its active form whereas in tumor-adjacent tissue and normal renal tissue only half of the enzyme appeared to be active. No correlation was obtained between urokinase antigen present in one of the 3 tissues investigated and plasma urokinase antigen.

Adult↗
PubMed1985

[Testicular trauma and its significance for male fertility].

The clinical evaluation of 8 patients after surgical treatment of unilateral testicular trauma showed a decreased testicular volume in 3 patients. The serum endocrine profiles were within normal range--except 1 patient with atrophy of one testicle. In all ejaculates investigated (n = 6) a moderate to high asthenozoospermia was shown. The density was normal in 5 of 6 patients, but 4 patients had a teratozoospermia. The possible causes of pathological spermiogram after rupture of the testis is discussed.

Adolescent↗
PubMed1985

Plasminogen activator activity in bone metastases of prostatic carcinomas as compared to primary tumors.

The plasminogen activator content of extracts of 14 prostatic carcinomas and the respective bone metastases was determined and found to be at an average 1.5 times higher in the extracts from bone metastases than in the primary tumors. Furthermore, the relative contribution of the two known types of plasminogen activators, urokinase-type (u-PA) and tissue-type (t-PA), was evaluated using specific antibodies. About 70% of the plasminogen activator activity in the primary tumors was inhibited by anti-urokinase IgG, whereas the same antibody nearly completely inhibited the plasminogen activator activity in extracts from bone metastases. Using antibodies against t-PA about 30% of the plasminogen activator activity could be quenched in extracts of primary tumors but less than 10% in extracts of bone metastases. Further studies revealed that the increased amount of u-PA in extracts of bone metastases is not caused by different extractability but is also reflected by a relative increase in the amount of u-PA demonstrable by immune histochemical techniques using anti-urokinase IgG. Upon purification, the predominant plasminogen activator from extracts of bone metastases could also be identified physicochemically as urokinase.

Adenocarcinoma↗