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H R Osterhage

Publications and source records attributed to H R Osterhage.

At least 19 recordsLinked to original sources
PubMed2003

[Pelvic lipomatosis--what to do?].

A diffuse fatty infiltration of all the intrapelvic organs (bladder, rectum, sigmoid, colon) was present in a 67-year old-man. This led to the typical topographical and functional changes in the organs affected. Treatment has been very controversial. Surgical measures such as exeresis of the fat tissue with or without the intrapelvic organs affected by the abnormal fat deposition with subsequent drainage (colostomy/ileum conduit) were carried out. Conservative treatment with or without temporary cortisone administration was recommended. Pelvic lipomatosis is diagnosed radiologically. If there is no unequivocal restriction in the function of the affected organs, treatment should remain conservative.

Aged↗
PubMed1988

[Experimental comparison of Maxon and chromic catgut in suturing of the urinary bladder].

The new monofile absorbable suture material Maxon was compared with Chromic catgut in bladder suturing in rabbits. Comparisons were made after 1, 2, 4, 8 and 12 weeks. The rate of stone formation was mainly determined by the suture technique used and not so much by the suture material. This was demonstrated by the low number of stones formed after using extramucosal suturing technique. Once a suture, be it Maxon or Chromic catgut, comes in contact with urine, concrements may form and the new monofile properties of Maxon do not offer any advantages here. On the other hand, Maxon does not enhance stone formation either. E. coli or Proteus infections did not influence formation of stones. The histological examinations showed Maxon to cause fewer inflammatory reactions. Sutures with Chromic catgut caused inflammation of the bladder wall, subsiding after 4 weeks. An existing urinary infection did not appear to influence the inflammatory process. Maxon offers an advantage over Chromic catgut in extramucosal sutures causing fewer inflammatory reactions.

Animals↗
PubMed1987

Diagnosis and treatment of renal angiomyolipoma (based on 15 cases).

Fifteen cases of renal angiomyolipoma not associated with tuberous sclerosis are presented. The clinical and radiological features, the pathology and the management of these rare but well-documented tumors are discussed. They pose problems in diagnosis, and controversy still exists regarding their management. Additional techniques such as ultrasonography and computerized tomography may help in the diagnosis. When conservative surgery is not possible, or when a solid tumor cannot be confidently excluded, nephrectomy should be performed.

Adult↗
PubMed1987

Are antireflux procedures indicated in patients with small pyelonephritic kidneys?

Antireflux surgery was successfully performed in 16 adults and children with bilateral or unilateral vesicoureteral reflux associated with a small pyelonephritic kidney. Although in 14 cases of the preoperative 131I-Hippuran clearance of the affected unit was less than 100 ml/min/1.25 m2, in 10 cases renal function was stabilized or slightly improved postoperatively. Only 1 child showed a severe deterioration of renal function. All 16 patients were cured of their acute pyelonephritis. Surgical correction of the reflux had no beneficial effect on renal size or renal scars. Urinary tract infection was eliminated in 12 of the 16 cases. It can be concluded that a small pyelonephritic kidney associated with a vesicoureteral reflux should not be removed even if its isotopic clearance is less than 100 ml/min.

Adolescent↗
PubMed1987

[Behavior of modern suture materials in infected urine].

The recently developed absorbable materials demonstrate a constant and reproducible high quality when compared with the resorbable suture materials. However, based on in vitro studies by different authors the use of these materials in infected urine is not recommended. We investigated in vivo in infected urines the stability of the suture materials composed of polyglycolic acid, and compared the results obtained in vitro and in vivo. In a controlled study the stability of the absorbable suture materials polyglycolic acid, polyglactin 910 and polydioxanon 4/0 USP were tested in infected urine in vivo and in vitro. In 21 patients with infected urine the suture materials were placed into the bladder for 7 days. In another experiment these materials were incubated up to 7 days in culture flasks with infected urine. After that the suture materials were examined by densitometry and electrone microscopy. When using the results obtained in vitro in clinical work caution is recommended. However, the in vivo tests show that the stability of the newly developed absorbable materials is not influenced dramatically by the infected urine.

Bacteriuria↗
PubMed1986

[Prenatal diagnosis and postnatal course in abnormalities of the kidneys and urinary tract].

The authors' own experiences concerning the prenatal diagnosis and postnatal course in 26 foetuses with anomalies of the urinary tract are reported. The malformations observed can be separated into five groups which can also be distinguished sonographically: Urinary tract malformations of poor prognosis, Unilateral cystic kidneys. Hydronephroses, Urinary tract malformations with ascites, Urinary tract malformations in combination with other anomalies of poor prognosis. Sonographic differentiation of the multicystic kidney (Potter type IIA) from the hydronephrosis is usually possible. The recognition of cystic renal dysplasia in urinary tract obstructions (Potter type IV) and the differentiation of renal hypoplasia from renal agenesis is difficult. The dilatation of the urinary system has to be generally regarded as an unspecific symptom, the cause of which can be finally clarified only in the postnatal period. Prenatal invasive diagnostic procedures were carried out only in two foetuses. A concomitant anhydramnios was always associated with a poor prognosis. In the case of unilateral of bilateral dilatation of the urinary tract with normal or slightly diminished amniotic fluid volume, induction of labour or prenatal intervention for drainage in utero was not indicated. The prognosis was infaust in 15 foetuses. One infant died of an unknown cause. Out of 10 surviving infants, six were successfully operated on, in three the dilatation of the urinary tract resolved spontaneously, and one child with prune belly-syndrome has to be catheterised daily.

Adolescent↗
PubMed1986

[Ureteral injuries in intervertebral lumbar disk surgery].

In lumbar disc surgery ureteral transection is a rare complication and only nine such cases have been reported so far. They are analyzed and two more cases are described. The complication in the first case was recognized immediately and the patient was treated successfully by end-to-end anastomosis of the ureter. The diagnosis in the second case was delayed and this lead to a septic course and finally required nephrectomy.

Adult↗
PubMed1985

Ureteral injury in lumbar disc surgery.

Among retroperitoneal injuries in lumbar disc surgery ureteral transection is a rare complication and only 8 cases have been reported so far. They are analysed and a ninth case is added and described. In this case the complication was recognized immediately and successfully treated by end-to-end anastomosis of the ureter with an internal stent. Usually the diagnosis was delayed due to uncharacteristic symptoms (fever, haematuria, abdominal pain and distension, ileus, palpable mass etc.) which led to septic courses and nephrectomy in 3 cases. The anatomical relationship of the lumbar spine and retroperitoneal structures is illustrated by CT scans. Factors contributing to these injuries and ways of recognizing and preventing complications are discussed.

Adult↗
PubMed1985

[Controversial aspects of the genesis of megaureter].

The cause of congenital ureter dilatation as well as its nomenclature are controversial. The question arises as to whether there is a common denominator for this multiform syndrome. There are abundant possibilities of disturbance during the development of the ureter. The muscle coat of the developing fetal ureter reacts with an alteration of the wall structure. In view of the multiplicity of etiological factors which can affect the development of the ureter, a disturbance of intrauterine urinary drainage which is transient or permanent probably has a functional or mechanical basis. At any events, a subvesical obstruction, which may also be the cause, must be excluded.

Dilatation, Pathologic↗
PubMed1984

[Current analysis of pathogen spectrum and resistance in bacterial urinary tract infections. Bacteriologic urine findings of hospitalized urologic patients].

We analysed the bacteriological urinary findings of all inpatients of the urological department on admission, during hospitalization and on discharge, over a period of one year. The percentage of urological patients with florid urinary tract infections was less than 10%. The most commonly found pathogen was E. coli, followed by Proteus, enterococci, Pseudomonas and Klebsiella. Any change in the bacterial spectrum was not associated with individual diseases or their treatment. Mixed infections were rarely seen. The nosocomial urinary tract infection rate was an overall 1.5%. Since the clinical findings on admission often require the immediate administration of antibiotics, the results of urine culture cannot always be awaited. Given the present situation with respect to resistance, the use of antibiotics with a sensitivity of only 50% does not appear to make good sense. Prior to receiving the bacteriological report, cephalosporins of the second and third generation are to be recommended to treat complicated urinary tract infections in hospitalized urological patients.

Anti-Bacterial Agents↗
PubMed1984

[Epidermoid cyst of the testis].

This is report of a group of four patients with epidermoid cysts of the testis. The pathogenesis, symptomatology, pathology and therapy of this benign testicular tumor (or tumor like testicular lesion) in these cases, including 150 reported cases in the literature are presented and discussed.

Adolescent↗
PubMed1983

Can a substitute for the bladder sphincter be attained by free transplants derived from vesical muscle tissue?

Smooth muscle transplants of the intestinal tract have been tested experimentally as a substitute for the bladder sphincter. An attempt was made to apply the proposed technique to the vesical muscle tissue and to achieve a sphincter replacement with freely transplanted autologous bladder tissue. An internal urethrotomy was performed several times in female sheep until a complete urinary incontinence resulted. For the bladder sphincter substitute a strip of vesical tissue was dissected from the anterior wall and following pre-stretching it was sewed circumferentially around the urethra in order to constrict it. The urethral pressure was registered during the operation before and after application of the sphincter 'graft'. For temporary urinary discharge a suprapubic catheter was inserted. The sheep were examined clinically and urodynamically for up to 3 months. Complete urinary continence was not obtained in any of the cases. The urodynamic examination showed a nearly complete loss of the urethral pressure which had been obtained by the operation. The histological studies showed progressing fibrosis of the desired continence zone. By way of freely transplanted autologous vesical muscle a sphincter substitute could not be achieved.

Animals↗
PubMed1982

[The results of combined treatment for testicular tumours. Report of 12 cases (author's transl)].

Over a ten year period, the authors have collected 120 cases of germinal tumours of the testis (35 seminomas and 85 non-seminomatous tumours). The largest single group was of mixed non-seminomatous tumours. The treatment of pure seminomas gave 100% good results by a combination of unilateral orchidectomy, radiotherapy and, in the case of stage III tumours with spread, chemotherapy. The prognosis of non-seminomatous tumours was dependent essentially upon the stage of spread. During the past three years, the best results of chemotherapy have been obtained with the combination of vincristin, bleomycin and platinum (1978, 1979, 1980). In his time, at stage I and stage II, all the patients are alive. Treatment consisted of a minimum of unilateral orchidectomy and retroperitoneal lymphadenectomy, Chemotherapy was envisaged only for those tumours with evidence of lymph node involvement. At stage III, they lost 3 patients out of 7, this being an excellent result bearing in mind the gravity of such tumours.

Choriocarcinoma↗
PubMed1981

[Effect of urethral stenoses on the urinary tract].

Intrauterine operations were carried out in fetal sheep varying from 50-122 days of gestation. Silk, catgut and polyglycolicacid sutures were used to produce varying degrees of stenosis. The urachus was ligated with a silk suture in all cases. Urachal ligation alone produces no ill effects on the upper urinary tract. The addition of urethral stenosis results in dilatation of the upper tract depending on the degree of infravesical obstruction. Partial ligation of the urethra produces a pyelocalyectasis which may disappear later. More severe degrees of obstruction are followed by hydronephrosis, hydroureter and megacystis. Dilatation begins in the region of the renal pelvis and proceeds in the antegrade manner towards the bladder. Histologically the parenchyma was reduced in thickness and showed dilated tubules. In the ureter and the bladder muscular hypertrophy was noticed. Depending on the time of the experiment, there was an increase of connective tissue within the ureter and bladder. In cases of extreme obstruction the ureter showed muscular atrophy. No infection, ureteral reflux, bladder diverticulosis, extravesicalisation of the ureter or narrowing of the ureter by hypertrophied musculature was seen. These experiments may throw some light on the pathogenesis of the megaureter syndrome occurring in childhood.

Animals↗
PubMed1980

Positive histological tuberculous findings despite stable sterility of the urine on culture: results of 111 nephrectomies and partial nephrectomies.

The therapy of genitourinary tuberculosis has changed: 'néphrectomie nécessaire' has been replaced by 'néphrectomie opportune'. Today, it is generally assumed that tuberculosis can be cured completely by chemotherapy. The following question must, however, be asked: How far may the stable sterility of the urine be considered as a complete cure? In order to assess the efficiency of chemotherapy as a function of time and dosage, the activity of tuberculosis of the kidneys was investigated on the basis of the histological preparation, after removal of the tuberculous renal tissue. Despite stable sterilization of the urine, 15% of the cases showed active tuberculosis. Using the triple therapy combination of rifampicin, ethambutol and isoniazid, the disease was found no longer to be active after 2--3 months of treatment in 90% of the cases. A longer period of treatment brought no further improvement.

Capreomycin↗