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J Thüroff

Publications and source records attributed to J Thüroff.

At least 19 recordsLinked to original sources
PubMed2006

[Therapeutic options for hormone-refractory prostate cancer].

For a long time, hormone-refractory prostate cancer was regarded as a chemoresistant tumor. The introduction of taxanes has prompted a change in this opinion. For the first time treatment with 75 mg/m(2) docetaxel every 3 weeks has evidenced a survival benefit in a phase III trial (median survival of 18.9 months versus 16.5 months with mitoxantrone). Further advantages were improved pain reduction and quality of life. Neutropenia was foremost among the side effects. Docetaxel is currently the standard treatment for hormone-refractory prostate cancer. The morbidity of metastatic hormone-refractory prostate cancer is influenced by bone metastases. Pain is a prominent feature. Skeletal complications are frequent. Therapy with 4 mg zoledronic acid reduced skeletal complications significantly in comparison to placebo. The most pronounced effect is the reduction of pathological fractures. Side effects include flu-like symptoms, muscle pain, and edemas. Zoledronic acid also belongs to the standard treatment of hormone-refractory prostate cancer with bone metastases.

Androgen Antagonists↗
PubMed2002

[Ultrasound screening of renal cell carcinomas].

The increasing number of incidentally by ultrasound detected small renal cell carcinomas raises the question of the practicability and efficacy of a systematic screening for renal cell carcinoma by ultrasound. A two year screening program for renal cell carcinoma (RCC) was established for the general population (age > 40 years) in two cities, Mainz and Wuppertal. In cooperation with different health insurers, the organizers recruited general practitioners, internists and urologists in private practice who were experienced in and equipped for performing renal ultrasound. The screening was offered in the form of a cost free renal ultrasound in the first year and a re-examination in the second year. For any equivocal/positive renal mass, a reference ultrasound was provided the urology departments at the two university hospitals. 9959 volunteers participated in the screening program (49% male, 51% female) in the first year. The mean age was 61 (40-94) years. 79% of these participants returned for re-examination in the second year. Thirteen (0.1%) subjects were found to have a renal mass, of which nine were RCC. The sensitivity of the program was 82% (one year of follow-up). The predictive value was 2% for equivocal findings on initial exam and 50% for positive findings. The incidence of other abnormal findings was 12%. The screening program was well accepted by physicians in private practice and by the eligible population. The method proved effective, especially if equivocal findings were re-studied by reference sonography before further imaging studies such as CT and MRI were performed.

Adult↗
PubMed2001

How widespread are the symptoms of an overactive bladder and how are they managed? A population-based prevalence study.

OBJECTIVE: To determine the prevalence of chronic and debilitating symptoms of the overactive bladder, defined here as the presence of chronic frequency, urgency and urge incontinence (either alone or in any combination), and presumed to be caused by involuntary detrusor contractions. Subjects and methods Data were collected using a population-based survey (conducted by telephone or direct interview) of men and women aged >/= 40 years, selected from the general population in France, Germany, Italy, Spain, Sweden and the United Kingdom, using a random stratified approach. The main outcome measures were: prevalence of urinary frequency (> 8 micturitions/24 h), urgency and urge incontinence; the proportion of participants who had sought medical advice for symptoms of an overactive bladder; and current or previous therapy received for these symptoms. RESULTS: In all, 16 776 interviews were conducted in the six European countries. The overall prevalence of overactive bladder symptoms in individuals aged >/= 40 years was 16.6%. Frequency (85%) was the most commonly reported symptom, followed by urgency (54%) and urge incontinence (36%). The prevalence of overactive bladder symptoms increased with advancing age. Overall, 60% of respondents with symptoms had consulted a doctor but only 27% were currently receiving treatment. Conclusion Symptoms of an overactive bladder, of which frequency and urgency are as bothersome as urge incontinence, are highly prevalent in the general population. However, only a few affected individuals currently receive treatment. Taken together, such findings indicate that there is considerable scope for improvement in terms of how physicians diagnose and treat this condition.

Activities of Daily Living↗
PubMed2000

The prevalence of overactive bladder.

Overactive bladder (OAB) is a disorder that encompasses frequency, urgency, and urge incontinence, singly or in combination. It often has a significant individual impact on quality of life and on limitations to activities, yet most individuals with OAB do not seek medical care. Therefore, it is not possible to estimate the prevalence and, more generally, the societal impact of OAB based on medical encounter data. With few exceptions, most epidemiologic studies have focused on urge incontinence, the most severe form of OAB. The prevalence of OAB increases with age and is more common in women than men. However, prevalence estimates vary considerably among studies, ranging from 3% to 43%. The variation in estimates from epidemiologic studies is the result in part of differences in the criteria used to define a case of urge incontinence among studies. This problem is attributable in part to the lack of a standardized, validated, and operational definition. Nonetheless, consensus exists regarding the significant individual and societal impact of urge incontinence and the recognition that it is underdiagnosed and undertreated. Frequency and urgency, the other 2 symptoms of OAB, have not received the same level of attention as urge incontinence, yet the societal impact of these symptoms of OAB may be considerably greater. Overall, frequency and urgency are considerably more common symptoms than urge incontinence, especially between 35 and 55 years of age, the period of peak productivity for most workers. Recent evidence indicates that a substantial proportion of individuals with frequency and urgency report a diminished quality of life and interference with activities in a number of roles, including work. Efforts are under way to more accurately describe the prevalence of frequency and urgency, using a validated and standardized epidemiologic case definition to determine the individual impact of each symptom of OAB and to estimate societal costs.

Adult↗
PubMed1998

Hypospadias.

The incidence of hypospadias is increasing. Decreased androgen sensitivity, 5alpha-reductase deficiency and chromosomal abnormalities are causes of the disease. Nonirritant suture material, coverage of the urethral reconstruction by additional tissue and perioperative care positively influence the outcome. Complication rates after repair of distal hypospadias are low. For severe hypospadias staged procedures provide good results. Buccal mucosa is promising for initial repair and repeat cases. Psychosocial function in patients with severe hypospadias is normal.

Journal Article↗
PubMed1994

Urinary undiversion after implantation of an alloplastic urethral sling for male continence.

A man in whom urinary diversion (colon conduit) was performed after 2 unsuccessful implantations of artificial urethral sphincters for treatment of iatrogenic incontinence became continent again after implantation of an alloplastic sling. Three months later the patient underwent urinary undiversion with augmentation cystoplasty. After 3 years ureteroneocystostomy was necessary due to distal ureteral stenoses. At 7-year followup the patient is continent. He has good bladder capacity, bladder emptying and a normal upper urinary tract.

Follow-Up Studies↗
PubMed1993

Management of ureteral strictures by different modalities and effect of stents on upper tract drainage.

Ureteral strictures were induced experimentally by unilateral partial ligation of the upper ureter on the left side in 56 female rabbits. Six weeks later, stricture stability was documented by intravenous urography. In all cases, there was fibrosis of the muscular wall of the ureter. The lumen, although narrowed to various degrees, was preserved in most animals, and moderate to marked hydronephrosis resulted. Control animals were not treated in order to study the natural progress of the stricture. The other strictures were treated either by dilation (catheter or balloon) with or without ureteral stenting, by intubated external ureterotomy, or by excision of the strictured segment and stented end-to-end anastomosis. Follow-up studies consisted of intravenous urography, renography, and histologic examination for 24 weeks. Ureteral dilation without and with 2 weeks of stenting could be an adequate treatment of strictures associated with a moderate degree of hydronephrosis. Intubated external ureterotomy did not give satisfactory results in any animal. Excision of the strictured segment with a stented anastomosis produced satisfactory results and has a great role in the treatment of the strictured ureter in comparison with the variable outcome of endourologic treatment. Stenting of the unobstructed ureter, tested in six rabbits, showed a positive correlation between renal obstruction and long-term ureteral stenting.

Animals↗
PubMed1992

[The "Mainz pouch" technique (bladder augmentation with ileum and cecum) for bladder augmentation, bladder substitution, and continent urinary diversion].

Back in 1983 we created a continent urinary reservoir, called the MAINZ pouch, using 10 to 15 cm. of cecum as well as two terminal ileal segments of equal length. Following detubularization, the posterior wall of the pouch is established by anastomosis of the ascending colon with the terminal ileal loop starting at the inferior aspect. The latter is then anastomosed with the next proximal ileal segment. The ureters are implanted in an antirefluxive manner in the open end technique through a submucosal tunnel of 4 to 5 cm length. For bladder augmentation the pouch is anastomosed to the bladder remnant. For bladder substitution a buttonhole incision at the most inferior aspect of the cecal pole is placed or the appendix is used for end-to-end anastomosis to the membranous urethra. For continent diversion an additional 7 to 12 cm of ileum are isolated in order to create an ileal intussuscepted valve. Alternatively the appendix can be used. Continence is achieved by submucosal embedding of the appendix into the cecal pole. A total of 346 patients underwent the MAINZ pouch procedure in Mainz and Wuppertal; 56 for bladder augmentation, 49 for bladder substitution and 241 for continent urinary diversion. We encountered early complications in 29 of the 346 patients (8.38%). Late complications were observed in 72 patients (20.8%). The major complications we encountered were stone formation inside the pouch in 19 patients and stomal stenosis in 21. 54 of the 56 patients with a bladder augmentation are completely continent (mean follow-up: 50 months, range: 10 to 83 months). All of the 49 patients who received a bladder substitution after radical cystectomy are continent during daytime. Three of these patients who do not empty their bladder at regular four hour intervals have leakage during the night (follow-up: 23 to 69 months). The revision rate due to nipple gliding and subsequent incontinence could be greatly reduced by the use of staples for fixation of the ileal nipple and the use of the appendix. For correction of the most frequently occurring complications standardized techniques have been developed.

Cecum↗
PubMed1990

Continent appendix stoma: a modification of the Mainz pouch technique.

The submucosally embedded in situ appendix guarantees an ideal continence mechanism in patients with ileocecal urinary reservoirs. To date this modification of the Mainz pouch technique has been performed successfully in 13 patients. The appendicocutaneous stoma was placed at the lower right abdominal quadrant in 12 patients and into the umbilical funnel in 1. Urodynamic investigations of the submucosally embedded appendix showed a maximum closure pressure of more than 80 cm. water in pressure profiles. Only 1 case of stomal stenosis required reoperation.

Adult↗
PubMed1990

[The Mainz-pouch. 6 years of clinical experience].

The surgical technique for creation of the Mainz-pouch uses 12 cm of cecum and ascending colon and 2 ileal loops of the same length for construction of an urinary reservoir, which has proven applicable for bladder augmentation, bladder substitution as well as for continent urinary diversion. For the creation of a continent nipple in urinary diversion 6 cm of ileum in addition are necessary. As a modification we use the non-infected submucosal imbedded appendix as continence mechanism. Since 1986 a total of 247 patients underwent a Mainz-pouch procedure: 54 for bladder augmentation, 27 for bladder substitution and 166 for continent diversion. The appendix as continence mechanism was used in 30. Postoperative mortality rested under 1%, early complications have been observed in 4.4% and late complications in 13.7% (mean follow-up of 35 months). In the bladder augmentation group 52 patients are completely dry, 2 patients have urge and frequency and 5 patients are on intermittent self catheterisation to avoid residual urine. In the bladder substitution group all patient are continent at daytime. At nighttime 3 patients have leakage if they don't empty their bladder all 4 hours. In the urinary diversion group all but 3 are completely dry and are on intermittent catheterisation. The main problem of our initial series was prolapse of the continent nipple which has been solved by stable fixation of the nipple to the bowel wall and to the ileocecal valve or by using the submucosal imbedded appendix.

Bioprosthesis↗
PubMed1989

[Extracorporeal shockwave lithotripsy of bile duct stones].

Extracorporeal lithotripsy (EL) was undertaken in 50 patients (mean age 73.7 years; range 29-90 years) with extrahepatic and, in five, with intrahepatic gallstones, the usual endoscopic methods having been unsuccessful in removing the stones. Occasionally stone fragments were passed spontaneously, but in most they had to be removed endoscopically, in 48 (96%) with extrahepatic and in three (60%) with intrahepatic stones. Biliary tract or gallbladder infections occurred after the lithotripsy and associated local litholysis in seven of the 48 with extrahepatic (14%) and three of the five (60%) with intrahepatic stones. There was one hospital death. The results indicate that EL has definite advantages over surgical treatment in these patients, who are usually elderly and in whom surgical intervention is more risky.

Adult↗
PubMed1989

Continent urinary diversion and bladder augmentation in children: the Mainz pouch procedure.

The formation of a bowel reservoir of large capacity at low pressure by using small and large bowel (ileocaecal segment) has proved reliable for achieving continent urinary diversion (n = 80), for bladder augmentation (n = 42) as well as for total bladder replacement (n = 24). Encouraged by the results we obtained in our adult patients, we have used this technique during the last 3.5 years in 29 children. Indications for urinary diversions in children have been: neurogenic bladder with diplegia (n = 8), bladder exstrophy (n = 2), traumatic loss of the bladder (n = 1), urogenital sinus (n = 1) and rhabdomyosarcoma of the prostate or bladder (n = 2). Bladder augmentation was indicated in 6 children with iatrogenic bladder loss, in 5 children with neurogenic bladder without diplegia and in 4 boys with incontinent epispadias or exstrophy. In children with bladder exstrophy or incontinent epispadias, continence was achieved using a modified Young-Dees technique with formation of a long intra-abdominal muscular tube made out of the bladder plate or the low-capacity bladder. The capacity of the urinary reservoir was guaranteed by bladder augmentation or bladder replacement with an ileocaecal pouch. During a mean follow-up period of 26 months (bladder augmentation) and 21 months (continent diversion) there was only one postoperative complication (intussusception ileus) which required operative revision. Two children had to undergo reoperation because of nipple problems. Follow-up, with monitoring of biochemical and metabolic parameters, is necessary to show whether this technique will provide a long-term successful solution for these problems.

Adolescent↗
PubMed1988

Karyotype analysis and marker chromosomes of renal cell carcinoma.

Karyotyping was performed in 46 human renal cell carcinomas of various histological grades. Controls included chromosome analysis of normal renal parenchymal cells from the same patients. Various numerical chromosome aberrations were found as well as marker chromosomes. They are specific of the individual tumor but no single marker was identified occurring in all tumors tested. Only trisomy 3 was found in different tumors (31%), suggesting a more general character of this aberration. Histological dedifferentiation and large tumor size correlate with focusing of the karyotype towards distinct chromosomal modes indicative of distinct tumor cell subclones within these tumors. Their rapid growth, reflecting biological aggressiveness, is most probably responsible for the patients' poor prognosis.

Carcinoma, Renal Cell↗
PubMed1988

Tumor-specific antigen for human renal cell carcinoma. Ultrastructural localization of the antigen by immunoelectron microscopy.

Hybridoma technology enabled the production of tumor-specific monoclonal antibodies reactive exclusively with human renal cell carcinoma. Intracellular localization of the antigen was undertaken in order to gain understanding of its possible physiological role in cellular metabolism and to investigate its future clinical applicability for immunoscintigraphy in tumor localization. For immunoelectron microscopy a special paraformaldehyde-periodate fixation process (PLP fixation) had to be employed, in order to preserve the cell's ultrastructure without destruction of the antibody-binding epitope. The antigen was found to be strictly intracytoplasmic in close correlation to the glycogen particles characteristic for human renal cell carcinoma. These findings suggest that this antigen may be involved in the pathological glycogen synthesis, explaining the specific staining pattern of these monoclonal antibodies.

Antibodies, Monoclonal↗
PubMed1986

The sapphire crystal infrared photocoagulator and polyglactin (Vicryl) mesh: two new alternatives to the suturing of radial nephrotomies.

The sapphire crystal infrared photocoagulator and polyglactin (Vicryl) mesh, two new methods for closure of radial nephrotomies, were assessed in 16 dogs. Six radial nephrotomies were carried out in each dog; in 10 the nephrotomies were sealed by the infrared photocoagulator and in six they were left open, but the kidney was covered with a polyglactin mesh. Functional and morphological studies were performed using creatinine clearance, microfil casting, corrosion cast angiography and histology. There was no significant loss of function or loss of renal tissue. Both methods were shown to be safe and effective in the closure of radial nephrotomies.

Animals↗
PubMed1984

Doppler sonography and B-mode ultrasound scanning in renal stone surgery.

Doppler sonography and B-mode ultrasound scanning have been used to perform nephrotomies without circular arrest of the kidney in 107 renal lithotomies. Between 1 and 12 nephrotomies were performed on a single kidney. Average duration of the operation was 270 minutes. The blood loss varied between 20 and 4,500 ml. Three patients required a short period of pedicle clamping. The residual stone rate was 7.5 per cent. Of 9 complications 2 are attributable to the surgical technique. Late follow-up studies in 14 patients showed a 10 per cent improvement of kidney function.

Adolescent↗