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Karl-Werner Schweppe

Publications and source records attributed to Karl-Werner Schweppe.

4 recordsLinked to original sources
PubMed2006

Endometriosis of the urinary tract in women of reproductive age.

AIM: We present our experience with diagnosing and treating 22 cases of urinary tract endometriosis in women of reproductive age. PATIENTS AND METHODS: From January 2001 to January 2003, 22 women of reproductive age (mean age 34.8 years) were diagnosed suffering from endometriosis of the urinary tract. We used the Endoscopic Endometriosis Classification (EEC) for assessing the stage of endometriosis. RESULTS: Endometriosis was present in the bladder, the lower third of the ureter, and in a postnephrectomy ureteral stump in 15 (68.1%), six (27.2%) and one (4.5%) cases, respectively. The EEC classification revealed stages I, II, III and IV in four (18.1%), one (4.5%), one (4.5%), and 16 (72.7%) patients, respectively. Urinary symptoms were present in 14 (63.6%) patients. For the treatment of bladder endometriosis, 10 patients underwent partial cystectomy, while the remaining five patients were treated with transurethral resection. In four patients ureterolysis was performed, by laparoscopy in two cases and by open surgery in the other two cases. Ureterectomy and re-implantation with bladder psoas hitching took place in six patients. In the case of endometriosis of the ureteral stump, open surgical excision took place. During the mean follow-up period of 20 months (range 16-40) no long-term complication or relapse was diagnosed. CONCLUSIONS: Bladder and ureteral endometriosis should be considered in women of reproductive age with non-specific urinary tract or abdominal symptoms, and surgical treatment is recommended.

Adult↗
PubMed2005

Endometriosis market research: an overview of findings in Europe and the United States.

A comparison of the surgical and medical approach to endometriosis in Europe and the United States reveals similar management strategies for the disease. Although scientific data indicate that laparoscopy alone is not a reliable method of diagnosis, this technique continues to be used in 54% and 66% of cases in Europe and the United States, respectively. The most frequently used medical treatments for endometriosis in Europe and the United States are oral contraceptives and nonsteroidal antiinflammatory drugs. Gonadotropin-releasing hormone (GnRH) agonists are prescribed pre-surgery in 16% of cases in Europe, while 20% of cases in the USA receive leuprorelin pre-surgery. Postsurgery, this increases to 26% and 63%, respectively. Clear guidelines for the use of laparoscopy in the diagnosis of endometriosis, and the possible extended role of GnRH agonists in symptom control and treatment need to be defined.

Endometriosis↗
PubMed2002

Peritoneal defects and the development of endometriosis in relation to the timing of endoscopic surgery during the menstrual cycle.

OBJECTIVE: In vitro studies demonstrated that implantation on membranes (peritoneum, amniotic membranes) can take place if there are defects on the surface of the membranes. If these mechanisms play a role for the development of endometriosis in vivo, then patients with surgical treatment of peritoneal endometriosis in the luteal phase must have a high recurrence rate. DESIGN: Retrospective analysis of operation charts and follow-up data. SETTING: Department of gynecology, in a hospital-based endometriosis treatment center. PATIENT(S): Two hundred twenty premenopausal women. INTERVENTION(S): Laparoscopic treatment for peritoneal endometriosis, stage I and II by revised American Society for Reproductive Medicine guidelines. MAIN OUTCOME MEASURE(S): During the follow-up period of 2 years, symptoms and gynecological and sonographic findings were documented. In case of suspected recurrence a repeat laparoscopy with biopsy was performed to prove the recurrent endometriosis macroscopically and histologically. RESULT(S): The total recurrence rate after 2 years was 9.6%. The recurrence rate of group III (15%) was twice as high as those of group I (7%) and group II (8%), as indicated by subjective complaints, clinical findings, macroscopy, and histology; no differences were found between groups I and II. CONCLUSION(S): Endoscopic surgery for the treatment of peritoneal endometriosis should not be performed in the luteal phase.

Biopsy↗