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Biomedical subjects

R H Ringert

Publications and source records attributed to R H Ringert.

At least 91 records · Page 5Linked to original sources
PubMed1988

[Anesthesia in transurethral surgery].

Transurethral resection (TUR) is a surgical operation generally performed in elderly patients, afflicted with polymorbidity and a high risk for anaesthesia. We studied 1351 transurethral resections during the years 1974-1984: 840 of these procedures were done under regional block--spinal as well as epidural--and 511 in general anaesthesia. Results and complications were related to the applied technique of anaesthesia. Considering that especially the very old patients belong to the regional anaesthesia group where general anaesthesia is known to be dangerous, the results of this study confirm definitely that regional anaesthesia is at present the most appropriate technique for TUR surgery.

Aged↗
PubMed1985

[Preoperative diagnosis of kidney cancers with involvement of the vena cava].

85 patients with adenocarcinoma of the kidney were operated in 1982 and 1983. 9 patients showed a tumor thrombus extending into the renal vena and vena cava. Ultrasound examination of the retroperitoneal cava up to the liver veins was always able to diagnose the tumor thrombus and its cranial extension. If the end of the thrombus was visualised ultrasonographically below the diaphragma and confluence of the liver veins into the cava, no additional diagnostic procedure except intravenous urography was found to be necessary for planning operative treatment. Arteriography, cavography and computer scanning did not give additional information important for surgical intervention.

Humans↗
PubMed1985

[Dissociation of testis and epididymis in incomplete descent].

Failure of fusion between testis and epididymis will usually be encountered during operations for undescended testis in children and for infertility in adults. In 325 groin dissections for undescended testis monorchism was diagnosed in 3.7% and nonfusion of testis and epididymis in 1.2%. Case reports of three unilateral and one bilateral conditions are presented. Intraoperative misjudgement of this condition is likely to occur if the blind ending epididymis is mistaken for an atrophic testis. Careful search for the missing testis is mandatory.

Adolescent↗
PubMed1985

[Progress in diagnosis of the urinary tract in children].

Ultrasound has enriched the armamentarium of the pediatric urologist. Miniprobes enable examination of preterm children without taking them out of the incubator. Special puncture needles facilitate percutaneous diagnostic procedures. A neonatal nephrostomy set was developed for temporary urinary diversion.

Biopsy, Needle↗
PubMed1985

[Dilated upper urinary tract. Evaluation of the obstructive relevance of the ureteral junction by intrapelvic pressure-flow measurement (Whitaker test) in 23 children].

Twenty-three children with equivocal uretero pelvic junction (UPJ)-obstruction underwent antegrade pressure flow studies. In three of the twelve children with upper urinary tract dilatation without vesicorenal reflux UPJ-obstruction could be excluded. Voiding cystograms showed vesicorenal reflux in eleven of the children with reflux induced hydronephrosis in seven cases. The coexistence of UPJ-obstruction and vesicorenal reflux has been noted in four children. In 23 pressure flow studies there was only one equivocal result. Twelve kidneys said to be obstructed were operated and the diagnosis was confirmed. The uneventful follow-up in the other ten children confirms the diagnosis of hydronephrosis without obstruction. The overall accuracy rate of the Whitaker-test was 96%.

Adolescent↗
PubMed1985

[Value of anatomic and functional obstruction of the urethra of girls in enuresis, recurrent urinary tract infections and reflux].

Enuresis, recurrent urinary tract infection and vesico-ureteral reflux in 157 girls between 4 months and 11 years of age were the reasons for urological examination including calibration of urethra and urodynamic evaluation. Meatal stenosis or distal urethral stenosis was found in 14% measured by bougie à boule calibration. Functional disorders of the lower urinary tract were found in 47.8%. While anatomical stenosis requires surgical intervention functional infravesical obstruction is treated by biofeedback procedures. Functional infravesical obstruction is found much more often than anatomical stenosis.

Adolescent↗
PubMed1985

[Results of operative therapy of double kidney].

107 patients were submitted to operative treatment of a duplex kidney from 1968 to 1980. In 62 kidneys of children heminephrectomy was performed and in 26 parenchymapreserving operations like ureterocystoneostomies (n = 17) and pyelopyelostomies (n = 9) were done. Fever and urinary tract infection was seen more often in patients submitted to partial ureterectomy than after total ureterectomy. Long time follow-up (medium 8.8 years) was available in 33% of the children. Two non-functioning renal units after heminephrectomy and one recurrent vesicoureteral reflux were documented. Renal length was determined by planimetry. While values within the +/- 2SD range were seen after antireflux surgery and after pyelopyelostomies growth of the kidneys after heminephrectomy seemed to be hampered. Although renal hypoplasia and dysplasia is seen in a lot of duplex kidneys, heminephrectomy should not be done routinely. Preoperative planimetry of the kidney gives information about the amount of parenchyma most probably lost by heminephrectomy. In addition malfunction of the contralateral "good" kidney should be suspected, if compensatory hypertrophy of this kidney does not develop in spite of a grossly scarred contralateral kidney.

Bacterial Infections↗
PubMed1985

[Operative therapy in boys with posterior urethral valves. How much is sensible?].

From 1976 to 1983 23 boys with posterior urethral valves were seen. Two boys died during early infancy from terminal renal failure. One boy is submitted to a chronic peritoneal dialysis program. Of the remaining 20 patients ten show signs of compensated renal failure (creatinine greater than 1.5 mg/dl), ten boys show normal renal function. Four out of 46 kidneys were removed. Vesicoureteral reflux was primarily present in 14 renal units (30.4%). Three of these kidneys were removed. Reflux ceased spontaneously after valve ablation in ten renal units, ureterocystoneostomy was done in one. Ureterovesical obstruction was seen in three renal units and treated by resection and neoimplantation. Renal hypoplasia and -dysplasia together with urinary tract infections determine the degree of renal function impairment in boys with posterior urethral valves. Surgical intervention of the upper urinary tract is seldom needed. Antenatal diagnosis of obstructive uropathy is helpful to avoid septic obstruction in the neonate. Percutaneous nephrostomy is the treatment of choice in critically ill children presenting with dilatation of the upper tracts.

Child↗
PubMed1984

[Percutaneous demonstration of ectopic megaureters].

Preoperative diagnosis of ectopic megaureter has become much simpler using percutaneous transvesical fine needle puncture of a sonographically visible retrovesical megaureter. Antegrade ureterography using watery contrast material together with indigocarmine dye was able both to demonstrate the megaureter roentgenologically and to help finding the ectopic orifice by direct vision or colposcopy in three girls.

Child↗
PubMed1983

[Ultrasonically guided antegrade pyelography in kidney transplantations].

The indications for, and technique of ultrasound-guided antegrade pyelography of renal transplants are illustrated by eight patients. Because of the detailed anatomical information which the antegrade method provides, it is superior to other diagnostic methods for the investigation of ureteric obstruction or fistulae. The severity of renal pelvis dilatation as shown by sonography must not be taken as a criterian for the grade of obstruction, since transplants may show dilated collecting systems, even in the absence of obstruction. In our view, real time sonography with a suitable probe provides the best means of achieving successful puncture of the renal pelvis. The combination of ultrasound-guided puncture and radiological contrast examination of the ureter is the best diagnostic method available and lead, in all eight cases, to immediate and definitive treatment.

Adolescent↗
PubMed1983

Interdisciplinary treatment of Wilms' tumour.

The results of treating the 51 children suffering from Wilms' tumour seen in the 10 years to January 1982 are described and the need of an interdisciplinary approach is stressed.

Child↗
PubMed1983

[Limitations of tumor marker surveillance after chemotherapy in advanced non-seminomatous testicular tumors].

Determination of the biochemical tumor markers, alpha-fetoprotein (AFP) and beta-human chorionic gonadotropin (beta-HCG) gained much importance in respect to staging and follow-up examination of patients presenting with testicular cancer. After cytostatic chemotherapy the reliability of tumor markers is diminished. Retroperitoneal lymphadenectomy (RLA) was done in 60 patients after chemotherapy. Tumor marker elevation was found only in 52% of the patients showing retroperitoneal carcinoma (n = 25).

Antineoplastic Agents↗
PubMed1983

[The risk of transurethral operations in childhood].

From 1976 to 1981 111 transurethral operations were performed in 93 children; 39 bladder neck incisions or resections, 43 urethrotomies, 6 resections of urethral valves, 13 transversal incisions of ureteroceles, 7 transurethral biopsies in suspected bladder tumors and 3 resections of the neck of a bladder diverticulum were done. Complications were seen especially in the myelodysplasia-group. Multi-resistant bacteriuria was found in many children even before therapy. Hospital-induced fungal infections were seen twice. Malfunctioning of the hydrocephalus drainage-system developed once after transurethral resection and had a fatal outcome. Indication and complications of seldom done transurethral operations in childhood are discussed.

Age Factors↗
PubMed1983

[Surgical therapy of vesicoureterorenal reflux in children].

Extravesical antireflux operations following Lich-Grégoir technique, intravesical Politano-Leadbetter technique as well as intra- and extravesical ureteroneocystostomies have been done on 433 ureters from 1977 to 1982 treating children with vesico-ureteral reflux and different concomitant malformations. Compared with results obtained in this institute from 1968 to 1973 antireflux operations were found to reliably form an antireflux mechanism whatever technique is used. Results of the "International Reflux Study Group" will be available in the near future. Looking at the variety of conditions grouped together under the diagnosis of vesico-uretero-renal reflux risk factors can be identified directing treatment strategy and surgical intervention. In children with concomitant vesical pathology like Hutch's diverticulum, ureterocele formation and refluxing double ureter surgery is primarily used. Children after correction of infravesical obstruction should be regarded as a high risk group and be submitted to antireflux surgery if reflux does not resolve spontaneously shortly after relief of infravesical obstruction. It is in children with sphincter-detrusor-dyssynergia causing functional infravesical obstruction where antireflux surgery is recommended if micturition without residual urine is not restored quickly. Finally in cases of poor patient compliance antibiotic prophylaxis should be omitted and substituted by antireflux surgery.

Child↗