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Biomedical subjects

U Retzke

Publications and source records attributed to U Retzke.

At least 19 recordsLinked to original sources
PubMed1992

[Urinary fistula after radical hysterectomy with lymph node excision].

In 908 radical hysterectomies including dissection of pelvic lymph nodes, 13 (= 1.43%) urogenital fistulas were seen. They occurred postoperatively between the 7th and 15th day. In 12 cases it was a uretero-vaginal and once a vesico-vaginal fistula. The operation report of 7 cases with uretero-vaginal fistula reveals difficulties in separating the ureter in its prevesical part proceeding from tumour spread, endometriosis, scar or bleeding. Since 1985 a percutaneous nephrostomy has been performed (5 cases). 4 fistulas were cured spontaneously, one of them had a percutaneous nephrostomy. In all cases, urography was normal. In 7 cases, ureterocystoneostomy had to be performed. This was done once with fixation of the psoas muscle and 6 times according to Boari. All patients were cured without any complications and with an undisturbed drainage assessed 1 year later by urography. 1 patient, who refused any follow-up, died subsequently. The only vesico-vaginal fistula has been closed by Latzko's procedure. In recent years the problems concerning urogenital fistulas resulting from surgery of cervical cancer have receded. However, if patients adopt an offensive attitude against surgical therapy of stage T2b, the rate of incidence of this complication can be expected to increase.

Adult↗
PubMed1992

[Occlusion of a vesicovaginal fistula with Latzko-repair].

UNLABELLED: The Latzko procedure is a well-known method for the closure of small vesico-vaginal fistulas occurring in the vaginal dome after hysterectomy. This method is favoured by gynaecologists. In three Departments of gynaecology, a total of 104 patients were treated. 76% had been referred from other hospitals. 56.7% resulted from gynaecological operations. In 69.2% was a benign and in 28.8% a malignant disease. In only 2 cases, the primary disease remained unknown. RESULTS: In 97 of 104 (= 93.3%) cases, the procedure according to Latzko succeeded at the first attempt. 5 of 7 recurrences were resolved by the second attempt with the same operative technique according to Latzko, signifying a secondary success rate of 98%. There were only 2 notable complications: the one, where a postoperative bladder haemorrhage attributed to anticoagulants, and the second with a bladder stone noticed 11 years after the Latzko procedure. This technique can be performed in 95% of all vesico-vaginal fistulas occurring. The fundamental advantages of its use are: short duration of the procedure, high cure rate and few complications.

Female↗
PubMed1991

[Micturition and incidence of postoperative urinary tract infections in surgical gynecology].

In a retrospective analysis postoperative courses of 879 patients (1987-1989) have been analysed with respect to micturition behaviour and incidence of postoperative urinary tract infections. 58.5 per cent urinary tracts infections could be registered following uro-gynecology operations and 48.9 per cent after radical hysterectomies according to Wertheim-Held. The lowest rate of 15.9 per cent we found after simple interventions at the adnexas. Within the uro-gynecological operations vaginal plastic procedures had a higher rate (66.4 per cent) than colposuspensions with 41.5 per cent. Because of the different extent of the bladder preparation there were distinct differences with regard to first spontaneous micturition and lack of residual urine.

Female↗
PubMed1991

[The colloid osmotic pressure of blood. Physiology, measuring technique and pre-analytic factors of influence].

Since the fundamental work of Starling the central of colloid osmotic pressure for maintaining volume homoeostasis and for transcapillary fluid exchange has been well known. To treat an intravasal volume deficit colloidal plasma substitution solutions are able to secure a sufficient colloid osmotic pressure. The last one can be measured by oncometry. Therefore an individual therapy is possible. This review describes the physiologic function, measurement techniques and important influencing parameters and disturbing factors which may be taken into consideration when colloid osmotic pressure is determined.

Blood Proteins↗
PubMed1991

[Decrease in premature birth rate through consequent application of diagnostic and therapeutic standards in pregnancy monitoring].

All pregnant women living in the district of Suhl have been observed in our prenatal outpatient department. All gave birth in our department for obstetrics and gynaecology. This observation is made on the base of a standard. From 1981-1987 there were 5,657 pregnant women with singleton pregnancies. In this time the rate of premature birth was on an average of 4.7%. But, over the time there was a slope from 7.3 to 2.8%. Consecutively there was a decrease of 50% in perinatal mortality. The successful standards for observation of pregnant women used in our department have been discussed.

Adult↗
PubMed1990

[Course and outcome of pregnancy in adolescents].

All pregnant women living in the district of Suhl were observed and delivered in our Department for Obstetrics and Gynaecology, County Hospital of Suhl. In a retrospective study, the course and outcome of 732 pregnancies in adolescents (less than or equal to 19 years) were analysed. In all women bearing to maturity, the course of delivery and the neonatal outcome were studied. All results were compared with those of an equal-sized group of women of 20-24 years of age. Out of the 732 adolescent pregnancies, nearly 62% gave birth; in 30% an artificial abortion was undertaken. In a subgroup of 179 adolescents aged less than 18 years, the rate of artificial abortion was 61.5%. Only 34% gave birth to a child. The course of pregnancy in adolescents was not more complicated as it was in older patients (comparison group). The rate of premature delivery was not increased and premature rupture of membranes was even rarer. During birth, there were no increased risks, the duration of birth being identical in both groups. In adolescents, there were a few more spontaneous deliveries. Body weights and neonatal conditions were the same as in the comparable group. Consequently, pregnancy in adolescents is not accompanied by increased risks for mother or child.

Abortion, Induced↗
PubMed1990

[Bacteriuria screening in gynecologic practice: what is the value of mid-stream urine?].

In 55 healthy women corresponding urine proofs were taken by suprapubic punction and by mid stream technique from the same content of the urinary bladder. For detection or exclusion of bacteriuria both collection-methods are of equal value. In 96% of the cases the microbiological results were corresponding. The leucocyte-count is of no value to detect indirectly a bacteriuria as well in punction- and in mid stream urine. A pathologic count is just as little pathognomonic for infection as a normal count excludes a bacteriuria. Therefore the counting of leucocytes should be given up to the favour of a better microbiological observation in gynecological outpatient departments.

Adult↗
PubMed1990

[Diagnosis of urinary tract infections in puerperium].

In 225 puerperant urine proofs were taken both by suprapubic puncture and by mid stream technique. The corresponding proofs were examined culturally and microscopically. 42% of the mid stream proofs containing more than 10(5) germs/ml were evaluated to be false-positive. The corresponding urine taken by suprapubic puncture was uninfected. A pathologic leucocyte-count is just a little representative for urinary tract infection as a normal leucocyte count excludes an infection. Therefore, the counting of leucocytes is worthless and should be given up to the favour of bacteriologic examinations. Every ward for puerperant should presuppose the technique to take urine proofs by suprapubic puncture.

Adult↗
PubMed1990

[Pelvimetry using computerized tomography. I. Theoretical and methodical fundamentals].

The first part of our article deals with the basic aspects of using computed tomography in obstetrical pelvimetry. A macerated osseous female pelvis was used to measure the true conjugate, the transverse plane of the pelvic inlet, the interspinous line and the distance between the ischial tuberosities. The same pelvis was then examined computed tomographically. A lateral and a posterior-anterior scan, and a single scan through the iliac spines were performed. The results of the direct measurement agreed highly with the values achieved computed tomographically if the phantom was positioned exactly on the mid-line of the examination-table, if not, the true conjugate was elongated. Measurements of the superficial and the intravaginal radiation dose in patients demonstrated a significantly lower risk in computed tomography than in conventional x-ray methods. We recommend computed tomography in obstetrics as a safe, accurate and reliable method.

Female↗
PubMed1989

[Rectal examination during labor--tradition or compelling necessity?].

6,639 consecutive deliveries are followed up with respect to the course of puerperium. All these patients were examined during delivery vaginally. Febrile temperatures sub partu were to be stated in 1.1% and post partum in 2.0%. Subfebrile temperatures within the first 7 days of puerperium were to be seen in 7.0%, neonatal infections in 0.5%. The pro and contra of vaginal versus rectal investigation are discussed. The use of an emulsion containing chlorhexidine an antiseptic gliding substance is recommended for obstetrical examinations before and during labour.

Bacterial Infections↗
PubMed1989

[Estrogen and progesterone receptors in mesenchymal structures of the female urogenital tract].

In 37 women being operated on gynecologically small portions of mesenchymatic tissue have been sampled and analysed with respect to the presence and concentration of estrogen and progesterone receptors within the cytosol fraction. The proofs were taken from: ligamentum cardinale, ligamentum sacrouterinum, pubo-vesico-cervical fascia, paracolpium, ligamentum teres uteri, levator muscle and serving as a comparison tissue from fornix vaginae posterior. In the proofs of pubo-vesico-cervical fascia and paracolpium there were no progesterone receptors. In all the other tissues there were as a matter of principle estrogen and progesterone receptors. However from sample to sample there were wide differences with reference to the existence and the concentration of hormone receptors. There was no correlation to the age of life. The results are discussed and compared with those to be found in literature. MeSH: D 12.776.543.750.830.630 Receptors, estrogen G 6.184.154.803.817.349 Receptors, estrogen G 12.803.817.349 Receptors, estrogen D 12.776.543.750.830.700 Receptors, progesterone G 6.184.154.803.817.777 Receptors, progesterone G 12.803.817.777 Receptors, progesterone A 5.360.319.114.170 Broad ligament A 5.360.319.114.803 Round ligament

Adult↗
PubMed1989

[Ectopic pregnancy--still a challenge in gynecology. A contribution to diagnosis and therapy].

The diagnostic and therapeutic management in 80 cases with ectopic pregnancy is analysed. Only in 36 cases (45%) there was an accordance of installation diagnosis with the intraoperative status. 44 patients (55%) were suspicious to suffer from acute pelvic inflammatory disease, abortion or irregular uterine bleedings. Only in 28 cases (35%) the clinical symptomatology was so characteristic for ectopic pregnancy that operation had been performed without any other diagnostic procedures. In 34 cases (43%) a laparoscopy was necessary to get the correct diagnosis. In all the other 18 patients (22%) the indication for operation was made by punction of the cul-de-sac, curettage, and/or ultrasound. Because of an increased blood loss more than 500 ml an intra- or postoperative blood transfusion was necessary in about 1/3 of all treated patients. In 32% it was possible to preserve the fallopian tube. The corresponding operative procedure consisted of salpingotomy and manual expression of tubal pregnancy. Local vasoconstrictive acting substances are recommended. If there are hints at an ectopic pregnancy by histologic examination of tissue got by curettage quick and well-organized management is necessary to use the possibility of conservative operation-procedures. Histologic examination of all abortion tissue is requested.

Adolescent↗
PubMed1988

[Preventive use of iron in pregnancy--a luxury or a necessity?].

In an exploratory study 128 healthy gravidae were given 0.114 g of iron daily from the 14th week of pregnancy until birth. Hematologically and clinically important parameters during pregnancy, birth, and puerperium were compared with an untreated control group of 115 gravidae. Following iron prophylaxis, hemoglobin concentration, hematocrit, and erythrocyte count were significantly higher at the time of birth; however, obstetrically significant parameters were unaffected. In view of the low incidence of anaemia during pregnancy and birth, as well as the completeness of the prenatal care system, general iron prophylaxis is unnecessary. High-risk pregnancies are an exception to this rule. The high incidence of anaemia early in puerperium justifies adequate, i.e., high-dose, oral iron therapy from the first day of the first week of confinement on wards.

Anemia, Hypochromic↗
PubMed1988

[Left ventricular ejection time (LVET) in the course of pregnancy].

In 101 normotensive healthy pregnant women, the left ventricular ejection time (LVET) was estimated. The examinations were performed in intervals of 14 days and 6 weeks after child-birth in left-side and in upright position. The LVET-values are closely frequency-related. Therefore the LVET-values were corrected with regression equations ascertained in 129 healthy non-pregnant women. The curve of the uncorrected LVET has a continuous shift downwards till to the end of pregnancy. However, after correction with the frequency the curve increases in the course of pregnancy till to the time of the 26th-30th week of pregnancy. After this time there is diminishing tendency. In orthostasis in upright position the curves have a similar shift but on a lower level. In the course of pregnancy the heart-frequency increases till to the 31st-35th week. After that it decreases slightly. It has to be assessed that the increase of the frequency-corrected LVET is related to the increasing loading with intravascular volume. On the other hand this increase can be the expression of the improved cardiac performance showing the adaptation to the increase charge of the cardiovascular system. The LVET is to be seen as a indirect destination value of the hearts contractility.

Adolescent↗
PubMed1988

[Mid-stream versus bladder puncture urine in the diagnosis of urinary tract infection in pregnant patients].

150 healthy women being pregnant in the 1st, 2nd and 3rd trimester were examined. From the same content of urinary bladder suprapubic puncture urine (BPU) and mid-stream urine (MSU) were collected. The results concerning microbiological and microscopical analysis of urine proofs were compared. For qualitative and quantitative germ analysis MSU is sufficiently clean enough. In 95.3 there is a good correspondence of the microbiological results of both proofs. Exceptionally in 4.7% the MSU-results were not confirmed by BPU. With respect to the findings in sediment there is no good correspondence of the results. In case of sterile bladder content the BPU sediment - findings are significantly more frequent normal and significantly more seldom abnormal than in MSU. The sediment findings in MSU are more frequent false positive than in BPU. In case of an infected bladder content there are no significant differences in the sediment findings of both techniques in taking urine proofs. The rate of normal sediment findings in case of an infected bladder content is unrealistic high: In MSU in 11% and in BPU in 26%. For microbiologic germ diagnosis MSU and BPU proofs are equivalent. But, for detection or for exclusion of urinary tract infections the sediment finding is poorly pathognomonic for a urinary tract infection. A normal sediment finding does not exclude the existance of an urinary tract infection. Therefore, in the system of prenatal care we should waive of the sediment finding as a guide for the diagnosis of urinary tract infections.

Bacteria↗
PubMed1988

[The use of a double balloon catheter in the topical extra-amniotic administration of prostaglandin F2alpha gel in indicated labor induction and cervix incompetence].

Using a self-made double-balloon-catheter the instillation of 2.5 mg Prostaglandin F2 alpha into the extraovular chorio-decidual space was down 46 times in 42 late pregnant women. The indication was the unripe cervix uteri in case of urgent parturition. This method is more effective than the pericervical and endocervical application, respectively. Under continuous supervision using external CTG there were neither complications in fetus nor in the mother.

Catheterization↗
PubMed1988

[Postpartum curettage--is it always indicated?].

Within five years (1982-1986) there were in the Dept. Obstet. Gynec., Main Hospital of Suhl 382 curettements after 7,462 term deriveries (greater than 37. week of pregnancy). This is a frequency of 5.2%. Only in 25% there was a histologic confirmation of placental tissue. Discussion about possibilities to reduce the frequency of such curettements post partum without neglecting necessary interferences.

Chorionic Villi↗