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Biomedical subjects

W Vahlensieck

Publications and source records attributed to W Vahlensieck.

At least 19 recordsLinked to original sources
PubMed2005

[Structure and process quality of inpatient urologic rehabilitation].

Inpatient rehabilitation and "Anschlussheilbehandlung" (rehabilitation soon after operation or acute intervention) are effective and economic for long-term improvement of urologic patients. Only therapy guided by urologic specialists during rehabilitation and afterwards guarantees the possibility of excellent results. Especially QOL and functional deficits are improved markedly by urologic rehabilitation. Therefore, inpatient urologic rehabilitation should be initiated more often in the future.

Combined Modality Therapy↗
PubMed2003

[European Association of Urology guidelines on urinary and male genital tract infections].

Today, the classical bacteria that cause venereal diseases, e.g. gonorrhea, syphilis, chancroid and inguinal granuloma, only account for a small proportion of all known sexually transmitted diseases (STDs). Other bacteria and viruses as well as yeasts, protozoa and epizoa must also be regarded as causative organisms of STD. Taken together, all sexually transmitted infections comprise more than 30 relevant STD pathogens. However, not all pathogens that can be sexually transmitted manifest diseases in the genitals and not all infections of the genitals are exclusively sexually transmitted. Concise information and tables summarising the diagnostic and therapeutic management of STDs in the field of urology allow a synoptic overview, and are in agreement with the recent international guidelines of other specialist areas. Special considerations (i.e. HIV infection, pregnancy, infants, allergy) and recommended regimens are presented.

Disease Notification↗
PubMed2002

[With alpha blockers, finasteride and nettle root against benign prostatic hyperplasia. Which patients are helped by conservative therapy?].

Symptomatic benign prostatic hyperplasia (BPH), which a man has a 50% chance of developing during the course of his lifetime, should receive stage-related treatment. While Vahlensieck stage I disease requires no therapy, stages II and III are indications for medication. Established medications for the treatment of BPH in current use are alpha-blockers, finasteride, and the phytotherapeutic agents pumpkin seed (cucurbitae semen), nettle root (urticae radix), the phytosterols contained in Hypoxis rooperi, rye pollen and the fruits of saw palmetto (sabalis serrulati fructus). If the patient responds, these medicaments can be given life-long, or intermittently. The hard criterion for the rational use of drug treatment of BPH is, over the long term, the reduction in the number of prostate operations. In stage IV disease surgical measures--after prior compensation of renal function--are to the fore.

Adrenergic alpha-Antagonists↗
PubMed1996

[Drug therapy of benign prostatic hyperplasia].

BPH patients with Vahlensieck stage II or III disease are suitable for drug treatment. The points of attack are reduction of testosterone, conversion of testosterone to dihydrotestosterone, conversion of testosterone to estrogen using GnRH analogues, antiandrogens and alpha reductase inhibitors or aromatose inhibitors. Furthermore a reduction in obstruction is achieved through the use of phytopharmaceuticals containing 5-lipoxygenase and cyclooxygenase inhibitors. At present, Curcurbitae pepo seeds, Urtica dioica root, Pollinis siccae extract and Sabal serrulata seed extract are approved for the treatment of prostatic diseases in Germany. The use of alpha-1-sympathicolytic treatment may reduce muscular tone in the prostate. Combination of the various modes of action may also offer an effective form of treatment.

Adrenergic alpha-Antagonists↗
PubMed1996

Polymerase chain reaction versus culture for detection of Ureaplasma urealyticum and Mycoplasma hominis in the urogenital tract of adults and the respiratory tract of newborns.

The efficiency of the polymerase chain reaction (PCR) was compared with that of culture for detection of Ureaplasma urealyticum and Mycoplasma hominis in 726 clinical specimens comprising 189 gynecological samples, 362 urological samples, and 175 samples from newborn infants. The sensitivity of PCR versus culture was 95% for both organisms, while the sensitivity of culture versus PCR was 91% for Ureaplasma urealyticum and 84% for Mycoplasma hominis. Furthermore, PCR tests were faster than culture tests, allowing the time to diagnosis to be reduced from two to five days to 24 h.

Adult↗
PubMed1996

Wilms' tumour in adults. Review of 10 cases.

Nephroblastoma (Wilms' tumour) is very rarely found in adult patients. We report on 10 cases to demonstrate the diagnostic and therapeutic problems. In case of flank pain, large tumour mass, fast tumour growth and young age, the possibility of Wilms' tumour should be taken into consideration even in adult patients. The chances for a successful treatment by primary surgery with adjuvant therapy are favourable for the lower stages I and II. All our patients presenting with tumour stages I and II have survived and have been free of disease for 68 months now. One of the patients with stage III Wilms' tumour died 8 months postoperatively while the other one has been free of disease for 120 months now. In the advanced stage IV no patient survived. In cases of inoperable large tumours in adults, the possibility of primary chemotherapy should be considered under certain circumstances. Rapid tumour regression may confirm the diagnosis and will make feasible a salvage operation in some cases.

Adolescent↗
PubMed1996

Wilms' tumor in adults. Review of 10 cases.

A nephroblastoma (Wilms' tumor) is very rarely found in adult patients. We report on 10 cases to demonstrate the diagnostic and therapeutic problems. In case of flank pain, large tumor mass, fast tumor growth, and young age, the possibility of a Wilms' tumor should be taken into consideration even in adult patients. The chances for a successful treatment by primary surgery with adjuvant therapy are favorable for the lower stages I and II. All our patients presenting with tumor stages I and II have survived and are free of disease since 68 months at the time of the study. One of 2 patients with a Wilms' tumor stage III died 8 months postoperatively, while the other is free of disease since 120 months. In the advanced stage IV no patient survived. In cases of inoperable large tumors in adults, the possibility of primary chemotherapy should be considered under certain circumstances. Rapid tumor regression may confirm the diagnosis and will enable salvage operation in some cases.

Adolescent↗
PubMed1993

[Benign prostatic hyperplasia--treatment with sabal fruit extract. A treatment study of 1,334 patients].

METHOD: In a drug monitoring study, 1,334 outpatients with benign prostatic hyperplasia (BPH) were treated for 12 weeks with an extract from the fruits of Sabal serrulata. RESULTS: Under this treatment, the volume of residual urine decreased by 50%, pollakisuria decreased on average by 37%, and nocturia by 54%. The percentage of patients with dysuric pain decreased from 75% to 37%. The efficacy of the drug was rated good to excellent in more than 80% of the cases, and good to excellent tolerability was reported by more than 95% of the patients. CONCLUSION: The improvement in the irritative symptoms may be considered relevant in terms of improvement in the quality of the life of the patients, and justifies this form of treatment.

5-alpha Reductase Inhibitors↗
PubMed1993

[Current chemotherapy in urinary tract infection].

Because of the many newly developed chemotherapeutics it is often hard to choose the most suitable substance for treatment of urinary tract infection (UTI). Substances for first-line oral treatment are the benzylpyrimidine/sulphonamide combinations, amino-penicillins, fluoroquinolones and cephalosporins. In severe infections any of these can be given i.v., as can amino-glycosides or the combination of imipenem and cilastin. It is easier to decide which substance to give before urine culture results are available if the local resistance patterns to the typical pathogens are known. Particular care is mandatory for risk groups such as children, pregnant women, immunocompromised patients and those with renal insufficiency. Before treatment clinical classification of UTI is necessary. In acute uncomplicated cystitis oral antibiotics should be given either as single-shot therapy or over 3 days. In acute uncomplicated pyelonephritis therapy should last for 7 days or until 3 days after fever is gone. If enteral absorption is not guaranteed or in complicated cases of UTI, intravenous drugs should be used for 10-14 days until fever is gone or the complicating factor has been corrected.

Administration, Oral↗
PubMed1992

Nitrofurantoin versus trimethoprim for low-dose long-term prophylaxis in patients with recurrent urinary tract infections. A prospective randomized study.

In a prospective randomized study 38 patients with recurrent urinary tract infections (rUTI) were included to take either 50 mg Nitrofurantoin (n = 19) or 50 mg Trimethoprim (n = 19) as low-dose long-term prophylaxis for half a year. Compliance was checked weekly by Bacillus subtilis spore test strips sent in by mail. The infection rate was reduced from more than three per patient year to 0.01. There were no significant differences between the two groups concerning the recurrence rate (Nitrofurantoin: one rUTI; Trimethoprim: three rUTI) or side effects. Under Nitrofurantoin treatment 3 symptomatic fungal infections occurred. Trimethoprim and Nitrofurantoin are equally suitable for low-dose long-term prophylaxis in rUTI. Surveillance of compliance gives important hints for failure of prophylaxis.

Adult↗
PubMed1992

Primary melanoma of urinary bladder.

The fourth case of primary melanoma of the bladder is presented together with a review of the previously reported cases and the relevant literature on malignant melanoma in urology. The criteria for classification of the bladder lesion as the primary site are discussed. The eighty-one-year-old female patient was felt not to be suitable for extensive surgery and was successfully treated with a combination of radiation and immunotherapy with recombinant alpha 2 interferon. After previous monthly recurrences of the tumor the patient is in complete remission fifteen months after initiation of therapy. It appears that this form of treatment might be a valuable alternative to radical surgery in elderly patients.

Aged↗
PubMed1991

Beta-human chorionic gonadotropin-positive extragonadal germ cell neoplasia of the renal pelvis.

A 56-year-old woman showed renal obstruction on the right side. Further examinations revealed a tumor of the renal pelvis. Nephroureterectomy on the right side was done. This extragonadal germ cell neoplasia had an immunohistochemically detected beta-human chorionic gonadotropin (beta-hCG) expression. There were no other primary tumors or metastases. Although there were normal values after the operation, during the postoperative follow-up, the serum beta-hCG temporarily reached 2400 IU/l and then dropped to normal without detection of metastases. No further therapy was given. The patient was alive and well 1 year and 10 months after surgery. To the authors' knowledge, this is the first extragonadal germ cell neoplasia of the renal pelvis with secretion of beta-hCG to the serum.

Biomarkers, Tumor↗
PubMed1991

Significance of glycosaminoglycans for the formation of calcium oxalate stones.

Glycosaminoglycans (GAG) are polysaccharide chains composed of repeating disaccharides of identical composition. Little is known about the mechanism of their excretion, but there is no doubt that urinary GAGs are degradation products of high molecular weight proteoglycans. Renal excretion takes place chiefly as glomerular filtration, and tubular reabsorption or secretion has not been demonstrated. Differences in the literature comparing GAG excretion in urolithiasis patients and healthy subjects are mainly attributable to methods of analysis and noncomparability of the investigation conditions. We found no differences between the two groups in several series. It is interesting to note that GAG excretion in men is significantly higher than in women, that a circadian rhythm of GAG concentration and excretion occurs in healthy subjects on a standardized diet, and that values are raised postprandially and at night. Seasonal course of GAG excretion curves is almost synchronous for men and women, irrespective of the absolute values, and GAG excretion in the spring and summer significantly exceeds that in winter months by up to 50%. All crystallization models cited demonstrate that GAG reduce the risk of calcium oxalate stone formation. Inhibitors of crystal growth and aggregation act by blocking the growth sites. Inhibition of calcium oxalate crystallization is also attributed to direct binding of calcium to GAG. In the presence of urate ions, and favorable pH, the ability of chondroitin sulfate C to bind calcium may be impaired by as much as 31%. These measurements support the concept that urate ions interact with GAG in urine.(ABSTRACT TRUNCATED AT 250 WORDS)

Calcium Oxalate↗