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W W Hochreiter

Publications and source records attributed to W W Hochreiter.

10 recordsLinked to original sources
PubMed2006

[Prostatitis--a frequently unrecognized disease].

The term "prostatitis" includes several entities ranging from the acute bacterial inflammation of the prostate gland to the chronic pelvic pain syndrome. Since both acute and chronic bacterial prostatitis are clearly defined by the documented detection of microbial agents, a standardised antimicrobial treatment eventually leads to a predictable rate of cure. However, the most common type is the chronic abacterial prostatitis, called "chronic pelvic pain syndrome" (CPPS) which is subdivided into an inflammatory and a noninflammatory form. CPPS affects men of all ages and is the most common urological diagnosis in men younger than 50 years. Chronic prostatitis/CPPS shares features with other chronic pain syndromes, including a poorly understood etiology, low correspondance of symptoms and objective findings, application of various treatments and frequent failure to be alleviated by medical treatment. Due to the intricacy of the syndrome a thorough clinical evaluation is required to define the causes, consequences and optimal management of this important health problem.

Acute Disease↗
PubMed2005

[Andropause].

The terms andropause, partial androgen deficiency of the aging male (PADAM) or late-onset hypogonadism (LOH) describe a clinical entity which has been defined as a syndrome associated with advanced age. This syndrome is characterised by a deficiency in serum testosterone levels that may result in significant alterations in the quality of life and adversely affect the function of multiple organ systems. Whereas in classic primary and secondary hypogonadism, the clinical picture of testosterone deficiency is clearly defined, the clinical diagnosis of PADAM might escape detection for various reasons: not all signs and symptoms necessarily present together; they often progress slowly and are subtle in nature; the non-specific signs and symptoms might not be discernible from the unavoidable process of aging itself. However, PADAM features many potentially serious consequences that can be avoided or treated, and is, therefore, clinically relevant. Testosterone substitution may be an effective way to manage this condition. Once patients begin treatment with testosterone substitution, follow-up and monitoring are essential.

Age Factors↗
PubMed2003

Male accessory gland infection: standardization of inflammatory parameters including cytokines.

Assessment of infection of the male accessory glands is usually based on the search for white blood cells in different specimens to document an inflammatory reaction. This widely used practice allows to establish the diagnosis of inflammation in many cases. However, clinical symptoms do not always correlate with the presence or absence of white blood cells. This is particularly true for chronic prostatitis/chronic pelvic pain syndrome. In the last few years different research efforts have been made to look for markers of inflammation other than elements of the white blood cell line. Several studies suggest that humoral rather than cellular parameters are involved in male accessory gland infections. Substances such as reactive oxygen species, nerve growth factor and cytokines seem to be important not only in the pathogenesis of the inflammatory reaction but may also serve as diagnostic markers to indicate the presence of inflammation.

Cytokines↗
PubMed2002

[Evaluation of symptoms in men with chronic pelvic pain].

According to the National Institutes of Health classification system, chronic non-bacterial prostatitis/chronic pelvic pain syndrome (CPPS) is subdivided into an inflammatory (category IIIa) and a non-inflammatory (category IIIb) form. The difference is based on the presence or absence of white blood cells in expressed prostatic secretions, urine after prostatic massage, or semen. This is the only criterion which allows a differentiation between the IIIa and IIIb forms. The symptoms, i.e. pain and urinary complaints of various degrees, are thought to be similar in both forms. These symptoms can be assessed with the Chronic Prostatitis Symptom Index (CPSI) and the International Prostate Symptom Score (IPSS), which are both available in a validated German translation. One hundred and six patients with CPPS were evaluated with CPSI and IPSS. Urinary symptoms troubled all patients. Men with category IIIa had significantly more urinary symptoms when compared to men with category IIIb. There was no difference between the two groups regarding pain and impact on the quality of life. Although pain is thought to be the hallmark of CPPS, the contribution of urinary troubles to the symptoms must not be underestimated.

Adult↗
PubMed2001

Influence of stent size on the success of antegrade endopyelotomy for primary ureteropelvic junction obstruction: results of 2 consecutive series.

PURPOSE: We evaluated the influence of stent size in 2 consecutive series of unselected patients in whom primary ureteropelvic junction obstruction was managed by antegrade endopyelotomy and stenting with a 14 or 27Fr stent at the level of the incision. MATERIALS AND METHODS: Antegrade endopyelotomy was performed in 132 patients with primary ureteropelvic junction obstruction. The endopyelotomy was stented for 6 weeks. In 77 patients (group 1) a 14/8.2Fr percutaneous endopyelotomy (Smith) catheter was used. In 55 patients (group 2) a modified 14/8.2Fr Smith catheter was over pulled with a 27Fr wound drain. The wound drain was removed after 2 to 3 weeks and the standard 14/8.2Fr stent remained in place for another 3 to 4 weeks. Success at 6 to 8 weeks, and 6 and 24 months postoperatively was based on clinical evaluation, and excretory urography and/or diuretic renography. Thereafter clinical and ultrasound followup was performed every 2 to 3 years. RESULTS: Preoperatively data on the risk factors of large pyelocaliceal volume and impaired renal function were similar in the 2 groups. The overall success rate was 70% in group 1 at a median followup of 67 months (range 2 to 118) and 94% in group 2 at a median followup of 23 months (range 2 to 52). The early success rate after 6 to 8 weeks in groups 1 and 2 was 83% and 94%, respectively. The long-term success rate after 2 years was 71% and 93%, respectively. Perioperatively and postoperatively the incidence of complications was 16% in group 1 and 24% in group 2. When group 2 complications due to a lack of experience with the new stent were excluded from analysis, the remaining 15% complication rate was comparable to that in group 1. Mean pyelocaliceal volume decreased significantly in each group and remained stable. Split renal function did not change preoperatively to postoperatively with no significant difference in the 2 groups. CONCLUSIONS: Stenting an antegrade endopyelotomy with a modified 27Fr instead of a 14Fr catheter seems to increase the early and, even more impressively, the long-term success rate to a level similar to that of open pyeloplasty.

Adult↗
PubMed2000

Evaluation of the cytokines interleukin 8 and epithelial neutrophil activating peptide 78 as indicators of inflammation in prostatic secretions.

OBJECTIVES: Chronic prostatitis/chronic pelvic pain syndrome (CPPS) is a disorder characterized by pelvic pain and varying degrees of inflammation exhibited in expressed prostatic secretions (EPS). To provide objective parameters of inflammation, we measured the cytokines interleukin 8 (IL-8) and epithelial neutrophil activating peptide 78 (ENA-78) in EPS of healthy men, men with benign prostatic hyperplasia (BPH), men with bacterial prostatitis (BP), and men with chronic prostatitis/CPPS. METHODS: Enzyme-linked immunosorbent assays of the EPS for IL-8 and ENA-78 were done in 63 men: control (n = 9), BPH (n = 6), BP (n = 3), inflammatory CPPS (National Institutes of Health [NIH] category IIIa) (n = 17), noninflammatory CPPS (NIH category IIIb) (n = 17), and asymptomatic inflammatory prostatitis (NIH category IV) (n = 11). RESULTS: IL-8 was detectable in all patients, and ENA-78 was detectable in all except 2 patients (threshold of detection 10 pg/mL for IL-8, 15 pg/mL for ENA-78). Mean levels of IL-8 [ENA-78] were similar in control (3010 pg/mL [423 pg/mL]), BPH (3341 pg/mL [98 pg/mL]), and IIIb (2751 pg/mL [335 pg/mL]) groups. Both cytokine levels were higher in BP (11,175 pg/mL [13,761 pg/mL]), IIIa (10,418 pg/mL [2240 pg/mL]), and IV (8571 pg/mL [1865 pg/mL]) groups. A statistically significant difference between the control group versus BP, IIIa, and IV (P <0.05) groups was found for IL-8 but not for ENA-78. CONCLUSIONS: IL-8 and ENA-78 are frequently elevated in the EPS of men with BP, CPPS IIIa, and asymptomatic inflammatory prostatitis category IV. These cytokines are direct mediators of leukocyte accumulation and activation at inflammatory sites and may be responsible, in part, for the presence of inflammatory reaction in the prostate.

Adult↗
PubMed2000

Evaluation of the bacterial flora of the prostate using a 16S rRNA gene based polymerase chain reaction.

PURPOSE: The role of bacteria in the chronic pelvic pain syndrome (nonbacterial prostatitis and prostatodynia) is controversial and difficult to assess because the bacterial flora of the prostate is not well defined. Polymerase chain reaction (PCR) is a highly sensitive molecular method of bacterial detection. It confirms the sterility of tissue with a high level of confidence and detects small numbers of microbial agents that may represent pathogens. We performed PCR to determine bacterial colonization of the prostate in presumably healthy men and in those undergoing simple or radical prostatectomy. MATERIALS AND METHODS: We analyzed 28 prostate samples from 18 organ donors from whom prostate tissue was obtained under sterile surgical conditions at organ withdrawal, 14 sterile surgical prostate specimens from 7 patients undergoing radical prostatectomy for prostate cancer who previously underwent transrectal biopsy and 6 sterile surgical specimens from 2 men who underwent simple prostatectomy for benign prostatic hyperplasia (BPH), including 1 with an indwelling catheter for several weeks. For PCR we used 2 sets of primers to detect bacterial 16S rRNA gene sequences. Normal prostate tissue seeded in vitro with known numbers of Escherichia coli was used to assess the sensitivity of PCR. RESULTS: Only 3 of the 28 organ donor samples had histological signs of minimal inflammation and all other samples appeared to be normal without evidence of inflammatory reaction. All of these samples were PCR negative. Of several PCR control reactions the mixture of prostate tissue seeded with known numbers of E. coli demonstrated the high sensitivity of the assay, allowing the detection of as few as 6 bacteria in the presence of 25 mg. of prostate tissue. A focal and heterogeneous distribution of inflammation and infection was noted in the 14 radical prostatectomy specimens. In the prostate cancer and BPH groups there was a strong association of inflammation with positive PCR findings. Of 11 samples 3 without but all 9 with inflammation were PCR positive. CONCLUSIONS: PCR is a highly sensitive method for detecting bacteria in the prostate. In our study negative PCR reactions in the prostate tissue of apparently healthy men made the presence of normal bacterial flora in the prostate extremely unlikely. The presence of bacteria and/or inflammation in radical prostatectomy specimens was found to be a localized process. Concordance between inflammation and positive PCR results in simple and radical prostatectomy specimens suggests that bacteria may frequently have a role in histologically inflammatory prostatitis.

Adolescent↗
PubMed1999

Urinary tract infection: a moving target.

Urinary tract infection is an old problem that continues to present new challenges. The purpose of this special edition is to pull together new basic scientific information regarding the pathogenesis of infection and to review the state of the art in the evaluation and treatment of urinary tract infection in some of the more complex or challenging clinical settings. The goal has been more than a summarization of current knowledge; the intent has been to highlight areas of uncertainty, thereby emphasizing the need for further investigation. Herein we briefly mention four clinical settings for urinary tract infection that, in our opinion, present important new or evolving challenges and are particularly fertile areas for further work.

Bacteriuria↗