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Biomedical subjects

W Weidner

Publications and source records attributed to W Weidner.

At least 19 recordsLinked to original sources
PubMed1992

Prostatitis--diagnostic criteria, classification of patients and recommendations for therapeutic trials.

Infections of the prostate may occur despite the numerous host defences of the male urogenital tract. It is important to distinguish patients with genuine inflammation of the gland from the larger number of men with symptoms but no signs of an inflammatory response (prostatodynia). To define prostatitis, the degree of the inflammatory reaction must first be determined. Increased numbers of leucocytes in expressed prostatic secrections (EPS) are essential for this diagnosis. Careful lower urinary tract studies may then be used to classify the patients into two major groups of bacterial and nonbacterial prostatitis. Chronic bacterial prostatitis is primarily due to Escherichia coli. Gram-positive prostatitis is debatable. In chronic bacterial prostatitis, secretory dysfunction is common. The increased alkalinity of the pH of expressed prostatic secretions is one of the reasons for poor results of antibiotic therapy. Uncommon microorganisms, such as Chlamydia trachomatis and Ureaplasma urealyticum may be involved in some cases of the "nonbacterial" form. Routine culture for these microorganisms is not recommended.

Acid Phosphatase↗
PubMed1992

Digital radiography in urologic imaging: radiation dose reduction on urethrocystography.

Digital luminescent radiography (DLR) is a new form of digital radiographic technology which can be used as an alternative to conventional radiologic systems; it replaces conventional screen-film systems by photostimulable phosphorus. Due to the linear dynamic range of photostimulable phosphorus, x-ray examinations can be performed with significantly lower radiation exposure. In this study radiation dose was reduced by about 90% using DLR for urethrocystography.

Humans↗
PubMed1992

Venous surgery in veno-occlusive dysfunction: long-time results after deep dorsal vein resection.

Follow-up of patients 1 year after deep dorsal vein resection gives evidence of an approximate 50-60% success rate. A careful selection of only this small percentage of patients, in whom abnormal drainage through the penile dorsum is obvious, is mandatory. Men with an arterial cofactor have to be excluded or to be subsequently treated by intracavernosal autoinjection of vasoactive substances. Late results from our study demonstrate a further loss of sufficient erection, also in men considered as persistent success by us, in the subjective view of the patient and/or his sexual partner.

Adult↗
PubMed1992

[Sex differentiation disorders from the andrologic viewpoint].

Abnormal sex differentiation with ambiguous genitalia now leads to prompt and comprehensive diagnostic evaluation in the neonate. If necessary, phenotypic gender assignment is done very early and appropriate surgical correction is performed. Management at puberty and later is more difficult. Andrological guidance at this time covers problems of genital identification, sexuality and fertility. The different types of abnormal differentiation, i.e. genetic, gonadal and phenotypic alterations, may result in different andrological problems, e.g. hypogonadism including micropenis and undescended testes, lack of secondary sex characteristics and impotence. With respect to fertility the major problems are testicular azoospermia and/or congenital abnormalities of the male reproductive tract. Any proposals for treatment have to take account of all these different aspects of pathogenesis and the natural course of the disease. In each case, andrological guidance must be formulated with due consideration for the results of genital determination in childhood, including surgical correction.

Disorders of Sex Development↗
PubMed1991

The evaluation of markers of prostatic function.

The concentrations of three secretory proteins of the human prostate, including prostatic secretory protein of 94 amino acid residues (PSP94), prostate-specific antigen (PSA) and prostatic acid phosphatase (PAP), were measured by enzyme-linked immunosorbent assay (ELISA) in semen from a collective of patients suffering from various inflammatory diseases of the genital tract. In addition, levels of the conventional markers citrate, glucosidase and fructose were determined. As compared with semen from men exhibiting no inflammatory condition, only levels of glucosidase in cases of epididymitis and concentrations of PSP94 in the collective suffering from prostatitis showed significant reductions. The changes in the secretion of PSA, PAP, fructose and citrate in the semen of patients with inflammation of genital tract tissue were not significant at the 95% range of confidence.

Acid Phosphatase↗
PubMed1991

Chronic bacterial prostatitis: therapeutic experience with ciprofloxacin.

Ciprofloxacin was used for the treatment of refractory chronic bacterial prostatis. 17 men with symptoms of prostatitis for more than one year who had not responded to treatment courses of six weeks trimethoprim-sulfamethoxazole or trimethoprim alone received 500 mg ciprofloxacin twice daily per os for two weeks. Up to one year follow-up proved eradication of Escherichia coli in seven of ten and of other pathogens in two of five cases. In a second study, 16 patients with proven chronic bacterial prostatitis who had failed on pretreatment with co-trimoxazole, trimethoprim or norfloxacin, respectively, received 500 mg ciprofloxacin twice daily for four weeks. E. coli was the causative organism for all cases. After a median follow-up of 30 (21-36) months, ten out of 16 patients are clinically cured with permanent eradication of the causative organism. In two men a second treatment course with ciprofloxacin is considered successful. Two patients stopped treatment for central nervous system complaints.

Ciprofloxacin↗
PubMed1991

Refractory chronic bacterial prostatitis: a re-evaluation of ciprofloxacin treatment after a median followup of 30 months.

A total of 16 men suffering from refractory chronic bacterial prostatitis caused by Escherichia coli was treated with ciprofloxacin for 4 weeks. After a median followup of 30 months (range 21 to 36 months) 10 of the 16 patients were considered cured as judged by bacteriological results and clinical symptoms. In 2 men a second ciprofloxacin regimen obviously showed success also. In 2 patients ciprofloxacin therapy failed and in 2 therapy had to be discontinued due to side effects of the central nervous system.

Administration, Oral↗
PubMed1991

HLA association of idiopathic Peyronie's disease: an indication of autoimmune phenomena in etiopathogenesis?

HLA typing for class I and class II antigens was done in 52 unrelated patients suffering from idiopathic Peyronie's disease. The controversially discussed association with the HLA-B7 cross-reacting group could not be confirmed. Marked deviations of antigen frequencies were observed for HLA-A1, B8, Cw7, DR3 and DQw2 compared to healthy local controls. After correction of p-values, A1 (pc less than 0.05) and DQw2 (pc less than 0.01) remained significant. A possible association of Peyronie's disease with markers of the HLA-A1, B8, Cw7, DR3, DQw2 haplotype, as first described here, would suggest autoimmunological factors in this disorder of otherwise unknown etiopathogenesis.

Adult↗
PubMed1991

Recurrent haemospermia--underlying urogenital anomalies and efficacy of imaging procedures.

Recurrent haemospermia is often regarded as "essential". Following routine diagnostic procedures, we found an associated factor in 54 of 72 patients (75%). With one exception (prostatic carcinoma), the benign character of the disease was confirmed. Urogenital infection was the most frequent concomitant finding (50%); in 26 men chronic prostatis was diagnosed. Other disorders such as hypertension and coagulation disorders played a minor role. Additional investigation of the prostate gland and seminal vesicles by transrectal prostatic ultrasonography revealed persistent asymmetry of the latter glands as the main finding in 20 men (28%). In every case seminal vesicle carcinoma was excluded; haemorrhage due to cystic distension, inflammatory lesions or ductal obstruction was associated in all cases with congenital abnormalities, chronic urogenital infection, coagulation disorders or hypertension.

Adult↗
PubMed1991

Significance of the intracavernosal pharmacological injection test, pharmacocavernosography, artificial erection and cavernosometry in the diagnosis of venous leakage.

149 men suffering from erectile failure underwent a standardized combined procedure including intracavernosal pharmacological injection test (P test) artificial erection, pharmacocavernosography and cavernosometry with analysis of intracavernosal erection pressure and pressure drop. Patients with negative P test were considered to be suffering from 'venous leakage'; data of cavernosography and cavernosometry were analyzed in relation to the results of the P test. 99 men (66.4%) were P-test-negative. 98 of these patients (99%) had pathological cavernous drainage of the plexus santorinii during cavernosography. Flow rates for induction and maintenance of erection of the P-test-negative men were increased and intracavernosal erection pressure decreased significantly compared to the P-test-positive patients. The very diversified range of values made any individual statement impossible. In contrast to these findings, duration of pressure drop was significantly shorter among men with suspicion of venous leakage and without any overlapping compared to P-test-positive men. The findings provide evidence for the necessity, besides pharmacocavernosography, to include an estimation of intracavernosal pressure drop time in the diagnostic procedure of venous leakage in all men with confirmed negative P test.

Adult↗
PubMed1990

Acute and chronic bacterial prostatitis due to E. coli. Description of an animal model.

Inoculation of Escherichia coli (serotype O:6) into the bladder of male and female Mastomys (Praomys) natalensis produced severe prostatitis. In this rodent both male and female animals possess a well developed prostatic gland. The histologic and microbiologic course of the prostatic infection resembled strongly the human disease. Acute bacterial prostatitis was followed by the development of chronic bacterial or nonbacterial prostatitis. The infection persisted in some animals for up to six months. Prostatitis was observed histologically in all animals sacrificed six months postinfection. Animals responded to the infection with a rise of anti-lipopolysaccharide antibodies. No major morphologic differences were detected in the histologic pattern of the inflammatory process between animals with positive and negative bacterial cultures and between male and female animals.

Animals↗
PubMed1990

The influence of inflammation of the human male genital tract on secretion of the seminal markers alpha-glucosidase, glycerophosphocholine, carnitine, fructose and citric acid.

Biochemical analysis was made of specific accessory gland products in the ejaculates of 362 men suffering from various acute inflammatory diseases of the reproductive tract and 33 normozoospermic patients acting as controls. The ejaculate content of the epididymal markers alpha-glucosidase and L-carnitine, but not glycerophosphocholine, was significantly reduced in ejaculates from men with epididymitis; citric acid was reduced in men suffering from prostatitis; both citric acid and alpha-glucosidase were reduced in men suffering from adnexitis. The ejaculate content of epididymal and prostatic markers in prostato-urethritis (adnexitis), where the exact localization of the inflammation was unclear, was not as low as in epididymitis or prostatitis. Seminal vesicle function, as judged from semen volumes and seminal fructose, was not different in these groups of patients. The results, although strongly related to the clinical diagnosis, were unrelated to the microbiological flora of the semen and indicate that both the epididymis and the prostate glands are involved in some forms of adnexitis.

Adolescent↗
PubMed1990

[Initial therapy of acute unilateral epididymitis using ofloxacin. I. Clinical and microbiological findings].

In a prospective study, 70 men suffering from uncomplicated acute unilateral epididymitis were treated initially with 2 x 200 mg ofloxacin p.o. per day for 14 days. Patients were reexamined at the end of therapy and again after 6 and 12 weeks. Patients were retreated when the pathogens had not been eliminated. Aetiologically epididymitis was caused in one-third of cases each by C. trachomatis (n = 20) and common urinary tract pathogens (n = 20); in the remaining one-third we found N. gonorrhoeae (n = 1). U. urealyticum (n = 3), or no pathogens (n = 26). At the first check-up examination, in 64/70 patients no pathogens were found. Relevant bacteria were still detected in 6 patients: C. trachomatis in 5 and E. aerogenes in 1. After 12 weeks, infection still persisted in 3 patients (E. coli, P. aeruginosa, enterococci). In vitro the microorganisms were invariably sensitive to ofloxacin. Due to abscess formation, surgical intervention became necessary in 6 patients. In 3 of these cases the causative agent was C. trachomatis. Regardless of the aetiology, after 12 weeks, in 20% of our patients the epididymis was still infiltrated and 14% complained of persistent symptoms.

Acute Disease↗
PubMed1990

[Initial therapy of acute unilateral epididymitis using ofloxacin. II. Andrological findings].

A total of 70 men suffering from uncomplicated acute unilateral epididymitis were enrolled in a prospective study. They were treated initially with 2 x 200 mg ofloxacin p.o. per day for 14 days, after which the spermatological examination was repeated for each. Ejaculate quality, i.e. density, motility, and morphology of spermatozoa, was determined on the last day of therapy, i.e. after 14 days, and again after 6 and 12 weeks. In most patients, initially decreased sperm counts increased significantly and global motility improved, while the numbers of abnormal spermatozoa decreased. Only in a few cases were azoospermia, kryptozoospermia, consistently reduced motility, and constant or even increasing numbers of deformed spermatozoa observed.

Acute Disease↗