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Biomedical subjects

W Weidner

Publications and source records attributed to W Weidner.

At least 127 records · Page 7Linked to original sources
PubMed1999

New aspects in Peyronie's disease--a mini-review.

There have been several advances in elucidation of the pathogenesis of Peyronie's disease. Transforming growth factor beta 1 seems to play a major role in this disease, while the importance of penile trauma is a matter of debate. High-resolution ultrasound sonography is the method of choice in detecting penile plaques, while magnetic resonance imaging is useful in the evaluation of actively inflamed plaques. There are still differences of opinion on the best drug therapy in noncalcified plaques. The results on tamoxifen or interferon therapy vary between useless and useful. Potassium-para-aminobenzoate seems to have a significant effect in decreasing plaque size and deviation angle. The operative strategy for big plaques or complex deviation has changed to the 'small incision' graft, leading to far lower post-operative impotence rates. Iontophoresis seems to be worthy of further trials, while the results of extracorporal shock wave therapy have to be discussed critically.

Erectile Dysfunction↗
PubMed1999

Prostaglandin E1 long-term self-injection programme for treatment of erectile dysfunction--a follow-up of at least 5 years.

Prostaglandin E1 (PGE1) is currently the vasoactive drug of choice for intracavernous self-injection therapy in the treatment of erectile dysfunction. PGE1 is often said to have a low incidence of side-effects. However, real long-term follow-up reports are rare. Here, a report is presented on 32 patients who joined a long-term self-injection programme in which they used PGE1 for a minimum of 5 years under standardized protocol conditions. All these patients had an organic aetiology of erectile dysfunction, and their mean age was 58.7 +/- 8.6 years. The period of observation was on average 75.4 +/- 16.9 months, and the PGE1 dosage 13.5 +/- 5.9 micrograms. A total of 6799 injections were registered. The average number of injections was 213 +/- 127 per patient, which is 2.8 injections per month and patient. As regards side-effects, haematomas were registered in 1.9% of the patients and five cases of prolonged erection (0.07%) caused by unauthorized redosing were noted. Three patients developed reversible penile nodules. In 10 patients, the initial dosage had to be increased. Five patients dropped out after 5 years, none of them due to treatment complications. It is concluded that PGE1 self-injection therapy is a simple and reliable method for long-term use with hardly any side-effects. The patients do not stop treatment because of complications.

Aged↗
PubMed1999

Prostate and sexuality: An overview.

OBJECTIVE: Diseases of the prostate, prostatitis, prostatodynia, benign prostatic hyperplasia (BPH), and carcinoma of the prostate interfere with sexual function. Since the American Urological Association have issued their position statement in 1990 that male sexual dysfunction is a recognized disease entity, studies examined the interrelation between sexuality and the prostate. These studies were identified in our review. METHOD: A computer- and hand-based search of the literature was conducted with the key words health-related quality of life, sexual function and the various disease states of the prostate, the drawback being that validated quality-of-life instruments have just recently and mostly nationally been validated. RESULTS: Sexual function is a dimension of quality-of-life questionnaires with 1 up to 11 questions addressing sexuality. The effect of aging on male sexuality as determined in Sweden serves as an important background information. Whereas prostadynia and sexual dysfunction aggravate each other, BPH and its treatment influence only certain sexual functions. Carcinoma of the prostate, untreated or under observation, has the greatest impact on sexuality which is tolerated differently from country to country and depends upon the expectation of survival. CONCLUSION: The impact of treatment of prostatic diseases on sexuality can now be studied easier in utilizing validated questionnaires. This update may serve as a base for these upcoming studies.

Aging↗
PubMed1999

Outcome of antibiotic therapy with ciprofloxacin in chronic bacterial prostatitis.

Chronic bacterial prostatitis (CBP) is a rare infection of the prostate with Escherichia coli being the predominant causative pathogen. Appropriate antimicrobial therapy is mandatory for cure. We report on our experience with a 4-week regimen of ciprofloxacin in 40 men suffering from CBP due to E. coli. Follow-up was conducted over a period of 12 to 24 months. The microbiological work-up included an analysis of expressed prostatic secretions (EPS) and semen. Eradication of the pathogen in EPS was achieved in 92% of patients 3 months after therapy and in about 70 to 80% of patients evaluated 12 and 24 months after treatment, respectively. Treatment failure was not associated with the presence of prostatic calculi, as assessed by transrectal ultrasonography. After successful therapy, mean EPS pH decreased significantly from 7.95 to 7.35. Significant bacteriospermia with E. coli was detected in 21/22 (95.5%) patients before treatment and in 6/22 (27.3%) patients 6 months after therapy. Our data reconfirm ciprofloxacin as an excellent antimicrobial agent in the therapy of CBP. However, eradication of the pathogen is unpredictable and cannot be achieved in every case. Further studies should correlate microbiological treatment success with symptomatic relief, as assessed by standardised questionnaires.

Adult↗
PubMed1999

Treatment-related stresses and depression in couples undergoing assisted reproductive treatment by IVF or ICSI.

The purposes of the study were to compare treatment-related stresses of couples undergoing IVF or ICSI treatment (ejaculated, epididymal or testicular spermatozoa) and to identify sex differences and risk factors for depression. A one-year cohort of couples was retrospectively sent questionnaires on infertility and treatment-related distress and depression (Depression Scale, D-S). Two hundred and eighty-one women and 281 men (61% of those eligible) were included. As determined by analysis of the medical charts, successful couples were more likely to participate. Treatment-related distress was generally higher for women than for men. Treatment by ICSI carried additional burdens for the men: they reported a greater subjective responsibility for the infertility, impact of childlessness on daily life, treatment-related stresses (particularly for MESA/TESE) and time demands. Even when clinical differences between treatments (e.g. age, previous treatments) were controlled statistically, depression scores did not differ. Independent of the treatment, women were significantly more depressed than their age-matched female controls from the general population and their husbands. The men only reported marginally elevated depression scores compared to their controls. Meaningful characteristics were identified that could guide clinicians to give psychological support to those couples at risk for depression, e.g. an unsuccessful treatment outcome, repeated treatment cycles, a low socioeconomic status, foreign nationality, or, for women, a lack of partner support.

Adult↗
PubMed1998

Urologic tumors in the Federal Republic of Germany: data on 56,013 cases from hospital cancer registries.

BACKGROUND: Since 1985, a special work group involved in the coordination of hospital cancer registries in Germany (the Arbeitsgruppe zur Koordination Klinischer Krebsregister) has been collecting, storing, and analyzing data on tumor patients received from cancer centers, oncologic departments, and specialized practices. METHODS: The documentation of tumor patients is based on information concerning localization, histologic findings, and tumor spread, among other things. The data are stored in a central data base administered by the work group. It currently contains data on approximately 500,000 oncologic patients. RESULTS: During the period 1987-1992, 56,013 initial entries were made concerning patients with urologic tumors. Of these cases, tumors of the kidney (n = 11,424) constituted 20.4%. In 94.6% of the cases, histologic investigation revealed a renal cell carcinoma, classified as follows: pT1, 5.8%; pT2, 53.6%; pT3, 37.2%; and pT4, 3.4%. Tumors of the urinary bladder (n = 16,246) constituted 29.0% of all urologic tumors. In 93.8% of cases, a transitional cell carcinoma was detected, classified as follows: pTis, 1.0%; pTa, 36.9%; pT1, 29.6%; pT2, 16.9%; pT3, 11.4%; and pT4, 4.4%. Transitional cell carcinomas of the ureter or of the collecting system (n = 1846) constituted 3.3% of the cases. The proportion of testicular tumors (n 6594) amounted to 11.8%; 53.6% of the germ cell tumors (n = 6281) were seminomas and 46.6% were nonseminomas; 66.3% of the cases were lymph node negative. Tumors of the prostate (n = 19,903) constituted 35.5% of the cases. During the period 1987-1992, the proportion of lymph node positive prostate carcinomas decreased, from 39.8% to 16.2%. CONCLUSIONS: A detailed analysis of these data shows how hospital cancer registries can contribute to the discussion of issues regarding diagnosis and therapy of urologic tumors.

Aged↗
PubMed1998

[Rational diagnosis of erectile dysfunction].

In diagnostics of erectile dysfunction there are different simple or large-scale procedures available. Referring to a three-step-scheme that makes difference in the diagnostics in I. non-invasive, II. semi-invasive and III. invasive procedures the current diagnostic measures will be explained. To the non-invasive measures do account the extensive patients history taking including the sexual history and the psychological diagnostics, the physical examination and laboratory screenings. The semi-invasive procedures include the intracavernous injection test with vasoactice substances, the doppler sonography and duplex or color duplex sonography, the corpus-cavernosum-electromyogram (CC-EMG) and other neurophysiological examinations. The third invasive step contains the dynamic infusion pharmacological cavernosography and cavernosometry (DICC) and the selective pharmacological phallo-arteriography. The procedures of this step are essentially limited to patients with erectile dysfunction who are planned for surgical interventions.

Diagnosis, Differential↗
PubMed1998

Ankylosing spondylitis and infections of the female urogenital tract.

Thirty-two female patients with confirmed ankylosing spondylitis (AS) and 33 women of similar age with pure ileitis terminalis Crohn were examined for genitourinary infection. Urethral syndrome was found in 15 out of 32 patients with AS: 11 of them had urethritis and 4 urethritis associated with vaginitis. Five women of the control group suffered from urethritis. In all cases with genitourinary infection, Chlamydia trachomatis was isolated. By comparing the AS-patients (urogenital infection group and the non-infected group) with regard to other present clinical parameters, it was found, as expected, that the erythrocyte sedimentation rate in the 1st hour was significantly higher in the infected group. In addition, the infected patients had a significantly higher incidence of enthesopathy, involvement of the spinal column, and higher C-reactive protein values (CRP > or = 5 mg/l). A family history of AS was equally present. Other clinical parameters, such as inflammatory involvement of the joints and HLA-B27 correlation, did not differ significantly between infected and non-infected patients.

Adult↗
PubMed1998

Historical milestones regarding torsion of the scrotal organs.

PURPOSE: The clinical syndrome of the acute scrotum, whereby the spermatic cord or appendix testis becomes twisted, commonly affects young men. Our knowledge of this condition, however, is of relatively recent origin. MATERIALS AND METHODS: We performed an historical survey of torsion of the scrotal organs dating back to 1703. In Bologna in 1703 Morgagni observed the first hydatid on the caput epididymis. He described 10 hydatid cases of the testis and epididymis producing, in his opinion, the fluid of hydroceles. The first illustration of appendix testis dates from Cooper 1841. Later these testicular appendages, or hydatids, were shown to be vestigial remnants of either the müllerian duct or the wolffian structures, depending on location. Actual torsion of the appendix testis was mentioned by Ombrédanne in 1913 but the first case report was published in 1922 by Colt. Appendix testis torsion was first schematically illustrated in 1923 by Mouchet and was characterized by Dix in 1931 in a manner that is still valid today. Interestingly, the great majority of case reports since 1932 have originated from America. In 1810 Hunter described a typical case of testicular torsion, and in 1840 Delasiauve presented the first case of surgically treated testicular torsion. A schematic and original illustration of a contorted undescended testis was published in 1894 by Lauenstein. RESULTS: Testicular torsion was, and still is, a true urological emergency but the historical survival rate of the testis was extremely low. Searching for improvement in clinical diagnosis, physicians have noted helpful specific signs, 1 of which is that the period of ischemia determines loss of the testis. CONCLUSIONS: The historical development of diagnosis of torsion of the appendix testis and spermatic cord highlights the ever present need for careful examination, a high index of suspicion and timely therapy.

Europe↗
PubMed1998

Patient assessment in chronic prostatitis.

Assessment of men suffering from proven chronic prostatitis involves a cascade of diagnostic steps, including evaluation of symptoms and clinical features, objectivation of the inflammatory response in expressed prostatic secretions, standardized localization techniques for common bacteria and a search for fastidious, uncommon pathogens.

Journal Article↗
PubMed1998

Evaluation of seminal plasma parameters in patients with chronic prostatitis or leukocytospermia.

Though detailed cytological and microbiological diagnostic procedures are routinely carried out in male genital tract infection, the correct diagnosis and localization of inflammation or infection is often difficult. In this prospective study, the relevance of the seminal plasma markers PMN elastase, complement C3, CRP, fructose, PSP 94, PSA, and alpha-glucosidase was investigated in 13 patients with chronic prostatitis, 31 patients with significant leukocytospermia, and 58 patients with non-inflammatory diseases (controls). Statistically relevant results were obtained for PMN elastase when comparing chronic prostatitis with controls, leukocytospermia with controls (P < 0.001) and chronic prostatitis with leukocytospermia (P < 0.05); for complement C3 chronic prostatitis and leukocytospermia vs. controls (P < 0.05) and for fructose/ejaculate leukocytospermia vs. controls (P < 0.05). No statistically relevant differences were found for C-reactive protein, alpha-glucosidase, PSA and prostatic secretory protein (PSP 94). To delimit genital tract inflammation from non-inflammatory patients, cutpoint levels for PMN elastase of 230 ng ml-1 and for C3c of 0.01 g l-1 were suggested. PMN elastase was shown to possess the strongest discriminating power. The assessment of a cutpoint for fructose to indicate seminal vesicle dysfunction is not possible as the significance level is weak (P < 0.05).

Adolescent↗
PubMed1998

Influence of different uropathogenic microorganisms on human sperm motility parameters in an in vitro experiment.

The influence of different uropathogenic microorganisms (E. coli, enterococcus, Pseudomonas aeruginosa, Staphylococcus saprophyticus, Candida albicans) on human sperm motility was studied in vitro with a computer-assisted sperm analyser (CASA). Native ejaculates were prepared with the swim-up technique and adjusted to 22 x 10(6) spermatozoa ml-1. The sperm suspension was artificially infected with microorganisms in concentrations varying from 2 x 10(3) to 2 x 10(7). Sperm motility was examined directly after incubation, 2, 4 and 6 h later using the Mika motion analysis, a computer-based, automatic motility analysis. Former results with E. coli (serotype 06) could be confirmed that a significant inhibitory effect on sperm motility was associated with bacterial growth. Experiments with the enterococcus strain and Staphylococcus saprophyticus indicated no significant influence on sperm motility parameters. Tests with Pseudomonas aeruginosa showed a decrease of progressive motility according to time, but not to different bacterial concentrations. A significant inhibitory effect of Candida albicans was only detected in the samples with the initial bacterial concentration of 2 x 10(7) microorganisms ml-1.

Bacteria↗
PubMed1998

[Induratio penis plastica].

The symptoms of Peyronie's disease consist of fibrotic plaque formation, penile deviation and painful erection. The etiology is still unknown. During its progress the disease can cause erectile failure. The plaques mainly involve the dorsal tunica of the penis. The diagnosis is made by palpation of the penis. The ultrasound examination evaluates the plaque localization and possible calcifications. Autophotography of penile deviation and duplex sonography of the cavernous arteries used to measure arterial blood flow complete the diagnostic efforts. Spontaneous remissions occur as well as chronic courses. Oral medication is the first step in therapy. In cases with severe penile deviation leading to disability to perform intercourse, persisting pain or erectile failure operative management is indicated. Plaque surgery, modified corporal plication or implantation of a penile prosthesis must be evaluated individually.

Diagnosis, Differential↗
PubMed1997

[Urologic tumors in Germany. Initial data of 56,013 cases from clinical cancer registers].

Since 1985 a special work group involved in the coordination of hospital cancer registries in Germany (AKKK) has been collecting, storing and analysing data on tumour patients, received from cancer centres, oncological departments and specialised practices. The documentation of tumour patients is based, among other things, on information concerning localisation, histological findings and tumour spread. The data are stored in a central database administered by the work group. At present it contains data on approximately 500,000 oncological patients. In the period from 1987 to 1992, 56,013 initial entries were made concerning patients with urological tumours. Of these cases, tumours of the kidney (n = 11,424) constituted 20.4%. In 94.6% of the cases, histological investigation revealed a renal cell carcinoma-pT1: 5.8%; pT2: 53.6%, pT3: 37.2% and pT4: 3.4%. Tumours of the urinary bladder (n = 16,246) constituted 29.0% of all urological tumours. In 93.8% of the cases a transitional cell carcinoma was detected-pTis: 1.0%; pTa: 36.9%; pT1: 29.6%; pT2: 16.9%; pT3: 11.4%; pT4: 4.4%. Transitional cell carcinomas of the ureter or of the collecting system (n = 1,846) constituted 3.3% of the cases. The proportion of testicular tumours (n = 6,594) amounted to 11.8%; 53.6% of these germ-cell tumours (n = 6,281) were seminomas and 46.6% were non-seminomas. In all, 66.3% of the cases were lymph-node negative. Tumours of the prostate (n = 19,903) constituted 35.5% of the cases. In the period from 1987 to 1992, the proportion of lymph-node-positive prostate carcinomas decreased from 39.8% to 16.2%. The detailed analysis of these data shows how the hospital cancer registries can support the discussion regarding diagnosis and therapy of urological tumours.

Adult↗