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Biomedical subjects

A Hofstetter

Publications and source records attributed to A Hofstetter.

At least 19 recordsLinked to original sources
PubMed1992

[Laser lithotripsy in the treatment of ureteral lithiasis].

Laser lithotripsy constitutes a safe method with a success rate of 95% in the treatment of ureteral calculi. The photoacoustic properties of the laser permit stone fragmentation without injury to tissue. The major disadvantage of this technique is its cost. The availability of increasingly smaller electrohydraulic systems that are less costly questions the routine use of the laser system. Another aspect that must be considered is the rapid development of endourologic techniques and instruments in recent years. The use of laser-induced shock waves is not exclusive to the field of Urology. In other surgical specialties where electrohydraulic energy is difficult to use, it constitutes a necessary technique. Such is the case of endoscopy of the bile ducts, fragmentation of pancreatic calculi and lithiasis of the salivary glands. Another possible field of application of laser-induced shock waves is coronary angioplasty.

Humans↗
PubMed1991

[Rational diagnosis of urinary tract infections].

The basis for a rational diagnostic work-up of urinary tract infections is a detailed history and a maximally standardised examination of the urine, with test strips measuring, measurement of specific density, microscopic examination of the sediment, and determination of the bacterial count in the urine employing dipstick procedures are recommended for use in the doctor's office. Isolation and identification of pathogens and the preparation of an antibiogram require a special knowledge of microbiological techniques. A requirement for the evaluation of the urine and its constituents is a knowledge of how the urine was collected; we recommend spontaneously passed urine in men and young children, and catheter urine in the case of women. Chronic inflammation of the male adnexa and chronic recurrent urinary tract infections requires radiological studies by the urologist, including a urogram, a urethrocystogram, a miction cystogram, urethropyelography and ultrasonography. Occasionally, nuclear-medical investigations and angiography or computed tomography may be necessary to obtain further clarification. In the case of outflow obstructions in the region of the lower urinary tract or urge or stress incontinence, uroflowmetry and cystometry should be performed. With the aid of this "stepwise diagnostic evaluation", both optimal clarification of the urinary tract infection and a saving of costs are possible.

Bacteriuria↗
PubMed1991

Complement C3, coeruloplasmin and PMN-elastase in the ejaculate in chronic prostato-adnexitis and their diagnostic value.

The clinical differential of chronic prostatitis and psycho-vegetative urogenital syndrome with objective laboratory tests is very difficult. 265 ejaculates with possible chronic prostatitis were bacteriologically examined (including the search for STD agents). To verify an inflammatory process in the prostate and adnexae, we tested the C3 complement, coeruloplasmin and PMN-elastase levels in ejaculate. In addition, semiquantitative leucocyte counts in stained smears of the ejaculate were carried out. 185 of 265 patients had C3 complement below detection levels or in the normal range excluding inflammation of prostate or adnexae. 16.8% of the C3-negative ejaculates showed an elevated PMN-elastase level associated with urethritis anterior and/or posterior caused by STD agents. 80 patients showed elevated C3 levels; 38.8% with elevated coeruloplasmin and PMN-elastase levels. The semiquantitative leucocyte count in the stained smear proved the least sensitive method for verifying an inflammation. Enterococci (55.3%), Mycoplasma (18.8%) and Escherichia coli (16.5) were the dominant pathogens of chronic prostatitis present in number of 10(2) cfu/ml or greater than 10(5) cfu/ml. A correlation to the intensity of the inflammation was not found. These results show how important it is to realise a complete bacteriological examination as well as to determine the C3 complement, coeruloplasmin and PMN elastase.

Adult↗
PubMed1991

[Erectile dysfunction. Current diagnosis and therapy].

Today the cause of erectile dysfunction can be evaluated by multidisciplinary diagnostics. Currently, medical treatment, external devices, operative procedures and self-injection of vasoactive drugs are used for therapy. We can therefore offer effective therapeutic options with a low risk, providing an acceptable solution for the patients.

Adult↗
PubMed1990

Bacillus Calmette-Guérin treatment and vesicorenal reflux.

14 patients with radiologically documented vesicorenal reflux (5 bilateral, 7 unilateral, 2 unilateral double-J stents) received intravesical immunotherapy with bacillus Calmette-Guérin (BCG) after treatment of their superficial urothelial tumors. 1 patient with a double-J stent suffered a highly febrile attack following obstruction of the indwelling ureteral catheter. The other patients tolerated 1 or 2 (6 of 14 patients) courses of BCG without an increase in side effects. Topical intravesical therapy with BCG in patients with vesicorenal reflux seems to be indicated in view of the multicentricity of urothelial carcinoma and can be performed without an increased risk of complications.

Administration, Intravesical↗
PubMed1990

[Laser lithotripsy with automatic shut-off on tissue contact].

A group of 88 patients with 89 ureteral calculi were treated with the pulsed dye-laser. Visual control was carried out through 8.5-F or 9.5-F ureteroscopes. The laser has automatic shut-off via spectrum analysis of back-scatter laser light. Effective laser pulses can therefore only be induced in the case of contact with the stone. Of the 89 stones 58 (65.2%) were completely fragmented by laser lithotripsy, 15 (16.8%) by laser lithotripsy in combination with ESWL and 9 (10.1%) by other ureteroscopic techniques. Ureterolithotomy was necessary only in 1 case (1%). There were 5 calculi (5.6%) that were too hard for fragmentation. The pulsed dye-laser is a safe and effective treatment modality for ureteral calculi that are not accessible for ESWL or in which ESWL has been unsuccessful. Further experimental and clinical trials will have to show whether miniature probes for electrohydraulic lithotripsy, dye-laser with automatic shut-off, or alexandrite laser will be the method of choice for lithotripsy of ureteral calculi.

Endoscopes↗
PubMed1990

[Late sequelae after urogenital trauma. Results of follow-up studies].

In the course of the Multicenter Study on Urological Traumatology ("UMCEST"), 61 patients who had been treated at the Departments of Urology of the Ludwig Maximilian University in Munich and the Heinrich Heine University in Düsseldorf were followed up. These included 39 patients with multiple trauma and 22 patients who had suffered isolated urological injuries. There were 45 patients with renal injuries, 7 with injuries to the bladder, and 11 who had presented with urethral injuries. Late complications were detected in 38% of the 45 patients with renal injuries. Of the 11 patients with urethral injuries, 6 suffered from urethral strictures, 9 from sexual dysfunction and 3 from incontinence. The 7 patients with bladder injuries had no late complications related to the bladder trauma.

Female↗
PubMed1989

[The neodymium:YAG laser in infiltrating bladder tumors].

Over the last 11 years we have treated 47 patients with infiltrating bladder carcinomas with the neodymium:YAG laser alone or in combination with TUR. After a mean observation period of 3 1/2 years (19-133 months) 39 patients (83%) were still alive. Only two of them showed tumor dissemination. Thirteen patients (27.7%) had no recurrent disease after laser therapy. Mostly heterotopic recurrences with no tumor progression were found in 23 patients (48.9%). Six patients (12.8%) developed recurrences with progression, including two cases with pelvic lymph node metastases. Five patients (10.6%) died of their tumor disease and three of myocardial infarction, having shown no signs of tumor recurrence at the last follow-up examination.

Combined Modality Therapy↗