[Current status of combined roll and sling plastic surgery using Kraatz's method in incontinence and descensus operations].
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Biomedical subjects
Publications and source records attributed to D Lamm.
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An investigation was made on patients with cervical carcinoma to test the efficiency of a general administration of antibiotics and chemotherapeutic drugs which are commonly used in urology. The study has been made to analyze the frequency of pathological findings in the urinary tract, in general, and, in particular, the pattern of bacteriological findings as well as antibiogramms at different times of carcinoma therapy. Additionally, consideration was given to the bacteriological situation before the onset of carcinoma therapy and to manifest urologic complications during and after carcinoma therapy. In cases of primary absence of bacteria in urine the therapy preferably used in this clinic was that with chloramphenicol and nifurantin administered up to the 4th week after operation and this was sufficient in two thirds of cases. Conversely, in patients with primary bacteriuria the results of treatment after 4 weeks were satisfactory in only one third of the cases. This poses the necessity of making a more subtle selection of drugs including broad spectrum penicillins. Moreover, therapy has to be continued mainly for women with a previous urological history and for women in whom infections of the urinary tract were observed on release from the hospital. In addition to prevention of chronic pyelonephritis improvement of postoperative wound healing as well as restriction of ureteral fibrosis, hydronephrosis and uremia, as a result of general control of infection are also of considerable importance.
Emptying disturbances demonstrated by the isotope nephrogram are frequent during pregnancy. For the obstetrician, however, they have only importance, if he can differenciate between changes only due to pregnancy and disturbances with a genuine pathological value. On hand of mean - value curves of radio - nephrograms for each of 50 cases of healthy pregnant women at different ages of pregnancy we try to make a specific judgement of the curves by the introduction of a so-called "Drain-rate A" and attempt to classify the disturbances occurring during normal pregnancy under the term "Gravidity-ING" in order to distinguish them from those with a pathological value.
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At first the general problems of operations in the x-ray treated tissue are discussed. After that 11 cases of patients, who were x-rayed, were demonstrated. With these patients we carried out a radical operation, because the cancer of cervicis was insufficiently affected by a primary radiological therapy. The bad turn of disease could not be stopped at 6 cases. The women patients got either uretero-vaginal-fistulae (2) or recto-vaginal-fistulae (2) or combined vesico-recto-vaginal-fistulae (1) and in less than one year they died of recidiv of cancer. Two women patients are still tended on account of their vesico-recto-vaginal fistulae. Only three women had been cured satisfactorily and they are till now free of recidivs for 4 to 7 years.
Striving to improve diagnosis of the functional urinary incontinence in female patients, we carried out colpocystographic examinations in 78 women. With inconspicuous X--ray photos (22) the rest of the diagnostic parameters--with the exception of one--indicate mostly an irritable bladder (4) or at the very least a notable component of an irritable bladder (56). With radiographic findings suggesting stress incontinence (56) a complete (19) or least a partial (27) coincidence with the clinical findings, was likewise more often than divergent findings (only 10 prevalent irritable bladders). Methodology of examination and analysis are explained. The essential advantage of the colpocystographic method over the traditional urethrocystographic methods is according to our hitherto existing experiences, that we can additionally recognize adhesions between urethra, bladder and vagina, which we have to operate. These adhesions can involve both a stress incontinence and an irritable bladder. Consequently this method is suitable for the complex diagnosis of the functional urinary incontinence in female patients.
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