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Biomedical subjects

E Petri

Publications and source records attributed to E Petri.

At least 19 recordsLinked to original sources
PubMed2006

Weak VLPP and MUCP correlation and their relationship with objective and subjective measures of severity of urinary incontinence.

The aims of the present study were to find the correlation between Valsalva leak-point pressure (VLPP) and cough leak-point pressure (CLPP) and to determine whether the water perfusion maximum urethral closure pressure (MUCP) correlates with VLPP. Seventy-nine women with previously untreated stress urinary incontinence were recruited to participate in a clinical study. Their mean age was 56.4 years, mean BMI was 27.8, and mean parity was 1.9. The mean values of VLPP and CLPP were 50.4 and 52.9 cm H(2)O, respectively. We did not find statistically significant differences in the mean values of VLPP and CLPP. The mean value of MUCP at rest was 44.2 cm H(2)O and the mean value of MUCP during maximal Valsalva maneuver was 37.2 cm H(2)O; with 500 ml of sterile saline in the bladder the difference between them is statistically significant. In the study group (n=79), 56 patients (77%) had low VLPP (< or =60 cm H(2)O), 21 patients (30%) had low MUCP (< or =30 cm H(2)O), and 8 patients had MUCP< or =20 cm H(2)O (all at rest). Of the 56 patients with low VLPP, 16 also had a low MUCP (< or =30 cm H(2)O). This study mainly compares two parameters-the MUCP and the VLPP. Based on our results we can conclude that there is no correlation between these parameters. MUCP measures urethral resistance at rest and VLPP measures urethral resistance during increased intra-abdominal pressure (Valsalva maneuver).

Adult↗
PubMed2004

Updated recommendations on ultrasonography in urogynecology.

Ultrasound is a supplementary, indispensable diagnostic procedure in urogynecology; perineal, introital, and endoanal ultrasound are the most recommended techniques. The position and mobility of the bladder neck can be demonstrated. In patients undergoing diagnostic work-up for urge symptoms, ultrasound occasionally demonstrates urethral diverticula, leiomyomas, and cysts in the vaginal wall. These findings will lead to further diagnostic assessment. The same applies to the demonstration of bladder diverticula, foreign bodies in the bladder, and bullous edema. With endoanal ultrasound, different parts of the sphincter ani muscle can be evaluated. Recommendations for the standardized use of urogenital ultrasound are given.

Female↗
PubMed2003

Introital and transvaginal ultrasound as the main tool in the assessment of urogenital and pelvic floor dysfunction: an imaging panel and practical approach.

This article reviews the different applications of ultrasound in benign urogynecological diseases. The findings presented here were obtained by introital and transvaginal ultrasound, both of which can be performed with the same equipment (5-7-MHz sector transducer, emission angle of at least 90 degrees; for introital sonography, the transducer is placed over the external urethral orifice with the transducer axis corresponding to the body axis). Female voiding dysfunction, including urge symptoms, recurrent urinary tract infections and urinary incontinence, may occur secondary to morphological and topographical changes of the urogenital organs. Findings such as urethral diverticula, periurethral masses, funneling of the urethra and distension cystoceles are identified by introital ultrasound. Transvaginal ultrasound enables the detection of pathologies of the bladder and uterus including its appendages. Ultrasound as part of the diagnostic work-up of stress urinary incontinence and genitourinary prolapse allows for the morphological and dynamic assessment of the lower urinary tract. It is possible, for example, to classify sonographically identified changes of the endopelvic fascia as lateral (distraction cystocele, funneling of the urethra) and central (pulsation cystocele) defects as well as to determine the reactivity of the pelvic floor muscles. Ultrasound has replaced radiography in yielding information on the abnormal morphology of the urogenital organs, which should be taken into account in planning the treatment of urogynecological conditions.

Female↗
PubMed2003

[Surgical therapy of female urinary incontinence].

Within the past years, surgical concepts for treating females with urinary incontinence have greatly changed. The spectrum of indications is becoming increasingly narrower. All possible conservative treatment modalities must first be attempted. Should the incontinence still continue to evoke social or hygienic problems, stress incontinence is usually treated with the minimally invasive TVT procedure (Tension-free Vaginal Tape), and in special cases, a modern modification of colposuspension is undertaken. Based on a success rate and specific complications, it is now known which slings and colposuspension techniques should no longer be used. Vaginal reconstructive surgery for pelvic organ prolapse, such as anterior and posterior repair and sacrospinous colpopexy are now obsolete for treating incontinence. Likewise discussed are operative procedures for rare forms of female incontinence and for urge incontinence, resistant to therapy.

Female↗
PubMed2001

[Colposuspension in treatment of female stress incontinence].

Colposuspension has emerged as the "golden standard" for the surgical treatment of female urinary incontinence. With a lateral and tangential approach for the placement of the sutures, the rate of obstructed micturition and de novo urgency is low. Success rates of 85% for primary and 70-75% for recurrent incontinence can be achieved. In competition with the tension-free vaginal tape (TVT) procedure, colposuspension will remain the first choice for all laparotomies necessitated by other pathologies, in cases of paravaginal herniation as the cause of prolapse, and in women with unstable bladders caused by anatomical defects. The endoscopic approach has not yet gained general acceptance.

Female↗
PubMed2001

[Surgical concepts in female urinary stress incontinence].

Severe anatomical and functional defects and failure or rejection of conservative treatment are clear indications for surgical repair of sphincter incompetence. Adequate pretherapeutical diagnostic work-up should rule out other reasons for incontinence and additional pathology and allow adequate selection of the surgical technique. Prospective randomized studies as well as meta-analyses enable us to recognize suitable procedures; for primary surgery colposuspension and tension-free vaginal tapes (TVT), and in selected cases traditional slings can be recommended, whereas vaginal repairs, needle suspensions and the different injectables should not be encouraged for primary cases.

Female↗
PubMed2001

[Legal aspects of urogynaecology].

Lesions of the urinary tract are rare, but, typical complications of gynecologic surgery. Gradual loss of surgical experience results in a lack of knowledge of prevention and management of lesions. Pretherapeutical work-up, selection of adequate procedure and surgeon, recognition of atypical postoperative symptoms might cause mistakes in selection and organization of the physician responsible. The principle possibility of a laceration is a rare cause, more frequently disregarding of typical symptoms of complication and prolonged timing of additional investigations are reasons for legal implications. Recommendations of medical associations are of help, but, might be a burden.

Expert Testimony↗
PubMed2000

Perioperative complications of Burch colposuspension.

In a review of the literature on the perioperative complications of Burch colposuspension we found only sparse data associated with this problem. We describe our own experience (> 1800 procedures) and the literature, discussing bleeding/hematoma, injury to the bladder, kinking/injury to the ureters, voiding dysfunction, infection, and rare complications such as deep venous thrombosis, pulmonary embolism, ileus, sepsis, external iliac vein injury and mortality rate. Knowledge of the possible risks and complications of Burch colposuspension may minimize the intraoperative complications and increase postoperative surgical success and patient satisfaction.

Female↗
PubMed1999

[Renal cell carcinoma. Immunohistological study to the expression of the inactive form of the pyruvate kinase].

PURPOSE: The inactive form of pyruvatekinase could be established in different tumours. Purpose of this study was to demonstrate the presence or absence of the inactive form of pyruvatekinase in renal cell carcinoma, metastases and benign renal tissue by immunohistology. METHOD: After deparaffinization of formaline-fixed tissue (5 original tumours, 2 metastases and 5 benign renal tissues) cells were stained (APAAP-method) with Clon DF4 (ScheBo Tech). RESULTS: All malign tissue showed a positive reaction, inside benign tissue we saw a positive reaction of endothelial cells however we saw no reaction with benign renal cells. CONCLUSION: Renal cell carcinoma and metastatic cells show a strong immunohistological reaction against the inactive form of pyruvatekinase, no reaction of benign renal cells. It should be possible to develop a serological tumour marker for renal cell carcinoma.

Biomarkers, Tumor↗
PubMed1999

Local treatment of urogenital atrophy with an estradiol-releasing vaginal ring: a comparative and a placebo-controlled multicenter study. Vaginal Ring Study Group.

Local estrogen substitution has been shown to be more appropriate than any systemic application for the treatment of urogenital symptoms of hormone deficiency. The efficacy, safety and acceptability of a new low-dose drug delivery system consisting of an estradiol-releasing silicone vaginal ring was studied in two multicenter trials. In an open-label comparative trial a total of 219 postmenopausal women were randomized to the estradiol-releasing vaginal ring or to estriol suppositories. In terms of efficacy both treatment arms were shown to be equivalent; however, significantly higher rates of acceptability were found for the vaginal ring. In a double-blinded placebo-controlled study a total of 84 patients were randomized to either treatment arm for a period of 24 weeks. The statistically significant improvement of the vaginal epithelial pH and maturation values demonstrated the efficacy of the estradiol-releasing vaginal ring compared to the placebo ring.

Adult↗
PubMed1999

Urological trauma in gynaecological surgery: diagnosis and management.

Lesions of the urinary tract being a rare, but typical, complication of gynaecological surgery need a skilled pelvic surgeon for prevention and, when they occur, knowledge of adequate techniques of repair or palliative solutions until final repair can take place. The increasing incidence of lesions of the urinary tract as a result of endoscopic surgery makes better training mandatory.

Female↗
PubMed1999

[Different techniques of reduction mammaplasty comparing clinical and esthetic complications with patient satisfaction].

OBJECTIVE: The purpose of this study was to evaluate whether the use of one singleton and safe surgical procedure could be replaced by modified procedures adapted to the individual pathology without increase of complications rates. MATERIAL AND METHODS: 225 consecutive reduction mammaplasties were evaluated retrospectively, comparing the inferior central pedicle (n = 89) to the superior central pedicle (n = 12), the superior medial pedicle (n = 13), the central gland pedicle (n = 17) and the free areola nipple transplantation (n = 34). We checked for surgical and aesthetic complications of different techniques and satisfaction of the patients by questionnaire and personal interview. RESULTS: There was no difference in the incidence of different complications, satisfaction of the patients was comparable. The most frequent perioperative complication was hematoma formation, long-term problems were scar formations. CONCLUSIONS: As different techniques of reduction mammaplasties are mainly variations of surgical procedures it seems to be possible to adapt the procedure to the individual situation. With thorough indication and technique this approach does not increase complication rates.

Esthetics↗
PubMed1999

[Breast-saving therapy and primary reconstruction with latissimus dorsi flap combined with radiotherapy].

OBJECTIVE: The use of latissimus-dorsi-flap with postoperative radiotherapy is method of choice in primary reconstruction of breast cancer. The efforts of radiotherapy on flap healing, cosmetic results and formation of edema in the arm were studied in 30 patients. MATERIALS AND METHODS: 30 patients were followed in three to six months intervals clinically and sonographically (ATL-Ultramark 9, HDI). RESULTS: The most frequent symptom was a moderate edema. No healing problems or interference with cosmetic results were observed. Blood flow in the thoraco-dorsal vessels showed unchanged pre- and postoperatively. CONCLUSIONS: The complains might be the consequence of the combination of surgical dissection of the axilla, radiotherapy and possible additional factors such as trauma and overstress for example. Cosmetic result and healing seems to be impaired by 50 to 60 gy.

Adult↗
PubMed1998

[Collagen metabolism in induratio penis plastica (IPP)].

The exact pathogenesis of Peyronie's Disease (PD) is still unknown. Histopathological investigations suggest, that the metabolism of the collogenious tissue plays an important role. Therefore, we started a prospective study in order to evaluate the metabolic situation of 11 patients with PD and 11 healthy controls. We measured biochemical parameters of penile and venous blood, which correspond to the collagen metabolism (procollagen III [P III P], PMN-elastase [PMN-E], fibronectin [FN], fibronectinreceptor [FN-R] und alpha-1-proteinase-inhibitor [alpha-1-PI]). There was no difference in PMN-E, P III P, FN and FN-R in all samples. There was no difference in penile and venous blood as well. But we found out a highly significant lower concentration of alpha-1-PI in patients with PD (158,55 mg/dl) than in controls (214,82 mg/ dl). A deficiency of alpha-1-PI can lead to a higher activity of serum proteases, such as PMN-E. This can result in a change in collagen metabolism by an increased synthesis of collagen type III, that is found in PD. This general pathophysiologic factor may be competed by an additional local alteration of the tissue.

Collagen↗