Biomedical subjects

E Würnschimmel

Publications and source records attributed to E Würnschimmel.

6 recordsLinked to original sources

PubMed1996

[Psoas abscess].

Psoas abscess is a rare infection, which can present a diagnostic challenge. The classical symptoms are fever, rigor and pain in the loin, lower abdomen, groin or hip, as well as a characteristic limp, but these symptoms can vary. The general health can deteriorate with delayed diagnosis and anemia, weight loss and anorexia can develop. CT is the best diagnostic method to demonstrate the localization and extent of the abscess and also possible sources of infection in the neighbourhood. 14 cases of psoas abscess, which were largely diagnosed and treated in the urological department, are presented and the clinical spectrum of this infection is discussed.

Adult↗

PubMed1995

[Is orthotopic ileal neobladder an acceptable form of urinary diversion from the viewpoint of the patient?].

In 19 patients with bladder cancer who required cystectomy, an orthotopic ileal bladder was created. The patients were followed up for an average of 36 months (12-60 months). In this study we present the early and late postoperative complications, the survival data, quality of life assessment, data from urodynamic investigations, metabolic changes and the situation in the upper tracts. Postoperative complications requiring reoperation occurred in 11% in the early postoperative and in 27.7% in the late postoperative phase. Two of 19 patients died from cancer 18 and 26 months after cystectomy. A further patient had an urethral recurrence and the cancer is progressing further. Questionnaires showed that 80% of our patients were satisfied with their new bladder. Eighty percent were continent during the day and at night. Stress incontinence (II-III) occurred in only 2 patients (12%). All patients were impotent, but in 5 SCAT therapy made intercourse possible. The metabolic acidosis required oral alkalization in 60%. Dilatation of the upper urinary tract was seen in 6% of the renal units. We conclude from our experience that an orthotopic ileal neobladder is an excellent method of urinary diversion after cystectomy.

Aged↗

PubMed1993

Endoscopic treatment of vesicoureteric reflux with collagen. Five years' experience.

Submucosal injections of bovine collagen (Zyplast) were administered to 67 children and 7 adults with 115 refluxing ureters. Reflux was grade I in 14 ureters, grade II in 54, grade III in 38 and grade IV in 9. All patients had a history of recurrent urinary infection. One year after treatment 70 ureters showed no reflux, 20 were grade I and 25 showed a complete recurrence. The cure rate was 81% if grade I recurrence is included. In all, 68 ureters were followed up for 2 to 4 years. In 19 ureters a second injection was given, 47 showed no reflux, 19 had grade I reflux and 2 had a recurrence. In 5 ureters reflux grade I disappeared without a second injection. The cure rate was 97%. Renal scarring was seen in 4 kidneys. Collagen injections are an adequate method of treatment for reflux grades I-III.

Adolescent↗

PubMed1992

[Urethral stricture after TURP and transvesical prostatectomy].

In an attempt to elucidate factors predisposing to the occurrence of urethral stricture after transurethral resection of the prostate, we performed a prospective follow-up of 178 patients over 12-20 months. We took account of 11 factors that we considered important. Urethral strictures developed in 14.04% of the patients. The resection operations were carried out by five different surgeons, who had different rates of stricture. The only one of the 11 factors studied that was found to involve a statistically significant risk was the presence of an indwelling catheter for more than 3 days. No other factor influenced the result. This patient group was compared with a group of 73 patients followed up for 12-60 months following transvesical prostatectomy. In this group only one stricture (1.36% incidence rate) was observed retrospectively. It seems that urethral ischaemia might increase the risk of urethral stricture. Urethral injuries are considerably less frequent with open prostatectomy. Therefore, we recommend transvesical prostatectomy for pronounced prostatic hyperplasias.

Catheters, Indwelling↗

PubMed1992

[Incidental prostatic cancer--"wait and see" or radical prostatectomy?].

In a comparative and retrospective study, outcome was examined in two groups of patients with incidental carcinoma of the prostate (stage T1a). In the 47 patients in the first group the carcinoma was kept under observation for 2-10 years without the administration of any treatment. During the mean follow-up of 5 years, the disease progressed in 11 (23.4%) of these patients, and 4 of them died. The other group was made up of 20 patients who underwent radical prostatectomy. The clinical and pathological staging were quite different in this group than in the other: more advanced stages and higher grades were seen in 10 patients, and the specimens taken from 6 were found not to contain any tumour. After a mean follow-up period of 4.5 years, all these 20 patients are alive with no evidence of disease. The management of patients with T1a tumour is still a problem. Observation only will be followed by progression in 23% of cases, while radical prostatectomy actually constitutes overtreatment in 30%. In conclusion, we prefer to perform prostatectomy in all patients with T1a carcinoma who are young and have a good life expectancy.

Aged↗

PubMed1989

Management of patients with localized prostatic carcinoma.

Three groups of patients with localized prostatic carcinoma are presented. One group of 42 patients was treated with radiation therapy. The second group of 43 patients was subjected to radical prostatectomy. The third group consisted of 42 elderly men with focal, incidental carcinoma who received no therapy. The preliminary results of management and observation are presented. Comparison of the two forms of management shows that radical prostatectomy gives better results than radiation in terms of cure, survival and disease progression. The probability of recurrence or metastases is very high in T3 lesions, despite radical surgery. In the group with incidental untreated carcinoma, a high incidence of progression was seen. It is concluded that these patients are at a certain risk despite old age and focal disease.

Age Factors↗