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Biomedical subjects

H Kiesswetter

Publications and source records attributed to H Kiesswetter.

14 recordsLinked to original sources
PubMed1979

[An urodynamic study of patients with benign prostatic hypertrophy treated conservatively with phytotherapy or testosterone (author's transl)].

Conservative therapy of benign prostatic hypertrophy comprises the administration of oestrogens, gestagens, androgens and anti-androgens. Phytodrugs, which contain an extract of Sabal serrulatum or Pygeum Africana as active substance are without side effects and are, therefore, being used increasingly. 74 patients with irritable or obstructive bladder symptoms due to benign prostatic hypertrophy were treated with a phytodrug (Sabal serrulatum) or with testosterone throughout a period of three months. In group one (20 patients given phytodrugs and 10 patients given testosterone) clinical symptoms and measurements of residual urine, residual urine quotient, bladder capacity, micturition pressure and maximum urethral closure pressure were recorded at the beginning and at the end of therapy. In group two 28 patients were treated with the phytodrug in the first and third months with an intervening placebo trial lasting four weeks and 16 patients were given testosterone. Clinical symptoms and uroflow and residual urine only were charted in this group. None of the patients in either group showed an improvement in the urodynamic parameters of obstruction, but all patients felt a subjective alleviation of their symptoms.

Aged↗
PubMed1978

[Hypertrophy of the internal urethral sphincter in children (author's transl)].

On the basis auf 2 cases congenital hypertrophy of the internal urethral sphincter the authors discuss problems of diagnosis and therapy. They attribute great importance particularly to the urodynamic approach in the assessment of disorders of urinary flow in children. Compared with static or non-physiological methods, such as endoscopy or retrograde urethrography functional diagnostic methods like uroflow, manometry and MCU have definite advantages, precisely where it is a matter of analysing functional disorders. However, if the child is to be spared protracted obstruction of urinary flow, early diagnosis is a prerequisite.

Diagnosis, Differential↗
PubMed1977

[The management of urinary and fecal incontinence due to a neurinoma of the cauda equina with an electrode implanted in the pelvic muscles (Caldwell) (author's transl)].

A woman, aged 49, had a complete sensory and motor deficit of the S2-5 segments with urinary and fecal incontinence due to a neurinoma of the cauda. A Caldwell electrode was implanted surgically into the muscles of the pelvic floor in April 1974. The patient was observed for 2 years thereafter and had an excellent result. The medical and technical problems of treating urinary and fecal incontinence due to a lower motor neuron lesion of S2-5 can be handled satisfactorily with an implanted electrode.

Cauda Equina↗
PubMed1977

Treatment of the neurogenic bladder with direct current on the spinal cord (Myelotron).

We carried out urodynamic examinations before and after galvanotherapy (Myelotron) of the spinal cord in 25 patients with upper and lower motor neuron lesions, mixed lesions and sensory lesions of the bladder. With the upper motor neuron lesions (neurogenic unhibited bladder, dyssynergia) there was a deterioration of the condition and therefore electrotherapy is contraindicated in this group of patients. With the lower motor neuron lesions and also the sensory lesions definite success was achieved with electrotherapy. Where there is a deficiency of impulses, it would appear to be compensated.

Adult↗
PubMed1977

Mucosal sensory threshold of urinary bladder and urethra measured electrically.

Urodynamic investigation consists of evaluation of detrusor stretch responses, muscle strength and motor activities. The electrosensitivity test is the only method to evaluate mucosal sensory threshold of exteroceptive receptors in urinary bladder and posterior urethra thus checking integrity of sensory reflex arcs. A constant current square wave pulse of 0.5 msec duration and 10 msec interval is used with increasing amplitude from 0 to 25 mA until the patient registers sensation. Skin electrosensitivity is tested to start with, then perception threshold of urinary bladder and posterior urethra is recorded. Sensory deficits after segmental sacral nerve lesions or after peripheral nerve injuries postoperatively can be quantitated in terms of milliamperes. The urgency syndrome in adult women is characterized by a low perception threshold in the posterior urethra (below 1 mA) while the bladder electrosensitivity is within normal range (3--10 mA).

Adult↗
PubMed1977

[Percutaneous direct current treatment (myelotron) of neurogenic bladder disorders due to injuries of the lower motor neurons].

We examined 18 patients with lesion of the lower motor neuron, conditioned partly by lesion of the spinal cord, partly by lesion of the peripheral vesical nerves, before and after the percutaneous electrostimulation (myelotron) and established the urodynamically verified effect. Apart from one case of unclarified and fully therapy-resistent atony of the urinary bladder we found in all patients a subjective improvement of their complaints (retarded beginning of miction, spontaneous miction only with straining, large quantities of residual urine). Objectively an improvement of the sensitivity of the urinary bladder or of the motoricity appeared, in most cases both. We could not establish an essential influence on the tonus of an empty bladder and the tonus of the sphincter musculature. In all patients the residual urine could be reduced drastically, after the treatment the major part of the patient could urinate without residual urine.

Adult↗
PubMed1976

[Neurological urology -- a new specialty].

Neuro-urological methods for investigating neurogenic bladder dysfunctions are discussed. A knowledge of central and autonomous pathways of bladder innervation is the basis for an understanding of the pharmacodynamics of the bladder. Successful treatment of neurogenic bladder dysfunction is impossible without urodynamic assessment. Conservative, as well as operative measures of therapy are mentioned. Urinary diversion (ileal conduit) is nowadays no longer undertaken merely as a last resort to prevent chronic upper urinary tract infection, stone formation, contracted kidney and uremia, but is a positive, practicable alternative for the disabled patient. Especially for the younger patient, in whom the social aspects of this situation are of great importance, ileal conduit provides the possibility of a socially-adjusted existence.

Humans↗
PubMed1976

EMG-patterns of pelvic floor muscles with surface electrodes.

On reviewing the literature most authors were found to have used needle electrodes for recording muscle potentials of pelvic floor muscles. We used for the first time a vaginal tampon electrode to record potentials of musculus levator ani in females and the same electrode to record potentials of the external anal sphincter. Recording with surface electrodes is especially recommendable for repetitive investigations for follow-up studies in outpatients and children. EMG patterns of pelvic floor muscles with vaginal tampon electrodes are comparable with those derived by needle electrode. EMG criteria of diagrams in upper motor neuron lesion, lower motor neuron lesion and with irritable bladders are discussed and explained.

Action Potentials↗
PubMed1976

The role of urine in the etiology of cancer of the urinary bladder.

It is shown that the site-frequency distribution of carcinomas relative to the upper and lower hemispheres of the urinary bladder is inhomogeneous. It is pointed out that the contact with urine is the important etiological factor and that other factors, if any, play only a secondary role. It is suggested that prolonged (forced) retention of urine should be avoided. Investigation of urinary carcinogens is needed.

Carcinogens↗
PubMed1975

Lioresal in the treatment of neurogenic bladder dysfunction.

Lioresal is a very effective compound in treatment of the neurogenic uninhibited bladder due to spinal cord lesions. It does not decrease, however, bladder spasms due to cerebral lesions. In detrusor-sphincter externus dyssynergia as frequently encountered in discreet spinal lesions Lioresal restores the normal reciprocal innervation of bladder and sphincter externus again. This effect is demonstrated electromyographically. Lioresal is of no effect on the normal bladder. Bladder capacity and micturition reflex before and after Lioresal therapy are unchanged.

Adult↗