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Biomedical subjects

M Westenfelder

Publications and source records attributed to M Westenfelder.

At least 19 recordsLinked to original sources
PubMed1995

Penile ossification and acquired penile deviation.

We report on 3 patients with penile deviation during erection caused by ossification in the corpora cavernosa. In each case hard plaques could be palpated. These indurations were removed through a dorsal longitudinal incision. Histologically, solid bone was demonstrable. Two patients were able to resume normal sexual intercourse, but one became impotent following postoperative cavernitis. Penile ossification is rare in man, and its etiology is unknown. It bears no relationship to the os penis normally present in many other mammals. Diagnosis is best made by palpation and X-ray examination. The treatment of choice for symptomatic ossification is surgical excision.

Adult↗
PubMed1992

Nitrofurantoin versus trimethoprim for low-dose long-term prophylaxis in patients with recurrent urinary tract infections. A prospective randomized study.

In a prospective randomized study 38 patients with recurrent urinary tract infections (rUTI) were included to take either 50 mg Nitrofurantoin (n = 19) or 50 mg Trimethoprim (n = 19) as low-dose long-term prophylaxis for half a year. Compliance was checked weekly by Bacillus subtilis spore test strips sent in by mail. The infection rate was reduced from more than three per patient year to 0.01. There were no significant differences between the two groups concerning the recurrence rate (Nitrofurantoin: one rUTI; Trimethoprim: three rUTI) or side effects. Under Nitrofurantoin treatment 3 symptomatic fungal infections occurred. Trimethoprim and Nitrofurantoin are equally suitable for low-dose long-term prophylaxis in rUTI. Surveillance of compliance gives important hints for failure of prophylaxis.

Adult↗
PubMed1992

[Treatment of hypospadias].

Treatment of all forms of hypospadias is difficult. Several abnormal components have to be differentiated and corrected in a very tight space, in addition to which the blood supply must be preserved and infection prevented. Technical progress now allows early correction (around the age of 12 months) in a single procedure, using methods that date back to the last century. Cosmetic results are as important as functional ones. The glans should be reconstructed around the neomeatus, and the penile shaft should be straight. Microsurgical techniques, short transurethral urinary diversion and reliable dressings are important. Strategies, the sequences of surgical procedures and a selection of practical methods are presented and discussed.

Bandages↗
PubMed1988

[Diagnosis and therapy of xanthogranulomatous pyelonephritis].

Xanthogranulomatous pyelonephritis (XGP) is a rare, unilateral and multifocal inflammatory response of the kidney against bacterial toxins. In the Department of Urology of the University of Freiburg 6 patients with XGP were observed within 10 years. Despite modern diagnostic procedures differential diagnosis from kidney tumors and other parenchymal kidney diseases remains difficult. Recurrent urinary tract infections, fever, urolithiasis, obstruction and leucocytosis may be indicative of XGP. The diagnosis has to be confirmed by surgical intervention which preferably should preserve functioning renal tissue. The prognosis in general is quite good.

Adolescent↗
PubMed1987

[MR of the urinary tract in pregnancy].

A report on the application of standard 2D-FT MR combined with RARE-MR-Urography in a pregnant woman with right sided abdominal pain, dilated upper urinary tract and possible stone or inflammatory disease. This technique visualised the complete obstructed ureter in relation to the surrounding organs (uterus, vessels), allows precise diagnosis of the cause of the obstruction and avoids ionising radiation.

Adult↗
PubMed1987

Development of nosocomial and iatrogenic urinary tract infections (UTI) following urological interventions. A prospective clinical study.

Development of nosocomial and iatrogenic UTI was investigated over 3 months period of time. Included were 140 patients following 228 instrumentations or endoscopical or surgical interventions. Of these 84 were carried out under antimicrobial medication. 30 UTIs developed 1-8 days after the various procedures (= 13.2%): 10% after TUR-B, 14% after TUR-P and ureteral instrumentation, 16% following cystoscopy and catheterisation. No significant difference was observed between: Males and females, patients with or without antimicrobial medication, younger and older patients and after long or short procedures. Indwelling catheters remain sterile for 3 days. Though antimicrobial prophylaxis did not significantly influence the generally low rate of infection it appeared as a trend that the elderly patient who requires repeated interventions and who suffers from additional diseases as diabetes, consuming tumours and renal insufficiency may benefit from medication.

Adult↗
PubMed1986

Clinical evaluation of Timentin in complicated urinary tract infections.

Timentin proved to be highly effective in the treatment of 70 urological patients suffering from complicated urinary tract infections. There were few adverse effects, and development of resistance was not observed. Surgical treatment was possible in each case, without any septic complications. The results show that Timentin is a very useful drug for the urologist who often treats complicated urinary tract infections, especially because of its low re- and super-infection rate and the absence of development of resistance.

Adolescent↗
PubMed1983

[Diagnosis and therapy of ectopic ureters and ectopic ureteroceles with double kidneys].

Diagnosis and treatment of ectopic ureters and ectopic ureteroceles with renal duplication is a rewarding challenge for any urologist, requiring specific knowledge, awareness of the anomaly and good surgical technique. The diagnosis is primarily based on the correct interpretion of the medical history and the excretory urogram, irreplaceable by sonography. Confusing details can easily be interpreted when the anomaly is detected, or the patient will be left on a long and frustrating path of medical treatment, diagnostic interventions, possibly leading to psychotherapy. The classical triad: renal duplication, incontinence and normal micturition is rarely helpful in complicated cases, compared to the typical findings on the excretory urogram which sometimes are incomplete or only suggestive but still have the highest diagnostic value. Their recognition usually leads to correct diagnosis and treatment. Modern surgical and anesthesiological techniques allow a one stage approach to correct the anomaly and avoid further complications. However, if the risk is considered to be too high, a two stage approach is justified starting with a heminephrectomy. After this 20% will require further surgical treatment of the bladder, due to complications. Dysplastic and nonvisualizing renal segments should not be preserved nor should dilated, ectopically ending ureters. Minimal surgical interventions, reducing, but not solving the problem (incision of ureteroceles, interpelvic anastomosis) are not recommended in modern urological treatment.

Adolescent↗
PubMed1980

[Efficacy and tolerance of trimethoprim/sulfamethoxazole administered intramuscularly in patients with urinary tract infections (author's transl)].

The antimicrobial efficacy, general and local tolerance of a new intramuscular application form of trimethoprim/sulfamethoxazole was evaluated in a French-German clinical study. Fifty-five urological patients with urinary tract infections were treated with two i. m. injections (3 ml) daily over three to five days followed by oral medication. The study revealed excellent antimicrobial efficacy of the drug. In general TMP/SMZ was tolerated well after i. m. administration. Elevation of creatinine phosphokinase was observed in only three patients treated i. m. for five days. The high viscosity of the solution renders i. m. injection technically difficult, leading to a high proportion of local complications. The indications for use of i. m. administered TMP/SMZ in the hospital are limited, however it should be suitable for private practitioners in that an effective antimicrobial treatment can be started which can be continued by oral or intravenous medication.

Adult↗
PubMed1979

[Lipoid A, a factor in the pathogenesis of chronic pyelonephritis. Experimental and clinical studies of a lipoid A dependent pathological immune reaction].

Lipid A injected into the temporarily occluded renal pelvis of adult dogs, persisted in the kidney tissue and induced an abacterial interstitial nephritis with positive anti-lipid A titers. This reaction was increased by a single dose of lipid A vaccine, reduced by four consecutive immunisations prior to the lipid A injection and absent in puppies. The presence of IgG, IgM and complement complexes in the kidney was demonstrated by immunofluoroscopy. Lipid A antibody titers were measured by the passive hemolysis test in 349 humans. In two out of 20 healthy adults and 16 out of 18 children with recurrent urinary tract infection anti-lipid A antibodies were present. In contrast, no titers were found in 23 newborn babies. In a group of 156 patients with acute urinary tract infection, 28% revealed positive titers, whereas in a group of 132 patients with recurrent urinary tract infection titers occurred in 81%. Selected from this group of 132 patients 61 suffered from an acute infection of the upper tract. 59 oft these (96%) showed definite titers. There was no difference in the development of anti-lipid A antibodies between men and women and the height of the titers did not correlate with the clinical picture of the disease (acute or chronic). The combination of proteinuria and anti-lipid A antibodies indicates the pressure of reccurrent urinary tract infection or chronic pyelonephritis with about 90% accuracy. The titers are caused by immunogenically active lipid A in the body. Since lipid A has the ability to remain in the renal tissue for a long period of time and thereby to maintain the inflammatory response, long-term antimicrobial prophylaxis (six months) should be given to patients with a high risk of recurrent urinary tract infection.

Animals↗
PubMed1977

[Occurence, significance and clinical consequences of lipid A antibody titers in patients with urinary tract infection (author's transl)].

Lipid A antibody titers were measured by the passive hemolysis test in 349 humans. In two out of 20 healthy adults and 16 out of 18 children with recurrent urinary tract infection (UTI) in the presence of anomalies anti-lipid A antibodies were present. In contrast, no titers were found in 23 newborn babies. In a group of 156 patients with acute UTI, 28% revealed positive titers, whereas in a group of 132 patients with recurrent UTI titers occurred in 81%. In a selected group of 132 patients with recurrent infections of the upper tract 59 (=96%) showed definite titers. There was no difference in the development of anti-lipid A antibodies between men and women and the height of the titers did not correlate with the clinical picture of the disease (acute or chronic). The combination of proteinuria and anti-lipid A antibodies indicates the presence of recurrent UTI or chronic pyelonephritis with about 90% accuracy. The titers are caused by immunogenically active lipid A in the body. Since lipid A has the ability to remain in the renal tissue for a long period of time and thereby to maintain the inflamatory response, long-term antimicrobial prophylaxis (six months) should be given to patients with a high risk of recurrent UTI.

Adolescent↗