Biomedical subjects

Patrick Honeck

Publications and source records attributed to Patrick Honeck.

3 recordsLinked to original sources

PubMed2007

Correlation between motor function and lower urinary tract dysfunction in patients with infantile cerebral palsy.

AIMS: The aim of this study was to evaluate urodynamic findings in patients with infantile cerebral palsy (CP) and to correlate the findings with impaired motor function. METHODS: We conducted a videourodynamic investigation on a highly select group of 29 patients (3-53 years). Motor function was assessed in each patient by the Gross Motor Function Classification System for CP (GMFCS). With this system, motor function is divided into five levels: patients in Level I have the most independent motor function and patients in Level V the least. The patients were divided into Group 1 (23 symptomatic patients with recurrent urinary tract infection or urinary incontinence) and Group 2 (6 asymptomatic patients). RESULTS: In Group 1, 21 patients (91%) had reduced compliance (0.6-16.4 ml/cmH(2)O) and 16 patients (70%) had increased DLPP (>40 cmH(2)O). Detrusor overactivity and pelvic floor overactivity were found in all 23 patients. In Group 2, two patients (33%) had reduced compliance (0.7 and 5.8 ml/cmH(2)O) and four (67%) had increased DLPP (>40 cm H(2)O). Detrusor overactivity and pelvic floor overactivity were observed in five patients (83%). Symptomatic patients showed higher GMFCS levels than asymptomatic patients. In the group of asymptomatic patients, there was no one classified as Levels IV or V, while there were no symptomatic patients classified as Level I. CONCLUSIONS: We conclude that urinary symptoms and pathological urodynamic findings increase along with the degree of motor function impairment shown by the GMFCS. Pathologic urodynamic findings can be found in both symptomatic and in asymptomatic patients.

Adolescent↗

PubMed2006

Risk of collateral damage to endourologic tools by holmium:YAG laser energy.

BACKGROUND AND PURPOSE: Today, the holmium:YAG laser is the gold standard in endourologic stone treatment because of its high efficacy. However, guidewires and stone-extraction tools often are close to the fiber and may be damaged accidentally by the laser. The aim of our study was to evaluate the duration of laser application required to disrupt wires at different energy settings. MATERIALS AND METHODS: Two standard wires (0.035-inch guidewire and 0.025-inch hydrophilic Terumo wire) and two baskets (1.9F Nitinol tipless and 3F stone extraction) were investigated. We used a holmium:YAG laser (Auriga; Wavelight Laser Technologie AG, Erlangen, Germany) and two fibers (230 and 365 microm) at 800 and 2000 mJ and a 5-Hz pulse rate. The laser was brought into direct contact with the wires. RESULTS: The average time required for transection was 55 to 103 seconds for a safety wire. The Terumo wire broke after 20 to 40 seconds of direct laser application; 15 to 34 seconds was required for a Dormia basket. Thin Nitinol basket wires were disrupted after only 1 to 4 seconds. One- and two-factorial variance analysis showed a high degree of significance (P < 0.0001) of the energy level and type of wire. CONCLUSION: The disruption of stone-extraction tools occurs in a remarkably short time with laser exposure, especially in case of Nitinol baskets, whereas guidewires are more resistant. Attention should be paid to avoiding contact of laser energy with wires and baskets during stone fragmentation.

Aluminum↗

PubMed2005

[Botulinum toxin injection for neurogenic and no neurogenic bladder dysfunction].

OBJECTIVES: Botulinum toxin A (BT A) has gained popularity among urologists in the treatment of detrusor muscle dysfunctions. The aim of this article is to review our experience with this therapy METHODS: From 2001 we used BT A in 28 patients. It was injected in the bladder wall under cystoscopical vision. We analyze the indication of treatment, clinical data and urodynamics before and after treatment. RESULTS: We treated 28 patients. 71 percent had neurogenic hyperreflexic bladder, 18% idiopathic unstable bladder and 11% other diseases. No direct complications were observed. Neurogenic hyperreflexic bladder (n = 20): Mean preoperative bladder capacity was 220 cc, improving to 430 cc after treatment. Non inhibited contractions disappeared. All patients except one with multiple sclerosis, who had spontaneous voiding, required self catheterization after injection. Average time interval between injections was 8.6 months. Idiopathic unstable bladder (n = 5): a lower dose was used, with an average of 100 U. Non inhibited contractions disappeared and all patients were able to maintain spontaneous voiding with post void residuals under 50 ml. No patients required self catheterization. Bladder capacity improved from 128 ml to 370 ml. Average number of voidings per day diminished from 16 to 7 times. Other diseases (n = 3): results were poor in these patients. There were no changes in either bladder function studies or average voiding frequency (15 times per day). These patients required surgery for bladder augmentation in 2 cases and continent diversion in 1 case. CONCLUSIONS: BT A has a role in the treatment of neurogenic hyperreflexic bladder diminishing incontinence and improving bladder capacity. In cases of idiopathic unstable bladder without anatomical changes its results are promising, but a limited number of patients does not allow a definitive conclusion. In other bladder diseases with anatomical changes results are poor and its use should not be routinely recommended.

Adult↗