[Acute penile fracture -- a rare urologic emergency].
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Acute Disease↗
Biomedical subjects
S Altziebler
Publications and source records attributed to S Altziebler.
Multiphasic helical CT of the kidney: increased conspicuity for detection and characterization of small (< 3-cm) renal masses.
PURPOSE: To evaluate the potential of thin-section multiphasic helical computed tomography (CT) in the detection and characterization of small (< 3.0-cm) renal masses. MATERIALS AND METHODS: Identically collimated helical CT of the kidney was performed before and after administration of contrast material in 93 patients with small renal masses. Helical CT scans were obtained during the corticomedullary and nephrographic phases. Differences between attenuation of the lesion and that of the kidney were measured quantitatively. The presence of a mass or absence of disease was confirmed with clinical, imaging, and histologic findings. RESULTS: The number of masses smaller than 3.0 cm detected on corticomedullary-phase scans (n = 211) was statistically significantly fewer than those on nephrographic-phase scans (n = 295) (P < .01). Mean differences in enhancement between the renal cortex and masses were 148 HU +/- 54 and 137 HU +/- 44 during the corticomedullary and nephrographic phases, respectively, and the difference in attenuation of the renal medulla and that of the masses was statistically significantly greater during the nephrographic phase (P < .01). False-positive results (n = 9) occurred only on corticomedullary-phase scans because of lack of enhancement of the renal medulla. CONCLUSION: Nephrographic-phase scans enabled greater lesion detection and better characterization of small renal masses than corticomedullary-phase scans. Nephrographic-phase scans should be obtained when only monophasic scanning is used to detect small renal masses.
Adult↗
Effect of extracorporeal shock wave lithotripsy on prostate specific antigen.
PURPOSE: We evaluated the effects of extracorporeal shock wave lithotripsy (ESWL) of distal ureteral calculi on serum prostate specific antigen (PSA). MATERIALS AND METHODS: A total of 29 consecutive men with distal ureteral calculi at a maximum of 25 mm. from the ureteral orifice, and without any history of urinary tract infection, benign prostatio hyperplasia or prostate cancer underwent ESWL with the Dornier MPL 9000 X lithotriptor. The therapeutic focus size was 48 X 7 mm. PSA was measured exactly 5 minutes before ESWL, as well as 120 minutes, 24 hours and 7 days after termination of treatment. RESULTS: Fragmentation rate was 100% and all patients were stone-free within 1 week of therapy. There was no statistically significant difference between PSA values before and after treatment. Only 15 patients had a slight increase in PSA at 120 minutes after treatment (range 0.01 to 0.41 ng./ml., mean 0.07). CONCLUSIONS: ESWL can be performed in men at risk for prostate cancer without impairing the predictive value of PSA.
Adult↗
[Erectile dysfunction in patients with type I diabetes mellitus].
To improve diabetes care according to the St. Vincent Declaration an interdisciplinary working group on erectile dysfunction in patients with diabetes was installed in the Departments of Internal Medicine, Urology and Psychiatry at the University of Graz. The screening and basic diagnostic procedures are performed in the diabetes clinic in the Department for Internal Medicine. To inform the patients about the options of treatment of diabetic erectile dysfunction and to determine prevalence data an anonymous questionnaire with a pre-stamped envelope was sent to 133 male patients with diabetes mellitus type I (IDDM). 59 (44%) of the questionnaires were returned and could be analyzed. Mean age and diabetes duration were representative for the male diabetes population. The prevalence of erectile dysfunction in this group was 49%. 7% of the patients were completely impotent. None of the patients reported the use of erection aids as a vacuum device or intracavernosal injection of smooth muscle-relaxant drugs. The prevalence of erectile dysfunction is high among patients with diabetes mellitus type I. Modern management offers satisfactory success in most cases, therefore screening for erectile dysfunction and adequate therapy should be offered to all patients.
Adolescent↗
[Nephrogenic adenoma after kidney transplantation].
We report five cases of nephrogenic adenoma that arose several years after cadaver kidney transplantation. Cystoscopy was performed in all patients because of gross haematuria and revealed multifocal tumorous lesions in all parts of the bladder. On admission to of hospital graft function was satisfactory in all patients. There were three female and two male patients. In all patients the therapeutic procedure consisted of transurethral resection. Only very small lesions were fulgurated. Postoperatively an indwelling catheter was left in place for 2-4 days, and after a check on kidney parameters and immunosuppressive therapy all patients were discharged. Postoperative management consisted in cystoscopy every 3 months in the first year and then every 6 months. Though the etiology of nephrogenic adenoma remains unclear, mechanical traumatization and recurrent urinary tract infection seem to be the most important factors in its development.
Adenoma↗
Laparoscopic procedure for varicocelectomy.
OBJECTIVE: To report the results of laparoscopic varicocelectomy, a new surgical technique which presents minimal risks and provides an effective management of clinical varicoceles. PATIENTS AND METHODS: Between July 1991 and November 1992, 45 laparoscopic varicocelectomies were performed in 44 patients whose ages ranged from 11 to 41 years. Endoscopic ligation, carried out according to the technique described by Palomo, was performed in 14 patients. In the remaining 30 patients ligation of 31 spermatic veins was performed according to Bernardi's procedure. RESULTS: On post-operative follow-up symptoms disappeared in all the patients treated. Two of the patients showed persistent venous reflux on colour Doppler ultrasound examination. CONCLUSIONS: The excellent identification of the anatomical structures, the minimal surgical trauma, the decrease in post-operative morbidity and the quick convalescence of the patients have made this new technique a viable alternative to routine open high ligation.
Adolescent↗