PubMed Health⌕ Search

Biomedical subjects

T Dørflinger

Publications and source records attributed to T Dørflinger.

At least 19 recordsLinked to original sources
PubMed1992

Transurethral prostatectomy compared with incision of the prostate in the treatment of prostatism caused by small benign prostate glands.

In a prospective, randomized study 60 patients with prostatism caused by small prostate glands (estimated weight < 20 g) had either transurethral prostatectomy (TURP, n = 31) or transurethral incision of the prostate (TUI, n = 29). Operating time and blood loss were significantly less in the group that underwent TUI. There were no differences between the groups in number of days with an indwelling catheter or days in hospital after operation. Eight patients in the TUI group required further operation, as did four in the TURP group, one of whom was discharged with a permanent indwelling catheter. In addition one patient developed a urethral stricture. Nine of the failures of treatment occurred within the first month. Fifty-one patients were followed up at 3 months and 47 were also seen at 12 months. Both operations significantly improved symptom scores and maximum flow rates compared with preoperatively, but the improvement in maximum flow rate was significantly better in the TURP group than in the TUI group. At 12 months TURP had also improved micturition time and voided volume, which TUI had not. Neither operation caused any significant change in sexual activity or erective potency postoperatively. Retrograde ejaculation was, however, seen in more than half of the patients in the TURP group, and only one in the TUI group. We recommend TUI for the treatment of prostatism caused by small prostate glands in patients who want to preserve normal ejaculation or are at poor surgical risk.

Aged↗
PubMed1991

[Experience from the first year of treatment of renal calculi with extracorporeal piezoelectric shockwave lithotripsy].

The experience of the first year with piezoelectric extracorporeal lithotripsy is described. One hundred and eighty-eight patients commenced treatment of 194 renoureteric stone units (a total of 328 stones). Twelve per cent required analgesics during therapy. The median number of treatments was two (1-6) and median number of shock waves 4,200 (450-24,606). One hundred and twenty-three stone units had concluded treatment and control schedules at the follow up end date. After six months, 59% of the stone units were stone-free, while 17% had residual fragments up to 2 mm, and additional 15% had residual fragments between 2 and 6 mm. Only few and insignificant complications were observed. Extracorporeal shock wave lithotripsy by the Wolf Piezolith 2300 is a well-tolerated, effective, relative painless and not complicated treatment of renal stones, and an important part of modern treatment of staghorn- and ureteric stones.

Adult↗
PubMed1988

Urodynamic and histological correlates of benign prostatic hyperplasia.

The tissue obtained from transurethral prostatectomies was evaluated histologically and correlated to the clinical findings in 81 patients with benign prostatic hyperplasia. A median of 9 hematoxylin and eosin-stained tissue slides per patient were examined, each containing from 1 to 15 curettings. The patients were divided into 3 groups according to the following histology: predominantly stromal hyperplasia (39 patients), predominantly glandular hyperplasia (29 patients), and equal proportions of stromal and glandular hyperplasia (mixed group, 19 patients). There was no significant difference among the groups in patient age and duration of symptoms. The weight of resected tissue was significantly lower in the stromal group (median 16 mg.), compared to the glandular group (median 20 gm.) and the mixed group (median 25 gm.). Additionally, 29 of the 81 patients had chronic inflammation characterized by multifocal infiltrates of lymphocytes. These patients had significantly larger prostates (median 25 gm.) compared to those without lymphocytic infiltration (median 15 gm.). Sixty-five patients had a 3-month followup examination. Preoperatively there was no difference among the groups in maximum flow at uroflowmetry but at 3-month followup the stromal group had a median maximum flow of 13 ml. per second compared to 16.8 ml. per second in the glandular group and 21.5 ml. per second in the mixed group. These findings document histologically what has been reported from a clinical perspective: the clinical prostatism/benign prostatic hyperplasia complex is a spectrum of histological entities, and the small prostate with predominantly stromal hyperplasia responds less favorably to transurethral resection as determined by urodynamic evaluation.

Aged↗
PubMed1987

The hydrodynamic consequences of transuretero-ureterostomia.

A transuretero-ureterostomy was performed in 8 pigs. In 4 pigs a non-dilated urinary tract was seen and pressure and electromyographic recordings showed that the procedure did not affect the electromyographic impulses in the recipient ureter. Impulses from the donor ureter were not transmitted to the common distal ureter. Two pigs died postoperatively from urinary leakage and two pigs developed stasis.

Anastomosis, Surgical↗
PubMed1987

The significance of age on symptoms and urodynamic- and cystoscopic findings in benign prostatic hypertrophy.

To evaluate influence of age on symptomatology and objective parameters in benign prostatic hypertrophy, preoperative findings in 199 unselected patients during one year were analysed. Symptoms of bladder instability increased with age, as did incidence of uninhibited detrusor contractions and bladder trabeculation, whereas maximum urine flow and obstructive complaints decreased, although prostatic size was the same. In the oldest age groups only was increasing prostatic size associated with increasing bladder trabeculation. Age related changes in neurological control and in the structure of the bladder may be involved, and the present results suggest age to be an important factor in the interpretation of symptoms and objective findings in prostatic hypertrophy.

Age Factors↗
PubMed1987

Significance of the extent of transurethral prostatic resection for postoperative complications.

The significance of the extent of transurethral prostatic resection for benign prostatic hypertrophy was evaluated as regards early and late postoperative complications in a prospective, randomized study. The two treatment groups were preoperatively comparable in age, incidence of urinary retention and estimated prostatic weight. In 83 cases the median weight of resected tissue was 18 (range 4-118) g, while in 84 cases the resection was less extensive--median weight 7 (1-40) g. No significant intergroup difference was found in incidence of bladder tamponade, bladder perforation, urinary tract infection or pneumonia. The blood transfusion need was greatest among the patients with complete transurethral adenomectomy of the prostate. Concerning late postoperative complications, the groups did not differ in incidence of urethral stricture, bladder neck contracture or reoperation for benign prostatic hypertrophy. Patients with preoperative urethral instrumentation had heightened risk of developing postoperative urethral stricture.

Aged↗
PubMed1987

Transurethral prostatectomy or incision of the prostate in the treatment of prostatism caused by small benign prostates.

In a prospective, randomized study 21 patients with prostatism caused by small prostates (estimated weight less than 20 gram) had a transurethral prostatectomy (TURP), and 17 patients a transurethral incision of the prostate (TUI). In the TUI group operation time and blood loss was significantly less than in the TURP group, while there was no intergroup difference in postoperative fever greater than 38 degrees C, antibiotic treatment, number of days with indwelling catheter or days of hospitalization after surgery. Three patients in the TUI group had repeated surgery. In the TURP group one patient underwent reoperation and one was discharged with a permanent indwelling catheter. Thirty-three patients had a follow-up of 3 months. Both surgical procedures significantly improved symptoms and maximum flow rates, and there was no intergroup difference of the surgical outcome. Forty-five per cent in the TURP group developed retrograde ejaculation versus none in the TUI group. In this preliminary report TUI was as effective as TURP in relieving bladder outlet obstruction caused by small prostates.

Aged↗
PubMed1987

Transurethral incision versus transurethral resection of the prostate for the treatment of benign prostatic hypertrophy. A preliminary report.

Thirty-seven patients with prostatism and an estimated prostatic weight of less than or equal to 20 g were randomly allocated to transurethral incision or resection of the prostate. Both procedures had an 85% success rate as judged by patients' personal evaluation. At 3 and 12 months follow-up a significant and identical improvement was noted in symptom score and uroflowmetry in the two groups. Postoperative catheterization time and hospital stay was only half as long in the incision group as in the resection group. No patients became impotent as a consequence of the procedures. Frequency of retrograde ejaculation was 28% in the incision group versus 100% in resected patients. Incision of the prostate is easy to perform and seems to be followed by less severe complications. It has a high patient acceptability and may cut the cost of transurethral surgery.

Aged↗
PubMed1987

Transurethral incisions of the prostate under local anaesthesia in high-risk patients: a pilot study.

Transurethral incision of the prostate under local anaesthesia was performed in 27 patients with symptoms of infravesical obstruction and an estimated prostatic weight of 20 g or less. Local anaesthesia (lidocaine 1%) was infiltrated transurethrally under the urethral prostatic mucosa using a special needle adaptable to the resectoscope. Pain control, assessed with a scoring system, was judged as good or very good by the majority of patients (25) and fair by the remaining 2 patients. No patient required conversion to another type of anaesthesia. The results of surgery as estimated by symptom score, uroflowmetry, and patients' personal evaluation were good. Transurethral incision of the prostate can be satisfactorily performed under local anaesthesia; this may be especially applicable to high-risk surgical patients. Incision of the prostate in the treatment of benign prostatic hyperplasia may be performed as an outpatient procedure in selected cases.

Aged↗
PubMed1987

Quinolone penetration into canine vaginal and urethral secretions.

Four newer quinolones (amifloxacin, ciprofloxacin, enoxacin, norfloxacin) were administered to female dogs by intravenous infusion. Drug concentrations in plasma, urine, and vaginal and urethral secretion were determined by bioassay. All four quinolones penetrated into vaginal and urethral secretion in concentrations several times higher than the MIC against common urinary pathogens, ciprofloxacin and norfloxacin reaching concentrations exceeding the simultaneous plasma concentrations. Because of their favorable antibacterial spectra, new quinolones should be investigated clinically for the treatment of recurrent urinary tract infection and bacterial vaginitis.

Animals↗
PubMed1986

3-year followup of urinary symptoms after transurethral resection of the prostate.

A total of 84 patients underwent detailed symptom analysis and urodynamic study preoperatively, and 3 and 12 months after transurethral resection of the prostate. In addition, 69 patients were contacted 3 years postoperatively for a detailed symptom analysis. These 3-year data then were compared to earlier evaluations. At 3 years 75 per cent of the patients claimed to have improvement, while 13 per cent stated that they were the same symptomatically. At the 1-year evaluation 84 per cent of the patients believed that they were improved and 10 per cent stated that they were unchanged. At 3 years 18 per cent of the patients had urge incontinence (an increase from 6 per cent at 1 year), while none complained of marked nocturia or frequency. Mean total irritative and obstructive symptoms were minimal and unchanged from the 1-year evaluation. Of the patients 33 per cent noticed decreased or absent erections and most blamed the surgery. One patient required another prostatic resection, while stricture developed in 3 and bladder neck contracture occurred in 6. We conclude that prostatic resection results in reasonable 3-year symptomatic improvement but it is hampered by other complications, including bladder neck contracture and, possibly, impotence.

Aged↗
PubMed1985

Amifloxacin distribution in the dog prostate.

Constant infusion experiments with amifloxacin, a quinoline carboxylic acid derivative, were performed in five anesthetized dogs to determine the drug concentrations in prostatic secretion (PS), prostatic interstitial fluid (PIF), prostatic tissue, and plasma (P). The experiments were carried out under steady-state conditions. Amifloxacin concentrations in PS and PIF were lower than the corresponding P concentrations, as might be expected for an acid compound. There was no significant difference between the PS/P and PIF/P concentration ratios of the drug, and none exceeded 1.0. The concentrations of amifloxacin in PS, PIF, and prostatic tissue were above the minimal inhibitory concentration values of most gram-positive bacteria causing chronic bacterial prostatitis. Clinical trials of amifloxacin seem justified.

Animals↗
PubMed1985

The significance of uninhibited detrusor contractions in prostatism.

In an attempt to identify preoperatively patients who will not benefit from prostatectomy, 84 patients with prostatism about to undergo transurethral resection of the prostate were evaluated prospectively with preoperative and postoperative symptom analysis and urodynamic examination, including cystometrograms. Of the patients 67 were followed at 3 months and 54 again at 12 months. Preoperatively, 65 per cent of the patients had uninhibited detrusor contractions, while 38 had persistent postoperative uninhibited detrusor contractions at 3 months. Patients in whom uninhibited detrusor contractions persisted postoperatively more often had unacceptable postoperative symptoms. Of the patients 13 per cent believed the symptoms to be the same or worse at 3 and 12 months. The incidence of uninhibited detrusor contractions in these patients was 57 and 71 per cent, respectively. While this finding suggests that persistent postoperative uninhibited detrusor contractions are associated with an unfavorable surgical outcome, we could not predict which patients would have uninhibited detrusor contractions following prostatectomy by use of preoperative cystometric findings together with detailed symptom analysis. Thus, we failed to define a role for preoperative cystometric screening of patients with prostatism.

Aged↗
PubMed1985

The role of antibacterial prophylaxis in urologic surgery.

The possible origins of post-TUR bacteriuria (urethral flora, prostate, bladder tumors, or contaminated irrigating fluids or instruments) are discussed. A review of the literature on antibacterial prophylaxis during TUR led to a positive assessment of its value. Preferred agents for prophylaxis of urinary tract infections include cephalosporins, extended-spectrum penicillins, ampicillin, and aminoglycosides. The value of antibacterial prophylaxis in open urologic surgery, such as prostatectomy, has not yet been clearly established, but studies have demonstrated significant benefit in patients undergoing transrectal needle biopsy of the prostate. New techniques of stone removal have not yet been thoroughly evaluated with respect to their potential for causing urinary tract infection and bacteremia. Since as many as 77 per cent of stones harbor bacteria, however, antibiotic prophylaxis is recommended. Nonurologic indications for antibacterial prophylaxis are outlined.

Anti-Bacterial Agents↗
PubMed1985

Infectious complications after instrumentation of urinary tract.

Urethral catheterization is the single most important predisposing factor in the development of nosocomial urinary tract infection. Infection rates, etiologies, and possible methods of prevention are reviewed. Cystoscopy may be followed by a transient bacteremia. It is recommended that patients with positive urine cultures who undergo diagnostic cystoscopy receive antibiotic prophylaxis, but this is not required in patients with sterile urine. The incidence of urinary tract infection following transurethral surgery in patients who have not been given prophylactic antibiotics ranges from 6 to 60 per cent. The value of antibacterial prophylaxis in TUR, is still somewhat controversial. The incidence of infection and the value of antibacterial prophylaxis in prostatic biopsy appear to be related to the technique (transperineal or transrectal) used for the biopsy. It is too early to assess the infection risks associated with relatively new urologic procedures, such as ureteroscopy and percutaneous nephrostomy. Nevertheless, any procedure that crushes or manipulates a potentially bacteria-harboring stone carries at least a theoretical risk of infection.

Bacterial Infections↗