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T Hanus

Publications and source records attributed to T Hanus.

At least 37 records · Page 2Linked to original sources
PubMed1997

[An artificial urinary bladder sphincter for men].

Urinary incontinence is a condition with involuntary escape of urine and causes not only medical but also social and hygienic problems. One of the causes of incontinence is insufficiency of the urethral closure mechanism which in men is usually caused by previous prostatectomy or neurogenic dysfunction of the lower urinary pathways. The method of choice is the application of an artificial sphincter (model AMS 800) to the bulbar urethra or cervix. The authors applied an artificial sphincter in 1993-1996 to one boy and 14 men aged 11-72 years. The basic components of the artificial sphincter of the urethra-AMS 800 is a cuff, balloon and pump. The whole system is filled with isotonic solution Omnipaque 300, the cuff which is 45-80 mm long is placed either round the bulbar urethra from a perineal approach or round the cervix by a retropubic approach. The pump is placed beneath the skin of the scrotum and the balloon is in a perivesical position. All parts of the AMS are connected by tubes. Because of infectious complications the authors had to explant the sphincter in two patients. In one patient it was necessary to add another cuff. The perineal approach is simpler, but is associated with a higher risk of erosion of the urethra. Patients with a neurogenic bladder had more complications than those after prostatectomy. Despite the fact that the method and aid is expensive, the treatment is very effective and makes the patients independent on other aids for incontinent patients.

Adolescent↗
PubMed1997

[Iatrogenic lesions of the ureter in women].

The changing etiology of ureteral lesions is associated with the expanding spectrum of ureteroscopic, gynaecological, coloproctological and vascular operations. During 1989-1995 the authors treated 60 women with a ureteral lesion, mostly in conjunction with gynaecological operations (37 patients). The assessment of the diagnosis was sometimes delayed. The most frequent initial treatment was the establishment of percutaneous puncture nephrostomy (in 47 instances before delayed reconstruction). The authors discuss the time interval between the development of the ureteral lesion and its reconstruction. The most frequent treatment was ureterorhaphy, ureterocystoneoanastomosis or Boari's flap.

Abdomen↗
PubMed1997

[Vesicovaginal and urethrovaginal fistulae].

The authors discuss treatment of vesicovaginal fistulae (VVF) in 36 patients and in six patients urethrovaginal fistulae treated in 1989-1995. The most frequent cause of VVF were iatrogenic lesions after hysterectomy. Occlusion of the fistula was performed 12x by the transvesical approach, nine times by a combined transperitoneal and vaginal approach, four times by a transvesical and transperitoneal approach, eight times by the vaginal route only and three times the authors had to make a continent derivation of urine of the sigma-rectum "pouch" type. Continence by primary operation was achieved in 86%, in urethrovaginal fistulae one reoperation was necessary. With the development of radical operations in the lesser pelvis in women the incidence of iatrogenic lesions is rising slightly, however when the technique of minimal invasive reconstruction urology is used, the prognosis of occlusion of fistulae is favourable.

Adolescent↗
PubMed1997

[Pregnancy after urinary bladder augmentation].

Pregnancy after augmentation enterocystoplasty is an increasingly frequent phenomenon in women with congenital anomalies or a neurogenic urinary bladder. Possible complications during pregnancy and the period near delivery and their treatment is described by the authors, based on the case-history of a 22-year-old primipara after ileocoecal augmentation. The authors summarise the so far scarce data reported in the literature.

Adult↗
PubMed1997

[Profile of radical retropubic prostatectomy during a 5-year period].

The authors evaluated 165 radical retropubic prostatectomies, which have been performed at the Department of Urology of the 1st School of Medicine, the Charles University and the General Faculty Hospital in Prague, from January 1992 until half of April 1997. After more precise indication criteria have been implemented, even more per cent of patients are operated in clinical T1c stage (only in this year it was up to 45%). Out of all, in 56 patients PSA exceeded 20 ng/ml, in 46 patients, there was proved seminal vesicles invasion and in 29 patients, there have been disclosed regional lymph node involvement. The postoperative decline of PSA below the 4.0 ng/ml within three months was recorded in 80% of patients with seminal vesicles involvement, but only in 69.2% of patients with nodal invasion. It may indicate the worse prognosis of latter patients. Nowadays we perform the routine peroperative staging lymphadenectomy provided PSA exceeds 10 ng/ml preoperatively and in case of presence of cancerous cells in regional lymph nodes, we do not proceed in the operation and the patient is indicated to another therapeutical modality.

Humans↗
PubMed1997

[Partial replacement of the ureter with the appendix in Ormond disease --case report].

Surgical repair of a damaged portion of the ureter cannot always be resolved by mere ureterolysis or resection of the ureter and its "end to end" anastomosis, but it is not always resolved by complete replacement of the ureter by an ileal loop. The presented case-record describes the partial replacement of the abdominal portion of the ureter (9 cm) by an excluded appendix in a 59-year-old patient with a solitary right kidney, suffering from morbus Ormond.

Appendix↗
PubMed1997

[Seminal vesical abscess and ipsilateral agenesis of the kidney].

So far only about 20 cases were published on abscesses of the seminal vesicles and only two patients suffered also from agenesis of one kidney. The presented case-history pertains to a patient with a history of haemospermia and a cystically dilated formation in the region of the posterior urethra on ascendent urethrocytography. The solution was surgery-revision and extirpation.

Abscess↗
PubMed1997

[Renal oncocytoma].

Renal oncocytomas are infrequent solid tumours of the renal parenchyma. Usually they are diagnosed incidentally. As to treatment conservative surgery predominates. The authors submit their experience with the treatment of eight patients during the past two years where they performed five times transperitoneal nephrectomy and three times resection of the tumour.

Adenoma, Oxyphilic↗
PubMed1997

[Primitive neuroectodermal tumors of the minor pelvis in women--case report].

A primitive neuroectodermal tumour (PNET) of the minor pelvis is a rare malignant small-cell tumour developing from the neural groove. It metastatizes into the lungs, bones, liver and brain. Treatment involves radical surgical extirpation followed by chemotherapy and actinotherapy. The author presents the case-history of PNET of the pelvis minor in a 33-year-old woman.

Adult↗
PubMed1997

[Complications of urinary diversion after cystectomy in bladder carcinoma].

Urinary diversion following cystectomy on account of carcinoma of the bladder are pretentious surgical operations involving the risk of early and late complications. The authors made a retrospective analysis of 198 cases. Death during the early postoperative period was recorded in 3 patients (2x ileus and 1x pulmonary embolism). Other early complications were dehiscence of the intestinal anastomosis (3x), dehiscence of the skin would/3x) and pneumonia (3x). Clinically relevant late complications were ileus due to adhesions (4x), stenosis of the ureteroenteric anastomosis (21 ureteroenteric units and urolithiasis (6x). Metabolic acidosis was recorded frequently (19x). Complications were more frequent in patients with advanced disease and in a poor biological state.

Adult↗
PubMed1996

[A continent urinary diversion with a detubularized rectum and sigmoid (sigmo-rectal pouch)].

BACKGROUND: The continent reservoir is an ideal urinary diversion in patients after cystectomy. The artificial closing mechanism construction in these reservoirs is rather complicated and the results are uncertain. The objective of the present work is to assess own experience with a relatively simple rectosigmoid reservoir created by a method described by M. Fisch. METHODS AND RESULTS: Since 1992 till 1995 the sigma-rectum detubularized reservoir was performed in 30 patients. The intricating bladder cancer was an indication for the operation in 27 patients and the other bladder diseases in 3 patients. The patients age ranged from 18 to 75 years. Diurnal continence was achieved in all 30 patients. 12 of them have to awake during the night to evacuate the reservoir 1 to 3 times. CONCLUSIONS: Sigma-rectum pouch is a good form of cintinent diversion in such patient, which are not suitable for orthoscopic neobladder because of oncologic limitation or bad general conditions. The patients tolerate the procedure very well, heal and adapt quickly to new evacuating mechanisms.

Adolescent↗
PubMed1996

[Orthotopic reconstruction of the urinary bladder with preservation of urethral function in women after cystectomy].

Since 1993 till 1995 cystectomy preserving the urethra in twelve female patients with infiltrating bladder cancer was performed. The patients age ranged form 32 to 72 years. The female urethra sparing radical cystectomy includes removal of the bladder together with the uterus and ovaries and resection of the anterior vaginal wall. The condition for preserving of the function of the urethra is its integrity including corresponding innervation and intact pelvic floor. The neobladder is made of a detubularized ileal segment and anastomosed with the urethra. Diurnal continence was achieved in 11 patients, one of them has so called hypercontinence with residual volume of 300 ml. One patient suffers from stress incontinence. The functional characteristics of the orthotopic neobladder in the operated females are very favourable. The risk of further affliction of the retained urethra with an urothelial tumor is possible to influence by a choice of selected patients for the overmentioned procedure.

Adult↗
PubMed1996

[Interstitial cystitis].

Interstitial cystitis (IC) is a complex of painful mictional symptomatology of unknown etiology. Is occurs more frequently in women. By cystoscopy the ulcerative and non-ulcerative form is differentiated. A typical diagnosis symptom are glomerulations during cystoscopy under general anaesthesia. There are diagnostic criteria which rule out IC. Histopathologically the following are differentiated: classical IC with proliferation of mastocytes in the detrusor, detrusor myopathy and eosinophil cystitis. Treatment includes intervesical instillation of various substances, transurethral procedures or supratrifonal cystectomy, incl. enterocystoplasty.

Adult↗
PubMed1989

[Perfusion pyeloureterography with manometry].

The degree of obstruction of the upper urinary pathways is assessed from the relative pressure value which is calculated by subtracting the intravesical pressure from the intrapelvic one. The intrapelvic pressure is measured after puncture of the renal pelvis by perfusion manometry. By using a contrast substance it is possible to perform at the same time antegrade pyeloureterography. The author presents experience assembled with 20 patients.

Adolescent↗
PubMed1989

[A continent artificial urinary bladder from detubulized ileal or ileocecal segments].

At present, the attention of reconstructive surgery is focused on continent reservoirs constructed from detubulized intestinal segments. Based on two-year experience, the authors present an analysis of the results obtained from 26 patients with continent ileal or ileocecal neovesica. These operations improve the quality of life and guarantee more safety. In most cases, the function of the neovesica approximates the natural physiological condition. The authors also discuss the economical aspect as regards the high cost of materials needed for ureteroileostomy--annual expenditure on flanges and bags (firm Pfizer) per 1 person amounts to 32,000 Czechoslovak crowns fco. The continent neovesica does not narrow the therapeutical spectrum of urinary deviations, on the contrary, it extends them, which is why the authors prefer to use it.

Adult↗
PubMed1989

Secondary megaureters in children: results of treatment.

Treatment results of 74 secondary megaureters in 48 children (25 males and 23 females with one segmental and 73 total megaureters) are presented. The left side prevailed over the right one (ratio 1.4:1.0); the lesion was bilateral in 54%. Forty-two children (88%) were treated surgically. Eleven megaureters (15%) were modelled. and 2 megaureters had to be reoperated. The follow-up period ranged between 7 months and 9.5 years. Urinary infection was reduced from 80 to 54%, chronical renal failure was reduced from 65 to 54%, and the occurrence of arterial hypertension remained unchanged. Excellent results were achieved in 27%, they were satisfactory in 60% and poor in 13% of the megaureters.

Adolescent↗
PubMed1989

[Urodynamics of the continent neovesical].

The authors present an account of urodynamic findings in 14 patients after replacement of the urinary bladder by a detubulized ileocoecal or ileal segment sutured in the shape of a pouch. An ileocoecal pouch (so-called Mainz pouch) was anastomized in nine patients to the urethra and in three it was led into the umbilicus by an ileal valve. Through this valve the patients are intermittently catheterized. In two patients an ileal neovesica stitched to the urethra was created. After a 1-12-months interval following operation the authors evaluate the urinary flow (average 12 ml/s), the residue after micturition (0-170 ml), the intravesical pressure at rest (mean 17 cm H2O), the compliance of the neovesica (mean 47 ml/cm H2O), the urethral closing pressure (mean 51 cm H2O) and continence. This type of replacement meets the demands of a large-volume, low-pressure reservoir, it has also a satisfactory evacuating ability and ensures satisfactory continence.

Adult↗