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Biomedical subjects

W Meinhardt

Publications and source records attributed to W Meinhardt.

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

Trazodone, a double blind trial for treatment of erectile dysfunction.

OBJECTIVE: to assess the effectiveness of oral trazodone 150 mg/d for treatment of erectile dysfunction. PATIENTS AND METHODS: A double-blind, placebo controlled, multicentre trial. A run-in period of two weeks was followed by four weeks of medication. Evaluation was done by patients diary, a questionnaire and Rigiscan nightly penile tumescence and rigidity (NPTR) measurements in the second and sixth week of the trial. RESULTS: 69 patients were randomised, two patients never returned for follow-up, nine patients stopped the medication due to side-effects, so 58 patients are evaluable for effect assessment. Half of the patients suffered psychogenic impotence. There was no significant difference in the subjective results of trazodone compared to placebo. Side effects occurred more often with the use of trazodone, but this was not statistically significant. CONCLUSION: In a group of patients, that was not selected on the basis of the etiology of the erectile dysfunction, nor selected on the duration of the complaint, the efficacy of trazodone 150 mg/d, could not be shown.

Adrenergic alpha-Antagonists↗
PubMed1996

[Internal radiotherapy in prostatic carcinoma; disappointing long-term results of retropubic Iodine-125 implantation].

OBJECTIVE: To evaluate the results of retropubic implantation of 1-125 seeds in patients with carcinoma of the prostate. DESIGN: Retrospective study of records. SETTING: Netherlands Cancer Institute/Antoni van Leeuwenhoek Hospital, Amsterdam, the Netherlands. METHOD: A retrospective study of records provided follow-up data on 75 patients treated in the period 1981-1990 with implantation of 1-125 seeds by a retropubic approach, preceded by pelvic lymph node dissection. Criteria for the treatment were: To, T1 or T2 carcinoma of the prostate, prostatic volume < 40 ml, no contraindications to surgery. RESULTS: The median follow-up was 103 (60-157) months. Four patients died of complications (5%). Major postoperative complications occurred in 23% (17/75) of the cases. Residual carcinoma or distant metastasization was encountered in 43 of the 71 patients (61%). Sixteen patients died from the consequences of the prostatic carcinoma. The 5- and 10-year survival rates amounted to 74% and 42%, respectively, the cancer-specific 5- and 10-year survival rates to 85% and 67%, respectively. At the latest check-up, 18 patients were alive with tumour, 16 of them under hormonal treatment, while 21 patients were alive without indications of active prostatic carcinoma. CONCLUSION: Treatment of carcinoma of the prostate with retropubic implantation of 1-125 seeds resulted in a high incidence of local therapeutic failure and numerous postoperative complications. These results are poorer than those of total prostatectomy and external radiotherapy.

Aged↗
PubMed1996

[Good results of bladder-preserving treatment in poorly differentiated and invasive bladder carcinoma using interstitial Iridium-192 radiotherapy].

OBJECTIVE: The analyse the efficacy and safety of conservative treatment for T1G3 and T2-T3a bladder carcinoma. DESIGN: Retrospective. SETTING: National Cancer Institute/Anthoni van Leeuwenhoek Hospital, Amsterdam, the Netherlands. METHODS: Between 1987 and 1994 (7 years) 63 patients with T1G3 or T2-T3a tumours < 5 cm diameter were treated with a combined approach consisting of a transurethral resection, a course of external irradiation (30 Gy in 15 fractions) to the bladder and an Iridium-192 implant procedure. RESULTS: After a mean follow-up of 4.2 years (range 3 months to 7.2 years) 42 patients were alive without tumour. Fourteen patients died from bladder cancer and 4 patients died from intercurrent disease. Three patients were alive with non-curable cancer. Nine patients had an isolated bladder relapse. Seven of these could be salvaged with cystectomy (3 patients) or transurethral resection (4 patients). Eight patients developed distant metastases only and 7 patients distant metastases combined with bladder recurrence. The 5 year actuarial survival was 66%. Acute and late morbidity was limited and mainly related to the surgical procedure. CONCLUSION: Bladder conservation using Iridium-192 implantation is an effective and safe procedure and in selected group of patients with bladder cancer it is a good alternative to radical cystectomy.

Adult↗
PubMed1996

Effects of estrogens only on the prostates of aging men.

PURPOSE: The effects of estrogen only on prostate tissue were studied in 9 aging male transsexuals who had undergone orchiectomy. MATERIALS AND METHODS: Prostate volume was measured by ultrasound. Biopsies were stained for prostatic acid phosphatase (PAP), prostate specific antigen (PSA), Ki-67 and sex steroid receptors. RESULTS: Prostates were small, and biopsies showed PAP and PSA in most cases. No malignancy was found. Few androgen receptors were detectable but there were ample estrogen and progesterone receptors in stroma and epithelium. CONCLUSIONS: Prostates were small after long-term estrogens only. The sex steroid receptor content was considerably changed. PSA and PAP in the specimens suggested that their production does not depend on testicular androgens alone.

Acid Phosphatase↗
PubMed1996

Prostaglandin E1 with phentolamine for the treatment of erectile dysfunction.

AIM OF THE STUDY: to evaluate the feasibility of a self-injection programme for impotence with a combination of 10 micrograms prostaglandine E1 (PGE1) and 0.5 mg phentolamine. METHOD: follow-up at outpatients department with history taking, physical examination and questionnaires of 58 patients using this combination. Many patients could compare this drug combination with previously used drugs for intracavernous use. RESULTS: 42 patients started regular use. After a follow-up of 14 months, 26 are still on the programme. Drug related problems encountered: 10 patients reported insufficient erectile response, five patients have had priapism, four patients experienced severe pain, one patient developed fibrosis. CONCLUSION: the combination of PGE1 and phentolamine is very effective. The complication rate is comparable with those reported from PGE1 alone and from papaverine with phentolamine.

Adrenergic alpha-Antagonists↗
PubMed1995

[From urostoma to bladder replacement: current possibilities in urinary diversion].

OBJECTIVE: To analyse 48 urinary diversions in an oncological patient population. DESIGN: Retrospective study. SETTING: The Dutch cancer institute 'Nederlands Kanker Instituut/Antoni van Leeuwenhoek Ziekenhuis' in Amsterdam, the Netherlands. METHOD: The medical records of all patients who had a urinary diversion in the period 1989-1993 were analysed for type of diversion, indication for this specific type and postoperative complications. RESULTS: In 48 patients (24 women and 24 men with a mean age of 62.1 years) a urinary diversion was constructed because of cystectomy for bladder cancer (n = 27), cystectomy in total pelvic exenteration (13), total urinary incontinence following radiotherapy (5), urethral cancer (1) or local palliation (2). Twenty-one diversions according to Bricker, 25 continent reservoirs according to Rowland and (or) neo-bladders, I ureterosigmoidostomy and I continent access to the bladder (Mitrofanoff procedure) were done. The standard diversion according to Bricker was preferred in the following circumstances: extensive intestinal resections (also previous ones), older age, fear of incontinence or no need for continent diversion. Specific problems of the new diversion techniques were difficulties of patients with catheterising the reservoir and folic acid deficiency. All other postoperative problems were related to the extensiveness of the primary oncological procedure rather than to the diversion technique. CONCLUSION: Apart from a few contraindications such as shortage of intestine, tumour growth into the urethra and patients' inability or unwillingness to catheterize themselves, there are no objections to the new diversion techniques (continent reservoir/neo-bladder). Patients being considered for urinary diversion ought to be informed about these new techniques.

Adult↗
PubMed1995

Recurrent priapism as a side effect of zuclopenthixol decanoate.

Priapism has been described as a rare side effect of certain phenothiazine antipsychotics with high alpha1-adrenergic blocking potential. We describe a patient who in the course of clinical treatment with the thioxanthene antipsychotic zuclopenthixol (Clopixol) decanoate had several episodes of priapism. Although the alpha-blocking potential of zuclopenthixol is only moderate, it seems that in sufficient dose, or in combination with other antipsychotics, this drug is capable of inducing priapism.

Adult↗
PubMed1995

Analysis of continuous nocturnal penile rigidity measurements with the use of the RigiScan summary analysis software program.

The evaluation of the RigiScan nocturnal recordings of 324 patients, 18 to 72 years old (mean age 49 years), according to guidelines based on normal data, were compared with analysis of these recordings by using the RigiScan Summary Analysis Software Program. This enabled us to provide normal values for this program. We conclude that it should be possible to extend this RigiScan software program in such a way that a probability of normality is given to its user. In patients with corporal veno-occlusive dysfunction a significant lower total event duration was found when compared with the results of patients with normal and abnormal findings.

Adolescent↗
PubMed1994

Comparison of a mixture of papaverine, phentolamine and prostaglandin E1 with other intracavernous injections.

OBJECTIVE: evaluation of a self-injection program with a mixture of papaverine, phentolamine and prostaglandin E1 (PGE1). METHOD: a self-injection program for erectile dysfunction was started by 48 patients, using a 1-ml mixture of 4.5 mg papaverine, 0.2 mg phentolamine and 1.5 micrograms PGE1. Patients completed a questionnaire at 6 weeks and at 3 months and were followed at the Outpatients Department for an average of 1 year. RESULT: of these patients 25 had previous experience with 20 micrograms PGE1 for intracavernous use and 22 patients had previously used 30 mg papaverine with 1 mg phentolamine. None of these 3 self-injection drugs is obviously superior in its ability to induce erections. Priapism occurred twice on a total of 1,290 injections. After 1-year follow-up, 4 patients had developed problems with fibrosis of the corpora, 2 of whom had encountered this problem also in a previous self-injection program. CONCLUSION: this triple mixture has the disadvantage of causing fibrosis and priapism in susceptible patients.

Alprostadil↗
PubMed1994

Relation of intracorporal pressure and end-diastolic velocity during duplex Doppler sonography in the evaluation of veno-occlusive dysfunction.

In 37 patients 25 to 69 years old (mean age 49.6 years) with suspected 'vasculogenic erectile dysfunction', diagnosed on the basis of repeated negative reactions to intracavernous pharmacological stimulation, duplex Doppler measurements and pharmacocavernosometry were performed in one session under simultaneous pressure registration. A statistically significant difference between patients with and without veno-occlusive dysfunction was found by combining end-diastolic velocity and pressure in time. We conclude that color Doppler scanning in combination with simultaneous pressure registration can predict veno-occlusive dysfunction in 83-95% of the patients.

Adult↗
PubMed1993

The negative pressure device for erectile disorders: when does it fail?

Of 74 men with erectile dysfunction who used a vacuum device at home only 20 were satisfied with the erections achieved. The device was offered only to men who had not been helped by sexual counseling, self-injection therapy or venous surgery, and to 8 patients who had had problems with a penile implant. Fibrosis reduces the chances of success with the vacuum device, and only 2 of 14 such patients used it successfully. In all 9 patients with psychogenic impotence the device failed. Although 9 men did achieve erections with the device, they disliked it so much that they did not begin regular use. Our disappointing overall result was probably due to negative patient selection.

Adult↗
PubMed1992

The value of increased end diastolic velocity during penile duplex sonography in relation to pathological venous leakage in erectile dysfunction.

In 58 patients 23 to 71 years old (mean age 49.5 years) with suspected vasculogenic erectile dysfunction diagnosed on the basis of repeated negative reactions to intracavernous pharmacological stimulation (rigidity less than 60% when measured with the RigiScan* device) pharmacocavernosometry and duplex Doppler measurements were performed. The end diastolic velocity in the 24 patients without venous leakage ranged from 0 to 21 cm. per second (mean 7.5 +/- 6.3, standard deviation). The end diastolic velocity in the 34 patients with venous leakage ranged from 0 to 26 cm. per second (mean 9.0 +/- 6.7). In 23 of the 58 patients a peak systolic velocity of less than 25 cm. per second was found, which is an indication of arterial disease. Of 35 patients with a normal peak systolic velocity 15 were in the group without and 20 were in the group with leakage. In the group with a normal peak systolic velocity no statistically significant difference was found in end diastolic velocity between patients with and without leakage. We conclude that the end diastolic velocity during color Doppler analysis of patients with negative reactions on intracavernous pharmacological stimulation does not provide a good indication of potential pathological venous leakage.

Adult↗