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  • Electronic Resource  (3)
  • Bladder exstrophy  (1)
  • Histomorphological parameter  (1)
  • Iatrogenic bladder loss, therapy of  (1)
  • 1
    Electronic Resource
    Electronic Resource
    Continent urinary diversion and bladder augmentation in children: the Mainz pouch procedure (1989)
    Springer
    Pediatric nephrology 3 (1989), S. 68-74 
    Details
    ISSN: 1432-198X
    Keywords: Continent urinary diversion ; Bladder augmentation ; Young-Dees technique, modified ; Ileocaecal pouch ; Iatrogenic bladder loss, therapy of
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The formation of a bowel reservoir of large capacity at low pressure by using small and large bowel (ileocaecal segment) has proved reliable for achieving continent urinary diversion (n=80), for bladder augmentation (n=42) as well as for total bladder replacement (n=24). Encouraged by the results we obtained in our adult patients, we have used this technique during the last 3.5 years in 29 children. Indications for urinary diversions in children have been: neurogenic bladder with diplegia (n=8), bladder exstrophy (n=2), traumatic loss of the bladder (n=1), urogenital sinus (n=1) and rhabdomyosarcoma of the prostate or bladder (n=2). Bladder augmentation was indicated in 6 children with iatrogenic bladder loss, in 5 children with neurogenic bladder without diplegia and in 4 boys with incontinent epispadias or exstrophy. In children with bladder exstrophy or incontinent epispadias, continence was achieved using a modified Young-Dees technique with formation of a long intra-abdominal muscular tube made out of the bladder plate or the low-capacity bladder. The capacity of the urinary reservoir was guaranteed by bladder augmentation or bladder replacement with an ileocaecal pouch. During a mean follow-up period of 26 months (bladder augmentation) and 21 months (continent diversion) there was only one postoperative complication (intussusception ileus) which required operative revision. Two children had to undergo reoperation because of nipple problems. Follow-up, with monitoring of biochemical and metabolic parameters, is necessary to show whether this technique will provide a long-term successful solution for these problems.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00859629
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    Paper (German National Licenses)
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  • 2
    Electronic Resource
    Electronic Resource
    Social integration, sexual behaviour and fertility in patients with bladder exstrophy —a long-term follow up (1996)
    Springer
    European journal of pediatrics 155 (1996), S. 678-683 
    Details
    ISSN: 1432-1076
    Keywords: Bladder exstrophy ; Interpersonal relations ; Sexual behaviour ; Fertility and education
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract After primary bladder closure or urinary diversion, other factors apart from the reconstruction itself gain importance for individuals with the exstrophy-epispadias complex: social integration and, after reaching puberty, sexuality and fertility. Between 1968 and July 1994 115 patients with bladder exstrophy or incontinent epispadias underwent surgery at our institution. A total of 104 patients could be followed, 2 of whom died in the meantime. Of the remaining 102 patients 48 attend school, 4 are in college, 40 have completed or are currently undergoing vocational training, 3 are unemployed, 1 lives in a therapeutic centre and 6 are younger than 6 years of age. A total of 95% of the patients with continent urinary diversion are continent day and night, whereas only three of five patients with a sling plasty (incontinent epispadias) or with primary bladder closure followed by a Young-Dees procedure are continent. None of the patients showed deterioration of renal function. In 25 females the external genitalia were reconstructed. Fixation of the uterus was done in 13 to correct or prevent uterine prolapse. Of the 17 women older than 18 years of age with genital reconstruction, 16 are satisfied with the cosmetic result. All adults engage in sexual intercourse. Five women have delivered seven children by Caesarean section. Of the 35 male adults 32 underwent reconstruction of the external genitalia and 34 males achieve erection. One developed necrosis of the penis early in life following primary bladder closure performed at an outside hospital. Penile deviation was present in 11 of the 32 patients with genital reconstruction, which is distressing in only 2. Thirty patients are satisfied with the cosmetic result. After genital reconstruction 9 males developed epididymitis, necessitating two orchiectomies and three vasectomies. No patient with reconstruction of the external genitalia can ejaculate normally or has fathered children, whereas ejaculation was normal in the three men who did not undergo genital reconstruction and in two patients prior to post-pubertal reconstruction. Furthermore, two of these three men have fathered four children.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01957152
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    Paper (German National Licenses)
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  • 3
    Electronic Resource
    Electronic Resource
    Vergleich der DNS-Analyse mit histomorphologischen parametern beim Magenkarzinom (1992)
    Springer
    Langenbeck's archives of surgery 377 (1992), S. 4-8 
    Details
    ISSN: 1435-2451
    Keywords: Stomach carcinoma ; DNA content ; Histomorphological parameter
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung Am Tumormaterial von 103 Patienten nach kurativer Resektion wegen eines Magenkarzinoms wurde ein Vergleich des DNS-Gehaltes der Tumorzellen mit den histomorphologischen Parametern vorgenommen. Es zeigte sich, daß der DNS-Gehalt mit den histomorphologischen Parametern korreliert, ohne jedoch eine weitere prognostische Aussage zu ermöglichen. In der multivariaten Regressionsanalyse zur Beurteilung der prognostisch unabhängigen Variablen war demzufolge die rezidivfreie Überlebenszeit allein von der Infiltrationstiefe des Tumors und dem Lymphknotenstatus abhängig. Keinen Einfluß auf die rezidivfreie Überlebenszeit hatten der histologische Tumortyp, die Tumorlokalisation, das Operationsverfahren und der DNS-Gehalt.
    Notes: Summary After curative resection of stomach carcinomas (adenocarcinomas: n=58, signet ring cell carcinomas: n = 24, undifferentiated carcinomas: n = 21) the DNA content of the tumor cells was compared with the histomorphological parameters. There was a correlation between the DNA content and the histomorphological parameters. The DNA analysis had no additionally prognostic influence. In the multivariate regression analysis the prognosis depended on lymph node status (p=0.0009), pT-stage (p = 0.02), tumor localization (p = 0.03) and the histological type (p=0.05). The prognosis was independent of the DNA content. Furthermore, neither did the degree of differentiation, the operative procedure, the safety distance, the size of the tumor, the sex nor the age of the patient have any influence on the prognosis.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00186141
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    Paper (German National Licenses)
    Fulltext
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