Transurethral resection for bladder cancer using 5-aminolevulinic acid induced fluorescence endoscopy versus white light endoscopy.

Purpose: Endoscopy done under fluorescence induced by 5-aminolevulinic acid has proved to be a procedure with high sensitivity for detecting transitional cell carcinoma of the bladder. In this multicenter, parallel group, phase III study we compared 5-aminolevulinic acid fluorescence endoscopy guided transurethral bladder resection with transurethral bladder resection done using only white light endoscopy. The proportion of tumor-free resected cases in the 2 groups was evaluated.

Second malignancies following pure seminoma.

Purpose: Second malignancies in patients with pure testicular seminoma were studied in order to look for adverse late effects of treatment and to study the significance of second malignancies during follow-up.

Patients, Methods: In a multicentric investigation, 839 consecutive patients with pure testicular seminoma were observed for a median follow-up of 3.9 years.

[Complications with portable ESWL--a multicenter study].

An increasing number of urological departments are taking advantage of portable lithotripsy units if a system is not available in their clinic or purchase does not seem feasible; however, infrequent application of ESWL in such a setting should not increase the rate of complications. From 1993 to 1995, up to 54 urological departments using mobile lithotripsy units collected data concerning all major complications. A total of 12,901 treatments were performed which led to 85 major complications (0.

Successful treatment of stage-IIIB seminoma with single-agent carboplatin therapy.

Single-agent carboplatin chemotherapy has recently been introduced into the therapy of limited seminoma. Because of poor compliance due to Down's syndrome we successfully treated a 32-year-old man with relapsed stage-IIIB seminoma with a dose-modified carboplatin monotherapy schedule leading to complete remission even after a follow-up of 4 years.

The Dornier-Lithotripter U30. First clinical experience.

Objective: It can be claimed that ESWL is an optimal alternative for ablation of calculi by external shock waves. The new developments in ESWL have focussed more on the economic aspects of treatment rather than enhancing its efficacy or reducing the side effects. Since August 1993, the prototype of the Dornier Lithotripter U-30 was used at the Department of Urology of the Katharinen hospital in Stuttgart.

The Dornier Lithotripter U 30: first clinical experience.

Since August 1993, the Dornier Lithotripter U 30 has been used at the Department of Urology of the Katharinenhospital in Stuttgart. The machine consists of an endourologic table with an X-ray unit mounted on a C-arm and an electromagnetic shockwave source equipped with an inline ultrasound scanner and oblique shockwave coupling with a water cushion. Stone location can be performed with fluoroscopy or simultaneous ultrasound scanning.

[Current status of extracorporeal shockwave lithotripsy].

Extracorporeal shockwave lithotripsy has become an established standard procedure for the treatment of nephrolithiasis. Almost 100 lithotripters are installed in large and medium-sized urological departments in Germany. The number of treatments per year averages 660 ESWL sessions per hospital.

[Bilateral ureteral rupture in a child after blunt trauma].

We report a case of bilateral subpelvic ureteral disruption in a child following blunt trauma sustained during a road traffic accident. This case illustrates the importance of coordinated interdisciplinary management in the primary diagnosis of patients with blunt abdominal trauma. The pathomechanism of traumatic ureteral avulsion is also discussed.

ESWL: current aspects.

Ten years after the first application, extracorporeal shock wave lithotripsy (ESWL) has gained world-wide acceptance as first choice therapy of urinary calculi. The introduction of different shock wave sources, shock wave coupling and imaging techniques have influenced treatment comfort, need of anesthesia, and costs of the device, but did not improve efficacy of treatment regarding complete disintegration of calculi without need for secondary treatments. Therefore the optimal device for lithotripsy providing high efficacy, no need for anesthesia, and inducing minimal tissue trauma has not been found yet.

Role of human chorionic gonadotropin in patients with pure seminoma.

Human chorionic gonadotropin (beta-hCG) and alpha-fetoprotein (AFP) are widely established specific and sensitive tumor markers for nonseminomatous testicular cancer. In 106 patients with pure seminoma, a highly sensitive method detected beta-hCG both before and repeatedly during therapy. The low detection limit of the test (0.

Lasertripsy of ureteral calculi using pulsed-dye laser with automatic shut-off after tissue contact.

Since June 1991, 54 patients with ureteral calculi (13 upper, 18 middle, and 23 distal) have been treated in our department using a flashlamp-pumped tunable-dye (rhodamine 6G) laser with a wavelength of 594 nm with an energy at the distal fiber tip between 30 and 120 mJ. The fiber core diameters were 200 and 300 microns. By spectral analysis of the reflected light, immediate shut-off of the laser was obtained after tissue contact.

Intra- and perivesical tumor growth in preoperative staging of bladder cancer: the role of transrectal ultrasonography and high resolution magnetic resonance imaging.

Bladder tumors were staged preoperatively before and/or after M-VEC poly-chemotherapy using transrectal ultrasonography and magnetic resonance imaging in 46 patients. The resultant findings were each compared with histomorphologic results. The sensitivity of both methods compared with pathohistology was 88%.

Spontaneous splenic rupture in a patient with multiloculated signet ring cell carcinoma of the urinary bladder.

We report a case of spontaneous splenic rupture caused by signet ring cell carcinoma of the urinary bladder. Rupture of the spleen usually stems from trauma and only rarely from solid tumor metastasis. Early diagnosis by ultrasound is essential since mortality is high without prompt splenectomy.

ESWL and the future of stone management.

Based on optimal efficacy regarding disintegration and stone clearance, combined with minimal invasiveness, extracorporeal shockwave lithotripsy (ESWL) represents the first choice therapy for urolithiasis. Further developments in ESWL have related more to economic aspects than to improvement of disintegration efficacy or reduction of side effects. Routine indications for ESWL are well known and widely accepted.

Tissue polypeptide antigen for monitoring of advanced bladder cancer after MVEC chemotherapy.

58 patients with advanced bladder cancer were treated with MVEC chemotherapy (methotrexate, vinblastine, epirubicin and cisplatinum). 22 patients suffered from locally advanced disease (pT3-4 M0 N0), in 20 patients regional lymph node metastases were found (pT3-4 N1-3 M0). In 16 patients distant metastases were noted (pT1-4 N0-1 M1).

Urologic experience with the Dornier multipurpose lithotripter MPL 9000.

From March, 1988 until October, 1989, 502 patients with 603 stones were treated with the Dornier multipurpose lithotripter MPL 9000. Sixty-six percent of the stones were situated in the calix, 29.6% in the renal pelvis, 3% in the upper, and 1% in the distal ureter; 18.

Minimal invasive therapy of ureteral calculi using modern techniques.

In a one year period from July 1985 to July 1986, 224 upper and 62 distal ureteric calculi were treated. In situ ESWL represents the therapy of first choice for upper and distal ureteric calculi with a success rate of 81% and 76%, respectively. Retrograde mobilization of the calculus was used only in cases where in situ ESWL was impossible because of localization difficulties (obesity, stone close to the spine, skeleton deformation).

Minimally invasive treatment of ureteric calculi using modern techniques.

Between July 1985 and July 1986, 226 upper and 62 distal ureteric calculi were treated. In situ extracorporeal shockwave lithotripsy (ESWL) is the treatment of choice for upper and distal ureteric calculi, with success rates of 81 and 76% respectively. Retrograde manipulation of the calculus was undertaken only when in situ ESWL was impossible because of difficulty in localisation.

ESWL for ureteral calculi. Using the Dornier HM 3, HM 3+ and Wolf Piezolith 2,200.

In a one year period from July 1985 to July 1986 226 upper and 62 distal ureteric calculi were treated. In situ ESWL represents the therapy of first choice for upper and distal ureteric calculi with a success rate of 81% and 76% respectively. Retrograde mobilization of the calculus was used only in cases where in situ ESWL was impossible because of localization difficulties (obesity, stone close to the spine, skeleton deformation).