[European Association of Urology guidelines on urinary and male genital tract infections]. / Synoptische Leitlinie der sexuell übertragbaren Erkrankungen (STD) mit Primärsymptomen im männlichen Genitale (S1). Leitinien der Deutschen Gesellschaft für Urologie.

Today, the classical bacteria that cause venereal diseases, e.g. gonorrhea, syphilis, chancroid and inguinal granuloma, only account for a small proportion of all known sexually transmitted diseases (STDs). Other bacteria and viruses as well as yeasts, protozoa and epizoa must also be regarded as causative organisms of STD. Taken together, all sexually transmitted infections comprise more than 30 relevant STD pathogens. However, not all pathogens that can be sexually transmitted manifest diseases in the genitals and not all infections of the genitals are exclusively sexually transmitted. Concise information and tables summarising the diagnostic and therapeutic management of STDs in the field of urology allow a synoptic overview, and are in agreement with the recent international guidelines of other specialist areas. Special considerations (i.e. HIV infection, pregnancy, infants, allergy) and recommended regimens are presented.

Correlation between the alpha 1-fetoprotein (AFP) concentrations determined in the sera and in the tumour tissues in patients with testicular tumours.

AFP was determined simultaneously in the sera and in the tumorous tissues of 10 patients with testicular tumour. Two seminomas proved to be negative with two methods. Out of the 8 non-seminomas 7 showed increased serum levels and AFP was detectable in the tumour tissues of 6 patients. Staining of AFP in the testicular tumour tissue with an indirect immunoperoxidase reaction has achieved clinical significance only in cases of metastases of unknown primary tumours or of extragonadal germinal cell tumours.

[Results of treatment following stage-dependent therapy of non-seminomatous testicular tumors]. / Behandlungsergebnisse nach stadiengerechter Therapie nichtseminatöser Hodentumoren.

The results of the treatment of 194 patients with non-seminomas were analyzed and statistically registered. The therapeutic approach is described and the cumulative probability of survival is compared according to the stages. For the total number of these tumours a cumulative 5-year-survival probability of 68.6% was calculated. In detail it reaches from 100% in clinical stage I to 39.7% in clinical stage III. The decisive change of the prognosis is between the clinical stages IIb and IIc. An adjuvant cytostatic therapy should, if performed, be aggressive. Relapses in the clinical stage I are possible and call for a critical valuation of the primary stage. A retarded cytostatic polychemotherapy should be performed only under certain conditions.

Results of systemic chemotherapy of advanced bladder carcinomas (phase II study).

At the time of operation advanced carcinomas of the urinary bladder often have developed subclinical metastases. In 20 patients with metastases, inoperable carcinoma of the bladder responded to chemotherapy with a combination of adriamycin and 5-FU. 55% of the patients experienced either a complete or incomplete remission, which lasted long in some cases. In the future, suitable combinations of chemotherapeutics could participate in improving the prognosis of advanced carcinoma of the urinary bladder.

[Possibilities for the use of exfoliative urine cytology in invasive and noninvasive bladder cancer]. / Einsatzmöglichkeiten der exfoliativen Urinzytologie bei invasiven und noninvasiven Harnblasentumoren.

In invasively growing tumours of the urinary bladder specificity and sensitivity of the urine cytology are sufficiently high with 100 and 66%, respectively, it is, however, not successful. Endoscopy and histological ascertainment are now as ever prevailing (TUR). Cytology is indispensable to the diagnosis of the carcinoma in situ of the urinary bladder. In non-invasive urothelial carcinomas the classification of the WHO after Friedell stands the test. It is also shown a better correlation to the cytological findings which more frequently become positive with growing degree of malignity. High degree of malignity, multiple tumours and positive cytology are to be valuated as particular risk factors concerning frequent relapses and their appearance of invasively growing tumours. The domain of cytology is the control of the course with curative aim of patients who were operated on in order to sustain the organ. Relapses are frequently more dedifferentiated than the primary tumour so that the recidivation is often indicated cytologically. The endoscopic demonstration of the recidivation may still be absent at the beginning. Also for controls under local chemotherapy cytology stands the test, in which cases we may not sufficiently judge the value of this treatment method due to the small number of cases.

[Flow technic for analysis of the pyelocaliceal system with regard to the genesis of urinary calculi. III. Studies of dynamic models]. / Strömungstechnische Analyse des Pyelon-Kelch-Systems hinsichtlich der Harnsteingenese. III. Untersuchungen an dynamischen Modellen.

Experiments with rubber models of the renal pelvis support the supposition that the state of flow in the pelvi-calyceal system influences the formation of urinary calculi.

[Course and stage control in testicular tumors using alpha 1-fetoprotein determination]. / Verlaufs- und Stadienkontrolle bei Hodentumoren mittels Alpha 1-Fetoproteinbestimmungen.

The serum AFP level of 52 patients with testicular tumours was measured using an ultra-micro-ELISA technique. The results confirm the importance of an uninterrupted observation of this marker in order to judge the course of the therapy of nonseminomatous testicular tumours. 85% of the patients with nonseminomatous testicular tumours showed positive values. AFP measurement is also important for staging. The assay used is precise, cheap and suitable for serial measurement.

[Flow technic analysis of the pyelo-calical system with reference to the origin of urinary calculi. II. 1st experimental results]. / Strömungstechnische Analyse des Pyelon-Kelch-Systems hinsichtlich der Harnsteingenese. II. Erste experimentelle Ergebnisse.

Theoretical considerations, part I (1), gave rise to the hypothesis that hydrodynamic disturbances in the upper urinary tract could have an influence on the formation of urinary calculi. Since it is not yet practically possible to find out the course of flow purely by calculation, experimental investigations were carried out using static glass models of the renal pelvis; the results, which are presented here, indicate the problems involved and our approach.

[Technic of percutaneous nephropyelostomy with a single-tube system]. / Technik der perkutanen Nephropyelostomie mit einem eigenen Schlauchsystem.

The technique of percutaneous nephropyelostomy with specially prepared tubes is described. The advantages are secure positioning and good drainage. The splint allows diagnostic and therapeutic intervention. With certain indications the percutaneous renal fistula represents a great therapeutic advance.

[Transcutaneous nephropyelostomy--indications, complications and results]. / Die transkutane Nephropyelostomie--Indikationen, Komplikationen und Ergebnisse.

The authors report on 34 successfully applied nephropyelostomies in 30 patients. The most frequent indication was obstruction of the uterus with retention of substances usually eliminated in the urine. The operation was carried out under local local anesthetic using a monitor. The rate of complication was very low. No deaths resulted. In the authors' opinion puncture nephrostomy is the best method of drainage in causes of obstruction with benign genesis. For carcinoma patients it must be individually decided whether this operation is indicated.

[Flow technic analysis of the pyelocalyceal system with regard to urinary calculi formation. I. Theoretical considerations]. / Strömungstechnische Analyse des Pyelonkelchsystems hinsichtlich der Harnsteingenese. I. Theoretische Aussagen.

The formation of urinary calculi is usually interpreted chemico-crystallographically. However, hydrodynamic examinations, both theoretical and experimental, show that unfavourable flow conditions in the pelvi-calyceal system may allow pathogens to remain in the appropriate zones for the length of time necessary for growth. Some light is shed on a new factor which has so far been ignored. Part I deals with theoretical considerations, while part II gives information on preliminary experiments using statistical models.

[Free peritoneal patch grafts in surgery on renal pelvis and ureter (author's transl)]. / Die Anwendung freier Peritoneallappen bei Operationen am Nierenbecken und Harnleiter.

36 operations of the renal pelvis or ureter were carried out in 35 patients. In all these cases a split stenosis or a tissue defect were covered by free peritoneal patches. Urographic controls of 30 patients showed 29 good or very good results. The following statements can be made: 1. In cases of a secondary scarred stenosis, of renal pelvic or ureteral wall defects, plastic operations of intrarenal pelvis of transsinus operations of staghorn calculi the splitting with splinting and covering by autologous tissue seems to represent a suitable operation. -- 2. As material the renal capsule, the venous wall and the peritoneum are suitable. -- 3. In cases of severe ureteral stenoses, which have to be resected, especially in cases of considerable differences of the ureteral lumen, the semicircular suture with covering should be preferred to the circular suture. -- 4. The covering of the defects by patches of autologous material reduces the time of the postoperative urinary diversion with all its dangers and the period of hospitalization. -- 5. In cases of a short covered stenoses (up to 4 cm) postoperative disturbance of the transport or urine was observed only once. The results of stenoses, longer than 4 cm, cannot yet be evaluated.

[Radionuclide function tests after transverse and longitudinal nephrotomy in coral calculi of the kidney]. / Nuklearmedizinische Funktionskontrollen nach Quer- und Längsnephrotomie bei Korallenausgusssteinen der Niere.

In 19 patients ING and scintigramme were compared before and 1 year after operations of coral calculi. 7 times a transversal, 12 times a longitudinal cutting was chosen. The evaluation of the isotope nephrogrammes did not show any significant differences. The pre- and postoperative scintigrammes in the chi 2-test resulted in highly significant differences in favour of the transversal nephrotomy. The present animal-experimental results can be confirmed clinically.

[Simulation of the urological disease picture in pre-existing basic urological disease]. / Simulation urologischer Krankheitsbilder bei vorbestehendem urologischem Grundleiden.

It is reported on four urological clinical pictures which were simulated in different conflict situations by the patient or his parents. On account of the known basic disease the diagnosing is made difficult. Possible causes are discussed. The therapy may be successful only in cooperation with a psychiatrist or psychologist. The refusing behaviour of the patients often renders impossible a final clarification.

[The circumcaval ureter--etiology, diagnosis and therapy]. / Der zirkumkavale Ureter--Atiologie, Diagnostik, Therapie.

The circumcaval course of the ureter can no more be regarded as a urological rarity. Primarily a disturbance of the development of veins in the 6th to 8th fetal week is present. A division in 2 forms of the course of the retrocaval ureter is possible. In addition to the pathologic course the type 1 still shows a disease of the precaval segment. The two forms are demonstrated with the help of own observations. According to the opinion of the authors the two types must be differentiated before operation and must be removed by different operation techniques. Associated malformations must be taken into consideration.

[Surgical treatment of plastic induration of the penis]. / Die operative Behandlung der Induratio penis plastica.

In a period of two years 16 patients with induration penis plastica were observed; 11 needed treatment. The therapy was performed according to the degree of severity with vitamin E or local injections of hyaluronidase-dexamethasone. When the conservative therapy failed the foci were removed by operation and the defect was covered by lyophilised dura. The results are rather encouraging. Disturbances of the erection could not be observed. In selected cases of successless conservative therapy the excision with covering of the dura seems to represent an accessible alternative.

Cystosigmoidostomy: indications and results.

The author reports on 15 patients with bladder-sigma anastomosis. The postoperative complications and late results up to a period of 10 years are discussed. Irreparable urethral strictures and bladder exstrophies are indications for this operation. It is only with reserve than it can be recommended for contracted bladder. According to the authors' experience and information by others, pyelonephritis and electrolyte disturbances seem to be rare complications. Because of the small number of cases a definite judgement of the method and its long-term consequences for the urinary system is not possible yet.