76
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Benedic M, Röttger P, Steffens J. Progredientes Lipogranulom des Penis nach subkutaner Paraffininjektion. Aktuelle Urol 2008. [DOI: 10.1055/s-2008-1054303] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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77
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Steffens J. 13. Kinderurologisches Symposium. Urologe A 2006; 45:749-52. [PMID: 16788792 DOI: 10.1007/s00120-006-1064-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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78
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Abstract
Economic requirements and the wishes of the patients have led to a clear increase in outpatient surgery. Besides the observance of legal conditions, a well-devised structure of organization is the prerequisite for a frictionless realization. The operating surgeon decides about the suitability of the patient, is responsible for a course without complications and takes on the postoperative care. The most frequent operations are circumcision, orchidopexy and the repair of inguinal hernias. Outpatient surgery stands out for a low rate of complications and a high satisfaction of the patients.
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79
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Steffens J, Breitling P. Traumatologie. Urologe A 2005; 44:861-2. [PMID: 15937682 DOI: 10.1007/s00120-005-0850-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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80
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Lotz J, Meyer GP, Wollert KC, Lippolt P, Steffens J, Hertenstein B, Galanski M, Drexler H. Intrakoronare Knochenmarkzelltherapie nach akutem Myokardinfarkt: 18-Monats-Follow-up der randomisierten BOOST-Studie mittels MRT-Volumetrie. ROFO-FORTSCHR RONTG 2005. [DOI: 10.1055/s-2005-867442] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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81
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Heller G, Langen PH, Steffens J. [Laser acupuncture as third-line therapy for primary nocturnal enuresis. First results of a prospective study]. Urologe A 2004; 43:803-6. [PMID: 15184983 DOI: 10.1007/s00120-004-0592-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Laser acupuncture is a painless, non-invasive, and cost effective treatment for children with therapy resistant monosymptomatic nocturnal enuresis. This kind of acupuncture is an alternative treatment with positive results. Currently, we are treating 24 children (22 males, 2 females) out of a planned 200 children aged between 5 and 12 years. These patients have had a classic monosymptomatic nocturnal enuresis. Up to now, school medicine therapy has been unsuccessful. Over 3 months, we treated the children once a week with acupuncture, inserting at the following points: medial Ren 3, bilateral Ma 36, bilateral Mi 6, bilateral Bl 33, medial Ren 6, medial Ex B5.A better enuresis frequency was achieved in 21 out of the 24 children (87.5%). Before the end of the 12th treatment, six of the 24 children (25%) were completely dry and 16 (66.6%) had an enuresis frequency reduced by more than half after the 12th treatment.
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82
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Abstract
In a prospective study, from September 2000 to September 2001, all ureteroscopies ( n=140) were performed under local and intravenous patient controlled analgesia using continuous infusion of remifentanil (Ultiva). The dosage of 0.15 micro g/kg/min was adapted to changing intraoperative pain (range 0.08-0.30 micro g/kg/min). Preoperative sedation with midazolam 2 mg was given 5 min prior to ureteroscopy. The efficacy of monitored anesthesia care ("Big MAC") was quantified by the patient using a visual analogue pain scale. A total of 97.1% (136/140) of the procedures were performed and finished under remifentanil. Only four male patients underwent conversion to general anesthesia due to insufficient analgesia. All but one patient would choose remifentanil again for first line anesthesia. Significant differences in pain scale values were noticed for male/female patients and ureteroscopies above/below the iliac vessel crossing. Side effects were rare being mainly hypoxic events (pO(2)<90% in 5.1%). Indication, intraoperative procedure, average surgery time (24 min), complications and primary success rate (96.6/90/63.3% stone free for distal/mid/proximal ureter, respectively) did not differ from the control group under general anesthesia. Ureteroscopies with remifentanil are safe, universally applicable because of refifentanil's organ independent esterase metabolism and as effective as general anesthesia. There is no need for PACU stay for patients due to the ultra-short drug half-life, and therefore remifentanil is cost effective and perfect in an outpatient setting.
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83
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Abstract
As one of the most frequently performed operations circumcisions can entail not only typical but also rare complications with possibly fatal consequences. The following areas are of particular importance: legal aspects of the operation, indication for an operation, pre-operative information, post-operative surveillance and after-care. The amount of circumcisions carried out in different European countries vary widely. This shows a difference in indication assessment, which may suppose that a number of operations are not necessary.
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84
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Steffens J. 12. Kinderurologisches Symposium Eschweiler 25.?26.4.2003. Urologe A 2003. [DOI: 10.1007/s00120-003-0399-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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85
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Schuster D, Pruss P, Langen PH, Steffens J. [Ovarian torsion--an unusual cause of childhood urinary retention]. Aktuelle Urol 2003; 34:52-4. [PMID: 14566702 DOI: 10.1055/s-2003-37560] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Acute urinary retention in children may be associated with a broad spectrum of different causes. Acute appendicitis or acute ovarian torsion are rare and complicate the diagnosis. The case of a 6-year-old girl with urinary retention caused by ovarian torsion is reported, in which clinical presentation showed nonspecific complaints and ultrasound demonstrated a retrovesical mass. The long-standing ovarian torsion could only be diagnosed by laparotomy. This case once again demonstrates possible difficulties in obtaining a correct diagnosis, especially when imaging techniques reach their limits. Here, the anatomical structures had become so altered by adhesions of the omentum that they were no longer identifiable, rendering the advantageous, non-invasive laparoscopy ineffective. As a result, laparotomy became the most accurate and reliable method for obtaining a correct diagnosis. The occurrence of acute urinary retention with ovarian torsion can be explained by an earlier disturbance of the vegetative nervous system.
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86
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Hohenfellner R, Molling L, Steffens J. [Diverticle of the female urinary tract]. Aktuelle Urol 2002; 33:33-5. [PMID: 14562238 DOI: 10.1055/s-2002-19983] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
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87
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Steffens J, Langen PH, Molling L, Hohenfellner R. [Not Available]. Aktuelle Urol 2002; 33:71-7. [PMID: 14562245 DOI: 10.1055/s-2002-19985] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
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88
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Haben B, Rausch S, Steffens J. Enuresis und kindliche Harninkontinenz - Vergleich zweier Behandlungskollektive. Aktuelle Urol 2001. [DOI: 10.1055/s-2001-19260] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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89
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Gülden H, Langen PH, Hiebl R, Karypiadou M, Steffens J. Patientengesteuerte Applikation von Remifentanyl während der extrakorporalen Stoßwellenlithotripsie. Aktuelle Urol 2001. [DOI: 10.1055/s-2001-14361] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
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90
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Steffens J, Langen PH, Haben B, Hiebl R, Steffens L, Polsky MS. Politano-leadbetter ureteroneocystostomy. A 30-year experience. Urol Int 2001; 65:9-14. [PMID: 10965295 DOI: 10.1159/000064827] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
PURPOSE We evaluated the results and complications of children with reflux treated with the Politano-Leadbetter ureteroneocystostomy. In particular, we evaluated pre- and postoperative renal parenchymal scarring and the late development of hypertension. MATERIALS AND METHODS From 1965 through 1996, 666 children (814 renal units) were reimplanted by nine urologists. The average postoperative evaluation was 10.3 years, and 68.8% of all patiens were evaluable 10 years after surgery. RESULTS Postoperative complications occurred in 7.8% and consisted of small bowel serosal injury (0.3%), vesicocutaneous fistula (0.4%) and retrovesical hematoma (0.3%). Persistent reflux was the most common postoperative complication (5.6%) and was found to occur in higher grades of vesicorenal reflux. Ureteral stricture and hydronephrosis were seen in 1.2% of children, and was corrected with a secondary reimplantation. Late stricture occurred in all but 1 patient (0.2%). Renal parenchymal scarring was found in 21.2% of patients preoperatively, and this increased over time postoperatively to 27.7%. In 8.7% of these patients, hypertension developed between the 6th and 17th postoperative year. In 6.1%, nephrectomy was carried out, which normalized blood pressures in 87. 9% of these 30 patients. CONCLUSIONS The Politano-Leadbetter ureteroneocystostomy was successful in 93.6% of all 814 renal units surgically treated. The operation is safe, but can be associated with late development of hypertension despite correction of the reflux.
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91
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Filla K, Haben B, Röttger P, Steffens J. Die arterielle Verschlusskrankheit der Harnblase - Arterial Occlusion of Urinary Bladder Vessels -. Aktuelle Urol 2001. [DOI: 10.1055/s-2001-10741] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
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92
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93
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Steffens J, Kosharskyy B, Hiebl R, Schönberger B, Röttger P, Loening S. Paraffinoma of the external genitalia after autoinjection of vaseline. Eur Urol 2000; 38:778-81. [PMID: 11111201 DOI: 10.1159/000020379] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Five cases of sclerosing lipogranulomas of the external genitalia after previous injection of vaseline are presented. The public should be informed about the disastrous effects of paraffin injections and the importance of a radical but organ-preserving surgical treatment.
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94
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Steffens J, Humke U. Niere und Nebenniere - Nierenteilresektion in kalter Ischämie*** -. Aktuelle Urol 2000. [DOI: 10.1055/s-2000-8363] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
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95
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96
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Karger N, Biederer J, Lüsse S, Grimm J, Steffens J, Heller M, Glüer C. Quantitation of renal perfusion using arterial spin labeling with FAIR-UFLARE. Magn Reson Imaging 2000; 18:641-7. [PMID: 10930773 DOI: 10.1016/s0730-725x(00)00155-7] [Citation(s) in RCA: 78] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Quantitative perfusion imaging of human kidneys was performed using arterial spin labeling MRI with a fast spin echo readout-sequence. Perfusion maps of centrally located single slices were obtained in axial and coronal orientations. In ten healthy volunteers, the mean value of perfusion was 213+/-55 mL/(100g min) with a range from 140 to 319 mL/(100g min). These results are in accordance with literature data, considering the fact that FAIR only measures the perfusion component normal to the imaging plane. Intra-individual reproducibility errors of +/-11% were smaller than the natural interindividual variability of renal perfusion (SD = +/- 25%). Perfusion in the cortex was approximately 3-4 times higher compared to the medulla. Considering the relatively high resolution of 2x2x10 mm3, the ability to quantify perfusion, and the lack of ionizing radiation and contrast media, this technique should prove useful in diagnosing renal pathologies that are associated with reductions in tissue perfusion.
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97
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Steffens J, Oberschulte-Beckmann D, Siller V, Röttger P, Polsky MS. Ectopic refluxing ureter entering a seminal vesicle cyst associated with ipsilateral renal dysplasia. World J Urol 2000; 18:232-4. [PMID: 10926089 DOI: 10.1007/s003459900098] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
Abstract
The unusual case of a 10-month-old infant with an ectopic refluxing ureter entering into a seminal vesical cyst associated with ipsilateral renal dysplasia is described. The embryology, differential diagnosis, and therapy are discussed.
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98
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Haben B, Krebber J, Steffens J. Funktionsgewinn nach organerhaltender Operation eines kindlichen stumpfen Nierentraumas - Improvement of Renal Function after Nephron-Sparing Operation of a Pediatric Blunt Renal Trauma -. Aktuelle Urol 2000. [DOI: 10.1055/s-2000-8974] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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99
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Günther J, Stratmeyer R, Steffens J. Kindliche Hodentumoren - Testicular Tumors in Childhood -. Aktuelle Urol 2000. [DOI: 10.1055/s-2000-8971] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
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100
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Steffens J, Humke U. Die Behandlung des kindlichen Megaureters durch passagere hohe Harnableitung: 15jähriger Erfahrungsbericht. Aktuelle Urol 2000. [DOI: 10.1055/s-2000-11685] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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