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Marand AJB, Bach C, Janssen D, Heesakkers J, Ghojazadeh M, Vögeli TA, Salehi-Pourmehr H, Mostafae H, Hajebrahimi S, Rahnama'i MS. Lower urinary tract signs and symptoms in patients with COVID-19. BMC Infect Dis 2021; 21:706. [PMID: 34311703 PMCID: PMC8312200 DOI: 10.1186/s12879-021-06394-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Accepted: 06/28/2021] [Indexed: 11/28/2022] Open
Abstract
Background The type of pneumonia that is caused by the new coronavirus (SARS-CoV-2) has spread across the world in a pandemic. It is not clear if COVID-19 patients have any lower urinary tract signs or symptoms. Methods The effect of COVID-19 on lower urinary tract function was studied in a prospective multi-centre, observational study including 238 patients who were admitted with symptoms caused by COVID-19 to the university hospital of Aachen in Germany and Tabriz in Iran. Results None of the patients reported to have any lower urinary tract symptoms. SARS-CoV-2 was found in the urine of 19% of the tested patients. The mortality rate in COVID-19 infected patients with microscopic haematuria together with white blood cells in their urine, was significantly increased from 48 to 61% in the Tabriz cohort (p-value = 0.03) and from 30 to 35% in the Aachen cohort (p-value =0.045). Furthermore, in the group of patients with SARS-CoV-2 urine PCR, the mortality rate rose from 30 to 58%. (p-value =0.039). Conclusion Patients admitted with COVID-19 did not report to have any lower urinary tract symptoms, even those patient who had a positive Urine SARS-CoV-2 PCR. In addition, hematuria, WBC in urine as well as SARS- CoV-2 presence in urine, were found to be strong negative prognostic factors in admitted COVID-19 patients.
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Affiliation(s)
- Aida Javan Balegh Marand
- Uniklinik RWTH Aachen, Pauwelsstrasse 30, 52074, Aachen, Germany.,Radboud University, Nijmegen, The Netherlands.,Society of Urological Research and Education (SURE), Heerlen, The Netherlands
| | - Christian Bach
- Uniklinik RWTH Aachen, Pauwelsstrasse 30, 52074, Aachen, Germany
| | | | | | - Morteza Ghojazadeh
- Research Center for Evidence-Based Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
| | | | - Hanieh Salehi-Pourmehr
- Research Center for Evidence-Based Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
| | | | - Sakineh Hajebrahimi
- Research Center for Evidence-Based Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mohammad Sajjad Rahnama'i
- Uniklinik RWTH Aachen, Pauwelsstrasse 30, 52074, Aachen, Germany. .,Radboud University, Nijmegen, The Netherlands.
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2
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Rahnama'i MS, Bach C, Schulze-Hagen M, Kuhl CK, Vögeli TA. Can the predictive value of multiparametric MRI for prostate cancer be improved by a liquid biopsy with SelectMDx? Cancer Rep (Hoboken) 2021; 4:e1396. [PMID: 33931984 PMCID: PMC8714534 DOI: 10.1002/cnr2.1396] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2020] [Accepted: 03/29/2021] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND SelectMDx is a urinary biomarker test for determining prostate cancer risk. AIM In a group of patients with a biopsy proven prostate cancer (PCa) who had undergone a multi parametric Magnetic Resonance Imaging (mpMRI) and urinary biomarker test with SelectMDx, we studied the additive value of SelectMDx to mpMRI and correlated that to the radical prostatectomy histology. METHODS AND RESULTS Thirty-nine consecutive patients with a positive prostate biopsy were included in the study. They all had mpMRI and SelectMDx and underwent a radical prostatectomy. Overall, the mpMRI showed a PIRADS ≤3 lesion in seven cases out of the 39 patients. Significant lesions (PIRADS ≥4) were found in 32 cases (82%), that is, in 17 cases a PIRADS 5 lesion and in 15 cases a PIRADS 4 lesion. The mpMRI missed significant PCa in seven cases (18%) who had a PIRADS ≤3 lesion but had a significant PCa on final histology after RP. In our study, the positive predictive values of mpMRI were 97% and that of the SelectMDx was 100%. CONCLUSION In this real-life selected group of consecutive patients with a confirmed positive PCa biopsy and available mpMRI, the liquid biopsy test with SelectMDx, did not provide an additional information about the PCa clinical significance. The addition of SelectMDx was only found valuable in those patients who had a very high-risk PCa (ie, GS ≥8) who had a positive SelectMDx test outcome despite of a negative mpMRI outcome.
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3
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Rose M, Maurer A, Wirtz J, Bleilevens A, Waldmann T, Wenz M, Eyll M, Geelvink M, Gereitzig M, Rüchel N, Denecke B, Eltze E, Herrmann E, Toma M, Horst D, Grimm T, Denzinger S, Ecke T, Vögeli TA, Knuechel R, Maurer J, Gaisa NT. EGFR activity addiction facilitates anti-ERBB based combination treatment of squamous bladder cancer. Oncogene 2020; 39:6856-6870. [PMID: 32978523 PMCID: PMC7605436 DOI: 10.1038/s41388-020-01465-y] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2020] [Revised: 08/11/2020] [Accepted: 09/10/2020] [Indexed: 12/13/2022]
Abstract
Recent findings suggested a benefit of anti-EGFR therapy for basal-like muscle-invasive bladder cancer (MIBC). However, the impact on bladder cancer with substantial squamous differentiation (Sq-BLCA) and especially pure squamous cell carcinoma (SCC) remains unknown. Therefore, we comprehensively characterized pure and mixed Sq-BLCA (n = 125) on genetic and protein expression level, and performed functional pathway and drug-response analyses with cell line models and isolated primary SCC (p-SCC) cells of the human urinary bladder. We identified abundant EGFR expression in 95% of Sq-BLCA without evidence for activating EGFR mutations. Both SCaBER and p-SCC cells were sensitive to EGFR tyrosine kinase inhibitors (TKIs: erlotinib and gefitinib). Combined treatment with anti-EGFR TKIs and varying chemotherapeutics led to a concentration-dependent synergism in SCC cells according to the Chou-Talalay method. In addition, the siRNA knockdown of EGFR impaired SCaBER viability suggesting a putative "Achilles heel" of Sq-BLCA. The observed effects seem Sq-BLCA-specific since non-basal urothelial cancer cells were characterized by poor TKI sensitivity associated with a short-term feedback response potentially attenuating anti-tumor activity. Hence, our findings give further insights into a crucial, Sq-BLCA-specific role of the ERBB signaling pathway proposing improved effectiveness of anti-EGFR based regimens in combination with chemotherapeutics in squamous bladder cancers with wild-type EGFR-overexpression.
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MESH Headings
- Aged
- Antineoplastic Combined Chemotherapy Protocols/pharmacology
- Antineoplastic Combined Chemotherapy Protocols/therapeutic use
- Carcinoma, Squamous Cell/drug therapy
- Carcinoma, Squamous Cell/genetics
- Carcinoma, Squamous Cell/pathology
- Carcinoma, Transitional Cell/drug therapy
- Carcinoma, Transitional Cell/genetics
- Carcinoma, Transitional Cell/pathology
- Cell Line, Tumor
- Cohort Studies
- Drug Resistance, Neoplasm/drug effects
- Drug Synergism
- ErbB Receptors/antagonists & inhibitors
- ErbB Receptors/genetics
- ErbB Receptors/metabolism
- Erlotinib Hydrochloride/pharmacology
- Erlotinib Hydrochloride/therapeutic use
- Female
- Gefitinib/pharmacology
- Gefitinib/therapeutic use
- Gene Expression Regulation, Neoplastic
- Gene Knockdown Techniques
- Humans
- Male
- Protein Kinase Inhibitors/pharmacology
- Protein Kinase Inhibitors/therapeutic use
- RNA, Small Interfering/metabolism
- Receptor, ErbB-2/antagonists & inhibitors
- Receptor, ErbB-2/metabolism
- Receptor, ErbB-3/antagonists & inhibitors
- Receptor, ErbB-3/metabolism
- Receptor, ErbB-4/antagonists & inhibitors
- Receptor, ErbB-4/metabolism
- Signal Transduction/drug effects
- Urinary Bladder/pathology
- Urinary Bladder Neoplasms/drug therapy
- Urinary Bladder Neoplasms/genetics
- Urinary Bladder Neoplasms/pathology
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Affiliation(s)
- Michael Rose
- Institute of Pathology, RWTH Aachen University, Aachen, Germany
| | - Angela Maurer
- Institute of Pathology, RWTH Aachen University, Aachen, Germany
| | - Julia Wirtz
- Institute of Pathology, RWTH Aachen University, Aachen, Germany
| | | | - Tanja Waldmann
- Department of Gynecology, University Clinic RWTH, Aachen, Germany
| | - Maximilian Wenz
- Institute of Pathology, RWTH Aachen University, Aachen, Germany
| | - Marie Eyll
- Institute of Pathology, RWTH Aachen University, Aachen, Germany
| | - Mirja Geelvink
- Institute of Pathology, RWTH Aachen University, Aachen, Germany
| | | | - Nadine Rüchel
- Institute of Pathology, RWTH Aachen University, Aachen, Germany
| | - Bernd Denecke
- IZKF Aachen, Medical Faculty of the RWTH Aachen University, Aachen, Germany
| | - Elke Eltze
- Institute of Pathology, Saarbrücken-Rastpfuhl, Saarbrücken, Germany
| | - Edwin Herrmann
- Department of Urology, University Hospital Münster, Münster, Germany
| | - Marieta Toma
- Institute of Pathology, University Hospital Gustav Carus TU Dresden, Dresden, Germany
- Institute of Pathology, University Hospital Bonn, Bonn, Germany
| | - David Horst
- Institute of Pathology, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Tobias Grimm
- Department of Urology, LMU Munich, Munich, Germany
| | - Stefan Denzinger
- Department of Urology, University of Regensburg, Regensburg, Germany
| | - Thorsten Ecke
- Department of Urology, Helios Hospital Bad Saarow, Bad Saarow, Germany
| | | | - Ruth Knuechel
- Institute of Pathology, RWTH Aachen University, Aachen, Germany
| | - Jochen Maurer
- Department of Gynecology, University Clinic RWTH, Aachen, Germany
| | - Nadine T Gaisa
- Institute of Pathology, RWTH Aachen University, Aachen, Germany.
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Abstract
Pyeloplasty is one of the most common urological reconstructive interventions. Since the presentation of the first open pyeloplasty by Anderson and Hynes in 1949, the management of ureteropelvic junction obstruction has dramatically developed. The most immense progress was made in the 1990s with the introduction of laparoscopy. A multitude of new minimal surgical techniques have been introduced since then. In the last few years, the innovations were based on refinement of already-existing techniques and technology. With this aim, single-port surgery, three-dimensional vision for laparoscopy, robotic technology, and alternative techniques for creating the anastomosis-like fibrin glue have been introduced. This unsystematic review is timely, and the scientific interest is to present and discuss some of the latest advances in surgical techniques and different approaches for the intra- and post-operative management in pyeloplasty. To the best of our knowledge, this is the only review looking at the recent advances in urological surgical techniques for pyeloplasty during the last few years with a focus on new technology and surgical techniques.
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Affiliation(s)
- Mikolaj Mendrek
- Departement of Urology, University Hospital Aachen, Aachen, 52074, Germany
| | | | - Christian Bach
- Departement of Urology, University Hospital Aachen, Aachen, 52074, Germany
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5
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Abstract
To assess the rate of residual cancer after transurethral resection (TUR) of superficial bladder cancer, a prospective study was carried out. All patients with transitional cell cancer (TCC) stage pTa-pT1 underwent a repeat TUR (ReTUR) within 6-8 weeks. Sites and rates of tumors found during ReTUR were documented as well as the morbidity of the ReTUR. Of a total of 192 TUR, superficial TCC was found in 124 cases; 83 underwent ReTUR according to the study protocol. Residual tumor was detected in 27% of pTa and 53% of pT1 tumors. Worsening of grading or T stage was found in 8%. Of the tumors detected by ReTUR, 81% were localized at the site of the first TUR. In this prospective study, residual tumor formation was detected in a high percentage. Routine ReTUR is therefore recommended in superficial bladder cancer except solitary pTaGI lesions.
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Affiliation(s)
- T A Vögeli
- Urologische Klinik, Heinrich-Heine-Universität, Moorenstrasse 5, 40225 Düsseldorf
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6
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Grimm MO, Kamphausen S, Hugenschmidt H, Stephan-Odenthal M, Ackermann R, Vögeli TA. Clinical outcome of patients with lymph node positive prostate cancer after radical prostatectomy versus androgen deprivation. Eur Urol 2002; 41:628-34; discussion 634. [PMID: 12074780 DOI: 10.1016/s0302-2838(02)00134-3] [Citation(s) in RCA: 50] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
OBJECTIVE(S) To compare the outcome of patients with stage D1 (TxN+M0) prostate cancer undergoing radical prostatectomy or androgen deprivation alone. PATIENTS AND METHODS Eighty-two patients treated for lymph node positive prostate cancer were retrospectively analyzed for time to progression, tumor-specific and overall survival. Furthermore, subsequent tumor and treatment related morbidity requiring intervention including frequency and duration of associated hospital stays was recorded. RESULTS The extent of lymph node metastasis was significantly lower in 50 patients undergoing radical prostatectomy (+/- early androgen deprivation) compared to 32 receiving androgen deprivation only. The treatment groups, however, did not differ with regard to other characteristics including age, comorbidity, stage, grade and preoperative PSA. Mean actuarial progression-free, and tumor-specific survival was significantly longer for the radical prostatectomy patients (36% and 47%, respectively at 10 years) compared to androgen deprivation (15% and 32%, respectively). The latter group required more secondary interventions resulting in more frequent and overall longer hospital stays. CONCLUSIONS Patients undergoing radical prostatectomy for stage D1 prostate cancer possibly benefit with regard to the necessity for secondary interventions and, at least for limited (solitary) nodal disease, in terms of progression-free and tumor-specific survival. However, the latter observation may be biased by a larger extent of lymph node metastasis in the androgen deprivation group.
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Affiliation(s)
- M-O Grimm
- Department of Urology, Heinrich-Heine-University, Düsseldorf, Moorenstr. 5, 40225, Düsseldorf, Germany.
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7
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Abstract
To evaluate the current status of laparoscopy, the "Working Group Laparoscopy" of the German Urological Association performed a questionnaire among urologists in Germany. Of 300 questionnaires 183 were returned and analyzed (61%): 54% of the departments already performed laparoscopy and another 50% are planning to introduce this technique. The major concerns are economical (70%), long learning curve (92%), investment (53%), and lack of scientific data (76%). Simple nephrectomy, cryptorchism, and varicoceles are treated by 66, 59, and 58 of the 96 departments laparoscopically (of 183 resp.). Laparoscopic surgery for radical prostatectomy and tumor nephrectomy is done by 32 and 34 of 96 departments. Only a minority of the centers performs more than 40 laparoscopies per year and indication. Compared to a survey conducted in 1995, the acceptance level of this technique has increased (100% vs 48%). Only a minority of the departments performs more than 40 laparoscopic interventions per year for one indication.
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Affiliation(s)
- T A Vögeli
- Urologische Klinik, Universitätsklinik Düsseldorf, Moorenstrasse 5, 40225 Düsseldorf.
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8
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Vögeli TA, Ackermann R. [Prognostic factors in urothelial carcinoma]. Urologe A 2001; 40:442-6. [PMID: 11760346 DOI: 10.1007/s001200170002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Intense efforts are being made to identify prognostic markers in superficial and muscle invasive bladder cancer in order to get more detailed information on the biological properties of urothelial cancer. Tumor associated antigens, angiogenetic factors and their inhibitors, cell adhesion molecules, cell cycle regulating genes and proteins, oncogenes and tumor suppressor genes are subjects of clinical investigations. This article provides a contemporary review of prognostic factors in bladder cancer and their possible clinical implication. A better characterization of urothelial cancer can be anticipated from new technologies allowing analysis of multiple genes or gene products in an automated one-step procedure.
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Affiliation(s)
- T A Vögeli
- Urologische Klinik, Heinrich-Heine-Universität Düsseldorf
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9
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Vögeli TA. [Surgical therapy of prostatic carcinoma]. Praxis (Bern 1994) 2001; 90:1516-1522. [PMID: 11593907] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
Radical prostatectomy (RPE) is considered to be the "gold standard" for the treatment of localized prostate cancer regardless the fact that up to now no prospective randomized trial has compared surgery against radiotherapy, brachytherapy or a surveillance strategy. Success of RPE mainly depends on patient selection. For patients without extraprostatic tumor growth results of RPE are excellent with a rate of 80-90% of patients without biochemical recurrence during a 10 year follow up. Despite current staging modalities including digital rectal examination, preoperative prostate specific antigen and Gleason score of the biopsy between 23-53% of patients will experience PSA recurrence during a 10 year follow up. Taken together all sources of presurgical information, accuracy of predicting pathological stage it 70%. Decision towards or against RPE based on this data may be difficult in the individual patient because it is unclear from which possible chance or percentage of cure RPE is the adequate treatment. Proper selection of patients is the key to success for surgical treatment of localized prostate cancer but we need more accurate information including molecular biology technology to predict the biological behavior of the tumor.
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Affiliation(s)
- T A Vögeli
- Urologische Klinik, Heinrich-Heine-Universität Düsseldorf
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10
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Abstract
A case of spontaneous, partial, unilateral thrombosis of the corpus cavernosum is described. A 35-year-old white male presented with a painful mass in the perineum without priapism. Diagnostic evaluation with sonography and magnetic resonance imaging revealed a thrombosis in the left posterior corporal body. Treatment consisted of intravenous heparin followed by prophylactic acetylsalicylic acid. The thrombosis resolved spontaneously over several months without sequelae. Conservative management of this rare disease appears to be possible and safe.
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Affiliation(s)
- R Thiel
- Department of Urology, Heinrich Heine University, Düsseldorf, Germany.
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11
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Peinemann F, de Villiers EM, Dörries K, Adams O, Vögeli TA, Burdach S. Clinical course and treatment of haemorrhagic cystitis associated with BK type of human polyomavirus in nine paediatric recipients of allogeneic bone marrow transplants. Eur J Pediatr 2000; 159:182-8. [PMID: 10664232 DOI: 10.1007/s004310050047] [Citation(s) in RCA: 43] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
UNLABELLED Of a total of 117 bone marrow transplant (BMT) recipients in the period from August 1988 to November 1995, 9 (7.7%) developed haemorrhagic cystitis. This condition was characterized in all nine patients by late onset (day +24 to +50 post-BMT), long duration (1 to 7 weeks), and the excretion of BK virus in the urine, as confirmed by electron microscopy, DNA hybridization and PCR analysis. Adenovirus was not involved. The serological assessment of BK virus-specific IgM and IgG pre- and post-BMT is consistent with viral reactivation in all patients, although a primary infection cannot be absolutely excluded in a single patient. A significant correlation between the use of high-dose busulphan (16 mg/kg) in the preparative regimen and development of haemorrhagic cystitis (P = 0. 0003) was evident. The severe course of the disease in two patients resulted in bladder tamponade; bleeding could not be inhibited with coagulation and laser treatment. Deterioration was prevented by bladder irrigation via a suprapubic catheter. Remission occurred spontaneously in all patients. CONCLUSION BK virus induced haemorrhagic cystitis in a paediatric bone marrow transplantation recipients is characterized by late onset, long duration, viral reactivation and correlates to high-dose busulphan. Severe bleeding could not be influenced by surgical intervention.
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Affiliation(s)
- F Peinemann
- Zentrum für Kinderheilkunde, Klinik für Pädiatrische Hämatologie und Onkologie, Heinrich-Heine-Universität, Düsseldorf, Germany
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12
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Vögeli TA, Peinemann F, Burdach S, Ackermann R. Urological treatment and clinical course of BK polyomavirus-associated hemorrhagic cystitis in children after bone marrow transplantation. Eur Urol 1999; 36:252-7. [PMID: 10450012 DOI: 10.1159/000068007] [Citation(s) in RCA: 38] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Hemorrhagic cystitis (HC) is a major complication of bone marrow transplantation (BMT). We describe the clinical course and urological management of BK polyomavirus-associated HC in children after bone marrow transplantation. From 8/88 to 11/95, a total of 117 consecutive pediatric patients received BMT. Nine patients (7. 7%) developed HC after transplantation. HC in all 9 patients was characterized by late onset (day +24 to +50 post-BMT), long duration (1-7 weeks) and the excretion of BK polyomavirus in the urine as confirmed by electron microscopy, DNA hybridization and PCR techniques. Six children developed mild HC (grade 1-2) and were treated successfully by hyperhydration. In 3 patients, severe HC (grade 3-4) over 6 weeks required surgical interventions. In these 3 patients, cystoscopy revealed circumscript papulous tumors as the source of hematuria. Severe and persistent hematuria required blood transfusions, insertion of large suprapubic catheters and permanent bladder irrigation because of recurrent blood clot retention. Attempts to stop the hematuria in 2 of these patients by coagulation and laser vaporization (Nd:YAG) failed to stop the bleeding. Differential diagnosis of hematuria after BMT includes urinary tract infection, cyclophosphamide-induced chemical cystitis and bleeding due to BMT-induced thrombocytopenia. With the increasing number of BMTs in children, urologists may be confronted with BK polyomavirus-associated HC and must consider this in the differential diagnosis of hematuria after BMT.
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Affiliation(s)
- T A Vögeli
- Departments of Urology and Pediatrics, University of Düsseldorf, Germany
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13
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Abstract
In a prospective study of 302 ureteroscopic procedures, 161 were commenced and 133 completed without the use of general or regional anaesthesia. In 15 patients ureteroscopy (URS) was performed with lignocaine jelly in the urethra only, and in 118 with additional intravenous analgesia. Alfentanil, a synthetic morphine derivative, was used for intravenous analgesia. Ureteroscopy was performed prior to extracorporeal shock wave lithotripsy in 46 patients, for stone basketing in 40, for stone fragmentation in 29, for diagnostic purposes in 14 and for cold knife ureterotomy in 4. Ureteric lesions were observed in 9 patients (6.8%) treated under intravenous sedoanalgesia. This percentage is within the range reported in other series of patients treated under general anaesthesia. The findings suggest that URS, when performed without general or regional anaesthesia, does not increase the risk of complications or compromise the results of treatment.
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Affiliation(s)
- T A Vögeli
- Department of Urology, University of Düsseldorf, Germany
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14
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Vögeli TA, Peter S, Ackermann R. [The methodology of percutaneous nephrostomy. The two-step technique]. Urologe A 1993; 32:339-42. [PMID: 8372419] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
A new two-step technique for percutaneous nephrostomy with a newly designed nephrostomy set is described. The technique combines the advantages of the a direct introducing method (one-step nephrostomy) with an introducing trocar and the "three-step" technique with an initial puncture by a needle and insertion of a rigid guide wire. Evaluation of the different techniques in 195 patients revealed no disadvantage of the new technique compared with the three-step technique.
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Affiliation(s)
- T A Vögeli
- Urologische Klinik der Universität Düsseldorf
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15
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Thiel R, Vögeli TA, Ackermann R. [Detection of fetal urinary obstructions requiring therapy in routine prenatal ultrasound]. Z Geburtshilfe Perinatol 1993; 197:119-22. [PMID: 8367987] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
Routine ultrasound during pregnancy is also performed for the detection of fetal malformations. This retrospective study comprises 31 children treated for urinary tract infection within 19 months postnatally. The charts of the young patients were evaluated how often a dilatation of the upper urinary tract (more than 3 cm in diameter) was observed already during pregnancy. In 18 patients (58%) the dilatation was detected antenatally and was missed in 13 (42%). Reasons of the low sensitivity may include low technical standard of the sonographic equipment and limited skill of the investigators.
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Affiliation(s)
- R Thiel
- Urologische Klinik, Heinrich-Heine-Universität Düsseldorf
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