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Einleitung: Fremdkörper intraperitoneal können wegen ihrer Größe und/oder wegen sekundären Verwachsungen zu Darmpassagestörungen führen. Wir beschreiben einen Fall eines Ileus in einem Patienten mit Spina bifida und neurogener Blasenfunktionsstörung. Der [zum vollständigen Text gelangen Sie über die oben angegebene URL]

Einleitung: Das Trigonum scheint eine essentielle Rolle bei der Miktion zu spielen, indem die Öffnung des Blasenhalses unterstützt wird. Tubularisierung des Trigonums, um eine Neourethra zu konstruieren, verändert die Blasenentleerung. Wir haben sechs Patientinnen nach trigonaler Tubularisierung [zum vollständigen Text gelangen Sie über die oben angegebene URL]

Einleitung: Die ideale Platzierung der Manschette des artifiziellen Sphinkters (AS) für neurogene Patienten ist der Blasenhals. Welche Möglichkeiten bestehen nach Arrosion des Blasenhalses? Ist eine erneute Implantation möglich? Wir beschreiben fünf Fälle erfolgreicher [zum vollständigen Text gelangen Sie über die oben angegebene URL]

The treatment of female urethral stricture disease is in flux in terms of developing guidelines for surgical treatment. Urethral strictures in women are rare, but frequently result because of urethral instrumentation or surgery. Stricture sites vary from proximal, intrasphincteric, distal or at the meatus. Stricture formation after previous urethral surgery may pose a special challenge. We describe the first Optilume® urethral drug-coated balloon dilation for female urethral stricture disease involving the sphincter. After six months follow-up the patient remains stricture free with full continence and complete bladder emptying.

Fragestellung: Gibt es überzählige Nieren? Wenn ja, wie häufig? Die erste überzählige Niere wurde bereits 1656 von Gerard Blaes beschrieben. Geisinger legte 1939 folgende Kriterien einer überzähligen Niere fest: eigene Nierenkapsel, eigene Blutversorgung [zum vollständigen Text gelangen Sie über die oben angegebene URL], 45. Gemeinsame Tagung der Österreichischen Gesellschaft für Urologie und Andrologie und der Bayerischen Urologenvereinigung

Fragestellung: Ist es möglich mit einer kompletten C6 Querschnittslähmung die Blase als Frau mit Tetraplegie selbstständig zu entleeren? Ziel: Zwei Sportlerinnen (27 und 22 Jahr alt) erlitten im Rahmen eines Sportunfalls eine hohe komplette Querschnittslähmung auf der[zum vollständigen Text gelangen Sie über die oben angegebene URL], 45. Gemeinsame Tagung der Österreichischen Gesellschaft für Urologie und Andrologie und der Bayerischen Urologenvereinigung

Fragestellung: Sind transurethrale Eingriffe bei Patienten mit künstlichem hydraulischem Sphinktersystem möglich? Ziel: Möglichkeiten der Kontinenztherapie bei inkontinenten Männern mit zusätzlich einer Vorgeschichte eines oberflächlichen Blasentumors (pTa [zum vollständigen Text gelangen Sie über die oben angegebene URL], 45. Gemeinsame Tagung der Österreichischen Gesellschaft für Urologie und Andrologie und der Bayerischen Urologenvereinigung

Fragestellung: Ist die Wiederherstellung der Kontinenz nach komplexem Beckentrauma, zweimaliger erfolgloser Faszienzügelplastik und eimaliger frustraner AMS 800 Implantation möglich? Ziel: Eine 18-jährige Patientin war 2004 infolge eines lebensgefährlichen Motorradunfalls[zum vollständigen Text gelangen Sie über die oben angegebene URL], 45. Gemeinsame Tagung der Österreichischen Gesellschaft für Urologie und Andrologie und der Bayerischen Urologenvereinigung

Fragestellung: Ist eine suprapubische transvesikale Prostataresektion zielführend? Ziel: Ein 52-jähriger Patient erlitt vor 13 Jahren einen Unfall mit einer Straßenkehrmaschine, wobei es zu einer komplexen Beckenfraktur mit Harnröhrenabriss, Rektumeinriss und in Folge[zum vollständigen Text gelangen Sie über die oben angegebene URL], 45. Gemeinsame Tagung der Österreichischen Gesellschaft für Urologie und Andrologie und der Bayerischen Urologenvereinigung

"Over the past two decades, the study of self-regulation and its associations with emerging psychopathology has become a major pursuit in developmental science. Early-childhood emotion regulation (ER) and executive function (EF), in particular, are interrelated aspects of self-regulation that have garnered extensive research and are theorized to promote social competence school readiness and achievement, and adjustment. However, the development of self-regulation is a complex process that occurs through coaction at multiple levels of analysis. Three studies were conducted to examine biobehavioral emotion responding in infancy, early childhood EF, and their prospective influences on trajectories of conduct problems (CPs), attention-deficit/hyperactivity disorder (ADHD), and callous-unemotional (CU) behaviors using multiple person-centered approaches. Study 1 used latent profile analysis (LPA) to prospectively examine the synchrony and asynchrony of infant behavioral reactivity, cortisol reactivity, and ER behaviors at 6, 15, and 24 months of age to determine whether groups of infants evidenced different patterns of arousal and regulation; and whether such patterns were bidirectionally related to parenting behavior over the same span of time. Study 2 used longitudinal latent class analysis (LLCA) to examine joint trajectories of CPs, ADHD symptoms, and CU behaviors from 3 years old to 5th grade in order to assess examine heterogeneity in CPs based on the presence of ADHD and CU behaviors. Study 3 built upon the prior two studies by in by investigating associations of infants’ emotional arousal and regulation with their later CP/ADUD/CU trajectories, as well as the role of early childhood EF in mediating these prospective associations. Results from Study 1 indicated that there is observable variation in infants’ patterns of behavioral reactivity, cortisol reactivity, and ER behaviors across infancy, and that infant emotion responding and parent sensitivity and harsh-intrusion were bidirectionally predictive of one another. Results from Study 2 showed that children did follow differing trajectories of CPs, but that these varied based on who reported their behavior (parents, teachers, or both), rather than on trajectories of ADHD symptoms and CU behaviors. In addition, these joint trajectories differentiated children’s likelihood of meeting diagnostic criteria for oppositional defiant disorder, conduct disorder, and ADHD, as well as clinically significant levels of CU behaviors, during preadolescence. Finally, results from Study 3 indicated that infants’ patterns of emotion responding were not prospectively related to their CP/ADHD/CU trajectories or their early childhood EF. However, better EF did significantly predict a decreased likelihood of following trajectories characterized by high problem behavior as rated by both parents and teachers, parents only, and teachers only. The implications for understanding the early development of self-regulation, CPs, ADHD, and CU behaviors are discussed, as is the utility of innovative person-centered approaches for understanding these phenomena."--Abstract from author supplied metadata.

Fragestellung: Malignes epitheliales Mesotheliom stellt eine besondere therapeutische Herausforderung dar. Wenn es die Hoden oder Hodenhüllen betrifft wird eine radikale chirurgische Sanierung empfohlen. Da Chemotherapie und Bestrahlung enttäuschende Erfolge erzielen, gibt es nur wenige Alternativen.[zum vollständigen Text gelangen Sie über die oben angegebene URL], 44. gemeinsamen Tagung der Bayerischen Urologenvereinigung und der Österreichischen Gesellschaft für Urologie und Andrologie

In den letzten Jahren haben mehrere Studien die Effektivität und Sicherheit der AdVanceXP male sling für die Therapie der männlichen Belastungsinkontinenz (BI) im Kurzzeit-Follow-Up belegt. Ziel dieser Arbeit war es, die Effektivität und Sicherheit des AdVance XP in der Therapie [zum vollständigen Text gelangen Sie über die oben angegebene URL], 44. gemeinsamen Tagung der Bayerischen Urologenvereinigung und der Österreichischen Gesellschaft für Urologie und Andrologie

The proximal urethral bulb in men is enlarged, surrounds the bulbous urethra, and extends dorsally towards the perineum. During intercourse engorgement takes place due to increased blood flow through the corpus spongiosum. Antegrade ejaculation is facilitated by contraction of the bulbospongiosus muscles during climax. Micturition during sexual stimulation is functionally inhibited. Supporting the bulb may indirectly facilitate continence in a certain subset of patients with postprostatectomy incontinence. During physical activity with increased abdominal pressure, reflex contraction of the pelvic floor muscles as well as the bulbospongiosus muscles occurs to support sphincter function and limit urinary incontinence. Operations to the prostate may weaken urinary sphincter function. It is hypothesized that the distal urinary sphincter may be supported indirectly by placing a hammock underneath the urethral bulb. During moments of physical stress the “cushion” of blood within the supported corpus spongiosum helps to increase the zone of coaptation within the sphincteric (membranous) urethra. This may lead to urinary continence in patients treated by a transobturator repositioning sling in patients with postprostatectomy incontinence. This paper describes the possible role of the urethral bulb in male urinary continence, including its function after retroluminal sling placement (AdVance, AdVance XP® Male Sling System, Minnetonka, USA).

"Deficits in emotion recognition have been associated with psychopathic and callous-unemotional (CU) behaviors among adults, adolescents, and children. However, few previous studies have examined such associations exclusively during early and middle childhood. The current study used a large, population-stratified, randomly-selected sample of 2nd grade children living in areas of high rural poverty to examine group differences in emotion recognition among children showing no conduct problems or CU behaviors (typical), conduct problems without CU behaviors (CP-only), and both CP and CU behaviors (CP+CU). Primary caregivers reported on children's conduct problems and callous-unemotional behaviors at 1st grade and children completed a computerized facial emotion recognition task at 2nd grade. Results indicated that group differences in emotion recognition accuracy were moderated by child race, with children in the typical group showing better overall accuracy and better recognition of fearful and happy faces among European American children, whereas no group differences were found among African American children. Implications for emotion socialization, etiology of CP and CU behaviors, and future directions for research and treatment are discussed."--Abstract from author supplied metadata.

The question is whether the urethral sphincter may be reconstructed after longitudinal injury similar to anal sphincter injuries. Analogue to obstetric, anal sphincter repair, an approximation repair of the sphincter may be feasible. An overlap repair is possible in anal sphincter repair, but because of the little tissue available in the urethral sphincter this is not an option. We describe three cases of urethral sphincter injury of different aetiologies. All resulted in a total longitudinal disruption of the muscular components of the urethral sphincter complex. After making the diagnosis of urethral sphincter injury, a primary approximation repair was done. Follow-up of at least two and up to three years is promising with one male patient being completely continent and the two female patients needing one safety pad per day. Longitudinal disruption of the muscular elements of the sphincteric urethra may be primarily reconstructed with good success using an approximation technique with simple interrupted sutures.

Objetivo: Resumir las lecciones aprendidas despues de haber realizado más de 250 intervenciones de inserción de la malla AdVance®.La incontinencia después de la prostatectomía es una realidad deprimente, frecuentemente subestimada por el cirujano. El esfínter urinario artificial ha sido el "gold standard" en el tratamiento de la incontinencia urinaria severa. No existe un consenso similar para la incontinencia leve-moderada. Este artículo trata sobre una operación para la incontinencia con el objetivo de dar soporte a la laxitud del esfínter uretral después de la prostatectomía. Método: La hipótesis de la laxitud esfinteriana post-prostatectomía es nueva, así como la restauración de la continencia mediante la reubicación proximal del cuerpo esponjoso proximal. Resumimos los trabajos que tratan este tema. Destacamos puntos seleccionados de la técnica quirúrgica, incluyendo las modificaciones que se han introducido con la experiencia. Finalmente, comparamos los primeros y últimos 20 pacientes tratados en esta serie de 250 pacientes, analizando indicación quirúrgica, técnica quirúrgica y resultados del tratamiento. Añadimos algunas definiciones para aportar claridad. Resultados: Se pudo demostrar que la posición final del AdVance® es retroluminal, es decir 5-10 mm dorsal/detrás de la luz de la uretra membranosa (= uretra esfinteriana). Comparando los primeros y últimos 20 casos, en estos últimos no hay ningún fracaso del tratamiento. El seguimiento a dos años muestra una tasa de continencia del 65% en el primer grupo comparada con el 85% del segundo, teniendo en cuenta una mediana de tiempo de seguimiento corta en el segundo grupo, de 4,1 meses. La tunelización subcutánea del cabestrillo disminuyó significativamente el aflojamiento postoperatorio. Conclusiones: El cabestrillo AdVance® es un método seguro de tratamiento de la incontinencia urinaria leve-moderada postprostatectomía, con ausencia de erosiones en esta serie. La hipótesis de la laxitud esfinteriana parece desempeñar un papel definitivo en la fisiopatología de la incontinencia masculina. La corrección de este descenso del soporte uretral o "prolapso" parece ser altamente eficaz. Son necesarios nuevos estudios para definir precisamente el mecanismo exacto de acción del cabestrillo AdVance® Objectives: To summarize the lessons learnt after having performed more than 250 AdVance® sling procedures. Postprostatectomy incontinence is a depressing reality that is often underestimated by the prostate surgeon. The practiced gold standard for treating severe stress urinary incontinence has been the artificial urinary sphincter. No such consensus exists for mild to moderate incontinence. This paper is about an incontinence operation with the goal to support postprostatectomy sphincter laxity. Methods: The hypothesis of postprostatectomy sphincter laxity is new, as well as restoring continence by proximal relocation of the proximal corpus spongiosum. Abstracts dealing with these issues are summarized. Selected points of technique are highlighted, including modifications that have been made along the way. Lastly the first and last 20 patients treated in this series of 250 patients are compared in terms of operative indication, surgical technique and treatment outcome. Some definitions are added for clarity. Results: It could be demonstrated that the final position of the AdVance® sling is retroluminal, i.e. 5-10mm dorsal/ behind the lumen of the membranous urethra (=sphincteric urethra). Comparing the first 20 to the last 20, there were no treatment failures in the latter. A two year follow-up showed a continence rate of 65% in the first group, compared to a 85% continence rate in the second group taking into account the short median follow-up of 4.1.months in the latter. Tunneling the sling subcutaneously decreased postoperative loosening significantly. Conclusion: The AdVance® sling is a safe method of treating mild to moderate postprostatectomy incontinence, with no erosions in this series of patients. The hypothesis of sphincter laxity seems to play a definitive role in the pathophysiology of male incontinence. Correction of this urethral support descent or "prolapse" seems to be highly effective. Further studies are needed to accurately define the exaxt mechanism of action of the AdVance® sling.