[Lithotripsy of biliary calculi by shock waves. Current possibilities and perspectives]. / La lithotripsie du calcul biliarie par ondes de choc. Possibilités actuelles et perspectives.

The extracorporal shock wave lithotripsy can be recommended for the destruction of cholelithiasis in the gallbaldder and in intra- and extrahepatic ducts. For this treatment a strict selection of patients is necessary. Only bile stones composed mainly of cholesterol can be treated. It is better if the gallbladder contains only one stone. The gallbladder has to be anatomically and functionally intact. With this technic of destruction of cholelithiasis associated with litholytic medication a good result can be obtained and about 60% of patients have no cholethiasis after one year.

[Differential diagnosis of contrast medium recesses of the renal pelvis or the renal calyx system (author's transl)]. / Zur Differentialdiagnose von Kontrastmittelaussparungen des Nierenbeckens oder Nierenkelchsystems.

Contrast medium recesses in the renal pelvis and calyx system of a retrograde pyelogram or urogram are due to many widely different pathologico-anatomical changes in the renal region. It is the aim of the present study to show up this multitude of differential diagnostic possibilities which lead to contrast medium recesses in the renal pelvis and renal calyx system of a pyelogram.

[Reconstruction of intraoperative ureteral injury]. / Zur Rekonstruktion intraoperativer Harnleiterverletzungen

Intraoperative injuries of the upper urinary tract are seldom and mostly found in the prevesical segment of the ureter. The immediate plastic reconstruction by reanastomosis or regeneration shows positive results. Depending on the localization of the ureter trauma, ureterocystoneostomy, end to end anastomosis, or pyeloureteroneostomy are the most successful reconstruction methods.

[A urologic-radiological view of perinephric abscesses (author's transl)]. / Der paranephritische Abszess aus urologisch-radiologischer Sicht

Perinephric abscess is a rare condition; it may be acute, but can take a chronic and atypical course as a result of incomplete treatment with antibiotics. In this case the diagnosis is often delayed. The most common cause is primary renal disease, with perforating ureteric stones, abscess-forming pyelonephritis, renal carbuncle and pyonephrosis as the most important factors. Diagnosis depends on a varying combination of clinical signs, any of which is not necessarily present and which is not pathognomic, but nevertheless, in their totality, are fairly typical. Characteristic are pain on percussion and pressure, resistance in the renal angle and fever. Laboratory investigations do not contribute to the diagnosis. These only show findings typical of any infection, and frequently a marked anaemia. An infected urine may be suggestive. The traditional clinical and radiological methods may well indicate a space-occupying lesion, but its further elucidation depends on angiography. Renal and perinephric abscesses must be distinguished from other space-occupying renal lesions. Abscesses can usually be distinguished from cysts because they are generally less clearly demarkated and often show a hypervascular margin with a "blush". A further differential diagnosis of perinephic abscess is a peri-renal haematoma. Radiologically, an haematoma also produces a perirenal mass with displacement and compression of the kidney. As with perinephric abscesses, the angiogram shows dilatation and displacement of the capsular arteries. Differences in the neovascularity, as well as in the clinical symptoms, permit differentiation between abscesses and hypovascular carcinomas in most cases, or at least suggest the probable diagnosis.

[The treatment of prostatic adenoma]. / Zur Benhandlung des Prostataadenoms

Prostatic hyperplasia is a benign disease of elderly men. In 30-40% of the men the prostatic adenoma causes obstruction which requires operative treatment. 75% of these patients consult the general practitioner. Stage I is treated conservatively. Early surgery is indicated only in those undergoing surgery for hernia and in cases of intermittent obstruction. Operation is definitely indicated in stage II. Stage III should be treated initially with an indwelling catheter for 3-4 months. Treatment with lifelong indwelling catheter is rarely indicated today.