[Successful penis replantation after auto-emasculation with suicidal intent]. / Erfolgreiche Penisreplantation nach Autoemaskulation in suizidaler Absicht.

We report a case of successful penis replantation in a young man with psychotic state and self-emasculation. For replantation we used microsurgical techniques. Success depends on microsurgery and postoperative management. Postoperative care consists in (1) improvement of microcirculation, (2) broad-spectrum antibiotic treatment, (3) blood flow control on a strict hourly schedule, (4) safe supra-pubic urinary diversion, and (5) an elevating dressing for the penis to ensure the blood flow.

[Rare metabolic and cerebral complications after polychemotherapy of a testicular tumor]. / Seltene metabolische und zerebrale Komplikationen nach Polychemotherapie eines Hodentumors.

In a 21-year-old patient with a tumor of the right testis, CT indicated a pathologically altered lymph node in the interaortocaval region. After high inguinal orchiectomy we performed a modified retroperitoneal lymph node dissection and monitored its success by immediate section for microscopic examination. Pathohistological investigation yielded immature teratoma. The patient was given two courses of adjuvant polychemotherapy containing cisplatin. Two days after the conclusion of the second course he was readmitted with grand mal epilepsy and visual agnosia. Two months later another grand mal epileptic fit occurred. The patient also suffered from marked metabolic disorders, such as hypokalemia, hyperreninism, hyperaldosteronism, kaliuresis, and hypertension. We consider these to be toxic side effects of cisplatin resulting in nephropathy. Evidence of cisplatin-induced encephalopathy was obtained by NMR tomography and EEG which indicated barrier disorders. Symptoms were relieved and continuous normalization of blood pressure, potassium level, and water and electrolyte balance was achieved by the administration of potassium substitution, ACE inhibition, and an aldosterone antagonist. The patient has since remained in a stable condition.

[Hamartoma polyps of the urethra]. / Hamartöse Polypen der Harnröhre.

Fibroepithelial polyps are rare benign tumours that can cause obstruction of the urethra. Most such polyps occur during childhood. We present two patients, one is a child, the second an adult male. The problematic diagnosis is emphasized.

[Morphology and diagnosis of acquired bladder deformities]. / Zur Morphologie und Diagnostik erworbener Harnblasenverlagerungen.

Acquired displacements of the urinary bladder refer to intrapelvic pathological anatomy. These alterations of the bladder are predominantly detected via an initial radiologic study with intravenous urography or suprapubic pelvic ultrasonography. According to their clinical incidence displacements of the bladder can occur in: pelvic space-occupying lesions; displacements in musculo-fascial defects of supporting structures as well as in extirpation cavities of the small pelvis; extrapelvic space-occupying lesions. Herniation, prolapse and descensus of the bladder can be accurately diagnosed by correct examination via intravenous urography. The diagnostics of pelvic and extrapelvic pathogenetic causes require the complex application of all methods of diagnostic imaging, the value of which is determined by clinical diagnosis and by the choice of an appropriate therapy.

[Frequency and distribution of arterial hypertension in hydronephrosis kidneys]. / Die Häufigkeit und Verteilung der arteriellen Hypertonie bei Harnstauungsnieren.

By means of a retrospective study disease cases with urinary stasis in the kidney from 1978 to 1982 were investigated. 228 cases were evaluated. The different genesis was demonstrated, in which cases the ureterolith dominated as most frequent cause. 127 (55.7%) patients were hypertensives, whereas 101 (44.3%) had non-hypertensive blood pressure values. With regard to the duration and degree of the kidneys with urinary stasis there were no significant differences between hypertensives and non-hypertensives, though, the hypertensives showed a distinct (p less than 0.05) restriction of the renal function. The prevalence of hypertension of 55.7% in coincidence with urinary stasis in the kidney speaks for a certain causal connection between the two diseases. Investigations of the pressor and depressor systems might contribute to the further clarification.

[The role of computerized tomography in the diagnosis and treatment planning of prostatic cancer]. / Die Rolle der Computertomographie in der Diagnostik und für die Therapieplanung des Prostatakarzinoms.

The influence of computerized tomography on planning the therapy of 58 patients with histologically confirmed carcinoma of the prostate gland was examined. In classifying the early tumour stages there were differences from the clinical findings. With more advanced stages CT in some cases gave much more detail for diagnosing the extension. In 11.5% of the cases this led to the irradiation field being either enlarged or reduced. CT also proved to be useful for follow-up, especially as regards decisions on increasing the irradiation dose.

[Nephropexy using tissue adhesive. A 10-year analysis]. / Nephropexie mit Gewebekleber. Eine 10-Jahresanalyse.

A report is given on 10 years' experience of nephropexy using tissue adhesive. The uncomplicated method of operation is described. Pathological aspects, indications, pre-operative data and post-operative results are dealt with. The method of operation described has proved its worth by acceptable results in practice.