Diagnosis of femoropopliteal venous thrombosis: comparison of duplex sonography and plethysmography.

Duplex sonography and impedance plethysmography were correlated with contrast venography to compare the sensitivity, specificity, and accuracy of the two noninvasive techniques for the diagnosis of femoropopliteal venous thrombosis. Sensitivity, specificity, and accuracy of duplex sonography were 90%, 100%, and 97%, respectively, when compared with venography in 32 patients. Sensitivity, specificity, and accuracy of plethysmography were 100%, 63%, and 72%, respectively, when compared with venography in 25 patients. In 21 patients, plethysmography was either nondiagnostic or could not be done because of clinical difficulties. Eighteen of these patients had diagnostic duplex examinations. Duplex sonography exhibits similar sensitivity but higher specificity than plethysmography. Duplex sonography also permits diagnostic examinations in patients in whom diagnostic plethysmography cannot be performed.

[Tuberculosis of the urogenital tract--guidelines for evaluation within the social compensation law and laws for the disabled]. / Tuberkulose des Urogenitaltraktes--Hinweise zur Begutachtung im Sozialen Entschädigungsrecht und nach dem Schwerbehindertengesetz.

For the urologist who works as a consultant in the German "Social Compensation Law" tuberculosis of the urogenital tract is of current interest. The assessment of a causal connection represents no difficulty, when the existence of a pleuritis exsudativa is proven or when tuberculosis is accepted as being military service connected. For the assumption of a causal connection in the so called compensation law the probability is sufficient and it should be considered, that long term latencies are typical. The consultant must realize that today tuberculosis is a curable infection because of the effective chemotherapy. One must be aware of this by the determination of the MdE. In the future a term of recovery will not be justified as a whole. The final decision will be made only according to the extent of the remaining functional disturbances. On the basis of 358 examinations of the Compensation board in Giessen an outline of present evaluation of tuberculosis of the urogenital tract is presented.

[Electron microscopy of the lymphatics of the ureter (author's transl)]. / Elektronenmikroskopische Untersuchungen des Lymphgefässsystems des Ureters.

Microvasculature of the mouse and human ureter was investigated by light and electron microscopy. Lymph vessels were only seen in the adventitial layer of the mouse ureter. Only one lymph capillary could be demonstrated in the submucosal and muscularis layer of the human ureter. Fenestrated blood capillaries were arranged just beneath the transitional epithelium. Numerous thin-walled postcapillary venules characterized by endothelial channels and fenestrations were seen in the adventitial layer. Apparently, a widespread ureteral lymphatic system is not necessary, since protein rich extracellular fluid can be reabsorbed by venous blood capillaries.

Endometriosis of the ureter.

Endometriosis of the ureter is an exceptional cause of ureteral obstruction. Pathogenesis and clinical picture are demonstrated on the basis of 2 cases, giving an example for the spread of endometrial tissue via the lymphatics. It is emphasized that young women should have a gynecological examination in case of pelvic ureteral obstruction. Final diagnosis of the isolate ureteral endometriosis can only be made by histological examination. Therapy is usually surgical followed by hormonal treatment. The routine use of excretory urograms in women suffering from endometriosis should prevent urological complications.

[Fistulas between bowel and urinary tract (author's transl)]. / Fistelverbindungen zwischen Darm- und Harntrakt.

From 1968 to 1977, 21 patients were observed who had fistulas between the bowel and the urinary tract. Except in five patients, fistulas were located vesicointestinally. The main etiologic factors were inflammatory lesions of the bowel, especially diverticulitis and appendicitis. All patients had symptoms relating to the urinary tract, mainly recurrent urinary infection with dysuria. On the average, nine months passed until the fistula was diagnosed. Urethrocystoscopy proved to be the most valuable aid in diagnosing intestinovesical fistulas, the fistulous opening was thus seen in 11 patients. Thirteen patients were treated by operation and eight by conservative treatment only. In the conservatively treated group, two fistulas healed spontaneously. Fistulas based on diverticulitis from the sigma were treated using a multiple stage procedure. No complications were observed.