I. Publizierte Arbeiten / Published studies:

137. Riedl C. R., Lorenz W., Plas E., Pflüger H.:
     „Adenocarcinoma of the Appendix Testis“,
     J. Urol., Vol. 161, 219-220, 1999

     

138. Riedl C. R., Plas E., Hübner W. A., Zimmerl H., Ulrich W., Pflüger H.:
     „Bacterial Colonization of Ureteral Stents“,
     Eur. Urol., 36, 53-59, 1999
     OBJECTIVES: The aim of this study was to assess the frequency of bacterial stent colonization and stent-associated bacteriuria, and to evaluate the significance of urinary cultures for identification of colonizing microorganisms. METHODS: A total of 93 ureteral stents from 71 patients were examined: 9 patients with permanent ureteral stenting due to malignant ureteral obstruction (27 stents), and 62 patients with temporary ureteral stents (66 stents). RESULTS: Bacteriuria and bacterial stent colonization were found in all patients with permanent stents. In patients with temporary stents, colonized stents were found in 69.3% (43/62), mainly in combination with sterile urine (45.2%, 28/62). Mean indwelling times did not differ between patients with sterile urine and sterile stents (11.8 days) and patients with sterile urine and colonized stents (11.2 days). Prophylactic antibiosis in 42/62 temporarily stented patients did not reduce colonization rates compared to patients without antibiotics (70 vs. 65%). Enterococci were the bacteria most frequently cultured from urine and stents. CONCLUSIONS: In the present study, ureteral stent colonization rates were 100% in permanently and 69.3% in temporarily stented patients. Antibiotic prophylaxis did not prevent stent colonization and should not be routinely administered. Since urinary cultures correctly identified all colonizing microorganisms in only 21%, removal/replacement and bacteriologic evaluation of ureteral stents may be necessary in case of urosepsis.

     

139. Riedl C. R., Vorauer K., Pflüger H.:
     „Recombinant human superoxid-dismutase (SOD) for the treatment of Peyronies’s Disease (PD)“,
     J. Urol., Vol. 161, No. 4, Supp., 205 (784), 1999

     

140. Riedl C. R., Plas E., Pflüger H.:
     „Fluorescence Detection of Bladder Tumors with 5-Amino-Levulinic Acid“,
     J. Endourol.,Vol. 13, No. 10, 1999
     BACKGROUND: Preliminary data suggest that photodiagnosis by fluorescence detection of protoporphyrin IX, a biosynthetic product of the photosensitizer 5-amino-levulinic acid (ALA), is superior to conventional cystoscopy in bladder tumor detection. PATIENTS AND METHODS: We instilled 1.5 g of ALA into the bladders of 52 patients with suspect bladder lesions 1 to 4 hours prior to transurethral resection or biopsy. Red fluorescence was induced by violet-blue light (wavelength 380-450 nm). RESULTS: In 13 patients (25%), significant tumors were detected by fluorescence that were missed on conventional cystoscopy. In the present series, ALA photodetection had a sensitivity of 94.6% (compared with 76% for cystoscopy) and a specificity of 43%. CONCLUSION: Fluorescence diagnosis with ALA may become a standard procedure for bladder tumor detection and resection, especially in endoscopically difficult situations (carcinoma in situ, multifocal tumors, multiple prior resections, or previous drug instillation therapy).

     

141. Riedl C. R., Pflüger H.: 
     „Photodiagnostik zur Feststellung von Blasenkarzinomen“, 
     Urologik, Editorial, Nr. 1, 1999
     Am 28. Oktober 1998 fand am Wiener AKH das erste Symposium der neu gegründeten Wiener Gesellschaft für photodynamische Diagnostik und photodynamische Therapie statt. Obwohl die heilende Wirkung von Licht in Kombination mit verschiedenen pflanzlichen Wirkstoffen schon den Ägyptern und Indern vor mehr als 3.000 Jahren bekannt war, hat eine kontinuierliche Erforschung photodynamischer Verfahren erst seit den 70er Jahren dieses Jahrhunderts stattgefunden. Heute eröffnet uns die Anwendung von Licht ein neues Spektrum an diagnostischen und therapeutischen Möglichkeiten.'
     

     

142. Pflüger H.:
     „Therapie des fortgeschrittenen Prostatakarzinoms“, 
     Onkologisch, Sonderausgabe 1, Interdisziplinäre Fortbildungsveranstaltung Focus: Prostatakarzinom, Feb./99, 1999

     

143. Plas E., Riedl C. R., Engelhardt P. F., Mühlbauer H., Pflüger H.: 
     „Unilateral or bilateral testicular biopsy in the era of intracytoplasmic sperm injection“, 
     J. Urol., Vol. 162, 2010-2013, 1999
     PURPOSE: Intracytoplasmic sperm injection has significantly improved the treatment of male infertility. Since only single vital spermatozoa are required for successful fertilization, the value of unilateral or bilateral diagnostic testicular biopsies in patients with azoospermia is controversial. We evaluated differences in bilateral testicular biopsies in azoospermic patients with regard to testicular histology and focal spermatogenesis. MATERIALS AND METHODS: Histopathological results of 100 testicular biopsies from 50 patients (mean age 33.3 years) were reviewed. In all cases azoospermia was the indication for diagnostic testicular biopsy. Intra-individual differences of bilateral testicular biopsies were retrospectively reviewed by determining the latest stage of spermatogenesis. RESULTS: After bilateral biopsy a difference in testicular histology was found in 28% and identical histopathology was noted in 70% of patients. An unsuspected burned out seminoma with maturation arrest in the contralateral testis was seen in 2% of cases. Testicular symmetry determined by a Prader orchidometer was noted in 54.8% of patients whereas 45.2% had asymmetrical testis. The frequency of divergent histopathologies in relation to testicular symmetry was 21.7 and 26.3%, respectively. Spermatozoa were found in 42% of right and 44% of left testes (p >0.05), and spermatids as the latest stage of differentiation were detected in 14 and 16%, respectively (p >0.05). Differentiation of testicular histologies according to the side of biopsy revealed spermatozoa and/or spermatids in 56% of right and 58% of left testes (p >0.05). Bilateral biopsies increased the detection of focal spermatogenesis to 68%. If only unilateral diagnostic testicular biopsies had been performed, in 20% of patients focal spermatogenesis in the contralateral testis would have been missed. CONCLUSIONS: Bilateral testicular biopsies are superior to unilateral biopsies in the evaluation of patients with azoospermia. A 28% intra-individual difference in testicular pathology was seen after bilateral biopsies, and in 20% of patients focal spermatogenesis would have been missed after unilateral biopsy only. Due to the prognostic relevance of testicular biopsies for successful sperm retrieval before assisted reproduction, bilateral diagnostic testicular biopsies are recommended in the evaluation of patients with azoospermia.

     

144. Engelhardt P. F., Simak R., Riedl C. R., Pflüger H.: 
     „Is a second look TUR-B in patients with superficial bladder cancer necessary?“,
     Eur. Urol., 35 (Suppl. 2), 93, 1999

II. In Druck / In print:

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