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Dive into the research topics where R. Hohenfellner is active.

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Featured researches published by R. Hohenfellner.


The Journal of Urology | 1986

The Mainz Pouch (Mixed Augmentation Ileum and Cecum) for Bladder Augmentation and Continent Diversion

Joachim W. Thüroff; P. Alken; Riedmiller H; Udo Engelmann; G. H. Jacobi; R. Hohenfellner

AbstractThe surgical technique for construction of the Mainz (mixed augmentation ileum and cecum) ileocecal pouch for bladder augmentation or continent urinary diversion focuses on 3 functional features: 1) creation of a low pressure reservoir of adequate capacity from cecum and 2 ileal loops, which are split open longitudinally, 2) antirefluxing ureteral implantation into cecum or ascending colon, achieved by a standard submucosal tunnel technique, and 3) in cases of bladder augmentation continence depends on competence of the bladder neck and urethral closure mechanisms, while in urinary diversion continent closure of the pouch is achieved by isoperistaltic ileoileal intussusception or implantation of an alloplastic stomal prosthesis.Of 11 patients with Mainz pouch bladder augmentation (5 of which were undiversions) 10 are completely dry day and night with normal intervals of bladder evacuation. Two patients with myelomeningocele are on intermittent catheterization for bladder evacuation, while the rema...


European Urology | 1985

The mainz-pouch (mixed augmentation ileum 'n zecum) for bladder augmentation and continent diversion

Joachim W. Thüroff; P. Alken; Udo Engelmann; Riedmiller H; G. H. Jacobi; R. Hohenfellner

SummaryThe ideal urinary reservoir constructed from bowel material should be a low-pressure system with a high capacity, capable of preventing upper tract deterioration resulting from ureteral obstruction or reflux. It should achieve reliable control of continence and assure easy emptying of the reservoir. In the Mainz-pouch, the combination of cecum and ileum, the latter of which is able to absorb pressure waves created by the cecum, produces a low-pressure system with a high capacity immediately postoperatively. By incorporating large bowel in our pouch, ureteral implantation can be done using a simple and reliable standard antireflux technique with a submucosal tunnel. The Mainz-pouch has been done since 1983 in 26 patients. Of these 11 were for bladder augmentation after subtotal cystectomy and 15 for continent urinary diversion. All of the patients with bladder augmentation are completely dry day and night; 2 patients with myelomeningocele are on intermittent catheterization for bladder evacuation. The remainder void spontaneously without significant residual urine. Of 15 patients with Mainz-pouch urinary diversion, 4 had an alloplastic stomal prosthesis implanted for control of continence and 11 have isoperistaltic ileo-ileal invagination, where by the invagination valve can easily be fixed to the intussuscepting ileum by sutures or staples. Of the 4 alloplastic stomal prostheses, 2 have been removed because of infection. In 1 of these patients, an ileo-ileal invagination was performed in the same operation to achieve continent closure. All patients with the invagination valve, as well as the 2 patients with an alloplastic stomal prosthesis, are completely continent, but in 3 cases, revision of the ileo-ileal invagination became necessary due to prolapse of the valve.


Quality of Life Research | 2000

Quality of life in patients with bladder carcinoma after cystectomy: First results of a prospective study

Jochen Hardt; Dragana Filipas; R. Hohenfellner; Ulrich Tiber Egle

This study reports the changes in the quality of life (QoL) of 44 patients observed prospectively from pre-surgery to one year post-surgery. Two kinds of surgeries were compared: continent and incontinent urinary diversion. In most areas the QoL returned to the prior level within one year after surgery. However, patients were restricted in their physical activity, sexual activity, and emotional well-being. Using individual weights for different aspects of life (Fragen zur Lebenszufriedenheit – Module FLZM), QoL was higher than when using an unweighted measurement (Short Form 36, MOS). Two trends for the different developments in the QoL were established: general life satisfaction and social functioning tended to improve after a continent diversion but decreased after an incontinent diversion. The perceived global satisfaction with both kinds of diversion was high – 75% of the patients would choose the same kind of diversion again.


The Journal of Urology | 1977

Ultrasound Litholapaxy of a Staghorn Calculus

K.H. Kurth; R. Hohenfellner; J.K. Altwein

A method for removal of a staghorn calculus from the kidney through 1 channel of a U-tube nephrostomy is presented. An ultrasound lithotriptor provided a safe and quick alternative to surgical treatment.


The Journal of Urology | 1977

Followup of irradiated prostatic carcinoma by aspiration biopsy.

K.H. Kurth; Jens E. Altwein; D. Skoluda; R. Hohenfellner

Of 66 patients with irradiated prostatic carcinoma 53 were controlled regularly by repeat aspiration biopsy every 6 months. Local sterilization was achieved in 43 per cent but the results of combined radiotherapy (endocrine therapy plus irradiation) were only 8 per cent more favorable than those in patients treated by radiotherapy alone. Thus, endocrine therapy is not warranted before the radiation effect is evaluated. Post-radiation treatment should be determined by the clinical and bioptic findings.


European Urology | 1998

History of oral mucosa.

D. Filipas; U. Wahlmann; R. Hohenfellner

Accessible online at: http://BioMedNet.com/karger For 100 years, oral mucosa has variously been utilized as a free graft in reconstructive plastic surgery. In urology an increasing interest concerning this form of tissue transfer has been observed in the recent past. The intention of the following historical overview (table 1) is to give a link to other domains where the applications for urology have been developed. The first report on the application of oral mucosa as a substitute for conjunctiva dates back to 1873, when Stellwag von Carion used lip mucosa to treat conjunctival defects. In the late 19th century further ophthalmologic applications followed. Van Milligen (1880) and Portmann (1900) transplanted oral mucosal strips to treat trichiasis. In the early 20th century, oral mucosa was often transplanted in ophthalmic surgery. Wolff (1905) used it to treat a symblepharon, Denig (1910) to correct scarring after burns. Morton (1898), De Voe (1945), and Stallard (1946) transplanted it to the orbit prior to placement of orbital prostheses. Today oral mucosa can be used for conjunctivodacryocystorhinostomy and serves as an excellent substitute for tarsal and conjunctival tissues [1]. The mucosa was harvested preferably from the inner aspect of the lower lip using a razor blade or a scalpel, alternatively from the buccal plane with sharp scissors or a scalpel [2]. Further donor areas include the inner aspect of the upper lip, the hard palate, the sublingual area and the posterior pharyngeal wall [3]. To get more predictable results, Castroviejo [4] presented a set of clamps to stretch the donor area and a motor-driven ‘Electrokeratotome’. In oral and maxillofacial surgery mucosal transplants were used predominantly for preprosthetic vestibuloplasty, but also for reconstruction of mucosal and lip vermilion defects [5]. Table 1. Historical overview


The Journal of Urology | 1982

Localization of Segmental Arteries in Renal Surgery by Doppler Sonography

Joachim W. Thüroff; D. Frohneberg; R. Riedmiller; P. Alken; G. Hutschenreiter; S. Thüroff; R. Hohenfellner

To avoid damage to major arteries of the renal parenchyma during nephrotomy, intraoperative Doppler sonography was used experimentally and clinical as an artery finder. In experiments with 7 beagles segmental arteries were detected easily and reliably by sonography, and the arterial course thus indicated correlated perfectly with arteriograms and casts. In a clinical trial the Doppler artery finder was used in 7 patients with staghorn calculi that were removed via the renal pelvis and additional multiple selective nephrotomies with as many as 7 selective nephrotomies in a single kidney there was no damage to the major arteries in any of these patients. Selective, avascular nephrotomy with the aid of the simple, quick and reliable technique of Doppler sonography promises improved functional results of transparenchymal stone manipulation.


BJUI | 2005

Uretero‐Ureterocutaneostomy (Wrapped By Omentum)

Michele Lodde; Armin Pycha; Salvatore Palermo; Evi Comploj; R. Hohenfellner

The tubularized‐incised plate urethroplasty has traditionally been used in children for repairing hypospadias. As shown here, it can also be used successfully in adults, with very good results. The rate of wound healing, infection and complications is the same as in children, as are the cosmetic and functional outcomes.


BJUI | 2007

Colon pouch (Mainz III) for continent urinary diversion

Jens-Uwe Stolzenburg; Thilo Schwalenberg; Evangelos Liatsikos; G. Sakelaropoulos; Kilian Rödder; R. Hohenfellner; Margit Fisch

Authors from Germany present data on the Mainz III pouch, where a colon segment is used. The results were very encouraging, with excellent continence rates. They suggest that this technique of continent urinary diversion should be considered as a suitable alternative to other methods.


The Journal of Urology | 1983

Doppler and B-mode ultrasound for avascular nephrotomy.

Riedmiller H; Joachim W. Thüroff; P. Alken; R. Hohenfellner

Doppler sonography for intraoperative localization of the intrarenal arteries combined with B-scan sonography for intraoperative visualization of stones allows complete stone removal via small radial nephrotomies for which clamping of the renal artery is no longer necessary. Since September 1980 we used this technique on 35 patients with staghorn or recurrent calculi. The main advantages of this technique are exact and quick stone localization, minimal loss of renal function owing to preservation of the intrarenal vascular system, and no need for renal ischemia and cooling.

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