MINISTRY OF SCIENCE AND TECHNOLOGY
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E-mail: ured@znanost.hr
Title: Conservative treatment of female stress incontinence with
imipramine in Neuromuscular dysfunction of the lower urinary tract
Title: Fibrinogen radiation and blood plasma osmolarity in the
development of ischemic cerebrovascular insult
Title: Comparison of radiological and histological analysis of
pyeloureteral segment in adult patients with hydronephrosis
Title: Multiple Injuries
Title: Urine incontinency:theory, diagnostic and therapy
Title: The sigma-rectum pouch (Mainz Pouch II)
Title:
Title: Evaluation of Biochemical Parameters of Ejaculate in
obstructive Azoospermia
Title: Percutaneous drainage of pyelon and secondary infection
Title: Value of limphadenectomy in combination with radical
nephrectomy
Title: Kidney tumors - survival analysis
Title: Possibilities ND:YAG laser treatment with TURP at prostate
cancer
Title:
Title: The sigmoidorectal pouch (Mainz II)
Title: Operative treatment of urethral strictures
Title: Functional subvesical obstruction in females with instable
bladder detrusor contractions
Faculty: Medicinski fakultet Zagreb
Author: ADLER NEVENKA
Date of defense: 05/22/91
Language: hrvatski
Number of pages: 184
Summary: Urge incontinence, which is clinical expression of
unstabledetrusor, of known or unknown etiology has remained an
unsolvedproblem. I think that it is unnecessary to talk
aboutsocio-psychological aspects of the same problem. Investigationincludes
four aspects: neurophysiological investigation of thecontrol of
micturition, urodynamic characterization of unstablecontraction of
detrusor, pharmacological characteristics ofunstable detrusor, urodynanmic,
pharmacological and surgicalcharacterization of the bladder neck.
Neurological investigation shows that micturition is not a simplesacral
reflex of distension, but that it is a far more complexprocess, which is
integrated on higher levels of central nervoussystem. Suprapontine lesions
lead to nornmal micturition, but thevoluntary control of micturition is
lost. Intrapontine lesions(up to sacral voiding centre) lead to a more
complex disfunctionsof micturition. Both, suprapontine and infrapontine
lesionsresult in detrusor hyperrflexia in 70% of patients.
Suprapontinelesions have no sphincter dyssynergia; while it appears in 50%
ofpatients with infrapontine lesions. Lesions in the pons can leadto
detrusor areflexia as well as to detrusor hyperreflexia.According to our
results, pons is the main integrative centrewhich provides normal
micturition. To achieve the coordinatedfunction of detrusor and urethral
sphincter, it is necessary tohave intact pontine-cacral pathways.Urodynamic
examination showthat unstable detrusor contraction is unsustained, of
shortduration and therefore inefficient. To manifest the unstabledetrusor
contraction as urge incontinence, the volume of thebladder and not the
strenght of contraction, is important. Onlywhen the critical bladder volume
is achieved, the unstablecontraction leads to urge incontinence, regardless
of thestrenght of contracion. The results of investigation show
thattogether with unstable detrusor contraction there is also adisfunction
of urethral sphincter. The most frequent finding isthe contraction of the
sphincter during unstable detrusorcontraction, which presents a functional
subvesical obstruction.Any unstable detrusor contraction which doesnt
result in voidingpresents a functional obstruction with all its
consequences.
The results prove that unstable detrusor, at least in some parts,is the
cause of recurrent uroinfections.Detrusor instability andvesicoureteral
reflux make a speial problem. If vesicoureteralreflux is corrected
surgically and detrusor instability stillremains, the latter could be the
cause of repeated reflux. Inthese cases the YV plasty of bladder neck
should be performed. Incases of conservative treatment anticholinergics
should be usedwith anbtibiotics. If after YV plasty of bladder neck
thedetrusor instability disappears, it shows that the bladder
neck(functional obstruction) could have been the cause of instabilityand
possibly of vesicoureteral reflux as well. The paritnts withnocturnal
enuresis are characterized by reduced functionalbladder capacity, together
with unstable detrusor. The fact thatdetrusor instability with sphicter
disfunction appears even afterenuresis has stopped shows that enuresis is
only a part of a morecomplex syndrom.Parasympathicolitics are the base in
thetreatment of detrusor hyperreflexia. Althogh detrusorhyperrflexia is
cured the sphincter dyssynergia remains. Inpatients with detrusor
instability and urine retention,vesicouretral reflux, YV plasty of bladder
neck is recommended.There is no danger of incontinence if the incision
towardsurethra is not longer than 0.5cm. In cases of neurogenic bladder and
urge incontinence the operation is not recommended. It isbetter to perform
detrusor transection or CLAM ileocystoplasty.
Keywords: urodynamic, continence, detrusor instabillity, hyperreflection of detrusor, YV plastic, miction
Title: Evaluation of diagnostic parameters in obstructive
azoospermia
Faculty: Medicinski fakultet Zagreb
Date of defense: 12/22/92
Language: hrvatski
Number of pages: 137
Summary: The 78 patients with obstructive azoospermia FSH, ph, and
volumenof ejaculate, acid phosphatase, fructose, citric acid and zinc
ofejaculate, were analyzed. The diagnosis of obstructiveazoospermia was
defined by the absence of spermatozoid inejaculate, FSH values and testis
byopsie. The patients weredivided in to 3 groups. In the first group there
were 26 patientswith bilateral obstruction on the level of epididimis.
Secondgroup consisted of 26 patients with bilateral agenesis of seminalduct
and seminal vesicles agenesis. In the third group there were26 patients
with bilateral ejaculatory duct obstruction. Groupswere defined according
to the vasography and surgicalexploration. Control group consisted of 26
fertile men.
Statistical analysis (testing of differences of mean valuesbetween the
groups of each parameter, estimation of specifity,sensitivity, predictive
positive and negative values) showed thatthe most valuable tests were LDH,
volume of ejaculate and citricacid for the laboratory diagnosis of
obstructive azoospermia andfor the determination of the level of
obstriction, respectivelyfor the distinction between groups.
Those tests can reduce the whole spectrum of above mentionedtests with risk
of error of 1.28% to establish block and todetermine its level.
Discriminant analisys enabled new functions which discriminedsingle groups.
First function is defined by fructose, citricacid, acid phosphatase and
volume. Factors analisys defined newfactors which described groups acid
phosphatase, citric acid andzinc.
Keywords: obstructive azoospermia, ejaculation, fructose, citric acid, zinc, FSH, acid phosphatase
Title: Frequency and specifity of prostate carcinoma at
adenomectomised patients
Faculty: Medicinski fakultet Zagreb
Date of defense: 11/05/92
Language: hrvatski
Number of pages: 89
Summary: In this very study, 44 patients with prostatic
carcinoma,previously surgical treated, were investigated. The period
fromsurgical treatment to diagnosis accomplishment was at least ayear.
Patients were observed during 16-year period at theDepartment of Urology at
Hospital in Varaždin. The control groupconsisted of patients with recently
discovered prostaticcarcinoma without previous surgical treatment of
adenoma.Approximate time form surgical treatment of adenoma was 7.1
year,and approximate age at the time of operation was 67.5 yrs.Approximate
age in control group was 73.3 yrs. Staging of thedisease was determined by
Jewet-Whitmores classification, anddidnt show significant differences in
stage of the disease at themoment of discovery, between the investigated
and the controlgroup. The differences were not found between the groups,
neitherin grading nor in Gleasons score. The most frequentsymptomatology at
the moment of malignoma discovery was caused bysubvesical obstruction in
59% of investigated, and 35% of thecontrol group. Afterwards macrohematuria
(13,6 against 11,3%) andpains in bones (27,2 against 18,8%) followed.
Digitorectalfinding was positive in 88,6% of the examinees of the first
groupand 81,3% of the second one. Bone metastases were found in
theinvestigated group in 36,3% and in control one in 31,2%. Theincreased
acid prostatic phosphatase in the first one was 31,8%and in second 23,8%.
From 44 patients with surgically treatedadenoma, and subsequent occurrence
of prostatic carcinoma in 36ones adenomectomy was accomplished in Varaždin.
Through thementioned period, there were 3257 adenomectomies
accomplished,that means that at least in 1,1% of the operated,
prostaticcarcinoma occurs subsequently. For the same age and time,
theincidence of prostatic carcinoma in Croatia is 1,56%, thatapproximately
corresponds to previously obtained value, andspeaks in behalf of the fact
that there is no difference inrpostatic carcinoma incidence between the
patients withaccomplished surgical treatment of prostatic adenoma and the
restof the population of the same group. From 549 patients withrecently
discovered prostatic carcinoma, in the observed periodof time, in 6,5%(36)
adenomectomy was previously done. All thesedata should be a kind of
warning, that after surgical treatmentof adenoma, there is still the
possibility of prostatic carcinomaappearance, and therefore, routine
digitorectal examinationsshould be continued. According to the data for the
approachablepatients from the investigated group 60% died,
survivingapproximately 2,5 years after the diagnosis was obtained.
Fromprostatic carcinoma died 37,5% of patients, and from other causes22,4%.
In the control group died 45,5% of patients, survivingapproximately 3,2
years after the obtained diagnosis,respectively from carcinoma died 23,5%,
and from other causes22%. In alive patients observation of time was 1-12
years,approximately 4,2 years. By statistical analysis,
statisticaldifferences in survival between the investigated and
controlgroup were not found.
Keywords: prostate carcinoma, adenomectomy
Title: Functional subvesical obstruction in females with instable
bladder detrusor contractions
Faculty: Medicinski fakultet Zagreb
Mentor: RADEJ MARJAN
Date of defense: 05/22/91
Number of pages: 184
Author: Gilja dr. sc. znanstveni suradnik Ivan
Degree level: Ph.D.
Title: Evaluation of diagnostic parameters in obstructive
azoospermia
Faculty: Medicinski fakultet Zagreb
Mentor: RADEJ MARJAN
Date of defense: 12/22/92
Number of pages: 137
Author: Parazajder prim. dr. sc. znanstv. surad. Josip
Degree level: Ph.D.
Title: Value of urodinamic assesment at intervertebral disk
hernia
Faculty: Medicinski fakultet Zagreb
Mentor: GILJA IVAN
Number of pages: 70
Author: Bartolin mr. sc. Željko
Degree level: Ph.D.
Title: Ultrasound in diagnostic static urinary incontinence in
women
Faculty: Medicinski fakultet Zagreb
Mentor: GILJA IVAN
Date of defense: 11/24/94
Number of pages: 170
Author: Jolić mr. sc. Vladimir
Degree level: M.A.
Title:
Faculty: Viša medicinska škola Zagreb
Mentor: RADEJ MARJAN
Date of defense: 10/19/95
Number of pages: 24
Author: Tepeš med. sestra Zdravka
Degree level: D.A.
Title: PN and uroinfections
Faculty: Viša medicinska škola Zagreb
Mentor: RADEJ MARJAN
Date of defense: 06/21/94
Number of pages: 30
Author: Bašić med. sestra Mira
Degree level: D.A.
Title:
Title: Urinary incontinence
Title: Neurogenic bladder at paraplegics
Institution: Bolnica za rehabilitaciju Varaždinske toplice
Year: 1995
Title: Urinary incontinence: theory, diagnostic and treatment
Institution: Hotel belvedere
Year: 1994
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