bluuebunny/crossref_metadata_2025 huggingface dataset:
Biological Behaviour and DNA Cytophotometry of Urothelial Bladder Carcinoma
Authors: Hofstaedter F. , Jakse G. , Lederer B. , Mikuz G. , Delgado R.
Published: November 2008

Summary—
In this prospective study, primary urothelial bladder tumour specimens from 64 patients were investigated by means of DNA Feulgen cytophotometry. The patients were followed clinically for at least 7 years. The objective cytophotometric parameters correlated well with the histopathological grading and the cytochemical data were of considerable prognostic value. They were closely correlated with the stage of the tumour, 5‐ and 7‐year survival rates and the probability of tumour recurrence.

It is concluded that DNA cytophotometry can serve as a method for the standardisation of histological grading and can give more objective and more detailed prognostic information than conventional histopathology.
Cis‐diamminedichloroplatinum (DDP) as Initial Treatment of lnvasive Bladder Cancer
Authors: Fagg Sara L. , Dawson‐Edwards P. , Hughes M. A. , Latief T. N. , Rolfe E. B. , Fielding J. W. L.
Published: November 2008

Summary—
Cis‐diamminedichloroplatinum (DDP) was used as the initial treatment in a pilot study of 17 patients with biopsy‐proven transitional cell carcinoma of the bladder. No patient had received any previous radiotherapy or chemotherapy. The clinical stages of the tumours were T2 (2 patients), T3 (13) and T4 (2).

Before treatment the tumours were assessed by cystoscopy, biopsy, examination under anaesthesia (EUA), computed axial tomography (CT scan) and ultrasound. DDP was given at a dose of 100 mg/m2 intravenously with hydration using mannitol and saline. Each patient received three treatments at 3‐weekly intervals. Twelve days after the third treatment, response was assessed by cystoscopy, biopsy, EUA, CT scan and ultrasound.

Eleven of the 17 patients had a partial response. Survival was significantly increased in responders compared with non‐responders. Seven patients had a low creatinine clearance following treatment, 5 had audiograms showing evidence of ototoxicity and 2 developed leucopenia during treatment.

This study confirmed the activity of DDP in bladder cancer and showed that it was active in producing a response in the primary tumour in 11 of 17 patients.
Lymphocytic Infiltration of the Prostate
Authors: Lewi H. J. E. , White A. , Cassidy M. , McCallum H. M. , Spilg W. G. S. , Scott R. , Hutchison A. G.
Published: November 2008

Summary—
Symptomatic presentation due to lymphocytic infiltration of the prostate is rare. Six patients are described in whom lymphocytic infiltration of the prostate was secondary to non‐Hodgkin's lymphoma, chronic lymphatic leukaemic, and myeloid leukaemia. The prostatic infiltration was sufficiently extensive to result in outflow tract obstruction.
Closure of Urethral Fistulae by Transverse Y‐V Advancement Flap
Authors: Moscona A. R. , Govrin‐Yehudain J. , Hirshowitz B.
Published: November 2008

Summary—
A transverse Y‐V advancement flap procedure for the closure of urethral fistulas is described. This simple and safe technical aid helps to provide a double‐layer closure and is also helpful in preventing recurrence of the fistula.
Urinary Tract Anomalies in Patients with Hypospadias
Authors: Kelly D. , Harte F. B. , Roe P.
Published: November 2008

Summary—
Fifty‐five patients with hypospadias were reviewed. Intravenous urography was carried out on 80%. The incidence of upper urinary tract anomalies was 22%. This was independent of the severity of the hypospadias. Patients with hypospadias and undescended testis were reviewed as a separate group. The incidence of upper urinary tract anomaly here was 31%. Again, the incidence was not influenced by the severity of the hypospadias. None of the upper urinary tract anomalies required surgical intervention. It is concluded that routine IVU is not indicated in all cases of hypospadias.
Clinical Results of Early and Late Operative Correction of Undescended Testes
Authors: Thorup J. , Kvist N. , Larsen P. , Tygstrup I. , Mauritzen K.
Published: November 2008

Summary—
Operative treatment of undescended testes was performed in 556 boys (695 testes). The histopathological changes in the testicular tissue were more severe in older patients. However, post‐operative clinical results were found to be significantly better in boys treated immediately before puberty than in boys treated at an earlier age.
Doppler Localisation of Intrarenal Vessels: An Experimental Study
Authors: FITZPATRICK J. M. , MURPHY D. M. , GOREY T. , ALKEN P. , THÜROFF J.
Published: November 2008

Summary— The use of the Doppler probe to localise the intrarenal vessels was assessed in 15 dogs. This prevented the need for renal artery clamping and radial nephrotomies were placed in silent areas on the renal surface. Functional studies were performed post‐operatively at 48 h and 1 month, using creatinine clearance, microfil casts and cast angiography. There was no significant loss of function when three or six radial nephrotomies were made and the Doppler accurately localised sites for nephrotomy between the intrarenal arteries and veins which were undamaged.
Is the Incidence of Renal Carcinoma Increasing?
Authors: RITCHIE A. W. S. , KEMP I. W. , CHISHOLM G. D.
Published: November 2008

Summary— An analysis of standardised incidence rates for renal parenchymal tumours over a 14‐year period in Scotland demonstrated a significant increase in disease incidence for males but not females. Reasons are presented to support the contention that this increase is in part real.
Gunshot Injuries of the Urinary Tract
Authors: HEHIR M. , DUFF F. A. , KELLY D. G.
Published: November 2008

Summary— Five cases of gunshot injuries to the kidney, ureter, bladder, urethra and male external genitalia are reported. One case required nephrectomy. The others regained normal genitourinary function after surgical repair and/or adequate drainage and splintage.
The Impact of Transurethral Ureteroscopy on the Management of Ureteric Calculi
Authors: FORD T. F. , PAYNE S. R. , WICKHAM J. E. A.
Published: November 2008

Summary— Transurethral ureteroscopy has now been used in an attempt to retrieve ureteric calculi in 48 patients. Six stones were located in the upper ureter, 11 in the middle and 31 in the lower third of the ureter. Successful retrieval was achieved in 27 patients at the first attempt and in 4 at a second ureteroscopy. Of the 17 failures, 7 patients have required open ureterolithotomy, 3 percutaneous nephrolithotomy and the remainder passed their stones either after in situ disintegration or ureteric meatotomy. There have been no serious complications to date. Transurethral ureteroscopy should now be regarded as the procedure of first choice in the management of ureteric calculi.
A New in vitro Microsuperfusion Technique for Investigation of Human Detrusor Muscle
Authors: PALFREY E. L. H. , FRY C. H. , SHUTTLEWORTH K. E. D.
Published: November 2008

Summary— There is a paucity of information regarding the behaviour of human detrusor muscle in vitro. This is mainly due to the dependence of muscle bath techniques on large strips of material, which can be obtained only at open operations and which may not be viable because of limited diffusion of oxygen and metabolites through the tissue.

We report a new technique for the in vitro study of muscle obtained during endoscopic procedures by cup biopsy. The results obtained from normal muscle show that this technique gives consistent and reproducible results.
Mazindol for Nocturnal Enuresis
Authors: TIPTAFT R. C. , WOODHOUSE C. R. J. , BADENOCH D. F.
Published: November 2008

Summary— Sixteen adult enuretics who had failed to respond to simple conventional treatment of their symptoms have been investigated and treated with mazindol. Sixty‐three per cent have been made dry and improvement achieved in a further 31%.
Maximum Perineal Stimulation. A Controlled Study
Authors: SHEPHERD ANGELA M. , TRIBE ELIZABETH , BAINTON D.
Published: November 2008

Summary— Previous workers have debated the value of maximal perineal stimulation (MPS) in the treatment of urinary incontinence in women. In order to assess the efficacy of this simple technique a prospective study was undertaken on 107 consecutive incontinent women. They included those with stress, urge and mixed patterns of leakage.

Patients were placed at random into treatment and control groups. All underwent clinical assessment, urodynamic study and a single session of pelvic floor re‐education with measurement of pelvic contraction and cystoscopy. Those in the treatment group were given MPS using monophasic square wave pulses while under anaesthesia. Independent follow‐up assessment was performed 6 and 12 weeks after treatment.

Of the 107 patients 94 completed the trial. Forty‐five were treated and 49 acted as controls. Analysis of age, parity, duration and severity of incontinence showed that randomisation had produced comparable results between the treated and the control groups. Sixty per cent of the treatment group and 66% of the control group had significant symptomatic improvement. Pelvic floor function was re‐assessed, using a perineometer, and found to be more efficient, having increased equally in both groups.

Both groups of women improved irrespective of the pattern of incontinence. This suggests that MPS does not contribute to the management and that a single physiotherapy session with skilful counselling can produce beneficial results in women with all types of urinary incontinence.
Promotion of Bladder Tumours by Endoscopic Procedures in an Animal Model
Authors: WALLACE D. M. A. , SMITH J. H. F. , BILLINGTON S. , SMITH M. R. , STEMPLEWSKI H. E. , TIPTON P. W.
Published: November 2008

Summary— An experimental study was performed to assess the possible tumour‐promoting action of urothelial trauma caused by repeated intravesical diathermy, catheterisation, and the instillation of water, glycine and saline in the rat bladder which had previously been exposed to an initiating dose of the carcinogen N‐methyl‐N‐nitrosourea. An increase in tumours and inflammatory changes was observed, especially in the group treated with water, and the significance of the findings is discussed.
Treatment of Invasive Bladder Cancer by Local Resection and High Dose Methotrexate
Authors: HALL R. R. , NEWLING D. W. W. , RAMSDEN P. D. , RICHARDS B. , ROBINSON M. R. G. , SMITH P. H.
Published: November 2008

Summary— Fifty‐seven patients with transitional cell carcinoma of the bladder, categories pT2, pT3a and pT3b, were treated by transurethral resection of the tumour mass (54 cases) or partial cystectomy (3 cases) followed by 8 doses of methotrexate 2 g i.v. every 3 weeks with appropriate Leucovorin rescue.

At completion of chemotherapy 6 months after TUR 33/57 patients were tumour‐free; 5/57 had new superficial tumours; 13/57 had persistent tumour invading muscle, 3 showed tumour progression and 3 had died from treatment complications. One‐year survival was 45/57 (82%);2‐year survival was 23/39. Although some patients developed metastases and others have grown new superficial tumours, of those surviving, the bladder was free of the original invasive tumour in 38/45 (84%) at 1 year and in 19/24 (79%) at 2 years.

It is concluded that transurethral resection plus high dose methotrexate may offer an effective alternative to radiotherapy or cystectomy for a significant proportion of patients with invasive bladder cancer.
Use of Alum to Control Intractable Vesical Haemorrhage
Authors: KENNEDY C. , SNELL M. E. , WITHEROW R. O.
Published: November 2008

Summary— Eight patients with hitherto uncontrollable vesical bleeding were treated by irrigating the bladder with a 1% solution of alum. The method does not require anaesthesia and bleeding ceased in every case.
Calcium Excretion in Metastatic Prostatic Carcinoma
Authors: GRAINGER R. , REDA M. , FITZPATRICK J. M.
Published: November 2008

Summary— In 64 men with prostatic carcinoma, calcium excretion per litre of glomerular filtrate (Cae) was persistently lower in those with bone secondaries than in those with soft tissue involvement only, despite a normal range of serum calcium in both groups. In three patients who showed an improvement in their bony metastases on bone scan 6 months after starting treatment, the Cae values had increased slightly but still remained in the low range. In a further five who showed no improvement on bone scan, Cae values were lower than before. In patients with prostatic carcinoma, Cae is an indicator of early changes in calcium homeostasis. It may also provide an objective indication of progression of bone secondaries.
Radical Prostatectomy and Cystoprostatectomy with Preservation of Potency. Results Using a New Nerve‐sparing Technique
Authors: WALSH P. C. , MOSTWIN J. L.
Published: November 2008

Summary— A surgical technique that preserves the branches of the pelvic plexus that innervate the corpora cavernosa was employed during radical retropubic prostatectomy in 64 men and radical cystoprostatectomy in 11 men. In patients undergoing radical retropubic prostatectomy, sexual function returned gradually in the vast majority of patients post‐operatively and by 1 year 86% were potent. The age of the patient did not influence post‐operative potency but potency did correlate with clinical and pathological stage. Preliminary data suggest that deliberate excision of the neurovascular bundle unilaterally did not adversely affect potency. Of the 11 patients who underwent radical cystoprostatectomy, 82% have erections. Of the 6 patients with sexual partners who have been followed for 1 year, 4 (67%) are potent. These data suggest that erectile function can be preserved in most patients following radical prostatectomy and cystoprostatectomy.
Nesbit's Operation for Peyronie's Disease
Authors: LEMBERGER R. J. , BISHOP M. C. , BATES C. P.
Published: November 2008

Summary— Nineteen patients with Peyronie's disease were treated by a modification of Nesbit's operation. The deformity was completely corrected in 18 patients. Potency was restored to 4 of the 6 impotent patients and satisfactory coitus became possible for 15 patients, whereas it had been possible for only 3 before operation.
Reappraisal of the Role of Radiotherapy and Surgery in the Management of Carcinoma of the Penis
Authors: EL‐DEMIRY M. I. M. , OLIVER R. T. D. , HOPE‐STONE H. F. , BLANDY J. P.
Published: November 2008

Summary— The iridium mould technique was used as the method of choice whenever possible in a series of 80 cases of cancer of the penis. When the growth was confined to the glans penis the survival rate was 89% but local recurrence called for subsequent amputation in 22%. When tumour had invaded the corpus cavernosum, irradiation improved the survival rate but amputation was required in 75 to 80%. Prognosis correlated well with histology, patients with a “cord” pattern having the worst prognosis.
Possible New Approaches to the Management of Seminoma of the Testis
Authors: OLIVER R. T. D. , HOPE‐STONE H. F. , BLANDY J. P.
Published: November 2008

Summary— A review of 21 newly diagnosed patients with either advanced Stage 2 or Stages 3 and 4 metastatic seminoma treated with platinum based chemotherapy regimes has demonstrated 17 long‐term disease‐free survivors (81%) compared with 10 of 18 such patients treated by radiotherapy between 1960 and 1977 (56%) and 10 of 34 treated before 1960 (29%).

These results somewhat overstate the benefit of chemotherapy over radiotherapy because the incidence of seminoma as a proportion of all germ cell tumours changed, following a change in histological and radiological staging procedures during that period. However, the data presented do suggest that seminoma may be even more sensitive to chemotherapy than malignant teratoma, since 12 of the 21 patients reported received cisplatin as a single agent and 10 of these survived.

These observations have lead to a re‐investigation of the relapse rate of Stage 1 seminoma in a surveillance study. To date, 10 of 11 patients observed have remained relapse‐free for a median of 11 months'follow‐up.
Randomised Trial of Mesterolone versus Vitamin C for Male Infertility
Authors: HARGREAVE T. B. , KYLE K. F. , BAXBY K. , ROGERS A. C. N. , SCOTT R. , TOLLEY D. A. , ABEL B. J. , ORR P. S. , ELTON R. A.
Published: November 2008

Summary— A prospective randomised trial was carried out to assess the effect of 9 months' treatment with either mesterolone or vitamin C in 368 men complaining of an infertile marriage. There was no significant difference in the wife's pregnancy rate between the two treatment groups. A separate analysis of the data was made to include only men with a low normal testosterone (< 16 nmol/l) and low sperm density (< 10 million/ml). This separate analysis was also restricted to men married to wives with normal test results for tubal patency and ovulation and again there was no difference in pregnancy rates between the two treatment groups. These results indicate that mesterolone therapy given in the absence of any defined endocrinopathy is of no benefit in promoting male fertility and furthermore we have been unable to find any subgroup who will respond. Improvements in the therapy of male infertility are only likely after a diagnosis has been defined.
Complications of Vasectomy: Review of 16,000 Patients
Authors: PHILP T. , GUILLEBAUD J. , BUDD D.
Published: November 2008

Summary— Sixteen thousand, seven hundred and ninety‐six men underwent vasectomy between 1970 and December 1983 and have been reviewed. Post‐operative side effects were few and significant complications were reported in 0.9%. Failure to achieve sterility occurred in 72 men, 69 of whom have been analysed. The early recanalisation rate was 0.36%. This rate was not influenced by the operative technique used, but varied markedly between individual surgeons. Experience and care with technique should result in a failure rate of 0.2% or better. There were six cases of late recanalisation in men previously thought sterile by two consecutive azoospermic analyses 4 months after vasectomy.
“Beehive on the Bladder”: an Indication of Colovesical Disease
Authors: KAISARY A. V. , GRANT R. W.
Published: November 2008

Summary— The “Beehive” sign in a cystogram indicates a primary colonic disease that involves the bladder and results in lower urinary tract symptoms.
Urinary Calculus in Zambia: its Incidence and Relationship to Schistosoma haematobium Infection and Vesicovaginal Fistula
Authors: ELEM B.
Published: November 2008

Summary— Radiological, cystoscopic and histological observations were made on 41 cases of urinary stones in a hospital in Zambia. The results of biochemical analysis of 31 of these stones are presented. The possible role of Schistosoma haematobium in the causation of urinary stones has been analysed; associated schistosomiasis was diagnosed in 17 cases (41.4%). It is concluded that there is no significant causal association between the two disorders and urolithiasis is an uncommon disease in Zambians.
Sensitivity of Exfoliative Cytology in Bladder Cancer Using the Divided One‐urine Specimen Examination
Authors: THEODOROU Ch. , GOULANDRIS N. , KOTZIA‐THEODOROU E. , NACOPOULOU L. , KYRKOS K. A. , DIMOPOULOS C.
Published: November 2008

Summary— The urine of 104 patients with bladder cancer was examined by exfoliative cytology. Three staining methods (Giemsa, Papanicolaou and Oil Red O) were used and the results compared with the histological diagnosis. Giemsa was found to be superior to the other two methods but the highest sensitivity (which was statistically significant) was obtained by a combination of the three methods.
Spontaneous Resolution of Multiple Bladder Neoplasms
Authors: STAFF W. G. , MORRIS J. A.
Published: November 2008

Summary— A unique case is reported in which multiple well and moderately well differentiated stage I papillary transitional cell carcinomas of the bladder underwent total spontaneous regression. Various histological features of the case suggest an immunological basis for the regression.
Do Bone Scans Predict Prognosis in Prostatic Cancer? A Report of the EORTC Protocol 30762
Authors: LUND F. , SMITH P. H. , SUCIU S. ,   EORTC UROLOGICAL GROUP
Published: November 2008

Summary— This report is an evaluation of the changes in bone scans in certain patients entered into the EORTC protocol 30762 and discusses the relevance of these expensive investigations.
Percutaneous Sclerotherapy of Varicoceles—an Alternative to Conventional Surgical Methods
Authors: PORST H. , BÄHREN W. , LENZ M. , ALTWEIN J. E.
Published: November 2008

Summary— Between May 1981 and October 1982, 259 varicoceles were identified by phlebography. It was possible to occlude 217 with Varicocid™ using a percutaneous Seldinger catheterisation technique under local anaesthesia. This method is an alternative to standard surgical techniques and has several advantages. It is cheap, it can be carried out on an outpatient basis, it lacks the risks associated with general anaesthesia and there are few complications.
Familial Pelviureteric Junction Hydronephrosis and its Association with a Duplex Pelvicaliceal System and Vesicoureteric Reflux. A Family Study
Authors: ATWELL J. D.
Published: November 2008

Summary— The incidence of pelviureteric junction (PUJ) hydronephrosis and a bifid pelvicaliceal collecting system was determined in the parents and siblings of 19 patients with PUJ hydronephrosis. The high incidence of hydronephrosis in first degree relatives supports the hypothesis that PUJ hydronephrosis is inherited by an autosomal dominant gene of variable penetrance. There is a genetic inter‐relationship between PUJ hydronephrosis and a bifid pelvicaliceal system and therefore indirectly between vesico‐ureteric reflux and paraureteric diverticula. Ultrasound screening of the children of adults with PUJ hydronephrosis may lead to earlier diagnosis and treatment, thus preventing renal damage.
Family History of Renal Stones in Recurrent Stone Patients
Authors: LJUNGHALL S. , DANIELSON B. G. , FELLSTRöM B. , HOLMGREN K. , JOHANSSON G.
Published: November 2008

Summary— A survey was carried out on the family history of renal stones among 380 patients in an out‐patient stone clinic, most of whom had experienced frequent recurrences.

In 55.4% of patients at least one first‐degree relative had experienced renal stones. A positive family history was more common in females (64.7%) than in males (51.O%) and was particularly apparent in those who had multiple recurrences. It was also significantly more common in female patients with evidence of renal tubular defects (incomplete forms of renal tubular acidosis). Among the ordinary stone patients 18% of the fathers and 8% of the mothers had also formed renal stones. The corresponding figures for female stone patients with renal tubular defects were 40 and 33% respectively. These findings indicate that tubular dysfunction could be an inherited trait that predisposes to the formation of renal stones.

Hypercalciuria or hyperuricosuria was not over‐represented among stone formers with a positive family history.
Unilateral Ureteric Reimplantation for Primary Vesicoureteric Reflux in Children: A Policy Re‐evaluated
Authors: QUINLAN D. , O'DONNELL BARRY
Published: November 2008

Summary— Fifty‐one children had unilateral ureteric reimplants for primary vesicoureteric reflux over an 11 ‐year period. Reflux was abolished in 50 patients but in 8 (15.7%) it developed or became worse on the contralateral side. An isotope renal scan (99mTc DMSA) was carried out in 15 of the 18 patients who had grossly scarred or dysplastic kidneys. Thirteen of these had less than 22% of total function coming from the affected kidney and seven had less than 10% of their total GFR coming from the kidney whose ureter had previously been reimplanted. Five of these children have undergone nephrectomy and it is felt that this would have been a better initial procedure. No patient was hypertensive at the conclusion of the study.
Low Pressure/Low Flow Voiding in Younger Men: Psychological Aspects
Authors: BARNES J. C. , HARRISON G. , MURRAY K.
Published: November 2008

Summary— Low pressure/low flow voiding in young and middle‐aged males in the absence of outflow tract obstruction has been reported as being associated with anxiety and a high incidence of dyspepsia. To assess objectively the psychological basis of this condition, an unselected group of 50 men aged 25 to 55 years was evaluated by psychiatric interview, questionnaires and urodynamic tests. In addition, patients involved in an earlier study were psychologically evaluated. Low pressure/low flow voiding was demonstrated in three (6%) of the new patients. This voiding pattern was related to a long preceding history, stress‐dependent symptoms and difficulty in voiding in public urinals. When compared with a control population, the experimental group scored significantly higher on measures of psychoneurosis. It is recommended that surgery be avoided in these patients and that simple behavioural therapy may be most appropriate.
Atropine Blockade of Nerve‐mediated Stimulation of the Human Detrusor
Authors: KINDER R. B. , MUNDY A. R.
Published: November 2008

Summary—The effect of atropine on the isometric contractile response of isolated human detrusor muscle strips to electrical field stimulation has been studied. A 94.1 % reduction in the response in the presence of tetrodotoxin demonstrated the neuronal nature of the stimulus. Atropine caused a 92.7% inhibition of the response. It was concluded that the nerve‐mediated stimulus in human detrusor is cholinergic in nature and that “atropine resistance” does not occur in man.
Hyponatraemia Following Transurethral Resection of the Prostate
Authors: RHYMER J. C. , BELL T. J. , PERRY K. C. , WARD J. P.
Published: November 2008

Summary— In a prospective study of 100 patients undergoing transurethral resection, changes in serum sodium were estimated during the per‐operative and post‐operative periods. The weight of prostate resected and the volume of irrigant fluid used influenced the changes in serum sodium. In 93 patients these changes were not statistically significant. In only seven patients were significant falls in serum sodium recorded, in one case to a level of 103 mmol/l. All seven exhibited the clinical features of the transurethral syndrome and there was one post‐operative death which we attributed to it. The TUR syndrome undoubtedly exists and its incidence in this series was 7%. Its pathogenesis and clinical management are discussed.
Serial Prostatic Histology; A Valid Marker of Response to Hormone Treatment
Authors: BISHOP M. C. , ANSELL I. D. , TAYLOR M. C. , THOMAS A. L.
Published: November 2008

Summary— Serial transrectal needle biopsies were taken from 146 patients (657 specimens) with advanced prostatic cancer (T3/T4, M1/MO) admitted to a trial of two forms of oestrogen therapy. Histological grading by Gleason and Mostofi techniques on the initial biopsy showed no correlation either with extent of disease or its eventual outcome on treatment. Change in grade was dissociated from the response of bone metastases to hormone treatment and did not appear to influence survival. However, the prognosis of 16 patients showing clearance of tumour from their serial biopsies was generally good.
Surgical Correction of Post‐Operative Retrograde Ejaculation
Authors: RAMADAN A. E.‐S. , EL‐DEMIRY M. I. M. , RAMADAN A. E.‐D. A. E.‐S.
Published: November 2008

Summary— Retrograde ejaculation is a known complication of bladder neck surgery. Revision of a bilharzial bladder neck obstruction accentuates the incidence of this complication. Some of the difficulties in the surgical correction of retrograde ejaculation are directly related to pathological changes caused by bilharziasis.

In this study a new length of premontanal urethra is formed using the trigonal urothelium and the trigonal muscles with their intact sympathetic innvervation to correct retrograde ejaculation following bladder neck surgery. Normal (antegrade) ejaculation was restored in four of five men using this procedure. The physiological basis of the procedure is discussed.
Carcinoma of Skin of Penis
Authors: I.B.ONUIGBO W.
Published: November 2008

Like the Jews, the Ibos or lgbos o Nigeria ritually circumcise males on the eighth day o birth. A retrospective review of approximately 15,000 surgical specimens collected from this ethnic group over a period of 13 years revealed 32 cases of carcinoma of the prostate but only 4 cases of penile carcinoma. One tumour arose on the glans penis. This localisation pattern suggests that, in circumcised males, smegma‐induced squamous carcinoma of the glans can be abolished but not the ordinary squamous carcinoma that can develop by chance on the rest of the penis as well as on the glans. International urology would benefit from careful documentation of squamous carcinoma affecting various parts of the neonatally circumcised penile skin.
Male Genital Injuries from External Trauma
Authors: CASS A. S. , GLEICH P. , SMITH C.
Published: November 2008

Summary— External trauma from a variety of causes, some unusual and bizarre, affect the male genitalia. Certain injuries are more common, have more severe consequences, or their management may be controversial. Seventy male genital injuries from external trauma are reported and include vacuum cleaner injuries, fracture of penis and the tourniquet syndrome.
Biochemical Studies in Paraplegic Renal Stone Patients. 1. Plasma Biochemistry and Urinary Calcium and Saturation
Authors: BURR R. G. , NUSEIBEH I.
Published: November 2008

Summary— Renal stone disease is a common problem in patients with spinal cord injury. The factors responsible are thought to include hypercalciuria and chronic urinary infection. There have, however, been no comparative studies of urinary composition in patients with neuropathic bladder with and without renal stone disease.

Blood, 24‐h urine samples and circadian variation of urinary composition were studied in male paraplegic patients with renal stone disease accompanied by urinary infection and in similar patients without stone disease with and without urinary infection.

Two categories of stone patients were recognised, according to whether or not urinary oversaturation with magnesium ammonium phosphate occurred. The urine of all stone patients was oversaturated with calcium phosphate for part of each day.

Urinary calcium was elevated in 16% and plasma urate in 30% of the paraplegics studied.
Management of the Posterior Peritoneum after Transperitoneal Renal Surgery
Authors: CIEŚLIK R. , CERKOWNIK L.
Published: November 2008

Summary— Between 1977 and 1982, 15 patients underwent renal operations carried out transperitoneally and in none was the posterior peritoneum reconstituted. There were no significant complications.
Blood Loss Measurement during Transurethral Resection of the Prostate Gland
Authors: FREEDMAN M. , MOLEN S. W. VAN DER , MAKINGS E.
Published: November 2008

Summary— The application of the indicator dilution technique for the estimation of blood loss during transurethral resection of the prostate gland is explained. The feasibility of using potassium ions as an intrinsic indicator was investigated. The most important factors affecting blood loss are considered. The advantages and inherent sources of error are discussed and some tentative conclusions drawn concerning the factors affecting blood loss.
Intravenous Urography as a Routine Investigation in Epididymitis
Authors: MURSHIDI M.S.
Published: November 2008

Summary—One hundred and forty‐two patients were admitted to the Jordan University Hospital with acute epididymitis between 1973 and 1983. Sixty‐five had intravenous urograms which revealed renal tuberculosis in 1 patient, renal or ureteric stones in 10, bladder neck obstruction in 3, unrelated congenital anomalies in 10 and no abnormalities in 41.

Twelve patients developed epididymal abscesses.
Percutaneous Pyelolysis: a New Approach to Post‐transplant Ureteric Obstruction
Authors: LEWI H. J. E. , McMILLAN I. , BRAMWELL S. , KYLE K. F.
Published: November 2008

Ureteric complications following renal transplantation remain a significant cause of morbidity and graft failure (Mundy et al., 1981). In ureteric obstruction, ureteropyeiostomy involving anastomosis of the recipient ureter to the donor pelvis has been used (Glass et al., 1982). Despite the low morbidity rate associated with this procedure, late stenosis at the pelviureteric anastomosis may occur.

Percutaneous pyelolysis has been suggested as an alternative to surgical treatment in patients with pelviureteric obstruction (Whitfield et al., 1983; Wickham and Miller, 1983).

We report a case of pelviureteric obstruction in a renal transplant recipient treated by percutaneous pyelolysis.
Ileocaeco‐urethroplasty after Total Cystectomy for Bladder Cancer
Authors: ALCINI E. , VINCENZONI M. , DESTITO A. , D'ADDESSI A. , CASTIGLIONI G. C.
Published: November 2008

Summary— Eleven cases of ileocaeco‐urethroplasty, performed over a 2‐year period, are presented. The patients had low grade bladder cancer infiltrating into but not extending beyond the muscle layer (B‐T3a). Following radiotherapy a total cystectomy was performed up to the verumontanum; afterwards the prostatic cuff was anastomosed to an ileocaecal segment.

The patients have been followed up for 13 to 39 months. One died from metastases after 30 months. The others are alive and in good psychological condition, with satisfactory micturition. We believe this surgical option deserves more careful consideration.
Is the Scrotal Testis Normal in Unilateral Cryptorchidism?
Authors: KIRBY R. S. , CHAPPLE C. R. , WARD SHIRLEY P. , WILLIAMS C.
Published: November 2008

Summary— Bilateral testicular biopsies were performed on 66 children undergoing orchiopexy for unilateral cryptorchidism and the tubular fertility index (TFI) recorded. The results in both the descended and undescended testes at various ages were compared with previously reported control data. There were no significant differences between the germ cell activity of the scrotal testis in cases with unilateral cryptorchidism and that of controls. By contrast, the mean TFI of the undescended testis was significantly less than that of control patients of all ages. In neither group was there evidence of a progressive loss of germ cell activity during childhood. It is concluded that there is little to be gained from very early orchiopexy, performed before the third year of life.
Treatment of Hydrocele of the Testis with Aspiration and Injection of Tetracycline
Authors: BØDKER A. , SOMMER W. , ANDERSEN J. T. , KRISTENSEN J. K.
Published: November 2008

Summary— Ten males over the age of 60 with primary hydrocele of the testis were treated by aspiration and injection of tetracycline. Nine were cured and one patient had a small recurrence but was satisfied with the result. There were no cases of haematoma or infection. We recommend this method since it can be carried out as an out‐patient procedure with minimal side effects and at low cost.
Varicocele and Puberty—the Critical Factor?
Authors: WYLLIE G. G.
Published: November 2008

Summary— In some boys variococele develops before puberty, when the testis is immature and vulnerable. Based on testicular size, evidence suggests that the time of development of a varicocele in relation to puberty may be the critical factor in the subsequent development of infertility. The recognition and treatment of an early‐developing varicocele may help to reduce the infertility associated with this condition.
The Value of Fine Needle Aspiration Cytology in the Management of Metastatic Germ Cell Tumours
Authors: OLIVER R. T. D. , HIGHMAN W. J. , KELLETT M. J. , CURLING O. M. , DACIE J. E.
Published: November 2008

Summary— Review of 19 patients with advanced metastatic malignant teratomas has revealed five serious complications possibly related to the surgical biopsy procedure, three of which led to the patient's death.

Preliminary results from a small series of patients diagnosed by fine needle aspiration (FNA) cytology suggest that this procedure is a reliable alternative method for diagnosing these patients. In addition, when used after chemotherapy this procedure may save patients with residual malignancy from having to undergo post‐treatment surgical staging. However, the absence of malignant cells in the aspirate cannot exclude malignancy because of the focal distribution of residual tumour in these masses.
Percutaneous Nephrolithotomy: A Report of 150 Cases
Authors: WHITFIELD H. N. , MILLS V. A.
Published: November 2008

Summary— One hundred and fifty patients with renal stones have been treated by percutaneous nephrolithotormy. Complete stone clearance was achieved in 130 cases (87%). The management of patients in whom stone removal was not achieved percutaneously and the complications of the procedure are discussed. Guidelines are set out for successful percutaneous nephrolithotomy.
Renal Stones in Children in Pakistan
Authors: RIZVI S. A. , NAQVI S. A. , HUSSAIN Z. , SHAHJEHAN S.
Published: November 2008

Summary— One hundred and fifty children up to the age of 12 years with documented evidence of renal or ureteric stones were studied between July 1973 and June 1983.

The peak age group was between 10 and 12 years, the male to female ratio being 1.9:l. Abdominal pain was the commonest presenting symptom (66.6%). Asymptomatic stones or vague symptoms in 23 patients warrant a higher index of suspicion of renal stone disease in children. Thirty patients had associated renal insufficiency. One third of the children had a positive urine culture, Proteus spp. being the commonest organism. Congenital anomalies of the urinary tract were seen in 12% of patients. In the majority (59%), aetiological factors related to stone formation could not be identified.

One hundred and thirty patients underwent surgery for removal of stones. Analysis of calculi by X‐ray diffraction and infrared spectroscopy revealed that stones were predominantly of mixed type, calcium oxalate being the commonest compound. The overall recurrence rate following surgical removal was 15%.
The Importance of Recognising Renal Oncocytomas
Authors: LAWRENCE W. T. , BAJALLAN N. M. S.
Published: November 2008

Summary— Oncocytomas of the kidney are infrequently reported tumours. They have distinct clinical and pathological features, but most cases have been discovered retrospectively. Nine series have been analysed (including four cases in Norwich) to define the features of these tumours. One of our cases is noteworthy because it is the largest individually reported tumour of this type and it contained a large cyst.

Oncocytomas are benign and have an excellent prognosis. Failure to identify this subgroup may bias the perceived effectiveness of treatment for renal carcinoma.
The Effects of Double J Stenting on Unobstructed Ureters. An Experimental and Clinical Study*
Authors: RAMSAY J. W. A. , PAYNE S. R. , GOSLING P. T. , WHITFIELD H. N. , WICKHAM J. E. A. , LEVISON D. A.
Published: November 2008

Summary— Upper tract pressure flow studies in four clinically unobstructed ureters with double J stents in situ indicated that urinary flow occurred mainly around the stent and that there was significant vesicorenal pressure transmission. This study examined the dynamics of ureteric urinary flow and morphological effects consequent upon stenting a ureter in vivo. In a porcine model, ureteric intubation caused a rise in intrapelvic pressures, hydroureter, vesicorenal reflux and generalised thickening of the ureteric wall with characteristic histological changes in the urothelium. These findings suggest that double J stents may compromise urinary drainage when ureteric obstruction is not present, urging caution in their use in the damaged, unobstructed upper urinary tract.
Micturition Disturbance in Parkinson's Disease
Authors: FITZMAURICE HELEN , FOWLER C. J. , RICKARDS D. , KIRBY R. S. , QUINN N. P. , MARSDEN C. D. , MILROY E. J. G. , TURNER‐WARWICK R. T.
Published: November 2008

Summary— Ten men with longstanding idiopathic Parkinson's disease (IPD) were investigated by urodynamic and electromyographic methods. The urodynamic studies were repeated after stopping anti‐Parkinsonian medication for several hours. All patients showed a difference between the two studies, but the changes were unpredictable.

Three patients who had high residual urine volumes in both studies were thought to have prostatic obstruction.

EMG analysis showed no evidence of a lower motor neurone lesion affecting the striated urethral sphincter.

It was concluded that micturition difficulty in the patient with IPD is due to detrusor hyperreflexia, influenced by the basal ganglia, which is not associated with impaired striated urethral sphincter activity.
Improved Presentation of Data in a Urodynamics Clinic by Use of a Microcomputer
Authors: CRAWFORD A. J. , WALKER JENNY
Published: November 2008

Summary— A microcomputer system is described for the collection, analysis and printing of the physiological data gathered during a urodynamic investigation. Examples are given of the results obtained from such a system.
Mitomycin C in Superficial Bladder Cancer: 24‐month Follow‐up
Authors: SOMERVILLE J. J. F. , NEWLING D. W. W. , RICHARDS B. , ROBINSON M. R. G. , SMITH P. H.
Published: November 2008

Summary— Twenty‐three patients who were given intravesical Mitomycin C for treatment of superficial bladder cancer have been followed up for a further 12 and 24 months after an initial assessment 5 weeks after completing therapy. At 5 weeks 17 (74%) showed complete disappearance of tumour and 4(17%) showed a partial response. Twelve months later 8 (35%) remained tumour‐free and 15 (65%) had recurrences; 5 of these (22% of all patients) had progressed to invasive cancer. The results at 24 months were little different except that one further patient (27% in all) progressed to invasive cancer.

Six patients with symptomatic carcinoma in situ became symptom‐free after Mitomycin C, but despite remaining free of symptoms three have progressed to invasive cancer.

This small series shows that involvement of large areas of bladder urothelium by tumour, carcinoma in situ and previous therapy for tumour are unfavourable prognostic indices.
The Role of Endoscopic Treatment after Radical Radiotherapy for Invasive Bladder Cancer
Authors: SMITH G. , QUILTY P. M. , DUNCAN W. , CHISHOLM G. D. , NEWSAM J. E. , HARGREAVE T. B.
Published: November 2008

Summary— In a 6‐year period 232 patients were treated by radical radiotherapy for transitional cell cancer of the bladder. Fifty‐eight patients had secondary surgical management to control either locally persistent or recurrent tumour. Endoscopic treatment alone was used in 31 patients with down‐staged tumours and the survival of this group compared favourably with that of 27 patients selected for salvage cystectomy (5‐year survival rate 88%cf. 44%). A group of patients with favourable prognostic factors may be identified in whom cystectomy can be avoided without prejudice to survival.
Transurethral Incision of Prostate (TUIP): 646 Cases in 15 Years—a Chronological Appraisal
Authors: ORANDI A.
Published: November 2008

Summary— Transurethral incision of the prostate was performed on 646 patients in 15 years. This operation is offered as a surgical cure for bladder outlet obstruction in men of all ages and different sized prostates. In large glands TUIP may not be desirable. Deep incisions cause surgical and sexual complications and may fuse by adhesions. In matched cases this method provided better results and fewer complications than the standard transurethral resection.
Long‐term Results of Two‐stage Urethroplasty
Authors: SOMERVILLE J. J. F. , ADEYEMI O. A. , CLARK P. B.
Published: November 2008

Summary— Forty‐two patients undergoing a two‐stage urethroplasty for stricture were reviewed and the long‐term sequelae of 30 patients followed up for a minimum period of 1 year (mean 6.3, range 1–14) are presented.

Twenty‐six patients (87%) were considerably improved, with only minor or no symptoms. Three patients (10%) continued to require treatment for urethral stone or recurrence of stricture and one patient was incontinent. The stricture was eradicated in 28 patients (93%).

The late sequelae showed that perineal fistula may not develop until 2 years after the second‐stage repair, urethral stone formation until 8 years and recurrence of stricture until 12 years after the second stage. This late onset of sequelae emphasises the importance of long‐term follow‐up in these patients.
Surgery for Peyronie's Disease: A Review of 200 Patients
Authors: BAILEY M. J. , YANDE S. , WALMSLEY S. , PRYOR J. P.
Published: November 2008

Summary— Approximately 10% of patients with Peyronie's disease require surgery for penile angulation or erectile failure severe enough to make coitus difficult or impossible. The results of three different operations performed on 200 patients over the period 1975 to 1984 have been reviewed. The results of plaque excision and dermal grafting in nine patients were disappointing and since 1977, Nesbit's procedure has been performed in 179 patients with excellent results in 53% and moderate results in 19%. Poor results (28%) were usually due to erectile failure and this was usually present pre‐operatively. Such patients are better treated by the implantation of penile prostheses and excellent (8) or moderate (2) results were seen in 12 patients so treated. The number of patients with poor results after a Nesbit's procedure increased from 14% at 3 months to 28% at 36 months, but then remained fairly constant. Prolonged follow‐up is therefore needed to allow valid conclusions about the ultimate outcome of surgery.
The Outcome of Antenatally Diagnosed Urological Abnormalities
Authors: POCOCK R. D. , WITCOMBE J. B. , ANDREWS HEATHER S. , BERRY P. J. , FRANK J. D.
Published: November 2008

Summary— Twenty‐eight patients undergoing routine antenatal screening by ultrasound were found to have a fetus with a major urological abnormality. In addition, two babies suspected of having an enlarged bladder were found postnatally to be normal. Seven of the 28 pregnancies were terminated before 26 weeks' gestation as a result of the ultrasound findings and all these fetuses had lethal renal abnormalities. Of the remaining 21 babies, four died of renal failure following delivery. Fifteen of the 17 babies who are alive and well had an ultrasound scan before 24 weeks' gestation. Only one of these scans revealed the abnormality. In the remaining patients the abnormality was first detected after 28 weeks. No patient had surgery in utero. Our data suggest that renal abnormalities detected prior to 24 weeks' gestation are associated with severe renal impairment. It appears that the role of antenatal drainage procedures may be of limited value.
Immunohistochemical Analysis of the Human Bladder
Authors: GARDINER R. A. , SEYMOUR G. J. , LAVIN M. F. , STRUTTON G. M. , GEMMELL E. , HAZAN G.
Published: November 2008

Summary— An immunohistochemical profile of cells in the mucosa and lamina propria of adult human bladders is described. Urothelial cells were HLA‐DR‐ve, ACP + ve and ATPase‐ve. All lymphocytes in this layer were of the suppressor/cytotoxic T subgroup and dendritic cells with an identical phenotype to Langerhans cells were seen. In the lamina propria most lymphocytes were of the suppressor/cytotoxic type with some helper/inducer cells. An occasional natural killer cell and Langerhans cell was identified and large macrophage cells with a common phenotype to antigen presenting interdigitating (ID) cells were noted. Fibronectin staining was dense in the vicinity of basement membranes merging to form fine interconnecting latticework‐like structures elsewhere in the lamina propria.