bluuebunny/crossref_metadata_2025 huggingface dataset:
The Structure and Innervation of Smooth Muscle in the Wall of the Bladder Neck and Proximal Urethra
Authors: GOSLING JOHN A. , DIXON JOHN S.
Published: November 2008

Neurohistochemical and electron microscopic techniques have been employed to compare the structure and autonomic innervation of the bladder detrusor with that of the bladder neck and urethra in male and female cats, rats and guinea‐pigs. In all specimens the structure and arrangement of smooth muscle in the detrusor was different from that in the bladder neck and proximal urethra. In male specimens this circular smooth muscle extended into the proximal urethra as far as the entrance of the ejaculatory ducts. A similar muscle coat was less well developed in the female but could be identified along the length of the urethra.

Differences in the distribution of autonomic nerves have also been demonstrated. Presumptive cholinergic nerves were frequently encountered amongst the smooth muscle cells of the detrusor whilst noradrenergic nerves were relatively sparse. In contrast, muscle in the bladder neck and urethra was richly innervated by both types of autonomic nerve. In the male these findings are considered to provide support for the concept of a sphincteric mechanism which prevents retrograde ejaculation. In both sexes the possible functional role of the autonomic innervation of the bladder neck and proximal urethra during micturition has also been discussed.
Traumatic Avulsion of the Ureter with Obstruction, Pseudocyst Formation and Hypertension
Authors: RIBEIRO B. F. , QUARTEY J. K. M.
Published: November 2008

Traumatic avulsion of the upper ureter produced by blunt injury is not an excessively rare occurrence although a review of the literature reveals only 24 instances where the diagnosis has been substantiated at operation. We report a patient who developed renal outflow obstruction with pararenal pseudocyst formation following traumatic avulsion of the ureter at the pelviureteric junction and was subsequently complicated by hypertension.
Asymptomatic Phaeochromocytoma of the Bladder Co‐existing with Carcinoma
Authors: LEONG C. H. , WONG K. K. , SAW D.
Published: November 2008

Phaeochromocytomata characteristically occur in the adrenals. Extra‐adrenal sites have also been reported in 10% of cases (Fries and Chamberlin, 1968; Remine et al., 1974; Van Way et al., 1974).

The urinary bladder is one of the possible extra‐adrenal sites. The first report of a phaeochromocytoma of the urinary bladder was made by Zimmerman et al. (1953). Since then 35 other cases have been reported in the literature (Sarma, 1969; Albores‐Saavedra et al., 1969; Cummins, Hill and Williams, 1969; Silver et al., 1971; Bogaert and Vermeulen, 1972; Doctor, Phadke and Sirsat, 1972; Remine et al.., 1974).

We report one further case of phaeochromocytoma of the urinary bladder, with the exceptional features of:

(a) Absence of symptoms connected with phaeochromocytoma;

(b) Association with bladder carcinoma.
A.I.D.—A Review of 200 Cases
Authors: NEWILL ROBERT
Published: November 2008

Very little has been written in British medical journals about the problems associated with artificial insemination from a donor (A.I.D.). This is probably because A.I.D. is a medical service which in the United Kingdom is almost confined to private medicine and is done only rarely in National Health Service hospital practice.

This is a review of 200 childless couples referred for A.I.D. in the past 2 years by gynaecologists, urologists and general practitioners.
Urological Follow‐up of 99 Spinal Cord Injured Patients initially managed by Intermittent Catheterisation
Authors: PEARMAN JOHN W.
Published: November 2008

99 spinal cord injured patients who were initially managed by intermittent catheterisation have been followed up for an average of 36 months (6 to 81 months) since their discharge from hospital.

The urological results in this group of patients have been compared with those of 2 series in which indwelling catheters were used in the initial period.

It appears that initial bladder management by intermittent catheterisation allows a higher percentage of patients to become catheter‐free and gives a lower incidence of urological coniplications.

The average incidence of re‐infection of the urinary tracts and the condition of the upper tracts compares favourably with those reported after management by indwelling catheterisation.

The work of the Catheter Team: Sister L. P. Riley, Mr A. A. Fisher, Mr J. L. Trewhella and Mr M. V. Gent is highly appreciated—without their dedication these results would not have been achieved, I am indebted to Mrs P. J. Eloy for typing the manuscript.
Perfusion Characteristics of Preserved Canine Kidneys Subjected to Warm Ischaemia
Authors: MODGILL V. K. , WIGGINS P. A. , GILES G. R.
Published: November 2008

Summary— Canine kidneys were subjected to 0, 15 or 30 min of warm ischaemia followed by 24 hours preservation by perfusion. Changes in perfusate concentration of acid radicles, lactate, free fatty acid and lactic dehydrogenase were assessed at 1 hour and 24 hours. With the exception of LDH concentration at 1 hour, no single parameter was capable of detecting kidneys which were so damaged as to be non‐life supporting.
Functional Obstruction of the Ureter and Renal Pelvis. A Histological and Electron Microscopic Study
Authors: GOSLING J. A. , DIXON J. S.
Published: November 2008

Summary— Histological, histochemical and electron microscopic techniques have been used to compare dilated and normal calibre segments of ureter and renal pelvis in cases of idiopathic hydronephrosis and primary obstructive megaureter. In both conditions a marked increase in collagen and elastic tissue occurs in the wall of the distended segment and this infiltration extends throughout the proximal dilated ureter and renal pelvis.

Evidence is presented to show that in the dilated segment, smooth muscle cells are directly involved in the synthesis of connective tissue elements. These findings support the view that the primary anomaly in idiopathic hydronephrosis and primary obstructive megaureter can be attributed to a malfunction of smooth muscle cells in the ureter and renal pelvis. However, the possibility remains that the changes in smooth muscle are secondary and have been induced by obstruction and distension caused in these pathological conditions by unknown aetiological factors.
The Influence of Wound Drainage on the Infection Rate in Kidney Transplant Patients
Authors: WALTER STEEN , POULSEN LARS RYTTER , FRIEDBERG MICHAEL , VEJLSGAARD RENÉ
Published: November 2008

Summary— The frequency of wound infection was studied in 92 patients who had received cadaver kidneys.

Wound drainage was performed in 26 patients and not performed in 66 patients. Wound infection was found in 31% of the wounds with drainage and in 14% of wounds without primary drainage.

The results were compared with the frequency of 34% infected wounds in a previous report where wound drainage was performed routinely.

It is advised that, when possible, wound drainage should be avoided.
Diagnostic Catheterisation and Bacteriuria in Women with Urinary Incontinence
Authors: WALTER STEEN , VEJLSGAARD RENÉ
Published: November 2008

Summary— The risk of single catheterisation in females with urinary incontinence and/or genital prolapse was studied in patients referred for urodynamic examination.

Two hundred and eighty‐six single catheterisations were performed followed by a mid‐stream specimen 1 week later, and in 31 of these the initial specimen contained more than 105bacteria.

Following catheterisation bacteriuria occurred in 5 (2%) of the patients with initially sterile urine.

The phenomenon of “asymptomatic bacteriuria”, “transient significant bacteriuria” and “bladder defence mechanism” is discussed.

The risk of introducing urinary tract infection in urodynamic studies is low.
The Influence of Early Post‐Operative Intravenous Nutrition upon Recovery after Total Cystectomy
Authors: FOSTER K. J. , ALBERTI K. G. M. M. , ALLEN N. , JENKINS J. , MacIVER A. , SMART C. J. , KARRAN S. J.
Published: November 2008

Summary— A retrospective review was made of the effect of early post‐operative total parenteral nutrition on recovery from total cystectomy with formation of an ileal conduit. No difference in mortality or time spent in hospital after operation was noted between 2 groups receiving either total parenteral nutrition or isotonic dextrose‐saline solutions.
Uretero‐Neo‐Cystostomy in Renal Transplantation. Is An Antireflux Mechanism Mandatory?
Authors: DEBRUYNE F. M. J. , WIJDEVELD P. G. A. B. , KOENE R. A. P. , CHAFIK M. L. , MOONEN W. A. , RENDERS G. A. M.
Published: November 2008

Summary— We report a retrospective analysis of 120 kidney transplantations in which a simple end‐to‐side ureteric implantation in the bladder without antireflux mechanism was made. From this study no greater incidence of vesico‐ureteric reflux could be demonstrated and, even when present, reflux neither interfered with graft function nor caused an increased incidence of recurrent urinary tract infections. The incidence of other urological complications (leakage, obstruction) being equal, this very simple technique yielded in our hands the best results and we recommend its use in kidney transplantation.
The Behaviour of the Bladder During Physical Activity
Authors: JAMES E. D.
Published: November 2008

Summary— The technical difficulties of obtaining reliable recordings of bladder, rectal and detrusor pressures from patients who are standing, walking or exercising have been largely overcome by a method described in this paper. The recordings help us to understand the behaviour of the lower urinary tract during physical activity and are of value in the diagnosis of urological problems, especially incontinence.
Inosine: Clinical Results of lschaemic Renal Surgery
Authors: WICKHAM J. E. A. , FERNANDO A. R. , HENDRY W. F. , WATKINSON L. E. , WHITFIELD H. N.
Published: November 2008

Summary— Ten patients requiring ischaemic renal surgery for calculus or tumour were operated on with the kidney protected by perfusion with a room temperature solution of inosine. The warm ischaemic times ranged from 35 to 75 min (mean 57.1 min).

Post‐operative recovery was uneventful in all patients. No adverse cardiodynamic effects due to inosine were noted. There was only moderate transient depression in renal function as assessed by gamma camera renography and serum creatinine estimations. Three of the 10 patients have now been followed for over a year. The results with inosine perfusion are comparable to those obtained with hypothermic protection.
Total Cystectomy ‐ A Review
Authors: VINNICOMBE J. , ABERCROMBIE G. F.
Published: November 2008

Summary— Analysis of 99 total cystectomies for malignant disease over a 1O‐year period in one unit has been carried out, in order to clarify the place of the operation in the overall management of the disease and to assess the quality of life in the patients so treated.
Results of Caecocystoplasty for Tuberculous Bladder Contracture
Authors: ABEL B. J. , GOW J. G.
Published: November 2008

Summary— The results of caecocystoplasty for tuberculous bladder contracture in 30 patients over a 15‐year period are presented. The operative mortality was 3.3%. Poor renal function was not a contraindication to surgery.

The results indicate that caecocystoplasty provided relief of symptoms in over 90% of patients. Renal function was preserved and associated obstructive uropathy was usually relieved. Efficient cystoplasty emptying was observed in 80% of patients if detrusor resection was kept to the minimum consistent with a wide caecovesical anastomosis.
Idiopathic Bladder Instability Treated by Biofeedback
Authors: CARDOZO LINDA D. , ABRAMS P. D. , STANTON S. L. , FENELEY R. C. L.
Published: November 2008

Summary— Biofeedback training has been used to treat 27 female patients suffering from symptoms associated with detrusor instability Re‐education to auditory and visual stimuli took place during 4 to 8 one‐hour sessions at weekly intervals. Using subjective and objective methods of assessment 81% of the patients were improved following treatment.
Bladder Rupture: An Acceptable Complication of Distension Therapy?
Authors: HIGSON R. H. , SMITH J. C. , WHELAN P.
Published: November 2008

Summary— Bladder rupture complicating prolonged bladder distension is reviewed. Rupture occurred in 7 of 128 distensions for detrusor instability, in 5 of 34 distensions for interstitial cystitis and in one of 4 distensions for reduced bladder capacity of unknown aetiology.

Management of extraperitoneal ruptures should be conservative. lntraperitoneal ruptures should probably be explored.

Rupture was more likely if the bladder wall was diseased, the distension pressure exceeded 145 cm H2O, and the patient was more than 50 years old.

The eventual outcome of prolonged bladder distension was not adversely affected by bladder rupture.
Indications for Testicular Biopsy or Exploration in Azoospermia
Authors: PRYOR J. P. , CAMERON K. M. , COLLINS W. P. , COLLINS W. P. , HIRSH A. V. , MAHONY J. D. H. , PUGH R. C. B. , FITZPATRICK J. M.
Published: November 2008

Summary— Investigation of 311 azoospermic males has shown that the combination of estimation of testicular size and plasma FSH allows the spermatogenic funciton of th testes to be accurately assessed by non‐invasive method.

Patients with small testes and grossly elevated levels of plasma FSH have absent, or grossly impaired spermatogenesis, and do not require surgical exploraion. They should be advised with regard to adoption or artificial inseminaition.

Patients with large testes (5 cm) or an FSH level which is not grossly elevated require operation and should undergo a surgical exploration and the possible corretion of an obstructive lesion. A testicular biopsy is essential if no obstructive lesion is found as the histology of these patients may show a spermatolgenic arrest.
Leukaemic Infiltration of the Prostate
Authors: MERIMSKY E. , BARATZ M. , KAHN Y.
Published: November 2008

SUMMARY— A biopsy of the prostate should be done in lymphoma/leukaemic patients suffering from urinary obstruction. Patients with a lymphomatous infiltration of the prostate should be irradiated and not subjected to surgery.

Two such cases successfully irradiated are described and the present literature is reviewed.
The Relation of Urinary Bilharziasis to Vesical Stones in Children
Authors: KAMBAL A.
Published: November 2008

Summary— Of 64 children in Khartoum with vesical stones only one had urinary bilharziasis. Bilharziasis appears to play no part in the development of these stones, which probably have the same aetiology as stones in other endemic areas.
Pre‐operative Bladder Irrigation with Povidone‐iodine
Authors: MERIMSKY E. , WERBIN N. , CANETTI R.
Published: November 2008

Summary— The effectiveness of pre‐operative disinfection of the bladder by irrigation with povidone‐iodine was assessed in 40 patients with indwelling catheters who underwent transvesical prostatectomy.

The results were encouraging: in 75% of the cases sterilisation of the urine was achieved and in 1 2.5% counts were <105organisms/ml.
Ileal Conduit Urinary Diversion in Children. An Assessment of the Long‐term Results
Authors: Orr J. D. , Shand J. E. G. , Watters D. A. K. , Kirkland I. S.
Published: November 2008

Summary— Forty‐three children who underwent cutaneous ureteroileostorny are described. Particular attention has been paid to long‐term follow‐up, which has produced disappointing results. Deterioration occurred in 61 % of the kidneys studied and although recurring urinary tract infections and stomal problems occurred in many patients, no single factor could be implicated as the cause of deteriorating renal function.
The Predictive Accuracy of Antegrade Pressure Flow Studies in Equivocal Upper Tract Obstruction
Authors: WITHEROW R. O'N. , WHITAKER R. H.
Published: November 2008

Summary— Twenty‐one of 27 antegrade pressure flow studies performed before 1973 have been reviewed at a minimum of 5 years to assess the predictive value of the studies. There is no case in this series that has suggested that the incorrect information was supplied at the initial investigation.
The Prognostic Value of Probe Renography in Ureteric Stone Obstruction
Authors: HOLM‐NIELSEN A. , JBRGENSEN T. , MOGENSEN P. , FOGH J.
Published: November 2008

Summary— During a 4‐year period 143 ureteric stone patients were monitored with probe renography during and after obstruction. Cases with obstruction of short duration (less than 2 weeks) all did well. In cases with longer duration the renographic function values could be used to predict irreversible kidney damage. Stone size showed no correlation with functional impairment. Infection proximal to ureteric stones accelerated kidney damage. Recommendations for the control of ureteric stone patients are given.
The Location of Urinary Calculi Using Radionuclide Imaging
Authors: NOBLE R. L. , BARKER M. C. J. , WILLIAMS R. E.
Published: November 2008

Summary— A method of in vivolabeling urinary calculi with 99mTc‐methylene diphosphonate is described. This enables a radionuclide image of the stones to be produced and permits their location at operation by means of a small scintillation detector. The degree of uptake of the radiopharmaceutical on renal stones appears to depend on a number of factors, particularly the chemical composition of the stones.
Hepatic Dysfunction in Renal Carcinoma
Authors: FLETCHER M. S. , PACKHAM D. A. , PRYOR J. P. , YATES‐BELL A. J.
Published: November 2008

Summary— In a retrospective review of 81 patients with renal carcinoma 34 (42%) had abnormalities of one or more liver function tests. Fifteen patients (1 8.5%) had abnormalities of 3 or more liver function tests but without evidence of hepatic metastases. There was a significant association between these patients and the presence of fever, anemia, weight loss and a raised ESR (P<0.001) compared with those whose liver function was normal. Following nephrectomy, liver function returned to normal in 5 patients. Median survival in these patients was 35 months, whilst in those whose liver function remained abnormal the median survival was 8 months (P<0.01).
The Natural History of Untreated “Prostatism”
Authors: BALL A. J. , FENELEY R. C. L. , ABRAMS P. H.
Published: November 2008

Summary— One hundred and seven patients with symptoms of prostatic obstruction in whom prostatectomy was not clinically indicated were reviewed after an interval of 5 years. Ten had subsequently required surgery and 97 remained untreated.

In the majority, symptoms did not worsen and only 2 developed acute retention. Urodynamic studies, where repeated, showed little change.

Although there was no certain indicator of progression, a flow rate measurement could identify the patients at risk of clinical deterioration sufficient to require surgery.
Critical Evaluation of Direct Vision Urethrotomy by Urine Flow Measurement
Authors: DESMOND A. D. , EVANS C. M. , JAMESON R. M. , WOOLFENDEN K. A. , GIBBON N. O. K.
Published: November 2008

Summary— Fifty‐two male patients were studied prospectively to assess the results of direct vision urethrotomy in the treatment of urethral strictures. The prognosis was found to be significantly worse in those patients who had received extensive previous treatment. A catheter is recommended for at least 3 days and for 4 weeks in patients who have had minimal previous treatment or who have impaired detrusor function. The use of a urine flowmeter is essential for determining the success of treatment and stricture recurrence. Measurement of the recurrence‐free period is important for assessing progressive improvement following repeat urethrotomy and for determining which patients cannot be cured by direct vision urethrotomy.
Use of the Tumour Colony Assay in the Evaluation of Patients with Bladder Cancer
Authors: NIELL H. B. , SOLOWAY M. S.
Published: November 2008

SUMMARY— In this study we examined the ability of tumour specimens derived from bladder barbotage to produce cluster/colony formation in a tumour colony assay. In 114 bladder washings from 65 patients and 15 control subjects, we found that cluster and colony formation was highest from bladder washings obtained from patients with biopsy proven bladder cancer who were not on intravesical chemotherapy. Growth rates were extremely low, restricting the usefulness of the in vitroassay in its present form. This study suggests that improvements in the growth rates in the tumour colony assay will be necessary before this system can have real value in monitoring transitional cell carcinoma of the bladder.
Bladder Neck Incision in the Female: a Hazardous Procedure?
Authors: DELAERE K. P. J. , DEBRUYNE F. M. J. , MOONEN W. A.
Published: November 2008

SUMMARY— Anterior bladder neck incision was carried out in 32 female patients suffering from difficult, mostly incomplete, bladder emptying. All patients underwent a full urodynamic investigation with voiding cystourethrography and endoscopy. Detrusor failure was observed in 20 patients; in the remainder, a mechanical iatrogenic bladder neck obstruction was held responsible for inefficient voiding. Twenty‐eight patients (56%) benefited in some degree from the procedure. Six were submitted to a repeat incision and two of them developed severe stress incontinence later on. As the results are far from promising, intermittent self‐catheterisation may be proposed in some cases as an alternative to bladder neck incision for fear of incontinence.

The urodynamic findings and the results of bladder neck incision, which are very different in the two sexes, are analysed. The poorer results in the female are presumably due to the decompensated state of the bladder, mostly responsible for incomplete bladder evacuation.
Comparative Examination of Female Urethral Pressure Profiles Measured by CO2and H2O Infusion Techniques
Authors: SHAWER M. , BROWN M. , SUTHERST J. R.
Published: November 2008

SUMMARY— The urethral closure pressure profile (UCPP) was recorded in 100 consecutive patients using both the water infusion and the carbon dioxide infusion methods. Ninety‐one per cent of the patients complained of discomfort during CO2infusion. Thirty‐two of the CO2profiles were distorted due to patient discomfort or shortcomings in the design of the measuring system, and in these no quantitative comparisons could be made. In 68 cases the profile measurements were compared: average maximum closure pressures and functional urethral lengths were slightly less with the CO2but some individual variations were substantial. We concluded that unreliability and patient reaction make CO2infusion less suitable than H2O for measuring UCPP.
Surgical Treatment of Renal Artery Aneurysms
Authors: ORTENBERG J. , NOVICK A. C. , STRAFFON R. A. , STEWART B. H.
Published: November 2008

Summary— Twenty‐seven patients have undergone surgical treatment of renal artery aneurysms and the classification, radiographic features and complications of these aneurysms are reviewed. Aortorenal bypass is the preferred method of in siturevascularisation. Extracorporeal microvascular branch arterial reconstruction is reserved for patients with complex intrarenal aneurysms. Removal of the aneurysm with preservation of the involved renal unit is possible in most cases.
Emepronium Bromide and Flavoxate Hydrochloride in the Treatment of Urinary Incontinence Associated with Detrusor Instability n Elderly Women
Authors: ROBINSON J. M. , BROCKLEHURST J. C.
Published: November 2008

Summary— A 4–week randomised, double‐blind, cross‐over study is described which compared the effects of a combination of emepronium bromide and flavoxate hydrochloride with placebo on incontinence and cystometrogram findings in 20 female patients aged 59 to 88 years. All patients initially had detrusor instability demonstrated on cystometrography: 14 patients completed the study; on placebo 10 still had unstable bladders and on active drugs seven were unstable. The number of wettings over a 48–h period before the study commenced and at the end of each course of tablets showed no significant differences; also the patients' opinions about the effect on their incontinence indicated that the majority had the same opinion of each course.

Active drugs significantly increased residual urine but did not significantly alter the values obtained for maximum cystometric capacity or effective cystometric capacity (the latter volume being maximum cystometric capacity minus the residual urine). No correlation was found, on either course of treatment, between the change to detrusor stability and the amount of improvement in incontinence. Some side effects are described.

Despite evidence of a pharmacological effect on the bladder and patients' opinions tending to favour the active combination, nonetheless the main results of this small study do not suggest that the combination of emepronium bromide and flavoxate hydrochloride is an effective treatment of urinary incontinence associated with detrusor instability in elderly women.
The Site of Functional lnfravesical Obstruction in Children
Authors: PALMTAG H.
Published: November 2008

Summary— In an attempt to localise the site of obstruction in children suffering from functional infravesical obstruction, it was found that primary bladder neck obstruction was rare. Only one boy suffering from prune belly syndrome and three children with megacystis demonstrated primary bladder neck obstruction. All of the others had functional bladder neck obstruction as a secondary phenomenon, following either an antireflux operation or electroresection. Bladder neck hypertrophy was found to be a typical secondary alteration following any kind of reactive detrusor hyperactivity.
Prognostic Validity of the Specific Red Cell Adherence Test in Upper Urothelial Tumours
Authors: GHAZIZADEH M. , NUMATA A. , KAGAWA S. , FUJIMURA N. , KUROKAWA K.
Published: November 2008

Summary— The specific red cell adherence (SRCA) test for blood group antigens was used in 32 patients with upper urinary tract tumours to determine whether their survival could be predicted by this test. The SRCA results correlated well with survival in each grade and stage of the tumours. Overall, patients with positive tests showed a significantly higher 5–year survival rate than those with negative tests (87.2%YS. 24.6%).

These findings add support to the prognostic importance of this test in upper urinary tract tumours.
Vesicoureteric Reflux in Patients with Bladder Tumours
Authors: AMAR A. D. , DAS S.
Published: November 2008

Summary— In the course of treatment of 224 patients with bladder neoplasms over an 18–year period, 44 patients were noted to have associated vesicoureteric reflux, bilateral in 12 and unilateral in 32. Reflux was suspected in 8 patients because of associated ureterotrigonal abnormalities such as paraureteric diverticulum, complete duplication of the ureter and gaping ureteric orifice, and it was diagnosed by micturating cystography obtained before the bladder tumour was treated. In the remaining 36 patients reflux developed after treatment of the bladder tumours.

In most patients with reflux the clinical course was benign, but it caused recurrent pyelonephritis in 9 cases and secondary struvite calculi in 2. Five patients had antirefluxing ureteric reimplantation to control episodes of recurrent pyelonephritis. The pathogenesis and implications of vesicoureteric reflux in association with bladder tumours are discussed.
Lignocaine Test and Detrusor Instability
Authors: REUTHER K. , AAGAARD J. , JENSEN K. SANDER
Published: November 2008

Summary—Detrusor instability in infravesical obstruction is well recognised and often resolves after surgery. The aetiology is not clearly understood but is probably due to increased vesical sensory input. Since intravesical lignocaine has been proved to have an effect (although shortlived) on detrusor instability in some patients, we have used it in order to differentiate between idiopathic detrusor instability and detrusor instability caused by infravesical obstruction. Our study showed that in patients with a positive lignocaine test pre‐operatively, the detrusor instability and micturition disorder disappeared after operation, and in patients with a negative lignocaine test, it persisted. The differences were statistically significant (xP < 0.5).
Urinary Carcinoembryogenic Antigen (CEA) in the Diagnosis and Follow‐up of Bladder Carcinoma
Authors: TAILLY G. , CORNELISSEN M. , VEREECKEN R. L. , VERDUYN H. , DEVOS P. , DEROO M.
Published: November 2008

Summary— The level of urinary carcinoembryogenic antigen (CEA) was evaluated in the diagnosis and follow‐up of urothelial carcinoma of the bladder.

Urinary CEA concentration, cystoscopic findings and the histopathology of an eventually resected bladder tumour were correlated in 177 cases. The sensitivity proved to be 34%, the specificity 82%. Possible correlations with sex, infection, primary tumour or recurrence, differentiation and invasion of an eventually resected tumour and influence of adjuvant therapy were also evaluated.

A comparison was made with the results of other authors and different factors which may influence urinary CEA levels are discussed.
Bone Marrow Aspiration Biopsy and Bone Scanning in the Staging of Prostatic Cancer
Authors: VARENHORST E. , ÅLUND G. , LINDSTRÖM E. , MÅNSON J. Ch.
Published: November 2008

Summary— Random bone marrow aspiration biopsies of iliac crests and bone scans/skeletal X‐rays were evaluated in 163 new cases of carcinoma of the prostate in order to assess the incidence of bone metastases and to compare the sensitivity of these two methods.

Bone marrow biopsy revealed cancer cells in 18.4% of all cases. The detection rate of skeletal metastases of bone scan/skeletal X‐ray was 32.5%. In this series all patients with positive biopsies had also positive scans. The superior sensitivity of bone scans compared with bone marrow biopsies in detecting metastatic spread of prostatic cancer is shown.
Transurethral Ureteroscopic Retrieval of Ureteric Stones
Authors: FORD T. F. , WATSON G. M. , WICKHAM J. E. A.
Published: November 2008

Summary— This report documents our initial experience in the transurethral retrieval of ureteric stones using the rigid ureteroscope. Ten patients are included. Half of the stones were located in the lower one‐third of the ureter and half in the upper two‐thirds. They varied in size from 5 to 10 mm in diameter. Seven were successfully extracted at the first attempt using stone baskets under direct vision. Of the remaining 3, one was retrieved at a second ureteroscopy, one was fragmented and subsequently passed and one required percutaneous nephroscopy for its removal from the renal pelvis. It is concluded that transurethral ureteroscopy offers a safe alternative to both open ureterolithotomy and blind manipulation.
Bladder Training—3 Years On
Authors: HOLMES D. M. , STONE A. R. , BARY P. R. , RICHARDS C. J. , STEPHENSON T. P.
Published: November 2008

Summary— Fifty‐six patients with the “urge syndrome” were reviewed between 1 and 5 years after in‐patient treatment by bladder training. There was an overall initial cure/improvement rate of 85%. The best long‐term results were obtained in those with objectively stable bladders before treatment. Forty‐three per cent of patients with reduced detrusor compliance and idiopathic instability relapsed after initial improvement. Those with primary instability or with associated degenerative disease responded poorly to treatment.
Preliminary Results of AS 791/792 Artificial Sphincter for Urinary Incontinence
Authors: STEPHENSON T. P. , STONE A. R. , SHEPPARD J. , SABUR R. Y.
Published: November 2008

Summary— Twenty‐seven patients with incontinence have been treated by implantation of the AS 791 or 792 artificial sphincter over the past 24 months. All but four were incontinent as a result of myelodysplasia or prostatic ablation: 22 are currently completely continent, 2 await activation and 3 have failed. There has been only one mechanical failure, though 3 patients have required the insertion of a higher pressure reservoir to resolve stress incontinence, reflecting our conservative approach to the initial choice of reservoir.
Fistulae Involving Rectum and Urethra: the Place of Parks's Operations
Authors: TIPTAFT R. C. , MOTSON R. W. , COSTELLO A. J. , PARIS A. M. I. , BLANDY J. P.
Published: November 2008

Summary— Twenty‐five rectovesical and rectourethral fistulae were treated over an 18–year period in which various methods for closing the rectal side of the fistula were developed, ultimately with two techniques using the full thickness of intestine. As a result of these operations the management of the urethral and vesical side of the fistulae became a relatively simple problem to which standard techniques could be applied.
Low‐dose Doxorubicin in the Management of Advanced Carcinoma of the Prostate
Authors: ROBINSON M. R. G. , CHANDRYSEKRAN S. , NEWLING D. W. W. , RICHARDS B. , SMITH P. H.
Published: November 2008

Summary— Twenty‐one patients with advanced metastatic carcinoma of the prostate, no longer responsive to conventional therapy, were treated with weekly low‐dose doxorubicin (Adriamycin). Twelve had an impressive subjective response in terms of pain relief and improved performance status and in nine this was maintained for 3 or more months.
Evaluation of Radiotherapy and/or Surgicopathological Staging after Chemotherapy in the Management of Metastatic, Germ Cell Tumours
Authors: OLIVER R. T. D. , BLANDY J. P. , HENDRY W. F. , PRYOR J. P. , WILLIAMS J. P. , HOPE‐STONE H. F.
Published: November 2008

Summary— Thirty of 83 patients with metastatic germ cell tumours undergoing cytotoxic chemotherapy have required post‐treatment surgicopathological staging and in ten of these, viable malignancy was detected. In 8, cystic mature teratoma was excised. Though this surgery can be extremely difficult and in 12 of the 30 cases necrotic tissue only was excised, the toxicity and distress of continuing unnecessary chemotherapy for the patients with necrotic tissue or mature teratoma, and the chance to cure patients with persistent malignant disease with second‐line chemotherapy, mean that the early use of this surgery will continue to be an extremely important element in the management of patients with malignant teratoma. However, for patients with metastatic pure seminoma, given the difficulty of removing residual necrotic tissue because of dense fibrous tissue and the exquisite sensitivity to single agent cisplatinum therapy demonstrated in this paper, it is preferable to delay surgery until post‐treatment regression has ceased.
Skeletal Scintigraphy in Carcinoma of the Kidney
Authors: REDDY P. S. , MERRICK M. V.
Published: November 2008

Summary— The scintigrams and radiographs of 32 patients with renal carcinoma were reviewed. False negative skeletal scintigrams were observed in four of 12 symptomatic patients with proven skeletal metastases from carcinoma of the kidney. A negative scintigram therefore does not exclude the possibility of skeletal metastases in this condition.
A Technique for Excising the Orthotopic or Ectopic Ureteric Remnant
Authors: BARTONE F. F. , HUSSAIN M. B.
Published: November 2008

Summary— A technique is described for removing the entire ureter in children by intussuscepting the ureter into the bladder. The technique has been successfully used in the orthotopic refluxing ureter and in the ectopic ureter.
Intramural Ganglia of the Human Urinary Bladder
Authors: DIXON J. S. , GILPIN SALLY‐ANN , GlLPlN C. J. , GOSLING J. A.
Published: November 2008

Summary—The arrangement and distribution of intramural autonomic ganglion cells have been examined in samples of the dome and lateral walls of the human urinary bladder. Ganglia were frequently observed in samples removed from either site and possessed histochemical characteristics to support their classification as presumptive cholinergic neurons. Unlike pelvic autonomic neurons, intramural bladder ganglion cells are not associated with noradrenergic (possibly inhibitory) preganglionic nerve terminals. The widespread distribution of ganglion cells within the bladder wall serves to frustrate surgical attempts to denervate detrusor smooth muscle. The outcome of such operative procedures is likely to result in decentralisation rather than denervation of the urinary bladder.
Further Experience of Free Muscle Transplantation in Children with Urinary Incontinence
Authors: GIERUP H. J. W. , HAKELIUS L.
Published: November 2008

Summary— Sixteen patients, 10 boys and 6 girls with severe urinary incontinence due to congenital malformations, were treated by free autogenous muscle transplantation. The mean follow‐up period was 2.3 years. In 10 patients the results were good, implying increase in functional bladder capacity and abandoning of napkins during the day. Two patients were improved and 4 were failures. The earliest signs of improvement appeared 2 to 6 months after surgery. Most patients showed further improvement for at least 2 years post‐operatively.

Cine studies of micturition clearly showed activity of the transplant, most patients with good results being able to interrupt completely the urinary stream at will. Seven patients exhibited normal urinary flow post‐operatively. In 5 patients the maximal urinary flow was around the lower normal limit, in two because of detrusor‐sphincter dyssynergia. In boys, erection was unimpaired post‐operatively. The prognosis seems to be better in girls than in boys, especially when comparing cases of epispadias. Patients with no sign of improvement during the first 6 months post‐operatively had a poor prognosis. A relatively large bladder capacity before operation is advantageous, but not a prerequisite for continence, as bladder capacity can develop after transplantation. The ideal age for transplantation is 5 to 6 years.
lndomethacin—an Alternative to Pethidine in Ureteric Colic
Authors: FLANNIGAN G. M. , CLIFFORD R. P. C. , CARVER R. A. , YULE A. G. , MADDEN N. P. , TOWLER J. M.
Published: November 2008

Summary— In this study the analgesic effect of indomethacin in ureteric colic was demonstrated in 15 patients. Of the 15 patients, 12 had prompt and effective pain relief. It is concluded that indomethacin suppositories offer a safe and effective alternative to pethidine in the treatment of ureteric colic.
A Simple Uroflowmeter Tester*
Authors: GRIFFITHS C. J. , MURRAY A. , RAMSDEN P. D.
Published: November 2008

Summary— A simple device for testing urine flowmeters is described. It is made from readily available components and is portable, easy to use, and requires no special care in setting up. The flow rate is accurate to within 0.5 ml/s. Nursing staff are now able to do regular calibration checks on the urine flowmeters and some flowmeter deficiencies have been exposed. Using the tester, examples of artefactual peak flow rates have been recorded.
The “Shrinkage” of the Prostate During Transurethral Resection
Authors: EINARSSON O. J. , LYRDAL F. , NEIDHARDT F. O.
Published: November 2008

Summary— Fresh hyperplastic prostate glands from 19 patients who underwent open prostatectomy were weighed and their volume measured. After a simulated transurethral resection the weight and the volume of the pieces were determined. The volume of each enucleated specimen was plotted against the volume after electroresection. The regression coefficient was 0.8039. Similarly, the regression coefficient for the weight was 0.7864. Therefore a diminution in volume and weight of approximately 20% can be expected after electroresection. The specific weight close to one remained unchanged. The supracollicular distance was an unreliable indicator of the size of the prostate.
Testicular Endocrine Function after Withdrawal of Oestrogen Treatment in Patients with Carcinoma of the Prostate
Authors: TOMIC R. , BERGMAN B. , DAMBER J.‐E.
Published: November 2008

Summary—The serum concentration of testosterone, luteinising hormone (LH), follicle stimulating hormone (FSH) and prolactin were determined at different intervals after withdrawal of oestrogen treatment in patients with prostatic carcinoma. Oestrogen therapy had been stopped in all patients because of the side effects of oestrogens. There was a negative correlation (r= ‐0.64) between serum testosterone concentrations and the duration of oestrogen treatment in patients investigated for more than 6 months after withdrawal of hormones. However, the decrease in testosterone concentration seems to be time‐dependent. Thus patients who were treated for less than 3 years had normal testosterone concentrations approximately 6 months after withdrawal of the oestrogen therapy. This group of patients had a positive correlation (r= 0.49) between serum testosterone concentration and time elapsed after cessation of therapy. In contrast, patients treated for more than 3 years retained low testosterone concentrations even after 6 months. The other hormones did not vary between the groups. It is concluded that patients with carcinoma of the prostate treated with oestrogens for more than 3 years have an impaired Leydig cell function which might be irreversible.
Sclerosant Therapy for Hydroceles and Epididymal cysts
Authors: MACFARLANE J. R.
Published: November 2008

Summary —Hydroceles and epididymal cysts presenting in 30 patients were treated by tapping and injection of the sclerosant solution sodium tetradecylsulphate. Ten patients required only one treatment and 20 patients had up to 3 repeat injections. There have been no recurrences in patients completing the course of treatment and the complication rate was low.
Particulate Activity in Urine
Authors: ADAMTHWAITE D. N.
Published: November 2008

Summary— A new method of measuring urinary particulate activity is described. The analytical process, using a Coulter Counter, is designed to have minimal effect on the dynamic nature of the specimen. Emphasis is placed on conducting the analysis during the first 5 min following voiding, preventing changes in temperature and pH and avoiding any form of dilution of the specimen.

Urinary particulate activity is measured by quantitatively evaluating the spontaneous changes which occur in particulate number and size. Resulting values demonstrate clearly defined differences between urine specimens which appear biochemically similar.

The results are reproducible under stable conditions but are significantly altered by temperature and pH change, or dilution of the specimen. This method measures the urinary potential to form precipitates and ultimately stones, and should be included in any investigation of urinary calculus disease.
Quantitative Assessment of Individual Renal Function A Comparison between Creatinine Excretion and a Radionuclide Method
Authors: Larsson I. , Lindstedt E. , White T.
Published: November 2008

Summary— Individual renal function was evaluated in 21 patients. Two methods were used in each case, namely gamma camera renography and measurement of creatinine excretion in urine collected via a nephrostomy. The scintigraphic technique utilized measurement of renal parenchymal radionuclide uptake in an early phase. Good agreement was found between the results from both methods in most patients. Gamma camera renography was found to be clinically useful for assessing the function of individual kidneys.
The Evaluation of Risk Factors in Male Stone‐formers Attending a Genera Hospital Out‐patient Clinic
Authors: Ryall Rosemary L. , Darroch J. N. , Marshall V. R.
Published: November 2008

Summary— The daily urinary excretion of calcium, oxalate, glycosaminoglycans and uric acid, and the 24‐h urinary pH and volume were measured in 61 normal men and in 81 men with a history of renal stone disease. The following features of these data were noted:

No significant difference could be demonstrated between the stone‐formers and normals with respect to any of the variables measured.

The values of each of the urinary parameters were positively and significantly correlated with those of at least two other parameters in one or both subject groups.

The probability density histograms constructed from the data for each urinary variable in each subject group were unsuitable as the basis for calculation of individual relative risk factors.

Thus it was concluded that the data were inappropriate for the calculation of ′overall relative probability of forming stones′ (P′SF) and that such an index is unlikely to be of use in the assessment and management of stone‐formers attending a general hospital out‐patient clinic.
Does Calcium Contribute to the Effectiveness of a Coagulum for Pyelolithotomy?
Authors: Watson G. M. , Wickham J. E. A. , Colvin B. T.
Published: November 2008

Summary— Adding calcium to a mixture of thrombin and fibrinogen increased the breaking strain of the resultant coagulum by 10‐fold, but did not significantly reduce the length to which it could be stretched. There was no detectable change in the time taken for the coagulum to dissolve in urine. Simulation pyelolithotomies were performed on pig kidneys containing ball‐bearings which represented calculi. Coagula formed with calcium were significantly more effective at retrieving the ball‐bearings than coagula without calcium. It is concluded that the ideal coagulum formula should include 1 mmol of calcium.
Blood Group Antigen Expression in Nephroblastoma Department of Paediatric Pathology, Hôpital Necker Enfants Malades, Paris, France
Authors: Gang: P. , Roth A. , Rousseau‐Merck M. F. , Rouger P. , Nezelof C.
Published: November 2008

Summary— —The histological distribution of A, B, H, Lewis, Pr, i and I blood group antigens (BGA) was studied in 19 nephroblastomas and one mesoblastic nephroma by means of the indirect immunofluorescence technique. In addition to general conclusions about the relatively limited BGA expression in the tumour cells, their histological distribution was found to be related to the differentiation level of these renal embryonic tumours. By comparison with normal embryonic, fetal and adult kidney it was shown that the nephroblastoma differentiation level is not higher than that of a 3‐month fetal kidney. Furthermore, i antigen appears to be a non‐specific marker of the histiocytic macrophage cells of the nephroblastoma stroma.
Bladder Function Following Spinal Cord Injury: a Urodynamic Analysis of the Outcome
Authors: Arnold E. P. , Anthony A. , Fukui J. , Utley W. L. F.
Published: November 2008

Summary— Repeated urodynamic testing was undertaken on a group of 58 consecutive patients admitted with acute spinal cord injury. Thirty‐seven (64%) were able to void satisfactorily spontaneously, whereas 10 required bladder outlet surgery and 11 achieved emptying by either abdominal straining, intermittent self‐catheterisation or an indwelling suprapubic catheter. The pattern of the initial cystometry soon after injury provided some idea of what possibilities could be expected of subsequent bladder function. Very high detrusor pressures exceeding 80 to 100 cm of water developed in a third of patients with supranuclear lesions. Six patients developed vesicoureteric reflux between 4 and 24 months after injury.
Surgical Intervention in Dilated Bilharzial Ureters
Authors: PAWAR H. N.
Published: November 2008

Summary—
Surgery has often been performed for presumed obstruction in dilated bilharzial ureters but with unrewarding results. In this report 55 non‐refluxing dilated bilharzial ureters were studied. Perfusion pressure flow studies and diuresis renography with washout technique were used to diagnose the presence or absence of obstruction. Surgery was performed only when obstruction was proven by PPFS and diuresis renography; thus patients were spared an operation when the obstruction could not be confirmed. Antegrade ureteropyelographic findings, evaluation of peristalsis and transport of urine were the basis for the selection of operation performed. The various surgical procedures are discussed.