bluuebunny/crossref_metadata_2025 huggingface dataset:
The Influence of Retinoic Acid Receptor (RAR) Status of Bladder Tumours on the Course of the Disease
Authors: BOLLA A. R. DE , SHAVE R. M. , FAGG S. L. , HEALD K. , HUGHES M. A. , WALLACE D. M. A. , EDWARDS P. DAWSON
Published: November 2008

Summary— Retinoids influence bladder tumour development in animals and tumour recurrence in man. Some human tumours contain intracellular receptor proteins for retinoids. The effect of the presence of such retinoic acid receptors (RAR) on tumour response to conventional therapy has been studied in 59 patients. Thirty‐two of 36 RAR + veand 11 of 23 RAR‐ve tumour patients were alive after a mean follow‐up period of 2.6 years. Higher stage and grade were more commonly associated with RAR‐ve tumours. Independent of stage, recurrence was more common in RAR‐ve tumours. These studies suggest that RAR‐ve tumours are more likely to recur and more likely to become invasive. However, further studies are required to determine the clinical value of RAR receptor status as a prognostic indicator.
Histochemical Changes after Ureterosigmoidostomies and Colonic Diversion
Authors: STRACHAN J. R. , REES H. C. , WILLIAMS GORDON
Published: November 2008

Summary— Forty patients with colonic urinary diversions were studied for morphological and histochemical changes in the colon using haematoxylin and eosin, and high iron diamine alcian blue stains. Eighty‐nine per cent of ureterosigmoidostomies biopsied at the ureteric orifice and 44% biopsied distal to the orifice showed “transitional” changes thought to represent a pre‐malignant state. Thirty‐eight per cent of patients who had had ureterosigmoidostomies in the past and 100% of the colon conduits also demonstrated this change. The earliest “transitional” change occurred 1 year after the diversion. This and the low incidence of morphological changes in this group of patients suggest that the finding of “transitional” mucosa is of no value in the follow‐up of patients with colonic urinary diversions.
Biochemical Markers and Skeletal Metabolism in Carcinoma of the Prostate: Use of Decision Matrix Theory and ROC Analysis
Authors: URWIN G. H. , PERCIVAL R. C. , YATES A. J. P. , WATSON M. E. , COUCH M. , MCDONALD B. , FORREST A. R. W. , WILLIAMS J. L. , KANIS J. A.
Published: November 2008

Summary— The discriminative ability of several skeletal and tumour markers was assessed in 102 patients with prostatic disease. These comprised serum acid and alkaline phosphatase, serum albumin and osteocalcin, urinary excretion of calcium, hydroxyproline and 6‐0times0 prostaglandin F1α None of the tests was of value in distinguishing patients with benign prostatic disease from those with tumour not involving the skeleton. Values of serum osteocalcin, urinary excretion of calcium and urinary 6‐0times0 prostaglandin F1α failed to discriminate significantly between patients with or without metastases. The remaining four markers were compared by decision matrix analysis and receiver operating characteristic (ROC) curves. Serum alkaline phosphatase provided the most sensitive marker of skeletal metastases (80.5%), followed by serum acid phosphatase (80%), hydroxyproline (68%) and albumin (30%). ROC analysis suggested that alkaline phosphatase conformed most closely to the “ideal marker” with highest specificity and sensitivity.
Prediction of Response to Radiotherapy for Localised Prostatic Cancer
Authors: RITCHIE A. W. S. , SMITH G. , PRESTON C. , BEYNON L. L. , DUNCAN W. , CHISHOLM G. D.
Published: November 2008

Summary— Fifty‐one patients with TO‐4 NX MO carcinoma of the prostate were treated by external beam radiotherapy. Comparison with 40 patients with TO‐3 NX MO disease, whose treatment was deferred initially, showed a higher incidence of local progression in the untreated patients.

Age at presentation and initial T category did not have a significant influence upon the probability of disease progression after radiotherapy, whereas all but one of the irradiated patients with Gleason sum scores ≥ 6 progressed.

Treatment‐related morbidity was appreciable and prolonged proctitis occurred in 31 patients. There was one treatment‐related death. Biopsy 1 year after treatment did not yield information of prognostic significance.

It is recommended that the selection of patients with localised carcinoma of the prostate for treatment by radiotherapy is based on histological grade. The Gleason score is a practical method for identifying those who would best be treated by other methods.
Surveillance or Lymph Node Dissection in Clinical Stage I Non‐seminomatous Germinal Testis Cancer?
Authors: PIZZOCARO G. , ZANONI F. , SALVIONI R. , MILANI A. , PIVA L.
Published: November 2008

Summary— Surveillance following orchiectomy alone has gained popularity in the management of clinical stage I non‐seminomatous germ cell tumours (NSGCT) of the testis. However, long‐term follow‐up of the retroperitoneal nodes can be difficult.

We analysed the results of 71 consecutive patients followed for more than 1 year. Fifty men (70.5%) remain disease‐free and 21 (29.5%) have relapsed. Relapses occurred 2 to 36 months after orchiectomy (median 6 months). Retroperitoneal nodes were involved in 12 cases (17%). In only one patient were retroperitoneal metastases diagnosed when smaller than 2 cm and in four they were diagnosed when larger than 5 cm. Furthermore, the late relapses occurred in the retroperitoneal nodes. After treatment of metastases, 69 patients (97%) are alive, disease‐free and off therapy.

As retroperitoneal relapses do not occur after a properly executed retroperitoneal lymph node dissection (RPLND) and ejaculation problems can be avoided with unilateral RPLND, it is suggested that RPLND can be used for clinical stage I NSGCT of the testis in experienced surgical centres, with the advantage of an easier follow‐up.
Lymphocyte Sub‐populations in the Male Genital Tract
Authors: EL‐DEMIRY M. I. M. , HARGREAVE T. B. , BUSUTTIL A. , JAMES K. , RITCHIE A. W. S. , CHISHOLM G. D.
Published: November 2008

Summary— A series of monoclonal antibodies that react with human lymphocyte subsets was used in an indirect immunoperoxidase technique to study representative blocks from normal human testis, epididymis, vas deferens, prostate and seminal vesicles. Biopsies of testis, epididyrnis and vas obtained during surgical procedures directed at the investigation and treatment of infertile males were also studied. In all normal tissues, apart from the peripheral testis where no lymphocytes were identified, Tlymphocytes were the predominant cell type (Leu 4 +). These lymphocytes were largely of the suppressor/cytotoxic phenotype (Leu 2a +) and were more abundant in between the epithelial cells in the rete testis, epididymis, vas deferens, seminal vesicles and prostatic acini. Cells of the helper/inducer phenotype (Leu 3a +) were identified mainly within the interstitium of the epididymis and the prostate. B‐lymphocytes (Leu 12 1) were few in number and were mainly in the stroma of the prostate. In each organ the ratio of the T‐cell subsets was determined and changes in this ratio were observed in epididymal and vasal biopsies from some infertile males. Finally, in testis biopsies from infertile men, suppressor/cytotoxic T‐cells were demonstrated between the germinal epithelium and the fibrous tunica of the seminiferous tubules and as focal aggregates in the interstitium.
Pyeloureterostomy or Ureteroneocystostomy in Renal Transplantation?
Authors: LANDAU R. , BOTHA J. R. , MYBURGH J. A.
Published: November 2008

Summary— A retrospective comparison of pyeloureterostomy and external ureteroneocystostomy as methods of reconstructing the urinary tract in 128 renal transplants is presented. There was one urological complication in 52 pyeloureterostomies (1.9%) compared with 4 in the 76 ureteroneocystostomies (5.3%). 6/0 Polydioxanone (PDS) is preferred to Prolene for the anastomosis because of possible calculus formation on the latter.

Wound sepsis is commoner in pyeloureterostomies undergoing concomitant nephrectomy, despite prophylactic antibiotics, though this is not statistically significant and the overall sepsis rate is higher for ureteroneocystostomy. Nephrectomy was avoided in 17 selected cases by simply ligating the recipient ureter where the pre‐transplant urine output was low. Two of these patients developed hydronephrosis in the isolated kidney and required later nephrectomy.
The Value of Aspiration Cytology in the Definitive Staging of Bladder Carcinoma
Authors: LUCIANI L. , PISCIOLI F. , PUSlOL T. , SCAPPlNl P.
Published: November 2008

Summary— Aspiration cytology is a simple, accurate and minimally invasive procedure in staging urological neoplasms. Percutaneous fluoroscopy‐guided fine needle aspiration biopsy of 99 lymph nodes was performed in 30 patients with bladder carcinoma and 62 lymph node chains were evaluated. Aspiration biopsy is more accurate and specific than lymphography in the pre‐operative staging of the neoplasm and represents a useful diagnostic procedure for the staging of bladder carcinoma.
Methotrexate, Cisplatin and Carboplatin as Single Agents and in Combination for Metastatic Bladder Cancer
Authors: OLIVER R.T.D. , KWOK H.K. , HIGHMAN W.J. , WAXMAN J.
Published: November 2008

Summary— A review of 78 previously untreated patients with bidimensionally measurable metastatic bladder cancer who were entered into a series of studies of cytotoxic chemotherapy has shown that complete response occurred in 1 of 23 patients receiving methotrexate, none of 1 5 receiving cisplatin, none of 20 receiving the platinum analogue carboplatin and 3 (2 with histological confirmation) of 20 receiving methotrexate in combination with cisplatin. WHO/UICC performance status 3 and 4, though a prediction of lower response, did not provide a means for excluding patients who might benefit from chemotherapy. Studies using serial cytology showed that 5 of 8 responders according to standard criteria had complete loss of malignant cells from the urine compared with none of 10 non‐responders and there was a suggestion that duration of response was longer in those whose urine was negative for malignant cells than in those which remained positive.
Objective Responses to Ketoconazole Therapy in Patients with Relapsed Progressive Prostatic Cancer
Authors: WILLIAMS GORDON , KERLE D. J. , WARE H. , DOBLE A. , DUNLOP HELEN , SMITH C. , ALLEN JANET , YEO T. , BLOOM S. R.
Published: November 2008

Summary— The contribution of adrenal androgens to the maintenance and progression of so‐called hormone‐unresponsive prostatic carcinoma was studied in 20 patients with advanced relapsed disease. The role played by testicular androgens had been negated by prior orchiectomy or concurrent LHRH analogue therapy. Ketoconazole, an antifungal agent which inhibits adrenal and testicular androgenesis, administered in a dose of 400 mg 8‐hourly, resulted in optimal suppression of adrenal androgens. The mean serum androstenedione concentration fell from 8.01 ± 0.84 nMol/l to 1.55 ± 0.25 nMol/l, P < 0.001, and serum testosterone from 1.25 ± 0.14 nMol/l to 0.36 ± 0.06 nMol/l, P <0.01, after 6 months treatment. There was, however, no significant difference between patients receiving 400 and those receiving 200 mg. Androgen suppression resulted in six objective and ten subjective clinical responses. Ablation of both testicular and adrenal androgens can now be achieved using ketoconazole in combination with orchiectomy or LHRH analogues, but the high incidence of side effects may preclude its use in all patients with prostatic cancer. The results of this study support the concept of “total androgen ablation” as primary therapy in advanced prostatic cancer as a possible means of improving survival in this common malignancy.
Bilateral Malignant Testicular Germ Cell Cancer
Authors: KRISTIANSLUND S. , D. FOSSÅ SOPHIE , KJELLEVOLD K.
Published: November 2008

Summary— Twenty‐six of approximately 1300 patients (1.9%) with unilateral testicular cancer developed a second primary germ cell cancer (seminoma 18; non‐seminoma 8). Patients with previous seminoma had a significantly higher risk of developing a new seminoma than those with a previous non‐seminoma. The diagnosis of second primary was made within 3 years of the first diagnosis in only 50% of the patients. In patients with a history of undescended and/or atrophic testes the interval significantly decreased between the diagnosis of the two testicular cancers.

The prognosis of bilateral testicular cancer is generally good. Patients in whom the second testicular cancer is at clinical stage I (no metastases) at diagnosis can safely be observed without further treatment after orchiectomy.

A patient with unilateral testicular cancer should be informed of the increased risk of developing a second primary germ cell tumour and should be encouraged to perform regular examination of the remaining testis. The need for life‐long follow‐up visits for patients with testicular cancer is questionable.
Rigid Ureteroscopy for the Treatment of Ureteric Calculi: Experience in 120 Cases
Authors: EL‐KAPPANY H. , GABALLAH M. A. , GHONEIM M. A.
Published: November 2008

Summary— Over a 1 ‐year period, rigid ureteroscopy has been used to retrieve ureteric calculi in 120 patients. The technical details, causes of failure and the complications are described. An initial success rate of 78% was obtained. It was concluded that ureteroscopy should replace blind procedures for the extraction of ureteric stones.
Endoscopic Correction of Vesicoureteric Reflux Secondary to Neuropathic Bladder
Authors: PURI P. , GUINEY E. J.
Published: November 2008

Summary— Eleven patients with vesicoureteric reflux secondary to neuropathic bladder were treated by endoscopic injection of pyrolised polytetrafluoroethyiene (Polytef) paste. Thirteen of the 15 ureters treated showed disappearance of reflux after one injection. The amount of Polytef paste injected varied from 0.2 to 0.9 mi (mean 0.45 ml). There were no complications, except in one ureter where distension of the collecting system was slightly increased compared with the pre‐operative urogram.
Influence of Serotonin on Lower Urinary Tract Smooth Muscle in Vitro
Authors: KLARSKOV P. , HØRBY‐PETERSEN J.
Published: November 2008

Summary—The influence of serotonin (5‐hydroxytryptamine) on human detrusor and on pig detrusor, trigone, bladder neck and urethral smooth muscle was explored in a series ofin vitroexperiments. Serotonin evoked a dose‐dependent and reversible contraction of the detrusor. The reverse response was triggered in trigone, bladder neck and urethral smooth muscle‐a dose‐dependent and reversible relaxation. The maximum amplitude of this relaxation was 85 ± 15% of the relaxation produced by electrical nerve stimulation.

The effect of serotonin was unaltered by blockade of ganglia, alpha‐ and beta‐adrenergic receptors, cholinergic receptors and prostaglandin synthesis. The serotonin antagonists ketanserin, methysergide and cyproheptadine partly inhibited the effect of serotonin. The antagonism differed in potency on strips of different origin. The antagonists were ineffective or minimally effective in blocking responses to nerve stimulation.

The effect of serotonin was probably mediated by specific serotonin receptors different from the serotonin‐s,‐receptors predominating in vascular smooth muscle. Serotonin is a potential neurotransmitter in lower urinary tract smooth muscle, but its importance in micturition physiology and pathophysiology is unknown.
Cell Surface Antigen in Bilharzial Bladder Tumours
Authors: HALIM A. , JAVADPOUR N. , KASRAEIAN A. , YOUNG J. D.
Published: November 2008

Summary— Detection of the ABO (H) blood group in the urothelium in cases of transitional cell carcinoma of the bladder is a good indicator of the future behaviour of these tumours. Since conventional histopathological and clinical examination in bilharzial bladder carcinoma shows a clinical staging error rate of 37.2%, we used the specific red cell adherence (SRCA) technique to study the cell surface antigens in 28 patients over a 5‐year period. A prediction rate of 63.6 to 84.6% was obtained when correlated with clinical behaviour.
Testosterone and Gonadotrophin Profiles in Patients on Daily or Monthly LHRH Analogue ICI 118630 (Zoladex) Compared with Orchiectomy
Authors: GRANT J. B. F. , AHMED S. R. , SHALET S. M. , COSTELLO C. B. , HOWELL A. , BLACKLOCK N.J.
Published: November 2008

Summary— Diurnal profiles of circulating gonadotrophins and testosterone have been measured in patients with prostatic carcinoma on long‐term treatment with the LHRH agonist analogue ICI 118630, which was administered either by subcutaneous daily injection or monthly injection of the depot preparation. These have been compared with profiles in patients who had undergone orchiectomy. Daily injection of the analogue induced a significant rise in the level of LH but this was not associated with a significant rise in circulating testosterone. There was no diurnal variation of LH or testosterone concentration in patients receiving the depot preparation and this did not differ in patients who were “mid‐cycle” compared with those who were “end‐cycle”. The depot preparation did, however, induce significantly lower circulating levels of testosterone than did daily injection of the analogue and the levels were comparable with those achieved after orchiectomy.
Report on the First 1000 Patients Treated at St Thomas' Hospital by Extracorporeal Shockwave Lithotripsy
Authors: PALFREY E. L. H. , BULTITUDE M. I. , CHALLAH S. , PEMBERTON J. , SHUTTLEWORTH K. E. D.
Published: November 2008

Summary—
Since March 1985, over 1000 patients have been treated on the lithotripter at St Thomas' Hospital. Since it is the only machine in the country offering treatment to National Health Service patients at no cost to the referring Health Authority, there has been a heavy demand for treatment and 97% of referrals have been accepted. Analysis of the first 1000 patients shows extracorporeal shockwave lithotripsy (ESWL) to be a safe procedure with a low morbidity rate and no mortality. The number of patients who were stone‐free 3 months after treatment was low (44.1%) compared with the numbers reported in other series. The most likely reasons for this are the poor follow‐up rate (48.9%), the stringent criteria for the diagnosis of “stone‐free” and a possible skewed referral and follow‐up pattern.
Percutaneous Nephrolithotomy: A Study of 171 Patients
Authors: BAPAT S. S.
Published: November 2008

Summary—
One hundred and eighty‐one patients with renal calculi were treated by percutaneous nephrolithotorny in 21/2 years. In 171 cases the calculi were removed successfully and the complication rate was low. Intrarenal manipulation and irrigation should be done for only a limited period of time. This procedure can be carried out safely, in many centres, with adequate experience and minimal facilities.
Endoscopic Correction of Primary Vesicoureteric Reflux
Authors: O'DONNELL BARRY , PURI PREM
Published: November 2008

Summary—
One hundred and three children with primary vesicoureteric reflux treated by endoscopic injection of Polytef paste between March 1984 and February 1986 have been followed up for periods ranging from 3 to 23 months. Seventy‐five per cent of refluxing ureters showed absence of reflux after one injection of Polytef paste; 14% of ureters required two to four sub‐ureteric injections of Polytef paste for the correction of vesicoureteric reflux; 8% of ureters showed improvement in the grade of reflux after the initial injection of Polytef paste.

Duplex systems were more difficult to correct and recurrence of reflux was much higher than in primary reflux. Follow‐up intravenous urograms showed no evidence of ureteric obstruction in the treated ureters.

The procedure is safe, simple and effective in correcting all grades of vesicoureteric reflux. To obtain best results, attention should be paid to minute details of the technique and the injection made with pinpoint accuracy.
Superficial Bladder Cancer: Intravesical Chemotherapy and Tumour Progression to Muscle Invasion or Metastases
Authors: SMITH G. , ELTON R. A. , CHISHOLM G. D. , NEWSAM J. E. , HARGREAVE T. B.
Published: November 2008

Summary—
Of 299 patients who presented with superficial bladder cancer (Ta, TI), 60 were treated by intravesical chemotherapy (Epodyl, methotrexate or mitomycin C). The rate of tumour progression to muscle invasion or metastases was identical for each intravesical regime. There was no evidence that mitomycin C promoted tumour progression. Carcinoma in situ in non‐tumour‐bearing urothelium was the most significant predictive factor for progression to muscle invasion or metastases.
Reduction of Post‐operative Bleeding after Transurethral Resection of the Prostate by Local Instillation of Fibrin Adhesive (Beriplast)
Authors: LUKE M. , KVIST E. , ANDERSEN F. , HJORTRUP A.
Published: November 2008

Summary—
A method for instilling a two‐component fibrin adhesive into the prostatic cavity after transurethral resection of the prostate is described. In a prospective, controlled study, 30 consecutive patients undergoing transurethral prostatectomy (TURP) were randomised either to receive treatment with the local instillation of fibrin adhesive into the prostatic cavity or to a control group that received no special treatment post‐operatively. There were no complications either during application of the fibrin adhesive or in the follow‐up period.

Post‐operative blood loss was significantly reduced in the fibrin group (P < 0.01).
Intracorporal Injection of Papaverine and Phentolamine in the Management of Impotence
Authors: ROBINETTE M. A. , MOFFAT M. J.
Published: November 2008

Summary—
Intracorporal injection of 0.5 ml papaverine (30 mg/ml) and phentolamine (2.5 mg/ml) was given to 144 patients presenting with various types of impotence. The high response rate (97%) precluded the use of this test to differentiate between types of impotence but provided patients with the choice of embarking on a self‐injection programme. Of the 101 patients entering the programme, 78 are continuing self‐injection therapy with a mean follow‐up of 6.5 months. The incidence of complications is low and patients are generally very satisfied with the treatment.
The Significance of Scrotal Interference in Stage I Testicular Cancer Managed by Orchiectomy and Surveillance
Authors: KENNEDY C. L. , HENDRY W. F. , PECKHAM M. J.
Published: November 2008

Summary—
Of 210 patients with clinical Stage I testicular tumours managed by orchiectomy and surveillance, 36 had scrotal interference at or prior to removal of their primary tumour. None developed inguinoscrotal relapse during a mean observation period of 37 months. The overall relapse rate of 4/36 (11%) compared favourably with that of the surveillance series as a whole (18%).
Leucocytes in the Ejaculate from Fertile and Infertile Men
Authors: EL‐DEMIRY M. I. M. , YOUNG H. , ELTON R. A. , HARGREAVE T. B. , JAMES K. , CHISHOLM G. D.
Published: November 2008

Summary—
The presence of leucocytes and their subpopulations was studied in the ejaculate from 69 men with an infertile marriage and 12 fertile men. Monoclonal antibodies specific for human leucocytes were used in an immunoperoxidase technique. In addition to the standard sperm analysis, each specimen was also tested for sperm antibodies, aerobic and anaerobic microorganisms, Ureaplasma urealyticum and Chlamydia trachomatis. Leucocytes were found in large numbers in the fertile men compared with the patients. Lymphocytes were found in 20% of the patients. Micro‐organisms were cultured from a similar proportion of both groups. We found no correlation between leucocyte counts, sperm density and motility, sperm antibodies and growth of micro‐organisms. Our results cast doubt on the conventional criteria of subclinical genital tract infection, namely positive culture and excess leucocyte counts.
Urinary Fibrin/Fibrinogen Degradation Products in Transitional Cell Carcinoma of the Bladder
Authors: EWING R. , TATE G. M. , HETHERINGTON J. W.
Published: November 2008

Summary— Urinary fibrin/fibrinogen degradation products (FDPs) were measured in 210 specimens from 174 patients with newly or previously diagnosed transitional cell carcinoma of the bladder. They were detected in 94% of patients with deeply invasive bladder tumours (pT2‐4) compared with 17% of superficial tumours. Microalbuminuria (> 50 μg/g creatinine) was also found in 80% of patients with pT2‐4 lesions. Both were compared with urine cytology.

Urinary FDPs are markers of bladder tumour invasion. Our results suggest that urinary FDPs are not of value in screening for the presence of bladder neoplasia but their role may be in following patients with superficial bladder tumours to detect those tumours which become invasive. The mode of excretion of the FDPs in the urine is discussed.
Use of the Transverse Colon Conduit for Vesicovaginal Fistula in Late‐stage Carcinoma of the Cervix
Authors: KISNER C. D. , KESNER K. M.
Published: November 2008

Summary— Fifty‐five patients with advanced carcinoma of the cervix and vesicovaginal fistula were managed by urinary diversion using the transverse colon as a conduit. The surgical technique is described and this form of urinary diversion is recommended for these patients.
Effect of Single Dose Aspirin on the Development of Penile Hypercoagulability during Erection
Authors: BORNMAN M. S. , FRANZ R. C. , JACOBS D. J. , PLESSIS D. J. DU
Published: November 2008

Summary— The effect of aspirin on the development of hypercoagulability in the penile blood during erection was studied in five Chacma baboons. Aspirin prevented the generation of hypercoagulability and may be of importance in delaying the development of penile atherosclerosis and ageing impotence.
The Use of Myocutaneous Flaps Following Radical Excision of the External Genitalia
Authors: KENNEDY C.L. , BREACH N. M. , SHEPHERD J. H. , HENDRY W. F.
Published: November 2008

Summary— Myocutaneous and fascio‐cutaneous flaps have enabled single stage combined surgical resections and reconstructive procedures to be carried out for locally advanced, non‐metastatic carcinoma of the external genitalia. The need for delayed repair procedures with their associated morbidity and prolonged hospital stay is minimised. Functional loss resulting from the removal of the supporting muscle is rarely a problem.
The Stamey Bladder Neck Suspension Operation for Stress Incontinence and Neurovesical Dysfunction*
Authors: LAWRENCE W. T. , THOMAS D. G.
Published: November 2008

Summary— Twelve patients with neurovesical bladder dysfunction and genuine stress incontinence were treated by the Stamey operation. The technique is described together with some minor modifications that we have found useful. Results have been encouraging and 11 of the 12 patients have been cured of incontinence.
Antibiotic Prophylaxis for Prostatic Surgery. Single‐dose Cephradine Compared with Single‐dose Cefotaxime
Authors: BENTSI I. K. , ELTON R. A. , RITCHIE A. W. S. , SMITH G. , GOULD J. C. , CHISHOLM G. D. , HARGREAVE T. B.
Published: November 2008

Summary— Several previous studies have attested to the value of antibiotic prophylaxis for prostatic surgery. We report a prospective randomised study which compared a single dose of cefotaxime with a single dose of cephradine given with the induction of anaesthesia. There was little difference between these regimens and it was concluded that either may be used, depending on availability and cost of the antibiotic. We have now completed a 5‐year study of antibiotic prophylaxis for prostatic surgery and we also report the results of a long‐term survey of the ward flora. There has been no significant change and there is no evidence for the emergence of resistant strains.
Gynaecomastia Following Cytotoxic Therapy for Testicular Cancer
Authors: SAETER G. , FOSSA SOPHIE D. , NORMAN N.
Published: November 2008

Summary— Sixteen patients in complete remission after chemotherapy or radiotherapy for testicular cancer developed gynaecomastia which appeared 2 to 9 months after the end of therapy and had a mean duration of 4.8 months. These patients had statistically significant higher levels of oestradiol, FSH and oestradiol/ testosterone ratio than a control group without gynaecomastia that had received similar treatment. Both groups tended to have testosterone levels in the lower normal range and all patients had normal levels of β‐HCG, prolactin and progesterone.

The gynaecomastia in our patients was probably the result of an absolute increase in oestradiol or an increase relative to testosterone. Cytotoxic therapy affects both spermatogenesis and Leydig cell function, with a resultant rise in gonadotropins which may in turn increase testicular oestrogen secretion.

In testicular cancer patients, gynaecomastia may be a sign of tumour activity but it may also be caused by hormonal changes resulting from cytotoxic therapy. It is our experience that the latter treatment‐related type is harmless, transient and unrelated to the patient's prognosis.
Urinary Tract Infection with Anaerobic Bacteria Following Endoscopic Urethral Instrumentation
Authors: SUTTON R. , CHEETHAM P. , BULLOCK D. W. , MUNSON K. W.
Published: November 2008

Summary— A prospective study of the pathogenic role of anaerobic bacteria was undertaken by suprapubic bladder aspiration in 100 patients prior to routine endoscopic urethral instrumentation.

Anaerobic and/or micro‐aerophilic bacteria were isolated from the suprapubic specimens of 11 patients (>105/ organisms/ml from 8), with identical species growing heavily from corresponding cystoscopic specimens and/or urethral swabs. Previous cystoscopies in all 11 patients and the presence of bladder tumour at the time of sampling in six were significantly and independently associated with the isolation of anaerobic bacteria from suprapubic specimens.

It was concluded that transurethral instrumentation entails a definite risk of anaerobic urinary infection in addition to the recognised risk of aerobic urinary infection. The findings suggest that the antibiotics used as prophylaxis for or treatment of patients undergoing transurethral procedures should be effective against anaerobic bacteria.
Heterotrophic Calcification as a Cause of Haemospermia
Authors: SINOKROT J. R. , PRYOR J. P.
Published: November 2008

There are many causes for haemospermia (Fletcher et al, 1981), but haemospermia due to calcification and ossification within the lumen of the vas has not been recorded previously.
Foreign Body in the Kidney
Authors: INAI T. , HIRAISHI K. , KUROKAWA K.
Published: November 2008

Foreign bodies in the kidney are rare. We report a case of trans‐intestinal migration of a sewing needle into the right kidney.
Marjolin's Ulcer of Urethrostomies and Urethroplasty
Authors: HOUSTON W.
Published: November 2008

Since Marjolin's description of his eponymous ulcer (Marjolin, 1826), the term has been applied more loosely to malignant ulceration associated with chronic irritation or infection.
The Effect of Pentosanpolysulphate and Carbenoxolone on Bacterial Adherence to the Injured Urothelium
Authors: PANTAZOPOULOS D. , LEGAKIS N. , ANTONAKOPOULOS G. , SOFRAS F. , DIMOPOULOS C.
Published: November 2008

Summary— The effect of the glycosaminoglycan (GAG) layer on the adherence of Escherichia coli to the bladder urothelium of rats has been studied. The study was performed by destroying the GAG layer and the changes were observed using the electron microscope. Bacterial adherence to the bladder with a destroyed GAG layer was much higher than to the normal bladder.

Following the destruction of the GAG layer, the instillation of sodium pentosanpolysulphate significantly reduced the adhesion of bacteria. Prophylactic intramuscular administration of carbenoxolone increased the speed of regeneration of the destroyed GAG layer.
The Treatment of Metastatic Prostatic Cancer with the Slow Release LH‐RH Analogue Zoladex ICI 118630
Authors: BEACOCK C. J. , BUCK A. C. , ZWINCK R. , PEELING W. B. , REES R. W. M. , TURKES A. , WALKER K. , GRIFFITHS K.
Published: November 2008

Summary— The clinical and endocrine response to a depot preparation of the LH‐RH analogue ICI 118630 (Zoladex) was assessed in 55 untreated patients with advanced prostatic cancer. Whereas gonadal androgen suppression was achieved in all patients, subjective and objective clinical response occurred in only 69%, indicated by a relief of bone pain, a decrease in the size of the primary tumour and lymph node metastases and improvement in bone scan appearances. A third of these patients, however, subsequently showed progression of their disease. Serious side effects were not encountered in this study. The depot formulation is a simple, safe and convenient method of administering Zoladex and offers an alternative treatment for metastatic prostatic cancer.
Tissue Alpha‐fetoprotein and Human Chorionic Gonadotrophin in Non‐seminomatous Testicular Tumours A Comparative Study with Serum Levels
Authors: ALTUG M. U. , AKDAS A. , RUACAN S. , ÖZEN A. H. , REMZI D.
Published: November 2008

Summary— The correlation between tissue localisation and serum levels of alpha‐fetoprotein (AFP) and human chorionic gonadotrophin (HCG) was studied in 20 tissue samples from 18 patients with non‐seminomatous testicular tumours. Specific immunoperoxidase stains were used for tissue staining and serum measurements were made by radioimmunoassay.

There was a close correlation between the tissue demonstration of AFP and HCG and elevated levels of serum markers. The cellular localisations of AFP and HCG were different and no cell stained concomitantly for both AFP and HCG.

From these results and from the demonstration of tumour markers in the tissue of some patients with normal serum marker levels, it was concluded that immunocytochemical localisation of the tumour markers was more sensitive than serum measurements.
Autonomic Innervation of the Canine Penile Artery and Vein in Relation to Neural Mechanisms Involved in Erection
Authors: KIMOTO Y. , ITO Y.
Published: November 2008

Summary—Neural control of the penile artery and vein of dogs was investigated using isometric tension recording and microelectrode methods. Field stimulation evoked twitch‐like contractions of these two vessels and these contractions were blocked by guanethidine. In the artery, twitch‐like contractions were more effectively blocked by yohimbine than by prazosin. During high tone of arterial and venous tissues evoked by noradrenaline (NA) in the presence of guanethidine, field stimulation evoked muscle relaxation that was not affected by atropine but was abolished by tetrodotoxin. In parallel to the mechanical responses, field stimulation evoked excitatory junction potentials (EJPs) in both arterial and venous smooth muscle cells. In the case of the artery, an action potential was superimposed on the EJP. The NA‐induced contraction was suppressed by vasoactive intestinal polypeptide (VIP), dose‐dependently. On the other hand, α,β‐methylene‐ATP did not affect the muscle relaxation induced by field stimulation.

These results indicate that the penile artery and vein of the dog are innervated by adrenergic excitatory nerves and non‐adrenergic, non‐cholinergic inhibitory nerves. The transmitter possibly involved in the latter is discussed.
Penile Function Following Intracavernosal Injection of Vasoactive Agents or Saline
Authors: KIELY E. A. , IGNOTUS P. , WILLIAMS GORDON
Published: November 2008

Summary— Few studies on the pharmacological assessment or treatment of impotence have included controls. In a double‐blind crossover study, 18 impotent men received either a 2 ml injection of a solution containing 30 mg papaverine and 1 mg phentolamine or a similar volume of normal saline into the corpus cavernosum. The immediate and delayed effects (4 weeks later) were assessed independently and the alternative injection then given. All injections with papaverine and phentolamine were followed by an immediate increase in penile length and rigidity, and 70% of these patients were able to have sexual intercourse for periods of 1 to 4 weeks. No change in penile length or rigidity occurred following the saline injection and only one patient showed some improvement in erection over the next 4 weeks. In the crossover study, no patient developed any increase in length or rigidity of the penis following injection of saline, and improvement in spontaneous erection occurred in only two cases. In contrast, all patients who received papaverine and phentolamine had an increase in penile length and rigidity, and 50% were able to have normal sexual intercourse over the next 4 weeks.

This study confirms the value of a combination of vasoactive agents in the management of impotence, irrespective of its aetiology, and suggests that any placebo effect is minimal in this group of patients with considerable psychological overlay.
Early Repair of Accidental Injury to the Ureter or Bladder Following Gynaecological Surgery
Authors: BADENOCH D. F. , TIPTAFT R. C. , THAKAR D. R. , FOWLER C. G. , BLANDY J. P.
Published: November 2008

Summary— Operative injury to the ureter or bladder in 59 women who had received no previous pelvic radiotherapy was repaired as soon as possible after referral. In 32, this was less than 6 weeks from the injury, while in 27 patients the delay in referral was greater than 6 weeks. Ureteric injuries in 40 patients (43 ureters) were repaired by the Boari‐Ockerblad technique. Post‐operative vesicovaginal fistulae in 19 women were repaired transvesically with an omental patch. Primary healing was obtained in all cases whether early or late. These results support our recommendation for early intervention in these injuries.
Polymer Treatments Reduce Adhesion of Comminuted Stone in Rat Bladder
Authors: MAROUDAS N. G. , LINDENBAUM E. S.
Published: November 2008

Summary— A method for inhibiting the adhesion of stone fragments in comminution is presented. Surfaces are coated with a molecular layer of so‐called “excluding” polymer.

In experimental tests, rat bladders were injected with comminuted urinary stone (phosphate or oxalate) in saline which contained small amounts of excluding polymer (0.1% hyaluronic acid or polyvinyl pyrrholidone). The urinary tract was then irrigated with fresh polymer solution and examined for residual stone. A ten‐fold reduction in particle count was obtained, compared with irrigation with normal saline.

The possible applications in percutaneous and extracorporeal lithotripsy are discussed. It seems that the “coagulum” and “exclusion” types of polymer irrigant might find complementary uses: the former for manual extraction of coarse particles and the latter for flushing out after fine comminution.
Vaginal Pressure as an Index of Intra‐abdominal Pressure during Urodynamic Evaluation
Authors: AL‐TAHER H. , SUTHERST J. R. , RICHMOND D. H. , BROWN M. C.
Published: November 2008

Summary— Vaginal pressure was measured using balloon catheters in 20 patients and open‐ended fluid‐filled catheters in another 21. The results showed excellent correlation between vaginal, vesical and rectal pressures in response to changes in abdominal pressure.
The “Congenital” Wide Bladder Neck Anomaly: a Common Cause of Incontinence in Children
Authors: MURRAY K. , NURSE DIANE , BORZYSKOWSKI MARGARET , MUNDY A. R.
Published: November 2008

Summary— In a study of 251 children (108 boys, 143 girls) undergoing videourodynamic studies for the assessment of non‐neuropathic bladder dysfunction, 45 (19%) were found to have a wide bladder neck as their primary abnormality. Based on these studies there is evidence that the wide bladder neck anomaly is congenital in origin. In addition to producing significant urinary symptoms in childhood, this anomaly may provide a basis for stress incontinence in later life.
The Diagnostic Value of Human Chorionic Gonadotrophin in Patients with Testicular Seminoma
Authors: PAUS E. , FOSSÅ S. D. , RISBERG T. , NUSTAD K.
Published: November 2008

Summary— Human chorionic gonadotrophin (HCG) was measured in sera from seminoma patients by an immunoassay which recognised both free β‐chains and intact HCG molecules. This seemed to increase the sensitivity of the assay without affecting its specificity. The HCG values were correlated to the clinical course in 151 patients. Pre‐orchiectomy samples were assayed in 57 patients. Elevated pre‐operative HCG levels were found in 15 of 38 patients (39%) in stage I and in 13 of 19 patients (68%) in stages II to IV. After orchiectomy the HCG values were normal in 114 of 115 patients in stage I and elevated in 13 of 36 patients (36%) in stages II to IV. Relapses were observed more often in stage II to IV patients who produced HCG at the time of diagnosis than in non‐producers (3 of 13 patients versus 1 of 23 patients). In 7 of 11 relapses the serum HCG was elevated. HCG positive relapses were seen in patients both with and without initially elevated serum HCG.
Digital Angiography of Erectile Failure
Authors: NESSI R. , DEFLAVIIS L. , BELLINZONI G. , FRERI F. , SALVINI A.
Published: November 2008

Summary— Digital angiography of pudendal and penile arteries was performed in 44 consecutive patients with erectile failure of suspected vascular origin. Intra‐arterial injection of contrast medium via selective catheterisation of the hypogastric arteries was used in six cases. In 39 patients, one of whom had already had arterial catheterisation, contrast medium was administered by the intravenous route, using a single, large volume, high speed bolus.

In 12/44 cases (27%), digital angiography showed a normal vascular picture at the pudendal and penile level but the remaining 32 patients (73%) had steno‐occlusive lesions of different degrees of severity.

The pictures obtained after administration of intravenous contrast were diagnostically as good as the studies with selective arterial catheterisation. In addition, the intravenous route allowed the simultaneous representation of the arterial network on both sides and was quicker and less invasive.

In 31/44 patients (79%), functional determinations of nocturnal penile tumescence and of penile blood flow with Doppler ultrasonography were performed for comparison. Nocturnal penile tumescence results correlated well with the angiographic picture. Penile blood flow measurements with the Doppler technique were less sensitive than digital angiography.
Renal Carcinoma: a Ten‐year Review 1971–1980
Authors: BEST B. G.
Published: November 2008

Summary— A review of 72 patients who underwent nephrectomy for renal carcinoma between 1971 and 1980 is presented. All survivors were followed for a minimum of 5 years. The clinical features, type of operation and pathological findings were analysed for their influence on survival. Patients with stage 1 to 3 disease had a 65% 5‐year survival rate, whereas all patients with stage 4 disease were dead within 2 years. The presence of malaise had a highly significant adverse influence on survival (P=0.00 14).
Renal Tubular Antigens in Regenarative Epithelium and Renal Carcinoma
Authors: FLEMING S. , MATTHEWS TINA J.
Published: November 2008

Summary—Antibodies to brush border antigen (BB) and epithelial membrane antigen (HMFG2) have been used in immunocytochemical preparations to define specific portions of the nephron. In both fetal and adult kidney BB was confined to the proximal tubule and HMFG2 to the distal tubule and collecting duct. The distribution of the antigens was studied in regenerative epithelium (15 cases) and renal carcinoma (35 cases). Regenerative epithelium in six cases expressed both antigens, and 29/35 renal carcinomas expressed both antigens. These results demonstrated some antigenic similarities between regenerative hyperplastic tubular epithelium and renal carcinoma.
Does the Severity of Presentation in Children with Vesicoureteric Reflux Relate to the Severity of the Disease or the Need for Operation?
Authors: OZEN H. A. , WHITAKER R. H.
Published: November 2008

Summary— The presenting symptoms, number of previous urinary tract infections, grade of reflux and incidence of renal scarring, together with an analysis of the need for reimplantation of the ureters, were assessed retrospectively in 222 patients with vesicoureteric reflux. The grade of reflux was found to be as severe in patients presenting after a single urinary tract infection as in those presenting after more than one infection. Regardless of whether patients presented with mild, moderate or severe symptoms, the degrees of reflux and renal scarring remained similar. There was no relationship between the severity of presenting symptoms and the eventual need for ureteric reimplantation.

All children should be investigated when they present for the first time with a urinary tract infection, irrespective of age, sex or severity of symptoms.
Clean Intermittent Self‐catheterisation in the Elderly
Authors: WHITELAW S. , HAMMONDS J. C. , TREGELLAS R.
Published: November 2008

Summary— The results of teaching the technique of clean intermittent self‐catheterisation (CISC) to 20 elderly patients (aged 65–81 years) are reported. The patients were followed up for a maximum of 4 years. The use of this technique in the management of selected elderly patients with lower urinary tract dysfunction is discussed.
The Efficacy of Bromocriptine in Benign Prostatic Hypertrophy: A Double‐blind Study
Authors: POPPEL H. VAN , BOECKX G. , WESTELINCK K. J. , VEREECKEN R. L. , BAERT L.
Published: November 2008

Summary— The efficacy and the safety of bromocriptine 7.5 mg daily were investigated in a double‐blind versus placebo trial in 32 patients with troublesome symptoms from benign prostatic hypertrophy. Differences between the treatments in respect of uroflowmetry, residual urine and safety parameters were not statistically significant. Differences in respect of nocturia, daytime frequency and overall efficacy were statistically significant in favour of bromocriptine. There could be a place for bromocriptine in the palliative treatment of the functional disability caused by benign prostatic hypertrophy when surgery is refused or contraindicated.
A New Technique for the Management of Urethral Injuries
Authors: TOWLER J. M. , EISEN S. M.
Published: November 2008

Summary— A new technique for the management of urethral trauma is described. Initial suprapubic catheterisation is followed by endoscopic assessment after approximately 2 weeks. Realignment over a splinting catheter may then be achieved by instrumentation and endoscopy via both suprapubic and urethral routes.

The development of the technique and the early results of a small series of patients are presented.
Bone Scintigraphy in Testicular Tumours
Authors: MERRICK M. V.
Published: November 2008

Summary— The role of bone scintigraphy was assessed by follow‐up and review of 61 patients with testicular tumours. Skeletal metastases were present in all five patients who died with seminoma and in two of the eight whose deaths were due to teratoma. The only patient with skeletal metastases to have a prolonged survival had a mixed teratoma/seminoma. Bone scintigraphy is indicated in patients with recurrence after radical treatment for seminoma and may be indicated in patients presenting with stage IV seminoma, to identify a sub‐group with the worst prognosis. In other patients it is indicated only if there is a specific clinical suspicion of bone metastases.
Multiple Simultaneous Bilateral Urothelial Tumours of the Renal Pelvis
Authors: ANSELMO G. , RIZZOTTI A. , FELICI E. , BASSI E. , MACCATROZZO L.
Published: November 2008

Summary— Three cases of simultaneous bilateral transitional cell carcinoma of the renal pelvis are reported. In one case the bladder and urethra were also involved. information provided by radiological studies (particularly renal angiography) and cytology allowed us to define with accuracy not only tumour sites but also the tumour itself and the degree of malignancy. Based on the latter finding, the surgical approach was adapted to each individual case and consisted of papillectomy, partial pyelectomy or heminephrectomy associated with contralateral nephroureterectomy. In one case total cystourethrectomy was performed. Long‐term follow‐up showed no recurrence in the residual urinary tract 5 to 8 years post‐opertively.