bluuebunny/crossref_metadata_2025 huggingface dataset:
Relative Value of Antibiotics and Catheter Care in the Prevention of Urinary Tract Infection after Transurethral Prostatic Resection
Authors: STRICKER P. D. , GRANT A. B. F.
Published: November 2008

Summary— One hundred patients were prospectively randomised into two groups to receive either a single dose of 1 g ampicillin and 80 mg gentamicin pre‐operatively or no antibiotic prophylaxis. The incidence of breakage in the continuity of the closed drainage system was documented. All patients with urinary tract infection (UTI), catheterisation, clinical prostatic carcinoma, neurogenic bladder and bladder tumours were excluded. UTls, bacteraemia and fever were noted. There were 7 late exclusions. The incidence of UTI in the control and antibiotic groups was 16 and 17% respectively. No blood cultures were positive. There were no significant differences in the incidence of fever between the two groups.

A break in the closed drainage system occurred in 13 patients. Fifteen of the 93 developed UTI. A break in the closed drainage system occurred in 7 of the 15 patients (40%) with UTI. Of the 78 patients without UTI, 8 had a break (10%). This difference was highly significant.

We recommend that less emphasis be placed on prophylactic antibiotics and more on avoiding breakage of the closed system in the prevention of UTI after transurethral resection of the prostate (TURP) in the low risk situation.
Urethral Dilatation Compared with Cystoscopy Alone in the Treatment of Women with Recurrent Frequency and Dysuria
Authors: RUTHERFORD A. J. , HINSHAW K. , ESSENHIGH D. M. , NEAL D. E.
Published: November 2008

Summary— The relative merits of cystoscopy alone and cystoscopy plus urethral dilatation were compared in a randomised study of women with recurrent frequency and dysuria.

One hundred women were studied before and at least 6 months after operation. A detailed questionnaire was completed, the severity of the symptoms was scored and patients underwent urodynamic investigation. Forty‐eight patients underwent cystoscopy alone and 52 underwent urethral dilatation. The two groups were well matched with regard to age, parity, menopausal status, previous gynaecological surgery and severity of symptoms.

A significant improvement in symptoms was observed in both groups after treatment: 30% had no residual symptoms, 50% were improved and 20% were no better. However, no difference in final outcome was observed between those who had undergone cystoscopy alone and those who had undergone urethral dilatation. Furthermore, 7 patients who underwent urethral dilatation experienced transient stress incontinence of urine, a complication not observed in women who underwent cystoscopy alone. No benefit was observed from the addition of urethral dilatation to cystoscopy alone in women with recurrent frequency and dysuria.
Prostacyclin in the Treatment of Painful Peyronie's Disease
Authors: STRACHAN J. R. , PRYOR J. P.
Published: November 2008

Summary— The effect of a prostacyclin infusion was studied in 5 men with persistent pain associated with Peyronie's disease. Marked side effects were associated with the infusion, which was of limited benefit.
Management of Clinical Data in Urology.: Experience with Integrated Personal Computers and a Relational Database
Authors: ENGELMANN U. , WALLENBERG H. v. , KÖHL U. , GEESKEN E.
Published: November 2008

Summary— The use of microcomputers in medicine is rapidly increasing. To handle clinical data and to facilitate clinical research, a system based on several personal computers that can be linked together was developed. Commercially available software was used, consisting of a powerful relational database complemented by programs for statistics, graphics and desk top publishing. The low cost, modular and flexible system was handled by untrained personnel; computer specialists were not needed. Data on more than 1100 patients have been entered so far and data retrieval can be done by the physician “on the spot” using standard prefabricated reports. Data can then be analysed statistically and processed to graphics and publications.
The Biphasic Nature of Renal Functional Recovery Following Relief of Chronic Obstructive Uropathy
Authors: JONES D. A. , GEORGE N. J. R. , O'REILLY P. H. , BARNARD R. J.
Published: November 2008

Summary— Twenty‐one patients with chronic obstructive uropathy due to high pressure chronic retention of urine underwent renal functional assessment both during the period of obstruction and repeatedly up to 3 months following its relief. Glomerular filtration rate (GFR) was determined using clearance of 99mTc‐DTP A and iohexol. Creatinine, water, urea and electrolyte excretion was assessed from timed urine collections.

Excretion of water, urea and electrolyte was normal during obstruction but increased dramatically immediately following relief (e.g. sodium 110 to 234 mmo1/24 h). Values returned to normal by 2 weeks (sodium excretion 148 mmo1/24 h). No further significant changes occurred up to 3 months. Mean 99mTc‐DTPA and iohexol clearances during obstruction were 59.0 and 50.5 ml/min respectively. Following relief of obstruction, no significant improvement occurred at 2 weeks but did at 3 months (mean = 68.4 and 55.7 ml/min). Mean creatinine clearance during obstruction was 32.5 ml/min. This improved 2 days following relief to 46 ml/min. No further improvement was seen until 3 months (mean = 57.3 ml/min).

It was concluded that recovery of renal function from obstructive injury occurs in two phases, an early tubular phase lasting up to 2 weeks and a later, predominantly glomerular phase, between 2 weeks and 3 months. There is some disparity between creatinine clearance and more accurate measurements of GFR which may be explained by tubular excretion of creatinine in the early phase of recovery.
Ureteric Obstruction Secondary to Endometriosis: Report of Three Cases with a Review of the Literature
Authors: LUCERO S. P. , WISE H. A. , KIRSH G. , DEVOE K. , HESS MARY L. , KANDAWALLA N. , DRAGO J. R.
Published: November 2008

Summary— Three cases of endometriosis are presented. In one patient bilateral obstruction was noted; in a second patient bilaterally enlarged kidneys with unilateral obstruction were found and in the third patient only unilateral obstruction was defined. Intrinsic ureteric obstruction and bilateral obstruction, both rare findings, are described in this report. The diagnosis, evaluation and management of these patients are discussed.
The Use of Endoscopic Detrusor Muscle Biopsies for in vitro Muscle Strip Studies
Authors: HARRISON S. C. W. , SIBLEY G. N. A. , DOYLE P. T. , FERGUSON D. R.
Published: November 2008

Summary— A technique is described for performing in vitro muscle strip studies using samples of detrusor muscle taken by means of endoscopic biopsy forceps. This study of pig bladder muscle showed that the nerve mediated and drug induced responses of the muscle biopsies were similar to those produced by traditionally dissected muscle strips. The importance of continued access to human material for pharmacological studies is discussed.
Long‐term Follow‐up of Selective Sacral Neurectomy
Authors: LUCAS M. G. , THOMAS D. G. , CLARKE S. , FORSTER D. M. C.
Published: November 2008

Summary— Between 1976 and 1981, 22 patients underwent selective, complete sacral root section as a treatment for severe detrusor overactivity. Eighteen were followed up for more than 4 years (mean 6.2). Thirteen of the 22 patients had significant symptomatic improvement lasting for more than 4 years post‐operatively (59%), 8 of whom had stable bladders. It was concluded that this operation still has a place in the treatment of detrusor overactivity.
X‐ray Microscopy of the Prostate Gland
Authors: DAVIES R. LI. , JONES D. R. , HARRISON T. J. , GRIFFITHS G. J. , EVANS K. T.
Published: November 2008

Summary— A technique is described for investigating the internal structure of the prostate gland (including calcification) by projection X‐ray microscopy (microradiography).

The results show that the technique can be used in conjunction with the corresponding histological preparations to complement the examination of the prostate gland by demonstrating tissue density and the structure and location of microcalcification < 5 μm in diameter.
Safety of Surveillance in the Management of Stage I Anaplastic Germ Cell Tumours of the Testis
Authors: CRAWFORD S. M. , RUSTIN G. J. S. , BEGENT R. H. J. , NEWLANDS E. S. , BAGSHAWE K. D.
Published: November 2008

Summary— A study was made of 46 patients with anaplastic germ cell tumours of the testis with no evidence of disease elsewhere as judged by computed tomography (CT) of thorax and abdomen, ultrasound and tumour marker measurements. A repeat CT 3 months after the first and clinical examination with chest X‐ray and tumour marker measurements ensured that the 30.7% of patients who relapsed were detected promptly enough for them all to enter complete remission. Lymphography as part of the staging did not reduce the relapse rate. There was no difference between this group and a comparable group who underwent radiotherapy to para‐aortic lymph nodes.
Renal Acidification Defects in Medullary Sponge Kidney
Authors: OSTHER P. J. , HANSEN A. B. , RØHL H. F.
Published: November 2008

Summary— Thirteen patients with medullary sponge kidney underwent a short ammonium chloride loading test to investigate their renal acidification capacity. All but 1 presented with a history of recurrent renal calculi and showed bilateral widespread renal medullary calcification on X‐ray examination. Nine patients had some form of renal acidification defect; 8 had the distal type of renal tubular acidosis, 2 the complete and 6 the incomplete form. One patient had proximal renal tubular acidosis. These findings, which suggest that renal acidification defects play an important role in the pathogenesis of renal calculi in medullary sponge kidney, have considerable therapeutic implications.
Recurrent and Residual Renal Calculi in Children
Authors: MacDONALD I. , AZMY A. F.
Published: November 2008

Summary— One hundred and thirteen children with non‐metabolic urinary tract calculi were operated on between 1960 and 1983. One hundred were followed up for 3 to 17 years (mean 8.2). Seventeen children (15%) developed recurrent calculi after complete clearance at the initial operation and in 13 of these the stones recurred within 5 years. Proteus urinary infection was a constant feature of stone recurrence. Five patients required re‐operation for removal of the recurrent calculus. Small residual caliceal fragments were left behind in 17 children but only 3 required surgical removal.
Renal Dysplasia—a Clnicopathologcal Review
Authors: QUINN CECILY M. , KELLY D. G. , CAHALANE S. F.
Published: November 2008

Summary— A review of 15 cases of unilateral renal dysplasia is presented. Seven patients came to medical attention with urinary tract infection. Only 4 presented with an abdominal mass. Eight patients were found to have ipsilateral ureteric anomalies and 4 of these also had contralateral ureteric problems. Five patients had extra‐renal anomalies and these included Turner's syndrome, scoliosis and congenital dislocation of the hip. Histological examination, in all cases, revealed the presence of primitive ducts surrounded by concentric layers of cellular mesenchyme. Metaplastic cartilage was noted in only 7 of the 15 cases.
Venous Bypass for Surgical Resection of Renal Carcinoma Invading the Vena Cava: a New Approach
Authors: ATTWOOD S. , LANG D. M. , GOITI J. , GRANT J.
Published: November 2008

Summary— A new technique is described which facilitates the surgical removal of renal carcinoma from the inferior vena cava. The use of cardiopulmonary bypass with or without cardiac arrest has been advocated but with this procedure only the inferior vena cava is bypassed, using femoral and right atrial cannulation, assisted by a closed system electromagnetic centrifugal pump. In appropriate cases this less complex technique allows prolonged access to the inferior vena cava whilst providing equal protection from pulmonary embolisation and tumour dissemination; it also reduces morbidity, operating time, difficulty and cost when compared with cardiopulmonary bypass.
Pelviureteric Junction Obstruction. The Value of a Post‐micturition View in 99mTc DTPA Diuretic Renography
Authors: GORDON I. , MIALDEA‐FERNANDEZ R. M. , PETERS A. M.
Published: November 2008

Summary— Eighty‐one 99mTc DTPA renograms were performed in 31 children who had previously undergone pyeloplasty for pelviureteric junction obstruction (PUJ). A post‐micturition image following a diuretic stimulus excluded obstruction in 50% of the patients in whom the frusemide T75 was abnormally prolonged beyond 10 min. Evaluating the 99mTc DTPA renogram and the response to a diuretic without both changing the patient's position and ensuring an empty bladder may lead to incorrect diagnosis of PUJ obstruction.
Cranial Nerve Dysfunction in Metastatic Cancer of the Prostate
Authors: SVARE A. , FOSSÅ SOPHIE D. , HEIER MONA S.
Published: November 2008

Summary— We report 11 patients with cranial nerve dysfunction due to bone metastases from advanced prostatic cancer. Diplopia, speech disturbances, tongue deviation and headache were the typical clinical symptoms. X‐ray and/or computed tomography of the base of the skull demonstrated bone destruction (and the surrounding soft tissue tumour) in 8 cases. In 1 patient the bone destruction was visualised only by bone scan. In 2 cases no bone destruction could be demonstrated in spite of the clinical findings. In 9 of the 10 evaluable patients the clinical symptoms improved after high voltage radiotherapy and high dose corticosteroid treatment.

Cranial nerve dysfunction is a late complication of hormone‐resistant prostatic cancer. The symptoms are usually due to bone destruction at the base of the skull. Radiotherapy combined with corticosteroid treatment is an excellent palliative measure if started immediately after the onset of symptoms.
Neurophysiological Investigations in Potent and Impotent Men Assessment of Bulbocavernosus Reflex Latencies and Somatosensory Evoked Potentials
Authors: PORST H. , TACKMANN W. , AHLEN H. VAN
Published: November 2008

Summary— A multidisciplinary investigation was carried out on 130 patients with erectile dysfunction. The bulbocavernosus reflex (BCR) latency times were evaluated in all patients and in 116 the somatosensory evoked potentials (SSEP) were also assessed. BCR latency times were examined in 39 potent control patients and the SSEP were measured in 30 members of this group.

There were no abnormal findings in the control group. Of the 130 patients with erectile dysfunction, 65 had anomalies in the BCR measurements and 36 of 116 patients had abnormal SSEP findings. When compared with the control group, 76 of 130 patients with erectile disorders (66%) had irregularities in BCR latency times and/or SSEP. As a result of these findings, lesions of the somatic penile innervation are considered to be one of the many causes of erectile dysfunction.
Irrigation and Acute Ureteric Dilatation—as for Ureteroscopy
Authors: BODDY SU‐ANNA M. , NIMMON C. C. , JONES S. , RAMSAY J. W. A. , BRITTON K. E. , LEVISON D. A. , WHITFIELD H. N.
Published: November 2008

Summary— The effects of irrigation with sterile and infected saline after acute ureteric dilatation by graded Teflon dilators were evaluated renographically and histologically in minipigs. The minipig ureter was dilated from its normal calibre of 4 F to 10 F, and 100 ml of sterile or infected saline were then introduced from a height of 60 cm under gravity.

One week after irrigation and dilatation the ipsilateral kidney was either functioning less than 10% or there was an obstructive nephropathy. Histology at 3 months suggested that extravasation of infected irrigating fluid was the most likely cause of ureteric stricture formation.
Assessment of the Results of Stamey Bladder Neck Suspension
Authors: KIRBY R. S. , WHITEWAY J. E.
Published: November 2008

Summary— A total of 48 patients with genuine stress incontinence underwent endoscopic bladder neck suspension; 36 patients (75%) were completely cured of their incontinence but 12 (25%) suffered recurrent leakage. In 2 cases this was due to infection and erosion of the vaginal sutures; in 4 cases failure was ascribed to a small capacity bladder and “pipe‐stem” urethra. In the remaining 6 unsuccessful cases the Stamey sutures had cut through flimsy endopelvic fascia.

It was concluded that endoscopic bladder neck suspension has advantages over colposuspension in terms of reduced dissection and hospital stay, but its success rate is lower than originally reported. Failures due to suture infection and buttress displacement may be avoided by not using Dacron and, instead, by picking up vaginal subdermis with nylon sutures‐the same tissue used to provide support in a Burch colposuspension.
The Density of Cholinergic and Alpha and Beta Adrenergic Receptors in the Normal and Hyper‐reflexic Human Detrusor
Authors: RESTORICK JANE M. , MUNDY A. R.
Published: November 2008

Summary— The density of cholinergic and of alpha and beta adrenergic receptors was measured in samples of normal and hyper‐reflexic human detrusor muscle. There was a significant reduction in the density of cholinergic receptors and a significant increase in the density of alpha adrenergic receptors in the hyper‐reflexic samples as compared with normal. There was no difference between the two groups in the density of beta adrenergic receptors.
Concurrent Adriamycin and Radiotherapy in Locally Advanced Bladder Cancer
Authors: JAKSE G. , FRITSCH ESTHER , FROMMHOLD H.
Published: November 2008

Summary— A prospective 2‐phase study was performed on 24 patients with locally advanced transitional cell carcinoma of the urinary bladder to evaluate the toxicity of integrated treatment with Adriamycin 10 mg/m2 (group A) or 20 mg/m2 (group B) and hyperfractionated, accelerated radiotherapy. Local and systemic toxicity with Adriamycin 10 mg/m2 was significantly lower than with 20 mg/m2. Complete tumour remission was achieved in 18 patients (6 of 8 patients in group A and 12 of 16 in group B). In 12 cases the treatment could be stopped after the first series.
The Effect of Spermine, Spermidine and Kallikrein on the Triple Adenosine Triphosphatase Enzyme Activity of Spermatozoa in Males with Oligoasthenozoospermia
Authors: KARACAGIL M. , IMAMOĞLU A. , PASLAOĞLU H. , GÜLMEZ I. , TATLIŞEN A.
Published: November 2008

Summary— Unknown factors in the seminal plasma of normal semen that affect the motility of spermatozoa have a positive effect on adenosine triphosphatase (ATPase) enzyme activity. In an attempt to produce such an effect, spermine, spermidine and kallikrein were added to the incubation media in which spermatozoal ATPase enzyme activity was determined. These seminal substances increased the triple ATPase enzyme activity of spermatozoa from oligoasthenozoospermic men. We propose that the ATPase enzyme activity of spermatozoa may indicate sperm motility as a biochemical test.
Effect of Phentolamine on Venous Return in Human Erection
Authors: WESPES E. , RONDEUX C. , SCHULMAN C. C.
Published: November 2008

Summary— A group of 25 patients underwent Doppler penile blood examination and cavernometry before and after 5 mg of phentolamine injected intracavernously.

The organic or psychogenic nature of impotence was determined by psychological testing, the intracavernous injection of papaverine, hormonal evaluation, neurological examination, Doppler penile blood flow measurement and cavernometry for vascular investigations.

The intracavernous injection of phentolamine had no effect on the venous return and it provoked penile arterial dilatation. The erectile angle, which was also measured, was less evident than after the injection of papaverine.

The results confirmed the fact that an increase in arterial inflow alone is not sufficient to induce a rigid erection in man.
Urological History‐taking and Management Recommendations by Microcomputer
Authors: GLEN E. S. , SMALL D. R. , MORRISON L. M. , POLLOCK K.
Published: November 2008

Summary— A system has been developed to acquire a complete urological history using an Apple microcomputer. The system can ask up to 300 multiple choice questions which the patient answers using a light pen. The questions are grouped into blocks for urological symptoms and complicating factors. A printout summarises the history and the recommended further investigations. A copy of this is given to the patient and the referring doctor. The clinician discusses the printout and proposed investigations with the patient. The system has been tested against experienced clinicians and the results are presented. The computer system was evaluated for 26 patients and was found to record all of the important information. The system is now in regular use in the out‐patient clinic as the first part of the diagnostic work‐up in suitable referrals. This system has shortened waiting times for first appointments. To date 261 patients have used the system. The consultant urologist continues his practice of reading all referral letters and allocating priorities. Conditions requiring immediate physical examination (e.g. testicular swelling) are not suitable for this type of approach.
Absence of Peripheral‐type Benzodiazepine Binding Sites in Renal Carcinoma: a Potential Biochemical Marker
Authors: KATZ Y. , MOSKOVITZ B. , LEVIN D. R. , GAVISH M.
Published: November 2008

Summary—In an attempt to identify a tumour marker, we investigated peripheral‐type benzodiazepine binding sites (PBS) in kidney specimens obtained from patients who underwent nephrectomy due to a renal mass. [3H]PK 11195, an isoquinoline carboxamide derivative, was used as a ligand. Binding assays were conducted on samples of membrane homogenate taken from both the healthy portion and the tumour site of the kidney. It was found that binding characteristics of benign tumours and normal kidney tissues were not significantly different,i.e. equilibrium dissociation constants of 2.20±0.73 and 2.38±0.98 nM, respectively, and maximal number of binding sites of 3190± 1081 and 4189±998 fmol/mg protein, respectively. In contrast, no PBS were detectable in renal carcinoma. The absence of PBS in malignant renal tissues may serve as a biochemical marker for tumours of the kidney.
Pelviureteric Obstruction in Children Treated by Retrograde Ureteroplasty
Authors: DORAISWAMY N. V. , BADER M. S. K.
Published: November 2008

Summary— Pelviureteric obstruction was treated by dilatation with a Fogarty balloon catheter in 2 children. The catheter was introduced through the cystoscope without any percutaneous procedure, ureteric stents or drainage. Follow‐up for 18 months indicated improved drainage and renal function. The merits and demerits of this technique are discussed.
Modified Stamey Procedure for Bladder Neck Suspension
Authors: JONES D. J. , SHAH P. J. R. , WORTH P. H. L.
Published: November 2008

Summary— A review of 76 patients who underwent endoscopic bladder neck suspension (EBNS) for stress incontinence is presented. Pre‐operative video‐urodynamic studies in 71 patients demonstrated stable stress incontinence in 61 (86%). There was a history of previous pelvic surgery in 52 patients (68%). Surgery was performed by trainee urologists in 35 cases (46%). The overall complication rate was 46%, of which 17% were per‐operative and did not influence the outcome of surgery. Infection occurred in 16% and necessitated removal of the suture buffers in 9%. Follow‐up ranged from 7 to 30 months (mean 18.3).

Complete resolution of stress incontinence or a marked improvement in symptoms was seen in 86% of cases.

Patients with no history of previous pelvic surgery were all either cured or improved by the procedure. Of the 52 patients who had undergone previous pelvic surgery, 42 (80%) were either cured or improved. All of the 10 failures were in this group. There was no difference between complication or success rates achieved by consultants or urologists in training.

It was concluded that EBNS is the treatment of choice in patients with primary stress incontinence and it is an effective procedure in patients who have undergone previous unsuccessful surgery for stress incontinence.
Recurrence of Superficial Bladder Carcinoma after Intravesical Instillation of Mitomycin‐Comparison of Exposure Times
Authors: GIESBERS A. A. G. M. , HELSDINGEN P. J. R. O. VAN , KRAMER A. E. J. L.
Published: November 2008

Summary— A total of 70 patients were treated with intravesical instillations of Mitomycin‐C (MMC) following transurethral resection for superficial bladder carcinoma. In this randomised prospective study the influence of 2 exposure times (0.5 and 1 h) was studied in relation to tumour recurrence, recurrence interval, tumour progression and toxicity. The number of patients with recurrent tumours was significantly lower in the 1‐h group. Tumour progression was seen in only 2 patients in each group and all had primary or secondary carcinoma in situ of the bladder or prostatic urethra. Fourteen patients were excluded from further evaluation because of side effects. A longer instillation time over a longer period and a lower dose of MMC are recommended.
Patients at High Risk of Cardiovascular Complications in Oestrogen Treatment of Prostatic Cancer
Authors: HENRIKSSON P. , EDHAG O. , ERIKSSON A. , JOHANSSON S.‐E.
Published: November 2008

Summary— The aim of this study was to predict cardiovascular complications in patients with prostatic cancer treated with oestrogen. A randomised prospective study of oestrogen therapy versus orchiectomy was performed. Patients with pre‐existing cardiovascular morbidity were excluded (16%). Prior to the initiation of therapy, patients were subjected to exercise stress tests, physiological evaluation of peripheral circulation, blood volume estimation, chest X‐ray, blood test, including hormones, lipoproteins, and antithrombin III, and a physical examination and history by a cardiologist. The oestrogen treatment and the orchiectomy group did not differ with regard to these pretreatment variables; 25% of the patients given oestrogen therapy had cardiovascular complications during the initial treatment year compared with none in the orchiectomy group.

Three statistical discriminating techniques were employed and they allowed us to identify 2 strong discriminating variables for cardiovascular complications if oestrogen therapy is instituted in patients with prostatic cancer but without overt clinical cardiovascular disease. These 2 discriminators were luteinising hormone (LH) and ST‐segment depression during exercise. This means that a patient with ST‐segment depression during an exercise test and/or a high luteinising hormone concentration should not be treated with oestrogen.
Hyperthermia with Simultaneous Administration of Interferon Using Established Human Renal Carcinoma Heterotransplanted in Nude Mice
Authors: ONISHI T. , MACHIDA T. , MORI Y. , IIZUKA N. , MASUDA F. , MOCHIZUKI S. , TSUKAMOTO H. , HARADA N.
Published: November 2008

Summary— Using human renal carcinoma heterotransplanted in nude mice, the effects of the combined use of hyperthermia and interferon (natural human interferon‐alpha; IFN‐alpha, and recombinant interferon‐gamma; IFN‐gamma) were examined. The hyperthermic device used was the Clini‐Therm, Mark VII, 915 MHz, microwave. The administration of interferon was started immediately before hyperthermia and carried out on consecutive days. The combined use of hyperthermia and IFN was compared with hyperthermia and with IFN alone. The combined use of hyperthermia and IFN‐alpha was shown to have significant anti‐tumour effects compared with the former or latter alone. Of 10 nude mice (10 implanted tumours) used for the experiment, 5 showed complete disappearance of the implanted tumours and the others showed prolongation of survival. Combined treatment with IFN‐gamma and hyperthermia showed no significant effect when compared with other treatment groups. Combined treatment with local hyperthermia and IFN‐alpha may have some application to the clinical management of renal carcinoma.
Renal Function after Autotransplantation with Direct Pyelocystostomy. Long‐term Follow‐up
Authors: RANCH T. , GRANERUS G. , HENRIKSSON C. , PETTERSSON S.
Published: November 2008

Summary— The function of 20 human autologous kidney grafts was studied for 4 to 8 years (mean 52) after autotransplantation with a direct pyelocystostomy. The indications for the operation were low‐grade, low‐stage tumour of the renal pelvis and/or ureter, frequently recurrent renal stones and remaining outflow obstruction after pyeloplasty for hydronephrosis.

The wide pyelocystostomy implies reflux of urine from the urinary bladder to the renal pelvis but no significant changes were found in glomerular or tubular function, studied with 51 Cr‐EDTA clearance, 131I‐Hippuran renography, analysis of β2‐microglobulin and total protein excretion in urine, and determination of concentration ability after administration of desmopressin. No increase in the severity or frequency of urinary tract infections was observed.
Anterior Transperitoneal Approach to the Upper Urinary Tract with One‐stage Bilateral Procedure
Authors: JAIN A. B. , YOUNG C. H.
Published: November 2008

Summary— A total of 109 unilateral and 4 bilateral upper urinary tract conditions were treated surgically from 1975 to 1985 by the anterior transverse transperitoneal approach; 26 of these were malignant conditions and 87 were benign. The approach gives good access to the kidney, its pedicle and the upper ureter. There is no increased risk of peritonitis or paralytic ileus due to urinary leak.

One‐stage bilateral surgical procedures were performed in 4 cases. There was no added risk to the patients. It allows both kidneys to recover simultaneously and provides the opportunity of examining the other intra‐abdominal organs.
Ureterolithotripsy: Report of 1000 Cases
Authors: KOSTAKOPOULOS A. , SOFRAS F. , KARAYIANNIS A. , KRANIDIS A. , DIMOPOULOS C.
Published: November 2008

Summary— A series of 1000 patients with calculi of the ureter at various levels were treated by ureteroscopy and lithotripsy over a period of 27 months. The overall success rate was 88.8%. Stones in the upper third of the ureter were removed in 15 of 39 patients. Calculi in the middle third were successfully removed in 52 of 102 patients. A success rate of 95.5% was achieved for calculi of the lower ureter. Per‐operative complications included 10 ureteric perforations, 4 of which were treated surgically and 6 conservatively. Urography, performed in 520 patients 3 months post‐operatively, showed 12 ureteric strictures; 9 of these were treated by insertion of a self‐retaining pig‐tail catheter and 3 required an operation. Ureterolithotripsy appears to be the method of choice in the management of ureteric calculi.
Physical Growth Velocity during Conservative Treatment and following Subsequent Surgical Treatment for Primary Vesicoureteric Reflux
Authors: SUTTON R. , ATWELL J. D.
Published: November 2008

Summary— Physical growth was studied in 6 males and 16 females during 1 year of antimicrobial prophylaxis and during the 2 years following subsequent surgical treatment for severe primary vesicoureteric reflux. Surgery was performed between the ages of 2 and 8 because of either repeated breakthrough infection or persistence of grade III or IV reflux. Height and weight velocities were calculated as yearly rates and then converted into interquartile ratios (IQRs).

Neither the mean centile height nor weight attained varied significantly between that at entry, after 1 year of medical treatment and at 2 years after surgery. However, the mean IQR for height velocity (± sem) rose significantly from –0.61 (± 0.45) during antimicrobial prophylaxis to 0.54 (± 0.25) following surgery. Similarly, the mean IQR for weight velocity rose significantly from –0.63 (± 0.50) during medical treatment to 0.47 (± 0.24) following surgery.

These results suggest that surgical treatment is preferable to continued medical treatment in patients with severe primary vesicoureteric reflux who fail to respond to a trial of antimicrobial prophylaxis.
Invasive Bladder Cancer. Prognostic Factors and Results of Radiotherapy with and without Cystectomy
Authors: MAMEGHAN HEDY , FISHER R.
Published: November 2008

Summary—We report the results and complications of treatment in 205 patients with non‐metastatic invasive bladder cancer. Between 1977 and 1982 there were 3 treatment groups: palliative radiotherapy, radical radiotherapy, and pre‐operative radiotherapy followed by total cystectomy. Data were complete on each patient until the end of 1985 (minimum follow‐up 3 years, median 5.6), when 48 patients were alive without evidence of bladder cancer and 28 had died of intercurrent illness (without clinical evidence of bladder cancer). The overall actuarial 5‐year survival rate (death from any cause) was 24%. The 5‐year survival rates were 13% for group 1, 25% for group 2 and 38% for group 3. Group 1 patients had a significantly shorter survival. The difference between groups 2 and 3 was not statistically significant. The prognostic factors of significance for survival were clinical stage and ureteric obstruction. Factors such as age, tumour grade and multiplicity were significant when examined singly but not in a multivariate analysis which included stage and ureteric obstruction. The actuarial incidence of all radiotherapy complications in bladder and bowel was 9.4 and 10.5% respectively.
Bonney's Blue Cystitis: a Warning
Authors: CHRISTMAS T. J. , CHAPPLE C. R. , PAYNE S. D. W. , MILROY E. J. G. , WARWICK R.T. TURNER
Published: November 2008

Summary— The instillation of diluted Bonney's blue into the bladder during gynaecological operations has been quite common practice over the last 50 years. Bonney's blue is composed of a 1: 1 mixture of brilliant green and crystal violet dissolved in ethanol (90%) or industrial methylated spirit. Before insertion into the bladder this solution must be diluted with water to a 0.5% solution. Failure to do this will result in a severe inflammatory reaction within the bladder. The degree of resultant damage depends upon the duration of exposure. Persistent pain is a feature of this condition, although the other symptoms (frequency and urgency) may settle in time. Two cases of chemical cystitis resulting from the use of undiluted Bonney's blue are described to illustrate the possible consequences. Both patients were awarded 6‐figure sums as compensation.
Salivary Testosterone in Prostatic Carcinoma
Authors: NAVARRO M. A. , AGUILO F. , VILLABONA C. M. , TORRECILLA C. , BONNIN R.
Published: November 2008

Summary— Testosterone concentrations in saliva were measured in 13 patients with prostatic carcinoma after surgical or medical (diethylstilboestrol or Estracyt) orchiectomy. The salivary testosterone values in these patients were significantly lower than in normal males but not significantly different from those in normal females. The salivary testosterone concentrations were measured for 6 consecutive months and did not vary significantly from month to month.

The results suggest that the measurement of salivary testosterone concentrations could be useful in evaluating the androgenic function of patients with prostatic carcinoma after medical or surgical orchiectomy.
The Cost of Bilateral Orchiectomy as a Treatment for Prostatic Carcinoma
Authors: McCLINTON S. , MOFFAT L. E. F. , LUDBROOK A.
Published: November 2008

Summary— Advanced prostatic carcinoma may be treated by a variety of methods of hormonal manipulation which affect the production of the male hormones. This can be achieved by surgical means, usually bilateral orchiectomy, or medically, by a number of drugs. One advantage of surgical over medical castration is that it is a once‐only procedure. Another factor, which could be considered a major advantage, is the low cost of the surgical procedure. This report outlines the costs involved in treating prostatic carcinoma by surgical castration and compares them with the costs of some forms of medical treatment.
Long‐term Follow‐up of the MAGPI Operation for Distal Hypospadias
Authors: HASTIE K. J. , DESHPANDE S. S. , MOISEY C. U.
Published: November 2008

Summary— Following the introduction of the MAGPI procedure, this operation has become established in the management of distal hypospadias. In our unit 45 boys have been treated in this way and the long‐term results have been assessed in 28. The cosmetic result of surgery and the direction of the urinary stream were satisfactory in 27 patients. In all but 2 cases there was partial ventral regression of the urinary meatus when compared with the immediate post‐operative appearances.

In the long term, it is our experience that the MAGPI operation does not maintain a terminal position for the external urinary meatus, but the functional and cosmetic results are satisfactory.
Effect of Unilateral Vesicoureteric Reflux on Renal Growth and the Uptake of 99mTc DMSA by the Kidney. An Experimental Study in the Minipig
Authors: GODLEY MARGARET L. , RISDON R. A. , RANSLEY P. G.
Published: November 2008

Summary— The influence of unilateral vesicoureteric reflux (VUR) on renal growth and the uptake of 99mTc DMSA by the kidney has been investigated in a 2‐kidney model in the growing minipig over a period of approximately 5 months. Animals with reflux in association with low voiding pressures and normal bladder function (n = 5), as well as those with raised voiding pressures and abnormal bladder function (n = 7), were investigated with appropriate non‐refluxing controls (n = 12). Urinary infection and renal scarring were avoided since these factors may affect kidney function and growth independently.

Statistical tests of difference failed to demonstrate any effect of VUR on renal growth or renal uptake of 99mTc DMSA even in the presence of elevated voiding pressures and abnormal detrusor function.
Terodiline in the Treatment of Children with Unstable Bladders
Authors: HELLSTROM ANNA‐LENA , HJALMAS K. , JODAL U.
Published: November 2008

Summary— A double‐blind study of terodiline compared with placebo was performed in 58 children aged 6 to 14 years with urgency or urge incontinence. All had an unstable bladder at cystometry. A bladder regimen was emphasised during the study. Continence was improved according to micturition charting and a pad test in both groups. Terodiline at 25 mg/day, however, gave significantly better results than placebo. In patients with a subnormal bladder capacity ( 150 ml), a significant increase in capacity was recorded on cystometry during medication with terodiline but not with placebo.

The improved continence seen in the placebo group was probably due to the non‐specific bladder training achieved by the child's increased awareness and adult involvement during treatment. The even better results attained in the terodiline group shows this drug to be a valuable adjunct to a bladder regimen in children with urge incontinence, particularly since no important adverse effects were noted during an 8‐week period.
Biocompatibility of Urinary Catheters. Effect on Complement Activation
Authors: GARRED P. , OLSEN J. , MOLLNES T. E. , BILDE T. , GLAHN BENEDICTE E.
Published: November 2008

Summary— The ability of 2 brands of urinary catheters to activate the complement system in vitro as a marker of biocompatibility was investigated. Pieces of a silicone/latex catheter and an all‐silicone catheter were incubated in human serum. Complement activation was tested in 2 enzyme immunoassays, one evaluating C3 activation and the other the terminal complement complex (TCC) formation. The silicone/latex catheter caused considerably more complement activation in both assays than did the all‐silicone one. The findings are in agreement with previous results of tissue toxicity tests. The methods presented may prove valuable for the practical purpose of testing the biocompatibility of urinary catheters.
Effect of Atropine and Terbutaline on Motor Activity of the Continent Caecal Reservoir for Urine
Authors: MANSSON W. , HEDLUND H. , ANDERSSON K. ‐E.
Published: November 2008

Summary— The effects of muscarinic receptor blockade (atropine) and of beta‐adrenoceptor stimulation (terbutaline) on the motor activity of the continent caecal reservoir for urine were studied in 12 patients during continuous filling of the reservoir. Basal pressure was low at high level filling, but pressure waves with amplitudes of 40 to 50 cm H2O occurred every other minute. The reservoir's functional adaptation, revealed as a diminished amplitude of pressure waves and evident soon after its construction, remained stable at long‐term follow‐up. Subcutaneously injected atropine or terbutaline did not influence the basal pressure but increased the volume at which the first pressure wave appeared and decreased the wave amplitude and frequency at high filling levels. Intra‐reservoir instillation of these drugs did not alter the dynamic behaviour of the reservoir. In selected patients, orally administered anticholinergic drugs or beta2‐adrenoceptor agonists may be useful in the management of hyperactivity in a colonic segment used as a continent reservoir or bladder substitute.
A New Stent for the Treatment of Urethral Strictures
Authors: MILROY E. J. G. , CHAPPLE C. R. , ELDIN A. , WALLSTEN H.
Published: November 2008

Summary— We describe a new urethral stent which was implanted into 12 patients with urethral strictures. The stent is woven in the form of a tubular mesh from fine stainless steel wire and is self‐expanding when released from its small diameter delivery catheter. All patients have been treated successfully, with a good calibre urethra visible on urethrography and direct endoscopy and with improved urine flow rates. The mean follow‐up of these patients was 7 months (range 2–13). Urethroscopy demonstrated complete epithelial covering of the implant in 4 to 6 months. Although the follow‐up period was short, it seems that this simple technique may offer a lasting treatment for many urethral strictures. A longer follow‐up will be necessary to exclude late complications.
Azoospermic Infertile Men
Authors: MBIZVO M. T. , CHIMBIRA T. H.K. , GWAVAVA N. N.J.T. , LUYOMBYA J. S. M.
Published: November 2008

Summary— Of 1518 consecutive cases of men referred with infertility, 369 (24%) had complete absence of spermatozoa from their semen (azoospermia). This is a high incidence compared with the rates of 4 to 14% reported in other studies. Primary testicular failure, ductal obstruction, endocrine abnormalities, cryptorchidism and infection were common findings in these men; 247 (67%) gave a history of sexually transmitted infection. The duration of involuntary infertility on presentation ranged from 1 to 16 years. Very few couples accepted artificial insemination with donor semen (AID) as a method of achieving pregnancy and none would consider adoption.
Duplex Scanning in Suspected Vasculogenic Impotence: a Worthwhile Exercise?
Authors: ROBINSON L. Q. , WOODCOCK J. P. , STEPHENSON T. P.
Published: November 2008

Summary— The value of duplex scanning in the assessment of impotence was evaluated in 146 impotent men. Scanning was by means of a Diasonics DRF 400 and penile artery measurements were taken before and after the intracorporeal injection of papaverine hydrochloride. The penile/brachial index was measured in 82 patients and its predictive value compared with the results of duplex scanning and papaverine‐induced erection. On scanning evidence of good arterial inflow but poor erections, indirect evidence of venous leakage was assumed.

The results showed that the deep artery responses best charaterised the erectile response, with the dorsal artery being less helpful.

All 37 patients with full erections following papaverine exhibited bilateral deep artery peak velocities of 25 cm/s. Of the remaining 109 sub‐optimal responders, 17 also has this finding; all had undergone dynamic cavernosography, with 16 exhibiting venous leakage.

The penile/brachial index was found to classify 13 patients incorrectly.

A critical value of deep artery response to attain erection is postulated, enabling more logical use of cavernosography. The penile/brachial index was shown to be suspect and it was concluded that duplex scanning is a useful, non‐invasive method in the assessment of impotence.
AIDS: The Contamination Risk in Urological Surgery
Authors: McNICHOLAS T. A. , JONES D. J. , SIBLEY G. N. A.
Published: November 2008

Summary— Increasing numbers of patients infected with the Human Immunodeficiency Virus (HIV) will be encountered in surgical practice. The risk of exposure to the virus during urological surgery is unknown. In an attempt to quantify the risk and to identify procedures that require change, 427 consecutive urological operations were prospectively assessed for contamination of the surgeon's skin, face and mucous membranes by potentially infected body fluids. Contamination occurred in 136 procedures (32%), of which 37 of 123 (30%) were open operations and 99 of 304 (33%) were endoscopic. Contamination of the face and eyes accounted for 46% (46 of 99 operations) of the contamination occurring in endoscopic surgery. Attention must be paid to reducing exposure of the surgeons' skin to patients' body fluids. The surgeons' eyes should be protected by modification of urological techniques and equipment to avoid spillage.
Radiation Safety during Percutaneous Nephrolithotomy
Authors: INGLIS J. A. , TOLLEY D. A. , LAW J.
Published: November 2008

Summary— Percutaneous nephrolithotomy entails a potential risk of radiation injury to the surgeon if undertaken regularly. The results of 55 consecutive cases of PCN are presented.
Intravesical Bacillus Calmette‐Guérin Treatment for Superficial Bladder Tumours
Authors: SHINKA T. , HIRANO A. , UEKADO Y. , KYOKU I. , AOSHI H. , OHKAWA T.
Published: November 2008

Summary— Intravesical instillations of Tokyo 172 strain BCG were given to 56 patients with superficial bladder cancer during the 24‐month period after transurethral tumour resection as a prophylaxis against tumour recurrence. The recurrence rate of tumours was compared with that of historical controls. Results were estimated by the person‐years method and there were statistically significant decreases in recurrent tumours following BCG therapy.

Our results suggest that the intravesical Tokyo 172 strain BCG is effective and safe as a prophylaxis against the recurrence of superficial bladder tumours.
Androgen and Oestrogen Receptor Status in Benign and Neoplastic Prostate Disease
Authors: EMTAGE L. A. , DUNN P. J. S. , ROWSE A. D.
Published: November 2008

Summary— TUR chips from 89 men were analysed prospectively for androgen and oestrogen nuclear and cytoplasmic receptors (ANR, ACR, ONR, OCR). Patients were selected on the basis of suspicion of neoplastic change on clinical feel of the prostate. A control group of benign cases was also collected prospectively. Histological examination showed that 46 patients had prostatic carcinoma and 43 had benign prostatic hyperplasia. No difference was found between the 2 groups in terms of prevalence of any of the receptors or in levels of receptor in those who were positive. The patients with neoplastic changes were followed up for a median of 53 months (range 47–64). No significant effect on duration of survival was noted with any of the receptor variables but there was a beneficial association between cytoplasmic oestrogen receptor positivity and progression‐free interval. Patients with T category 3 or 4 had a significantly higher chance of being ANR positive than those of lower T category and this may reflect sampling error. There appears to be some evidence to suggest that cytosol oestrogen receptor positivity has a prognostic role in prostate cancer, in terms of time to progression on hormone therapy. Receptor status did not influence survival.
Radical Retroperitoneal Node Dissection after Chemotherapy for Testicular Tumours
Authors: WILLIAMS S. N. , JENKINS B. J. , BAITHUN S. I. , OLIVER R. T. D. , BLANDY J. P.
Published: November 2008

Summary— A group of 29 patients underwent salvage node dissection for residual retroperitoneal masses following orchiectomy and combination chemotherapy for advanced testicular cancer between 1980 and 1988. The results confirm that surgery for residual retroperitoneal masses following combination chemotherapy is worthwhile and whenever possible the sympathetic chain should be preserved.