bluuebunny/crossref_metadata_2025 huggingface dataset:
Genesis of Papillary Tumours: Histological and Microangiographic Study
Authors: Sarma K. P.
Published: November 2008

Summary —The technique developed to study the microangiography of healthy bladders has been applied to study the known vagaries of papillary tumours, their associated changes and their genesis.

Epithelial hyperplasia (reactive hyperplasia), which develops as a form of mucosal self‐defence, is a general, non‐specific tissue response to an adverse environment. The conversion of reactive hyperplasia into reactive autonomy represents the neoplastic process. The growth of abnormal arteries precedes the development of tumours. A papillary tumour results from a symbiotic growth relationship between such an abnormal artery and the overlying normal or hyperplastic epithelium. All known vagaries of papillary tumours have been studied.
The Use of Cooled Irrigating Fluid for Transurethral Prostatic Resection
Authors: Kulatilake A. E. , Roberts P. N. , Evans D. F. , Wright J.
Published: November 2008

Summary —Forty patients selected for transurethral prostatic resection (TUR) were randomly allocated to one of 2 groups. Irrigating fluid used in the first group of 20 patients was cooled to a constant 8°C; in the second group fluid at ambient temperature was used. Measurements were made of the volume of irrigating fluid used and haemoglobin loss during and after operation; the weight of resected tissue and its histological appearance were also studied. The core temperature of each patient was monitored throughout the operation.

Significantly less irrigating fluid was used in the group receiving cooled fluid. Although per‐operative and post‐operative haemoglobin loss was also markedly reduced in this group, the difference failed to achieve statistical significance. The clarity of the operative field was considerably improved by the use of cooled fluid.
Unheralded Urinary Tract Infection in the Male A Clinical and Urodynamic Assessment
Authors: Booth C. M. , Whiteside C. G. , Milroy E. J. G. , Turner‐Warwick R. T.
Published: November 2008

Summary—Fifty adult males presenting with unheralded single or recurrent urinary tract infections, but without prior urinary symptoms or disorders, were investigated by appropriate urodynamic techniques. Pressure/flow videocystography revealed significant underlying lower urinary tract abnormalities in 40 cases (80%) compared with only 11 (22%) whose abnormalities were also demonstrated by standard intravenous urography or endoscopy.

We suggest that videocystography is the most efficient diagnostic procedure for these cases in a specialist unit but recommend the intravenous urodynamogram as a simpler screening test for general use.
An Evaluation of the HCG Stimulation Test in the Investigation of Male Infertility
Authors: Traub A. I.
Published: November 2008

Surnmary —Of 159 patients being investigated at the infertility clinic during 1978, 31 agreed to undergo the human chorionic gonadotrophin (HCG) stimulation test. Twenty‐one of these patients exhibited varying degrees of oligozoospermia and their response to HCG, measured by a rise in serum testosterone, was not significantly different from that of the remaining patients who had normal sperm counts.

Endocrine function of the testes appears to be unaltered even in patients with severely impaired tubular function. It is concluded that assessment of Leydig cell function is of no value in the routine investigation of male fertility.
Bilateral Retroperitoneal Xanthogranuloma
Authors: VANDENDRIS M. , SCHULMAN C. C. , GEPTS W.
Published: November 2008

Retroperitoneal processes involving the urinary tract are relatively infrequent and include mainly idiopathic retroperitoneal fibrosis or carcinoma‐tous periureteritis. The existence of a retroperitoneal xanthogranuloma leading to bilateral hydro‐nephrosis is exceptional, since only one case has been reported (Sadoughi et al., 1973).
Contrast Filling of Cysts in Potter Type III Adult Polycystic Kidney Disease by Retrograde Pyelography
Authors: REINKE D. B. , GONZALEZ R.
Published: November 2008

Contrast filling of cystic structures during retrograde pyelography has been seen in patients with traumatically ruptured cysts (Reiss, 1967), necrotic abscesses and tumours (Kyaw, 1973). Cyst filling in adult polycystic kidney disease has not been reported previously.
Idiopathic Retroperitoneal Fibrosis— the Role of Autotransplantation
Authors: DEANE A. M. , GINGELL J. C. , PENTLOW B. D.
Published: November 2008

SUMMARY— The presentation and management of 12 patients with idiopathic retroperitoneal fibrosis (IRPF) are described. There was a high incidence of venous thromboembolism. External ureteric drainage was associated with complications. A case treated by autotransplantation is described.
Percutaneous Nephrostomy under Guidance of Ultrasonography and Fluoroscopy Using a Pigtail Catheter
Authors: ELYADERANI M. K. , KANDZARI S. J. , GABRIELE O. F.
Published: November 2008

SUMMARY— Percutaneous nephrostomy using a pigtail catheter was performed in 37 patients under the guidance of ultrasonography and fluoroscopy. The only failure in 60 attempts was due to a subcapsular haematoma. The catheter appears to be well tolerated and is large enough for good drainage.

Ultrasonography has proved to be a valuable part of this technique and has made antegrade pyelography easy.
An Evaluation of a Simple Stick Test for Pyuria
Authors: RAINSBURY R. M. , SHEARER R. J.
Published: November 2008

SUMMARY— The results of a simple stick test for the detection of urinary leucocyte esterase are compared with the findings from conventional examination of 150 cytoscopic specimens of urine. The test was found to indicate the presence of significant numbers of white cells in urine with accuracy, and its relevance to urological surgery is discussed.
Catheter Encrustation by Struvite
Authors: HUKINS D. W. L. , HICKEY D. S. , KENNEDY ANNE P.
Published: November 2008

SUMMARY— Encrusted catheters from 10 female patients were the source of 26 samples of deposits which were examined by X‐ray diffraction. Four different types of catheter were represented. The only detectable compound in all of the samples was ammonium magnesium orthophosphate hexahydrate (NH4MgPO4.GH4O), which occurs naturally as the mineral struvite.
The Prognosis of Prostatic Cancer in the Younger Man
Authors: HARRISON G. S. M.
Published: November 2008

SUMMARY— The effect of age on the prognosis of prostatic cancer is uncertain. Younger patients are commonly assumed to have a worse prognosis. To investigate this impression, survival rates were calculated for two groups of patients with histologically proven prostatic cancer aged under 60 years (46 patients) and 65 to 74 years (193 patients). Age‐corrected actuarial survival curves for the two groups were not significantly different when tested by the log rank method. Similar curves constructed for well and poorly differentiated tumours, the presence of metastases and different treatment groups were also not significantly different. The survival of younger patients with prostatic cancer is not significantly worse than that of older patients, nor is it better.
Interdisciplinary Treatment of Wilms' Tumour
Authors: RINGERT R. H. , HARTUNG R. , HAVERS W.
Published: November 2008

Summary— The results of treating the 51 children suffering from Wilms' tumour seen in the 10 years to January 1982 are described and the need of an interdisciplinary approach is stressed.
Carbon Dioxide versus Water for Cystoscopy: a Comparative Study
Authors: MATTHEWS P. N. , SKEWES D. G. , KOTHARI J. J. , WOODHOUSE C. R. J. , HENDRY W. F.
Published: November 2008

Summary— In a prospective study of 120 patients, the cystoscopic views provided by carbon dioxide (CO2) insufflation of the bladder were compared with the views obtained during standard water cystoscopy. The clarity of vision was uniformly good during CO2cystoscopy and in 21 patients with haematuria the views were significantly better than those obtained by standard water cystoscopy. There was no evidence of any significant absorption of CO2. This safe and simple technique would seem to have considerable advantages in the investigation of patients with haematuria.
Histological and Urodynamic Study of the Bladder in Enuretic Children
Authors: BOOTH C. M. , GOSLING J. A.
Published: November 2008

Summary— In a study of the bladders of 12 enuretic children by cystoscopy, light microscopy and urodynamics, cystoscopic trabeculation was found in 10 cases. Histologically, the trabeculation resembled adult trabeculation of obstructive aetiology, collagen infiltration being the characteristic hallmark.

Using urodynamic measurements, the bladders behaved like those of adult enuretics; 10 out of 12 were unstable and voiding occurred at relatively high pressures.

There was no correlation between symptoms and either cystoscopic or histological trabeculation.
ABO, MNSs and Rhesus Blood Groups in Bladder Cancer
Authors: CARTWRIGHT R. A. , ADIB R. , APPLEYARD I. , GLASHAN R. W. , RICHARDS B. , ROBINSON M. R. G. , SUNDERLAND E. , BARHAM‐HALL DENISE
Published: November 2008

Summary— Data are presented on a group of cases of primary carcinoma of the bladder detailing their ABO, MNSs and rhesus blood antigenic phenotypes. Differences, either between all cases and controls or between particular stages of presentation and controls, have been found in the ABO red cell system as well as the MNSs red cell system. In the case of the ABO system an excess of the A gene is present but detailed study shows this to be only in patients with T1 and T2 tumours. No excess was seen in patients with carcinoma in situor T3 or T4 stage disease. The S gene of the MNSs system is also in excess in cases of bladder cancer.
Cutaneous Ureterostomy as Last Resort Treatment of Intractable Haemorrhagic Cystitis Following Radiation
Authors: POMER S. , KARCHER G. , SIMON W.
Published: November 2008

Summary— Sixteen patients with severe intractable haemorrhagic cystitis following radiotherapy, two of them with bleeding tumours, were treated surgically by cutaneous ureterostomy with or without contralateral nephrectomy. They had undergone various forms of conservative treatment and were treated by surgery only when conservative therapy had failed. In these poor risk patients a cutaneous ureterostomy was employed as a lesser procedure than an ileal loop.

Of the 16 who underwent urinary diversion 11 were completely free of haemorrhage and three continued to have slight intermittent haematuria.
Micturition Studies and Sexual Function in Operated Hypospadiacs
Authors: SVENSSON J. , BERG R.
Published: November 2008

Summary— Micturition patterns in 33 males, aged 15 to 34 years, were investigated after hypospadias repair in childhood. Spraying of the urinary stream was the most common complaint (13 patients). Urinary flow was low in five patients as compared with controls, but in only one of these patients was an obstruction found that required treatment. Five patients had persistent curvature of the penis. One of them was unable to perform sexual intercourse.
Errors Inherent in the Performance of a Routine Semen Analysis
Authors: JEQUIER ANNE M. , UKOMBE E. B.
Published: November 2008

Summary— A group of 26 medical laboratory technicians and pathologists performed a semen analysis on an aliquot of the same sample of semen. The mean sperm concentration obtained was 46.7 ± 106/ml ± 40.1 (2 s.d.) with a range of values lying between 10 and 98 ± 106/ml and giving a coefficient of variation of 44.3%. Similar wide ranges were seen in the visual estimation of percentage motility and abnormal morphology. Results obtained from three technicians, all highly experienced in performing semen analyses, produced a mean sperm concentration of 66 times 106/ml with a coefficient of variation of 37.8%. When the sperm concentration in semen was low, replicate analyses of four separate semen specimens produced coefficients of variation that were unacceptably high.
Bilharzial Strictures of the Lower Third of the Ureter: a Critical Review of 560 Strictures
Authors: AL‐SHUKRI S. , ALWAN M. H.
Published: November 2008

Summary— In a series of 329 patients with urinary bilharziasis, 560 strictures occurred in the lower third of the ureter. Bilateral ureteric involvement was seen in 231 patients (70.2%).

Two hundred and fifty‐two strictures (45%) were juxtavesical, 210 (37.5%) intramural, 50 (8.9%) were combined juxtavesical and intramural, 43 (7.7%) were pelvic and 5 (0.9%) were ureteric meatal strictures.

The main operative procedures were pull‐through ureteroneocystostomy (47.1%), ureteric reimplantation into the dome of the bladder (28.8%) and nipple ureteroneocystostomy (20.3%). Post‐operative complications occurred in 17 patients (5.2%) and the operative mortality was nil.

It is concluded that the best results are achieved through selection of the appropriate operative procedure and prevention of reinfestation.
Zinc, Vitamin A and Prostatic Cancer
Authors: WHELAN P. , WALKER B. E. , KELLEHER J.
Published: November 2008

Summary— The serum zinc, vitamin A, albumin, copper and retinoid‐binding protein content was measured in 27 patients with benign prostatic hyperplasia and 19 patients with carcinoma of the prostate. A significantly lower (P = <0.05) level of serum zinc was found in the cancer group as well as a significant zinc/vitamin A correlation (P = <0.05). The possible significance of this in relation to the pathogenesis of carcinoma of the prostate is discussed.
Incomplete Obstruction of the Male Genital Tract: a Cause of Oligozoospermia
Authors: JEQUIER ANNE M. , CRICH JOAN P. , HOLMES S. C.
Published: November 2008

Summary— Of 71 patients with obstructive azoospermia, 8 gave a history and/or had documentary evidence of oligozoospermia in the past and 2 gave a history of paternity. Thus a period of oligozoospermia preceded their azoospermia. “Partial obstruction” is therefore postulated as a cause of oligozoospermia.
Antibiotic Prophylaxis after Instrumentation for Urodynamic Testing
Authors: BERGMAN A. , McCARTHY T. A.
Published: November 2008

Summary— This study of 96 women shows that there is doubtful value in routine antibiotic prophylaxis after urodynamic investigation. An unexpectedly high number of women harboured unsuspected infections at the time of evaluation despite prior screening, which suggests prophylaxis would be more useful if given before the tests.
Laser Fragmentation of Renal Calculi
Authors: WATSON G. M. , WICKHAM J. E. A. , MILLS T. N. , BOWN S. G. , SWAIN P. , SALMON P. R.
Published: November 2008

Summary— Pulsed Nd YAG lasers will fragment all types of urinary calculi rapidly in air. The fragments are much smaller than with any other technique. Large stones can be split into a few discrete fragments which may prove to be an advantage in that the fragments could then be extracted without leaving multiple small fragments behind. Certain pulsed lasers can be transmitted through fine, flexible glass fibres which are small enough to pass through any sized instrument channel. There is therefore an immediate possibility of using this type of laser in the bladder with carbon dioxide instead of an irrigant. Further experiments are planned in order to investigate the possibility of using this mode of laser in the kidney percutaneously.
Advances in the Techniques of Localisation of Adrenal Tumours and their Influence on the Surgical Approach to the Tumour
Authors: SNELL M. E. , LAWRENCE R. , SUTON D. , SEVER P. S. , PEART W. S.
Published: November 2008

Summary— The results of attempts to localise adrenal tumours in 65 patients are presented. In the first series (1966–1978) adrenal phlebography and adrenal vein sampling located 18 of 20 (90%) of adrenocortical tumours and 18 of 19 (94%) phaeochromocytomas were defined by angiography and venous sampling. In the second series CT located 7 of 8 adrenocortical and all 6 intra‐abdominal phaeochromocytomas. Scintigraphy located all 9 adrenocortical tumours and both of the phaeochromocytomas examined. Confidence in the ability of newer techniques allows the use of a flank incision in most cases, thus reducing the operative morbidity.
Pelvic Evoked Responses
Authors: EWING R. , CHOA B. , SHUTTLEWORTH K. E. D.
Published: November 2008

Summary— An electrophysiologicai method to measure the sacral reflex arc has been developed and is described in detail. The lactencies of 15 normal subjects are recorded. The electromyographic responses were abolished in seven multiple sclerotic patients with unstable bladders after subtrigonal phenol injection.
Prognostic Significance of Biopsy Results of Normal‐looking Mucosa in Cases of Superficial Bladder Cancer
Authors: SMITH G. , ELTON R. A. , BEYNON L. L. , NEWSAM J. E. , CHISHOLM G. D. , HARGREAVE T. B.
Published: November 2008

Summary— Quadrant biopsies of normal‐looking mucosa were used as part of the assessment of cases with superficial Ta, T1 transitional cell cancer of the bladder. Patients with one or more abnormal biopsies were shown to have a significantly greater chance of developing recurrent tumour compared to patients with normal mucosal biopsy findings. Other factors noted at the time of initial assessment, such as size, number of tumours, Ta, T1 category or grade of tumour did not predict recurrence, although recurrences that invaded muscle were associated with G3 histology in the primary tumour. The results of mucosal biopsy identified patients at risk for recurrence and it is possible that this group would derive particular benefit from adjuvant chemotherapy.
Urethral Sphincter Abnormalities in Parkinsonism
Authors: GALLOWAY N. T. M.
Published: November 2008

Summary—Urethral sphincter function was studied in 14 patients with Parkinsonism. All patients had urethral pressure profiles, sphincter electromyography and a voiding study with or without cystourethrography. Abnormalities were found in all patients, but profound abnormalities were present in four patients who had markedly increased sphincter tone and sphincter tremor and who failed to relax the sphincter when voiding. These abnormalities may be a significant cause of urinary symptoms in these patients.
The Impact of Optical Urethrotomy on the Management of Urethral Strictures
Authors: CHILTON C. P. , SHAH P. J. R. , FOWLER C. G. , TIPTAFT R. C. , BLANDY J. P.
Published: November 2008

Summary— The introduction of optical urethrotomy by Sachse has reduced the need for urethroplasty: 261 urethroplasties were performed between 1964 and 1983, of which 87 were performed in one stage on patients who would today have undergone urethrotomy as the procedure of first choice. The results in this group are compared with those in 151 patients treated between 1978 and 1983 by 265 internal optical urethrotomies. At 5 years 50% of those treated by urethrotomy needed no further treatment, compared with 83% of those treated by urethroplasty. Nevertheless, the ease and safety of urethrotomy makes it the procedure of first choice, and urethroplasty should be reserved either for cases where urethrotomy is unsuitable or where it has been tried on several occasions without success.
Computed Tomography and Transrectal Ultrasound in the Diagnosis of Prostatic Disease—a Comparative Study
Authors: RICKARDS D. , GOWLAND M. , BROOMAN P. , MAMTORA H. , BLACKLOCK N. J. , ISHERWOOD I.
Published: November 2008

Summary— Computed tomography (CT) and transreclal ultrasound were performed in 88 patients with clinically and histologically proven prostatic disease. An ultrasound diagnosis of prostatic cancer was suggested in 49 of 54 patients with proven disease, whereas CT identified only 21 of those patients. There were no specific features of confined prostatic malignancy on CT and the most reliable feature of an unconfined tumour was infiltration of the posterior aspect of the bladder base.

It was not possible on ultrasound to differentiate between prostatic inflammatory disease and a confined carcinoma but ultrasound was accurate in detecting defects in the prostatic capsule, the hallmark of unconfined prostatic malignancy.
Radionuclide Imaging in Scrotal Swellings
Authors: BLACKLOCK A. R. E. , KWOK H. K. Y. , MASON G. R. , MILLS J. A. , TAYLOR D. N.
Published: November 2008

Summary— The patient with an acute scrotal swelling may be misdiagnosed and either have unnecessary surgery or not have necessary surgery. Radionuclide imaging has been used on 33 patients with scrotal swellings and has been found to be an easy, cheap and painless investigation with a high degree of accuracy of diagnosis. It is recommended as a useful diagnostic tool in cases of scrotal swelling of doubtful aetiology, particularly when emergency surgery is being considered.
Orchiectomy Alone for Stage I Testicular Non‐Seminoma. A Progress Report on the Royal Marsden Hospital Study
Authors: PECKHAM M. J. , BARRETT A. , HORWICH A. , HENDRY W. F.
Published: November 2008

Summary— Eighty‐four patients with clinical Stage I nun‐seminomatous germ‐cell testicular tumours were entered into a prospective study after orchiectomy to evaluate a policy of close surveillance without lymph node irradiation or node dissection; 16 (19%) have manifested evidence of metastatic disease and received chemotherapy.

All patients in the study are alive, 3 of the 16 relapsing patients are receiving chemotherapy and the 13 who have completed it are in complete remission at 4 to 43 months (mean 21). Relapses were diagnosed at 2 to 8 months (mean 5.3 months) after orchiectomy and were not invariably associated with elevated serum markers. The relapse rate was significantly higher for malignant teratoma undifferentiated (MTU) primary turnours than malignant teratoma intermediate (MTI) (40.7 and 6.8% respectively) and preliminary data suggest that the association of MTU with vascular invasion places the patient at high risk of relapse. Pre‐orchiectomy serum marker status was not a significant prognostic factor. Despite sub‐optimal surgical management in 11/84 patients no example of scrotal recurrence has been encountered.

It is concluded that a rigorously monitored policy of close surveillance after orchiectomy is a feasible and successful method of management in Stage I testicular non‐seminoma. Further experience should allow patients requiring immediate post‐orchiectomy chemotherapy to be identified.
The Hellstrom Operation for Hydronephrosis
Authors: HICKINBOTHAM P. F. J.
Published: November 2008

Summary— It is suggested that lower polar renal vessels are a common cause of idiopathic hydronephrosis and that the Hellstrom operation, combined with pelviureteric lysis, is an effective and simple treatment of such cases. The operation is described and a prospective study of 15 cases so treated is outlined. The results were studied by clinical, radiological and renographic criteria and showed that deconvolution renography is a less valuable means than the relief of pain and improvement in appearance of the IVU and diuretic urograms in assessing results. The operation is minor and cannot make things worse and there is no possibility of urine leakage or late stenosis.
The Place of the 99mTc‐polyphosphonate Bone Scan in Renal Carcinoma
Authors: CLYNE C. A. C. , FRANK J. W. , JENKINS J. D. , SMART C. J.
Published: November 2008

Summary— Forty‐two bone images carried out on 33 patients with renal carcinoma have been evaluated. The bone image seems more sensitive than conventional radiology in detecting bone secondaries, but covert metastases are unlikely in the patient presenting with purely urological symptoms.
Periurethral Teflon Injection: a Simple Treatment for Urinary Incontinence
Authors: LIM K. B. , BALL A. J. , FENELEY R. C. L.
Published: November 2008

Summary— The follow‐up of 28 patients with urinary incontinence treated with periurethral Teflon injection revealed significant improvement in 53.6% and complete cure in 21.4%. Patients most likely to benefit were those with weak sphincters and stable detrusors.

The method is quick and safe and requires only a brief hospital stay. It is suitable for patients in whom conventional operative techniques have failed or in whom surgery is best avoided on medical grounds.
The Role of Catheter Surface Morphology and Extractable Cytotoxic Material in Tissue Reactions to Urethral Catheters
Authors: WILKSCH J. , VERNON‐ROBERTS B. , GARRETT R. , SMITH K.
Published: November 2008

Summary— Batches of urethral catheters associated with stricture formation during clinical usage were found to be amongst those causing marked acute and chronic inflammation after subcutaneous implantation in rats. The degree of inflammation did not correlate with the surface roughness of catheters assessed by scanning electron microscopy, but showed an excellent correlation with the cytotoxic effects of soluble extracts from catheters on macrophage monolayers in tissue culture. The findings suggest that stricture formation may be chemically induced and may not relate to surface roughness of catheters.
Orchiopexy: Trans‐septal lpsilateral Positioning
Authors: PARKASH S. , RAMAKRISHNAN K. , BAGDl R. K.
Published: November 2008

Summary— Orchiopexy based on a method of testicular fixation by ipsilateral placement with a valvular passage through the septum is described. By passing the testis through the soft septum twice, a low scrotal position is assured without tension or risk of compression of the cord.
The Effects of Vasectomy on Testicular Volume
Authors: DlAS P. L. R.
Published: November 2008

Summary— Testicular volumes were estimated by caliper measurements of testicular dimensions in 1 5 patients, before and at varying periods of time after vasectomy. There was no significant change in testicular volume one year after surgery.
Fournier's Gangrene: Necrotising Fasciitis of the Male Genitalia
Authors: BAHLMANN J. C. M. , FOURIE I. J. V. H. , ARNDT T. C. H.
Published: November 2008

Summary— The aetiology, clinical syndrome and outcome of nine patients with necrotising subcutaneous infections of their external genitalia have been analysed. These patients constituted just under 1% of all of our urological admissions during a nine‐month period. Eight of the nine patients suffered from the secondary variety of this disease with urethral strictures and extravasation being the most common precipitating conditions. Necrotising fasciitis of the genitalia still carries a high risk of mortality and morbidity, frequently necessitating long periods of hospitalisation and repeated surgical procedures. Special attention was given to the bacteriology of the disease and recommendations concerning antibiotic therapy are made.
Lymphocyte Subsets in Renal Carcinoma—a Sequential Study Using Monoclonal Antibodies
Authors: Ritchie A. W. S. , James K. , Micklem H. S. , Chisholm G. D.
Published: November 2008

Summary— Using monoclonal antibodies in conjunction with flow cytometry, circulating lymphocyte subsets with distinct functions in the regulation of the immune response were enumerated in 32 patients with proven renal carcinoma. Analyses were performed at presentation and sequentially during the clinical course of the patients.

Untreated patients with advanced disease had a deficit of T cells with the “helper/inducer” phenotype (Leu‐3a+) and this resulted in abnormal T “helper/suppressor” (Leu‐3a+/Leu‐2a+) ratios.

Following nephrectomy, performed in 26 patients, there was a significant increase in the number of T cells with the “helper/inducer” phenotype and a significant increase in T “H/S” ratios. Subsequent follow‐up at a minimum of 2 months after nephrectomy showed that the increase in T cells with the “helper/inducer” phenotype was maintained (with the exception of 6 patients with disease progression) and was then accompanied by a significant increase of the T cell subset with the “suppressor/cytotoxic” phenotype (Leu‐2a+).

Pre‐operative renal arterial embolisation resulted in an early transient lymphopenia. The response to embolisation combined with nephrectomy was little different when compared with nephrectomy alone. These observations represent a novel view of the immunosuppressive effects of renal carcinoma and their relation to anaemia and disease progression are discussed.
The Clinical Significance of Bladder Speed
Authors: MILLARD R.J. , Millard R.J.
Published: November 2008

Summary— By calculation of a notional maximum possible flow rate (Qm) from the pressure‐flow parameters of clinical urodynamic studies, a variable is obtained which relates to the speed of shortening of the muscle fibres and hence to detrusor contractility. Bladder outlet obstruction causes a reduction in detrusor contractility. After the satisfactory relief of outflow obstruction, the clinical results are related to the degree of recovery of detrusor contractility
CO2 Cystoscopy Using a Flexible Fibreoptic Endoscope
Authors: MAITHEWS P. N. , BIDGOOD K. A. , WOODHOUSE C. R. J.
Published: November 2008

Summary— Flexible carbon dioxide cystoscopy has been carried out in 65 patients using an Olympus BF type 1 TR endoscope (usually used for bronchoscopy). Good views were obtained and comparison with standard cystoscopy confirmed that no lesions were missed. The procedure was well tolerated under local anaesthesia. The flexible cystoscope was particularly useful in examining patients with diverticula, anterior bladder neck lesions or the post‐radiation fibrotic pelvis.
Routine Cross‐Matching is not Necessary for a Transurethral Resection of the Prostate
Authors: Fraser I. , Stott M. , Campbell I. , Wood J. K. , Gordon Smart J. , Osborn D. E.
Published: November 2008

Summary— Two hundred and fifty‐five consecutive patients undergoing transurethral prostatectomy were studied prospectively to test a policy of not routinely cross‐matching blood. Blood was ordered only for patients with anaemia, a major medical risk factor, a prostate gland estimated to be greater than 60 g, or the presence of red cell alloantibodies. Of the 203 patients who were “grouped and saved” only, 30 (12%) were subsequently cross‐matched and 22 (8.5%) transfused. There were no significant problems as a result of the operation of this policy. The value of these pre‐operative criteria for cross‐matching was confirmed, apart from the clinical estimation of prostatic size. The use of such a policy cauld be of significant value to the hospital blood transfusion services.
Factors Influencing Recurrence of Urethral Strictures after Endoscopic Urethrotomy: the Role of Infection and Peri‐operative Antibiotics
Authors: Pain J. A. , St. J. Collier St. J. Collier D. G.
Published: November 2008

Summary— One hundred patients who had undergone 162 urethrotomies were reviewed. Factors which influenced the outcome of the procedure are discussed. Peri‐operative infection occurred in 38% of cases and significantly increased the recurrence rate unless the patients were treated with antibiotics.
Percutaneous Antegrade Pyelography in Children
Authors: MAN D. W. K. , RANSLEY P. G.
Published: November 2008

Summary—
We report our experience with 107 percutaneous antegrade pyelograms in 79 children aged between 3 days and 14 years. The main indications for the procedure are outlined, together with a note on the technique. Puncture of the pelvicaliceal system failed in 10% of cases. The procedure is simple to perform and is preferred to retrograde urography, which carries significant morbidity and is impracticable in the male infant. Antegrade pyelography provides the definitive anatomical diagnosis of obstruction of the upper urinary tract. It is particularly useful in megaureters after reimplantation and in grossly dilated and/or poorly functioning systems where diagnosis of obstruction by radionuclide renal scan could be difficult. The procedure has been found to be safe and complications are minimal.
Clinical Experience with Long‐term Bendroflumethiazide Treatment in Calcium Oxalate Stone Formers
Authors: Ahlstrand C. , TISELIUS H.‐G. , Larsson L. , Hellgren E.
Published: November 2008

Summary—
Bendroflumethiazide was administered to 85 patients (62 men, 23 women) with recurrent calcium oxalate stone disease. Side effects leading to interrupted treatment were observed in 26 (31%) of the patients. Fifty‐nine (40 men, 19 women) remained on treatment for a mean (± SD) period of 3.7 ±1.0 years, and 21 reported late side effects. Twenty patients were given 2.5 mg bendroflumethiazide daily (Group A), 27 were given 2.5 mg twice daily (Group B), and 12 were given 5 mg once daily (Group C). Eight patients (14%) formed new stones and another two demonstrated stone growth during treatment. A beneficial effect on stone formation was observed in Groups B and C but not in Group A. Patients who failed to respond to treatment had a pre‐treatment stone formation rate of 0.74 stones per year compared with 0.22 in those who did not form new stones. Those with recurrence during treatment had a lower citrate excretion than other patients. No effect on urinary citrate was recorded during treatment, and long‐term treatment with bendroflumethiazide did not affect oxalate excretion.
Percutaneous Pyelolysis: Indications, Complications and Results
Authors: RAMSAY J. W. A. , MILLER R. A. , KELLETT M. J. , BLACKFORD H. N. , WICKHAM J. E. A. , WHITFIELD H. N.
Published: November 2008

Summary— The results of percutaneous pyelolysis in 28 patients are presented. There were 18 successful and 10 unsuccessful cases. The indications for the procedure are defined in the light of this analysis.
A Flexible Cystoscope
Authors: POWELL P. H. , MANOHAR V. , RAMSDEN P. D. , HALL R. R.
Published: November 2008

Summary— An assessment of the prototype Olympus Flexible Cystoscope in routine urological practice is presented. The results show that the instrument compares favourably in all respects with standard rigid equipment and has the advantage that cystoscopy can be performed supine and under local anaesthesia with ease. Biopsies may be taken; small lesions fulgurised and ureteric catheterisation can be performed without general anaesthesia.
Urinary Chemiluminescence—an Evaluation of its Use in Clinical Practice
Authors: CHILTON C. P. , ROSE G. A.
Published: November 2008

Summary— It has been proposed that a substance, as yet unidentified, is excreted in the urine and acts as a chemical carcinogen. This substance during oxidative reactions will exhibit urinary chemiluminescence (UCL) and it is this release of energy in the form of light which activates the intracellular changes responsible for carcinogenesis. One hundred and seventy‐seven people, 110 patients being followed up endoscopically for transitional cell carcinoma of the bladder (TCCB) and 67 controls, had their UCL measured. The UCL estimations confirmed previously reported trends where those with active disease had the highest UCL (84) and the controls had the lowest (55). These results did not reach statistical significance and the wide variations of the results do not allow UCL, as yet, to be of practical clinical use.
Nuclear Magnetic Resonance (NMR) Imaging of the Prostate
Authors: STEYN J. H. , SMITH F. W.
Published: November 2008

Summary— Nuclear magnetic resonance (NMR) imaging is a safe, non‐invasive technique of visualising the prostate gland. The Aberdeen NMR imager has a field strength of 0.08 T and can image in three planes. A correct diagnosis was made in 48 of 51 patients studied with prostatic disease. At this field strength benign and malignant prostatic tissue has the same Ti value. The presence of a metallic hip prosthesis does not interfere with the imaging.
The Stable State is not an Objective Response in Hormone‐escaped Carcinoma of Prostate
Authors: BEYNON L. L. , CHISHOLM G. D.
Published: November 2008

Summary— In some clinical trials the use of criteria of stable response of hormone‐escaped prostate cancer is justified on the ground that it delineates patients with markedly improved survival, similar to that of partial regression patients. Forty‐three patients with hormone‐escaped prostate cancer were studied in order to identify other factors which might also predict improved survival. Fifteen patients received palliative treatment only, 17 secondary hormone therapy and 11 chemotherapy. Only one objective partial regression was seen. Thirty‐seven patients have died of prostatic cancer, 3 have died of other causes and 3 remain alive.

The mean initial hormone response was 14.8 months, the mean time from progression to death 11.3 months, and the mean time from symptoms to death 5.9 months. There was no significant correlation between length of initial response and survival following progression (r= 0.25).

Six features of progression were reviewed. Patients presenting with one feature of progression had a significantly better mean survival, 14.8 months, compared with 8.2 months when multiple features indicated progression.

It is concluded that the stable state is not an objective response in hormone‐escaped carcinoma of prostate but a reflection of the patient's natural disease progression and that the mode of presentation may be a significant prognostic indicator.
Function of Human Autologous Kidney Grafts after Extracorporeal Preservation with Sacks' II Solution
Authors: RANCH T. , BRYNGER H. , GRANERUS G. , HENRIKSSON Ch. , NILSON A. E. , PETTERSSON S.
Published: November 2008

Summary— The function of 18 human kidney grafts was studied before and 3 months after autotransplantation without prior bench surgery on the parenchyma or the vessels. Kidney protection was accomplished by pre‐treating the patient with mannitol and low molecular weight dextran solution and flushing the kidney with a Xylocaine‐heparin mixture and cold Sacks' II solution. The mean cold ischaemia time was 239 min (range 140–345 min).

The glomerular filtration rate (GFR) remained unchanged post‐operatively in terms of both total and split kidney GFR. Proximal and distal tubular integrity, as studied by determination of beta2‐microglobulin excretion and concentration ability respectively, was also preserved.
Immunohistological Detection of T Antigen and ABH Blood Group Antigens in Upper Urinary Tract Tumours
Authors: KAGAWA S. , TAKIGAWA H. , GHAZIZADEH M. , KUROKAWA K.
Published: November 2008

Summary— The status of T antigen was assessed by means of peanut agglutinin (PNA) used in an immunoperoxidase technique, and the status of ABH blood group antigens was determined by the specific red cell adherence (SRCA) test. Thirty‐eight patients with upper urinary tract tumours were examined.

Our data indicated that T antigen status did not correlate with conventional prognostic indicators such as grade and stage of tumour and survival of patients, while the expression or deletion of ABH blood group antigens did correlate well.

It was concluded that ABH blood group antigen determination might provide a useful prognostic probe in upper urinary tract tumours should it find clinical application.
Prostaglandin Synthetase Inhibition of Renal Pelvic Smooth Muscle in the Rabbit
Authors: LUNDSTAM S. , JONSSON O. , KIHL B. , PETTERSSON S.
Published: November 2008

Summary— The prostaglandin synthetase inhibitors diclofenac and indomethacin relieve pain in renal colic probably by decreasing renal pelvic pressure. Decreased diuresis and effects on the oedema around the obstructing stone are plausible explanations. In the present study on rabbit renal pelvic tissue strips it was found that both indomethacin and diclofenac decreased the spontaneous phasic activity of the strips. ED50 was 5.4 ±0.7 × 10‐5M for indomethacin and 2.4 ±0.5 × 10‐5M for diclofenac (P < 0.001). With the prostaglandin synthetase inhibitors still in the tissue bath the activity was regained when either prostaglandin E2 or F2α was added, prostaglandin E2 being more potent in this respect. It was concluded that protaglandin synthetase inhibitors seem to reduce smooth muscle activity in the renal pelvis, a mechanism which might contribute to the pain‐relieving ability of these drugs in renal colic.
Prostatic Ultrasonography: a Useful Technique?
Authors: KADOW C. , GINGELL J. C. , PENRY J. B.
Published: November 2008

Summary— Two hundred and forty‐four transrectal prostatic ultrasonograms have been reviewed and the findings compared with the final pathological or clinical diagnosis. A high degree of accuracy was achieved in diagnosing benign prostatic hyperplasia.

Ultrasonography proved invaluable in staging proven prostatic carcinomas but it was disappointing as a primary diagnostic tool for cancer, with false positive and negatives rates of 12 and 31 % respectively. These findings are discussed in the light of other workers' results.

Further applications for prostatic ultrasonography are outlined.
Direct Vision Internal Urethrotomy in the Treatment of Urethral Fistulas due to Urethral Strictures
Authors: SHAH S. B. , MEHENDALE V. G.
Published: November 2008

Summary— Five cases of urethral fistula—three with single and two with multiple fistulous tracts—were treated by optical urethrotomy. All of the fistulas healed completely.
The Changing Workload in Paediatric Urology
Authors: O'DONNELL BARRY , BUICK R. G.
Published: November 2008

Summary— Almost 3000 (2969) paediatric urological procedures carried out by three paediatric surgeons over a 3‐year period have been analysed. Almost half of the patients were managed as day cases. The content of the work has been examined and the implications for continuing patient care, surgical training and the desirable paediatric infrastructure noted. Inguinoscrotal operations, surgery for hypospadias and ureteric reimplant for vesicoureteric reflux are the commonest “open” operations.

Most paediatric urological procedures will continue to be done by a variety of surgeons of different specialities.
A Computer Program for Urology
Authors: ROSE M. B. , GEORGHIADES P. A. , DOWSLAND W. B.
Published: November 2008

Summary— Modern information technology offers new opportunities for the storage and manipulation of clinical data within hospital departments. We have designed and put into use a microcomputer system for urology. its basic structure and main functions are described.
Ureteroscopy. An Alternative View
Authors: TOLLEY D. A. , BEYNON L. L.
Published: November 2008

Summary— Forty‐six ureteroscopies were carried out over a 12‐month period. A simple technique is described. The desired level was reached in 72% of cases and the pre‐operative objective achieved in 60% of cases overall. Fifty per cent of all ureteric stones were safely retrieved by ureteroscopy. The instrument was used to establish a diagnosis of upper urinary tract abnormality in 16 of 23 cases. The overall complication rate was low, most problems relating to short‐lived ureteric colic (23%) which was seen mainly after stone manipulation.

Transurethral ureteroscopy is a safe procedure with a number of diagnostic and therapeutic possibilities.
Bone Imaging and Serum Phosphatases in Prostatic Carcinoma
Authors: BISHOP M. C. , HARDY J. G. , TAYLOR M. C. , WASTIE M. L. , LEMBERGER R. J.
Published: November 2008

Summary— One hundred and twenty‐seven patients with locally advanced prostatic cancer were evaluated for the presence and progress of bone metastases before and during hormonal therapy, by serial radionuclide imaging and frequent measurement of plasma acid (tartrate‐labile) and alkaline phosphatase. For comparison, serial changes in imaging and phosphatases were classified in each patient into one of six groups.

Of 71 patients with negative imaging before treatment, 82% had normal alkaline phosphatase levels and 83% had normal acid phosphatase levels. Of 56 patients with bone metastases at presentation, false negative alkaline and acid phosphatase levels were noted in 18% and 36% respectively, though a few patients eventually developed abnormal levels.

Serial plasma biochemistry and particularly alkaline phosphatase showed a response to treatment which was not always obvious on imaging. An assessment of the hepatic component of alkaline phosphatase by reference to plasma gamma glutamyl transpeptidase and isoenzyme electrophoresis was helpful in the evaluation of a false positive result but unnecessary where imaging was positive and phosphatase elevated.

It is concluded that serial alkaline phosphatase estimation is essential in the follow‐up of patients with prostatic cancer and bone metastases, and probably renders serial imaging studies superfluous once the presence of skeletal metastases has been proven. By comparison, acid phosphatase is a much less effective marker.
Flutamide Therapy for Advanced Prostatic Cancer: a Phase II Study
Authors: MacFARLANE J. R. , TOLLEY D. A.
Published: November 2008

Summary— A non‐steroidal antiandrogen (flutamide) was used to treat 17 patients with advanced prostatic cancer. Twelve of 14 patients who had already failed to respond to conventional hormone therapy were dead within 12 months of starting flutamide therapy and there was a high incidence of side effects. Of three patients who had not received prior hormone therapy, two showed an early partial response and one showed no evidence of response to therapy.
Familial Torsion of the Testicle
Authors: STEWART J. O. R. , MAlTl A. K.
Published: November 2008

Summary— Two families in which several siblings suffered torsion of the testicle are described. The literature is reviewed and comments made on management.
Post‐treatment Fertility in Patients with Testicular Cancer: I. Influence of Retroperitoneal Lymph Node Dissection on Ejaculatory Potency
Authors: FOSSÅ SOPHIE D. , OUS S. , ÅBYHOLM T. , LOEB M.
Published: November 2008

Summary— “Dry ejaculation” occurred in none of 1 5 patients with testicular cancer treated by right‐sided retroperitoneal lymph node dissection (RLND). After left‐sided and bilateral RLND, “dry ejaculation” was observed in 7/21 and 51 /61 men respectively. Twelve of 21 patients with “dry ejaculation” or small volumes of seminal fluid had true retrograde ejaculation. In 7 of 10 men the ejaculatory volume increased significantly after treatment with imipramine chloride. Four men impregnated their wives during treatment with the drug.

Without impairing the results of therapy it is possible to spare fibres from the sympathetic chains and pre‐sacral plexus during RLND due to testicular cancer, thus preserving fertility in at least 40% of patients.
Prevention of Wound Infection Following Vasectomy
Authors: RANDALL P. E. , GANGULI L. A. , KEANEY M. G. L. , MARCUSON R. W.
Published: November 2008

Summary— A prospective study on 90 patients undergoing vasectomy as day cases is reported. The use of a chlorhexidine gluconate bath or shower on day 1 and day 2 post‐operatively reduced the wound infection rate from 37.8 to 6.7%. It is suggested, therefore, that this technique is an economical and successful way of reducing the incidence of infection in these patients.
First‐line Intravenous Cisplatin for Deeply Invasive Bladder Cancer: Update on 70 Cases
Authors: PEARSON B. S. , RAGHAVAN D.
Published: November 2008

Summary— Seventy patients with T2–T4 NX MO bladder cancer were treated with intravenous cisplatin (100mg/m2q 3‐weekly) followed by radiotherapy and/or cystectomy. Objective responses to cisplatin were seen in 57%. For the first group of 50 patients (treated between August 1981 and November 1983), the actuarial survival rate at 2 years was 64%, with a median survival of 20+ months: 81% of deaths occurred within 18 months of entry. Most relapses occurred in the bladder/pelvis. A randomised, controlled study is in progress to assess the true value of this approach to the treatment of invasive bladder cancer.
TURP Without TURP Syndrome
Authors: GALE D. W. , NOTLEY R. G.
Published: November 2008

Summary— A series of 500 patients studied retrospectively and prospectively to examine changes in the serum sodium following transurethral resection of the prostate showed no significant incidence of induced hyponatraemia. TheTURP syndrome has not been encountered clinically in this department for 10 years, which correlates with the findings of this study. The possible reasons are the habitual use of the irrigating resectoscope, a policy of simplification of management for patients undergoing TURP, and operations being performed only by experienced surgeons.