bluuebunny/crossref_metadata_2025 huggingface dataset:
Renal Scarring Secondary to Vesicoureteric Reflux. Critical Assessment and New Grading
Authors: MONSOUR M. , AZMY A. F. , MacKENZIE J. RUTH
Published: November 2008

Summary— One hundred and fifty children with proven urinary tract infection who were assessed by renal ultrasound (U/S), intravenous urography (IVU) and dimercaptosuccinic acid (M99mTc DMSA) scan, were studied to identify the sensitivity of each examination and the pick‐up rate of renal scarring secondary to vesicoureteric reflux. Sixty‐three of these children who had the examinations carried out within a 6‐month period were assessed in detail. A scan is the most accurate method of detecting early renal scars in the young age group (0–2 and 2–5 years), followed by ultrasound. The examinations are equally sensitive over the age of 5. A new grading system of the severity of renal scarring is presented.
Oral Ciprofloxacin as Prophylaxis for Optical Urethrotomy
Authors: MURDOCH D. A. , BADENOCH D. F.
Published: November 2008

Summary— It is known that urethral strictures predispose to bacteriuria. We studied a series of patients underogoing optical urethrotomy to see if antibiotic prophylaxis was justified. Twenty‐three patients were randomised to receicve either no prophylaxis or a short peri‐operative courser of oral ciprofloxacin. Two patients with sterile pre‐operative urine and two patients with pre‐operative bacteriuria given no prophylaxis had post‐operative becateriuria, whereas all patients given ciprofloxacin has sterile urine after operation. Antibiotic prophylaxis may be indicted in patients undergoing optical urethrotomy.
Effect of Changes in Epidemiological Factors on the Composition and Racial Distribution of Renal Calculi
Authors: BEUKES G. J. , BRUIYN H. DE , VERMAAK W. J. H.
Published: November 2008

Summary— One thousand and two calculi, which occurred in both black and white patients during a 15‐year period, have been analysed by the X‐ray diffraction technique. Calcium oxalate calculi were the most common irrespective of race. Whewellite calculi were equally distributed in both race groups, while weddelite stones appeared to be much less common amongst blacks; the opposite applied for struvite and the rare ammonium acid urate stones. The other calculi were approximately equally distributed between the two race groups. A statistically significant rising trend in the prevalence of renal stones in blacks, accompanied by changes in the ratios of the major stone forming constituents, have been a prominent feature of this survey. However, the aforementioned remained unchanged in white patients. Contrary to previous impressions, total urates exceed phosphates in whites as a major stone forming constituent. The composition of upper urinary tract stones in blacks, during the 3‐year period 1981 to 1983, was very similar to the composition previously reported for the Sudanese.

The profile of renal stones in blacks over the last 3 years, however, is now becoming substantially different from that of the other previously reported surveys and may be approaching that of their white compatriots. A change in the dietary patterns in blacks is occurring which is also reflected in an increasing incidence of ischaemic heart disease and which may also be responsible for the observed changes in renal stones.
Demonstration of Papillomavirus Structural Antigen in Human Urinary Bladder Neoplasia
Authors: BRYANT P. , SKELLY J. , WILSON D.
Published: November 2008

Summary— Clear cells showing characteristic features of koilocytotic atypia were found in 41 (82%) of 50 paraffin sections of urinary bladder tumour. Papillomavirus common structural antigen was detected in seven (14%) of the samples using an avidin‐biotin peroxidase staining technique. The results suggest a role for the human papillomavirus in the aetiology of urniary bladder neoplaisa.
Schistosomiasis‐associated Squamous Lesions of the Bladder. Expression of Low Molecular Weight Cytokeratin Proteins
Authors: TUNGEKAR M. F. , ADNANI M. S. AL , GATTER K. C.
Published: November 2008

Summary— The monoclonal antibody CAM 5.2 was used to investigate the expression of lower molecular weight cytokeratin proteins immunocytochemically in conventionally processed samples of schistosoma‐associated squamous metaplasias and carcinomas of the urinary bladder. The antibody did not differentiate between squamous metaplasias and well differentiated squamous carcinomas, though it did focally label moderate to poorly differentiated tumours. The results suggest that squamous carcinomas of the bladder in this setting differ fundamentally from such tumours at other sites in their patterns of cytokeratin protein expression.
Continuous Monitoring of Bladder Pressure in Dogs in a Completely Physiological State
Authors: TAKAYAMA K. , TAKEI M. , SOEJIMA T. , KUMAZAWA J.
Published: November 2008

Summary— Bladder pressure changes in the completely physiological state of dogs were recorded on voiding, coughing, defaecating, vomiting, etc, by a pressure transducer embedded in the submucosal layer of the anterior bladder wall. The static pressures in the standing and lying positions were almost the same at about 10 cm H2O and in the sitting position the pressures were about 30 cm H2O. The voiding pressure was recorded 28 times and ranged from 44 to 257 cm H20 (average 141). These data were higher than expected and we recommend further studies on the maximum voiding pressure. On voiding, various patterns of pressure curve were observed and in the monophasic pressure curve, which probably shows normal urination, there was a time difference between urine flow and voiding pressure curve. Our new method may be useful not only as a sensory device for neurogenic bladder patients but also as an experimental system to study the effect of drugs on autonomic nerves.
Application of Computerised Penile Arterial Waveform Analysis in the Diagnosis of Arteriogenic Impotence
Authors: DESAI K. M. , GINGELL J. C. , SKIDMORE R. , FOLLETT D. H.
Published: November 2008

Summary— A new method is described for evaluating arteriogenic impotence by means of noninvasive quantification of penile Doppler arterial waveforms using computerised analysis based on the Laplace Transform model. The haemodynamic changes occurring during a papaverine‐induced erection in healthy potent volunteers have been recorded by this technique, which has also been shown to be capable of discriminating between a normal and an abnormal penile arterial supply in an initial study of potent and impotent men.
Urothelial Reaction to Ureteric Intubation A Clinical Study
Authors: RAMSAY J. W. A. , CROCKER R. P. , BALL A. J. , JONES S. , PAYNE S. R. , LEVISON D. A. , WHITFIELD H.N.
Published: November 2008

Summary— Urothelial biopsies from ureters intubated with silicone (11) and other polymer (13) double J stents revealed features of mucous metaplasia in 12/24 cases. These changes were associated with encrustation of the stents and occurred principally in stone‐forming patients.
Ureteroscopy and Ureteric Calculic how Useful?
Authors: KINDER R. B. , OSBORN D. E. , FLYNN J.T. , SMART J. G.
Published: November 2008

Summary— The results of management in 134 patients admitted to hospital during 1985 with ureteric colic are presented in relation to the size and position of a ureteric stone. Spontaneous passage of a stone occurred in 100 patients and 34 required surgical intervention. Stones measuring 5 mm or less in maximum dimension passed spontaneously in 92% of cases; stones measuring 6 mm or more had only a 28% chance of passing.

Of 34 surgical procedures 19 were endoscopic. In three cases a stone was removed under vision with ureteroscope and Dormia basket. In five patients ureteric dilatation before attempted ureteroscopy permitted later passage of the stone. In 1986 similar results were obtained with ureteroscopic stone removal performed in three cases. Fewer open operations and more Dormia basket extractions were performed in 1986.

In this series the size of the stone was closely related to outcome. The high chance of spontaneous passage (75% in 1985 and 84% in 1986) puts the need for surgical intervention, and in particular ureteroscopy, into perspective in the management of patients with ureteric colic.
The Effect of pH and Lignocaine on Detrusor Instability
Authors: SETHIA K. K. , SMITH J. C.
Published: November 2008

Summary—The effects of intravesical alkaline solution and lignocaine have been studied in 42 patients with detrusor instability, eight patients with low bladder compliance and eight with stable bladders. Filling the bladder with alkaline solution instead of saline resulted in a significant increase in bladder capacity in the unstable and low compliance bladders (35.9 and 27.5% respectively). The addition of lignocane to the alkaline solution further increased bladder capacity in patients without bladder outflow obstruction. In all patients with flow rates of less than 10 ml/s, lignocaine reduced bladder capacity. There was a qualitative improvement in instability on using an alkaline filling medium. However, in three patients with outflow obstruction lignocaine caused the instability to worsen. Possible mechanisms for these findings are discussed.
Methotrexate Toxicity Associated with an IIeal Conduit
Authors: BOWYER G. W. , DAVIES T. W.
Published: November 2008

Heal conduit urinayr diversion is oftern used to reliever obstrucitve uropathy in patients with balder cancer. The effectivenss of methotrexate in transitional cell cercinoma of the baldder has also been shown (Natale et al., 1981). We report unexpaected methotrexate toxicity when the the durg was used in a patient with and ideal conduit.
Oncocytomas of the Kidney
Authors: KriŽANAC Š. , VRANEŠIČ D. , OBERMAN B.
Published: November 2008

Summary—
Seven cases of oncocytoma of the kidney are reported. In three patients this was the original histological diagnosis; the other four were diagnosed after a review of 165 renal tumours which had been previously diagnosed as carcinoma. The oncocytomas were also analysed by electron microscopy. In one case adenomas of the suprarenal glands were also found.
The Choice of Suprapubic Continent Catheterisable Urinary Stoma
Authors: CUMMING J. , WORTH P. H. L. , WOODHOUSE C. R. J.
Published: November 2008

Summary—
Two types of contient urinary diversion are compared. In six patients a koch pouch was used. Two were completely successful but the other four aptients required 10 revision operations between them and only two achieved complete continence. In seven patients a Mitrofanoff operation was. done. The results were much and six achieved complete continence with only three revision operations in two patients. It was concluded that the kock pouch was more difficult and where possible the Mitrofanoff operation should be used to from a continent suprapubic catheterisable stoma.
Atypical Germ Cells in Prepubertal Cryptorchid Testes
Authors: ANEIROS J. , ZULUAGA A. , LOPEZ J. , CARACUEL M. , GOMEZ M.
Published: November 2008

Summary—
Four cases of prepubertal cryptorchid testes with atypical germ cells were stuied. These cells were charcteristically large, showing a wide, pale cytoplasm and a large nucleus with both fine and coarse granular chromatin. Ferritin was shown to be absent. It is possible that these cells are dysplastic in nature and that they could form the basis of a premalignant intratubular lesion Thus periodic follwo‐up of these patients is recommended.
Infrequency of Primary Hyperparathyroidism in Renal Stone Formers
Authors: FUSS M. , PEPERSACK T. , CORVILAIN J. , VANDEWALLE J. C. , VAN GEERTRUYDEN J. , SIMON J. , KINNAERT P.
Published: November 2008

Summary— Repeated measurements of serum calcium and immunoreactive parathyroid hormone were performed in 1433 renal stone formers systematically referred from Accident and Emergency Departments and from Departments of Urology and Nephrology, irrespective of their serum calcium. Primary hyperparathyroidism was found in 23 patients and confirmed in 19/20 patients who underwent neck surgery, including 8 with intermittent hypercalcaemia. Our data suggest that when selection bias is minimised, primary hyperparathyroidism is found in about 2% of renal stone formers in a western country such as Belgium.
Primary Choice of Intervention for Distal Ureteric Stone: Ureteroscopy or ESWL?
Authors: EL‐FAQIH S. R. , HUSAIN I. , EKMAN P. E. , SHARMA N. D. , CHAKRABARTY A. , TALIC R.
Published: November 2008

Summary— Either transurethral ureteroscopy (URS) or extracorporeal Shockwave lithotripsy (ESWL) was the primary method of intervention in two series of patients presenting consecutively with stones located in the ureter distal to the radiological marking of the sacroiliac joint. Of 65 patients treated by URS, successful evacuation of the major part of the stone was achieved in 97% in one or two sessions. Of those subsequently attending for review, 93% proved stone‐free but 3% required surgery for serious complications. In the ESWL series of 53 patients, successful stone fragmentation was recorded in 94%, with 2 patients requiring a supplementary endourological or surgical procedure. No significant complications were related to ESWL and 90% of those followed up after successful ESWL proved stone‐free at 6 weeks. In uncomplicated cases, the mean procedure time for ESWL was one‐third of that required for URS and the hospital stay one‐half. It is suggested that ESWL should be the primary method of intervention in patients with distal ureteric stone, with URS reserved for the small number that prove refractory to such treatment.
Development of Bladder Tumour Containing HPV Type 11 DNA after Renal Transplantation
Authors: QUERCI DELLA ROVERE G. , OLIVER R. T. D. , McCANCE D. J. , CASTRO J. E.
Published: November 2008

Summary— We report a case of bladder cancer developing in a patient after renal transplantation in whom it was possible to demonstrate DNA evidence for infection of the tumour with HPV Type 11.

The significance of the observation is discussed in relation to the hypothesis that immunosurveillance can control the development of malignancy.
Teflon Injection in Female Stress Incontinence. Effect on Urethral Pressure Profile and Flow Rate
Authors: VESEY S. G. , RIVETT A. , O'BOYLE P. J.
Published: November 2008

Summary— Thirty‐six females with genuine stress incontinence (GSI) were treated by bladder neck teflon injection. Urethral pressure profilometry (UPP) and uroflowmetry were performed both pre‐and post‐operatively on 18 patients. In 24 patients who were either completely cured or improved by this procedure, the mean urine flow rate was reduced by 23% and the mean functional profile length increased by 9% compared with pre‐operative values. Although these findings appear to explain the mechanism by which teflon improves continence, these differences were not statistically significant.

Fourteen of the 18 patients who had not responded to previous anti‐incontinence procedures were successfully treated by teflon injection. The improved response rate in these patients was not statistically significant. It was not possible to predict with certainty those patients most likely to respond to teflon injection. However, in women with normal or near normal pelvic floor anatomy the procedure had an acceptable success rate. In view of the simplicity, lack of morbidity and the ease with which it can be performed and repeated, bladder neck teflon injection deserves consideration as an alternative, particularly where open surgery has failed.
Long‐term Outcome of Boys with Posterior Urethral Valves
Authors: PARKHOUSE HELEN FITZMAURICE , BARRATT T. M. , DILLON M. J. , DUFFY P. G. , FAY J. , RANSLEY P. G. , WOODHOUSE C. R. J. , WILLIAMS D. I.
Published: November 2008

Summary— One hundred and fourteen boys with posterior urethral valves were treated between 1966 and 1975. Four died during the first hospital admission, 6 died from renal failure during childhood, 1 died from other causes and 15 were lost to follow‐up. Eighty‐eight were reviewed 11 to 22 years after diagnosis and the renal outcome of 98 patients is therefore known. Approximately one‐third of patients presented under 1 month of age, between 1 month and 1 year, and over 1 year respectively. Bilateral vesicoureteric reflux was observed in one‐quarter of the boys, more frequently in those presenting in the first month of life. Half of the patients were treated by primary valve ablation and half underwent temporary upper tract diversion: the outcome was worse for the diverted group.

One‐third of the boys had a long‐term bad outcome for renal function. This outcome was associated with early presentation, bilateral vesicoureteric reflux and day‐time urinary incontinence after the age of 5 years. The association of bad outcome with incontinence points to continuing bladder dysfunction as a major determinant of long‐term outcome for renal function.
The Management of Advanced Testicular Teratoma
Authors: PECKHAM M.J. , HORWICH A. , EASTON D. F. , HENDRY W. F.
Published: November 2008

Summary— Of 320 patients with metastatic malignant non‐seminomatous germ cell tumours of the testis (NSGCT) treated with chemotherapy, 266 (83%) are alive and well after a median follow‐up of 39 months. Deaths from treatment‐related causes occurred in 9 patients and were related to intensity of chemotherapy. Relapse after chemotherapy was rare except in presentations with large tumour volume and high serum marker concentrations and a strategy has been developed of risk‐related choice of chemotherapy in order to reduce treatment toxicity in good prognosis sub‐groups of patients.
Ureteric Obstruction Secondary to Pelvic Actinomycosis
Authors: JACKSON A. E. , PARRY J. R. W. , SHAH P. J. R.
Published: November 2008

Pelvic actinomycosis is a rare cause of ureteric obstruction. The diagnosis is usually difficult and often only apparent after histological examination of an operative specimen. The following case led us to consider the aetiology, clinical findings and to review the management of reported cases.
Multilocular Hydrocele after Sclerotherapy
Authors: RENCKEN R. K. , BORNMAN M. S. , REIF S.
Published: November 2008

Sclerotherapy for hydroceles is effective therapy (Moloney, 1975; Thomson and Odell, 1979; Macfarlane, 1983). We report a case in which sclerotherapy failed because of multilocular cyst formation.
The Value of Sonography in the Diagnosis and Follow‐up of Patients with Blunt Renal Trauma
Authors: FURTSCHEGGER A. , EGENDER G. , JAKSE G.
Published: November 2008

Summary— Eighty‐eight patients with blunt renal trauma were examined sonographically. Rupture of the kidney was diagnosed in 41 patients and contusion of the kidney in 45. The correlation between operative findings, sonography and urography showed positive sonographic findings to be correct in all patients with rupture of the kidney. In 4 patients with normal sonograms, the diagnosis of a contusion was based on the urographic results. Three patients underwent angiography. An intimal lesion was seen in 2 and a tear of the renal artery in 1.

The results of our investigation suggest that sonography should be applied in the first place in the evaluation of blunt renal trauma. It is the investigation of choice during follow‐up after surgical as well as conservative therapy.
Cranial Blind‐ending Branch of a Bifid Ureter Report of 3 Cases
Authors: TILLEY ELISABETH A. , DOW C. JEAN
Published: November 2008

Summary— Three cases of cranial blind‐ending branches of bifid ureters are presented, all occurring in women. None was associated with complications requiring surgery, suggesting that they were of little clinical significance in these patients. The anomaly was best shown with oblique views at intravenous urography.
Clinical Significance of Ureteric Diameter on Intravenous Urography after Spinal Cord Injury
Authors: ARNOLD E. P. , COWAN I. A.
Published: November 2008

Summary— The ureteric diameter on IVU was compared with the MCU findings of reflux or lower urinary tract dysfunction in a group of patients followed up after spinal cord injury. A wide ureter was associated with reflux in 20%, but 8 normal sized ureters on IVU also refluxed—5 of them to a significant degree. In the non‐refluxing group, wide ureters were noted more often in patients whose bladder pressures were high and wildly fluctuating than in those with normal bladder pressures. Similarly, the incidence of reflux was higher in patients with high bladder pressures and wild fluctuations of bladder pressure than in those with normal pressures.

While a wide ureter on IVU should arouse suspicion that reflux or lower urinary tract dysfunction might be present, these conditions are not necessarily excluded by the finding of a ureter of normal size.
Saline‐induced Artificial Erection without Papaverine: A Potential Source of Error in Diagnosing Cavernosal Venous Leakage
Authors: DESAI K. M. , GINGELL J. C.
Published: November 2008

Summary— The diagnosis of venous leakage as a cause of impotence, based on failure to induce an artificial erection by means of rapid saline infusion alone, may be invalid. Our recent experience with 2 men whose impotence was subsequently found to be psychogenic in nature suggests that saline erection cavernosometry should routinely incorporate the intracavernosal administration of papaverine, in order to avoid a falsely positive diagnosis of venous leakage.
Procedure for the Measurement of Calcium Oxalate and Phosphate Crystals in Urine
Authors: HALLSON P. C. , ROSE G. A.
Published: November 2008

Summary— A method is described for the chemical measurement of calcium oxalate and phosphate crystal formation in urine. The crystals were centrifuged, washed and the oxalate measured by an immobilised oxalate oxidase technique and the phosphate by a standard centrifugal analyser procedure. The methods proved precise and recoveries were good. Calcium oxalate crystal formation after evaporation is time‐dependent and this parameter must therefore be standardised. Values for normal urinary calcium oxalate crystal concentration after concentration are given.
Transrectal Ultrasound versus Cystography In the Evaluation of Anatomical Stress Urinary Incontinence
Authors: BERGMAN A. , McKENZIE CLAUDETTE J. , RICHMOND J. , BALLARD C. A. , PLATT L. D.
Published: November 2008

Summary— Thirty‐two female patients with clinical and urodynamic findings of genuine stress urinary incontinence were evaluated before and 6 months after surgery for stress urinary incontinence. Twenty‐nine control patients had identical evaluations before and 6 months after surgery which did not involve the urethrovesical junction. Twenty‐four patients with primary bladder instability had similar evaluations and served as a second control group.

Anatomical landmarks indicating support to the urethrovesical junction were evaluated by the position of the urethra at the most dependent point in the bladder on straining and the urethral descent on straining to beneath the posterior ramus of the symphysis pubis on bead chain cystography. The urethrovesical junction drop on straining was evaluated by transrectal ultrasonography.

Cystographic and ultrasonographic tests for the position of the urethrovesical junction at the most dependent position in the bladder during straining were very sensitive in women with stress urinary incontinence (94 and 87% respectively) but much less specific (45 and 48% respectively). When evaluating anatomical support to the urethrovesical junction and its descent on straining, these tests were both highly sensitive (97 and 94% respectively) and specific (76 and 96% respectively) in women with genuine stress urinary incontinence.

Simple clinical tests for support of the urethrovesical junction, such as the Q tip test, are nonspecific in patients with stress urinary incontinence. Transrectal ultrasonography is a simple and quick out‐patient procedure. The availability of ultrasound equipment in most clinics and the high sensitivity and specificity of the test make it an attractive and cost‐effective alternative to X‐ray cystography in the pre‐operative evaluation of anatomical support to the urethrovesical junction.
Prophylactic Subcutaneous Heparin does not Increase Operative Blood Loss in Transurethral Resection of the Prostate
Authors: WILSON R. G. , SMITH D. , PATON G. , GOLLOCK J. M. , BREMNER D. N.
Published: November 2008

Summary— A prospective randomised study of subcutaneous heparin compared with no heparin was performed in 60 patients undergoing transurethral resection of the prostate. Operative blood loss in the irrigation fluid was measured using a haemoglobinometer. Blood loss correlated with the amount of prostate resected and the duration of the procedure. Subcutaneous heparin had no significant effect on the measured blood loss in transurethral resection of the prostate and can be used as a safe means of prophylaxis against thrombo‐embolic complications.
Deferred Treatment for Prostate Cancer
Authors: HANDLEY R. , CARR T. W. , TRAVIS D. , POWELL P. H. , HALL R. R.
Published: November 2008

Summary— The clinical outcome of 278 prostate cancer patients managed by a deferred treatment policy was analysed retrospectively. Following TURP or biopsy, all patients were asymptomatic and deemed suitable for management by a deferred treatment policy, i.e. hormone therapy or other forms of treatment were only initiated if and when symptomatic progression occurred. The overall 5‐year survival rate was 30%; 18% of patients died from other causes without needing treatment for their prostate cancer; 11% were alive and untreated after 5 years' follow‐up; 17% died from prostate cancer without further treatment. Poor tumour grade, anaemia, metastatic disease, a short history, presentation with retention, and a raised serum creatinine at presentation were associated with a poor prognosis.
Relationship of DNA Content to Conventional Prognostic Factors in Clinically Localised Carcinoma of the Prostate
Authors: RITCHIE A. W. S. , DOREY F. , LAYFIELD L. J. , HANNAH J. , LOVREKOVICH H. , de KERNION J. B.
Published: November 2008

Summary— One hundred and nine patients treated by total prostatectomy for apparently localised carcinoma were analysed to investigate the prognostic significance of capsular invasion and penetration, seminal vesicle invasion, lymph node metastases, grade as assessed by the Gleason and MD Anderson Hospital (MDAH) systems and DNA content measured by flow cytometry of nuclear material extracted from paraffin embedded tumour. Comparison of DNA content was made with 36 benign prostates. Mean follow‐up/survival was 60.7 months, at which time 21 patients had evidence of recurrence or had died. Only 5 patients had local recurrence. Tumour grade, as assessed by both the Gleason Sum Score and the MDAH system, correlated with anatomical extent and was the most important determinant of time to recurrence. Fifty‐nine tumours were diploid, 44 tetraploid and 6 aneuploid. One of 36 benign prostates showed aneuploidy. Ploidy did not correlate with the anatomical extent of the tumour or with grade. Tetraploid tumours recurred earlier than diploid tumours. None of 6 aneuploid tumours have recurred, although only 3 have been followed beyond 5 years. Multivariate analysis showed that after accounting for grade, none of the other variables, including ploidy, contributed any additional significant prognostic information. Although the results must be regarded as preliminary, in view of the small number of patients with recurrence, they suggest that DNA content offers limited prognostic information in clinically localised prostate cancer.
Significance of Scrotal Violation in the Prognosis of Patients with Testicular Tumours
Authors: OZEN H. , ALTUG U. , BAKKALOGLU M. A. , REMZI D.
Published: November 2008

Summary— Thirty‐five patients with testicular cancer who had scrotal contamination during or prior to their primary treatment were compared with 70 patients who had undergone radical inguinal orchiectomy. The survival curves, disease‐free intervals and 2‐year survival rates of the two groups did not differ significantly and we do not advocate additional aggressive surgical treatment to the scrotum and superficial inguinal lymph nodes in these patients.
1500 Cases of Renal and Ureteric Calculi Treated in an Integrated Stone Centre
Authors: DAS G. , DICK J. , BAILEY M. J. , FLETCHER M. S. , BIRCH B. , COPTCOAT M. J. , WEBB D. R. , KELLETT M. J. , WHITFIELD H. N. , WICKHAM J. E. A.
Published: November 2008

Summary— Fifteen hundred consecutive cases of renal and ureteric calculi were treated in an integrated stone centre; 1464 of these were treated by extracorporeal Shockwave lithotripsy, percutaneous nephrolithotomy, ureterorenoscopy and ureteroscopic lasertripsy. Only 36 (2.4%) required open surgery.
Controlled Trial of Intravesical Noxythiolin in the Prevention of Infection Following Outflow Tract Surgery
Authors: JONES M. A. , HASAN A.
Published: November 2008

Summary— A randomised control trial was undertaken in 100 consecutive patients undergoing endoscopic surgery for outflow tract obstruction to assess the efficacy of noxythiolin in preventing post‐operative bacteriuria; 1% noxythiolin or sterile water was instilled at the time of catheter removal. The incidence of bacteriuria in the treated group (7/50) was significantly lower than in the control group (19/50). This was statistically significant. This difference was more marked in patients who had been catheterised for retention of urine. There was no difference in the complication rate despite a reduction of infection in the treated group.
A Technique for Total Substitution of the Lower Urinary Tract without the Use of a Prosthesis
Authors: R. MUNDY A.
Published: November 2008

Summary— A technique is described for total replacement of the lower urinary tract in women in which a pedicled labial skin tube is created and anastomosed to a substitution cystoplasty with a submucosal tunnelled type of “anti‐reflux” anastomosis which provides a continence mechanism. The patients thereafter void by intermittent self‐catheterisation.

This technique has been used in 6 women as part of total pelvic reconstruction for vesico‐vagino‐rectal fistula following radical radiotherapy, with or without a Wertheim's hysterectomy, for carcinoma of the cervix. A similar technique using a pedicled preputial/penile skin tube has been used in 2 men following a cystoprostato‐urethrectomy for transitional cell carcinoma of the bladder.
The Effects of Transurethral Prostatectomy on Serum Prostate Specific Antigen
Authors: VESEY S. G. , GOBLE N. M. , STOWER M. J. , HAMMONDS J. C. , SMITH P. J. B.
Published: November 2008

Summary— Serum prostate specific antigen (PSA) was recorded in 75 patients immediately before and after transurethral resection of the prostate (TURP). Fifty‐eight patients had benign prostatic hypertrophy (BPH) and 17 had prostatic carcinoma (CaP). In patients with BPH there was a statistically significant rise in PSA immediately following TURP. No such rise was seen in patients with prostatic carcinoma.

A statistically significant correlation was identified between the weight of the benign hypertrophic prostate and the baseline pre‐operative serum PSA.

Because of the effects of TURP on serum PSA it is important to avoid PSA estimations immediately following such surgery. The failure of the malignant prostate to release PSA in significant amounts during TURP suggests that the elevated levels of PSA found in patients with prostatic carcinoma arise not from the local disease but from its metastases.
Oestrogen Pre‐treatment Abolishes Luteinising Hormone‐Releasing Hormone Testosterone Stimulation
Authors: KREIS W. , AHMANN F. R. , JORDAN V. C. , de HAAN H. , SCOTT M.
Published: November 2008

Summary— In patients with histologically confirmed prostate cancer, oestrogen priming with diethylstilboestrol (DES) (3 mg/day) for 4 weeks prior to the first injection of the LHRH agonist Zoladex (3.6 mg depot form) prevented any rise in the serum testosterone concentration. In contrast, in the groups pre‐treated with DES, the first, but not subsequent, injections with Zoladex were associated with a marked surge in luteinising hormone. Treatment with DES beyond the time of the first administration of Zoladex did not provide further endocrinological advantage. Oestrogen priming for 1 month prior to treatment with Zoladex may prevent an exacerbation of signs and symptoms of prostate cancer.
Influence of Antisperm Antibodies on Human Sperm Function
Authors: AITKEN R. J. , PARSLOW J. M. , HARGREAVE T. B. , HENDRY W. F.
Published: November 2008

Summary— Antisperm antibodies have been found in about 8% of men with infertility and in 60 to 80% of patients following vasectomy. I n order to investigate the way antibodies influence sperm function we studied serum and seminal plasma from patients with infertility (n = 61) or undergoing vasovasostomy (n = 25). These antisera were characterised to determine their TAT titre, the nature of the target antigens and their capacity to interfere directly with fertilisation.

The results indicate that antibodies from both groups of patients exhibit a capacity to stimulate or suppress sperm/oocyte fusion. The proportion of samples showing stimulatory activity was higher (50%) in the vasovasostomised population than in patients with infertility (21%). The remainder of the antisera suppressed sperm/oocyte fusion. There was no correlation between the titre of antisperm antibodies and their capacity to influence sperm function, indicating that it is the nature of the target antigens which is of significance rather than the antibody concentration. Western blot analysis indicated that these antisera targeted a group of sperm surface antigens with molecular weights of 30kD (35,45,66,90 and 115kD). Monoclonal antibodies are now being prepared in order to determine which of these specific components are involved in the suppression of sperm function.
Vasectomy: How Much is Enough?
Authors: HALLAN R. I. , MAY A. R. L.
Published: November 2008

Summary— Bilateral vasectomy was performed in 30 men. The vasa were tied with radio‐opaque ligatures and X‐rays taken to assess the separation of the ends. There was good correlation between the length of vas excised and the resulting separation of the markers. In order to achieve a separation greater than that of sperm granulomas associated with vasectomy failure, at least 7 cm of vas would have to be removed. However, excision of this length cannot be recommended because of subsequent difficulties with vasovasostomy. It is suggested that as well as excising a length of vas during vasectomy, a second method is also used to prevent spontaneous recanalisation.
CT Scanning in the Diagnosis and Management of Radiolucent Urinary Calculi
Authors: DEAN T. E. , HARRISON N. W. , BISHOP N. L.
Published: November 2008

Summary— The diagnosis of non‐opaque calculi can be difficult. In 4 patients with protracted symptoms, 2 had renal pelvic filling defects, 1 a possible filling defect and 1 complete obstruction of the ureter at L4. Non‐opaque calculi were readily diagnosed by CT scanning. Three patients have successfully undergone surgery (2 open, 1 percutaneous) and 1 awaits percutaneous nephrolithotomy. Of two stones available for analysis, one was composed of uric acid and the other calcium and phosphate. We recommend CT scanning as the investigation of choice for unexplained filling defects in the renal pelvis and ureter or when a non‐opaque calculus is suspected.
Association between Symptomatology and Uroflowmetry in Benign Prostatic Hypertrophy
Authors: HERBISON A. E. , FRAUNDORFER M. R. , WALTON J. K.
Published: November 2008

Summary— The symptoms of 128 consecutive patients (mean age 65 years) with benign prostatic hypertrophy were assessed and compared with flowmetry recordings. The 84 patients (65%) with peak flow rates ≥2 standard deviations from the mean were considered to have abnormal flowmetry and their symptoms were compared with those of the 44 men with normal peak flows. No significant correlation between peak flow rate and age was found within this group. Symptoms of poor stream, nocturia, post‐micturition dribble and nocturnal or full‐bladder hesitancy were present in over two‐thirds of the whole series. Poor stream, hesitancy and nocturnal or full‐bladder hesitancy were found to have significant associations with abnormal flowmetry recordings but also to have a high incidence within the normal flowmetry group. Discriminant analysis was unable to define a symptom complex which would accurately predict those within our group with abnormal peak flows. It was concluded that symptomatology and flowmetry evidence of lower urinary tract obstruction are not associated and subjective and objective evidence must be considered independently in selecting candidates for prostatectomy.
Single Dose, Oral Antibiotic Cover for Transurethral Prostatectomy
Authors: SHEARMAN C. P. , SILVERMAN S. H. , JOHNSON M. , YOUNG C. H. , FARRAR D. J. , KEIGHLEY M. R. B. , BURDON D. W.
Published: November 2008

Summary— A double‐blind, randomised, placebo‐controlled study was carried out to determine the incidence and significance of bacteriuria in 110 patients undergoing transurethral resection of the prostate (TURP) and to assess the effect of a single pre‐operative dose of Ciprofloxacin, a 4‐quinolone antibiotic.

Fifteen (68%) of the 22 patients in the placebo group with a positive post‐operative urine culture subsequently developed a clinically apparent urinary tract infection (UTI) or received antibiotics in view of a positive urine culture. Adequate prostatic concentrations of Ciprofloxacin were achieved in all who received the drug. A significant reduction in the number of positive post‐operative urine cultures and urinary tract infections requiring antibiotic therapy was achieved in this group. Six patients (5.5%) developed clinical evidence of septicaemia, 5 of whom were in the placebo group. No organisms resistant to Ciprofloxacin were encountered.

Prior to surgery, 19% of all patients were found to have previously unsuspected bacteriuria. Ciprofloxacin tended to reduce the chances of this group developing a UTI or requiring antibiotics. Further, there was a highly significant reduction in post‐operative infective complications in those with sterile urine at the time of resection who had received the drug.

This study suggests that antibiotic cover for TU RP is of clinical benefit. Ciprofloxacin may prove suited to this purpose, although further experience with the drug is still required.
Ethanolamine Oleate as a Sclerosant for Testicular Hydroceles and Epididymal Cysts
Authors: HELLSTRÖM P. , TAMMELA T. , KONTTURI M. , LUKKARINEN O.
Published: November 2008

Summary— Forty patients with testicular hydroceles and 16 patients with epididymal cysts were treated by tapping and injection of ethanolamine oleate; 97.5% of the hydroceles and 31% of the epididymal cysts were completely cured, 50% of the latter partly cured and 19% failed. About half of the patients experienced pain after treatment. Two patients developed infection. Ultrasonography showed no change in the testicular tissue during the follow‐up period. Sclerotherapy with ethanolamine oleate is a rapid and cost‐effective modality which can be recommended as primary treatment for hydroceles and for unilocular epididymal cysts, especially in elderly males.
Variations in the Activity of Urinary Inhibitors in Calcium Oxalate Urolithiasis
Authors: GRASES F. , GENESTAR C. , MARCH P. , CONTE A.
Published: November 2008

Summary— Opinions vary on the effects produced by urinary inhibitors of crystallisation. We describe a simple method for studying inhibitory effects in urine based on nephelometry and optical microscopy. It was concluded that the inhibitory effect of a given substance on calcium oxalate crystallisation depends on the particular sample of urine being examined and that the most effective inhibitor can be determined only by studying the urine of each patient individually.
Adenine Phosphoribosyltransferase Deficiency: 2, 8‐Dihydroxyadenine Urolithiasis in a 48‐year‐old Woman
Authors: USENIUS J.‐P. , RUOPURO M.‐L. , USENIUS R.
Published: November 2008

Summary— We report the first patient in Finland and Scandinavia with a deficiency of adenine phosphoribosyltransferase (APRT). About 30 clinically affected patients have been reported in the literature. APRT deficiency is an enzyme disorder which is inherited autosomally in a recessive manner. The use of adenine in purine metabolism is disturbed and it accumulates in the body, where it is oxidised to poorly insoluble 2, 8‐dihydroxyadenine by xanthine oxidase. The dihydroxyadenine forms stones which can be mistaken for uric acid stones.

Our patient had had frequent episodes of urolithiasis and the diagnosis was finally made after pyelolithotomy and stone analysis. The total APRT deficiency was detected in the haemolysate of erythrocytes. Partial eficiency of APRT in the patient's relatives showed heterozygosity of the enzyme defect.

The only clinical manifestation of the defect is the formation of urinary stones. This can be prevented by diet and allopurinol.
Primary Vesicoureterlc Reflux Treated by Antireflux Ureterocystostomy at the Vertex of the Bladder A 12‐year Follow‐up and Analysis of Operative Failure
Authors: BRADIĆ I. , BATINICA S. , HUSAR J.
Published: November 2008

Summary— A total of 618 children with primary vesicoureteric reflux (VUR) were examined preoperatively and 6, 9 and 24 months after an antireflux ureterocystostomy of the vertex of the bladder (AUVB); 206 children were operated on bilaterally, so that 824 AUVBs were performed. Most patients had grade 3 or 4 reflux and only 5% had grade 2 reflux. Successful results were noted in 792 ureteric units; in 10 cases of post‐operative stenosis and 17 cases of recurrent VUR a second AUVB was performed. The following causes of operative failure were found: obstruction of the submucosal ureter after tailoring (5 cases), stricture of the new ureteric orifice (3), necrosis of the terminal part of the ureter (2), submucosal ureter too short or too wide (12) and fibrosis of the detrusor muscle over the submucosal ureter (5); a success rate of 84% was noted after the second procedure.
Age, and Size and Grade of Tumour Predict Prognosis in Incidentally Diagnosed Carcinoma of the Prostate
Authors: GOODMAN C. M. , BUSUTTIL A. , CHISHOLM G. D.
Published: November 2008

Summary— Of 403 consecutive cases of prostatic carcinoma 69 were diagnosed incidentally and were managed with a deferred treatment policy. The mean age at diagnosis was 74 years and mean follow‐up was 42 months. Retrospective analysis confirmed that many such patients die of intercurrent disease before symptomatic tumour progression. However, patients aged 70 years or less at diagnosis with diffuse, high grade disease were shown to be at greater risk of symptomatic tumour progression. In this study 60% progressed to skeletal metastases within 3 years. Deferral of treatment in such patients appears inappropriate.
Diathermy Hook Ablation of Posterior Urethral Valves in Neonates and Infants
Authors: DEANE A. M. , WHITAKER R. H. , SHERWOOD T.
Published: November 2008

Summary— An insulated diathermy hook was used to destroy the posterior urethral valve in 10 boys. The technique needs no anaesthetic, no endoscopic equipment, no perineal urethrostomy and only occasional catheter drainage of the bladder. It is performed in the X‐ray department, where the efficacy of the procedure can be checked immediately with a further cystogram. The results are compared with those in 7 other boys whose valves were destroyed by conventional endoscopic means.
Functional Innervation Patterns in the Corpus Spongiosum and Glans in the Dog
Authors: KIMOTO Y. , ITO Y.
Published: November 2008

Summary—The neural control of smooth muscle cells in the corpus spongiosum, helicine artery and bulbus giandis of the dog was investigated in relation to the mechanism involved in erection, using isometric tension recording and micro‐electrode methods.

In the corpus spongiosum, field stimulation evoked twitch‐like contractions followed by relaxations. These relaxations were enhanced and prolonged by neostigmine and partly suppressed by atropine. Guanethidine abolished the twitch‐like contractions and increased muscle tone. The relaxations observed after pre‐treatment with guanethidine were abolished by tetrodotoxin (TTX), thereby indicating that these muscles are innervated by adrenergic excitatory, cholinergic and non‐adrenergic non‐cholinergic inhibitory nerves.

In the helicine artery and bulbus glandis, field stimulation evoked contractions and these contractions were abolished by guanethidine or TTX, indicating that these muscles are innervated by adrenergic excitatory nerve fibres. After pre‐treatment with guanethidine and atropine, muscle relaxation appeared in response to field stimulation in the helicine artery but not in the bulbus giandis, indicating that the helicine artery in the corpus spongiosum is also innervated by non‐adrenergic non‐cholinergic inhibitory nerves in addition to the excitatory adrenergic nerves. In the smooth muscle cells of the corpus spongiosum, slow potential changes were correlated with spontaneous contractions and field stimulation evoked excitatory or inhibitory junction potentials.

The neural mechanism involved in erection is discussed in relation to the topical difference in the autonomic innervation patterns in the corpus spongiosum, helicine artery and bulbus giandis.
Assent to Ascent of the Testis
Authors: ROBERTSON J. F. R. , AZMY A. F. , COCHRAN W.
Published: November 2008

Summary— We report 13 boys in whom the testis ascended from the normal scrotal position to an undescended position. A patent processus vaginalis was identified in 10 patients at orchidopexy and is believed to have contributed to testicular ascent. The other three patients had retractile testes which were held in the high position by surrounding adhesions.
Torsion of Scrota1 Contents in Children
Authors: McCOMBE A. W. , SCOBIE W. G.
Published: November 2008

Summary— One hundred and forty consecutive cases of torsion of scrota1 contents were reviewed retrospectively. There were 95 cases of torsion of the testicular appendage and 45 cases of testicular torsion. Testicular torsion was more common on the left and patients tended to present earlier with more systemic upset in the form of vomiting, abdominal and groin pain than patients with torsion of a testicular appendage. Pathognomic features of examination were an elevated or ectopic testis in 50% of cases of testicular torsion and a palpable tender blue nodule in 21% of cases of torsion of a testicular appendage.

We believe that it is often possible to distinguish between these two conditions and, where this is possible, a trial of conservative management is justified for torsion of a testicular appendage.
Comparison of in vitro Encrustation on Silicone and Hydrogel‐coated Latex Catheters
Authors: COX A. J. , HUKINS D. W. L. , SUTTON T. M.
Published: November 2008

Summary— Mid‐shaft sections of 100% silicone (Bardex) and hydrogel‐coated latex (Biocath) catheters were subjected to controlled in vitro encrustation conditions for periods of up to 18 weeks. There was no significant difference in the quantities of encrusting deposits formed on these two materials during the course of the experiment.
Urolithiasis in Jordanian Children.: A Report of 52 Cases
Authors: DAJANI A. M. , KHADRA A. L. ABU , BAGHDADI F. M.
Published: November 2008

Summary— Fifty‐two children with urinary calculi seen between 1975 and 1986 were reviewed. Males dominated the series. The age distribution ranged from 10 months to 14 years (mean 7.2 years); 71% presented after school age. Most patients had upper tract stones. The main presenting symptoms were abdominal pain, infection and haematuria. The causative factors or co‐factors were infection, malformations and urodynamic abnormalities. Metabolic disorders were rare. Calcium oxalate and uric acid stones were found most often. Surgical management was required in 88% of patients and only 3.8% had a recurrence. Presenting symptoms are variable and so a high index of suspicion is required for diagnosis.