bluuebunny/crossref_metadata_2025 huggingface dataset:
Primary Vesicoureteric Reflux: Treatment with Subureteric Injection of Polytef Paste
Authors: DAVIES N. , ATWELL J. D.
Published: November 2008

Summary— A series of 34 children with 40 primary refluxing ureters were treated endoscopically with a subureteric injection of polytetrafluoroethylene paste (Polytef). The amount injected ranged between 0.1 and 0.8 ml (mean 0.3). A single injection cured the reflux in 26 ureters (65%) and the grade of reflux improved in a further 9 ureters. Seven ureters required a second injection and reflux was cured in 6 of these. The overall cure rate was therefore 80% after the second injection. There was one complication due to self‐limiting ureteric obstruction following injection. The procedure is quick, easy to perform and effective. We have some reservations about the long‐term efficiency and safety of subureteric Polytef injection in children.
Experience with Penile Fractures in Saudi Arabia
Authors: AGRAWAL S. K. , MORGAN B. E. , SHAFIQUE M. , SHAZELY M.
Published: November 2008

Summary— Seven patients with penile rupture were treated surgically within a 9‐month period. All were operated on as emergencies, with successful results, except in 1 case which was associated with urethral rupture. Sexual performance was satisfactory in 6 of 7 cases.
Bladder Compliance in Myelodysplastic Children: Effect of Anti‐reflux Surgery and Conservative Treatment
Authors: KONDO A. , KATO K. , GOTOH M. , NARUSHIMA M. , ITOH Y.
Published: November 2008

Summary— Little is known about changes in bladder compliance and bladder capacity in myelodysplastic patients following anti‐reflux surgery. A study group of 70 patients was divided as follows: group A included 20 myelodysplastic patients who had been operated on for reflux and whose subsequent treatment was conservative. Group B comprised 31 myelodysplastic patients who had been treated conservatively; a third group of 19 non‐myelodysplastic patients, treated by anti‐reflux surgery because of primary reflux, formed the control group. The follow‐up period for group A averaged 61 months (extending from a urodynamic study 3 months after surgery to the most recent test). In group B the mean follow‐up period between the initial test and the latest test was 86 months.

Bladder compliance in group A patients did not increase significantly (from 5.5 to 6.9), but patients in group B did show a significant increase (from 5.9 to 10.7). Compliance in the 19 non‐myelodysplastic patients decreased only marginally 6 months after surgery (from 29.6 to 26.3). Changes in bladder capacity showed a similar trend. In their most recent test, however, the bladder capacity of group A patients increased to the same volume as that of group B. A high correlation between radiological bladder deformity and bladder compliance was found. We propose a bladder compliance of 10.0 as the lower limit for myelodysplastic patients' preferred range.

It was concluded that anti‐reflux operations prevent any improvement in bladder compliance (but not in bladder capacity) compared with conservative treatment.
A User's Guide to Flexible Cystoscopes
Authors: POPE A. J. , WICKHAM J. E. A.
Published: November 2008

Summary This survey, carried out on behalf of the BAUS Instruments Committee, aims to assist the urologist in choosing a flexible cystoscope. The 5 most commonly available flexible cystoscopes (from ACMI, Olympus, Pentax, Storzand Wolf) were assessed in a clinical setting for handling, image quality and user satisfaction. Several technical characteristics, including deflection range, irrigant flow rate and optics, were tested in the laboratory. Whilst all instruments were satisfactory, the favourite of our testing panel was the Olympus CYF‐2, which also came out best in the technical assessment and has the most comprehensive service support. The cheaper Storz instrument also performed well.
Long‐term Effect of Pelvic Floor Exercises on Female Urinary Incontinence
Authors: MOURITSEN L. , FRIMODT‐MØLLER C. , MØLLER M.
Published: November 2008

Summary In order to assess the permanent effect of pelvic floor exercises on female stress incontinence, 76 incontinent women, referred for incontinence surgery, underwent a 3‐month exercise programme conducted by an experienced physiotherapist.

The patients were followed up for 1 year. At the last assessment 30% were cured and 17% improved. Altogether 47% avoided surgery.

No relapses were seen during the follow‐up period. Patients with mild incontinence benefited from intensified training, since 72% could expect to be cured, while patients with severe incontinence and no immediate effect did not benefit from further exercises. Patients with a positive hormone status and those with normal weight had a significantly higher cure rate.

The subjective results were confirmed by the 24‐h pad test. Anal pressure profilometry was a valid method for instruction and objective control of pelvic floor function. It was concluded that pelvic floor exercises should precede surgery, since exercises had a permanent effect in half of the patients.
Detection of Human Papillomavirus DNA in Cancer of the Urinary Bladder by in situ Hybridisation
Authors: BRYANT P. , DAVIES P. , WILSON D.
Published: November 2008

Summary The association of the human papillomavirus (HPV) with cancer of the urinary bladder was assessed by in situ hybridisation using probes selective for HPV types 6/11 and 16/18 DNA. No hybridisation signal was detected with the type 6/11 probe on 100 formalin‐fixed, paraffin‐embedded bladder tumours sampled. However, when the same samples were hybridised with the HPV type 16/18 DNA probe, 11 of 66 (16.6%) papillary and 1 of 10 (10%) solid transitional cell carcinomas gave positive signals. These results suggest the involvement of HPV in cancer of the bladder, although the frequency of multiple HPV types in these tumours is uncertain.
High‐dose Medroxyprogesterone Acetate versus Estramustine in Therapy‐resistant Prostatic Cancer: A Randomised Study
Authors: JOHANSSON J.‐E. , ANDERSSON S.‐O. , HOLMBERG L.
Published: November 2008

Summary A series of 105 patients with metastatic prostatic cancer, having progressed on first‐line hormonal treatment, were randomised to high‐dose medroxyprogesterone acetate (MPA) 1000 mg i.m. daily for 15 days, followed by 1000 mg weekly (53 patients), or to estramustine 280 mg per os twice daily (52 patients). The treatment was discontinued because of side effects in 3 of 51 evaluable MPA‐treated patients and in 8 of 51 evaluable estramustine‐treated patients. Progression‐free survival was short in both groups and no statistically significant difference between them was observed. After 1 year, 70% of the patients had died and there was no statistically significant difference between the 2 treatments in the cumulative observed survival rates. According to modified SPCG criteria, remissions lasting from 12 to 56 weeks were noted in 13 MPA‐treated patients and in 4 estramustine‐treated patients. This difference was statistically significant. After cross‐over, 6 of 33 patients in the MPA group had a remission compared with 1 of 24 in the estramustine group. It was concluded that the response rate, considering both subjective and objective response criteria, was better with MPA and the side effects were fewer.
Treatment of Recurrent Urethral Strictures Using Clean I ntermittent Self‐catheterisation
Authors: ROBERTSON G. S. M. , EVERITT N. , LAMPRECHT J. R. , FRCS M. BRETT , FLYNN J. T.
Published: November 2008

Summary The treatment of urethral strictures has been greatly improved by the use of the optical urethrotome. However, there remains a group of patients with recurrent strictures for whom the alternatives remain long‐term dilatation/urethrotomy or urethroplasty.

Over the last 3 years we have treated 65 such patients using clean intermittent self‐catheterisation as a method of self‐dilatation. This has resulted in a dramatic decrease in the number of operations performed on these patients, with no significant reduction in urinary flow rate over an average follow‐up period of 20 months.

The method offers the possibility of long‐term cure and should be offered to all such patients, reducing still further the number of patients who require urethroplasty.
Retrovesical Hydatid Causing Haemospermia
Authors: WHYMAN M. R. , MORRIS D. L.
Published: November 2008

Hydatid disease is relatively uncommon in the United Kingdom (approximately 50 new cases/year) and involvement of the urinary tract is rare.
Nephrogenic Adenoma of the Ureter
Authors: FERNANDEZ P. L. , NOGALES F. F. , ZULUAGA A.
Published: November 2008

Nephrogenic adenoma has been reported in the bladder, renal pelvis and urethra, but to date there have been only 5 reports of its occurrence in the ureter (Jakse and Mikuz, 1983; Lugo et al., 1983; Satodate et al., 1984; Marek and Hradec, 1985; Bernado et al., 1986). We present a further case of this lesion in this unusual location.
Clinical Patterns of Paediatric Urolithiasis
Authors: DIAMOND D. A.
Published: November 2008

Summary— A series of 270 paediatric stone patients was studied retrospectively according to the clinical pattern of urolithiasis (age and sex, stone location, stone analysis, recurrence rate) and aetiology of stone disease (infection, anatomical, metabolic or idiopathic). Infection stones occurred earliest and more commonly in males and were usually upper tract struvite calculi related to Proteus infection. Anatomical stones were most commonly associated with pelviureteric junction (PUJ) obstruction and had a high recurrence rate, despite surgical correction of obstruction. Idiopathic stones most resembled those found in adult urolithiasis by virtue of occurring latest, being sited in the ureter more often and being more frequently composed of calcium oxalate. Metabolic stones were most frequently calcium phosphate or cystine and virtually all were renal. They comprised the smallest group but had the highest recurrence rate.
Lumbar Nerve Root Compression and Interstitial Cystitis—Response to Decompressive Surgery
Authors: GILLESPIE LARRIAN , BRAY R. , LEVIN N. , DELAMARTER R.
Published: November 2008

Summary An identifiable lumbar nerve root compression appears to cause urological dysfunction consistent with interstitial cystitis. Ten patients (9 females, 1 male) were evaluated for chronic pelvic pain. Cystoscopic and histological appearances were consistent with a diagnosis of interstitial cystitis. Magnetic resonance studies of the lower spine consistently demonstrated a lateral compression of the L5 dorsal nerve root. Decompression of the lateral foramina of L5 resulted in immediate relief of pain in 9 patients, who have been followed up for 6 months without a recurrence. Possible mechanisms involving sympathetic dystrophy of the pelvic plexus are reviewed.
Role of Continent Suprapubic Diversion in Pelvic Cancer
Authors: GELISTER J. S. K. , WOODHOUSE C. R. J.
Published: November 2008

Summary Seventeen patients with either current (n = 14) or previous (n = 3) pelvic malignant disease underwent continent urinary diversion using the Mitrofanoff principle in 16 and a Kock pouch in 1. Eight patients had bladder carcinoma, 6 had gynaecological malignancy, 2 had rectal cancers and 1 had a squamous cell carcinoma of the perineum. Fourteen underwent synchronous exenterative surgery and continent suprapubic diversion; plastic reconstructive procedures were required in 4. There were 2 post‐operative deaths and 5 patients have developed further tumour recurrence. Continence was satisfactory in all patients with a median interval of intermittent self‐catheterisation of 4 h.
Carcinoma in situ as a Prognostic Factor for G3pT1 Bladder Tumours
Authors: VICENTE J. , LAGUNA M. P. , DUARTE D. , ALGABA F. , CHÉCHILE G.
Published: November 2008

Summary G3pT1 bladder cancer has traditionally been regarded as a superficial tumour with a high risk of progression. We have studied 37 patients with initial G3pT1 bladder tumours treated between January 1981 and December 1985. They were divided into 2 groups according to the association with carcinoma in situ (Cis) at the time of diagnosis.

Clinical behaviour was analysed at 5 years. The first group (without Cis) showed progression and recurrence rates similar to those of low grade, low stage bladder tumours. The second group (with Cis) had a similar rate of recurrence but their progression rate was 65%.
Late Complications of Prostakath Treatment for Benign Prostatic Hypertrophy
Authors: ROSENKILDE P. , PEDERSEN J. F. , MEYHOFF H.‐H.
Published: November 2008

Summary The self‐retaining intra‐urethral device “Prostakath” was inserted in a consecutive series of 29 men with obstructive benign prostatic hypertrophy.

Fifteen patients were relieved of prostatic symptoms for an observation period of 22 weeks (range 2–60). The spiral was removed in 14 cases (48%) at an average of 14 weeks (range 1–82) after insertion; in 9 patients this was because of urinary retention and in 5 it followed dislocation of the stent into the bladder. Five stents removed after 44 weeks of treatment (range 21–82) were severely calcified. Light microscopic investigation of the Spirals that were removed revealed no damage to the gold‐plated surface. All patients with calcification had chronic urinary infection resistant to antibiotic treatment. We believe that infected urine is the major factor responsible for the calcification. We suggest that patients with recurrent urinary infection after insertion of the Prostakath should be closely followed up and checked for stone formation by a plain X‐ray of the bladder region. It may be advisable to change the Prostakath in patients with resistant urinary tract infection at 6‐monthly intervals.
Calculation of Irrigant Absorption by Measurement of Breath Alcohol Level during Transurethral Resection of the Prostate
Authors: HAHN R. G.
Published: November 2008

Summary If ethanol is added to the irrigant used in transurethral resection of the prostate, absorption of the fluid can be immediately detected by measuring the ethanol concentration in the expired breath. During 90 resections where the irrigant contained 1.5% glycine and 1% ethanol, the breath alocohol level was compared with the amount of irrigant absorbed as determined by volumetric measurement. The results showed that the expired‐breath ethanol level depended not only on the volume of irrigant absorbed but also on the rate of ethanol diffusion in the total body water, which increased with the ethanol concentration. By applying a derived mathematical model the absorption could be estimated from the breath alcohol level at any time during surgery, with a median deviation of 19% from the measured value.
Gluteal Device for Penile Injection
Authors: HELMY A. M.
Published: November 2008

Summary Locally acting vasodilator drugs have been used in the treatment of male impotence. Self injection, which may be most suitable in these circumstances, often presents difficulties. An implantable device was therefore used to make self injection possible for a wider selection of patients and 37 have now been treated successfully between January 1987 and September 1988.
A Comparison of Aspiration, Antazoline Sclerotherapy and Surgery in the Treatment of Hydrocele
Authors: ROOSEN J. U. , LARSEN T. , IVERSEN E. , BERG J. B. S.
Published: November 2008

Summary Of 98 hydroceles (mean volume 125 ml) in a consecutive series of 92 patients, treated initially by aspiration, 14% (mean volume 70 ml) were cured.

The 76 recurring hydroceles (mean volume 146 ml) were then randomised to either antazoline sclerotherapy on an out‐patient basis or surgery. Cure rates were 89 and 100%, respectively, at follow‐up 6 months later. Operated patients were admitted for a mean duration of 2.5 days.

The results indicated that aspiration alone was inadequate, and sclerotherapy is advocated as the first choice of treatment for hydrocele.
Subtrigonal Phenol Injection. How Safe and Effective is it?
Authors: CHAPPLE C. R. , HAMPSON S. J. , TURNER‐WARWICK R. T. , WORTH P. H. L.
Published: November 2008

Summary A series of 24 patients underwent 27 transtrigonal phenol injections for the treatment of bladder instability. Only 2 of 18 patients with detrusor instability and 2 of 6 with detrusor hyper‐reflexia continued to derive benefit from the procedure 6 months after it was carried out. Serious complications attributable to phenol were seen in 2 patients in this series and in a further 4 patients referred for complications resulting from this therapy in other centres. These results and a review of the literature lead us to suggest that transvesical phenol injection should not be used except in the hyper‐reflexic bladder when no alternative treatment is possible. Particular care should be exercised in patients who have undergone extensive prior surgery or radiotherapy.
How Effective is Topical Alpha‐2b Interferon in Preventing Recurrence of Superficial Bladder Cancer?
Authors: HOELTL W. , HASUN R. , ALBRECHT W. , MARBERGER M.
Published: November 2008

Summary A total of 44 patients with low and intermediate grade superficial urothelial bladder cancer Ta and T1 were randomised into a controlled, long‐term, phase III trial on topical instillation therapy with high dosealpha‐2b interferon (100 × 106 IU versus low dose alpha‐2b interferon (10 × 106 IU) versus ethoglucid. Thirteen patients in the low dose group, 11 in the high dose group and 10 in the ethoglucid group completing the trial were evaluable (median follow‐up 36.5 months) and were followed up for 3 years. They were treated weekly for 10 weeks and then monthly for a total of 1 year. The aim of the trial was to establish the prophylactic efficacy and the toxic side effects, if any, of alpha‐2b interferon in the topical treatment of superficial bladder cancer. Recurrence rate and disease‐free survival were chosen as study end‐points. The recurrence rate was 4.4 in the low dose interferon group, 2.76 in the high dose interferon group and 3.08 in the ethoglucid group. In the low dose interferon group the time to the first recurrence was 22.23 months versus 22.36 in the high dose group and 21.76 months in the ethoglucid group. No differences of statistical significance were noted between the 3 groups. Progression occurred in 5 patients on interferon but was not seen in those on ethoglucid. Neither systemic nor local side effects were seen in the interferon groups, but 3 patients had to be taken off ethoglucid because of severe chemocystitis. In superficial bladder cancer, topical instillation therapy with interferon is as effective as conventional chemotherapy and has no side effects.
The Role of Colour Duplex Ultrasonography in the Diagnosis of Vasculogenic Impotence
Authors: PICKARD R. S. , OATES C. P. , SETHIA K. K. , POWELL P. H.
Published: November 2008

Summary Colour duplex ultrasonography was used to obtain peak systolic velocity (PSV) readings from cavemosal arteries at rest and during papaverine‐induced tumescence. Results from 31 men with vasculogenic impotence were compared with those from 17 men with non‐vasculogenic impotence and a control group of 6 potent men.

In the flaccid state no significant differences in PSV readings were found between the vasculogenic and control groups. Following the injection of papaverine, men from the vasculogenic group without venous leakage were alone in having significantly lower PSV readings compared with the potent controls.

All 23 men with normal penile haemodynamics had a mean PSV ≥ 20 cm/s during tumescence. This was also the case for 19 (61%) of the vasculogenic group, including 9 (69%) of the 13 patients with venous leakage. The remaining 12 men in the vasculogenic group (39%) had a mean PSV <20 cm/s, this being diagnostic of an inadequate arterial inflow.

Colour duplex ultrasonography can identify patients who have marked arterial insufficiency as the major cause of their impotence and hence allows more rational selection for angiography and revascularisation. Lesser degrees of arterial deficit are difficult to characterise using mean PSV readings alone.
Bladder Augmentation and Replacement
Authors: ROBERTSON A. S. , DAVIES J. B. , WEBB R. J. , NEAL D. E.
Published: November 2008

Summary— Bladder augmentation has a role in the management of patients with neuropathic bladder dysfunction and in urinary undiversion. Several reports attest to its clinical value, but there have been few detailed urodynamic studies of its effects. We have carried out a prospective review over a 4‐year period of 25 patients undergoing bladder augmentation or substitution assessed by conventional and ambulatory urodynamic studies. All patients had a detubularised reservoir made of ileum in 6, and of the ileocaecal segment in the remainder. Six patients also had an artificial sphincter fitted and 2 underwent colposuspension.

There was no mortality. After operation, bladder capacity increased from 122 ± 91 ml to 659 ± 431 ml and there were significant decreases in the pressure rise during filling and increases in bladder compliance. Hyper‐reflexia was present in 74% before operation and 23% after operation. Regular phasic activity was observed in 77% of patients at the end of filling after operation, probably due to bowel activity despite detubularisation. Four patients described urge incontinence associated with this activity.

After operation, one man had persistent major stress incontinence. He has since undergone insertion of an artificial urinary sphincter (AUS) and is now completely dry. Of the remainder, 10 patients had minor, infrequent defects in continence, 9 patients with leakage when the bladder was full and 4 with occasional leakage at night. With the exception of the patient with major stress incontinence, all but one felt the operation had been worthwhile—40% reporting complete success and 52% excellent improvement. Reconstruction of the neuropathic lower urinary tract is a major surgical procedure, but the final clinical outcome is very satisfactory.
Effect of Catheter Material on the Incidence of Urethral Strictures
Authors: ROBERTSON G. S. M. , EVERITT N. , BURTON P. R. , FLYNN J. T.
Published: November 2008

Summary— The aetiology of urethral strictures in patients catheterised for short periods at the time of surgery is the subject of some debate. The occurrence of epidemics of strictures associated with certain batches of latex catheters, and the demonstrable in vitro cytotoxicity of latex in general, have supported the suggestion that catheter material (and in particular latex) has an important role.

We have looked retrospectively at 299 patients undergoing transurethral resection of the prostate gland by 1 urologist, 135 of whom had a latex catheter and 164 a plastic one; 19 patients developed strictures over the next 12 months with no proven difference attributable to the catheter material.

The study provides no evidence that the short‐term use of latex catheters is associated with stricture formation.
Urethral Calculi Caused by Cholestyramine
Authors: COURTNEY S. P. , WIGHTMAN J. A. K.
Published: November 2008

We report a case of spontaneous passage of urinary tract calculi caused by the treatment of hypercho‐lesterolaemia with cholestyramine, which has not previously been implicated in the development of urinary tract calculi.
Unusual Hyperechoic Appearance of Prostate Cancer on Transrectal Ultrasonography
Authors: EGAWA S. , WHEELER T. M. , GREENE D. R. , SCARDINO P. T.
Published: November 2008

A series of 157 patients with prostate cancer underwent transrectal ultrasonography prior to radical prostatectomy. In 112 patients (71.3%) the tumours appeared hypoechoic relative to the echo pattern of the normal peripheral zone; in 43 (27.4%) they appeared isoechoic, and in only 2 (1.3%) did they appear purely or predominantly hyperechoic. These 2 hyperechoic tumours were unusual ductal adenocarcinomas with central necrosis and dystrophic calcification within solid tumour nests, a pattern similar to that of comedo‐carcinoma of the breast. Calcification within prostate cancer was found in 4 of the 157 radical prostatectomy specimens, including 2 other hypoechoic cancers which contained intraluminal or psammomatous calcification. Although the most common sonographic appearance of localised prostate cancer is hypoechoic, a predominantly hyperechoic pattern is seen occasionally and suggests the presence of a high grade ductal adenocarcinoma.
Renal Carcinoma in Patients Undergoing Nephrectomy: Analysis of Survival and Prognostic Factors
Authors: SENE A. P. , HUNT L. , McMAHON R. F. T. , CARROLL R. N. P.
Published: November 2008

Summary— A series of 155 patients who underwent nephrectomy for renal carcinoma between 1965 and 1985 at Manchester Royal Infirmary were analysed for survival in relationship to presenting features, surgical staging and histopathology. Univariate and multivariate analyses were carried out. Five‐year survival estimates for stage 1 disease were 81%, for stage 2 disease 65%, for stage 3 disease 39% and for stage 4 disease 6%. An erythrocyte sedimentation rate (ESR) greater than 30 mm/h was associated with worse survival and a history of hypertension was associated with better survival. Renal vein invasion alone was related to worse survival. Perinephric fat invasion was also associated with worse survival and this association in the multivariate analysis was more significant than expected, suggesting that the principles of radical surgery should be observed. The presence of granular cells as opposed to clear cells worsened survival. Patients with papillary tumours had a better survival than those with solid tumours.
Blood Transfusion and Survival Following Surgery for Renal Carcinoma
Authors: EDNA T.‐H. , VADA K. , HESSELBERG F. , MJØLNERØD O. K.
Published: November 2008

Summary— The effect of peri‐operative blood transfusion on survival after surgery for renal carcinoma was studied in 201 patients. In addition to blood transfusion, several other factors were included in a multivariate analysis. Using Cox's proportional hazards model, transfusion of more than 4 units of blood was found to be an independent prognostic factor in addition to tumour stage, erythrocyte sedimentation rate and macrohaematuria.
Voiding Dysfunction and Urodynamic Findings in Patients with Cervical Spondylotic Spinal Stenosis Compared with Severity of the Disease
Authors: TAMMELA T. L. J. , HEISKARI M. J. , LUKKARINEN O. A.
Published: November 2008

Summary— A group of 30 consecutive patients (26 men and 4 women, mean age 51 years), with clinically and radiologically verified cervical spondylosis causing radiculopathy and/or myelopathy, were questioned about voiding symptoms, examined urodynamically and subjected to tests of tibial somatosensory evoked potentials (SEP). Seventeen patients (61%) complained of irritative bladder symptoms and detrusor hyperactivity was demonstrated urodynamically in 13 (46%). Three (11%) experienced difficulty in emptying the bladder, and all of these had a hypotonic detrusor. The bladder was insensitive to cold in 36%, this and SEP abnormalities being more common in the patients with clinically severe myelopathy, whereas detrusor hyperactivity was found equally in all patients. Urodynamic investigation seems to provide additional information on the severity of the disease and is therefore recommended for wider use in these patients.
Intravesical Instillation of Beta‐Interferon in the Treatment of Bladder Cancer
Authors: MIGLIARP R. , DEMIRY M. EL , MUSCAS G. , USAI E.
Published: November 2008

Summary— A total of 36 patients with single superficial bladder cancer TNM stage Ta‐T1/G2 was studied over a 24‐month period before entering the study to evaluate the efficacy and tolerance of high doses of beta‐interferon (beta‐INF); 24 patients had a primary tumour (group 1)and 12 had had more than 3 recurrences (group 2). They received 8 intravesical doses of beta‐INF, 50,000,000 IU in 50 ml sterile water, at weekly intervals, 15 days after transurethral resection of the bladder (TURB).

Efficacy was estimated by simple recurrence rate and by the person‐years method. The recurrence rate was 25% in group 1 with a mean follow‐up of 21.6 months. Comparison with the recurrence rate of a historical control group treated only by TU R showed that there was a slight statistically significant difference. Group 2 had a recurrence rate of 100% in the period before beta‐INF (follow‐up 24 months) and 91% after INF administration (mean follow‐up 20.5 months).

Patients were questioned about side effects before and after each treatment; tolerance of the drug was excellent. The results suggest that beta‐interferon could be safely used as a prophylactic agent against the recurrence of primary superficial bladder cancer. Its efficacy seems comparable to that obtained with other current chemoprophylactic agents.
Localised Deep Microwave Hyperthermia in the Treatment of Benign Prostatic Hyperplasia: Long‐term Assessment
Authors: YERUSHALMI A. , SINGER D. , KATSNELSON R. , LEVY E. , SHANI A.
Published: November 2008

Summary— A group of 133 patients with benign prostatic hyperplasia who were either poor operative risks or who had refused surgery underwent localised deep microwave hyperthermia, without supplementary drugs. In 59% of patients who had had an indwelling catheter, freedom from urological obstruction and satisfactory voiding were maintained for 7 years and catheterisation was not required. In patients with severe prostatic symptoms, 65% showed general improvement and satisfactory voiding for 8 years.

There were no side effects. Patients who relapsed were given a second course of treatment and 75% responded positively.

This positive response and the lack of side effects suggest that localised deep microwave hyperthermia may be an effective alternative to surgery in the management of high risk patients and those who are reluctant to undergo surgery.
Adult Wilms' Tumour: Review of 14 Patients
Authors: WILLIAMS GRANT , COLBECK R. A. , BOWING N. F. C.
Published: November 2008

Summary— Wilms' tumour, or nephroblastoma, is the commonest renal neoplasm found in children, but is rarely found in adults, the world literature recording only approximately 200 cases. Individual case reports continue to be published but only within the last 10 years have definitive treatment regimes been suggested. In order to determine the UK experience of adult Wilms' tumour, members of the British Association of Urological Surgeons were circulated with a questionnaire, and from 141 replies, 13 members reported 17 cases. Critical review of the original histology slides excluded 3 of these; the 14 remaining cases are described and their management discussed in the light of current recommended treatment.
Outcome in Carcinoma in situ of Bladder Treated with Intravesical Bacille Calmette‐Guérin
Authors: HARLAND S. J. , CHARIG C. R. , HIGHMAN W. , PARKINSON M. C. , RIDDLE P. R.
Published: November 2008

Summary— Fifty‐three patients with carcinoma in situ of the bladder were treated with Evans strain BCG given intravesically. Complete remission was achieved after either one or two 6‐weekly courses in 53% of patients. The median duration of remission was 32 months. Treatment‐related bladder symptoms were minor during the first course, more severe during the second. There was no relation between severity of symptoms and likelihood of response. With a median follow‐up of 32 months, disease progression has occurred in 10% of complete responders, whereas failure to respond on either cystoscopic, histological or cytological grounds was associated with a 48% progression rate. Although intravesical BCG produces impressive responses in carcinoma in situ of the bladder, managed conservatively the condition remains a dangerous one.
The Open Access Continence Resource Centre for Greater Glasgow Health Board
Authors: MORRISON L. M. , GLEN E. S. , CHERRY L. C. , DAWES H. A.
Published: November 2008

Summary— The development of an open access Continence Resource Centre is described. The role of the Centre in helping the sufferers and carers is highlighted. The educational role exceeded expectations. The benefits of the centre in education, research and potential cost saving are discussed. The aims and achievements are in accord with the Department of Health document “An Agenda for Action on Continence”. From its opening in August 1989 to the end of February 1992 the centre has served 8070 incontinent individuals and 4736 carers. At a cost of £44,000 per annum this represents good value for money.
Outcome and Prognostic Factors in Patients with Advanced Prostate Cancer and Obstructive Uropathy
Authors: SANDHU D. P. S. , MAYOR P. E. , SAMBROOK P. A. , GEORGE N. J. R.
Published: November 2008

Summary— a series of 51 patients with prostate cancer and obstructive uropathy, unilateral or bilateral obstruction was identified in 22 (43%) and 29 (57%) respectively. This included a non‐functioning kidney in 12 patients. In 86% of patients the T category was advanced. Bone metastases were present in 36 cases (7 1%); 19 patients (37%) had chronic retention. All patients with metastatic disease underwent hormonal manipulation and 43 underwent transurethral resection of the prostate. External beam radiotherapy, percutaneous nephrostomy and ureteric reimplantation were performed in 4,5 and 1 patient respectively. non‐function did not predict a worse prognosis in comparison with patients with unilateral hydroureteronephrosis. Raised alkaline phosphatase and prostatic acid phosphatase were of no prognostic value, while creatinine reached marginal significance. A positive bone scan and raised urea were strongly predictive of a poor outlook. It was concluded that prostate cancer and obstructive uropathy should not uniformly imply a terminal event, and interventional therapy is justified with a 25% 5‐year survival rate.

Actuarial survival of all 51 patients was 57 and 25% at 2 and 5 years. Presentation with bilateral or non‐function did not predict a worse prognosis in comparison with patients with unilateral hydroureteronephrosis. Raised alkaline phosphatase and prostatic acid phosphatase were of no prognostic value, while creatinine reached marginal significance. A positive bone scan and raised urea were strongly predictive of a poor outlook. It was concluded that prostate cancer and obstructive uropathy should not uniformly imply a terminal event, and interventional therapy is justified with a 25% 5‐year survival rate.
Extracorporeal Lithotripsy of Ureteric Calculi Using the Dornier HM‐3 Lithotriptor
Authors: BENIZRI E. , AUGUSTI M. , AZOULAI G. , CHARBIT L. , CUKIER J.
Published: November 2008

Summary Over a 5‐year period (November 1984 November 1989), we treated 356 patients with ureteric calculi; 170 were treated by extracorporeal shock wave lithotripsy (ESWL) on a Dornier HM‐3 lithotriptor. The calculi (n = 176) were uniformly distributed along the length of the ureter: 44 were just below the periureteric junction, 59 were lumbo‐iliac, 42 were in the upper bony pelvis and 32 in the lower bony pelvis. The mean diameter of the upper ureteric calculi was 10 mm and for the others it was 8 mm. Thirty‐four patients with acute obstructive pyelonephritis required pre‐ESWL drainage of the urine. X‐ray localisation required intraveneous urography during lithotripsy in 52 cases (30%). On plain X‐ray the following day 170 stones (96%) were judged to have disintegrated. The 6 patients whose stones were not fragmented received further treatment (ureterotomy (4) and ureteroscopy (2)). Five patients required additional treatment because of pain or fever (catheterisation (3) and ureterotomy (2)) and 2 patients had a second lithotripsy owing to insufficient fragmentation. Four patients were lost to follow‐up.

In 153 patients (90%) the fragments were eliminated completely, 146 in the first month and the remainder before the sixth month. No serious sequelae were observed. In addition to the 5 patients who required supplementary treatment. 11 patients with pain or fever needed medical treatment. We recommend first intention in situ ESWL for all ureteric calculi.
Morphological Effects of Photodynamic Therapy on Rabbit Bladder Using Photofrin II and Photosan Intravesically and Intravenously
Authors: TAARI K. , TALJA M. , RIIHELÄ M. , RANNIKKO S. , MOKKA R.
Published: November 2008

Summary Photodynamic therapy (PDT) has proved effective against superficial papillary bladder tumours and focal and diffuse carcinoma in situ. Effective topical administration of the sensitiser would be a welcome improvement.

The morphological effects of PDT on the normal bladder were examined in 13 rabbits when 2 photosensitisers (Photofrin II and Photosan III) were applied intravesically (5 mg/kg for 1 h) and compared with intravenous administration (3 or 5 mg/kg). Four animals served as controls without a sensitiser. Intravesical red light (630 nm) from an argon dye laser was used to activate the photosensitiser, using light doses of 12 or 24 J/cm2. The animals were sacrified either 1 or 5 to 7 days after the laser treatment.

Intravenous dosage induced bladder wall oedema/haemorrhage and total necrosis of the epithelium. There was no difference between the effects of the 2 sensitisers. Intravesical application induced superficial epithelial necrosis. The control animals treated with laser light alone showed slight superficial injury to the cell layer.
Prognostic Correlation of Morphometric Values with Survival in Invasive Transitional Cell Carcinoma of the Bladder
Authors: PORTILLO J. A. , VAL‐BERNAL J. F. , GARIJO M. F. , BUELTA L. , GUTIÉRREZ J. L.
Published: November 2008

Summary A morphometric study was made of 95 invasive bladder tumours, differentiating 34 papillary and 61 solid carcinomas. In the invasive papillary tumours, the deeper the zone of the tumour measured, the higher the value of the mean nuclear area. A higher histological grade was also seen to correspond to a higher mean nuclear area value except for Grade IV tumours, whose nuclear area was no larger than that for Grade III tumours. This led us to separate Grade IV tumours from transitional cell carcinomas and classify them as undifferentiated. A better prognosis was found for those tumours whose mean nuclear area was ≤ 30 μm2 in category T2. For T3 and T4A tumours no conclusive results were obtained in this respect.
Phase II Study of Epirubicin in Advanced Hormone‐resistant Prostatic Carcinoma
Authors: DELAERE K. P. J. , LELIEFELD H. , PEULEN F. , STAPPER E. W. , SMEETS J. , WILS J.
Published: November 2008

Summary Twenty‐nine patients with metastatic prostate cancer that had progressed following orchiectomy were treated with intravenous epirubicin 90 mg/m2 every 28 days. Their median age was 71 years (range 49–78) and the median Zubrod scale (WHO score) was 1. Two patients had soft tissue lesions, 20 had bone metastases and 7 had both. Tumour response was assessed according to the National Prostatic Cancer Project criteria. Of 29 patients, 11 (38%) achieved a partial remission. The median duration of response was 6 months and the median survival time of all patients was 9 months (range 2–27). It seemed that treatment with epirubicin was not associated with an increase in survival. Toxicity was moderate and consisted of alopecia and mild nausea/ vomiting. There was no significant haematological toxicity and no clinical cardiotoxicity. It was concluded that epirubicin was active in hormone‐resistant metastatic prostate cancer in approximately 33% of the patients.
A New Vacuum Device as Alternative Treatment for Impotence
Authors: ALOUI R. , IWAZ J. , KOKKIDIS M. J. , LAVOISIER P.
Published: November 2008

Summary Vacuum erection devices are an acceptable alternative for the management of erectile dysfunction. The safety of such devices has been questioned because of their effects on penile blood flow. We report the use of Doppler ultrasonography to assess arterial flow and its value in ensuring long‐term safety of a new external vacuum device. Sixteen patients were studied. At 3 months it was possible to confirm the efficacy and safety of the method and model in 14 patients, 12 of whom had a significant improvement in their sexual function. By 10 months, only 6 were continuing to use the device. Doppler sonography appears to be an effective technique for assessing penile blood flow during restriction from a vacuum device. The new vacuum device provides a satisfactory short‐term alternative to other more invasive forms of therapy.
Testicular Cancer and Cryptorchidism
Authors: ABRATT R. P. , REDDI V. B. , SAREMBOCK L. A.
Published: November 2008

Summary The records of 273 patients with germ cell tumours of the testis referred between 1970 and July 1991 were reviewed. There were 25 (9%) black, 40 (14%) mixed race and 214 (77%) white patients. Histology showed seminoma in 53% and non‐seminomatous and germ cell tumours in 47% of patients. Maldescent of the testis (MDT) was found in 30 patients–an incidence of 11% overall. MDT was present in 8 of 25 (32%) black, 7 of 40 (18%) mixed race and 15 of 214 (7%) white patients with testicular cancer. The incidence of MDT was statistically significantly higher in both black and mixed race patients compared with white patients. None of the black patients had undergone orchiopexy but 71% of mixed race and 87% of white patients had done so. This resulted in a different pattern of presentation in black compared with mixed race and white patients with MDT and testicular cancer. The mean age was 40 years for black, 32 years for mixed race and 33 years for white patients. Black patients presented with abdominal or inguinal tumours rather than scrotal tumours and they had an increased tendency to present with seminomas.
Wilms' Tumour in New Zealand 1960–1986
Authors: DELAHUNT B. , BETHWAITE P. B. , NACEY J. N. , LEWIS M. E. , FRASER J.
Published: November 2008

Summary Between 1960 and 1986, 177 cases of Wilms' tumour were reported to the New Zealand National Cancer Registry. There was an equal sex distribution and 93.2% of patients were in the paediatric age group with a mean age of 3.4 years. The mean symptom interval was 2.0 months and the majority of patients presented with localised disease, although the incidence of advanced disease was greater than that reported from other series. The 5‐year survival rate for all cases was 52.5%. Data were divided into patients presenting before and after the publication of the first National Wilms'Tumour Study (NWTS) in the United States in 1976. In patients presenting after 1976 the diagnosis was based on histology in 100%, compared to 58.6% in patients before 1977. Treatment was considered curative in a greater proportion of the post‐1976 group. Treatment modalities reflected the recommendations of the NWTS and the 5‐year survival rate of this group was 78.3%, this being similar to that reported from the NWTS. Multivariate analysis showed patient age, symptom interval, tumour stage and treatment (pre‐ and post‐NWTS) to be independent predictors of survival.
Epispadias Surgery–Belgrade Experience
Authors: PEROVlC̀ S. , ŠČEPANOVIC̀ D. , SREMČEVIC̀ D. , VUKADINOVIC̀ V.
Published: November 2008

Summary From 1987 to 1991,46 patients underwent surgical treatment for epispadias. Of these, 14 had isolated epispadias and 22 had epispadias within the exstrophy/epispadias complex. The patients ranged in age from 6 months to 20 years. To correct the genital aspect of the anomaly the basic principles of Ransley's technique were used. In addition, the island flap technique was used for the most severe, so‐called “cripple” form. In patients with exstrophy/epispadias complex, only elongation of the penis was performed during primary reconstruction, while the correction of epispadias, using the above techniques, was performed in the second‐stage operation. Complications occurred in 6 patients.
Postsurgical Management of the Patient Undergoing Radical Prostatectomy
Authors: SOLE‐BALCELLS F. , VILLAVICENCIO H. , ORTIZ A.
Published: November 2008

Summary— Radical prostatectomy is a useful procedure for the treatment of prostate cancer limited to the gland; however, failure may occur as a result of the immediate or delayed complications of surgery, or to disease recurrence related to incomplete tumour excision. Seventy‐nine radical prostatectomies were performed between April 1985 and August 1991 in patients with prostate cancer (primarily stage B1) who averaged 63 years of age. Immediate post‐operative complications included vesicocutaneous fistulae, cystic lymphangiomas, abdominal wall abscesses, extraperitoneal haematoma, acute cholecystitis, and enterocutaneous fistula. Massive pulmonary embolism accounted for 2 deaths. Of the 77 surviving patients followed up for an average of 34 months, 79.2% (61) were continent, 15.6% had stress‐related incontinence or severe incontinence and 5.2% were lost to follow‐up. Sexual potency was preserved in 13 of the 33 patients (39%) who were pre‐operatively potent. A favourable outcome as defined by no recurrence was seen in 69 patients (87.3%). Four patients (5.1%) are living with recurring prostatic cancer and 1 patient has died of the disease 46 months after surgery.
Detrusor Mast Cells in Refractory Idiopathic Instability
Authors: MOORE KATE H. , NICKSON P. , RICHMOND D. H. , SUTHERST J. R. , MANASSE P. R. , HELLIWELL T. R.
Published: November 2008

Summary— The diagnosis of interstitial cystitis (IC) is not usually considered in patients with idiopathic instability. Because histamine provokes detrusor contractions in vitro, we assessed detrusor mast cell counts in 29 females with refractory instability. Raised mast cell counts (> 28/mm2 of detrusor muscle, consistent with a histological diagnosis of IC) were found in 29% of such cases. Thus cystoscopy and bladder biopsy should be considered in patients with idiopathic instability which fails to respond to anticholinergic drugs, as alternative therapy may be useful.

Patients with refractory instability and normal detrusor mast cell counts often gave a history of prolonged childhood nocturnal enuresis (55% of cases); in contrast, patients with intractable instability and abnormally high mast cell counts seldom gave such a history (12%). These trends may give some insight into the aetiology of idiopathic instability—“congenital” or acquired?
The Effect of Ranitidine on Urine Mucus Concentration in Patients with Enterocystoplasty
Authors: GEORGE V. K. , GEE J. M. , WORTLEY M. I. , STOTT M. , GACHES C. G. C. , ASHKEN M. H.
Published: November 2008

Summary— We describe the effect of ranitidine in reducing mucus in urine in 8 patients with enterocystoplasty and present a simple technique for measuring the concentration of mucus in urine. After a 10‐day course of ranitidine (300 mg daily in divided doses) the concentration of mucus had fallen significantly from an initial level of 1.38 ± 0.18 to 0.39 ± 0.04 mg/ml.

Based on a Poster Demonstration at the 47th Annual Meeting of the British Association of Urological Surgeons in Glasgow, June 1991
Bladder Cancer Mortality in the Netherlands, 1955–1988
Authors: KIEMENEY L. A. L. M. , VERBEEK A. L. M. , NELEMANS P. J. , WITJES J. A. , STRAATMAN H.
Published: November 2008

Summary— In 1955, 234 men and 116 women died from bladder cancer in the Netherlands. In 1988 the numbers were 794 and 317 respectively. After adjusting for the ageing of the Dutch population since 1955, female mortality rates per 105 person‐years appear to be very stable: 2.9 from 1955 to 1959 and 3.0 from 1985 to 1988. By contrast, an increasing trend exists in males. From 1955 to 1959 and from 1985 to 1988, bladder cancer mortality rates per 105 person‐years were 7.5 and 12.4 respectively. For men in particular, increasing mortality (and incidence) rates are seen all over the world. In many cases this increasing trend is thought to originate from a higher risk of dying from bladder cancer in successive birth cohorts rather than from a higher risk in successive calendar periods. This so‐called cohort effect is explained by changes in smoking behaviour in the male population.

Statistical modelling of bladder cancer mortality data from 1955 to 1988 in the Netherlands shows that the increasing temporal trend in men can also be described as a cohort effect. The risk of dying from bladder cancer increases from the 1875 birth cohort to the 1910 birth cohort, but decreases thereafter. It is concluded that this decreasing risk for generations born after 1910 will probably result in a decreasing trend in mortality in the near future, when more and more of these “youngsters” reach the age of 70+.