bluuebunny/crossref_metadata_2025 huggingface dataset:
The Clinical Presentation of Chlamydia trachomatis in a Urological Practice
Authors: GRANT J. B. F. , BROOMAN P. J.C. , CHOWDHURY S. D. , SEQUEIRA P. , BLACKLOCK N. J.
Published: November 2008

Summary— Fifty‐nine men with Chlamydia trachomatis (CT) infection have been studied. Epididymitis was the most common presentation (26) compared with urethritis (8) and prostatitis (9). Only 13 patients gave a history of a urethral discharge. Fifteen of 21 female consorts screened were CT positive and 13 of these were asymptomatic. This demonstrates the major aetiological role of CT in lower genitourinary infection and indicates the importance of screening and treating consorts.
Urinary Infection in Adult Men: a Laboratory Perspective
Authors: CLARKE MINA , PEAD LINDA , MASKELL ROSALIND
Published: November 2008

Summary— During a 1O‐week period all mid‐stream urine specimens from males aged 15 years and upwards, excluding hospital in‐patients, with symptoms suggesting urinary tract infection were examined by techniques capable of detecting aerobes and fastidious organisms. Five hundred and eighty‐five such specimens were received; 85% were sent by general practitioners and 182 were from men aged less than 45 years, indicating that urinary symptoms are commoner in young men than is usually believed and that diagnosis and treatment are usually undertaken by general practitioners. One hundred and seventy‐nine specimens yielded aerobic pathogens and 140 yielded fastidious organisms; 70% of the former and 33% of the latter showed pyuria. Only 12% of the 196 specimens showing pyuria yielded a negative culture. The possibility of prostatic infection and its relevance to treatment are discussed. Some post‐treatment data are presented.
DNA Content of Human Semen‐an Objective Measurement of Sperm Density
Authors: BADENOCH D. F. , FOWLER C. G. , EVANS P. R. , LOWREY P. A.
Published: November 2008

Summary— In this study we have adapted a well tried and sensitive fluorometric assay for DNA that uses m‐diamino benzoic acid (DABA) for its reaction with deoxyribose which is cleaved by perchloric acid from DNA. We have confirmed that this is easily measured in human semen. The method has been used on 200 samples of semen from patients attending the Infertility Clinic and men attending before and after vasectomy to give a wide range of sperm density. The objective DNA estimation has been compared with sperm density measurement made by an experienced laboratory observer using the Makler chamber and making his observations in ignorance of the DNA estimations. There was good correlation between DNA concentration and sperm density. The experimental accuracy of the two methods was found to be comparable. The advantage of the method is its objectivity. However, its disadvantages are its cost in terms of time and material and it cannot be used to confirm post‐vasectomy azoospermia because the method also measures DNA in leucocytes.
Clinical Evaluation of the Heterologous Oocyte Penetration (HOP) Test
Authors: SUTHERLAND P. O. , MATSON P. L. , MOORE H. D. M. , GOSWAMY R. , PARSONS J. H. , VAID P. , PRYOR J. P.
Published: November 2008

Summary— The heterologous oocyte penetration (HOP) test, using zona‐free hamster oocytes, was used to assess the fertilising capacity of human spermatozoa. There was good correlation between the ability of ejaculated spermatozoa to penetrate the zona‐free hamster oocytes and intact human oocytes. Using epididymal spermatozoa, the HOP test results showed that the ability to penetrate oocytes was acquired during their passage through the epididymis. Applied clinically, the HOP test enables a group of infertile men to be identified with a functional defect of their spermatozoa; these men may not be identified at routine seminal fluid analysis. Men with two negative HOP test results were confirmed as being infertile since their wives, if normal, conceived rapidly when donor spermatozoa were artificially inseminated.
Primary Malignant Lymphoma of the Bladder
Authors: GUPTA D. R. , GILMOUR A. M. , WARD J. P.
Published: November 2008

Malignant lymphoma arising in the bladder is one of the rarest extranodal lymphomas. A new case is reported and the literature reviewed.
Urodynamic Changes Following Removal of a Large Ovarian Cyst
Authors: ORMISTON M. C. E. , OSBORNE J. L. , MILROY E. J. G.
Published: November 2008

We describe the case of a young woman who presented with recurrent episodes of acute urinary retention due to a large ovarian cyst. She was found to have detrusor instability and vesical diverticula. Following removal of the cyst, the urodynamic behaviour and radiological appearance of her bladder returned to normal.
Unilateral Renal Cortical Necrosis
Authors: BLUTE M. L. , TEMPLETON A. C.
Published: November 2008

Renal cortical necrosis is a result of failure of perfusion. Most of the 400 cases reported to date are bilateral and occur in pregnancy. Only nine cases of unilateral necrosis are reported, of which seven showed obstruction of the ureter on the protected side and the remainder showed renal artery stenosis on the protected side. In this patient neither of these two features was present, but the protected kidney contained a tubular carcinoma.
Relationship of Stone Growth and Urinary Biochemistry in Long‐term Follow‐up of Stone Patients with Idiopathic Hypercalciuria
Authors: MARICKAR Y. M. F. , ROSE G. ALAN
Published: November 2008

Summary— One hundred and twenty‐four male stone formers with idiopathic hypercalciuria were followed up for 4 to 27 years (mean 12.2). Twenty‐eight received restricted calcium diet alone, 52 also received bendrofluazide, 11 cellulose phosphate, and 33 received mixtures of those drugs. Although urinary calcium values fell in all groups, the stone recurrence rate remained unacceptably high. Patients on cellulose phospate fared worst and this drug seems unsatisfactory as a sole agent. Urinary calcium was highest in patients without stone recurrences, but in patients with stone activity a higher stone recurrence rate was associated with higher urinary calcium and lower urinary volume.
DNA/RNA Ratio in Bladder Cancer: a Factor Indicating the Recurrence Rate?
Authors: HADJISSOTIRIOU G. G. , GREEN D. K. , McINTYRE M. A. , HARGREAVE T. B. , CHISHOLM G. D.
Published: November 2008

Summary— Flow cytometry (FCM) was used to monitor 24 patients receiving intravesical mitomycin C (MMC) therapy. The patients were selected for MMC therapy because of multiple low stage bladder tumours which had not been cleared by previous endoscopic management. The response to treatment was monitored with cystoscopy, cytology, mucosal biopsies and flow cytometry.

Follow‐up was for a minimum of 12 months and 19 patients (79%) remained free of tumour. Four patients developed recurrences 6 months after therapy (16.5%) and one showed no response. There were no partial responders. The flow patterns of the four patients who developed recurrence showed an increased RNA/DNA ratio; this was detected after the third MMC instillation and remained throughout the follow‐up period. The patients who did not develop recurrence demonstrated either a 1:1 or decreased RNA/DNA ratio. The increased RNA/DNA ratio appears to precede cystoscopic, urine cytology or biopsy evidence of recurrence. If this is confirmed in a larger series it could be used to select patients at high risk for recurrence who would be suitable for alternative therapy.
The Effect of Intravesical Thiotepa on the Recurrence Rate of Newly Diagnosed Superficial Bladder Cancer. An MRC Study
Authors:   MRC WORKING PARTY ON UROLOGICAL CANCER, LONDON
Published: November 2008

Summary—Four hundred and seventeen patients with newly diagnosed superficial bladder tumours (Ta or T1) were treated with complete transurethral resection and then randomised between three groups. Group 1 had an instillation of 30 mg thiotepa at the time of primary treatment. Group 2 had instillations of thiotepa at 3‐monthly intervals for a year. Group 3 was given no instillation. Regular check cystoscopies revealed no significant difference in the rate at which tumours recurred in the three groups (p = 0.4 and P=0.7 for controlvsthiotepa given once and five times respectively). It was concluded that neither thiotepa regimen produced sufficient improvement to justify its use in this group of patients.
Generalised Increase in Bone Resorption in Carcinoma of the Prostate
Authors: URWIN G. H. , PERCIVAL R. C. , HARRIS S. , BENETON M. N. C. , WILLIAMS J. L. , KANIS J. A.
Published: November 2008

Summary— Several indirect biochemical indices of bone resorption are increased in patients with carcinoma of the prostate and skeletal metastases. We have examined histological indices of bone resorption in biopsies from affected patients. Bone‐forming surfaces and active osteoblast numbers were increased in skeletal sites adjacent to tumour tissue and indices of bone resorption were significantly increased at sites adjacent to tumour. Contrary to expectation, indices of bone resorption were also increased in bone distant from skeletal metastases. These findings suggest that prostatic cancer induces generalised loss of trabecular bone which may minimise disturbances in plasma calcium homeostasis but could contribute to morbidity.
Is Delayed Treatment Justified in Carcinoma of the Prostate?
Authors: PARKER M. C. , COOK A. , RIDDLE P. R. , FRYATT I. , O'SULLIVAN J. , SHEARER R. J.
Published: November 2008

Summary— We report a retrospective survey of 263 patients with prostate cancer presenting between 1975 and 1979, with a minimum follow‐up period of 5 years. We have evaluated the effects of anti‐cancer therapy on survival and disease‐free interval. The mean survival time of all patients was 39.6 months.

Of 91 patients (37.7%) with demonstrable bone metastases at presentation, 64 (70.3%) have died of prostatic cancer, the mean duration of survival being 25 months. There was no difference in terms of response to treatment or of duration of symptom‐free life between patients treated by immediate hormone manipulation and those in whom treatment was delayed.

Of 115 patients without metastases at presentation, 42 (36.5%) received no anti‐cancer treatment. Thirty‐seven (32.2%) have died of unrelated causes and 39 (33.9%) are alive and well.

Neither survival nor subjective response to treatment was adversely affected by delaying treatment.
Clinical Stage II Non‐seminomatous Germ Cell Testicular Tumours. Results of Management by Primary Chemotherapy
Authors: PECKHAM M. J. , HENDRY W. F.
Published: November 2008

Summary— Between 1977 and 1984, 92 patients with clinical Stage II non‐seminomatous germ‐cell testicular tumours were treated by primary chemotherapy, with surgery reserved for the excision of persisting masses. Eighty patients (87%) are alive and disease‐free: 96% for Stages IIA and IIB and 74% for Stage IIC. Of 43 Stage IIA, B and C patients treated with bleomycin. etoposideand cisplatin (BEP), 40 (93%) are disease‐free. For the whole group there was a significant difference between the outcome of treatment in patients with retroperitoneal masses > 8 cm in transverse diameter compared with those in whom masses were < 8 cm, the disease‐free rates being 54 and 97% respectively. Primary histology did not influence the outcome of treatment. However, whereas 51 % of patients with teratocarcinoma had masses resected after chemotherapy, only 26% of embryonal carcinoma patients came to surgery. The results obtained in this series are as good as those obtained when lymph node dissection is employed as the initial form of treatment. The avoidance of surgery with preservation of ejaculatory function in 78% of Stage IIA and IIB patients argues in favour of an initially non‐surgical approach to management.
True Hermaphroditism. A Review of 41 Cases with Observations on Testicular Histology and Function
Authors: AARONSON I. A.
Published: November 2008

Summary— Thirty‐six children and five adults with true hermaphroditism have been reviewed. Twenty‐five were raised as males and 16 as females. Those assigned as males had all ovarian tissue excised, leaving either a single testis or the testicular portion of one or both ovotestes. Postoperative testicular function was studied in 15 males. Basal testosterone levels were low in all four post‐pubertal patients. Eleven children had plasma testosterone measured before and after stimulation with HCG. Response was poor in eight and normal in only three. Although social factors in South Africa usually result in true hermaphrodites being raised as males, the functional outcome of this decision is often disappointing
Extracorporeal Shockwave Lithotripsy and Percutaneous Renal Surgery: Comparisons, Combinations and Conclusions
Authors: WEBB D. R. , PAYNE S. R. , WICKHAM J. E. A.
Published: November 2008

Summary— Although percutaneous nephrolithotomy (PCNL) and extracorporeal shockwave lithotripsy (ESWL) were introduced clinically at approximately the same time (1980–1981), their clinical progress appeared to progress along separate paths and to compete with each other. After 5 years it has become apparent that for optimal removal of nearly all renal stones by minimal or non‐invasive techniques, PCNL and ESWL are required either separately or as combined procedures. This review traces the development, introduction and progress of these procedures and defines the current indications for extracorporeal, percutaneous and open renal stone surgery.
Renal Oncocytoma
Authors: LEWI H. J. E. , ALEXANDER C. A. , FLEMING S.
Published: November 2008

Summary— Oncocytic renal tumour is an uncommon tumour of the kidney, previously associated with a good outcome. Twenty‐two patients are described in whom the incidence of metastatic disease was 18% and the overall 5‐year survival rate 65%.
Prostatic Carcinoma: Complications of Megavoltage Radiation Therapy
Authors: LINDHOLT J. , HANSEN P. T.
Published: November 2008

Summary— Megavoltage radiation therapy and radical prostatectomy are at present the only curative treatments for prostatic carcinoma. Because a high complication rate appeared to follow radiotherapy, all patients with prostatic carcinoma presenting to a Danish provincial hospital between 1975 and 1980 were reviewed. Of 31 radiation‐treated patients, 23 had serious complications. No recurrence was noted in eight patients. Twenty‐three had a recurrence despite radiotherapy but 11 of these patients had no local recurrence. In view of the high level of complications following radiation therapy and the high incidence of latent carcinomas in the prostate gland, a cautious approach to radiotherapy is recommended.
An Experimental Study of Hydrophilic Plastics for Urological Use
Authors: RAMSAY J. W. A. , MILLER R. A. , CROCKER P. R. , RINGROSE B. J. , JONES S. , LEVISON D. A. , WHITFIELD H. N. , WICKHAM J. E. A.
Published: November 2008

Summary— Hydrophilic graft copolymers of polyethylene vinyl acetate (PEVA) were extruded into tubular form. These materials increase both external and internal diameters by 60% on contact with water. The tubes were used as ureteric stents in an experimental study and were superior to silicone stents of the same calibre in the limitation of urinary extravasation. Histological, cytotoxic and electron microscopic studies showed that PEVA is a biocompatible material suitable for clinical use in urology.
The Pressure‐Volume Plot and Prediction of Treatment Outcome in Female Incontinence
Authors: WHEELAHAN J. B.
Published: November 2008

Summary— A graphic representation of the micturition cycle by a pressure‐volume plot has been obtained in 120 women, both incontinent patients and normal controls.

The pattern of contraction during voiding allowed prediction of the outcome of treatment. Patients with urethral sphincter incompetence and a sustained detrusor contraction had a good result from colposuspension even if detrusor instability was found during filling. Where the urethral sphincter was competent, patients with urge incontinence with or without detrusor instability during filling cystometry had a good response to drugs, providing a sustained detrusor contraction was present during voiding. Urethral sphincter incompetence was characterised by a low detrusor voiding pressure.
Comparison of Silicone and Latex Catheters in the Development of Urethral Stricture after Cardiac Surgery
Authors: FERRIE B. G. , GROOME J. , SETHIA B. , KIRK D.
Published: November 2008

Summary— In an earlier series of 100 men followed up for between 3 and 12 months after coronary artery bypass grafting, the incidence of urethral stricture was 2%. These patients have now been followed up for between 15 and 24 months and the incidence of urethral stricture has risen to 5.2%. Latex catheters were used in these patients. A separate group of 117 men underwent coronary artery bypass grafting and were catheterised with silicone catheters. They were followed up for between 12 and 28 months and no urethral strictures were found. It is recommended that silicone catheters be used routinely for short‐term catheterisation in men undergoing cardiac bypass surgery.
Ureterorenal Endoscopy: Which Instrument, What Cost?
Authors: MILLER R. A. , RAMSAY J. W. A. , CROCKER P. R. , CARTER S. , EARDLEY I. , WHITFIELD H. N. , WICKHAM J. E.A.
Published: November 2008

Summary—
This report describes the design, availability, repair facilities and costs of rigid ureteroscopes. Clinical factors affecting design are detailed. A classification is given. A new test of flow dynamics is described. Short operating ureteroscoges with a stable or integral telescope system appear to be superior to other types, especially as they may be used for antegrade ureteroscopy.
Serum Iron: a Tumour Marker in Renal Carcinoma
Authors: LOUGHLIN K. R. , GITTES R. F.
Published: November 2008

Summary—
Many patients with renal carcinoma have associated anaemia that is not related to the degree of their haematuria. We report our experience with 18 patients who were anaemic with low serum iron at the time of diagnosis. The serum iron was found to be useful as a tumour marker in following the course of the disease. In patients who had no evidence of metastases following radical nephrectomy, the serum iron returned to normal. In those who had residual disease or who developed recurrent disease, the serum iron was low. It was concluded that serum iron is a useful, inexpensive tumour marker in selected patients with renal carcinoma.
Rigid Transurethral Ureteroscopy
Authors: HOSKING D. H. , RAMSEY E. W.
Published: November 2008

Summary—
Since March 1984 we have performed ureteroscopy in 58 patients. The indications were ureteric calculi in 49 cases and dilatation of ureteric strictures, evaluation of unexplained haematuria, evaluation of ureteric filling defects and the insertion of ureteric stents in the remainder. Stone removal was successful in 33 patients (67%). We have found rigid ureteroscopy to be a time‐consuming procedure with a high risk of minor injury, but long‐term complications are uncommon and we believe that rigid ureteroscopy should be the procedure of choice for the management of calculi in the lower and middle thirds of the ureter.
Long‐term Management of Patients who have had Urinary Diversions into Colon
Authors: SILVERMAN S. H. , WOODHOUSE C. R. J. , STRPCHAN J. R. , CUMMING J. , KEIGHLEY M.R. B.
Published: November 2008

Summary—
Thirty‐four patients with urinary‐colonic diversions have been followed up for 13 to 41 years (mean 20.3). The commonest long‐term complication was hyperchloraemic acidosis (50%). The most serious was neoplasm at the anastomotic site: benign lesions occurred in three patients and carcinomas in two (15%).

Staining for sialomucins in colonic biopsies adjacent to the anastomoses was positive in 17 of 19 patients. It has been suggested that this represents a pre‐malignant change.

Analysis of faecal flora in 17 diverted patients and 27 controls revealed a significant difference in the carriage rate and viable count of Peptostreptococcus species. This finding has not been reported previously and the species could have a role in the aetiology of the neoplasms.
Chronic Retention of Urine. The Relationship between Upper Tract Dilatation and Bladder Pressure
Authors: A. STYLES ROSEMARY , RAMSDEN P. D. , NEAL D. E.
Published: November 2008

Summary—
Twenty‐five men with chronic retention of urine were studied in order to investigate the relationship between upper tract dilatation and bladder pressure. Each underwent assessment of upper tract dilatation and urodynamic investigation before bladder drainage. Patients were reassessed 3 or more months after operation. Residual urine and detrusor contraction pressure decreased significantly after operation (P < 0.000l: P < 0.0l). A significant increase in effective cystometric capacity and a significant decrease in pressure rise during filling led to an improvement in compliance.

At pre‐operative assessment, patients with upper tract dilatation had a significantly greater resting bladder pressure (P < 0.05), end filling pressure (P < 0.002) and pressure rise during filling (P < 0.02) than those without upper tract dilatation. In addition, statistically significant correlations were found between serum creatinine and end filling pressure (P < 0.05) and between upper tract dilatation and both high end filling pressure (> 25 cm H2O) and high pressure rise during filling (> 15 cm H2O: both P < 0.05).

Whilst high end filling pressure and high pressure rise during filling were found to be closely associated with upper tract dilatation (sensitivity 93 and 100%), there was a high false positive rate (specificity 64 and 45%). Furthermore, statistical analysis demonstrated that these data had a continuous though skewed distribution, suggesting that it is not possible to make a clear distinction between high and low pressure chronic retention.
Restriction of Long‐term Indwelling Urethral Catheterisation in the Elderly
Authors: COOLS H. J. M. , MEER J. W. M. VAN DER
Published: November 2008

Summary—
Eighty‐nine (16%) of 543 patients admitted to a chronic care centre in 1983 had an indwelling urethral catheter. Of the 89, 51 patients (57%) received the catheter in a general hospital, 4 (5%) at home and 34 (38%) in the centre. More than half of the catheters that were inserted in the hospital could be removed within 4 weeks of admission to the centre, implying that a more restricted use of indwelling catheters in hospitals is possible. Only 18% of the indwelling catheters remained in situ for the designated period of 1 month. The other catheters were changed before that time, mainly because of obstructed drainage or leakage of urine around the catheter.

The incidence of bacteriuria among catheterised patients was 90%. The bacteria were multiresistant in 37% of these cases, compared with 25% of non‐catheterised patients. Multiresistant microflora were present significantly more often in the urine of patients admitted from hospitals (irrespective of whether they had a catheter) and the catheterised residents of the centre than in that of the other patients (P<0.001). When all patients of the centre were considered, it was found that 30.6% were treated with antimicrobial agents in the course of the year; 10.9% were treated more than once a year. This latter group of patients received 58% of all prescribed antimicrobial drugs; 37% of them had an indwelling catheter. The majority of catheterised patients (65%) did not need antimicrobial treatment.

No significant influence of catheterisation on mortality could be demonstrated.
Diagnosis of Testicular Torsion Using Doppler Ultrasonic Examination
Authors: LEAHY P. F.
Published: November 2008

Summary—
The differential diagnosis of acute scrotum in an emergency is difficult and the diagnosis is rarely certain. Moreover, torsion is often diagnosed too late to save the testis involved.

The Doppler ultrasonic flowmeter has enabled us to make a correct and rapid diagnosis of acute scrotum and has reduced the number of negative scrotal explorations. It seemed logical to use the Doppler flowmeter in the diagnosis of torsion of the testis, since testicular blood flow should be diminished in torsion and unaffected in most other intrascrotal conditions. one testis can be used as a control in the qualitative evaluation of the sound of the testicular blood flow.

The testes lend themselves to the use of this instrument because they are accessible and because one testis can be used as a control in the qualitative evaluation of the sound of the testicular blood flow.
The Fate of the Human Testes Following Unilateral Torsion of the Spermatic Cord
Authors: ANDERSON J. B. , WILLIAMSON R. C. N.
Published: November 2008

Summary—
In an attempt to explain the oligozoospermia commonly observed after unilateral testicular torsion, 56 patients with acute torsion were investigated prospectively. Blood was taken pre‐operatively for antibody studies and a contralateral testicular biopsy was performed at the time of orchiopexy. At review 3 to 6 months post‐operatively, late testicular atrophy was assessed and repeat antibody studies were performed together with a hormone profile and seminal analysis. Although the duration of torsion showed a close correlation with the degree of testicular atrophy (P < 0.001), no such association could be demonstrated between duration of torsion and subsequent sperm concentration. Twenty of 35 patients had histological evidence of a pre‐existing partial maturation arrest in spermatogenesis. Fifteen of 19 with the abnormality were oligozoospermic, while all of those with normal testicular histology had a sperm concentration within the normal range. Anti‐sperm antibody formation following torsion was minimal and anti‐testis antibodies were absent. Testes prone to torsion already show impaired spermatogenesis.
Vas Cannulation with Implanted Sperm Reservoirs for Obstructive Azoospermia or Ejaculatory Failure
Authors: BRINDLEY G.S. , SCOTT G. I. , HENDRY W. F.
Published: November 2008

Summary—
Seven patients with azoospermia due to obstruction of the abdominal part of the vas deferens, and five paraplegic men with ejaculatory failure, were treated with implanted sperm reservoirs. In eight patients (67%) motile spermatozoa were recovered. Two pregnancies (17%) were achieved with subsequent live births (by AIH). In two patients the fertilising capacity of the spermatozoa was unsuccessful as assessed by IVF. Infection required the removal of two reservoirs.
Modified Method of Diuresis Renography for the Assessment of Equivocal Pelviureteric Junction Obstruction
Authors: ENGLISH P. J. , LAWSON R. S. , CARROLL R. N. P. , EDWARDS E. C.
Published: November 2008

H. J. TESTA

Summary— Thirty‐ive hydronephrotic kidneys, in which diuresis renography showed either an equivocal (13) or non‐obstructive (22) response pattern, were studied by a modified method in which intravenous frusemide was given 15 min before the start of the renogram so as to assess elimination during the period of maximum diuresis. Thirteen kidneys were identified as obstructed, including three in which the standard diuretic renogram appeared to exclude obstruction. These results indicate that the modified method increases the specificity of diuresis renography when used to assess patients with equivocal pelviureteric junction obstruction.
Enkephalin Inhibits Presynaptically the Contractility of Urinary Tract Smooth Muscle
Authors: KLARSKOV P.
Published: November 2008

Summary— The influence of methionine‐enkephalin and leucine‐enkephalin on human detrusor and on pig detrusor, trigone, bladder neck and urethral smooth muscle was investigated in vitro. The enkephalins inhibited the smooth muscle contractility presynaptically. Methionine‐enkephalin was about 40% more potent than leucine‐enkephalin.

Phentolamine‐resistant contractions were less inhibited by the enkephalins than atropine‐resistant contractions and contractions that were not blocked. The inhibitory nerve responses of the trigone, bladder neck and urethra were unaffected.
Urodynamic Findings in Sacrococcygeal Chordoma
Authors: SNAPE J. , DUFFIN H. M. , CASTLEDEN C. M.
Published: November 2008

Summary— The clinical and urodynamic findings in two cases of sacrococcygeal chordoma are described. The urodynamic findings suggest that the urinary problems in this condition are caused by an incomplete lower motor neurone lesion.
Phenoxybenzamine in Prostatic Hypertrophy A Double‐blind Study
Authors: FERRIE B. G. , PATERSON P. J.
Published: November 2008

Summary— Forty‐five patients awaiting prostatectomy participated in a double‐blind study of phenoxybenzamine 10 mg/day for 5 weeks. Objective measurements of peak urine flow, voided volume, residual urine and frequency of micturition and nocturia showed no significant difference between phenoxybenzamine and placebo. Patients taking phenoxybenzamine had a significantly greater improvement in hesitancy and flow symptoms than those on placebo. Side effects occurred in 47.6% of patients on phenoxybenzamine and 22.2% of those on placebo. In this study phenoxybenzamine 10 mg/day was ineffective in patients with benign prostatic hypertrophy.
Scope and Limitations of the MAGPI Hypospadias Repair
Authors: OZEN H. A. , WHITAKER R. H.
Published: November 2008

Summary— Results and complications are reported in 67 boys who underwent a modified MAGPI procedure for hypospadias between 1981 and 1986. Excellent cosmetic and functional results were achieved in 91% of the patients. Some degree of chordee can be corrected by this procedure but severe degrees of chordee were associated with an increased complication rate.
Renal Abscess with Gas Formation Secondary to Acute Appendicitis
Authors: CORDER A. P.
Published: November 2008

Gas‐forming infections of the kidney are rare and dangerous (Costas, 1972). An unusual case with a satisfactory outcome is reported.
Intermittent Hydronephrosis due to Transitional Cell Carcinoma of the Renal Pelvis
Authors: ENGLISH P. J. , WILLIAMS G. , CARROLL R. N. P.
Published: November 2008

We report an unusual case of intermittent hydronephrosis where the cause was thought to be a transitional cell carcinoma of the renal pelvis.
Indications for Investigation of Post‐micturition Dribble in Young Adults
Authors: CORCORAN M. , SMITH G. , CHISHOLM G. D.
Published: November 2008

Summary— The endoscopic and urodynamic findings in eight male patients in whom post‐micturition urinary dribble (PMD) was either the sole or predominant urinary symptom have been reviewed. In three patients whose only symptom was PMD, both endoscopic and videocystometric examinations were normal. In the remaining five patients with additional urinary symptoms, a functional or anatomical abnormality of the lower urinary tract was found in every patient. We conclude that in the assessment of patients with PMD, endoscopic and/or urodynamic investigation is of value only in those patients with multiple urinary symptoms.
Do Normal Mucosal Biopsies Predict Prognosis in Patients with Transitional Cell Carcinoma of Bladder Treated by Radical Radiotherapy?
Authors: QUILTY P. M. , HARGREAVE T. B. , SMITH G. , DUNCAN W.
Published: November 2008

Summary— A biopsy of normal‐looking mucosa showed mucosal abnormalities in 48.9% of patients with transitional cell carcinoma of the bladder. The presence of dysplasia or carcinoma in situ was significantly associated with grade but not with tumour category. In 100 patients who completed a course of radical megavoltage X‐ray therapy, the result of mucosal biopsy gave no significant prognostic information about tumour regression, durable local control, survival or the risk of subsequent metastases.
Diagnostic Intracorporeal Papaverine and Erectile Dysfunction
Authors: STRACHAN J. R. , PRYOR J. P.
Published: November 2008

Summary— Intracorporeal papaverine has been used as an out‐patient procedure to assess the erectile dysfunction of 129 men. The technique is a valuable diagnostic aid and has few side effects. Prolonged tumescence occurred in four patients, two of whom required treatment with intracorporeal metaraminol.
Autologous Bladder Mucosa Graft for Urethral Substitution
Authors: RANSLEY P. G. , DUFFY P. G. , OESCH I. L. , HOOVER D.
Published: November 2008

Summary— Bladder mucosa was used to construct a neourethra in 32 children. Twenty‐five of them had had previous failed surgery for hypospadias and seven had severe congenital defects of the urethra. A satisfactory functional and cosmetic result was achieved in 30 patients.
Renal Carcinoma Presenting as a Goitre
Authors: BADENOCH D. F. , ROSS H. B. , BADENOCH M. P.
Published: November 2008

Metastatic carcinoma to the thyroid gland is rare. We describe a case of clear cell carcinoma of the kidney presenting as a goitre.
Accessory Scrotum
Authors: KOLANDAIVELU G. , SEENIRAJ K. , BOSE J. C. , RAJAGOPAL P.
Published: November 2008

An accessory scrotum is an uncommon congenital deformity with obscure embryology and is often associated with other abnormalities of the genitourinary tract as well as with congenital defects of other systems (Williams, 1958).
Incidence of Renal Stones in 18 British Towns A Collaborative Study
Authors: POWER C. , BARKER D. J. P. , BLACKLOCK N. J.
Published: November 2008

Summary— The geographical distribution of renal stones in England and Wales was investigated by selecting 18 towns which encompassed a range of social and economic conditions. Case registers of stone patients were maintained in the hospitals for 2 years; they included out‐patients and inpatients. The annual registration rate was 22/100 000 population. Additional information was available for 1980 from Hospital Activity Analysis and the annual rate was 28/100 000. It is suggested that this is the best estimate of the incidence of renal stones in England and Wales. The rate ranged from 56/100 000 in Canterbury to 15/100 000 in Burton‐on‐Trent. The incidence of renal stones was higher in towns with better social and economic conditions. In comparison, climatic factors, latitude and water hardness were not important determinants of the distribution of renal stones.
Computed Tomography in Acute Pyelonephritis
Authors: SENN E. , ZAUNBAUER W. , BANDHAUER K. , HAERTEL M.
Published: November 2008

Summary— The computed tomographic findings in nine female patients with acute pyelonephritis were reviewed. The major impact of CT was the demonstration of renal enlargement, abnormal contour, perirenal inflammatory extension and, on contrast‐enhanced scans, abnormal nephrograms and impaired renal function. It was concluded that CT can provide specific information about the nature and extent of the inflammatory process, thus complementing intravenous urography so that appropriate therapy may be selected. Follow‐up studies can be helpful in monitoring the progress of a patient.
Pathogenesis of Nocturnal Urinary Incontinence after Ileocaecal Bladder Replacement Continuous Measurement of Urethral Closure Pressure during Sleep
Authors: JAKOBSEN H. , STEVEN K. , STIGSBY B. , KLARSKOV P. , HALD T.
Published: November 2008

Summary— Urethral closure pressure was recorded in four patients during sleep in order to determine the pathogenesis of nocturnal incontinence after radical cystectomy and ileocaecal bladder replacement. The sleep stages were determined by electroencephalography. The resting pressure in the intestinal bladder was low and increased only slightly during filling. The maximum urethral pressure decreased during sleep but the urethral closure pressure remained positive when the intestinal bladder was not contracting. The peristaltic contractions in the intestinal bladder continued during sleep, causing incontinence. The nocturnal incontinence is probably a result of the reduced level of consciousness that makes it impossible to increase the tone of the external urethral sphincter during contractions of the intestinal bladder.
Assessment of the Immediate and Long‐term Effects of Pharmacologically Induced Penile Erections in the Treatment of Psychogenic and Organic Impotence
Authors: KIELY E. A. , WILLIAMS GORDON , GOLDIE L.
Published: November 2008

Summary— Thirty‐eight patients with predominantly organic and 29 with psychogenic impotence had intracavernosal injections of a combination of 30 mg papaverine and 1 mg phentolamine on at least one occasion. An immediate increase in length and penile rigidity resulted in all subjects. Eighteen of the organic patients subsequently developed spontaneous erections for periods ranging from 1 week to 1 month. Nineteen of the 24 patients in the psychogenic group had spontaneous erections, five for at least 4 months and 14 for 2 to 8 weeks. Increasing the dose was of benefit only to organic patients who initially had a poor response. Three of eight patients with a poor immediate response to pharmacologically induced penile erections (PIPE) were found to have venous incompetence. PIPE is therefore of value in the diagnosis and treatment of organic and psychogenic impotence.
Application of Leeches to Reduce Swelling after Reconstructive Surgery
Authors: MAKIN C. A. , EDWARDS L.
Published: November 2008

Surgery to the scrotum can be associated with tremendous swelling due to the lax nature of the skin in this region. Oedema, with or without haematoma formation, tends to be diffusely spread through tissue planes and is therefore not amenable to surgical drainage. We report a case where the timely application of leeches quickly reduced an extreme swelling.
Removal of Foreign Bodies from the Female Bladder
Authors: WALMSLEY B. H.
Published: November 2008

The literature abounds with reports of intravesical foreign bodies but, if recent experience with rectal foreign bodies may be taken as an indicator (French et al., 1985), the number of such cases may be on the increase. This report describes a technique that can be particularly useful for the safe removal of foreign bodies from the female bladder.
Detection of Blood Group Antigens in Frozen Sections of Prostatic Epithelium
Authors: ABEL P. D. , MARSH C. , HENDERSON D. , LEATHEM A. , POWELL P. H. , WILLIAMS GORDON
Published: November 2008

Summary— The detection of blood group antigens (BGA) in non‐malignant prostates by previous workers has been at best inconsistent. BGA have not before been detected in prostatic carcinomas. In this preliminary study, a variety of anti‐BGA reagents, with known specificities that involve the carbohydrate backbone in addition to the BGA specific terminal monosaccharides, were used to study the expression of the A and H(O) BGA in cryostat sections of 16 patients with benign prostatic disease and nine with prostatic cancer.

Positive staining, appropriate to the patients' blood group, was seen in all of the benign tissues when anti‐BGA reagents that included specificity against type 2 backbone structures were used. Staining was absent, however, if the reagent had only type 1 specificity. The anti‐A and anti‐H(O) reagents which gave the best staining patterns in benign tissues were used in malignant tissues. No cancer was found to express A antigen but eight of the nine prostatic cancers were positive for the H (0) antigen irrespective of blood group.

Using fresh frozen material and appropriate reagents, BGA may be reproducibly detected in the epithelium of all non‐malignant prostates, suggesting that a significant component of BGA is probably lipid‐based on type 2 carbohydrate backbone chains. Further studies of changes in BGA expression in prostatic cancer are warranted.
Incontinence in Female Neurogenic Bladders. Resolution by Endoscopic Bladder Neck Suspension
Authors: KATO K. , KONDO A. , TAKITA T. , GOTOH M. , TANAKA J. , MITSUYA H.
Published: November 2008

Summary— Five incontinent females with neurogenic bladder diseases underwent endoscopic vesical neck suspension (Stamey procedure). Four patients have become dry on clean intermittent catheterisation and one has shown improvement. Bladder capacity was increased to a reasonable size in all patients. There has been no upper tract deterioration during the follow‐up period of 3 to 25 months.

We believe that the Stamey procedure is useful in alleviating urinary incontinence in neurogenic bladders provided that the bladder is drained regularly by intermittent catheterisation and that low detrusor compliance or detrusor hyper‐reflexia is adequately managed.
Endoscopic Bladder Transection for Detrusor Instability
Authors: LUCAS M. G. , THOMAS D. G.
Published: November 2008

Summary— Eighteen patients with intractable detrusor instability were treated by endoscopic bladder transection. In two patients there was complete symptomatic relief. Two more were rendered continent but continued to complain of urgency and nocturia. The remaining 14 patients were not improved by the procedure. These results have caused us to abandon this operation as a treatment for detrusor instability.
Intravesical BCG Therapy in the Management of Multiple Superficial Bladder Carcinoma Comparison between Glaxo and Pasteur Strains
Authors: KAISARY A. V.
Published: November 2008

Summary— Intravesical Bacillus Calmette‐Guérin (BCG) therapy in the treatment and prophylaxis of superficial bladder cancer has shown encouraging results in North America but disappointing results have been reported in Great Britain. This was attributed to differences in quality between BCG (Glaxo strain) used in Great Britain and BCG (Pasteur and Tice strains) used in North America. Twenty‐one patients with multiple superficial recurrent transitional cell carcinoma of the bladder were entered into a pilot study comparing the efficacy of BCG Glaxo (Evans Medical Ltd, Dunstable, UK) and Pasteur (L'Institut Pasteur, France) strains. Comparable and encouraging results were demonstrated, indicating that this mode of therapy is effective.
Fluid Absorption During Urological Endoscopy
Authors: RAO P. N.
Published: November 2008

Transurethral prostatectomy (TURP) and, more recently, percutaneous nephrolithotomy and endoureteric procedures for stones in the kidney and ureter have justifiably become popular because of the many advantages offered by these less invasive prcedures. Any surgical operation has its attendant complications and absorption of irrigant fluid is a major and potentially fatal complication of all of these endoscopic techniques. This review examines the incidence, the causes and the pathological sequelae of excessive fluid absorption and suggests some ways to prevent it.
Vasoactive Intestinal Polypeptide Concentration in Human Bladder Neck Smooth Muscle and its Influence on Urodynamic Parameters
Authors: KLARSKOV P. , HOLM‐BENTZEN M. , NØRGAARD T. , OTTESEN B. , WALTER S. , HALD T.
Published: November 2008

Summary— Three human studies were performed to evaluate the influence of vasoactive intestinal polypeptide (VIP) on bladder and urethral function.

Bladder neck smooth muscle biopsies were obtained from nine men with functional bladder neck obstruction, from 10 men with medium sized benign prostatic hypertrophy and from four patients with a normal infravesical outlet. The biopsies were analysed for VIP by radioimmunoassay and by immunohistochemistry. No differences were found between the groups.

Pressure‐flow‐EMG studies were performed in five men and urethrocystometry was performed in six women at rest, repeated coughing and at squeezing before, during and after VIP 3 μg/kg x h intravenously. No systematic changes developed in any of the urodynamic parameters.
An Assessment of the Complications of the Brantley Scott Artificial Sphincter
Authors: HEATHCOTE P. S. , GALLOWAY N. T. M. , LEWIS D. C. , STEPHENSON T. P.
Published: November 2008

Summary— A Brantley Scott artificial sphincter has been inserted into 95 patients since 1981; more than half of the patients had lower urinary tract neuropathy and most of the others post‐TUR incontinence. The main problem with the device has been cuff failure (12), which should be resolved by the new “dipped” cuffs. The major surgical complication has been erosion (10), usually associated with infection. Twenty‐four patients had variable degrees of incontinence but the artificial sphincter remains the cornerstone of continence control when other methods have failed or are inappropriate.
Prazosin in the Treatment of Prostatic Obstruction A Placebo‐controlled Study
Authors: KIRBY R. S. , COPPINGER S. W. C. , CORCORAN M. O. , CHAPPLE C. R. , FLANNIGAN M. , MILROY E. J. G.
Published: November 2008

Summary— Eighty patients with prostatic obstruction were entered into a double‐blind parallel study of prazosin versus placebo. There were 25 withdrawals or exclusions, leaving 55 patients for analysis. Mean maximum flow rates increased significantly more in patients treated with prazosin than in those treated with placebo (P <0.005), but there was no significant reduction in maximum voiding pressure. The mean number of voids, recorded on diary cards, was reduced from an initial 10.0/24 h by 2.1 in the final week, a significantly greater reduction than in the placebo group (P <0.01). However, there were no statistically significant changes in the filling cystometrograms. When patients were classified as responders or non‐responders in terms of bladder filling, urine flow, bladder emptying, weekly average of voids/24 h and nocturia, the proportion of patients responding to prazosin was significantly greater in all categories except bladder filling and emptying.

It was concluded that prazosin at a dose of 2 mg bd is a safe and effective treatment for prostatic obstruction and may be used in patients awating surgery and those who are unfit for operation.
Oral Ciprofloxacin as Prophylaxis in Transurethral Resection of the Prostate
Authors: MURDOCH D. A. , BADENOCH D. F. , GATCHALIAN E. R.
Published: November 2008

Summary— A new quinolone antibacterial, ciprofloxacin, was evaluated as oral prophylaxis for transurethral resection of the prostate in a randomised controlled trial. A 3‐day course of peri‐operative ciprofloxacin 250 mg twice daily reduced the post‐operative infection rate, the post‐operative hospital stay and the frequency of infective complications.

Ciprofloxacin was well tolerated and no significant haematological or biochemical side effects were detected.
Epidemiology of Cancer of the Prostate in Canada: 1950–1984
Authors: AYIOMAMITIS A.
Published: November 2008

Summary— Canadian patterns of morbidity and mortality from malignancies of the prostate were examined for the periods 1970 to 1980 and 1950 to 1984 respectively. Age‐standardised morbidity (ASMR) and mortality (ASDR) rates have risen dramatically during the two periods. The rise in ASMRs, at 1.07 additional new cases per 100,000 population per year since 1970 (P=0.0001), is attributable to significant increases in age‐specific morbidity rates for males aged 45 to 54,55 to 64, 65 to 74 and 85+ (0.5 to 15.2 additional new cases per 100,000 population per year) (P<0.002). The significant increase in ASDRs, 0.09 additional deaths per 100,000 population per year since 1950 (P=0.0001), is a reflection of significant increases in age‐specific mortality rates for males aged 75 to 84 and 85+ (2.8 and 9.3 additional deaths per 100,000 population per year) (P=0.001).
Haemospermia: Observations in an Area of Endemic Bilharziasis
Authors: ELEM B. , PATIL P. S.
Published: November 2008

Summary— Observations are presented on 1 1 cases of haemospermia in the University Teaching Hospital, Zambia, a country where bilharziasis is endemic. Seven patients were severely hypertensive but only two had urinary bilharziasis. The incidence of Schistosorna haernatobiurn infection of the prostate and seminal vesicles is discussed and it is concluded that there is no significant association between the parasitic infection and haemospermia.
Penile Deep Dorsal Vein Cushions and Erection
Authors: WESPES E. , DEPIEFFEUX M. , SCHULMAN C. C.
Published: November 2008

Summary— During surgical treatment of impotence due to venous leakage, the deep dorsal veins from 10 patients were resected and studied histologically to see if any morphological anomaly could be implicated in the physiopathological mechanism of venous leakage. Normal venous cushions were present in these veins similar to those observed in the deep dorsal veins of patients with normal erections. Their function and possible deterioration are discussed.