bluuebunny/crossref_metadata_2025 huggingface dataset:
Lntravesical Instillation of Mitomycin C in the Prophylactic Treatment of Recurring Superficial Transitional Cell Carcinoma of the Bladder*
Authors: DEVONEC M. , BOUVIER R. , SARKISSIAN J. , BENDIMERAD O. , GELET A. , DUBERNARD J. M.
Published: November 2008

Summary— Twenty‐six patients with an elevated recurrence rate of stage O or A bladder tumours were treated prophylactically after transurethral resection (TUR) with short‐term intravesical instillations of mitomycin C in a non‐randomised study. The data before intravesical chemotherapy (IVC) were taken as the internal control for each patient. Mitomycin C was administered in one course of 10 daily doses of 40 rng, starting 24 to 48 hours after TUR.

The average follow‐up was 13.9 months before and 28.5 months after IVC. Before IVC, the average number of recurrences was 2.6, with an average recurrence rate of 1 every 5.3 months. After IVC there was no tumour recurrence in 4 patients, with a mean of 12.2 months' follow‐up, but there was tumour recurrence in 22 patients. For 17 patients (77%) the free interval averaged 2.3 times longer than the mean interval of recurrence before IVC and for 18 patients (82%) the recurrence rate averaged 3.3 times less than the recurrence rate before IVC.
Blood Loss in Prostatic Resection after Relief of Acute Retention of Urine by Prolonged Catheter Drainage
Authors: LEEN G. L. S. , FEGGETTER J. G. W.
Published: November 2008

Summary— Blood loss in transurethral resection of the prostate was measured in 31 patients and a comparison made between 12 who had required prolonged preoperative bladder drainage by indwelling urethral catheter and 19 who had not been catheterised. There was no difference in blood loss per gram weight of prostatic tissue resected per minute operating time between the two groups.
Specific Red Cell Adherence Test in Benign and Malignant Lesions of the Prostate
Authors: GHAZIZADEH M. , KAGAWA S. , TAKIGAWA H. , KUROKAWA K. , NUMOTO S.
Published: November 2008

Summary— The specific red cell adherence test (SRCA) for blood group antigens has been shown to have some bearing on the invasive potential of bladder tumours. Hitherto there have been few data published from patients with prostatic disease. The results of SRCA testing in 69 such patients are presented.

Each of the 30 cases of adenocarcinoma was antigen negative. However, as 18 of 39 patients with only benign hyperplasia were also antigen negative, the test clearly does not reflect extant tumour and is probably not an indicator of subsequent growth of prostatic cancer. Antigen expression was also negative in sections showing prostatitis.

As the test was invariably negative in patients with adenocarcinoma, whether or not metastases were present and whatever the degree of differentiation of the primary tumour, it lacks the power to discriminate invasive potential.
Change in White Cell Count during Treatment of Advanced Cancer of the Prostate with Estramustine Phosphate and with Stilboestrol
Authors: DAPONTE D. , SYLVESTER R. , PAUW M. DE , FRYSZMAN A. , SMITH R. M. , SMITH P. H.
Published: November 2008

Summary— Patients with locally advanced (category T3–4 of the TNM system) and metastatic prostatic cancer, not previously treated, seen by one of the authors (P.H.S.) have been entered into EORTC Protocol 30762 which has compared the therapeutic effects of estramustine phosphate (Estracyt) and of diethyl‐stilboestrol (DES) as primary treatment.

A gradual and as yet unexplained rise in the total leucocyte count was seen in patients treated with estramustine phosphate. This was always apparent within 2 months of starting treatment and did not change significantly thereafter unless treatment was stopped, when the raised values soon returned to normal. In four patients in whom the white cell count rose to levels above the normal range a neutrophil leucocytosis was always reported. The cause of this is not yet understood.
Verrucous Carcinoma of the Penis (Buschke‐Lowenstein Tumour): a Clinico‐pathological Study
Authors: LOWE D. , McKEE P. H.
Published: November 2008

Summary— The variant of squamous carcinoma of the penis known as verrucous carcinoma is an uncommon but distinct clinical and pathological condition which has a significantly better prognosis than the more common infiltrative type. We report seven cases from a continuing larger study of the disease and discuss the clinical features, the histological criteria for diagnosis and the methods of treatment available.
Occult Germ‐cell Testicular Tumours
Authors: POWELL S. , HENDRY W. F. , PECKHAM M. J.
Published: November 2008

Summary— Eighteen men presenting with metastatic germ‐cell malignancy in whom no primary tumour could be palpated in either testis are described. All patients had both testes in the scrotal sac and none had a history of maldescent. All had abdominal node involvement, in most cases associated with metastases at other sites. Ten men presented with Stage 4 disease, five with Stage 3 and three with Stage 2.

The most common histological sub‐type associated with an occult primary testicular tumour was trophoblastic malignant teratoma (9/18 patients). Abdominal pain (12 patients) and systemic symptoms (10 patients) were common presenting features. There was a history of testicular atrophy in eight patients and seven had experienced episodes of transient testicular pain up to 18 months before presentation.

In three of four patients in whom the testis was examined histologically following a history of atrophy and/or pain, there was evidence of a primary tumour, manifest as spontaneous turnour regression (one), differentiation (one) or a small micro‐primary trophoblastic teratoma (one). In a fifth patient an ultrasonic scan showed a 1–cm echogenic mass in an atrophic testis. In 10 patients the diagnosis of germ‐cell malignancy was established by laparotomy. Obstructive uropathy was present in six patients, associated with haematuria in four patients.
Mineral Composition of 103 Stones from Iran
Authors: CIFUENTES J. MIÑTÓAN , POURMAND G.
Published: November 2008

Summary— The mineral composition of 103 stones from Iran was determined by a polarisation microscope and infrared spectroscopy. The commonest components were whewellite (81.5%), weddellite (40.7%), apatite (69%) and ammonium acid urate (24.4%). Ectopic ossification in the nuclei was found in three renal calculi (2.9%). Twenty‐five stones were from children, where one of the most frequent patterns was formed by both ammonium acid urate and calcium oxalate. This suggests that a high proportion of the children from Iran with urolithiasis have nutritional disorders.
Permeability and Ultrastructure of Human Bladder Epithelium
Authors: ELDRUP J. , THORUP J. , NIELSEN S. L. , HALD T. , HAINAU B.
Published: November 2008

Summary— Leakage of tight junctions as observed with electron microscopy and demonstration of solute transport across bladder epilhelium was investigated in 13 patients with different bladder diseases: urinary retention and infection, bladder tumours and interstitial cystitis. The latter group showed consistent leakage of solutes through the urothelium. Electron microscopy revealed leaky tight junctions. This finding might be helpful in establishing the histological criteria and explain the pathogenesis of interstitial cystitis.
Chronic Bacterial and Non‐bacterial Prostatitis
Authors: THIN R. N. , SIMMONS P. D.
Published: November 2008

Summary— Chronic prostatitis is ill‐understood, difficult to diagnose and often unresponsive to treatment. To clarify some of the diagnostic difficulties 135 patients and 28 control subjects were prospectively studied. Patients with chronic bacterial prostatitis, chronic non‐bacterial prostatitis and recurrent non‐specific urethritis (NSU) without prostatitis resembled each other in demographic characteristics. Patients with prostatodynia were more often married and born abroad. Symptoms were more common in prostatodynia but diagnosis of prostatitis and prostatodynia depended on examination of the expressed prostatic secretion (EPS) for leucocytes and microorganisms. An inflammatory response in the EPS was found in both forms of prostatitis but not in the other conditions. Leucocyte counts of the EPS appeared to be more sensitive than simple microscopic estimation. The EPS leucocyte figures support a previous finding that the upper limit of normal for the EPS count is around 500 cells per mm3by the method used. The pathogenic micro‐organisms cultured from the EPS of the patients with chronic bacterial prostatitis were the usual urinary pathogens reported by others. For reasons which are not clear, saprophytic organisms were more common in chronic non‐bacterial prostatitis than in the other groups. While the demographic differences and increased symptoms in patients with prostatodynia will not help in diagnosis, there may be a relationship with emotional stress and this should be considered in the management of these patients.
Review of Results of Four Regimens for Treatment of Chronic Non‐bacterial Prostatitis
Authors: THIN R. N. , SIMMONS P. D.
Published: November 2008

Summary— Review of the treatment of chronic non‐bacterial prostatitis, defined by the presence of more than 500 leucocytes per mm3in the expressed prostatic secretion (EPS), showed symptomatic response after 3 months of minocycline, trimethoprim, co‐trimoxazole or diazepam. Reduction in the EPS cell count was most marked with minocycline, trimethoprim was less effective and poor results were obtained with co‐trimoxazole and diazepam. In the absence of established treatment for chronic non‐bacterial prostatitis it is suggested that antimicrobial therapy is worth consideration.
Adjuvant Treatment Using Bleomycin in Squamous Cell Carcinoma of Penis: Study of 19 Cases
Authors: MAICHE A. G.
Published: November 2008

Summary— Nineteen patients with squamous cell carcinoma of the penis had surgical treatment or a combination of surgery and radiation. They also had chemotherapy using bleomycin as a single agent or in combination with vincristine and methotrexate. The total doses of bleomycin varied between 89 mg/m2and 212 mg/m2. The best results were obtained in well differentiated carcinomas.
Is Cervical Spondylosis an Occupational Hazard for Urologists?
Authors: WHITAKER R. H. , GREEN N. A. , NOTLEY R. G.
Published: November 2008

Summary— Amongst 248 urologists who spend a substantial amount of their operative work performing endoscopic procedures and who were surveyed with reference to symptoms of cervical spondylosis, 118 admitted that they were, or had been, troubled by such symptoms (47.6%). A control group of 113 General Practitioners matched for age at qualification had no significantly fewer symptoms (43.4%). Similar numbers in each group had a history of neck injury, often of a sporting nature, and also had similar incidences of symptoms including pain down the arm.

Significantly more urologists have current severe symptoms and more frequent attacks of trouble. Urologists offered a variety of advice on how to ameliorate these symptoms, which included attention to posture, the need for self‐controlled motorised endoscopic tables, an endoscopic stool with wheels and the limitation of the number of transurethral prostatectomies per operating list.
Studies on the Prevalence and Epidemiology of Urinary Stone Disease in Men in Leeds
Authors: ROBERTSON W. G. , PEACOCK M. , BAKER M. , MARSHALL D. H. , PEARLMAN B. , SPEED R. , SERGEANT V. , SMITH A.
Published: November 2008

Summary— A postal survey among 2% of men in Leeds showed that the prevalence of urinary stone disease is 3.8%. The prevalence of upper urinary tract and spontaneously passed stones increases progressively from 0.7% in social class 5 to 5.0% in social class 1 but that of bladder stones (0.7% in the group as a whole) is independent of social class.

There is an initial peak of upper urinary tract and spontaneously passed stones commencing at age 20 and having a projected prevalence at age 90 of 5.7% and a second peak of bladder stones, commencing about age 50, with a projected prevalence of 1.9%.

The prevalence of stone disease increases according to the order: single < divorced/separated < married < widowed men. A family history of stones tends to be higher amongst relatives of stone‐formers than amongst the corresponding relatives of control subjects, the male/female ratio being 2:1.

The occurrence of urinary stones is significantly associated with that of gallstones, high blood pressure, backache, arthritis and gout but not with that of peptic ulcer, diabetes, thyroid disease or bronchitis.
Percutaneous Nephrolithotomy
Authors: WHITFIELD H. N.
Published: November 2008

Summary— Percutaneous nephrolithotomy is becoming an established technique for the surgical management of renal stones. In a series of 48 patients treated by this method a success rate of 89% was achieved after an initial learning phase. The technique is suitable to be practised in any Department of Urology.
Long‐term Results of Bladder Transection for Urge Incontinence
Authors: MUNDY A. R.
Published: November 2008

Summary— One hundred and four patients with urge incontinence associated with detrusor instability who had failed to respond to standard conservative treatment were treated by a modified bladder transection procedure.

Initially 74% were symptomatically cured, 14% were improved and 12% were failures. At 2 to 5 years after operation these results were 65%, 19% and 16% respectively. There was no significant morbidity and no mortality.

Bladder transection is still a useful method of treatment for the refractory patient with detrusor instability, although improvements in conservative treatment have reduced the need for it.
A Phase II Study of lntravesical Mitomycin C in the Treatment of Superficial Bladder Cancer
Authors: HARRISON G. S. M. , GREEN D. F. , NEWLING D. W. W. , RICHARDS B. , ROBINSON M. R. G. , SMITH P. H.
Published: November 2008

Summary— Twenty‐three patients with histologically prjoven superficial bladder cancer (Tis, Ta, T1) were treated with intravesical instillations of Mitomycin C at a dose of 20 mg in 20 ml of water 3 times weekly for 21 instillations. Seventeen patients (77%) showed complete disappearance of all known disease and a further 4 showed partial responses. In 8 patients toxic effects developed (thrombocytopaenia 1, chemical cystitis 2, skin rash 3, urinary tract infection 2). All resolved rapidly on stopping the treatment but were severe enough in 5 patients to prevent them from receiving a full course of treatment.
Asepsis and Out‐Patient Cystoscopy
Authors: FOZARD J. B. J. , GREEN D. F. , HARRISON G. S. M. , SMITH P. H. , ZOLTIE N.
Published: November 2008

Summary— Cystoscopy was performed on a control group of 74 patients under full sterile precautions and on a study group of 83 patients under aseptic conditions, which required fewer materials. The incidence of urinary infections in the two groups was 4 and 6% respectively; this difference is not statistically significant. Rigors were rare in both groups (?1%). The financial savings achieved by using an aseptic technique for out‐patient cystoscopy are discussed.
A Trial Comparing the Stamey Bladder Neck Suspension Procedure with Colposuspension for the Treatment of Stress Incontinence
Authors: MUNDY A. R.
Published: November 2008

Summary— Fifty‐one women with urodynamically proven genuine stress incontinence were alternately allocated to either colposuspension or a Stamey‐type bladder neck suspension.

One year after operation 89% of the patients who had had a colposuspension were subjectively cured and 73% were objectively normal. In the Stamey procedure group these figures were 76 and 40% respectively.

The Stamey procedure is a quicker, simpler and a lesser procedure but has a higher incidence of post‐operative voiding difficulties and residual urge symptoms.

Colposuspension is to be preferred for the younger, healthier patient. The Stamey procedure is useful in the elderly, obese or unfit patient or the patient who has had multiple previous surgical attempts at a cure.
A Controlled Trial of Otis Urethrotomy
Authors: CHOA R. G. , ABRAMS P. H. , PYNSENT P. B. , ASHKEN M. H.
Published: November 2008

Summary— Otis urethrotomy is an empirical procedure when used in the treatment of recurrent urinary tract infection and the urethral syndrome. Sixty‐four female patients were randomised into two treatment groups. One group had cystoscopy alone and the other cystoscopy and Otis urethrotomy. The patients were assessed pre‐operatively and at 6 weeks after surgery both symptomatically and by urodynamic testing. There was no significant difference in the results obtained in the two groups. We conclude that Otis urethrotomy has no advantage in the routine treatment of patients with lower urinary tract symptoms.
Semen Analysis in Testicular Cancer and Hodgkin's Disease: Pre‐ and Post‐Treatment Findings and Implications for Cryopreservation
Authors: HENDRY W. F. , STEDRONSKA J. , JONES C. R. , BLACKMORE C. A. , BARREIT A. , PECKHAM M. J.
Published: November 2008

Summary— Over a 7–year period, seminal analysis has been performed on 208 patients with testicular tumours, after orchiectomy, but before any other treatment. Only 22% of 54 patients with seminomas, and 29% of 154 patients with teratomas or mixed tumours, had sperm counts exceeding 10 million per ml. Very low sperm counts were observed in some patients who had previously fathered children.

Post‐treatment sperm counts were done in 117 patients, 80 of whom had received multiple drug chemotherapy: 42 of these men had pre‐ and post‐treatment sperm counts. Overall, 24% of men receiving chemotherapy recovered sperm counts greater than 10 million per ml up to 3 years after therapy. Surprisingly, such recovery was seen in 35% of 23 men with initially poor sperm counts, but in only 26% of 19 with good initial counts.

Only 27% of 49 patients with Hodgkin's disease had initial sperm counts of more than 10 million per ml; after chemotherapy only 1 of 29 patients recovered to this level.

Only one quarter of these young men had semen which was adequate for cryopreservation. Artificial insemination with semen preserved in liquid nitrogen has been performed in 15 couples: 2 normal babies have been produced and a third pregnancy is progressing normally.
Is Conventional Sperm Analysis of Any Use?
Authors: HARGREAVE T. B. , ELTON R. A.
Published: November 2008

Summary— The computerised records of 867 couples were used to investigate the prognostic significance of semen volume, motility, density and morphology. The couple‐months method of statistical analysis was used, with allowance being made for the duration of involuntary infertility (trying time). Both motility and density were shown to give independent prognostic information, and a table of estimated probabilities is presented which may be helpful when advising the infertile couple on their chances of future conception. If the product of the motility times the density exceeded 0.5 million motile sperm per ml, then one semen analysis was sufficient from the point of view of giving a prognosis.
Exploratory Scrototomy in 168 Azoospermic Males
Authors: HENDRY W. F. , PARSLOW J. M. , STEDRONSKA J.
Published: November 2008

Summary— In 168 azoospermic males with normal or only slightly raised serum FSH levels, serum antisperm antibodies were measured, and the site of obstruction or the nature of the failure of spermatogenesis was defined by exploratory scrototomy with inspection of epididymes, vasography and testicular biopsy. When possible, surgical reconstruction was done by side‐to‐side epididymovasostomy, with vasovasostomy when necessary using 6/0 Prolene and no splints.

Acquired blocks of cauda epididymis (34 cases) and vas (23 cases) were significantly more commonly associated with serum antisperm antibodies than congenital bilateral absence of vasa (29 cases) or blocks at the caput epididymis (48 cases), most of which were associated with sinusitis, bronchitis or bronchiectasis (Young's syndrome). Many of the former patients came from abroad, whereas most of the latter came from the British Isles.

Sperm counts of 10 million per ml or more were produced by 23 (45%) of 51 adequately followed up patients with acquired blocks following surgical reconstruction, and 11 pregnancies (21.5%) were produced. Amongst those with spermatozoa in the ejaculate after surgery, serum antisperm antibodies were found significantly less often in those whose wives became pregnant compared with those who failed to produce pregnancies. It is concluded that failure of surgical treatment in some of these cases may have an immunological basis. No success was achieved with other groups.
The Biomechanical Principles of Upper Urinary Tract Pressure‐flow Studies
Authors: BULLOCK K. N.
Published: November 2008

Summary— An experimental model is described in which the relationship between relative renal intrapelvic pressure and perfusion rate at varying degrees of ureteric obstruction was investigated in the rabbit ureter. There was smooth, laminar (Poiseuille) flow in the ureter over a wide range of flow rates even in the presence of sharp constrictions. The theoretical basis of these findings in terms of the fluid mechanics of collapsible tubes is defined and their importance in the assessment of equivocal upper tract obstruction discussed.
Clinically Unrecognised Renal Carcinoma: Aspects of Tumour Morphology, Lymphatic and Haematogenous Metastatic Spread
Authors: HELLSTEN S. , BERGE T. , LINELL F.
Published: November 2008

Summary— In a series comprising 235 clinically unrecognised renal carcinoma, metastatic spread was found in 56 cases (24%). In 82% of cases with metastases the spread involved more than one site.

Lymphatic spread was diagnosed in 37 patients. Lymph node metastases were usually multiple and multifocal and were almost as common in the mediastinum as in the retroperitoneal space. In cases with involvement of these sites and/or supraclavicular nodes, concomitant metastases in the lungs were observed in 86% and in other organs in 11%.

Since lymph node invasion is a strong indicator of systemic spread, the therapeutic benefit of radical lymphadenectomy seems very low, whereas a limited unilateral dissection is justified mainly for its value as a staging procedure.
The Management of Female Incontinence by Suprapubic Catheterisation, with or without Urethral Closure
Authors: FENELEY R. C. L.
Published: November 2008

Summary— Thirty‐two female patients with continued urinary incontinence, following a period of urethral catheterisation, have been treated by suprapubic catheterisation. A technique is described for closure of the female urethra and this has been effective in 20 out of 24 patients. The procedure has been undertaken in some patients with advanced neurological disease and in the presence of pressure sores.
Extended Bladder Neck Incision for Outflow Obstruction in Male Patients
Authors: DELAERE K. P. J. , DEBRUYNE F. M. J. , MOONEN W. A.
Published: November 2008

Summary— Thirty‐two male patients with mechanical or functional bladder outlet obstruction were treated by bilateral endoscopic bladder neck incision. In three cases a repeat incision was necessary. Subjective cure or improvement was obtained in 81%. Objective evaluation, including uroflowmetry and residual urine measurements, showed a similar improvement. Bladder neck incision takes only a few minutes, is simple and less traumatic than transurethral resection. The aetiology of impaired micturition and the value of urodynamic assessment are discussed and some attention devoted to the problem of post‐operative retrograde ejaculation.
The Accuracy of a Hand‐held Real Time Ultrasound Scanner for Estimating Bladder Volume
Authors: RAVICHANDRAN G. , FELLOWS G. J.
Published: November 2008

Summary— In a prospective study using a portable real time ultrasound scanner, 82 estimations of the bladder volume were made in male patients with neurogenic bladder and these were compared in each case with the measured volume of urine obtained by catheterisation performed immediately after estimation. A further 25 estimations/measurements were made in patients in whom the bladder volume was less than 150 ml. Both studies showed that the scanner offered a reproducible and safe alternative to catheterisation for estimatng bladder volumes. The accuracy is sufficient for most clinical purposes.
Post‐catheterisation Urethral Strictures. A Clinical and Experimental Study
Authors: EDWARDS L. E. , LOCK R. , POWELL C. , JONES P.
Published: November 2008

Summary— Seventeen patients who developed urethral strictures following catheterisation have been studied; 14 of these (82%) were catheterised for standard monitoring purposes during and after major heart surgery, which was a coronary artery bypass graft (CABPG) in 12 cases. The possible aetiological mechanisms for the development of this complication are discussed.

Animal experiments were designed and carried out to compare the effects of different catheter materials on the urethral mucosa. Silicone catheters provoked the least inflammation and rubber the most. A further experiment determined the flow rates through catheters of different sizes. From our results, we suggest that the careful insertion of a small silicone catheter, distally fixed, is least likely to induce stricture formation.
Experience with Two‐Stage Scrotal Flap Urethroplasty for Stricture
Authors: KlNN ANNE‐CHARLOTTE , FRITJOFSSON Å.
Published: November 2008

Summary— A series of 50 men with variously‐caused stricture of the bulbar and/or membranous urethra is presented. The 2‐stage scrotal flap urethroplasty described by Blandy was used. As a rule the operation was technically simple. Post‐operative incontinence was not a problem. Recurrence or new stricture appeared in 7 cases, but 5 of these strictures were short and could be corrected with internal urethrotomy. Timed micturition showed improved voiding in all of the 18 patients studied before and after urethroplasty. Urodynamic studies in the last 8 cases of the series before and after urethroplasty showed significantly improved urinary flow and voiding post‐operatively, with reduction of detrusor pressure and residual urine.
Island Patch Urethroplasty: Effects on Urinary Flow and Ejaculation
Authors: VIJAYAN P. , SUNDIN T.
Published: November 2008

Summary— Seventeen patients had a single‐stage operation for urethral stricture. To avoid recurrence (which occurred in 2 patients) the urethra should be opened not only through the stricture but well beyond the pathological cavernous tissue. In 3 patients it was not possible to reconstruct the bulbocavernosus muscle over the bulb. This resulted in urethral pouching which did not interfere with micturition, except for after‐dribbling, but prevented forceful ejaculation and the semen leaked slowly for several minutes. Excision of the apex of the scrotal skin flap to the island patch seems to prevent marginal skin necrosis.
A Clinical Evaluation of Serum Placental Alkaline Phosphatase in Seminoma Patients
Authors: JEPPSSON A. , WAHREN B. , STIGBRAND T. , EDSMYR F. , ANDERSSON L.
Published: November 2008

Summary— Serum levels of placental alkaline phosphatase (PLAP) were measured in 100 patients with seminoma. A specific double antibody radioimmunoassay was used. PLAP was elevated for 9 out of 21 patients with primary tumours, to a mean of 53 μgII. Of the 12 cases with recurrent or metastatic growth, nine had raised PLAP. The sensitivity of PLAP determinations for primary and advanced disease was 55%. After successful treatment of seminoma, the PLAP level decreased. In a group of 68 patients with no evidence of disease, nine had slightly elevated serum PLAP. In many, but not all patients, serum PLAP parallelled the changes in tumour burden. In such patients and for follow‐up of treatment, PLAP might be used as a new marker for seminomatous disease.
Urinary Particulate Activity in Urinary Calculus Disease
Authors: ADAMTHWAITE D. N.
Published: November 2008

Summary— In urinary calculus disease there remains a group of patients with no demonstrable biochemical abnormality. A method is described measuring particulate activity in freshly voided urine using a Coulter Counter, which demonstrates the abnormality in these cases. Urine from 100 normal controls and 100 persons with urinary calculus disease was analysed, demonstrating a statistically significant difference between the 2 groups (P< 0.001).
A Prospective Study of Renal Stone Recurrences
Authors: Ljunghall S. , Danielson B. G.
Published: November 2008

Summary— A simple metabolic investigation was carried out in 54 patients presenting with their first attack of renal stones. In three cases a probable cause for stone formation was found. During the following 8 years 53% of the patients developed recurrences, the risk of which was highest during the first years after the initial attack. Recurrences were more common in males than in females. As a group, patients who were to have recurrences had higher urinary calcium levels but there was a considerable overlap between the two groups.

This prospective study confirms the opinion from retrospective evaluation of the natural history of renal stones that recurrences are common. However, they cannot be predicted from standard laboratory findings in individual patients.
Study of the Venous Phase on Renal Angiography in Cases of Renal Carcinoma
Authors: Masuda F. , Ohnishi T. , Nakada J.
Published: November 2008

Summary— The venous phase on renal angiography was studied in 65 cases of renal carcinoma. Opacification of the renal vein stem was observed in 33 cases (51%). The visualisation rate of the renal vein was lower in high stage than in low stage tumours but there was no difference between these groups if patients with tumour thrombus of the renal vein were excluded from the high stage group. Renal arteriovenous fistulas were observed in six cases (9%), in three of which tumour thrombus of the renal vein was also seen. The thrombus was discovered at operation in 14 of the 65 cases and it was in 10 of these that the striated vascular pattern was observed on renal angiography. Collateral veins were observed in 15 cases (23%), only five of which had tumour thrombus of the renal vein.
Endoscopic Injection of the Vasoconstrictor Ornithine‐8‐Vasopressin in Transurethral Resection
Authors: Smart R. F.
Published: November 2008

Summary— A simple technique to inject the synthetic vasoconstrictor agent ornithine‐8‐vasopressin endoscopically into the prostate has been developed. The method has been assessed by two prospective randomised controlled trials on patients undergoing transurethral resection of the prostate. Results from the first trial, involving 56 patients who had general anaesthesia, were that the mean operative blood loss was 48% less in the treated group, a significant difference (P= 0.05). Results from the second trial, involving 57 patients who had spinal anaesthesia, were that the mean operative blood loss was 75% less in the treated group, a highly significant difference (P= 0.01).

The pharmacology of the drug is reviewed, and it seems to be a safe agent which aids transurethral resection. It frequently causes a modest and transient elevation in blood pressure shortly after injection and, although not encountered by the author, it is possible that a more severe elevation' necessitating treatment may rarely occur.
Serum Level of Prostatic Acid Phosphatase After Diagnostic Rectal Examination: Comparison between Spectrophotometric and a Radioimmunological Assay
Authors: Grenabo L. , Eddeland A. , Ståhl A. , Tengström B.
Published: November 2008

Summary— The serum level of prostatic acid phosphatase was measured before and after diagnostic rectal palpation in 24 patients with a clinically normal prostate and in 32 patients with benign hyperplasia of the prostate. There was a significant rise in the 32 patients with benign prostatic hyperplasia. All of the values had returned to the original level after 24 h. Similar results were obtained with either a spectrophotometric method or a radioimmunoassay.
The Composition of Catheter Encrustations, including the Effects of Allopurinol Treatment
Authors: HEDELIN H. , EDDELAND A. , LARSSON L. , PETERSSON S. , ÖHMAN S.
Published: November 2008

Summary—
The composition of encrustations precipitated on long‐term indwelling urethral catheters was analysed using a newly developed wet chemical method that allows determination of small sample volumes. In contrast to earlier studies, the major portion of the encrusted material could be identified; ammonium magnesium phosphate and calcium phosphates (brushite and apatite) were the major components. The effect of allopurinol was also investigated and it was found to decrease significantly the amounts of urate and calcium phosphate but not to lower significantly the total amount of material precipitated on the catheters.
Prognostic Factors in Renal Carcinoma. An Evaluation of Operative Findings
Authors: NURMI M. J.
Published: November 2008

Summary—A consecutive series of 257 patients with renal carcinoma treated by radical nephrectomy is presented. The crude 5–year and 10–year survival rates for all patients were 47 and 31% respectively and for patients without distant metastases 62 and 50%. The importance of factors relating to prognosis was investigated with multivariate survival analysis. Metastases, nodal involvement and histological grade were strongly and independently associated with survival, but the influence of venous invasion was less important. When these factors are taken into consideration, direct extension, size and cell type of the tumour or sex and age of the patient give no significant additional prognostic information.
Fibrescope Urethrocystoscopy
Authors: Fowler C. G.
Published: November 2008

Summary—
Cystourethroscopy with a small calibre flexible fibrescope may be performed under topical lignocaine anaesthesia with less discomfort to the patient than with a conventional rigid cystoscope. The method is safe and reliable. The technique is especially useful in out‐patient surveillance of bladder cancer.
Direct Vision Internal Urethrotamy. A Critical Review of 365 Operations
Authors: Holm‐Nielsen A. , Schultz A. , Møller‐Pedersen V.
Published: November 2008

Summary—
Internal urethrotomy under direct vision for urethral strictures in the male was employed on 369 occasions in 225 patients during a 4‐year period.

A retrospective review of results showed an overall cure rate of 77% but the cure rate after each individual operation was less than 50%. Operations for recurrence carried a significantly lower cure rate than initial operations but even after several recurrences there were reasonably good results considering the relatively minor procedure.

An active post‐operative follow‐up employing routine urethroscopy showed significantly better results than mictiographic follow‐up.

The post‐operative period of catheterisation and positive urine culture at the time of follow‐up had no significant influence on the results.
Percutaneous Nephrolithotomy: One Stage or Two?
Authors: WICKHAM J. E. A. , MILLER R. A. , KELLETT M. J. , PAYNE S. R.
Published: November 2008

Summary— Two hundred and fifty cases of percutaneous nephrolithotomy (PNL) are described. One hundred and fifty cases were treated in two stages, 100 in a single stage. The one‐stage method has been shown to be as safe as the two‐stage method but should be reserved for those with experience of the technique and who possess adequate instrumentation. PNL has proved to be a preferable option to open stone surgery and a useful alternative to extracorporeal shock wave lithotripsy (ESWL).
Electrohydraulic Nephrolithotripsy: a Preferable Alternative to Ultrasound?
Authors: MILLER R. A. , PAYNE S. R. , WICKHAM J. E. A.
Published: November 2008

Summary— Three hundred patients have undergone percutaneous nephrolithotomy in our unit; 66 required disintegration of their renal calculi, 24 by electrohydraulic lithotresis (EHL) and 42 by ultrasonic lithotresis (USL). EHL has been associated with a lower residual stone rate, a reduced number of repeat endoscopic sessions and no additional complications. EHL has been shown to be efficient, safe and preferable to USL. The occurrence of residual stone fragments following disintegration suggests that mechanical extraction should be used whenever possible and that disintegration, whether by electrohydraulic or ultrasonic lithotresis, should be reserved for stones which are either impacted or too large for mechanical extraction.
Inhibition of Calcium Oxalate Crystallisation by Pentosan Polysulphate in Control Subjects and Stone Formers
Authors: NORMAN R. W. , SCURR D. S. , ROBERTSON W. G. , PEACOCK M.
Published: November 2008

Summary— In vitro studies showed that sodium pentosan polysulphate (SPP) is an active inhibitor of calcium oxalate (CaOx) crystal growth and agglomeration and that it acts by increasing the negative zeta potential on the surface of CaOx crystals. Oral administration of SPP to control subjects, recurrent stone formers and patients with primary hyperoxaluria resulted in an overall increase of 8% (P < 0·1) in the polyanionic inhibition of CaOx crystallisation in urine as measured by the zeta potential. SPP could provide a novel approach to the medical prevention of recurrent CaOx stone disease.
Practical Experience with Flexible Fibrescope Cystoscopy in Out‐patients
Authors: FOWLER C. G. , BADENOCH D. F. , THAKAR D. R.
Published: November 2008

Summary— Four hundred and seventy‐four patients were examined by flexible cystoscopy under topical urethral anaesthesia in the out‐patient clinic in the first year after the technique was introduced as the routine method for diagnostic cystoscopy. The technique has proved safe, efficient and highly cost‐effective.
Results of Transvesical Infiltration of the Pelvic Plexuses with Phenol in 116 Patients
Authors: BLACKFORD H. N. , MURRAY K. , STEPHENSON T. P. , MUNDY A. R.
Published: November 2008

Summary— One hundred and sixteen patients with detrusor instability, detrusor hyper‐reflexia or bladder hypersensitivity who had failed to respond to standard conservative methods of management were treated by transvesical infiltration of the pelvic plexuses with phenol. A satisfactory response was obtained in detrusor hyper‐reflexia (82%), in detrusor instability in patients over 55 years of age (69%) and in idiopathic bladder hypersensitivity (68%). The response rate was much less satisfactory in detrusor instability in patients less than 55 years of age (14%) and when there was a definable cause for bladder hypersensitivity (0%).
Malignant Lymphoma of the Testis
Authors: BALDETORP L. A. , BRUNKVALL J. , CAVALLIN‐STÅHL EVA , HENRIKSON H. , HOLM E. , OLSSON A. M. , ÅKERMAN M.
Published: November 2008

Summary— Lymphoma presenting in the testis was evaluated in 24 patients. The tumours were classified according to both the Rappaport and the Kiel classification. The Rappaport classification yielded only two tumour types—15 diffuse histiocytic and 9 diffuse mixed histiocytic‐lymphocytic, with no pure lymphocytic lymphoma. No difference in survival time was found between these two tumour types. According to the Kiel classification there were four histological tumour types—immunoblastic (11 cases), centroblastic (2), centroblastic/centrocytic (6) and polymorphic immunocytic (5). In comparison with the other tumour types, the centroblastic/centrocytic lymphomas seemed to be advantageous as regards survival. It is concluded that systemic treatment with chemotherapy in accordance with current principles for malignant lymphoma is indicated following orchiectomy in localised testicular lymphoma as well as in disseminated disease. The value of post‐operative radiotherapy to regional nodes is questionable.
Prostaglandin Synthetase Inhibitors and their Effect on Urinary Calcium Excretion and other Parameters in Idiopathic Hypercalciuria
Authors: SHAH P. J. R. , ROSE G. A.
Published: November 2008

Summary— The treatment of idiopathic hypercalciuric stone formers with the prostaglandin synthetase inhibitors flurbiprofen and indomethacin has been studied in two phases. Ten patients were studied in a metabolic unit for 14 days that included a control period of 7 days on a controlled intake of dietary calcium, followed by treatment with flurbiprofen 50 mg tds. Three patients were studied along similar lines and were treated with indomethacin 25 mg tds.

A significant reduction in urinary calcium excretion was noted during the 7‐day control period during which dietary calcium intake was reduced to 700 mg daily. No further significant reduction in urinary calcium excretion was observed during the treatment with either flurbiprofen or indomethacin.

Thirteen patients then continued to take flurbiprofen 50 mg tds for between 1 and 12 months. A small but not statistically significant reduction in urinary calcium excretion was noted by the third month of treatment, but this was not sustained.

This study confirms the benefit of dietary restriction of calcium as the primary approach to the treatment of idiopathic hypercalciuria. Neither flurbiprofen nor indomethacin reduced urinary calcium excretion to significant levels. Their routine use for the treatment of idiopathic hypercalciuria cannot be recommended from the evidence of this study.
Practical Management of Patients with Dilated Upper Tracts and Chronic Retention of Urine
Authors: GEORGE N. J. R. , O'REILLY P. H. , BARNARD R. J. , BLACKLOCK N. J.
Published: November 2008

Summary— Patients with chronic retention of urine associated with dilated upper tracts have been investigated by means of combined lower tract urodynamics and upper tract renography. It has been shown that minor alterations in bladder volume lead to marked changes in isotope washout from the upper tracts. It is concluded that the practice of slow decompression of the bladder in these patients is clinically impractical, and attention should be directed to the management of the post‐obstructive diuretic state.

Further observations have suggested that upper tract drainage in such patients may be dependent upon postural factors, and the practical implication of this finding is discussed.
The Smooth Muscle of Rat Bladder in the Early Stages of Streptozotocin‐induced Diabetes
Authors: LINCOLN J. , HAVEN A. J. , SAWYER M. , BURNSTOCK G.
Published: November 2008

Summary— The morphology of the rat bladder was studied following 8 weeks of streptozotocin‐induced diabetes, at which stage distension of the bladder had occurred. Evidence is presented for hypertrophy of the smooth muscle of the bladder wall in experimental diabetes. It is suggested that the morphological changes found in the diabetic rat bladder are associated with polyuria. The results are discussed in relation to clinical studies of bladder dysfunction in diabetes mellitus.
Experience with Meatal Advancement and Glanuloplasty (MAGPI) Hypospadias Repair
Authors: MAN D. W. K. , HAMDY M. H. , BISSET W. H.
Published: November 2008

Summary— Our experience with the procedure of meatal advancement and glanuloplasty (MAGPI) is reviewed with a note on the technique. It was found that MAGPI can improve the position of the urethral meatus, correct meatal stenosis, release associated skin chordee and produce the aesthetic appearance of a normal penis. The fistula rate was zero and there were no other complications. It is recommended as the operative procedure of choice for glanular, coronal and selected cases of subcoronal hypospadias.
Intraepithelial Lymphocytes in the Normal Epididymis. A Mechanism for Tolerance to Sperm Auto‐Antigens?
Authors: RITCHIE A. W. S. , HARGREAVE T. B. , JAMES K. , CHISHOLM G. D.
Published: November 2008

Summary— Using a monoclonal immunoperoxidase technique on frozen tissue sections of normal testis and epididymis, a distinctive distribution of lymphocytes has been identified. Almost all of the intra‐epithelial lymphocytes were T cells and the majority of these belonged to the T8+ (“suppressor/cytotoxic”) subset. The distribution contrasted with the predominance of the T4+ (“helper/inducer”) subset in the interstitial tissues and in normal peripheral blood. The predominance of the “suppressor/cytotoxic” subset within the epithelium of the epididymis may exist in order to prevent the development of the immune response to auto‐antigens on spermatozoa.
Ultrasound Assessment of Residual Urine: A Quantitative Method
Authors: BEACOCK C. J. M. , ROBERTS E. E. , REES R. W. M. , BUCK A. C.
Published: November 2008

Summary— A method of measuring residual urine volume using ultrasound is described. The volume is computed from serial parallel sections of the bladder. This method is found to be significantly more accurate than previously reported techniques and is quick and easy to perform.
Perineal Nerve Damage in Genuine Stress Urinary Incontinence; An Electrophysiological Study
Authors: SNOOKS S. J. , BADENOCH D. F. , TIPTAFT R. C. , SWASH M.
Published: November 2008

Summary— Twelve patients with genuine stress incontinence of urine were investigated using manometric and electrophysiological techniques. All were shown to have slowed conduction in the perineal branch of the pudendal nerve which innervates the periurethral striated sphincter muscle. The mean perineal nerve terminal motor latency in these patients was 3.9 ± 0.8 (ms) and in 20 age and parity matched control subjects was 2.0 ±0.2 (ms) (P < 0.001). These results are consistent with a neurogenic factor in patients with genuine stress incontinence of urine which may have implications regarding selection of patients for surgery to restore urethral competence.
Adenomatous Metaplasia (Nephrogenic Adenoma) of Urothelium: An Analysis of 70 cases
Authors: FORD T. F. , WATSON G. M. , CAMERON KATHARINE M.
Published: November 2008

Summary— A retrospective analysis of 70 cases of adenomatous metaplasia seen in the St Peter's Hospitals over a 15‐year period has been carried out. The lesions occurred at all ages (7–81 years) and in both sexes (51 males, 19 females) and were found throughout the urinary tract from pelvis to urethra. In the pelvis and ureter the finding was usually an incidental one in association with stones or chronic inflammation; ulceration was a frequent accompaniment. Most vesical and urethral lesions followed a surgical procedure months or years previously, the patients re‐presenting with haematuria or irritative bladder symptoms. The endoscopic appearances varied but there was often a striking correlation between the location of the lesions and the site of previous surgery. The association of adenomatous metaplasia with ulceration and previous surgery leads us to suggest that it is merely an unusual response to wound healing and attempts to treat it by diathermy resection are, therefore, likely to meet with limited success. Cystoscopic follow‐up of persistent lesions gives no reason to suppose they are pre‐malignant.
Vesico‐uterine Fistula
Authors: ILOABACHIE G. C. , NJOKU O.
Published: November 2008

Summary— Nine cases of vesico‐uterine fistula caused by injury to the bladder at Caesarean section or by rupture of the uterus and bladder following obstructed labour are described.

Symptoms depend on the level of the lesion, menstruation into the bladder and menouria occurring when the fistula is above the internal cervical os: whatever the level, most patients with vesico‐uterine fistula present with incontinence of urine.

A transperitoneal approach appears to give better results than a transvesical repair.
Ascent of the Testis: Fact or Fiction
Authors: ATWELL J. D.
Published: November 2008

Summary— Ascent of the testis from the normal to an undescended position has been observed in 10 patients. In 9 of them there was a complete hernial sac and it is suggested that the acquired malposition of the testis is due to partial absorption of the processus vaginalis into the parietal peritoneum. Alteration in the length of the inguinal canal with growth may be an additional contributory factor. The mean interval between the original and subsequent observations was 5.2 years, leading to a late orchiopexy at a mean age of 9.4 years.