bluuebunny/crossref_metadata_2025 huggingface dataset:
Risk Factors for Urinary Calcium Oxalate Crystals as Revealed by their Specific Enzymatic Assay
Authors: HALLSON P. C. , ROSE G. A.
Published: November 2008

Summary— Calcium oxalate crystal concentrations were assayed by a new highly specific enzymatic method in 1200 urine samples from normal subjects and stone formers. Examination of the crystals was also carried out by light microscopy and urines were analysed for oxalate, calcium, magnesium, citrate, urate, pH and osmolality.

A striking positive correlation was established between urinary oxalate concentration and calcium oxalate crystal concentration as well as incidence of calcium oxalate crystals and aggregates seen by microscopy. A less striking relationship, also supported by light microscopy, was found between calcium oxalate crystal concentration and urinary calcium concentration. A small rise in calcium oxalate crystalluria was seen with increasing osmolality, but no relationship found between concentration or urinary urate, citrate or magnesium and that of calcium oxalate crystals. Higher levels of calcium oxalate crystal concentration appeared in alkaline urines in association with calcium phosphate.

The dominance of urinary oxalate as a risk factor for calcium oxalate crystalluria is confirmed.
Measurement of Calcium Phosphate Crystalluria: Influence of pH and Osmolality and Invariable Presence of Oxalate
Authors: HALLSON P. C. , ROSE G. A.
Published: November 2008

Summary— Calcium phosphate and calcium oxalate urinary crystal concentrations in normal and stone‐forming subjects were measured. The urinary crystals were examined by light microscopy and urine samples were analysed for oxalate, pH and osmolality.

Calcium phosphate crystal concentrations were clearly related to urine pH but unrelated to urine osmolality. An unexpected finding was co‐precipitation of oxalate with calcium phosphate. Consequently, precipitated invariable oxalate increased with rising urinary pH. Possible explanations and implications are discussed.
Possible Role of Tamm‐Horsfall Glycoprotein in Calcium Oxalate Crystallisation
Authors: YOSHIOKA T. , KOIDE T. , UTSUNOMIYA M. , ITATANI H. , OKA T. , SONODA T.
Published: November 2008

Summary— The role of Tamm‐Horsfall glycoprotein (THGP) in the crystallisation of calcium oxalate was investigated. The results showed THGP to have a weak inhibitory effect on crystal growth. In contrast, urinary macromolecules showed a strong inhibitory effect. THGP should, therefore, not be considered the main component of urinary macromolecules which have a strong inhibitory effect on crystal growth. However, THGP did enhance crystal production in the early phase of crystallisation. It appears that THGP should be viewed as a promoter rather than an inhibitor of calcium oxalate crystallisation at physiological concentrations.
Hot Flushes are Induced by Thermogenic Stimuli
Authors: McCALLUM K. A. , READING C.
Published: November 2008

Summary— Hot flushes were caused by hot drinks, alcohol, radiant heaters and thermal blankets in men undergoing treatment for carcinoma of the prostate and in menopausal women. Avoiding or changing these commonplace stimuli appears to reduce the frequency of flushing.
Chemotherapy of Advanced Seminoma: Clinical Significance of Radiological Findings before and after Treatment
Authors: FOSSÅ SOPHIE D. , KULLMANN G. , LIEN H. H. , STENWIG ANNA E. , OUS S.
Published: November 2008

Summary— The predictive significance of the mass detected following chemotherapy was assessed in 46 patients with advanced seminoma. Patients with residual viable seminoma in the post‐chemotherapy operation specimen or who developed recurrent disease were regarded as chemotherapy failures. This group included 1 of 20 patients in whom the retroperitoneal masses were ≤ 10 cm2 3 to 4 weeks after chemotherapy and 4 of 15 patients whose residual masses were >10cm2.

Four of 11 patients with mediastinal tumours achieved a complete remission (mediastinal masses ≤ 1 cm2). However, 2 of these 4 patients relapsed, as did 2 of the 4 who achieved a partial remission. In no case was the original size of the tumour significantly related to treatment failure. Three patients had residual lung masses; 1 of these contained histological evidence of viable tumour.

In one‐third of the irradiated relapse‐free patients, slightly enlarged masses were visible on follow‐up computed tomography scans taken several years after treatment, even in patients without tumour activity.

There is a 25% risk of relapse in patients with advanced seminoma who have retroperitoneal masses > 10 cm2 following cisplatin‐based chemotherapy. They should be followed up regularly for many years.
Deep Dorsal Vein Arterialisation in Vascular Impotence
Authors: WESPES E. , CORBUSIER A. , DELCOUR C. , VANDENBOSCH G. , STRUYVEN J. , SCHULMAN C. C.
Published: November 2008

Summary— A series of 12 patients with vasculogenic impotence (4 arterial lesions; 8 arterial and venous lesions) underwent deep dorsal vein arterialisation after pre‐operative assessment by a multidisciplinary approach. Cumulative graft patency was 58% (7 of 12 patients) up to 21 months but only 4 patients developed almost normal erections.

Digital angiography, with and without the intracavernous injection of papaverine, was performed during follow‐up to determine the vascular physiological status. At flaccidity, the corpora cavernosa were never opacified in the absence of a venocorporeal shunt. The penile glans was always visualised. Opacification of the deep dorsal vein and the circumflex system decreased with penile rigidity, resulting from their compression between Buck's fascia and the tunica albuginea. Intracavernous pressure recorded before and after the surgical procedure showed a marked increase when a caverno‐venous shunt was performed. Hypervascularisation of the glans occurred in 2 cases. The relevance of this new surgical technique and its functional mechanism are discussed.
Nodular Peri‐orchitis
Authors: HEATON N. D. , KADOW C. , PACKHAM D. A.
Published: November 2008

Chronic proliferative nodular peri‐orchitis or vagin‐alitis is a rare benign “tumour” which presents with features suggestive of scrotal malignancy.
Submeatal Injection of Polytetrafluoroethylene Paste for the Endoscopic Treatment of Vesicoureteric Reflux in Adults
Authors: YACHI D.A.
Published: November 2008

Summary— The injection of submeatal Teflon paste is often used for the treatment of paediatric vesicoureteric reflux (VUR). We present our results using this treatment in 7 adults and 1 female child; 11 ureters were injected with a 73% success rate. The simplicity of the procedure and the encouraging results make this a desirable treatment for adult VUR.
Endoballoon Rupture and Stenting for Pelviureteric Junction Obstruction: Technique and Early Results
Authors: O'FLYNN K. , HEHIR M. , McKELVIE G. , HUSSEY J. , STEYN J.
Published: November 2008

Summary— Endoballoon rupture and stenting was performed on 31 patients with pelviureteric junction obstruction. A percutaneous antegrade approach was used in 20 patients, a retrograde technique in 11. Clinical and renographic improvement was seen in 21 patients. Four patients later underwent nephrectomy, all of whom had a GFR of less than 20% in the affected kidney.

Endoballoon rupture is technically undemanding, easier and less invasive than endopyelotomy. In patients with adequate renal function it provides a suitable alternative to pyeloplasty.
Transrectal Ultrasound Scanning in Urinary Incontinence: the Effect of the Probe on Urodynamic Parameters
Authors: RICHMOND D. H. , SUTHERST J.
Published: November 2008

Summary— A linear array real time transrectal ultrasound technique was used to screen the bladder and urethra of female patients with urinary incontinence during urodynamic investigation. There was no significant difference in any of the urodynamic measurements with or without the probe in situ.
Structure and Per‐rectal Ultrasonography of Prostatic Disease using Cadaver Specimens
Authors: JONES D. R. , GRIFFITHS G. J. , PARKINSON M. C. , EVANS K. T. , ROBERTS E. E. , DAVIES R. LI. , HARRISON T. J. , PEELING W. B.
Published: November 2008

Summary— One hundred cadaver prostates were examined by per‐rectal ultrasound and the findings correlated with the microradiographic and histopathological features of whole sections taken at the levels of scanning.

The normal gland consists of both periurethral muscle and glands. The periurethral muscle has little structure on microradiography and is therefore hypoechoic (low amplitude echoes) on ultrasound scanning. The gland itself, both central and peripheral zones, has a lattice appearance on microradiography (reticular structure) and therefore produces mid‐range amplitude echoes on ultrasound.

Benign hypertrophy develops at the edge of the periurethral muscle and is microadenomatous in structure. This produces mid‐range amplitude echoes which are coarser than in the normal gland. Associated calcification has a characteristic distribution around the adenomas.

Cancer produces an amorphous structure resulting in loss of ultrasonic echoes (hypoechoic). In a few cancers irregular calcification is present, resulting in high echoes in the ultrasound scan (hyperechoic) which are not in the typical benign distribution.

The internal structure of the prostate was therefore demonstrated in its histopathological states by the technique of microradiography and seen to relate to its representation by ultrasound.
The Treatment of Sphincter Strictures
Authors: MUNDY A. R.
Published: November 2008

Summary— A group of 25 patients with strictures of the membranous urethra following transurethral resection of the prostate (TURP) were investigated and treated initially by careful urethral dilatation. This controlled the stricture in 14 patients, 6 of whom continued with occasional dilatation or self‐catheterisation to maintain control; 8 required an artificial urinary sphincter (AUS) and 2 required a “clam” ileocystoplasty for detrusor instability. Eleven had persistent or recurrent strictures requiring urethroplasty. Nine underwent bulbo‐prostatic anastomotic urethroplasty, 4 with simultaneous bladder neck reconstruction and 5 with subsequent implantation of an AUS; 2 had a preputial patch urethroplasty with subsequent implantation of an AUS. Four of the 9 patients with a urethroplasty and an AUS are satisfactory, 1 developed a recurrent stricture and 2 developed erosions. Two of those with a bulbo‐prostatic anastomosis and bladder neck reconstruction are satisfactory and 2 are incontinent.

These results were compared with those of 18 other patients who underwent bladder neck reconstruction and 12 who had a urethroplasty in conjunction with an AUS for reasons other than a post‐TURP sphincter stricture. The success rate of bladder neck reconstruction was 55% and the success rate of urethroplasty in conjunction with an AUS was 83%, but the main complication of AUS implantation, erosion, was a more serious problem than failure of bladder neck reconstruction. However, the much higher success rate makes AUS implantation a more satisfactory procedure. Surgery should be avoided if at all possible and reliance placed on urethral dilatation.
Acquired Ventral Penile Curvature: Spongiofibrosis Caused by Urethral Manipulation
Authors: YACHIA D.
Published: November 2008

Summary— Fibrosis of the corpus spongiosum, caused by urethral manipulation, and the resulting ventral penile curvatures are known as the urethral manipulation syndrome. This acquired, largely iatrogenic deformity is noticed only by sexually active patients.

Partial, gradual disappearance of glans engorgement and irregularities palpable along the penile urethra associated with ventral curvature are constant findings. The post‐manipulative ventral curvature can be transient, disappearing when the inflammatory process subsides or the repeated urethral manipulation ceases. Since fibrosis of the corpus spongiosum begins with urethral inflammation, patients in whom irregularities of the penile urethra are observed during urethrography should be questioned about any erectile deformity.

Surgical treatment is indicated when the deformity interferes with sexual intercourse or is accompanied by severe urethral strictures.
Anterior Pelvic Osteotomy. A New Operative Technique Facilitating Primary Bladder Exstrophy Closure
Authors: FREY P. , COHEN S.J.
Published: November 2008

Summary— Posterior iliac osteotomy is a recognised method employed to facilitate and support anterior abdominal wall closure in patients with bladder exstrophy, but it adds considerably to the already lengthy procedure of bladder exstrophy surgery. Anterior pelvic osteotomy of the superior ramus of the pubic bone was developed to overcome this problem and to achieve a stable anterior pelvic ring with tension‐free soft tissue closure. It can easily be performed after completing the bladder closure, without the need to turn the patient.
Vesicoureteric Reflux and Urinary Calculi in Children
Authors: ROBERTS J. P. , ATWELL J. D.
Published: November 2008

Summary— We present 5 patients with urinary calculi and vesicoureteric reflux (VUR). In 4 patients the VUR was probably primary and in 1 it was secondary to the calculus disease. The incidence of calculi with reflux is approximately 0.5% whereas the incidence of reflux with calculi is approximately 8%.
Management of Localised Prostatic Carcinoma
Authors: INGLIS J. A. , FOWLER J. W. , GRIGOR K. M.
Published: November 2008

Summary— Localised carcinoma of the prostate may be amenable to radical curative therapy. Staging pelvic lymphadenectomy is controversial but is the only means of demonstrating lymph node spread accurately. Five patients in a group of 16 who presented apparently with localised prostatic carcinoma, and who had negative bone scan and CT scan, were shown at operation to have metastatic carcinoma involving their lymph nodes; 3 of 8 patients with high grade tumours were free of lymph node metastases. Without staging lymphadenectomy, these patients may have been inappropriately treated.
Neurophysiological Aspects of Penile Erection: the Role of the Sympathetic Nervous System
Authors: JÜNEMANN K.‐P. , PERSSON‐JÜNEMANN CHARLOTTA , LUE T. F. , TANAGHO E. A. , ALKEN P.
Published: November 2008

Summary— Recent studies have revealed that the initiation, maintenance and rigidity of penile erection are under parasympathetic and somatotopic control. The mechanism of penile detumescence is still under debate. Single and combined cavernous and hypogastric nerve stimulation was used to study the influence of the sympathetic nervous system on penile erection and to indentify the mechanism of penile detumescence.

Penile arterial flow and intracorporeal pressure recordings during various stimulation patterns indicated that erection induced by stimulation of the cavernous nerve could be blocked by excitation of the upper hypogastric nerves. Venous outflow studies demonstrated that the inhibitory effect of the sympathetic nervous system was due to active vaso‐ and corporeal smooth muscle constriction. It was concluded that subsidence and suppression of erection is a sympathetic function.

Previous studies have shown that the neurophysiology of erection can be explained by 3 major inhibitory (sympathetic). Our findings are of clinical importance, since a better appreciation of the basic erectile mechanism is essential for successful management of erectile dysfunction.
Renal Carcinomas Missed by Urography
Authors: GLEN D. A. , GILBERT FIONA J. , BAYLISS A. P.
Published: November 2008

Summary—
It is well accepted that renal masses are missed on intravenous urography. We present 3 patients with renal carcinoma; their tumours, measuring between 3 and 5 cm, were not detected on good quality IVU but were demonstrated on ultrasound. We wish to emphasise the importance of performing an ultrasound or computed tomography examination in cases where a renal tumour is suspected when the IVU is normal.
The Value of Intravesical Echography Combined with Double‐surface Coil Magnetic Resonance Imaging in Staging Bladder Cancer
Authors: HENDRIKX A. J. M. , BARENTZ J. O. , STAPPEN W. A. H. v.d. , DEBRUYNE F. M. J. , RUIJS S. H. J.
Published: November 2008

Summary—
Correct staging of bladder tumours is essential for planning the best therapeutic strategy and is therefore directly related to the prognosis. In this study of 15 patients with bladder cancer, a new method using magnetic resonance imaging (MRI) with a newly developed double‐surface coil was tested for bladder cancer staging and compared with other existing techniques.

Ultrasonography produced 2 cases of overstaging and 2 of understaging. This was due to the inability of this method to evaluate muscular infiltration accurately. All superficial bladder tumours were staged correctly with ultrasound with the exception of 1 case that was overstaged because of superficial tumour calcification. Double‐surface coil MRI correctly staged all infiltrating tumours. Two small superficial tumours were missed by MRI, while another superficial tumour was overstaged.

It is suggested that double‐surface coil MRI and intravesical ultrasonography are good complementary examinations in the pre‐operative staging of bladder tumours. Larger studies are necessary to prove the reliability of this conclusion.
99mTc‐Nanocolloid Bone Marrow Scintigraphy in Prostatic Cancer
Authors: HADDOCK G. , GRAY H. W. , McKILLOP J. H. , BESSENT R. G. , KIRK D.
Published: November 2008

Summary—
Bone marrow scintigraphy was performed in 23 patients with histologically proven carcinoma of the prostate, using a new radiopharmaceutical, Technetium‐99m nanocolloid. The results suggest that although bone marrow scintigraphy is less sensitive than conventional bone scintigraphy in the detection of skeletal metastases from prostatic carcinoma, the technique may have a place in the management of patients with advanced metastatic disease, especially those who are anaemic, by identifying those patients at risk from myelosuppressive therapy.
High Dose Polyoestradiol Phosphate with and without Acetosalicylic Acid versus Orchiectomy in the Treatment of Prostatic Cancer
Authors: ARO J. L. V. , HAAPIAINEN R. K. , RANNIKKO S. A. S. , ALFTHAN O. S.
Published: November 2008

Summary—
The clinical efficacy of high dose (160 mg) polyoestradiol phosphate (PEP) was compared with that of orchiectomy in a prospective randomised multicentre study including 200 prostatic cancer patients. The effect of daily low dose (75 mg) acetosalicylic acid (ASA) on possible cardiovascular complications during the first 6 months of therapy was also evaluated.

Oestrogen‐treated patients had more progressions, but follow‐up was too short to draw any definite conclusions on the efficacy of treatment. There was no cardiovascular mortality and there were no thromboembolic complications in any treatment group. It was concluded that parenteral high dose PEP is not associated with an increased risk of cardiovascular complications and there is no need for daily low dose ASA.
Extracorporeal Shock Wave Lithotripsy with the Lithostar Lithotriptor
Authors: GRACE P. A. , GILLEN P. , SMITH J. M. , FITZPATRICK J. M.
Published: November 2008

Summary—
Early experience of extracorporeal shock wave lithotripsy (ESWL) using the Lithostar lithotriptor is reported; 145 patients underwent 185 treatments for 189 stones. Treatments were performed with either intravenous sedation and analgesia (90%) or general anaesthesia (10%). There were 123 renal calculi, 44 ureteric calculi and 22 staghorn calculi. Stone fragmentation was achieved with 1724 ± 1035 shocks at 19 kv. The immediate stone fragmentation rate was 90% and the 3‐month clearance rate 88%. Secondary treatments were required in 19% of patients and additional procedures in 17%. A comparison between stone size and the number of shock waves required to achieve stone fragmentation revealed a linear relationship. The Lithostar is a very effective second generation lithotriptor which can be used for renal, staghorn and ureteric calculi in situ, without manipulation.
Evaluation of Surgical Procedures for Bilharzial Strictures of the Ureter
Authors: AWAD E. M. , IBRAHIM A. I. A. , BASHEER A. A. , FUDA B. I.
Published: November 2008

Summary—
A series of 35 patients, with unilateral hydronephrosis complicating bilharzial stricture of either the upper or the middle third of the ureter, was divided into 2 groups. Group A, comprising 21 patients, was treated by resection anastomosis. Group B, comprising 14 patients, was treated by other reparative procedures without resection of the stricture. The results of the surgical correction, assessed clinically and radiologically, showed that significantly better results were achieved with resection anastomosis than with the other procedures.
Adenocarcinoma of the Urinary Bladder
Authors: GILL H. S. , DHILLON H. K. , WOODHOUSE C. R. J.
Published: November 2008

Summary—
We report 40 patients seen over a 15‐year period with a histological diagnosis of adenocarcinoma of the bladder; 18 patients had primary adenocarcinoma of the bladder, arising either from the urachus or from glandular metaplasia of the urothelium, and the other 22 had secondary lesions representing invasion from adjacent structures, notably prostate, colon and ovary. In this latter group symptoms related to the primary lesion were variable. The distinction between primary and secondary neoplasm is an important one and was rarely made on the basis of endoscopic or clinical findings alone. Urachal tumours were more common in females, whereas primary and secondary vesical adenocarcinomas were more common in males. The urachal tumours also occurred in a younger age group. Most of the adenocarcinomas, urachal or primary, were already advanced at the time of diagnosis. All tumours were palpable bimanually after resection and were at least T2 or T3. In the urachal carcinomas the results of partial cystectomy were disappointing because of the high rate of local recurrence and death from metastases. Primary non‐urachal vesical adenocarcinoma carried an even poorer prognosis if non‐radical surgery was carried out. The mean survival was 13 months. Radiotherapy was not effective in urachal and primary adenocarcinomas as these tumours are generally radioresistant. The treatment of secondary adenocarcinoma was governed by the primary site of the tumour. Radical surgery combined with chemotherapy and radiotherapy appeared to give the longest survival in the colonic tumours. Patients with prostatic cancer had a poorer survival rate than those with the same stage tumour but without bladder involvement, with renal failure secondary to obstructive uropathy being the commonest cause of death.
Evaluation of the Home Pad Test for Quantifying Incontinence
Authors: WILSON P. D. , MASON MURIEL V. , HERBISON G. P. , SUTHERST J. R.
Published: November 2008

Summary—
The home pad test to quantify urinary incontinence is described. Patients conduct the test in their homes and bring the pad, in a self‐sealing plastic bag, for weighing at their next clinic visit. The validity of the procedure was assessed by measuring evaporation loss from the pads and comparing the home with the standard hospital test. Evaporation loss was shown to be acceptable if the test was carried out within 72 h of weighing. There were no significant differences between home and hospital tests and 95% of home results were within 32% below to 16% above hospital results. This was at least as consistent as the “gold standard” hospital test as 95% of the hospital results were within 28% below to 44% above repeated test results. The principal advantages in performing the pad test at home are simplicity, cost effectiveness and the relaxed environment, which reproduces more accurately the conditions leading to incontinence when compared with the relatively unfamiliar hospital setting.
Urethral Stricture Following Aortic Graft Surgery
Authors: FERRIE B. G. , GROOME J. , KIRK D.
Published: November 2008

Summary—
The incidence of urethral stricture following aortic graft surgery was investigated retrospectively in a group of 127 men. They had been catheterised prior to their operation with latex catheters. One man had been treated for a stricture 9 months after his operation. Information about post‐operative urinary symptoms was obtained from a further 94 surviving patients by postal questionnaires sent at least 12 months following surgery. Eight patients underwent urological review including, where indicated, urethrography under antibiotic cover; 3 patients were identified with urethral strictures, an incidence of 3.2%. This is similar to that occurring after cardiac surgery, and urethral strictures should be considered a hazard whenever catheters are used in surgical procedures.
Initial Management of Acute Urethral Injuries
Authors: LIM P. H. C. , CHNG H. C.
Published: November 2008

Summary—
A study was made of 30 cases of acute urethral trauma treated over a 7‐year period. There were 10 anterior and 20 posterior urethral injuries, the majority of these being partial ruptures. Posterior urethral injuries were caused by road traffic accidents in 75% of cases while 80% of the anterior urethral injuries were of the “straddle” type. There was only 1 case of iatrogenic injury to the anterior urethra.

During follow‐up, all patients required periodic dilatations for stricture except for the single case of iatrogenic injury. An average of 5 dilatations controlled all of the strictures except for 2 that required urethroplasties.
Urinary Oestrogen Excretion in Benign Prostatic Hyperplasia and Prostatic Cancer
Authors: RANNIKKO S. , ADLERCREUTZ H. , HAAPIAINEN R.
Published: November 2008

Summary—
Urinary oestrogen excretion was measured in 20 healthy middle‐aged men (controls), in 30 patients with benign prostatic hyperplasia (BPH) and in 32 prostatic cancer (PC) patients. The mean oestradiol (E2) excretion was significantly lower in the PC patients than in the controls and BPH patients. No other significant differences were found in oestrone (E1), oestriol (E3) and total oestrogen (E1 + E2 + E3) excretion between the 3 groups. The decreased E2 excretion in the PC patients is in accordance with our previous finding concerning significantly lower E2 plasma levels in PC patients. It seems possible that elderly men with lower endogenous oestrogen levels are at higher risk of developing cancer. On the other hand, the age‐dependent increased oestrogen levels may play an aetiological role in BPH.
The Fate of Testes Following Unilateral Incarcerated Inguinal Hernia in Adult Rats
Authors: TANYEL F. C. , AYHAN A. , BÜYÜKPAMUKÇU N. , HIÇSÖNMEZ A.
Published: November 2008

Summary—
The histological effects of unilateral incarcerated inguinal hernia on the ipsilateral and contralateral testes were examined in adult rats. Three groups were established. In the first group the left testis and caecum were exposed and replaced. In group 2 a left‐sided incarcerated inguinal hernia was created with bilateral orchiectomy 24 h later. In group 3 a left‐sided incarcerated inguinal hernia was created with reduction after 24 h. The testes of animals in groups 1 and 3 were removed after 15 days. The mean seminiferous tubular diameter (MSTD) and mean testicular biopsy score (MTBS) were determined for ipsilateral and contralateral testes in each of the 3 groups. A decreased MSTD and depressed MTBS, were pronounced in the ipsilateral testes, were found in the testes of group 3 animals. While unilateral incarcerated inguinal hernias caused more pronounced histological changes in the ipsilateral testes, they also affected the contralateral testes, but a time interval was required for the changes to become manifest.
Prostaglandin 15‐hydroxydehydrogenase Activity in Human Penile Corpora Cavernosa and its Significance in Prostaglandin‐mediated Penile Erection
Authors: ROY A. C. , ADAIKAN P. G. , SEN D. K. , RATNAM S. S.
Published: November 2008

Summary—
Prostaglandins may be involved in human penile erection and erectile failure. To evaluate the possible role of prostaglandin metabolism in the penile tissue, the activity of nicotinamide adenine dinucleotide‐dependent prostaglandin 15‐hydroxydehydrogenase was assayed in the corpora cavernosa of the human penis. Km values (mean ± SD) of the enzyme for PGE1, PGE2 and PGF2α were 60.1 ±4.2, 17.7 ± 1.5 and 16.1 ± 1.2 μM respectively; Vmax values (mean ± SD) were 0.219 ± 0.062, 0.510 ± 0.012 and 0.424 ± 0.007 nmol/min/mg protein respectively. The implications of these findings in the erectile process are discussed.
Failure of Allopurinol to Modify Urinary Composition in Enteric Hyperoxaluria
Authors: D'CRUZ D. P. , GERTNER D. J. , KASIDAS G. P. , RAMPTON D. S. , ROSE G. A. , SAMUELL C. T.
Published: November 2008

Summary—
Conventional treatment of enteric hyperoxaluria (EHO) consists of dietary restriction of oxalate and fat and correction of its underlying cause whenever possible. Recent work suggests that allopurinol reduces the incidence of urolithiasis and the urinary excretion of both oxalate and uric acid in patients without intestinal disease. We have assessed the effect of allopurinol, 300 mg daily for 2 weeks, on urine biochemistry in patients with EHO due to small bowel Crohn's disease and/or resections. Compliance with treatment was confirmed by a fall in plasma uric acid in every patient. Allopurinol failed to alter 24 h urinary oxalate excretion or oxalate concentration. There were also no significant changes in the urinary excretion of glycollate (like oxalate, a breakdown product of glyoxylate), citrate, magnesium or calcium, each of which was at the lower end of the normal range before and during treatment with allopurinol. It appears unlikely that allopurinol will prove useful in the prevention of urolithiasis in patients with EHO.
Flow Cytometry Analysis of Leucocytes Infiltrating Bladder Tumours According to Grade and Urothelial Cell DNA Content
Authors: HIJAZI A. , DEVONEC M. , BRINGUIER P. P. , DUTRIEUX‐BERGER N. , PERRIN P. , REVILLARD J. P.
Published: November 2008

Summary—
A series of 76 bladder tumours was studied using a panel of 5 anti‐human leucocyte monoclonal antibodies (mAb): anti‐pan‐leucocytes (SLC1), anti‐T lymphocytes (ST1), anti‐B lymphocytes (SB3), anti‐macrophages (PHM2) and anti‐granulocytes (WEMG1). The DNA content and the expression for each mAb were measured in separate samples with flow cytometry. The importance of local inflammatory reaction was measured objectively according to tumour grade. These cells formed 41, 32 and 31% of the total cell count for grade I, II and III tumours respectively. The percentage of each leucocyte population according to grade I, II or III was as follows: 8, 5 and 6% respectively for T‐lymphocytes; 3, 3 and 4% for B‐lymphocytes; 10, 7 and 6% for granulocytes; 17, 18 and 24% for macrophages. No relationship was found between mAb expression and DNA content of tumours. This study demonstrates the importance of the inflammatory reaction in bladder tumours and the preponderance of cells expressing a macrophage phenotype. In a flow cytometry study, leucocytes may mask the presence of a minor group of urothelial tumour cells with an elevated DNA content associated with a poor prognosis; on the other hand, host leucocytes within a tumour could be used as an internal reference for precise measurement of the DNA content of tumour cells.
Microbiology of the Urethral (Frequency and Dysuria) Syndrome. A Controlled Study with 5‐year Review
Authors: GILLESPIE W. A. , HENDERSON E. P. , LINTON K. B. , SMITH P. J. B.
Published: November 2008

Summary—
In a clinical and microbiological study of women with urinary frequency and dysuria (excluding those with bacterial cystitis), 41 patients were compared with 42 control subjects. No difference was found between patients and controls in the incidence of infection by Chlamydia trachomatis or other sexually transmitted organisms. The numbers of lactobacilli and other fastidious organisms in the urine of patients with either mild or severe symptoms were similar and did not differ from the numbers in the urine of control subjects. The numbers of leucocytes in urine were also similar in both patients and controls. Our findings support the view that the urethral syndrome is not caused by bacterial or chlamydial infection.
Long‐term Assessment of 107 Patients Undergoing Bladder Neck Incision
Authors: WAYMONT B. , WARD J. P. , PERRY K. C.
Published: November 2008

Summary—
The notes of 134 consecutive patients undergoing bladder neck incision (BNI) were analysed retrospectively. Details of pre‐operative symptoms and the short‐term results of the operation were studied, as well as the need for reoperation. Long‐term results of the operation were not available in 100 patients and a questionnaire was sent to them asking for details of their present symptoms. This produced results on the long‐term follow‐up of 107 patients with a mean follow‐up of 31 months (range 18–48); 86% of patients showed an improvement in symptoms in the short term whilst 68% maintained a subjective improvement in symptoms in the long term. Further surgery was required in 18 patients (13%). Possible reasons for this are discussed.
Glycine Irrigation and Urinary Oxalate Excretion
Authors: HAHN R.G.
Published: November 2008

Summary—
The short‐term effect of glycine supplementation on urinary oxalate excretion was studied. An intravenous infusion of 1 litre of a solution of 2.2% glycine, 1.5% glycine+ 1% ethanol or 5% mannitol (control) was given on 13 occasions to 5 healthy volunteers. Glycine irrigation was used in 9 patients undergoing transurethral prostatic resection and the absorption of irrigant was measured volumetrically (range 0–2.7 I). The results suggest that glycine irrigation in transurethral prostatic surgery does not raise the urinary oxalate level in the early post‐operative period.
Treatment and Complications of Fournier's Gangrene
Authors: WOLACH M. D. , MacDERMOTT J. P. , STONE A. R. , WHITE R. W. deVERE
Published: November 2008

Summary—
Ten patients with Fournier's gangrene were seen over an 11 ‐month period; 3 had indwelling urethral catheters, 3 had preceding perineal infection and 6 had a history of alcohol abuse.

An average of 2.1 operations was required per patient and the average hospital stay was 41 days. The mortality rate was 20%; 7 patients developed acute renal failure and 5 developed adult respiratory distress syndrome. Early treatment of these complications should help to reduce the mortality of this disease.
Stop‐flow Measurement of Detrusor Contractility in Bladder Outflow Obstruction
Authors: KINN ANNE‐CHARLOTTE
Published: November 2008

Summary—
Detrusor contractility was evaluated by measuring the increase in isometric pressure during a stop test in 25 men with benign prostatic hyperplasia. Before transurethral prostatic resection (TUR), a low pressure increase (ΔPdet iso) was associated with a large volume of residual urine. After TUR both the speed and the amplitude of isometric detrusor contractions during the stop test increased. A pre‐operative low detrusor pressure increase was correlated with a great improvement in flow rate after TUR. The value of the stop‐flow test was limited, however, since improvement in other urodynamic parameters could not be predicted.
Biofilms, Bacteria and Bladder Catheters A Clinical Study
Authors: RAMSAY J. W. A. , GARNHAM A. J. , MULHALL A. B. , CROW ROSEMARY A. , BRYAN J. M. , EARDLEY I. , VALE J. A. , WHITFIELD H. N.
Published: November 2008

Summary—
Biofilms were present on 16 of 33 urethral catheters examined. In 11 cases the catheter carried a different microbial flora from that of the bladder urine. The length of time the catheter was in situ did not influence biofilm formation, and all types of materials tested supported biofilm growth. Biofilms were seen on 2 of the 7 catheters where prophylactic antibiotics had been used.
Detection of Recurrent Bladder Tumours by Transrectal and Abdominal Ultrasound Compared with Cystoscopy
Authors: DAVIES A. H. , CRANSTON D. , MEAGHER T. , FELLOWS G. J.
Published: November 2008

Summary—
Transrectal and transabdominal ultrasound was used to detect the recurrence of bladder tumours and compared with conventional cystoscopy. Forty patients with a previous history of bladder tumour were examined by these methods; 50% had a recurrence.

Transabdominal and transrectal ultrasound together identified 95% of recurrences; 1 tumour (diameter 1 mm) was missed. The false positive rate was 5% and these areas, identified wrongly by ultrasound as tumour, were shown to be scars on cystoscopy. Combination ultrasound may be used as an alternative to check cystoscopy in certain categories of bladder tumour.
Enhanced Cavernometry: Procedure for the Diagnosis of Venogenic Impotence
Authors: BENNETT A. H. , GAROFALO F. A.
Published: November 2008

Summary—
A technique of cavernometry to diagnose corporovenous leakage (CVL) is described. The criterion used to define CVL was a corporeal infusion rate >60 ml/min after the intracorporeal injection of 60 mg papaverine or 30 mg papaverine and 1 mg phentolamine. Alpha blockade in addition to papaverine decreased the incidence of corporovenous leakage.
A Consumer's Guide to Laparoscopic Equipment for Urology
Authors: EDEN C. G. , ISON K. T. , POPERT R. J. , CARTER P. G. , COPTCOAT M. J.
Published: November 2008

Summary— The ever increasing amount of laparoscopic instrumentation and the lack of any objective comparison make choosing the most appropriate equipment a difficult task for the urological neo‐laparoscopist. All major manufacturers of laparoscopic equipment were invited to submit as much of their equipment as possible for inspection. A selection of ports, hand instruments, haemostatic devices and imaging systems was then tested in a laboratory and clinical setting. Costings are provided for evaluated ports, hand instruments and imaging systems. Vessels with a diameter greater than 7 mm, such as renal artery and vein, should be secured with a linear stapler‐cutter. The optics of the Olympus 0TV‐S4, CLV‐10 light source, Olympus light cable and A5254A telescope are superior to the other imaging systems tested. Laparoscopic equipment is diverse in specification, performance and cost. Due consideration must be given to these factors when purchasing equipment to avoid disappointment and wastage of resources, particularly with regard to disposable instruments and imaging systems.
Helically Ridged Ureteric Stent Facilitates the Passage of Stone Fragments in an Experimental Porcine Model
Authors: PHAN C. N. , STOLLER M. L.
Published: November 2008

Summary— We have developed a ureteric stent with features designed to facilitate active expulsion of ureteric stone fragments. Its unique characteristics include a helix‐like ridge along a thin central core; the superior edge of the ridge is bevelled caudally and the inferior is concave. The ridge's outer edge is smooth and hydrophilic. As the stent is moved in relation to the ureteric wall (owing to respiratory motion and/or peristalsis), stone fragments will slip over the superior edge of the helical ridge. Once past this edge, they cannot migrate in a cephalad direction; they will pass down the helical trough or be ratcheted by the repetitive bevel and emerge through the ureteric orifice. To evaluate the effectiveness of the design it was compared with a conventional, smooth‐surfaced double‐pigtail stent in an ex vivo porcine model. A single artificial stone fragment (3×2×2 mm, 4×3×2 or 5.5×3×2 mm) was placed in the proximal ureter and the stent was moved up and down (56 studies with each type of stent). The helically ridged stent required a mean of 79 excursions (standard deviation 60, range 8–291). In contrast, the conventional stent was unable to move any stone fragments‐even after more than 1000 excursions.
Association between Urinary Incontinence in Women and a Previous History of Surgery
Authors: MOMMSEN S. , FOLDSPANG A. , ELVING L. , LAM G. W.
Published: November 2008

Summary— In a cross‐sectional study, 85% of 3114 women responded to a questionnaire on urinary incontinence and a history of abdominal, gynaecological and urological surgery. In 1987 the prevalence of urinary incontinence was 17%; 63% had undergone surgery, mainly gynaecological, and almost one‐third of the respondents had had more than one operation. Bivariate and multivariate analysis showed stress urinary incontinence to be associated with previous exposure to surgery.
Desmopressin in Elderly Women with Increased Nocturnal Diuresis
Authors: ASPLUND R. , ÅBERG H.
Published: November 2008

Summary—We report the changes in the pattern of diuresis in 20 women (average age 71 years) with increased nocturnal diuresis who were treated with 20 ng desmopressin (Minirin). Before treatment, antidiuretic hormone levels were measured every 4 h over a 24‐h period and 75% of the levels were found to be beneath the lowest detectable limit (<0.4 pmol/l).

Nocturnal diuresis decreased by 355 ± 208 ml and in 8 cases the decrease exceeded 400 ml. Diurnal diuresis, on the other hand, increased by 226 ± 331 ml. Side effects were mild and occurred in only 2 women.
The Role of the Mathieu Repair as a Salvage Procedure
Authors: WHEELER R. , MALONE P.
Published: November 2008

Summary— Conceived as a primary single‐stage procedure for coronal and subcoronal hypospadias, the Mathieu repair has not been previously described as a salvage operation in situations where other forms of hypospadias surgery have failed to give an adequate functional or cosmetic result. We describe the use of the operation as a planned salvage procedure.
Quantitative Analysis of Adrenergic Alpha‐1 and Alpha‐2 Receptors in Human Prostatic Urethral Tissue
Authors: KONDO S. , TASHIMA Y. , MORITA T.
Published: November 2008

Summary—We measured the adrenergic alpha‐1 and alpha‐2 receptors in 3 types of prostatic tissue (prostatic urethral mucosa, prostatic adenoma and prostatic capsule) in a group of patients with benign prostatic hypertrophy (BPH) and in another group without BPH, using radioligand binding techniques. In all tissues examined, more alpha‐1 and alpha‐2 receptors were found in the hypertrophy group than in the other group. The increase in density of these receptors in the hypertrophy group was most marked in the prostatic adenoma. The density of alpha‐1 and alpha‐2 receptors was almost the same in the adenoma in both groups. The prostatic capsule and urethra in both groups contained more alpha‐1 than alpha‐2 receptors. Both receptors were found more in the adenoma than in the other 2 tissues in both groups. These results suggest that alpha‐1 and alpha‐2 receptors both play an important part in the symptoms of benign prostatic hypertrophy.
Prostate Specific Antigen in Screening for Recurrence following Radical Prostatectomy for Localised Prostatic Cancer
Authors: BENTVELSEN F. M. , OUDEN D. VAN DEN , SCHRODER F. H.
Published: November 2008

Summary— Eighty‐five patients treated by radical prostatectomy for clinically localised prostatic cancer were followed up for 1 to 4 years with measurement of prostate specific antigen (PSA). Six patients with recurrences had elevated levels (cut‐off level was 1.0 ng/ml). PSA is therefore considered an excellent tool for monitoring treatment failures. Levels exceeding 1.0 ng/ml preceded evidence of tumour recurrence by a mean interval of 11 months.

PSA offers the possibility of detecting residual prostatic cancer after surgery. It is not known, however, whether these patients would have benefited from adjuvant endocrine or early radiotherapy.
Urethral Atresia and the Prune Belly Syndrome
Authors: REINBERG Y. , CHELIMSKY GISELA , GONZALEZ R.
Published: November 2008

Summary— An association between urethral atresia and the prune belly syndrome (PBS) has been recognised, but few reports discuss the outcome of treatment for these gravely ill patients. Of the 34 patients with prune belly syndrome evaluated at our institutions, 6 had urethral atresia (3 males and 3 females). Two of these patients died as neonates as a result of pulmonary insufficiency and 1 was stillborn. The common feature of the 3 surviving patients (2 males and 1 female) was the presence of a vesicocutaneous fistula. As neonates, 2 suffered from pulmonary insufficiency due to oligohydramnios. The mean length of follow‐up for these 3 patients was 37 months (range 13–58). The urinary tract was decompressed in 2 patients by a formal vesicostomy performed early in life. The surviving girl has normal renal function following reconstructive surgery. Because both the bladder and urethra were absent in this patient, an ileocaecal bladder substitute and an appendiceal urethra were constructed. The 2 surviving boys both have renal insufficiency. One has received a renal transplant from a living relative and is doing well. In one of the boys, urethral atresia was initially managed by perineal urethrostomy and then by reconstructive surgery. Progressive catheter dilation was used on the other boy. Urethral atresia occurred in 18% of our patients with PBS; the incidence was equal in males and females. Survival correlated with the development of a spontaneous vesicocutaneous fistula. Two‐thirds of the survivors developed end‐stage renal failure.
Intracorporeal lithotripsy with the Swiss lithoclast
Authors: WADHWA S.N. , HEMAL A.K. , SHARMA R.K.
Published: November 2008

Objective To evaluate the use of the Swiss lithoclast in the management of urinary calculi.

Patients and methods Between January and November 1993, 60 patients with a total of 61 urinary calculi were treated with the Swiss lithoclast. Forty patients had a ureteric calculus, two had a ureterocele with a calculus, one a steinstrasse, 16 a vesical stone and two a urethral calculus. Eighty per cent of patients were treated on a day‐care basis.

Results Fragmentation of the urinary calculi was successful in 59 of the 60 patients. Both patients with a urethral calculus and 15 of 16 with a vesical calculus were stone‐free after the procedure. All those with a ureteric calculus were stone‐free at 6 weeks. There were no intra‐operative or long‐term complications directly related to the use of the Swiss lithoclast.

Conclusion The results of this study show that the Swiss lithoclast is a simple, safe, reliable and economical method of endoscopic lithotripsy for the treatment of urinary tract calculi. Although the lithoclast's use is limited to rigid or semi‐rigid endoscopes there is now a suction facility for the immediate removal of small stone fragments
Excitatory neurotransmission in the mammalian bladder and the effects of suramin
Authors: CREED K. E. , CALLAHAN S. M. , ITO Y.
Published: November 2008

Objective To compare the electrical and mechanical activity, and assess the effect of suramin on strips of detrusor from various species.

Materials and methods Bladder muscle strips from guinea‐pigs, rabbits, monkeys and sheep and detrusor strips from humans (obtained at operation) were studied. The mechanical responses to nerve stimulation were recorded with a force transducer and electrical activity was recorded with the double sucrose gap.

Results In all species acetylcholine was released from the nerves and a prolonged contraction was produced. A second transmitter, possibly adenosine triphosphate, produced a rapid transient contraction, the amplitude of which varied with the species. In the rabbit and guinea‐pig the phasic contraction and accompanying depolarization were large, whereas in primates they were small and in sheep were intermediate. At high concentrations, suramin reduced the contraction and accompanying depolarization in rabbit and guinea‐pig muscle but not in sheep. Suramin enhanced the late cholinergic responses and increased spontaneous mechanical activity in all species. These latter effects were not seen after desensitization of the receptors with the ATP analogue α, β‐ methylene ATP.

Conclusion Although suramin reduces the excitatory effect of nerve activity in some species, it would produce little beneficial effect in the human hyperexcitable bladder as any inhibitory effect might be offset by the increase in spontaneous activity.