bluuebunny/crossref_metadata_2025 huggingface dataset:
Percutaneous Suprapubic Cystostomy after Spinal Cord Injury
Authors: COOK J. B. , SMITH P. H.
Published: November 2008

Suprapubic cystostomy was, for many years, the treatment of choice in the management of prostatic hypertrophy with retention of urine; for many patients it was the only treatment. Its use in patients following spinal cord injury was discussed by Thomson Walker (1917) and by Vellacott and Webb‐Johnson (1919).

The formal cystostomy had many disadvantages but these were largely overcome by the Riches technique (1943). Gradually, however, with the advent of latex catheters and antibiotic therapy the technique of intermittent catheterisation (Guttmann and Frankel, 1966) became more fashionable. It is, however, time‐consuming and satisfactory only in those units with numbers of well‐trained medical and nursing staff.

The introduction of the Bard suprapubic catheter (the suprapubic angiocath, 1966, S. P. Bard‐Davol Ltd) allowed us to reconsider the virtues of percutaneous suprapubic catheterisation (Smith, Cook and Robertson, 1969) in the hope that its use would save nursing and medical time and that the preservation of the integrity of the urethra would minimise both infective complications and the possibility of external sphincter spasm. We report our results in our first 43 patients treated with either the Bard catheter or with a Braunperitoneal dialysis catheter which is somewhat more rigid and has proved more reliable.
Trigonal Cyst in Childhood
Authors: TACCIUOLI M. , LAURENTI C. , RACHELI T.
Published: November 2008

Trigonal cysts are a rare congenital abnormality and only 18 cases have been described since 1889. There appears, however, to be some controversy regarding this number since, according to some authors, several of the cases reported were probably ureteroceles. Only 4 cases of trigonal cysts in infancy, including the present one, have been reported.

A case of trigonal cyst is described in a 7‐year‐old girl with secondary bilateral ureteric dilatation, left ureteric reflux and a non‐functioning left kidney.

Reference is made to 3 cases of trigonal cysts in children reported in the literature.
Leukoplakia associated with Renal Tuberculosis in the Chemotherapeutic Era1
Authors: BYRD RICHARD B. , VINER NICHOLAS A. , OMELL GARY H. , TRUNK GARY
Published: November 2008

The association of renal tuberculosis and leukoplakia of the renal pelvis was quite conimon in the prechemotherapy era of tuberculosis but has apparently not been seen since effective drugs became available.

Despite a prompt response of the tuberculosis to chemotherapy the leukoplakia formation with intermittent passage of keratinised material continued.

Surgical removal of the accumulated material was of no lasting benefit.
Transient Ureteric Dilatation in Neonates with Imperforate Anus: a Report of 4 cases
Authors: RICKWOOD A. M. K.
Published: November 2008

Summary— In a series of 64 patients with imperforate anus, 4 were identified with ureteric dilatation without vesico‐ureteric reflux. The appearance resembled that of the primary obstructive megaureter. However, since the dilatation resolved spontaneously in each case, it is concluded that the condition represents a separate entity, the cause of which has not yet been elucidated.
Urodynamics in Benign Prostatic Hypertrophy
Authors: ANIKWE R. M.
Published: November 2008

Summary— Synchronous urinary flow and pressure studies were carried out on 51 male subjects of whom 12 were normal subjects and 39 had benign prostatic hypertrophy with varying degrees of bladder outlet obstruction.

A urodynamic scoring system was evolved for accurate and objective diagnosis of bladder outlet obstruction. The minimum urethral resistance was found to be the most valuable single urodynamic parameter for the diagnosis of bladder outlet obstruction. Hitherto this urodynamic parameter was determined through tedious calculations.

In the course of the present study a new instrument, the Urethroresistance, was devised for the direct recording of urethral resistance during micturition.
Pre‐operative Balloon Occlusion of the Renal Artery for Radical Nephrectomy
Authors: MEE A. D. , HEAP S. W.
Published: November 2008

Summary— Six of 8 patients with renal tumours were successfully catheterised pre‐operatively and the renal artery occluded by a Swan Ganz balloon tipped arterial catheter. At subsequent radical nephrectomy early ligation of the renal vein was readily accomplished and there was noticeable decrease in vascularity and engorgement of the kidney and its tumour.
A Radioisotope Method of Assessing Uretero‐ureteric Reflux
Authors: O'REILLY P. H. , LAWSON R. S. , SHIELDS R. A. , TESTA H. J. , EDWARDS E. CHARLTON , CARROLL R. N. P.
Published: November 2008

Summary— A simple radioisotope method of assessing the presence and type of uretero‐ureteric reflux in incomplete duplication of the upper urinary tract is described.

The application of the technique in 2 cases in demonstrated.

It is suggested that this simple, non‐invasive, non‐toxic technique may possess some advantages over conventional methods of evaluating this condition.
Bone Scanning and Plasma Phosphatases in Carcinoma of the Prostate
Authors: O'DONOGHUE E. P. N. , CONSTABLE A. R. , SHERWOOD T. , STEVENSON J. J. , CHISHOLM G. D.
Published: November 2008

Summary— Bone scanning with 99mTc‐Sn‐HEDP, radiographic skeletal survey and determination of plasma acid and alkaline phosphatase values were carried out in a consecutive series of 90 untreated patients with carcinoma of the prostate.

99mTc‐Sn‐HEDP provided satisfactory bone imaging and was convenient in use.

The addition of bone scanning to radiographic survey increases the detection rate of skeletal metatases by 16%.

Radiography increases the accuracy of bone scanning by identifying false positive scans due to benign disease and false negative scans when there are diffuse symmetrical bony metastases.

The plasma phosphatases alone are less accurate staging tests. The acid phosphatase data support the validity of scan positive—X‐ray negative findings. Bone scan abnormalities due to secondary deposits usually precede elevation of plasma alkaline phosphatase.
The Role of Bone Scanning in the Assessment of Prostatic Carcinoma
Authors: McGREGOR B. , TULLOCH A. G. S. , QUINLAN M. F. , LOVEGROVE F.
Published: November 2008

Summary— Fifty new cases of carcinoma of the prostate were assessed prior to treatment to determine the incidence of bony metastases. The radioisotope bone scan was the most sensitive method of detecting metastases and of localising them. It was twice as accurate as the serum acid phosphatase estimation. Skeletal X‐rays were the least accurate method. Forty‐six per cent of patients had abnormal bone scans at presentation.

The histological grade of the tumour correlated well with the bone scan. The higher the grade, the more likely was the bone scan to be abnormal. There is need for greater accuracy in detecting metastases, and the bone marrow acid phosphatase estimation, either alone or in conjunction with the bone scan, may provide this accuracy.
Outflow Obstruction in Neuropathic Bladder Dysfunction: The Neuropathic Urethra
Authors: SUNDER G. SHAM , PARSONS K. F. , GIBBON N. O. K.
Published: November 2008

Summary— Urethral pressure profiles were recorded in a series of patients with traumatic lesions of the spinal cord producing vesico‐urethral dysfunction. Patients were classified into groups depending upon the relationship of the lesion to the sympathetic outflow to the bladder and urethra from the spinal cord. Using alpha‐adrenergic blocking agents, the smooth muscle contribution to the maximum urethral pressure was ascertained in each group and differences in both the configuration of the profile, and the smooth muscle component, were found.

Increases in the maximum urethral pressure in response to a change in posture were also investigated, and the extent of the increase found to vary according to the level of the spinal lesion in respect of the sympathetic outflow, and with the integrity of the sacral cholinergic reflex arcs.

The hypothesis that these changes may be due to urethral “decentralisation supersensitivity” from alterations in circulating catecholamine levels is suggested.
Prediction of Renal Recovery in Hydronephrotic Kidneys
Authors: IBRAHIM AHMED , ASHA HASSAN ABU
Published: November 2008

Summary— Urine produced by obstructed kidneys was analysed in 35 cases. In the absence of infection by urea splitting organisms, estimation of urinary pH of hydronephrotic kidneys was found to be a reliable method for determination of recovery potential.

After removal of obstruction, radiological recovery was almost complete when the pH was lower than 6.

Obstructed kidneys producing urine with a pH between 6–7. 1 showed only partial radiological recovery after surgical correction.

All kidneys that showed no function on IV urography and those found at operation to possess only a very thin shell of cortex to justify nephrectomy were found to have urinary pH near 7. 3 or more, implying inability of those kidneys to acidify urine.

Urinary specific gravity and sodium concentration of obstructed kidneys were not reliable in prediction of renal recovery.
Ureteric Reimplantation for Vesico‐Ureteric Reflux in the Adult
Authors: DOUNIS A. , DUNN M. , SMITH P. J. B.
Published: November 2008

Summary— A retrospective study of 32 adult patients undergoing ureteric reimplantation for reflux has been carried out.

Reflux and reimplantation in relation to urolithiasis, pregnancy, renal failure, hypertension and bladder neck obstruction have been discussed. Eighty‐four per cent of patients with primary reflux had pyelonephritic scarring compared with only 34% of patients where reflux was secondary.

Reimplantation has been technically successful in preventing reflux in every patient in this series, with 18 patients (65%) becoming symptom free. Pyelonephritis, hypertension and renal failure were not significantly improved but no progressive changes were observed in the follow‐up period after reimplantation.
Design of a Urodynamic Questionnaire
Authors: CARDOZO LINDA , STANTON STUART L. , BENNETT A. E.
Published: November 2008

Summary— This paper describes the design of a Urodynamic Questionnaire for female patients. Reference is made to the layout of the clinical history, examination and investigation. Emphasis is placed on the need for clarity and ease of transference of data for computer storage.
Renal Mobility in Women Attending a Pyelonephritis Clinic and in Controls
Authors: THOMSON W. N. T. , INNES J. A. , MUNRO J. F. , GEDDES A. M. , PRESCOTT R. J. , MUROCH J. McC.
Published: November 2008

Summary— The range of vertical renal mobility was established in a group of 129 healthy female subjects and compared with the range of mobility observed in 236 female patients attending a pyelonephritis clinic.

The mobility was significantly greater on the right side in both groups and both kidneys moved significantly more in the patient group than in the controls. Excessive mobility could not be directly related to bacteriologically confirmed infection, renal pain or IVP abnormality.

Nephroptosis remains an enigma and excessive renal mobility must not be interpreted in isolation.
Diuresis Renography in Equivocal Urinary Tract Obstruction
Authors: O'REILLY P. H. , TESTA H. J. , LAWSON R. S. , FARRAR D. J. , EDWARDS E. CHARLTON
Published: November 2008

Summary— A trial of the value of diuresis renography in equivocal upper urinary tract obstruction is presented.

Fifty‐two patients were examined by standard renorgraphy and renography under a diuretic provocation.

The results indicate that the technique is of considerable value in making the vital distinction between dilatation on the excretion urogram due to atonicity and that caused by a genuine obstruction.

A quantitative index of the response to diuresis reflecting the degree of impedance to flow is described—the Diuresis Excretion Index.

Diuresis renography is recommended in the evauation of the patient with equivocal urinary tract obstruction.
Experience with Anteromedian (12 O'Clock) External Urethral Sphincterotomy in 100 Male Subjects with Neuropathic Bladders
Authors: III W. F. WHITMORE , FAM B. A. , YALLA S. V.
Published: November 2008

Summary— One hundred male spinal cord injured patients have now undergone anteromedian (12 o'clock) external urethral sphincterotomy alone or in combination with transurethral incision or resection of the bladder neck.

The functional effect of this procedure has been documented by voiding cystourethrogram and urodynamic studies.

The morbidity and clinical results including blood loss and loss of reflex erections are reviewed.

The short‐term clinical results suggest that this is the best of currently available techniques to lower external urethral sphincter resistance.
The Management of Indwelling Catheters
Authors: BROCKLEHURST J. C. , BROCKLEHURST SUSAN
Published: November 2008

Summary— Eighteen geriatric patients with indwelling catheters were observed for a total of 393 weekly urine specimens. The effects of a 1 week course of antibiotics/chemotherapeutic agent followed by urinary antiseptics for 6 weeks, and also of regular bladder washouts, were noted.

All urine specimens were infected except 24% during antibiotic treatment and 9% during antiseptics and 6% after washouts. Only washouts reduced the extent of catheter blockage.

There was little difference in the time in situbetween silastic and latex Foley catheters—only 31% of silastic remaining for longer than 4 weeks. Bard‐Roberts catheters were the least satisfactory. Catheter leakage was not affected by urinary pH.

Further developments in long‐term catheter management are needed.
Radiograph Measurements and Contralateral Renal Size in Primary Pelvic Hydronephrosis
Authors: MILEWSKI P. J.
Published: November 2008

Summary— Renal size was estimated from the radiographs in 47 cases of primary pelvic hydronephrosis. The area of functioning renal tissue of the side opposite to the disease was greater in patients with severe hydronephrosis treated by pyeloplasty, compared with those with moderate disease (P < 0.05). This suggests that compensatory hypertrophy had occurred in the contralateral kidney. This finding did not appear to affect the outcome of pyeloplasty. It is suggested that the finding of compensatory hypertrophy in the kidney opposite to a severe hydronephrosis is not a contra‐indication to conservative surgery.
Alpha‐Adrenergic Agents in Urinary Disorders of the Proximal Urethra: Part II. Urethral Obstruction due to “Sympathetic Dyssynergia”
Authors: AWAD S. A. , DOWNIE J. W. , KIRULUTA H. G.
Published: November 2008

Summary— Lower urinary tract obstruction in patients with neurological lesions can be due to “sympathetic dyssynergia”.

The obstruction can be at the level of the external sphincter.

Phentolamine (i.v.) used during the voiding cystourethrogram helps to make the diagnosis.

Phenoxybenzamine therapy produced improvement in 10 of 18 patients.

As a rule, patients had to continue on the drug to maintain their response.
Immunological Studies of Testicular Tissue in Oligozoospermic and Azoospermic Patients*
Authors: TAYLOR T. A. , SCOTT D. G. , ANDERSON C. K. , JONES N. , STEWART P. A. H.
Published: November 2008

Summary— Testicular biopsies from 6 oligozoospermic and 12 azoospermic patients were examined histologically and immunohistologically. Evidence of maturation arrest and of Type II allergic reactions involving tubular basement membranes was found in all oligozoospermic patients. No evidence of an immune reaction was found in 9 azoospermic patients with maturation arrest. Unilateral or bilateral germ cell aplasia with evidence of mixed Type II and III or Type III and IV reactions was present in 2 oligozoospermic and 2 azoospermic patients.

The findings have been interpreted to indicate that maturation arrest and germ cell aplasia may occasionally be linked in a chain of immunological events, initiated possibly by damage to tubular basement membranes. No correlation was demonstrable between the histological and immunohistological findings and indirect immunofluorescent tests for sperm antibodies. It is suggested that testicular biopsy is a potentially hazardous procedure in the investigation of infertility, and that prepubertal testicular tissues as well as sperm be used as antigens in the immunological investigation of infertility
The Distinction between Obstructive Uropathy and Nephropathy by Radioisotope Transit Times
Authors: WHITFIELD H. N. , BRITTON K. E. , HENDRY W. F. , NIMMON C. C. , WICKHAM J. E. A.
Published: November 2008

Summary— Deconvolution analysis of different regions of interest on gamma camera renography enables obstructive lesions causing impairment of nephron function to be distinguished from obstructive lesions in which parenchymal function is unimpaired. Quantitation of isotope transit time through the parenchyma is a reliable method of diagnosing upper urinary tract obstruction.
A New Urinary Test for Stone “Activity”
Authors: HALLSON P. C. , ROSE G. ALAN
Published: November 2008

Summary— Rapid evaporation of urine to osmolarity 1200 results in a high incidence of envelope Wedellite and calcium phosphate crystals. The Wedellite crystals closely resemble those seen in untreated urine samples of stone formers.

The incidence of crystalluria produced by these tests is higher in the stone formers than in the normal subjects, reduced by thiazides and increased by cellulose phosphate; combined thiazide and cellulose phosphate therapy was most effective in reducing crystalluria.

Simple calcium and oxalate concentration products were calculated and did not correlate well with incidence of calcium oxalate crystalluria. Although the product is important, inhibitors of crystal formation must be equally important.

It is postulated, but not proven, that the evaporation tests may indicate normal subjects at risk to stone formation when exposed to chronic dehydration and whether a stone former is still metabolically active.
Pre‐operative Arterial Embolisation in Renal Carcinoma
Authors: ARKELL D. G. , COTTER K. PAULE , FITZ‐PATRICK J. D. , SHAW R. E.
Published: November 2008

Summary— Nephrectomy for carcinoma is often accompanied by moderate or severe bleeding but this may be reduced by prior occlusion of the renal artery.

Embolisation with fresh autologous clot is rendered ineffective by rapid lysis.

In vitro experiments showed that the clot could be stabilised by the addition of epsilon amino caproic acid (EACA).

By injecting stabilised clot into the renal artery, satisfactory devascularisation of kidney and tumour was achieved in 10 patients.
The Use of Pure Carbon Stomata (Biocarbon) in Urinary Diversion
Authors: HARZMANN R. , BICHLER K.‐H. , IDELER V.
Published: November 2008

Summary— A new synthetic material, Biocarbon, has the advantages of tissue compatibility and chemical inactivity, so that there is minimal salt sedimentation.

Experiments with animals extending over a period of more than 2 years showed good healing after various surgical and urological operations.

Biocarbon stomata were then used for vesicostomies in 6 patients. The period of follow‐up has been 15 months.

We conclude that Biocarbon implants used for ureterocutaneostomies and for various conduit operations can improve the care of stoma patients.
Radical Cystectomy for Carcinoma of the Bladder
Authors: CLARK P. B.
Published: November 2008

Summary— A personal series of 50 radical cystectomies has been reviewed to decide whether it is a justifiable operation and, if so, when it should be performed.

In spite of the fact that radical cystectomy had a higher operative mortality than simple cystectomy and was sometimes followed by lymphoedema, in patients with invaded iliac lymph nodes it was followed by a 25% 5‐year survival. It appears, therefore, to be a justifiable procedure.

It is recommended that simple cystectomy should be performed for patients with papillomatosis, carcinoma in situ, and as a salvage procedure after radiotherapy has failed, and that radical cystectomy should be reserved for elective cases of invasive vesical tumours, and for those patients who are found at exploration to have obvious metastatic deposits in the iliac lymph nodes.
The Induction of Cystitis and the Implantation of Tumours in Rat and Rabbit Bladders
Authors: EDWARDS L. , ROSIN D. , LEAPER D. , SWEDAN M. , TROTT P. , VERTIDO R.
Published: November 2008

Summary— A method of inducing tumour growth in rat and rabbit bladders is described. Tumour induction is dependent on a pre‐induced cystitis. In rats, tumour also grows in the kidneys because of species characteristic vesicoureteric reflux. The possible significance is discussed in relation to the management of human bladder tumours.
Bladder Instability in Women with Recurrent Cystitis
Authors: REES D. L. P. , WICKHAM J. E. A. , WHITFIELD H. N.
Published: November 2008

Summary— Factors in the aetiology of bladder instability in women with recurrent cystitis are analysed. A multifactorial approach to patient management is advocated and supported by a treatment failure rate of only 3.6% with these patients over a mean follow‐up of nearly 2 years.
Urethral Injury and Fractured Pelvis
Authors: GLASS R. E. , FLYNN J. T. , KING J. B. , BLANDY J. P.
Published: November 2008

Summary— In 333 consecutive cases of fractures of th pelvis admitted as emergencies to one hospital 53% were in males, of whom 34 had suspicious clinical signs of urethral or vesical injury.

In 15 patients catheterisation was performed uneventfully and in no case did this make the injury worse; in 8 an attempt at primary realignment was performed, resulting in 4 cases without any stricture, and 2 who needed annual dilatation only. In 4 additional cases associated laceration of teh bladder was repaired which one had no stricture and 2 needed infrequent dilatations. In a further 41 cases a catherter was used and led to no strictures.

Among 67 males with post‐tramatic urethral injures caused by pelvic fracture the best results were seen when the 2 ends were urethral injuries caused by pelvic fracture the best entirely, and in 17 others it led to an easy urethroplasty. Difficult strictures occurred in servere injuries with uncorrected displacement of the soft parts. Where feasible, early surgical repair appears to give the best chance of minimislng the severity of subsequent urethral stricture.
CT Scanning and the Surgery of Metastatic Teratoma of the Testis: a Preliminary Report
Authors: BOYD P. J. R. , HUSBAND J. E. , PECKHAM M. J. , HENDRY W. F.
Published: November 2008

Summary— Accurate definition of metastases in pare‐aortic lymph nodes and lungs is essential in planning treatment for for patients with testicular teratoma. The addition of CT scanning to routine investigation of these patients has given additional sensitivity in detection and localisation of metastases. The extent of para‐aortic metastases could be clearly defined, even when bulk replacement of nodes prevented definition lymphosgraphy. This information was used in planning the best surgical approach for apra‐aortic lymphadenectomy, which was done as part of combined treatment of large volume metastases.
Use of the Surgical Staple for Bowel Anastomoses in Urology
Authors: GOTTESMAN J. E.
Published: November 2008

SUMMARY— The use of the Autosuture* stapling devices for performing enteric anastomoses is described. Such anastomoses can be performed more quickly and more uniformly than sutured ones, with few complications.
The Effect of Exogenous Prostaglandins F2αand E2and lndomethacin on Micturition
Authors: KHALAF I. M. , GHONEIM M. A. , ELHlLALl M. M.
Published: November 2008

SUMMARY— The influence of exogenous infusion of prostaglandins (PGs) of the F2αand E2series and of indomethacin on micturition cycles was investigated in 30 anaesthetised female dogs. In 30 other animals, urethrovesical disconnection was performed to study the action of PGs and of indomethacin without the muscle continuity factors.

In the intact animal model during vesical distension, PGElproduced a significant urethral pressure drop and a dose‐dependent reduction in the threshold micturition volume. PGF2αproduced a significant urethral pressure rise. At doses higher than 0.3 μg/kg, PGF2αreduced the threshold micturition volume. On the other hand, indomethacin significantly increased the threshold micturition volume and reduced the maximum intravesical pressure.

In the disconnected model, PGE2produced a dose‐dependent decrease in the resting urethral pressure and hardly affected the intravesical pressure; PGF2αproduced a dose‐dependent increase in both urethral and intravesical pressures.

Thus it is suggested that endogenous PG release during vesical distension could play a facilitatory role in micturition.
Incontinence Following Transurethral Resection of the Bladder Neck in the Female
Authors: BHATNAGAR B. N. S. , BARNES R. W.
Published: November 2008

SUMMARY— Incontinence is an unwelcome complication of transurethral resection (TUR) of the bladder neck in the female. A computerised analysis of 238 procedures performed during the period 1940 to 1972 was carried out to assess the morbidity due to this complication and to evaluate possible predisposing factors.

Initially 1 5.2% of patients were incontinent but 70% of these soon became continent without further treatment. The remaining 4.7% were treated by surgical or other measures. The incidence of incontinence was unrelated to the amount of tissue removed or to the number of operations, but was significantly lower when the operation was done for polypi of the bladder neck and significantly higher in patients with a cystocele or urethrocele. It seems possible to reduce the incidence of incontinence by careful selection of cases.
A Comparative Study of the Human External Sphincter and Periurethral Levator Ani Muscles
Authors: GOSLING J. A. , DIXON J. S. , CRITCHLEY HILARY O. D. , THOMPSON SALLY‐ANN
Published: November 2008

SUMMARY— Specimens from the human male and female external urethral sphincter and the periurethral levator ani muscle have been examined using histochemical and electron microscopic techniques.

In both sexes the external sphincter consists of a single population of type I (slow twitch) fibres with a mean diameter of 1 7.47±0.7 μm in the absence of muscle spindles. In contrast, the periurethral levator ani possesses muscle spindles and the constituent fibres form a heterogeneous population of type I and type II (fast twitch) fibres, with mean diameters of 45.5±0.8 μm and 59.5±3.4 μm respectively.

These findings indicate that the external urethral sphincter is functionally adapted to maintain tone over prolonged periods and may be of considerable importance in producing active urethral closure during continence. The anatomical location and fibre characteristics of the levator ani muscle suggest that these fibres actively assist in urethral closure, particularly during events which cause elevation of intra‐abdominal pressure.

In view of the differences in fibre characteristics between the external urethral sphincter and the levator ani, EMG activity recorded from a single site in the levator ani may not be representative of the functional status either of other levator ani muscle fibres or of the external urethral sphincter.
Re‐evaluation of Viability Testing of Cadaveric Kidneys for Transplantation
Authors: NEWMAN C. P. St. J. , SHENTON B. K.
Published: November 2008

SUMMARY— Twenty‐three human cadaver kidneys were studied during hypothermic pulsatile perfusion prior to transplantation. The accumulation of laevo‐lactate and lactate dehydrogenase, alterations in pH and perfusion flow rate were measured and compared with organ function following transplantation. No parameter measured was found to be an accurate index of potential function.
The Role of N‐nitrosamine in Carcinogenesis at the Ureterocolic Anastomosis
Authors: STEWART M. , HILL M. J. , PUGH R. C. B. , WILLIAMS J. P.
Published: November 2008

SUMMARY— Seven cases of colonic tumours occurring at the ureterocolic anastomosis (UCA) in patients diverted for benign disease are presented and comparisons made with existing literature.

There appears to be a definite increase in the incidence of colonic malignancy in patients with this diversion. A theory of carcinogenesis involving bacterial activation of endogenously formed N‐nitrosamine is suggested. Preliminary results of rectal urine analysis support this theory in that high concentrations of N‐nitrosamine have been found and mutagens demonstrated.
Bladder Exstrophy. Primary Reconstruction with Human Dura Mater
Authors: LIMA S. V. C. , NORōES J. A. A. , CARVALHEIRA F. , de MENDONÇA P. P.
Published: November 2008

SUMMARY— A new surgical technique for primary reconstruction of bladder exstrophy is described. Human cranial dura mater is used as an alloplastic free graft to replace the missing anterior bladder wall. The technique has been successfully applied to 8 patients and the early achievement of good bladder capacity seems to improve urinary continence.
Different Cystometric Types of Deficient Micturition Reflex Control in Female Urinary Incontinence with Special Reference to the Effect of Parasympatholytic Treatment
Authors: MEYHOFF H. H. , NORDLING J.
Published: November 2008

SUMMARY— The effect of 4 weeks' treatment with emepronium bromide in 20 incontinent female patients with detrusor hyperreflexia was compared to the effect in 20 patients who did not have uninhibited detrusor contractions during filling cystometry but who were unable to suppress a voluntarily induced detrusor contraction.

In both groups, 65% benefited from the drug and no statistically significant differences were seen in the decrease in frequency of voiding and incontinence episodes during treatment. There were no differences between the groups for age, type and degree of urinary incontinence, and radiological findings of bladder suspension defects.

In these patients it is important to perform cystometry, including detrusor reflex activation procedures and the testing of their ability to suppress a voluntarily induced detrusor contraction.
Elastin and Collagen in the Normal and Obstructed Urinary Bladder
Authors: CORTIVO R. , PAGANO F. , PASSERINI G. , ABATANGELO G. , CASTELLANI I.
Published: November 2008

SUMMARY— Histological and chemical studies were carried out on the elastin and collagen content of the normal and the obstructed urinary bladder wall. The observations were made on 3 different age groups: (1) 3‐month‐old children with vesical outlet obstruction, (2) children aged between 4 and 8 years with partial vesical obstruction, and (3) adults with a chronically obstructed bladder.

An increase in elastic tissue was shown only in the newborn and in the adults. The collagen did not vary in any of the cases studied. The elastin showed an increase in polar amino acids in the pathological organs compared with the normal. A similar increase in elastin was observed in normal individuals as a result of the ageing process.
Osteitis Pubis: Treatment by Heparinisation
Authors: MERIMSKY E. , CANETTI R. , FIRSTATER M.
Published: November 2008

SUMMARY— Three cases of osteitis pubis following prostatectomy, herniorrhaphy and combined prostatectorny and herniorrhaphy are presented.

Each case was successfully treated by intravenous heparin after other treatments had failed.
Characteristics of the Urethral Pressure Profile in Flaccid Male Paraplegics
Authors: CLARKE S. J. , THOMAS D. G.
Published: November 2008

SUMMARY— Several aspects of urethral function were studied in an attempt to identify the factors causing urinary retention in the flaccid paraplegic patient.

The urethral pressure was much higher in all patients at the external sphincter than at the bladder neck. In patients studied sequentially, even from very early following injury, there was little variation in the maximum urethral closure pressure. Radiological studies showed the point of maximal resistance to be distal to the verumontanum. The urethral pressure at this point was largely abolished by phentolamine infusion. There was no variation in the activity of this region with bladder filling or postural change.

It is concluded that in flaccid male paraplegics the major component of urethral resistance is constant, adrenergically innervated muscular resistance in the external sphincter region.
The Single Ectopic Ureter and the Dysplastic Kidney
Authors: SCOTT J. E. S.
Published: November 2008

Summary— Eight children, 3 girls and 5 boys, with single ectopic ureters arising from non‐concentrating kidneys are described. Two children, both girls, complained of persistent wetting with a pattern suggestive of ectopic ureter: 2 of the boys presented in the neonatal period with massive abdominal distension: the remaining children developed a urinary infection or chronic urinary retention.

Diagnosis depends on an appreciation of the possibility that a non‐concentrating kidney on intravenous urography may be giving rise to an ectopic ureter and, in the boys, on a correct interpretation of cystourethrographic findings. Careful endoscopic examination of the urethra and in the girls of the vagina also will lead to the identification of the ectopic ureteric orifice in most cases. When the ectopic ureter joins the male genital tract there may be anextravesical ureterocele which can be recognised cystoscopically.

The condition is treated by nephroureterectomy.
Teflon Tape Suspension for the Control of Stress Incontinence
Authors: CATO R. J. , MURRAY A. G.
Published: November 2008

Summary— Vaginal surgery for the relief of stress incontinence has a failure rate which is unacceptable. Since 1964 the authors have combined in the management of female urinary disorders. Where surgery was indicated the combined approach was used as the primary procedure.

The bladder neck was elevated by a technique of suspension using 2 mm Teflon tape, via the cave of Retzius. It was not a sling. The results of 100 consecutive operations are presented.

The team approach has led to a better understanding and management of all varieties of female bladder problems.
Surgical Correction of Torsion of the Penis
Authors: AZMY A. , ECKSTEIN H. B.
Published: November 2008

Summary— Torsion of the penis is a rare anomaly, believed to be due to abnormal skin attachment and not to any structural abnormality of the corpora. The rotation is usually to the left in a counter‐clockwise fashion. The urethral meatus is placed in an oblique position and the median raphe makes a spiral curve from the base of the penis towards the meatus.

Three boys with congenital torsion of the penis are reported. A corrective operation for this condition is described.

Penile torsion was first described by Verneuil in 1857, but in the past no operative correction was recommended, since attempts to move the skin around were believed not to correct the spiral alignment of the corpora cavernosa.
Urological Complications of Traumatic Diastasis of the Symphysis Pubis in the Female
Authors: Stanton S. L. , Cardozo Linda D. , Riddle P. R.
Published: November 2008

Summary— We report on 2 cases of traumatic distasis of the symphysis pubis in the female with injury to the soft tissue supports of the bladder neck resulting in urinary incontinence, unnoticed until discharge from hospital.
The Diagnosis and Management of Acute Scrotal Conditions in Boys
Authors: Hemalatha V. , Rickwood A. M. K.
Published: November 2008

Summary— In a consecutive series of 69 boys with an acute scrotal condition, 55% were suffering from torsion of a testicular appendage, 22% from torsion of the testis and the remainder from idiopathic scrotal oedema or epididymitis. The general clinical features and specific scrotal findings in each of these conditions are compared and contrasted.

It is concluded that on clinical grounds alone, torsion of the testis can be excluded in many boys presenting with an acute scrotal condition. The implications for management are discussed.
The Effect of pH on the Urinary Inhibition of Calcium Oxalate Crystal Growth
Authors: Tiselius H.‐G.
Published: November 2008

Summary— Urinary inhibition of calcium oxalate crystal growth was measured in metastable solutions of sodium oxalate and calcium chloride at different pH.

Inhibition of calcium oxalate crystal growth in urine from patients with calcium oxalate stone disease increased with increasing pH. The increase was most pronounced between pH 5.5 and 7.0

Sodium pyrophosphate in a similar way inhibited calcium oxalate crystal growth in this pH interval, and between pH 6.0 and 7.5 there was also a slight increase in the inhibiting activity by chondroitin sulphate and citrate.

Approximative correction factors were calculated in order to obtain a more appropriate value of the inhibition index when urine pH was different from 6.0, and a reasonably good correlation was obtained between inhibition indices calculated by means of the correction factor and inhibition indices derived from direct measurements of the crystal growth rate in solutions with different pH
The Influence of Renal Prostaglandins on Glomerular Filtration Rate (GFR) and Calcium Excretion in Urolithiasis
Authors: BUCK A. C. , SAMPSON W. F. , LOTE C. J. , BLACKLOCK N. J.
Published: November 2008

Summary— In a clinical study of 275 idiopathic stone formers the GFR was significantly raised in hypercalciuric patients compared with normal controls P<0.001). The possibility that the mechanism underlying hypercalciuria and raised GFR may be prostaglandin‐mediated was considered because it is now well established that prostaglandins regulate intra‐renal haemodynamics and influence tubular electrolyte excretion.

Experiments were performed in conscious Sprague Dawley rats to determine the changes in calcium and sodium excretion following prostaglandin synthetase inhibition with indomethacin. Both calcium and sodium excretion together with urine flow were significantly reduced (P<0.002). Further experiments were performed in anaesthetised monkeys (Macacca fascicularis) to see if the inhibitory effect of indomethacin was reversible. Exogenous prostaglandin (PGE2) infusion resulted in a marked calciuretic response without producing changes in GFR or blood pressure.

Selected hypercalciuric patients were treated with indomethacin, which resulted in a significant fall in urinary calcium excretion (P<0.001). This clinical and experimental study suggests that PGE2is the hormone which determines the renal handling of calcium by controlling renal tubular function.
The Place of Extended Pyelolithotomy (Gil‐Vernet Operation) in the Management of Renal Staghorn CalcuIi
Authors: WOODHOUSE C. R. J. , FARRELL C. R. , PARIS A. M. I. , BLANDY J. P.
Published: November 2008

Summary— In the 17 years up to 1979 189 kidneys have had an extended pyelolithotomy for staghorn calculus and have been followed up. In only 1 of 96 unilateral cases did a stone form in a normal contralateral kidney, whatever the outcome of surgery on the affected side. Seven early nephrectomies were performed for non‐function and in 6 bilateral cases, with advanced renal failure, surgery did not arrest the loss of renal function. Regrowth of stone occurred in 43 cases (complete staghorns in 24). Regrowth did not occur in 1 8 of 20 incompletely cleared kidneys nor in 22 of 41 with persistent infection. Renal function was improved in 1 3 of 1 5 cases where it had not already deteriorated beyond a critical point.

It is concluded that unilateral staghorn stones may be treated in their own right, without fear of compromising a normal contralateral kidney; that regrowth of stones is not inevitable, even with incomplete clearance; and that renal function is usually improved by surgery.
Bladder Transection —a Functional, Neurophysiological, Neuropharmacological and Neuroanatomical Study
Authors: STASKIN D. R. , PARSONS K. F. , LEVIN R. M. , WElN A. J.
Published: November 2008

Summary—Experimental models to represent the surgical methods of bladder transection in humans were performed on dogs and rabbits. The effects on vesical neurophysiology were studied by cystometry with bethanechoI supersensitivity testing; byin vitropharmacoIogicaI responsiveness; by determination of autonomic receptor densities using radio‐ligand binding and by autonomic neurohistochemical staining. Analysis revealed that transection with or without neurovascular preservation resulted in an alpha‐adrenergic denervation and cholinergic decentralization. A comparison with the surgical models is presented and proposed mechanisms of action are discussed in relation to the experimental results.
Radiotherapy and Cystectomy for T3 Bladder Carcinoma
Authors: HALL R. R. , HEATH A. B.
Published: November 2008

Summary— The survival of 1 02 patients with category T3 transitional cell carcinoma of the bladder treated by pre‐operative radiotherapy and radical cystectomy has been analysed according to the degree of down‐staging of tumour as assessed by the depth of infiltration of cancer in the operative specimen. Five‐year survival was 60% for patients showing evidence o down‐staging compared with 30% when persistent deeply invasive tumour was present at the time of cystectomy.

Analysis of available data suggests that survival of patients with category T3 bladder cancer is determined by the response of the tumour to initial radiotherapy rather than the dose of radiotherapy or the addition of cystectomy. Despite radical treatment, the survival of patients with locally advanced bladder cancer is poor; alternative, more effective forms of therapy should be sought.
The Clinical Application of Electron Microscopy and the Heterologous Ova Penetration Test to the Assessment of Spermatozoa from Infertile Men
Authors: PRYOR J. P. , COLLINS W. P. , LANDON G. , TYLER J. P. P.
Published: November 2008

Summary— Ultrastructural studies of spermatozoa from men whose spermatozoa repeatedly had shown poor motility demonstrated an increase in morphological abnormalities. This was considered significant in the 8 men in whom all of the spermatozoa were abnormal and probably significant in those where more than 90% were abnormal (9 men). Spermatozoa from 1 5 fertile men adhered to and penetrated 60% of hamster oocytes, whereas those from infertile men, with both normal and poor semen quality, failed to adhere or penetrate. The heterologous sperm penetration test offers a new approach to the assessment of semen quality in infertile men.
Urinary Continence in Children with Neurogenic Bladders
Authors: Kaye K. , van Blerk P. J. P.
Published: November 2008

Summary —Seventy‐three children with neurogenic bladder dysfunction were assessed for urinary continence over periods ranging from 6 months to 4 years.

Acceptable continence was achieved in 35 (48%), the majority by means of intermittent clean catheterisation, usually with drug manipulation. Two children had to be diverted purely for intractable incontinence. A plan of management for children with neurogenic bladder dysfunction is described.
Intravenous Urography in the Follow‐up of Carcinoma of the Bladder
Authors: Booth C. M. , Kellett M. J.
Published: November 2008

Summary—A urographic survey of 250 patients being followed for bladder cancer revealed 3 unsuspected ureteric tumours and 18 cases of ureteric obstruction. The tumours occurred in patients always affected by bladder recurrences and the obstructions were largely due to treatment of paraureteric bladder tumours by cystodiathermy or radiotherapy.

Regular follow‐up intravenous urography is therefore unnecessary except in patients with frequent recurrences, but we advocate radionuclide renography as an essential, inexpensive screening test to rule out ureteric obstruction following the treatment of paraureteric tumours.
The Urethral Syndrome: Morphological Studies
Authors: Splatt A. J. , Weedon D.
Published: November 2008

Summary—Tissue removed at Richardson urethroplasty from 50 patients with the urethral syndrome, together with material obtained from the urethras of 44 cadavers, was examined in an attempt to elucidate the pathological basis for this syndrome. There was a significant increase in fibrous tissue in the urethrovaginal septum, accompanied by a loss of smooth muscle fibres and focal clumping of elastic tissue, in patients with the urethral syndrome.
Do Intravenous Urography and Cystoscopy Provide Important Information in Otherwise Healthy Women with Recurrent Urinary Tract Infection?
Authors: MOGENSEN P. , HANSEN L. K.
Published: November 2008

SUMMARY— An investigation of the influence on therapy of intravenous urography (IVU) and cystoscopy in a prospective study of 93 women with recurrent urinary tract infections is presented. The patients fullfilled the following criteria: a history of recurrent urinary tract infection (at least three episodes a year), a physical and gynaecological examination, determination of plasma creatinine, urine culture, microscopy, and uroflowmetry. It is concluded that IVU seldom reveals abnormalities that influence treatment in otherwise healthy women. On the other hand, uroflowmetry and cystoscopy occasionally yield helpful information.
Haemoglobin‐F Levels in Urogenital Cancers
Authors: MÜDERRISOČLU C. , KANSU E. , AKDAS A. , LALELI Y. , FIRAT D.
Published: November 2008

SUMMARY— The haemoglobin‐F levels and F‐cell numbers were assessed in 19 patients with different urogenital cancers. Alpha‐fetoprotein (AFP), β human chorionic gonadotrophin (βHCG), total and prostatic acid phosphatase levels were also measured. HbF levels were found to be elevated in patients with testicular and prostatic cancer. No significant correlation was observed between HbF, AFP and βHCG levels. The findings suggest that HbF production could be enhanced in patients with testicular and prostatic carcinomas and might be a useful marker for the disease activity.
The Structure of the Bladder Neck in Male Bladder Neck Obstruction
Authors: BOOTH C. M. , SHAH P. J. R. , MILROY E. J. G. , THOMPSON SALLY‐ANN , GOSLING J. A.
Published: November 2008

SUMMARY— A light microscope and neurohistochemical study is presented of full thickness biopsies from the bladder neck of 10 middle‐aged males with urodynamically proven bladder neck obstruction.

Apart from varying degrees of collagen deposition in seven cases, no abnormality was present in the detrusor and pre‐prostatic components of the bladder neck muscles or in the distribution of cholinergic nerve fibres. The normal noradrenergic innervation to the pre‐prostatic sphincter was absent in all specimens; this may be age‐related.
The Urilos Recording Nappy System
Authors: EADIE A. S. , GLEN E. S. , ROWAN D.
Published: November 2008

SUMMARY— A technical and clinical evaluation of the Urilos recording nappy system is presented. The recording pads were calibrated to determine the variation between and within batches of 25 pads supplied by the manufacturer. Fifty patients were assessed by this system for periods of 2 to 7 h. The results show that the system is useful in the verification of patient histories, although it is difficult to obtain a quantitative measure of urine loss.
Accuracy of Transcutaneous Aspiration Biopsy in the Definitive Assessment of Nodal Involvement in Prostatic Carcinoma
Authors: LUCIANI L. , PISCIOLI F.
Published: November 2008

SUMMARY— The inaccuracy of lymphangiography in predicting nodal involvement and the complications of pelvic lymphadenectomy prompted us to evaluate other methods of staging prostatic cancer. On the basis of the results obtained in 24 patients with carcinoma of the prostate, the authors suggest transcutaneous fluoroscopy‐guided fine needle aspiration biopsy as a satisfactory alternative to lymphadenectomy. In 95.8% of patients pelvic lymphadenectomy confirmed the cytological findings of transcutaneous aspiration biopsy of pelvic lymph nodes using a “long‐bevelled, side‐holed” thin needle.

It is considered essential to perform aspiration biopsy on most of the pelvic lymph node chains spacified, regardless of lymphographic diagnosis.