bluuebunny/crossref_metadata_2025 huggingface dataset:
An in vitro Study of Intracavitary Pressures During Percutaneous Nephrolithotomy
Authors: GOBLE N. M. , HAMMONDS J. C.
Published: November 2008

Summary— Pyelorenal reflux and irrigant extravasation secondary to raised intrapelvic pressure during percutaneous nephrolithotomy account for a significant percentage of the operative morbidity. The effect of irrigant flow rate, height of irrigant reservoir, diameter of Amplatz sheath and lithotripsy on intracavitary pressures has been studied in an in vitro model. The elevation of pressures produced by these variables suggests that percutaneous techniques should be modified.
Blood Transfusion and Survival Following Nephrectomy for Carcinoma of Kidney
Authors: MOFFAT L. E. F. , SUNDERLAND G. T. , LAMONT D.
Published: November 2008

Summary— Blood transfusion has been reported adversely to affect survival following surgery for a number of malignancies. We have examined retrospectively the records of 126 patients undergoing nephrectomy for renal carcinoma and established that 80 (63%) were transfused. Comparison of the two groups of patients, after controlling for differences in age, sex, tumour stage and haemoglobin level, showed that the transfused patients did not necessarily have poorer survival. In this study, peri‐operative transfusion did not appear to have an adverse effect on long‐term survival following surgery for renal cancer.
A Geographical Focus of Duplex Ureter
Authors: PHILLIPS D. I. W. , DIVALL J. M. , MASKELL R. M. , BARKER D. J. P.
Published: November 2008

Summary— Following the observation of an unusually high number of patients presenting with duplex ureter in Dorchester, a prospective study of 1930 autopsies was carried out in nine centres throughout the Wessex region. The prevalence of duplex ureter in Dorchester was 2.5% (5 of 200 autopsies) but did not exceed 0.6% elsewhere. The finding was confirmed by study of intravenous urograms in south‐west Dorset carried out between 1982 and 1983, which showed a 6.0% prevalence of urinary tract duplication in radiographs from Dorchester.
The Role of Chlamyudia trachomatis in Epididymitis
Authors: GRANT J. B. F. , COSTELLO C. B. , SEQUEIRA P. J. L. , BLACKLOCK N. J.
Published: November 2008

Summary— Microbiological studies have identified an infective micro‐organism in 28 of 54 patients (52%) with epididymitis. Chlamydia trachomatis was the commonest infection isolated, occurring in 15 patients. An additional 17 patients (31%) who were culture negative had serological evidence which suggested recent chlamydial infection. Most patients with chlamydia were under 26 years of age, in contrast to patients over 35 years, in whom coliform infections predominated. Of the 12 consorts of patients with chlamydial epididymitis who wer screened, nine were also positive for this micr‐organism. These findings have important implications in the management of epididymitis, especially in young men.
A Computer‐based System for Urology and Nephrology
Authors: EL‐GAMAL S. S. , GHALY A. M. , HEAULME M. DE , GHONEIM M. A.
Published: November 2008

Summary— Modern technology offers new opportunities for the storage and manipulation of hospital information. A computer‐based system for urology and nephrology has been designed and developed in this centre. It uses a program that allows the analysis of unrestricted non‐codified texts and the operation by hospital staff who have had no more than minimal computer training. The potential of such a system is outlined and a comparison is made with other existing systems. Future prospects and potential lines of development are presented.
Urinary Risk Factors in Calcium Oxalate Stone Disease: Comparison of Men and Women
Authors: RYALL ROSEMARY L. , HARNETT RUTH M. , HIBBERD CATHERINE M. , MAZZACHI BERYL C. , MAZZACHI R. D. , MARSHALL V. R.
Published: November 2008

Summary— The daily excretion of calcium, oxalate, uric acid and glycosaminoglycans, the 24‐h urinary pH and volume, and the inhibitory effects of the urines on calcium oxalate crystal growth and aggregation, were measured in 44 normal women, 41 normal men, 32 female stone formers and 63 male stone formers. No significant differences could be found between the normal men and women, the male and female stone formers, or between the patients and their normal controls with regard to the excretion of oxalate and glycosaminoglycans, and the urinary pH. The normal women exhibited significantly lower urinary volumes and excreted less calcium per day than did the other subject groups. The excretion of calcium by the female stone formers was indistinguishable from that of both groups of men. The male and female stone formers did not differ from their corresponding control groups with regard to the excretion of urate, but both groups of male subjects had significantly higher daily urate excretions than did either female category. This was attributed to the greater body weights of the men. There were no discernible differences between any of the subject groups with regard to the inhibitory effects of their urines on calcium oxalate crystal growth, but urines from both groups of female subjects demonstrated a significantly greater inhibitory influence on crystal aggregation than did those of the men. It would appear that the relatively low incidence of uninfected calcium oxalate urolithiasis in women compared with men may be attributable to (a) a lower daily calcium excretion and (b) a higher inhibitory activity of their urines towards crystal aggregation.
Relationship between Voiding Pressures, Symptoms and Urodynamic Findings in 253 Men undergoing Prostatectomy
Authors: NEAL D. E. , STYLES R. A. , NG T. , POWELL P. H. , THONG J. , RAMSDEN P. D.
Published: November 2008

Summary— Two hundred and fifty‐three men (age 69.2pL7 years) undergoing prostatectomy for bladder outflow obstruction were studied. The aims were to determine the distribution of voiding pressures and their relationship to presenting symptoms and urodynamic findings. Symptoms were scored by means of a standardised questionnaire and urodynamic studies were performed.

Within this study group, high obstructive symptom scores were associated with low flow rates and high urethral resistance. However, high voiding pressures were not associated statistically with low flow rates or obstructive symptoms. Voiding pressures followed a unimodal, parametric distribution and a significant number of men had voiding pressures within the normal range: 9.1% had voiding pressures less than 55 cm H2O and 27.7% less than 75 cm H20.

Irritative symptoms, on the other hand, correlated significantly with obstructive symptoms, high voiding pressures and urethral resistance. Furthermore, high voiding pressures were associated with small cystometric bladder capacities, low compliance and detrusor instability.

Whilst these clinical and urodynamic parameters were associated statistically with voiding pressures, none proved specfic in being able to identify men with vioding pressures in the high or low end of the range.
Relationship between Detrusor Function and Residual Urine in Men undergoing Prostatectomy
Authors: NEAL D. E. , STYLES ROSEMARY A. , POWELL P. H. , RAMSDEN P. D.
Published: November 2008

Summary— Two hundred and fifty‐three men undergoing prostatectomy were studied by means of urodynamic investigation to determine the relationship between the volume of residual urine and detrusor function.

Increased volumes of residual urine were associated significantly with increasing age, low peak flow rate and high urethral resistance. However, weak voiding pressures were uncommon and did not correlate with increased residual volumes. Increased residual volumes also correlated significantly with a high resting detrusor pressure and a high detrusor pressure rise during the filling phase, but there was a wide scatter of the results for pressure rise and patients could not be classified into groups on the basis of this parameter.

Whilst detrusor decompensation was not manifest by weak voiding pressures in patients with increased residual volumes, impairment of the ability of the detrusor to empty the infused cystometric capacity during the subsequent voiding study correlated with increased residual volumes. These data are consistent with theories relating bladder outflow obstruction to the development of increased volumes of residual urine in men undergoing prostatectomy.
Local Hyperthermia of the Prostate Gland for the Treatment of Benign Prstatic Hypertrophy and Urinary Retention: A Preliminary Report
Authors: LINDNER A. , GOLOMB J. , SIEGEL Y. , LEV A.
Published: November 2008

Summary— The Prostathermer (TM), a system designed to deliver hyperthermic treatment to the prostate gland, was used to treat six patients with benign prostatic hypertrophy and urinary retention. The 99‐D model consists of a microwave generator operating at 915 MHz, an applicator with a built‐in water cooling system, temperature probes and an IBM PC‐XT type computer. The treatment regimen differed from patient to patient in the number of treatments (range 5–10), frequency per week (range 1–2), and average radiofrequency (RF) transmission. Sustained controlled heating of the prostatic tissue up to 39.4 to 45.2d̀C was carried out for 60 min in each session. Five patients were relieved of their indwelling catheters and at follow‐up 6 months after termination of therapy they were well by objective and subjective criteria. No complications were encountered. This is a preliminary report of our results of treatment with 47 hyperthermic sessions in six patients.
Studies on the Immunosuppressive Effect of Seminal Plasma
Authors: QUAYLE ALISON J. , SZYMANIEC S. , HARGREAVE T. B. , JAMES K.
Published: November 2008

Summary— In vitro suppression of immune responses by seminal plasma is well documented, but the mechanism by which it exerts its effects remain to be established. Our studies on T‐lymphocyte proliferation and natural killer cell target‐cell lysis reval that seminal plasma mediated suppression is dose‐dependent and temperature‐dependant, and that cells which have been activated are less susceptible to suppression. In the case of mitogen‐induced T‐cell responses this results in a decrease in the expression of the Interleukin‐2 receptor whose generation is essential to T‐cell proliferation. These stuies provide further evidence about suppression of the immune response by seminal plasma. This may be contibutory factor in the aetiology of AIDS, other sexually transmitted diseases, infertility and malignancies of the urogenital tract including carcinoma of the cervix.
Neurophysiological Measurement of the Voiding Reflex Arcs in Patients with Functional Disorders of the Lower Urinary Tract
Authors: FIDAS A. , ELTON R. A. , McINNES A. , CHISHOLM G. D.
Published: November 2008

Summary—
Neurophysiological measurements were carried out in 180 patients presenting to a Joint Incontinence Clinic with a history of lower urinary tract dysfunction. A full urodynamic assessment was performed along with neurophysiological measurement of the voiding relfex arcs. The majority of patients were shown to have significantly abnormal responses on neurophysiological measurement when compared with normal controls. Two particular groups, patients with acute retention and females with stress incontinence, were shown to have markedly poorer results than patients with other urodhynamic problems. These results suggest that many patients with lower urinary tract dysfunction may have a neurological component.
The Vagina as an Alternative to the Rectum in Measuring Abdominal Pressure during Urodynamic Investigations
Authors: JAMES E. D. , NIBLETT P. G. , MacNAUGHTON J. A. , SHALDON C.
Published: November 2008

Summary—
Pressure in the vagina as well as within the bladder and rectum was measured during urodynamic investigations. Rectal pressure is normally used to represent changes in abdominal pressure which, when subtracted from the total bladder pressure, provides a method of assessing detrusor function.

This study showed that vaginal pressure represented changes in abdominal pressure more accurately and consistently than did rectal pressure, and the vagina is therefore recommended as an alternative site in conducting urodynamic studies.
Intraperitoneal Rupture of the Bladder Causing the Biochemical Features of Renal Failure
Authors: HEYNS C. F. , RIMINGTON P. D.
Published: November 2008

Summary—
A group of 20 patients with intraperitoneal rupture of the bladder was compared with a group of 20 patients with haematuria due to renal injury. In patients admitted to hospital within 24 h of sustaining an intraperitoneal bladder rupture, the mean serum levels of creatinine and potassium were increased and the mean serum sodium level was decreased. However, the individual serum creatinine values were within normal limits in six of the 11 patients in this group. Patients presenting more than 24 h after intraperitoneal bladder rupture had an increased mean serum urea, creatinine and potassium level and a decreased mean serum sodium and CO2 content. The individual serum urea and creatinine values on admission to hospital were higher than normal in all nine patients in this group but the serum urea/creatinine ratio was not significantly elevated. A dramatic decrease in serum urea and creatinine levels was seen within 24 h after laparotomy and suturing of the bladder rupture.

In patients with abdominal symptoms and signs, haematuria and the biochemical features of renal failure (elevated serum urea, creatinine and potassium, decreased serum sodium and CO2 content), the clinician should suspect an intraperitoneal rupture of the bladder.
Invasive Bladder Cancer. Should Patients who Respond to Radiotherapy be Treated by Cystectomy?
Authors: LANGEMEYER T. N. M. , PEER P. G. M. , JANKEGT R. A. , LEERS W. H.
Published: November 2008

Summary—
A retrospective study was carried out on the long‐term survival (5–12 years) of 160 patients with invasive transitional cell cancer of the bladder treated with irradiation between 1972 and 1980. Follwing 40 Gy irradiation of the lower abdomen, treatment consisted of cystectomy or continued irradiation of the bladder region only. A full urological examination of the baldder established whether a patient was arespondr or non‐responder. The patients were divided into four groups: 27 responders treatd with cystectomy and diversion; 48 responders treated with continued radiotherapy up to 65 Gy; 24 non‐responders treated with cystectomy and diversion; 42 non‐responders treated with continued radiotherapy up to 65 Gy. Survival and complications of treatment were compared with regard to category and grade of the tumours and sex and age of the patients.

It was concluded that the responders who underwent cystectomy after 40 Gy irradiation survived longer than those who received a full course of radiotherapy. The responders had a better survival rate than non‐responders, regardles of further treatment. Salvage cystectomy was rarely carried out and proved to be an unsatisfactory alternative, with a high operative risk and short survival.
Treatment of Persistent Enuresis. Results of Severing a Tight Filum Terminale
Authors: KONDO A. , GOTOH M. , KATO K. , SAITO M. , SASAKIBARA T. , YAMADA H.
Published: November 2008

Summary— A tight filum terminale was severed in an attempt to treat intractable enuresis in 27 children. Urodynamic studies demonstrated pre‐operative bladder instability in all cases. Although symptom scores for enuresis improved significantly 6 months after surgery, only 7 patients benefited clinically (3 were cured and enuresis was reduced in 4). An average of 26 months later, 12 patients were either dry or their enuresis was reduced, probably due to spontaneous cure rather than surgery. We found no clinical parameters able to predict a favourable outcome. It was concluded that although a tight filum terminale is a cause of intractable enuresis, transection of the filum is not recommended because of the low success rate.
Transurethral Prostatectomy with Computer‐monitored Resectoscope
Authors: CHANG L. S. , YOUNG S. T.
Published: November 2008

Summary— Based on the difference in electrical conductivity between hyperplastic prostatic tissue and tissue of the surgical capsule, we have developed a monitoring computer that distinguishes the former from the latter. The computer sounds an alarm when the cutting loop of the resectoscope touches the capsule, followed by an automatic cut‐off of the power source 0±4 s later; thus inadvertent perforation of the surgical capsule can be avoided in most cases. The function of the computer has been tested in 73 patients with benign prostatic hyperplasia. The results show that, with Nesbit's technique of transurethral resection, tiny perforations of the surgical capsule, usually 1 to 2 mm in diameter, occurred in all 30 patients operated on without computer monitoring, but only 3 of 73 computer‐monitored patients had such an occurrence. There was a slight increase in the weight of resected prostatic tissue among the computer‐monitored patients, but the difference between the time spent on the procedure between the two groups of patients was not significant. Apart from its monitoring function, the computer may reduce eye strain and mental stress in the surgeon, especially when resecting a large hyperplastic prostate.
Ureteric Obstruction in Stented Renal Transplants
Authors: GEDROYC W. M. W. , KOFFMAN G. , SAUNDERS A. J. S.
Published: November 2008

Summary— The use of renal stents in renal transplants is becoming increasingly popular and has been routine practice at this institution for the past 4 years. Despite this procedure, however, obstruction of the transplant ureter still occurs and we describe 7 patients who developed renal obstruction in the presence of a stented transplant ureter. The underlying causes of these findings are discussed together with suggested recommendations for optimum radiological assessment of transplant ureteric stents. The implication of these observations is that urine may flow down stented ureters between the ureter and the stent rather than down the stent lumen.
Should pT1 Transitional Cell Cancers of the Bladder still be Classified as Superficial?
Authors: ABEL P. D. , HALL R. R. , WILLIAMS GORDON
Published: November 2008

Summary— Of 171 patients consecutively presenting with newly diagnosed transitional cell cancer (TCC) of the bladder, 107 were “superficial”; 98 have been followed up for 2 years and 84 for 3 years. No patient with pTa TCC developed muscle infiltrating recurrences, although 15% progressed to pT1 category by 3 years. At 2 and 3 years respectively, 33 and 46% of the pT1 TCC had progressed to infiltrate muscle.

The use of the term “superficial” to describe pTa and pT1 category TCC together in one grouping should be reconsidered.
Optical Internal Urethrotomy as the Treatment of Choice for Primary Stricture of the Urethra
Authors: MOHANTY N. K. , KACHROO S. L.
Published: November 2008

Summary— Seventy‐five patients with primary urethral strictures were treated by optical urethrotomy with catheter drainage for 7 days. Good results were obtained in 66% of cases, which were all post‐traumatic in nature; 34% had to undergo further procedures such as dilatation or repeat internal urethrotomy.
Clinical Value of Scrotal Ultrasound in the Investigation of Scrotal Pathology
Authors: HOWE D. , FOSTER M. E. , GATELEY C. , STURDY D. E. , GRIFFITHS G. J.
Published: November 2008

Summary— The investigation of scrotal swelling has been aided by the advent of scrotal ultrasound. We have reviewed 100 patients in whom 112 scans were performed. One quarter of this group presented with scrotal pain without swelling. Of these patients, 33% were shown to have normal testes on scan; the remainder all had benign disease. A similar number presented with scrotal pain and swelling and the majority were diagnosed on scan as having epididymitis. Nineteen patients were thought on clinical grounds to have tumours; 6 were proven at operation and all were correctly identified pre‐operatively by scanning. Scrotal ultrasound is a useful investigation in the management of both painless and painful scrotal swellings.
Diet and Renal Stones in 72 Areas in England and Wales
Authors: BARKER D. J. P. , MORRIS JULIE A. , MARGETTS B. M.
Published: November 2008

Summary—Geographical differences in emergency admission rates for renal stones and colic in England and Wales have been shown to correlate with the incidence of renal stones determined from case registers. The rates in 72 areas were related toper capitaconsumption of different foods, measured from household food purchases. There was an inverse relation with consumption of dietary fibre and all cereal foods. Differences in adult diet are not, however, the major determinants of the geographical variations in renal stone incidence within Britain.
Bone Mineral Content in Patients with Carcinoma of the Prostate
Authors: MOBB GILLIAN E. , MOISEY C. U. , RING E. F. J.
Published: November 2008

Summary— This study investigated the effect of metastatic prostatic carcinoma on bone density. Thirty patients underwent a lumbar spine scan with a dual photon absorptiometer. Of these patients, 9 had proven skeletal metastatic deposits in the area being investigated. Comparison of results with a non‐matched control population with proven benign prostatic histology showed a significantly elevated linear bone mineral content (BMC) in the disease group. Patients scanned after a 3‐ or 6‐month period of hormonal therapy demonstrated a rise in BMC values, although the trend was not statistically significant. Indices of calcium metabolism have also been investigated.
Variations of Cortisol Hydroxylation and Paracetamol Metabolism in Patients with Bladder Carcinoma
Authors: DOLARA P. , LODOVICI M. , SALVADORI M. , SALTUTTI C. , ROSE A. DELLE , SELLI C. , KRIEBEL D.
Published: November 2008

Summary—We investigated the possibility that variations of the metabolism of xenobiotic compounds might be involved in the process of bladder carcinogenesis, by studying activation reactions (phase I) and detoxification reactions (phase II) of xenobiotic compounds in a group of patients with transitional cell carcinoma of the bladder and in a group of controls hospitalised with other diseases. As an indirect estimate of activating reactions (phase I) we measured Cortisol hydroxylation, expressed as the ratio between urinary 6‐beta‐OH‐Cortisol and 17‐OH‐corticosteroids. Cortisol hydroxylation was not increased in the group of patients when compared with controls. The variations of phase II conjugating enzymes were followed indirectly by administering paracetamol and measuring the urinary excretion of its main metabolites over a period of 12 h. The variations in the metabolic conjugation of paracetamol were expressed as a percentage of each metabolite, or of unmodified paracetamol excreted in the urine, or as the ratio between a given metabolite and unmodified paracetamol. The data were analysed with a logistic regression model, analysing the effects of possible confounding variables such as age, smoking, alcohol, blood nitrogen, blood creatinine, glutamic‐pyruvic (SGPT), glutamic‐oxalacetic transaminases (SGOT) and percent recovery of paracetamol in the urine. Statistical analysis showed that the excretion of mercapturate derivatives of paracetamol was significantly increased in the group of patients. The levels of glucuronic, sulphate and cysteine metabolites were not varied significantly. Since mercapturate derivatives are formed as a consequence of the formation of short‐lived metabolites of paracetamol which react with protein, nucleic acids or glutathione, the increased excretion of mercapturic acid derivatives in cancer patients might be an indication of a higher capability of forming reactive molecular species from xenobiotic compounds. We suggest that this factor might play a role in the induction of bladder cancer.
Lack of Gonadal Protection by Medroxyprogesterone Acetate‐induced Transient Medical Castration during Chemotherapy for Testicular Cancer
Authors: FOSSÅ SOPHIE D. , KLEPP O. , NORMAN N.
Published: November 2008

Summary— The serum FSH levels were analysed in 24 testicular cancer patients 3 to 9 years after intensive chemotherapy. Sperm cell counts were performed in 12 patients. In all cases a temporary medical castration had been achieved during intensive chemotherapy by the use of medroxy‐progesterone acetate (MPA) (500 mg daily per os). The hormone treatment was initiated on day 1 of the first chemotherapy cycle. Thirteen additional patients did not receive this hormone treatment but were treated by similar chemotherapy. The latter patients served as a control group.

There was a tendency towards higher FSH levels in the MPA‐treated patients than in the controls. Following treatment, serum testosterone was significantly lower in patients who had received MPA during their intensive chemotherapy than in the controls. There was no difference between the groups with regard to recovery of sperm cell production after chemotherapy.

An MPA‐induced medical castration during intensive chemotherapy in testicular cancer patients is ineffective in protecting the remaining testis against treatment‐induced damage to spermatogenesis, at least if hormone treatment is started simultaneously with chemotherapy.
Cytokeratin Shedding in Urine: a Biological Marker for Bladder Cancer?
Authors: BASTA M. T. , ATTALLAH A. M. , SEDDEK M. N. , EL‐MOHAMADY H. , AL‐HILALY E. S. , ATWAAN N. , GHONEIM M.
Published: November 2008

Summary— Cytokeratin shedding into the urine was measured using an enzyme‐linked immunosorbent assay in 154 individuals. Samples include urines of normal controls, patients with urological conditions other than bladder cancer and bladder cancer patients. The assay results reflect the potential value of cytokeratin shedding in urine as a new urinary marker for bladder cancer. A 94% sensitivity for patients with squamous cell carcinoma of the bladder suggested the importance of using antibodies prepared against cytokeratin extracted from the same cell type of carcinoma as that to be detected. The relatively low sensitivity shown while detecting transitional cell carcinoma patients and the relatively low degree of assay specificity suggested the use of a panel of monoclonal antibodies specific to various types of cytokeratins of bladder carcinoma.
Detrusor Behaviour Followng Implantation of the Brantley Scott Artificial Urinary Sphincter for Neuropathic Incontinence
Authors: MURRAY K. H. A. , NURSE D. E. , MUNDY A. R.
Published: November 2008

Summary— During a 3‐year period, 102 Brantley Scott artificial urinary sphincters were implanted to control urinary incontinence. Nineteen patients underwent endoscopic sphincterotomy and artificial sphincter implantation for the control of sphincter weakness incontinence due to congenital neuropathic bladder dysfunction. None had previous augmentation or substitution procedures. Nine patients (47%) subsequently showed a deterioration in detrusor function, resulting in either recurrent incontinence or upper tract dilatation. Eight of these (89%) had previously been shown to have an intermediate pattern of neuropathic bladder abnormality.

All patients implanted with an AUS require long‐term surveillance including videourodynamic studies, and patients with intermediate neuropathic bladders should be considered for augmentation or substitution at the time of implantation.
Subcapsular Orchiectomy under Local Anaesthesia Technique, Results and Implications
Authors: DESMOND A. D. , ARNOLD A. J. , HASTIE K. J.
Published: November 2008

Summary— One hundred patients with carcinoma of the prostate have been treated by bilateral subcapsular orchiectomy under local anaesthesia over a 5‐year period. The indications, technique and results of performing the operation in this way are described. The procedure is simple, effective and well tolerated by the patients.
Covariance Biplot Analysis of Trace Element Concentrations in Urinary Stones
Authors: WANDT M. A. E. , UNDERHILL L. G.
Published: November 2008

Summary— The covariance biplot, a relatively new technique for displaying multivariate data, was applied to trace element contents and compound concentrations of urinary stones. The biplot is demonstrated to give a compact graphical representation of the multivariate data with interpretations in terms of familiar statistical concepts such as correlations and standard deviations. It displays strong correlations between various trace elements like Zn and Sr, and Sr and Na. The biplot also suggests concentration relationships which could play a hitherto unknown role in the genesis of calculi. It is shown to help in the interpretation of analytical results as well as in exposing erroneous or incomplete analyses.
Transitional Cell Carcinoma of the Urethra in Men after Radical Cystectomy for Bladder Cancer. Is Prophylactic Urethrectomy Indicated?
Authors: LOPEZ‐ALMANSA M. , MOLINA R. , HUBEN R. P.
Published: November 2008

Summary— A retrospective study of the incidence and clinical course of transitional cell carcinoma of the urethra is reported. Of 110 consecutive male patients who underwent cystectomy during a 9‐year period, 9 had or developed a urethral tumour. Five patients undergoing radical cystectomy had known or suspected urethral involvement which was confirmed at urethrectomy. All 5 had deeply invasive (T3 or T4) transitional cell carcinomas of the bladder and subsequently died of metastatic disease. Four patients underwent urethrectomy because of signs or symptoms of urethral recurrence at an average interval of 2.5 years after cystectomy. There were two deaths in this group, neither of which appeared to be due to urethral recurrence. Six additional patients had undergone prophylactic urethrectomy because of prostatic urethral involvement or diffuse carcinoma in situ in the cystectomy specimen, and none had identifiable tumour in the anterior urethra. The residual urethra is a potential focus for recurrent tumour and this necessitates careful follow‐up with serial cytology, but the low incidence of urethral recurrence (3.5% in this series) does not appear to warrant routine urethrectomy at the time of cystectomy.
Vesicopyelostomy in the Treatment of Pelvic Kidneys with Pelviureteric Junction Obstruction: Long‐term Follow‐UP
Authors: KUMAR A. , SHARMA S. K. , VAIDYANATHAN S. , GOSWAMI A. K. , BAPNA B. C.
Published: November 2008

Summary— The surgical management of 6 male patients with pelvic kidneys with pelviureteric junction obstruction is discussed. Two patients presented in advanced renal failure and 1 had peritonitis and septicaemia due to rupture of the renal pelvis. Vesicopyelostomy was preferred to pyeloplasty in 5 patients because of adhesions, multiple aberrant vessels, multiple stones, malrotation and the low pelvic position, but pyeloplasty was done in 1 case. Though vesicoureteric reflux was observed during voiding cystourethrography in all patients, no deleterious effect on the kidney was seen during the 3‐ to 5‐year follow‐up period.
Prostatectomy or Conservative Management in the Treatment of Benign Prostatic Hypertrophy?
Authors: KADOW C. , FENELEY R. C. L. , ABRAMS P. H.
Published: November 2008

Summary— A randomised, prospective trial comparing transurethral prostatectomy with conservative management was carried out in 38 men with proven bladder outflow obstruction. Patients were assessed urodynamically before treatment and 6 months later. All 21 patients who had a prostatectomy showed a significant improvement in peak flow rate, voiding pressures and residual urine volume, but only 71 % were symptomatically better. Of the 17 patients treated conservatively, 56% noted an improvement in their symptoms, although their peak flow rates and residual urine volume were virtually unchanged. Following prostatectomy, the incidence of detrusor instability fell by 78%, whereas in the conservatively treated group the reduction was only 50%.

Patients who had done well or badly after treatment were analysed as separate subgroups. The single feature which distinguished between these two groups was the high incidence of reversion to bladder stability in those who had a good symptomatic response to treatment.
Ketoconazole as Primary Treatment of Prostatic Cancer
Authors: MOFFAT L. E. F. , KIRK D. , TOLLEY D. A. , SMITH M. F. , BEASTALL G.
Published: November 2008

Summary— Ketoconazole 400 mg 8‐hourly was used as primary hormonal treatment in 12 patients with advanced prostatic carcinoma. Four patients were withdrawn because of side effects and 1 died. The 7 patients who tolerated the drug had a reduction in testosterone and adrenal androgens. Six patients were fully evaluable. There was one partial response with complete remission of symptoms. Two patients enjoyed a subjective response and 3 showed no response. Ketoconazole had an effective biochemical action but the side effects seen in this study severely limit its usefulness. Ketoconazole has now been withdrawn as a treatment for prostatic cancer. However, less toxic derivatives might prove a useful addition to the drugs available to treat this condition.
Analgesic Effect and Tolerance of Voltaren and Ketogan in Acute Renal or Ureteric Colic
Authors: SOMMER P. , KROMANN‐ANDERSEN B. , LENDORF A. , LYNGDORF P. , MOLLER P.
Published: November 2008

Summary— Fifty‐six patients with renal or ureteric colic were entered into a randomised, prospective, double‐blind investigation of the analgesic efficacy and tolerance of VoltarenR versus KetoganR, both administered intramuscularly. There were no significant differences regarding pain‐relief but side effects were fewer in patients treated with Voltaren.
The Severity of Urinary Incontinence in Women Comparison of Subjective and Objective Tests
Authors: FRAZER M. I. , HAYLEN B. T. , SUTHERST J. R.
Published: November 2008

Summary— The subjective assessment of urine loss in 84 incontinent women was quantified by using a 10‐cm visual analogue scale. These results were compared with the results of a 2‐h pad weighing test. We found no relationship between a patient's subjective impression of the severity of her incontinence and the corresponding objective assessment by a 2‐h pad weighing test.
Lack of Relationship of Conus Reflexes to Bladder Function after Spinal Cord Injury
Authors: LUCAS M. G. , THOMAS D. G.
Published: November 2008

Summary— A series of 20 patients with acute complete suprasacral cord lesions underwent serial urodynamic assessment of vesicourethral function and serial measurement of sacral reflex latency times (SRL) and reflex threshold throughout a follow‐up period of 42 to 83 weeks (mean 50).

No correlation was found between any pattern of SRL latencies or reflex thresholds and subsequent bladder behaviour. The reproducibility of sacral reflex latencies was found to be poor (mean variation of serial measurements from initial reading 21%) and could not be explained on the basis of “dynamic” neurological recovery. Studies using the bladder as a stimulus site were unreliable. The value of SRL studies in detecting subtle neurophysiological changes is discussed.
New Combination Chemotherapy Programme for Bladder Cancer
Authors: WAXMAN J. , ABEL P. , JAMES N. , FARAH N. , O'DONOGHUE E. P. N. , MEE D. , COLBECK R. , SIKORA K. , WILLIAMS GORDON
Published: November 2008

Summary— Forty patients with either metastatic, post‐radiotherapy recurrent, or poor prognosis locally advanced transitional cell carcinoma of the bladder were treated in a new combination chemotherapy programme with methotrexate, vinblastine, mitozantrone and JM8 (carboplatin); 33 patients were assessable for response. There were 9 complete responses (27%), 12 partial responses (36%) and 7 disease stabilisations (21%); 5 patients (15%) had progressive disease. The median duration of complete response has not been reached and is in excess of 9 months (range 4– > 18 months). This regimen was without significant toxicity and this is in contrast with M‐VAC, which is thought to be currently the most effective treatment for urothelial cancer.
Epididymo‐orchitis and Brucellosis
Authors: KHAN M. S. , HUMAYOON M. S. , AL MANEE M. S.
Published: November 2008

Summary— A series of 40 patients presented with epididymo‐orchitis between January 1983 and August 1985. In 14 brucellosis was diagnosed. In 10 of these (72%) both testis and epididymis were involved and 1 had bilateral disease. All patients with brucella epididymo‐orchitis were treated with streptomycin and tetracycline and complete resolution occurred in 8 (57%).
Unexplained Spontaneous Regression and Alpha‐interferon as Treatment for Metastatic Renal Carcinoma
Authors: OLIVER R. T. D. , NETHERSELL A. B. W. , BOTTOMLEY J. M.
Published: November 2008

Summary— A series of 73 patients with measurable metastatic disease referred to a tertiary referral centre for consideration for an experimental treatment protocol were entered into a surveillance protocol in order to establish the incidence of spontaneous regression. Initially, patients were taken off the study if metastases showed > 25% increase in products of bidimensional measurement but with increasing confidence patients went into therapy protocols only following the development of symptomatic progression. We observed 3 complete and 2 partial unexplained spontaneous regressions and a further 4 patients had prolonged stable disease for more than 12 months.

A group of 21 patients on progression subsequently received treatment with alpha‐interferon (Wellferon) as part of a multicentre study which included an additional 61 cases; 12 responded (3 surveillance relapse patients and 9 others). Patients with lung metastases only had the highest response rate (10/17 compared with 5 unexplained responses seen in 38 such patients on surveillance). These results confirm that alpha‐interferon is active against metastatic renal carcinoma and that the responses are not totally explicable by spontaneous regression.
Transvaginal Ultrasound in the Assessment of Bladder Volumes in Women: Preliminary Report
Authors: HAYLEN B. T. , FRAZER M.I. , SUTHERST J. R. , WEST C. R.
Published: November 2008

Summary— Transvaginal linear array ultrasound is described as a method of measuring bladder volumes in the range 2 to 175 ml, overcoming the limitations of abdominal ultrasound at these smaller (though clinically important) volumes.

The mean error over the range 10 to 175 ml was 23%. Statistical analysis of preliminary data obtained by this technique shows that bladder volume in ml can be calculated by the formula:

Volume = 5.9 × (height × depth) ‐ 14.6 ml

(95% confidence limits=±37 ml)
Retrospective Study of Radiotherapy in Early Carcinoma of the Prostate
Authors: READ G. , POINTON R. C. S.
Published: November 2008

Summary— During the years 1978 to 1983 there was a 10‐fold increase in the number of patients with T1‐T4 NX MO carcinoma of the prostate referred to the Christie Hospital for radical radiotherapy. A retrospective survey of 170 patients treated during this period showed an overall age‐corrected 5‐year survival rate of 49%. The survival of patients in whom referral for radiotherapy had been delayed was 37% compared with 56% for those given immediate treatment. Patients with poorly differentiated tumours had a significantly reduced survival compared with those with well differentiated tumours. The overall complication rate from radiotherapy was 4% and this low rate is attributed to the small volume used uniformly for treatment.
Circannual Rhythmicity in the Occurrence of Idiopathic Priapism in North‐Western India
Authors: MANDAL A. K. , VAIDYANATHAN S. , KRISHAN K.
Published: November 2008

Summary— A group of 26 patients who were operated upon for idiopathic priapism between 1972 and 1986 were classified according to the date on which they attended hospital. During the same 15‐year period 150 patients with penile cancer were treated and they served as controls.

The data were analysed for circannual rhythmicity (365.25 days = 360° and 0°= 22 December. This revealed a significant circannual rhythmicity in the occurrence of idiopathic priapism, with the acrophase located on 2 August. There was a significantly higher incidence of idiopathic priapism between April and September.
The “Plain Film” Bladder Shadow in Outflow Obstruction: as Accurate a Discriminant of Residual Urine as Ultrasound
Authors: TIMONEY A. G. , PAYNE S. R. , DAVIES L. A. L. , ABERCROMBIE G. F.
Published: November 2008

Summary— The height, width and area of the bladder shadow on post‐micturition plain abdominal radiography was compared with the residual urine obtained at endoscopy from 58 men presenting with pure bladder outflow obstruction. Each parameter of the bladder shadow correlated significantly with the residual urine in patients in whom this shadow was visible. Post‐micturition plain abdominal radiography is considerably cheaper than ultrasound and appears to be equally effective in the determination of residual urine. Its use as the sole imaging technique in the routine management of bladder outflow obstruction is recommended.
Effect of Suprapubic Operation on Urethral Closure Evaluation by Single Cough Urethrocystometry
Authors: PENTTINEN J. , KÄÄR K. , KAUPPILA A.
Published: November 2008

Summary— To evaluate urodynamic effects of modified Burch colposuspension, 24 patients with stress urinary incontinence were investigated before and 6 to 9 months after the operation. A new method of urodynamic evaluation was performed using a multitransducer‐catheter, 5 microtransducers inside the urethra and 1 in the bladder, connected to a computer and graphic plotter. Single coughs were analysed with the catheter in a fixed position and the patient in the standing position.

The operation, which was successful, in all but 1 patient, did not alter urethral pressure at rest, but urethral closure pressure at stress after the operation (mean 45.0 cm H2O (SD 21.6)) was significantly higher (P < 0.005) than the – 3.6 cm H2O (SD 10.2) recorded before the operation.

The pressure transmission ratio was less than 100% in 22 patients before the operation and more than 100% in 18 patients afterwards, the pre‐and post‐operative mean values being 78.9% (SD 11.9) and 109.5% (SD 17.2) respectively (P < 0.0005).

Burch colposuspension markedly improves urethral closure function as evaluated by this method, which analyses the pressure data at different points of the urethra and bladder during one single cough.
Serum Lactate Dehydrogenase and Human Choriogonadotrophin in Seminoma
Authors: FOSSÅ A. , FOSSÅ SOPHIE D.
Published: November 2008

Summary— The clinical significance of serum lactate dehydrogenase (LDH) and serum human choriogonadotrophin (HCG) as tumour markers was assessed in 105 patients with pure seminoma from whom 981 blood samples were analysed. The specificity of elevated HCG and LDH was 100 and 93% respectively. The comparable sensitivity was 32 and 47%. Serum LDH could not discriminate between patients with clinical stage I seminoma, prior to orchiectomy, and those with benign testicular lesions. In patients with advanced metastatic seminoma subjected to orchiectomy, serum LDH was increased in 82%, but elevated HCG was found in only 40%. After cisplatin‐based chemotherapy, falsely elevated LDH was observed in 7 of 37 tumour‐free patients, but HCG was normal in all patients with no evidence of disease. Six patients with residual tumour after chemotherapy had normal LDH and 4 of them had elevated HCG; 70% of the relapses in seminoma patients were associated with increased LDH (64%) and/or HCG (48%). In seminoma patients with comparable disease extension, elevated HCG seemed to be correlated with a high risk of relapse. Patients with normal pre‐treatment LDH had a lower relapse‐free survival rate than patients with elevated LDH. HCG is a highly specific tumour marker in seminoma with a rather low sensitivity. HCG is particularly useful for the primary diagnosis in patients with testicular lesions and during monitoring of chemotherapy in seminoma patients. LDH is less specific than HCG. Both markers should be analysed during follow‐up of seminoma patients, since 70% of relapses are associated with an increase in one or both markers. Elevated pre‐treatment HCG, but not elevated LDH, seems to indicate an increased risk of relapse in patients with seminoma.
Prospective Study of Routine Scrotal Ultrasonography in Urological Practice
Authors: LONDON N. J. M. , SMART J. G. , KINDER R. B. , WATKIN E. M. , REES Y. , HALEY P.
Published: November 2008

Summary— The value of routine scrotal ultrasonography has been evaluated in a prospective study of 109 men with scrotal symptoms or signs. Ultrasonography had a sensitivity of 100% and specificity of 99% for testicular tumour. Clinically useful information was provided in 53% of patients and 8% might have avoided surgery if the ultrasound report had been heeded. Ultrasonography did not provide any additional information in patients with scrotal pain and an entirely normal scrotum clinically, and in those with epididymal cysts in whom the testis was palpably normal. If these 2 groups had been excluded from routine scrotal ultrasonography there would have been a 25% reduction in the number of examinations without any reduction in diagnostic yield.
Clinical Application of Transrectal Ultrasound for the Investigation of the Incontinent Patient
Authors: RICHMOND D. H. , SUTHERST J. R.
Published: November 2008

Summary— A transrectal ultrasound technique is described for imaging the bladder neck and urethra. A group of 25 continent female volunteers was examined initially; 59 incontinent women were then studied pre‐operatively and again 6 months after either a Burch colposuspension, Pereyra operation or ox fascial sling to determine the ultrasonic characteristics of successful surgery.
Videoprostatectomy. Guidelines for Choosing an Effective Microvideo Operating System
Authors: O'BOYLE P. J. , RAINA S. , HOLDOWAY A. T.
Published: November 2008

Summary— Videoprostatectomy is gaining increasing acceptance by urologists. Guidelines are suggested to assist in the selection of a suitable video operating system and to optimise both the quality of the video image and safety of operation.
Optical Urethrotomy—Experience in Oman
Authors: JOHN J. , GEORGE K. , AL BUSAIDY Q. M. S. , SMITH J. C.
Published: November 2008

Summary— Over a 4‐year period 170 men with urethral strictures were treated with optical urethrotomy; 80% required no further treatment during the 2‐year follow‐up; 2 patients with urethral fistulae associated with stricture were also treated successfully.
The Fine Structure of Human Pseudomembranous Trigonitis
Authors: JOST S. P. , GOSLING J. A. , DIXON J. S.
Published: November 2008

Summary— The present investigation provides a histological and fine structural description of pseudomembranous trigonitis, an ill‐understood metaplastic condition affecting particularly the female trigone. Normal trigonal urothelium consists of 3 cell layers (basal, intermediate and superficial), whereas pseudomembranous trigonitis constitutes many layers of stratified squamous epithelium. The basal cells contain prominent nuclei with condensed chromatin, nucleoli and nuclear bodies. The cytoplasm of these cells is rich in mitochondria. The profiles of the urothelial cells become progressively elongated, their nuclei increasingly smaller and their content of cell organelles gradually reduced as the luminal surface is approached. The squamous surface cells, linked by desmosomes, retain many longitudinally arranged fine filaments, together with an occasional degenerate nucleus. The mitotic index of pseudomembranous trigonitis is 0.17% (SD 0.09%), i.e. significantly higher than normal (0%).
Acid Phosphatase Levels in Serum during Transurethral Prostatectomy
Authors: HAHN R.G.
Published: November 2008

Summary— Serum prostatic acid phosphatase (S‐PAP), serum electrolytes, blood loss and volume of irrigating fluid absorbed were measured during 10‐min periods in the course of 35 transurethral prostatic resections. Elevation of the S‐PAP concentration occurred in association with a large blood loss, with absorption of irrigant followed immediately by hyponatraemia, and with a sudden drop in systolic blood pressure. The volume of blood lost during irrigant absorption was the most important index of the S‐PAP level. A model for the transfer of PAP to the circulation during TURP is presented.