bluuebunny/crossref_metadata_2025 huggingface dataset:
Lymphocele following Renal Transplantation: an Unusual Cause of Urinary Retention
Authors: Schiff Martin , Feldman RobertA.
Published: November 2008

Retroperitoneal pelvic lymphoceles have been reported in 1% to 2% of patients receiving renal transplants (Starzi et al., 1970; Schweizer et al., 1972). They usually become evident within 3 months following transplantation and are thought to be due to disruption of the small lymphatics adherent to the iliac vessels. Their most common mode of presentation has been mild deterioration of renal function caused by ureteric obstruction.
An Apparatus for Helmstein's Hydrostatic Pressure Treatment
Authors: MONGA L. S.
Published: November 2008

A new method of producing a balloon catheter for distension of the bladder is presented and an appropriate infusion set for the balloon is described.

Various advantages and disadvantages have been discussed.

I wish to express my sincere thanks to: Mr J. W. Eadie, FRCS, FRCS(Ed.) Consultant Surgeon, and M r J. D. C. Kelly, FRCS, Consultant Surgeon, for their encouragement to develop the apparatus described; Dr Myers, FFA, RCS, for his help in administering epidural anaesthetic; Theatre Sisters and the Staff for providing useful help during experimentation; Mrs Border, the Medical Photographer; Mrs Williamson, the Medical Secretary, for her help in drafting this article.
Leukoplakia of the Male Urethra
Authors: Vijayan P. , Clark P. B. , Anderson C. K.
Published: November 2008

Leukoplakia of the renal pelvis, ureter, bladder, glans penis and vulva has been well documented but very little has been written about leukoplakia of the urethra, except to mention that it does occur. 8 cases have been reported—3 by Kretschmer (1928), I each by Schloss (1956) and Perl (1965) and 3 by Reece and Koontz (1975). The following case is probably the first to be reported from the United Kingdom and has several unusual features.
Relative Contributions of Smooth and Striated Muscles to the Canine Urethral Pressure Profile
Authors: Awad S. A. , Downie J. W.
Published: November 2008

Canine urethral pressure profiles were analysed using pharmacological and nerve sectioning techniques.

The presence of significant sympathetic and somatic neural components was detected and their locations along the proximal urethra were identified.

The neural components peaked at different points in the urethra but overlapped.

The non‐neural component appeared to form an even base along the whole proximal urethra.

It was concluded that in the proximal part of the profile the non‐neural and the sympathetic components are significant.

The sympathetic component becomes larger in the peak pressure zone.

More distally and overlapping with the sympathetic component is the contribution of the striated external sphincter.
Methyl Cholanthrene and Cadmium Induced Changes in Rat Prostate
Authors: SCOTT R. , AUGHEY E.
Published: November 2008

Summary— Cadmium workers have been thought to be more likely to develop prostatic cancer. The present study compares the effects of cadmium on rat prostate as compared with a known carcinogen, 20 methyl cholanthrene. The various histological effects produced are discussed.

Possibly the most important aspect is the stratification and primitive clear cells found in rat prostatic acini in cadmium injected rats.
The Measurement and Interpretation of Urethral Pressures Obtained by the Method of Brown and Wickham
Authors: ABRAMS P. H. , MARTIN S. , GRIFFITHS D. J.
Published: November 2008

Summary— The most significant error in routine measurement of urethral pressure by the Brown‐Wickham method is caused by the slow response of the system to increasing pressure. Errors due to viscous pressure losses in the measuring catheter and to variable orientation of the catheter sideholes are not normally important.

The distensibility of the urethra may be estimated from the variation of the measured pressure with infusion flow rate in the range above 2 ml/min.

In highly distensible urethras the pressure actually measured is similar to the true pressure in the undistended urethra, but in less distensible urethras this is not so.

Substantial leakage, at a flow rate of 2 ml/min or more, begins to occur when the intravesical pressure is approximately equal to the maximum pressure in the undistended urethra. Therefore, in highly distensible urethras the maximum measured pressure is a satisfactory guide to the intravesical pressure needed for substantial leakage. In less distensible urethras, however, substantial leakage may occur when the intravesical pressure is perhaps 25 cm H2O below the maximum pressure measured in the urethra.

Leakage at very low flow rates may be possible through some urethras when the intravesical pressure is very low indeed. The urethral closure pressure profile, as ordinarily measured, is not a reliable guide to the possibility of such leakage.

With care, the method of Brown and Wickham gives satisfactory measurements of the urethral closure pressure profile. However, the maximum profile pressure exceeds, sometimes by a considerable amount, the bladder pressure needed to cause leakage.
Cordopexy: A New Approach to the Undescended Testis
Authors: SAHA S. K.
Published: November 2008

Summary— Fixation of the spermatic cord, and not the testis—“cordopexy”—is a new and useful addition to an orchidopexy.

The results in 25 patients are encouraging. There has been no morbidity.
The Effect of Routine Digital Examination of the Prostate on Serum Acid Phosphatase
Authors: KHAN A. N. , LEE G. S. , JACKETT D. M. R. , NEWCOMBE R. G. , PATHY M. S.
Published: November 2008

Summary— Hock and Tessier in 1949 recorded an elevation of serum acid phosphatase levels in 17 out of 20 patients 1 h after prostatic massage. Since that time, it has been widely held and taught that prostatic massage causes a rise in the serum acid phosphatase levels for up to 48 h.

This study was designed to evaluate the effect of prostatic examination on serum acid phosphatase levels, along with the magnitude of laboratory variations and the effects of tourniquet application on blood sampling.
Reflex Urethral Instability
Authors: McGUIRE EDWARD J.
Published: November 2008

Summary— Eleven patients with incontinence and large post‐voiding residual urine volumes have been studied with a urodynamic technique. Results indicate that reflex urethral relaxation was responsible for urinary incontinence. A probably relationship of this syndrome to bladder overdistension is suggested by ancillary evidence.
Visualisation of the Lymphatics of the Vulva and Scrotum by Direct Intratissue Injection of the Dye
Authors: VLAHOS L. , KARATZAS G. , GIANNOPOULOS A. , BENAKIS V. , DIMOPOULOS C. , PONTIFEX Gr.
Published: November 2008

Summary— Visualisation of the regional lymph nodes of the vulva and scrotum was obtained in 12 dogs (6 females and 6 males) by direct intratissue injection of Lipiodol Ultra Fluid.

The advantages as well as the potential applications of the method in humans are discussed.
Pyeloplasty in Infants and Children with Particular Reference to the Method of Drainage Post‐operatively
Authors: RICKWOOD A. M. K. , PHADKE D.
Published: November 2008

Summary— Sixty‐three consecutive Anderson‐Hynes pyeloplasties in infants and children have been reviewed with particular reference to any influence the method of drainage might have on the post‐operative course and the final radiological result.

Extra‐anastomotic drainage, usually with a sump drain, was used in 40 cases and pyelostomy drainage in 23 cases. Fewer post‐operative complications were encountered in the former group.

The final radiological result was not influenced by the method of drainage except that, in patients under 2 years of age, those with pyelostomy drainage fared rather better.

It is concluded that (a) extra‐anastomotic sump drainage is the method of choice following pyeloplasty in children over 2 years of age, and (b) in infants under 2 years of age pyelostomy drainage probably should be combined with a trans‐anastomotic splint.
The Site of Recurrence of Non‐Infiltrating Bladder Tumours
Authors: PAGE B. H. , LEVISON V. B. , CURWEN M. P.
Published: November 2008

Summary— A study of 56 cases of non‐infiltrating bladder tumour showed a striking difference in the distribution within the bladder of the primary and the recurrent tumours. More than three‐quarters of the primary tumours were confined to a restricted area near a ureteric orifice whereas only one‐fifth of recurrent tumours were found in this site. By far the commonest site for recurrent tumours was the postero‐superior wall of the bladder. Forty‐five recurrent tumours formed in the air bubble region, a site in which no primary tumour was found in the whole series.

The postero‐superior wall of the bladder is subject to mild trauma and abrasion by the tip of an endoscope and the air bubble region is the recipient of hot gas produced by the diathermy. These gas bubbles may also convey detached tumour cells to the recipient site.

Local trauma may encourage tumour formation either by producing a raw surface which allows implantation of tumour cells, or possibly also by reducing local resistance to the primary carcinogenic factor.
The Thermographic Characteristics of Varicocele: an Analysis of 65 Positive Registrations
Authors: MONTEYNE REGINALD , COMHAIRE FRANK
Published: November 2008

Summary— Sixty‐five positive thermograms in patients suspected of subclinical varicocele or presenting with clinically palpable varicocele have been analysed. Two distinct patterns of varicocele associated thermograms could be distinguished, hyperthermia always exceeding 1d̀C.

A correlation was found between the clinical grade of varicocele and both the extension and the degree of hyperthermia.
Coagulum Pyelolithotomy
Authors: SMITH P. J. B. , ROBERTS J. B. M. , DUNN M.
Published: November 2008

Summary— In 25 patients undergoing pyelolithotomy a supplementary coagulum technique has been used. Initial difficulties were found in the preparation, instillation and extraction of the coagulum, but with experience a satisfactory technique has been developed.

The type of stone situation most likely to benefit from coagulum pyelolithotomy would seem to be where there is a small, mobile stone or stone fragment lying in a calix or in a wide renal pelvis.
Calculi in Renal Transplants
Authors: LUCAS B. St. C. , CASTRO J. E.
Published: November 2008

Summary— Three patients who underwent live donor renal transplantation subsequently developed calculi in their allografts.

Hypercalcaemia and secondary hyperparathyroidism were present in 2 cases and these were treated by subtotal parathyroidectomy.

Urinary stagnation and infection were contributory factors in the third case and reimplantation of the ureter was necessary.

In all patients no further calculi have developed following treatment and allograft function remains satisfactory.
The Diagnosis and Treatment of Lymphocoeles Associated with Renal Transplantation:A report of 6 cases and a review of the literature
Authors: BROCKIS J. G. , HULBERT J. C. , PATEL A. S. , GOLINGER D. , HURST P. , SAKER B. , HAYWOOD E. F. , HOUSE A. K. , van MERWYK A.
Published: November 2008

Summary— Six patients have developed a lymphocoele after renal transplantation, an incidence of 4%. A lymphocoele should be suspected in a patient who develops a rising creatinine with a pelvic mass or pressure effects on the pelvic veins 1 or more months after operation.

The diagnosis is confirmed by intravenous urography, venography and ultrasongraphy: the use of the latter as a diagnostic measure is recommended. Treatment is by marsupialisation into the peritoneum or external drainage with breakdown of all loculi. Aspiration is unsatisfactory.
Ureteric Involvement with Abdominal Aortic Aneurysm
Authors: PETERS J. L. , COWIE A. G. A.
Published: November 2008

Summary— The clinical presentations of 3 patients found to have an abdominal aortic aneyurysm with ureteric involvement have been described. The world literature concerning this problem and methods of surgical treatment have been reviewed.

The importance of medial displacement of the ureters as an ealry diagnostic sign indicating the presence of an abdominal aoritc aneurysm is again emphasised. The possibility of a relatively benign course for the aneurysm should be considered in patients with renal ior cardiorespiratory complications. In such cases, treatment of the ureteric involvement alone is justified.
Polyglycolic Acid Versus Chromic Catgut in Bladder Surgery
Authors: KRONBORG O. , ØSTERGAARD A. , STEVEN K. , GØTRIK J. K.
Published: November 2008

Summary— The clinical importance of calcified deposits on sutures in bladder surgery was evaluted in a blind paried randomised trial of 3/0 chromic catgut versus polyglycolic acid 3/0. Cystoscopy with photographic recording was performed 8 weeks after operation in 40 patients wihout and 8 patients with previous or present bladder stones. None had visible calcified deposits at that time and sutures were only visible in 1 patient form each of the 2 groups without bladder stones.

It was concluded that neither chronmic catgut nor polyglycolic acid sutures carry any significant risk of bladder stone formation, whether infection is present or not; the conclusion includes both patients with and without previous bladder stones, but is less firm in the formar becuase of the small number of patients studied.
Apha‐Adrenergic Agents in Urinary Disorders of the Proximal Urethra Part I. Sphincteric Incontinence
Authors: AWAD S. A. , DOWNIE J. W. , KIRULUTA H. G.
Published: November 2008

Summary— Phenylpropanolamine, and alpha receptor stimulant, was found effective in 11 of 13 female and 6 of 7 male patients with sphincteric incontinence. In all the male patients except 1, the incontinence has followed prostatectomy.

Side effects occurred in only 1 patient.

As a rule, the beneficial response depended on the therapy being continued. The results are consistent with the distribution of alpha receptors and their effect in the proximal urethra.
The Pattern of Urolithiasis in the Sudan
Authors: KAMBAL A. , WAHAB S. M. A. , KHATTAB A. H.
Published: November 2008

Summary— Vesical stones in children are the commonest stones in the Sudan. In recent years there has been a progressive increase in the number of operations for upper tract stone, suggesting a change in the pattern of urolithiasis.
Can Follicle Stimulating Hormone Estimation Replace Testicular Biopsy in the Diagnosis of Obstructive Azoospermia?
Authors: HARGREAVE T. B. , JEQUIER A. M.
Published: November 2008

Summary— Sixty azoospermic men were investigated by means of testicular biopsy and estimation of serum follicle stimulating hormone (FSH) levels. High FSH levels when associated with small testes indicated severe testicular damage. We suggest that these findings offer sufficient evidence to regard such patients as infertile and that further investigation is unnecessary. In men with normal FSH levels testicular biopsy is still necessary for accurate diagnosis; in practice this may often be done at the same time as epididymovasostomy.
A New Self‐Retaining Catheter with Triple Microtip Pressure Transducer: “The Baghdad Modification”
Authors: HAKKY S. I.
Published: November 2008

Summary— A new self‐retaining triple microtip pressure transducer on a silicone rubber catheter was assessed on 12 patients with bladder neck obstruction or obstruction at the distal urethral component (external sphincter). The catheter gave reliable and accurate information on pressures in the bladder, prostatic and bulbar urethras simultaneously. It is, however, an expensive piece of equipment and requires delicate handling.
A Critical Evaluation of the Results of Transurethral Resection of the Prostate
Authors: CHILTON C. P. , MORGAN R. J. , ENGLAND H. R. , PARIS A. M. I. , BLANDY J. P.
Published: November 2008

Summary— In a review of 1057 consecutive prostatectomies of which 95% were performed transurethrally, carcinoma was present in 11.8%. There were 10 deaths within a month of operation (0.9%), 9 of these patients having been exceptionally old and unfit. The rate of complications and the end results appear to justify using transurethral resection as the method of choice for prostatectomy whenever it is feasible.
Serial Bone Scanning: The Assessment of Treatment Response in Carcinoma of the Prostate
Authors: FITZPATRICK J. M. , CONSTABLE A. R. , SHERWOOD T. , STEPHENSON J. J. , CHISHOLM G. D. , O'DONOGHUE E. P. N.
Published: November 2008

Summary— Serial bone scans and radiographic surveys were performed in 167 patients with histologically proven carcinoma of the prostate: 435 scans and surveys were performed.

Nineteen of 99 patients with negative findings on diagnosis have become positive on follow‐up. Forty‐nine patients had positive findings on presentation; 8 have regressed on follow‐up and 26 have progressed; 15 have remained unchanged.

This is a sensitive method of follow‐up in patients with carcinoma of prostate. Changes occurred in bone scans and skeletal surveys before any alteration in serum acid or alkaline phosphatases, symptoms of metastases or change in prostatic size in the majority of cases.

The documentation of progression from MO to M1 disease presents no problems. However, problems in quantitation may arise in patients presenting with M1 disease.
Urethral Tumours
Authors: STEWART P. A. HAMILTON , ANDERSON C. K. , WILLIAMS R. E. , CLARK P. B.
Published: November 2008

Summary— A series of 33 patients with urethral tumours has been studied to asess the risk of dissemination by endoscopic diathermy. This risk is less than that of cystourethrectomy. Urethral tumours should be treated like the vesical tumours they follow and so closely resemble: by endoscopic treatment while they remain small, sparse and superficial; by cytourethrectomy as soon as they become larger and more extensive.

Recurrence of tumour in the urethral stump following cystectomy should always be treatment by urethrectomy.
The Management of Azoospermia
Authors: SADE M. , SAVERYMUTTU INDIRA , DINSDALE OLIVE , GOW J. G.
Published: November 2008

Summary— Azoospermia in the presence of a normally funcitioning testis and a normal vasogram has been thought to be due to an obstruction in the epididymis between the body and the head. However, bypass operations have been singularly unsuccessful except when there was evidence of past inflammation causing fibrosos fo thel body and tail of the epididymis. Two substances, glycerylphosphory|choline and carnitine, which are known to be secreted by the epididymis, were investigated. The results of this preliminary study suggest that they may play a part in teh management of patients presenting with azzospermia.
Urolithiasis in the Sudan. Studies on a Stone‐prone and a Stone‐free Population
Authors: KAMBAL A. , WAHAB E. M. A. , KHATTAB A. H. H. , ZAKl J.
Published: November 2008

SUMMARY— Biochemical studies were performed on 80 adult males with renal stones and 24 controls from Northern Sudan. Similar studies were performed on 44 controls from Southern Sudan, where urinary stones rarely occur.

No significant differences between stone formers and controls from Northern Sudan were found regarding serum uric acid, phosphate, alkaline phosphatase, total protein, albumen, daily urine calcium or uric acid. Similarly, no significant difference was found between the 2 groups in the incidence of hypercalciuria, hyperuricaemia or hyperuricosuria. The serum calcium was significantly higher in stone formers.

The mean serum and daily urine calcium were significantly lower, and the mean serum and daily urine uric acid were significantly higher in controls from Southern Sudan compared to either stone formers or controls from Northern Sudan. The mean daily urine volume was significantly higher in Southern controls compared to Northern controls.

The increased prevalence of stone formers in Northern Sudan appears to result from the higher calcium output in the urine and the lower urine volume in the North compared with the South.
A Double‐blind Trial of Half‐strength Polybactrin Soluble GU Bladder Irrigation in Cystoscopy
Authors: HARES M. M.
Published: November 2008

SUMMARY— In an attempt to reduce post‐cystoscopy urinary tract infection half‐strength Polybactrin Soluble GU solution was used as the bladder irrigating fluid. Although the infection rate was markedly reduced, this just failed to be significant. However, it is believed that with a better combination of antibiotics the incidence of post‐cystoscopy urinary tract infection can be significantly reduced.
A Technique for Hemiacidrin Dissolution of Renal Stone Complicating an Ileal Conduit
Authors: WALKER R. G. , BECKER G. J. , KINCAID‐SMITH PRISCILLA
Published: November 2008

SUMMARY— A technique for dissolving a. renal stone complicating an ileal conduit is described. Free ureteric reflux was present, which allowed retrograde irrigation of the stone by infusion of hemiacidrin solution into the ileal conduit. With careful attention to urine infection and the pressure within the system, this technique might be applicable to other patients in whom free ureteric reflux is present and pyelolithotomy, percutaneous nephrostomy or the passage of ureteric catheters is difficult.
Comparison of Cephazolin and Gentamicin in the Prophylactic Treatment of Infection in Out‐patient Urinary Tract Endoscopy
Authors: REILLY C. S. , HART A. J. L. , McALLISTER T. A.
Published: November 2008

SUMMARY— Previous studies have shown that the incidence of rigors following urinary tract endoscopy in out‐patients may be as high as 1 6% and that this incidence can be significantly lowered to about 7% by the administration of intramuscular cephazolin sodium at the time of endoscopy. In order to reduce further the rigor rate, a comparison of intramuscular cephazolin with gentamicin has been carried out with 200 patients in each group. There was a rigor rate of 10% and 9% respectively with no significant difference between the 2 drugs. There was no correlation between an infected urine and the occurrence of a rigor. Cephazolin sodium remains the drug of choice in this situation because of its low toxicity.
The Safety of Transrectal Biopsy of the Prostate as an Out
Authors: EATON A. C.
Published: November 2008

SUMMARY— The complications following transrectal prostatic biopsy are reviewed in 1 50 patients.

The most frequent complications were urinary infection and pyrexia.

A prospective study within the reported series demonstrated a high incidence of bacteriaemia following biopsy.

The results suggest that transrectal prostatic biopsy may be performed safely as an out

patient procedure without the use of prophylactic antibiotics, although antibiotic therapy may be indicated when complications do arise.
Suppressive Effects of Surgical Stress on Circulating Androgens During and After Prostatectomy
Authors: GHANADIAN R. , PUAH C. M. , WILLIAMS GORDON , SHAH P. J. R. , McWHlNNEY N.
Published: November 2008

SUMMARY— Changes in circulating testosterone (T) and dihydrotestosterone (DHT) levels were investigated 2 days before and 2, 7, 30 and 60 days after retropubic prostatectomy in 28 patients with benign prostatic hypertrophy. Following operation the concentrations of both steroids declined and reached minimal levels 2 days after surgery. One month post

operatively testosterone had recovered to its pre

operative value, whilst the recovery of dihydrotestosterone to its pre

operative level required a minimum period of 2 months. These data indicate the need for careful interpretation of any androgen measurement following surgery.
Flutamide in the Treatment of Metastatic Carcinoma of the Prostate
Authors: NARAYANA A. S. , LOENING S. A. , CULP D. A.
Published: November 2008

SUMMARY— Twenty‐five patients with metastatic carcinoma of the prostate were treated with Flutamide, a non‐steroidal anti‐androgen. All patients showed progression; the longest response was 1 20 weeks. The side effects were nausea, vomiting, breast tenderness and gynaecomastia.
Non‐seminoma Germ Cell Tumours (Malignant Teratoma) of the Testis Results of Treatment and an Analysis of Prognostc Factors*
Authors: PECKHAM M. J. , BARRETT ANN , McELWAIN T. J. , HENDRY W. F. , RAGHAVAN D.
Published: November 2008

SUMMARY— The results of treatment of 1 26 patients with non‐seminoma germ cell tumours (malignant teratoma) of the testis are presented. Of this group 81 % are alive and 70% disease‐free. Of 98 patients who had had no prior treatment 83% are alive and 76.5% disease free. Of 43 early‐stage patients 41 (95%) are alive and tumour‐free despite a 21 % relapse rate after radiotherapy.

The disease‐free rate in patients with advanced disease treated with chemotherapy, and in some cases radiotherapy and/or surgery, ranged from 100 to 9% and was strongly dependent upon the volume of metastatic tumour and the histology. Patients with malignant teratoma undifferentiated (embryonal carcinoma) showed a significantly higher disease‐free survival rate than those with malignant teratoma intermediate (teratocarcinoma). Twenty‐six men with advanced disease received radiotherapy after chemotherapy and of these 23 (88%) are alive and 21 (81 %) are disease‐free. No difference in disease‐free survival rate was seen between advanced‐stage patients receiving vinblastine and bleomycin and those receiving, in addition, cis‐platinum. The overall drug‐related mortality was 4.5%.

Serum alpha‐fetoprotein (AFP) and beta‐human chorionic gonadotrophin (β‐HCG) levels were valuable monitors in advanced disease but not prognostically significant if allowance was made for tumour volume. Fifteen patients had surgical resection of residual masses and one died post‐operatively.
The Histopathology of the Epididymis in a Group of Cases of Azoospermia with Normal Testicular Function
Authors: McCONNELL E. M.
Published: November 2008

SUMMARY— The histopathology of the head of the epididymis in cases of azoospermia associated with normal testicular function is described. In 2 specimens congenital absence of the vas deferens was associated with stuffing of all of the tubules with normal spermatozoa but no other abnormality. In 30 specimens from cases with idiopathic epididymal obstruction there were abnormalities in the vasa efferentia. These included both extreme narrowing of the lumen due to thickening of the wall by fibrosis and also distension of the lumen by sperm and degenerate debris. Small sperm granulomata were present in the tubular wall in 10 specimens and foreign body granulomata were present in 20 specimens.

It is suggested that either persistent low grade infection, congenital abnormality or acute obstruction due to ischaemic or traumatic damage may be the initial lesion. If the infection or the obstruction is not speedily resolved, the condition may become self‐perpetuating.
Chemotherapy in Non‐seminomatous Testicular Tumours Stage I
Authors: EKMAN E. P. , EDSMYR F.
Published: November 2008

SUMMARY— Chemotherapy improves the survival rate of patients with disseminated teratoid testicular tumours, but patients without evidence of metastatic spread are not usually given further treatment after retroperitoneal lymphadenectomy because of the high toxicity of most drugs; 10 to 20% of these patients die later with widespread disease.

In an earlier series of 24 patients from our hospital the survival rate in stage I disease was below 70%. Since 1 973, when we began to use adjuvant chemotherapy in this group, there have been no relapses.
Surgical Management of Idiopathic Retroperitoneal Fibrosis
Authors: OSBORN D. E. , RAO P. N. , BARNARD R. J. , ACKRILL P. , RALSTON A. J. , BEST J. J. K.
Published: November 2008

Summary— The management of 10 patients with idiopathic retroperitoneal fibrosis causing obstructive uropathy is presented. In all cases the obstruction was relieved by ureterolysis and corticosteroid therapy was not used during the initial treatment.

In 9 patients the operation was well tolerated but one, who developed a pyonephrosis after pre‐operative ureteric drainage, died of septicaemia 1 5 days post‐operatively. In 2 patients further explorations and ureterolysis were necessary for recurrent fibrosis which may have been related to urinary leakage. A policy for the management of these cases is presented which recommends the use of silastic tubing splints after ureteric mobilisation and the use of an ornental wrap.
A Long‐term Study of the Persistence of the Urodynamic Characteristics of the Unstable Bladder
Authors: BOOTH C. M. , WHITESIDE C. G. , TURNER‐WARWICK R. T.
Published: November 2008

Summary— Sixty‐four patients with normal bladder function, stress incontinence, idiopathic instability or instability associated with enuresis underwent pressure/flow videocystography. This was repeated from one month to 8 years later (average 1 9.4 months).

Filling cystometry remained qualitatively unchanged in 95% of cases overall, whilst the actual pressure recordings during cystometry in the 37 patients with instability remained identical or very similar in 73%.

The results demonstrated the accuracy of cystometry and the consistency of bladder dynamics over the longest period so far reported in these apparently non‐progressive disorders.
Vesical Leukoplakia Progressing to Squarnous Cell Carcinoma in Women
Authors: DeKOCK M. L. S. , ANDERSON C. K. , CLARK P. B.
Published: November 2008

Summary— A series of 1 3 women and 4 men with vesical leukoplakia is presented. Three of the women progressed to squamous cell carcinoma. Early diagnosis of malignant change is difficult and prophylactic cystectomy for persistent widespread vesical leukoplakia may be justifiable in both sexes
Combined Chemotherapy in the Management of Metastatic Bladder Cancer
Authors: GIRALT E GARCIA , AUVERT J. , LACHAND A. T. , BOTTO H. , ABBOU C. , HANNOUN M. , POUILLART P. , PALANGIE T. , JOUVE M. , MORlN Ph.
Published: November 2008

Summary —In a non‐randomised study, 30 patients with metastatic bladder cancer were treated with a combination of Adriamycin, VM 26, 5‐fluorouracil (5‐FU) and mitomycin C. A significant response was observed in 1 8 patients and the median survival was 300 days.
Urinary Protein Profiles in Patients with Urothelial Bladder Tumours
Authors: HEMMINGSEN L. , RASMUSSEN F. , SKAARUP P. , WOLF H.
Published: November 2008

Department of Clinical Chemistry, Central Hospital, Nykpbing Falster; Department of Urology, Hvidovre University Hospital and Urological Department H, Herlev University Hospital, Copenhagen, Denmark

Summary —Urinary protein profiles were studied in 32 patients with urothelial bladder tumours, using immunonephelometry. In patients with and without residual or recurrent tumours a glomerular type of proteinuria was demonstrated. In patients with grade Ill‐IV transitional cell carcinoma the glomerular proteinuria was more severe than in patients with grade I‐II tumours. lncreased excretion of low molecular weight proteins was observed only in patients with grade Ill‐IV tumours.

The use of the increased relative clearance of albumin, transferrin, and haptoglobin as a diagnostic test was attempted in detecting residual or recurrent tumours. In patients with grade Ill‐IV turnours the predictive value of a positive or negative test was 92% and 100% respectively, whereas the relative protein clearance was without predictive value in patients with grade I‐II tumours.
A Study of Cefamandole Prostatic Tissue Levels
Authors: KAISARY A. V.
Published: November 2008

Summary— Cefamandole is a new cephalosporin with a broad spectrum activity. A study was undertaken to determine the distribution of cefamandole in the prostate gland. It was found that the drug was concentrated in the prostate gland and that the concentration was dose related.
Reimplantation of the Ureter in Prostatic Carcinoma Associated with Bilateral Ureteric Obstruction
Authors: KIHL B. , BRATT C.‐G.
Published: November 2008

Summary— Bilateral ureteric obstruction from prostatic carcinoma is not uncommon. A number of techniques for urinary diversion have been used in selected patients when uraemia develops.

Reimplantation of the ureter(s) as an alternative to urinary diversion has been carried out in 21 patients over a 7‐year period. In 6 of these patients bilateral reimplantation was done. In another 6 patients reimplantation of the ureter was not possible and cutaneous ureterostomy was carried out. The overall survival time was 10.6 months. In 13 patients living more than 6 months post‐operatively, survival time was 1.8 years.

Most patients had severe uraemia and advanced (clinical stage III or IV) prostatic carcinoma. The immediate management of these patients is outlined and the importance of early diagnosis is stressed. It is concluded that, whenever possible, ureteric reimplantation should be considered for relieving ureteric obstruction in patients selected for active treatment.
Detection of Urethral Incompetence. Erect Studies Using the Fluid‐Bridge Test
Authors: SUTHERST J. R. , BROWN M.
Published: November 2008

Summary— The fluid‐bridge test (FBT) detects the entry of urine into the proximal urethra during coughing. In this study it was applied in the investigation of incontinent patients when they were first supine and then standing up. The test results in 76 women with urinary incontinence and 27 women with normal urinary control are reported.

When the test was performed erect at 0.5 cm from the urethrovesical junction, it was positive in 68 (90%) of the study group and 4 (1 5%) of the controls. The difference between the results in the 2 groups is highly significant (P<0.001).

In 12 (16%) of the incontinent group the test at 0.5 cm became positive only when the subject was standing up, indicating that erect testing adds to the diagnostic efficiency of the method.

Erect testing seems more relevant to the investigation of stress urinary incontinence. This study has shown that this is possible using simple urodynamic apparatus.
The Use of the Renal Capsule in Renal and Ureteric Surgery
Authors: MORELLE V. R. , FONTEYNE E. J. C.
Published: November 2008

Summary— Repair of a large defect of the renal pelvis by a pedicled flap of the renal capsule can be carried out when conventional operative techniques are inapplicable. The renal capsule can also be used to enlarge a stricture or to cover a defect of the proximal ureter.
A Control Study of Dietary Factors in Renal Stone Formation
Authors: Griffith Helen M. , O'Shea B. , Kevany J. P. , McCormick J. S.
Published: November 2008

Summary— Fifty‐one first admission renal stone patients and an equal number of controls were interviewed and a dietary history of the average weekly intake was collected from each participant.

A comparison of the dietary intake per kilogram body weight in each group was made using standard statistical procedures. None of the nutrient intakes showed a significant difference, but dietary fibre intake and the percentage of energy provided by carbohydrate were consistently higher in the control group, whereas the percentage of energy provided by fat was consistently higher in the renal stone group.
The Use and Mechanism of Anal Sphincter Stretch in the Reflex Bladder
Authors: Low A. I. , Donovan W. D.
Published: November 2008

Summary— Anal sphincter stretch enables good bladder emptying with excellent continence in some paraplegics with reflex bladders. It produces relaxation of both the external urethral sphincter and the detrusor, and micturition is achieved by abdominal straining.
An Appraisal of 12 Solutions Used for Bladder Irrigation or Instillation
Authors: Harper W. E. S.
Published: November 2008

Summary— Twelve solutions used for bladder irrigation or instillation have been reviewed. The advantages and disadvantages of the solutions are discussed and a regimen is suggested for intermittent 6‐hourly catheterisation procedures using the mixtures polymyxinheomycin and EDTAA/lsozyme alternately.
Combined Surgery and Adjuvant Chemotherapy with High Dose Methotrexate and Folinic Acid Rescue (HDMTX‐CF) for Infiltrating Tumours of the Bladder
Authors: Socquet Y.
Published: November 2008

Summary— Of the 44 patients seen during the period January 1974 to March 1979 with category T3 or T4 bladder cancer, 33 were treated by partial or total cystectomy followed by adjuvant chemotherapy with high dose methotrexate and folinic acid rescue (HDMTX‐CF), with a survival rate at 2 years of 90%. Two patients were given palliative treatment with HDMTX‐CF alone; one of them is alive and disease‐free after 39 months.
Loewenstein‐Buschke Tumour of Penis—a Carcinomimic: Report of 24 Cases with Review of the Literature
Authors: Ananthakrishnan N. , Ravindran R. , Veliath A. J. , Parkash S.
Published: November 2008

Summary— Twenty‐four patients with invasive penile condylomatosis (Loewenstein‐Buschke tumour) seen over a 10‐year period are presented.

The clinical behaviour of the lesions, their pathological nature and response to treatment are reviewed. Their true significance and differentiation from condyloma acuminatum and squamous cell carcinoma are discussed.

It appears that the lesions are not as rare as hitherto believed but are often incorrectly diagnosed as carcinoma.
Renal Transit Time Measurements in the Diagnosis of Ureteric Obstruction
Authors: WHITFIELD H. N. , BRITTON K. E. , NIMMON C. C. , HENDRY W. F. , WALLACE D. M. A. , WICKHAM J. E. A.
Published: November 2008

Summary— Deconvolution analysis of the gamma camera renogram has been used in a prospective study of 60 cases presenting with radiologically demonstrated ureteric dilatation.

The results show that ureteric dilatation due to obstruction can be differentiated from ureteric dilatation without obstruction on the basis of parenchymal tracer transit times.
Regional Renography in Segmental Renal Disease
Authors: LUPTON E. W. , TESTA H. J. , O'REILLY P. H. , EDWARDS E. C. , COHEN S. J. , CARROLL R. N. P.
Published: November 2008

Summary— Twenty‐nine patients with symptomatic segmental renal disorders were studied by regional renography. Twenty‐three patients had duplex kidneys and 6 had other segmental disease. Abnormal gamma camera findings included ureteroureteric reflux, vesicoureteric reflux, impaired function, obstruction and non‐obstructive dilatation. Comparison between renography and radiology in duplex kidneys showed agreement in 10 cases. In 7 kidneys the gamma camera provided additional information and in 6 cases the X‐rays alone were abnormal.

It is concluded that regional renography should be performed wherever possible to complement conventional radiology in the functional and urodynamic evaluation of segmental renal disease.
ln vitroStudies on Optimum Preparation of Coagulum for Surgery of Renal Calculi
Authors: NORRIS R. W. , COLVIN B. T. , KENWRIGHT M. G. , FLYNN J. T. , BLANDY J. P.
Published: November 2008

Summary— In renal calculus surgery, human dried fibrinogen produces a coagulum with a much greater tensile strength, stickiness, deformability and extractability than cryoprecipitate, which produces a relatively weak and friable clot. A useful coagulum may be prepared at room temperature at any convenient time prior to use if a mixture of 1 9 ml human dried fibrinogen solution and 1 ml thrombin solution is used. If mixed in a single syringe and injected within 35 s through a butterfly needle into the renal pelvis, complete mixing of the solutions is guaranteed.

By using this simple method, the unpredictability of the coagulum can now be eliminated and a strong and elastic clot can be produced.
The Late Results of Conservative Surgery for Upper Tract Urothelial Carcinomas
Authors: WALLACE D. M. A. , WALLACE D. M. , WHITFIELD H. N. , HENDRY W. F. , WICKHAM J. E. A.
Published: November 2008

Summary— In a selected series of 14 patients, upper tract urothelial tumours were excised with preservation of the ipsilateral kidney. The 5‐year survival rate was 83%. The ipsilateral local recurrence rate was 5/14 (36%) but in 4 cases salvage surgery was effective and in 2 cases a functioning kidney was still preserved. The results of conservative surgery and its indications are discussed.
The Clinical Significance of Tissue Polypeptide Antigen (TPA) in the Urine of Bladder Cancer Patients
Authors: KUMAR S. , COSTELLO C. B. , GLASHAN R. W. , BJÖRKLUND B.
Published: November 2008

Summary— A 2‐stage study has been carried out to evaluate the usefulness of urinary tissue polypeptide antigen (TPA) levels in patients with bladder cancer as an adjunct to the routine procedures for detection of bladder tumours. Two‐hour urine samples were collected from 83 bladder cancer patients and normal individuals for the first part of the study, 24‐h samples from 54 patients and normal individuals for the second part. Urinary TPA was determined using radio immunoassay. In 2‐h samples there was no significant difference in the amounts of TPA/I in any of the groups.

In contrast, the TPA results of 24‐h urine samples (n = 54) were markedly different from 2‐h samples and the former correlated very well with the presence or absence of bladder cancer. A reason for this difference may be circadian rhythm effects
Early Multiple‐dose Adjuvant Thiotepa in the Control of Multiple and Rapid TI Tumour Neogenesis
Authors: ENGLAND H. R. , FLYNN J. T. , PARIS A. M. I. , BLANDY J. P.
Published: November 2008

Summary— In 45 patients each with a well established and constant pattern of widespread tumour neogenesis following cystodiathermy, early multiple dose adjuvant thiotepa was used in an effort to control the tumours.

The response was good in 32 patients as judged by the reduction in the number of new tumours and by the downgrading and downstaging of new lesions when compared with pre‐thiotepa histology. Continuing maintenance therapy was required in the majority but, with the passage of time, the dosage could be progressively reduced, suggesting a cumulative effect of treatment.

Of 13 non‐responders, 7 showed evidence of higher than average malignant potential against which thiotepa appears ineffective.

The timing of administration is probably a key factor in success and one which accounts for much of the variation in reported results.
Transitional Cell Carcinoma involving the Prostate —An Unfavourable Prognostic Sign in the Management of Bladder Cancer?
Authors: KIRK D. , SAVAGE ANN , MAKEPEACE A. R. , GOSTELOW B. E.
Published: November 2008

Summary— Among 38 male patients undergoing cystectomy for bladder carcinoma, invasion of the prostate, or coincident dysplasia or carcinoma of the prostatic ducts was found in 21. It is suggested that these changes confer a poor prognosis with regard both to response to non‐operative treatment and to survival following cystectomy.
A Comparison Between Digital Examination and Per‐rectal Ultrasound in the Evaluation of the Prostate
Authors: BROOMAN P. J. C. , PEELING W. B. , GRIFFITHS G. J. , ROBERTS E. , EVANS K.
Published: November 2008

Summary— Three hundred and fifty‐two patients have been examined by per‐rectal ultrasound and histological confirmation of the diagnosis was obtained in 242 cases. Per‐rectal ultrasound compared favorably with digital palpation both as a method of diagnosing prostatic cancer and also as a method of staging a primary tumour. Confirmation of the accuracy of this technique as a method of staging was gained by a study involving the use of cadaver material.

Repeat examinations on patients with prostatic carcinoma have shown that per‐rectal ultrasound is an ideal method for monitoring response of the primary tumour to treatment.
A 10‐year Prospective Study of Hypospadias Repair at Frenchay Hospital
Authors: REES M. J. W. , SINCLAIR S. W. , HILES R. W. , SMITH P. J. B.
Published: November 2008

Summary— A 10‐year prospective study of 91 cases of hypospadias treated in Bristol hospitals is reviewed.

By using only 3 basic repairs and a refined technique, which includes the use of magnification and fine instruments, the fistula rate has been markedly reduced in this series compared with that reported in 1976.
The Long‐Term Results of Surgery for Obstructive Azoospermia
Authors: HENDRY W. F.
Published: November 2008

Summary‐Thirty azoospermic patients with normal testes and normal serum FSH levels had scrotal exploration with photographic record of the appearance of the epididymes and vasography; bilateral epididymovasostomies were done if possible, with vasovasostomies if there were coexisting vasal blocks. Follow‐up studies showed no success when the epididymes were empty (Type 11, when the vasa were absent or malformed (Type 21, or when tubular dilatation was confined to the heads of the epididymes; all of the latter cases had coexisting sinusitis, bronchitis or bronchiectasis (Type 4 —Young's syndrome). Five patients with post‐inflammatory disease had epididymes distended down to their tails (Type 31, and 3 also had vasal blocks. Three achieved sperm counts greater than 1 0 million per ml and impregnated their wives. Ten of 1 6 vasectomy reversals done by a similar side‐to‐side technique were successful.

A simple classification of obstructive azoosperrnia is described and it is concluded that in about 50% of cases the underlying cause of failure in sperm transport remains obscure.
The Aetiology and Investigation of Haemospermia
Authors: FLETCHER M. S. , HERZBERG Z. , PRYOR J. P.
Published: November 2008

Summary— The cause of haemospermia was determined in 70 (86%) of 81 patients. Inflammatory lesions accounted for the bleeding in most men under 30 years of age. Neoplasia (61, trauma (3) and amyloidosis (2) of the seminal vesicle were diagnosed in the other patients. Persistent haemospermia should always be investigated since clinically unsuspected tumours may be the source of bleeding in the older age groups. Analysis of the semen, prostatic fluid and urine should be performed initially. Cystourethroscopy should then be carried out if the initial investigations are negative and, if this too is negative, vasography is indicated.
Anterior Tran peritoneal Approach for Stone Removal in Horseshoe Kidneys (its Advantage for Bilateral Stones)
Authors: PROCA E.
Published: November 2008

Summary—The anterior transperitoneal approach for removal of stone from a horseshoe kidney is described. The valuable advantages inherent in this technique have been shown in 1 3 patients, 7 with unilateral calculus and 6 with bilateral calculi, and all with horseshoe kidneys.

No urinary leak occurred and the post‐operative course was uneventful. The operative field is extensive and a good exposure of both sides of the horseshoe kidney can be obtained, enabling bilateral pyelolithotomy or other conservative renal procedures to be performed.
Symptomatic Renal Angiomyolipoma
Authors: Rao P. N. , Osborn D. E. , Barnard R. J. , Best J. J. K.
Published: November 2008

Summary—Two cases of symptomatic renal angiomyolipoma not associated with tuberous sclerosis are presented. The clinical and radiological features, the pathology and the management of these rare but well documented tumours are briefly discussed. They pose problems in diagnosis and controversy still exists regarding their management. Recent radiological techniques such as CT may help in the diagnosis. When conservative surgery is not possible, or when an adenocarcinoma cannot be confidently excluded, nephrectomy should be performed.
Carcinoma of the Bladder Treated by Interstitial Irradiation
Authors: Williams Grant B. , Trott P. A. , Bloom H. J. G.
Published: November 2008

Summary —A retrospective study is presented of 180 patients with clinically infiltrating transitional cell carcinoma of the bladder treated by interstitial irradiation. The cases were re‐classified by clinical tumour extent and histopathological grade according to the UlCC (1978) classification. The actuarial survival rates and complications are presented and treatment policy reviewed.