bluuebunny/crossref_metadata_2025 huggingface dataset:
The Role of Schistosomiasis in Urolithiasis
Authors: CUTAJAR C. L.
Published: November 2008

Summary— Both urinary schistosomiasis and urolithiasis are common in Saudi Arabia and other countries and an aetiological relationship between them has been suggested. One hundred and fifty Saudi Arabian patients suffering from urinary schistosomiasis were compared with a similar number of patients suffering from urolithiasis and with a control group. The evidence suggests that in Saudi Arabia, schistosomiasis plays a very limited role in urinary tract stone formation.
Vasectomy and Atherosclerosis: an Association in Man?
Authors: CAMPBELL W. B. , SLACK R. W. T. , CLIFFORD P. C. , SMITH P. J. B. , BAIRD R. N.
Published: November 2008

Summary— We have investigated the distensibility of the lower limb arteries by an ultrasonic technique following vasectomy. Vasectomy accelerates the development of atherosclerosis in animals and this has been attributed to an immunological mechanism. Immunological changes are common in men following this operation, but epidemiological surveys have failed to reveal evidence of an increase in arterial disease. We have studied distensibility at the posterior tibial arteries by Laplace transform analysis of Doppler waveforms in 49 vasectomised men and 33 controls. Statistical analysis of each subject's higher (less distensible) value showed reduced distensibility in the vasectomised group (P =0.006). This result lends support to the possibility that vasectomy may accelerate the development of peripheral arterial disease in man.
Perinatal Ultrasound Monitoring: Early Detection and Treatment of Congenital Uropathy
Authors: DELL'AGNOLA C. A. , TOMASELLI V. , FERRAZZI E. , KUSTERMANN A. , NlCOLlNl U.
Published: November 2008

Summary— In childhood, delay in the diagnosis of congenital obstructive or refluxing urinary tract pathology can contribute to progressive renal failure.

Ultrasound examination is a safe and reliable means of investigating the urinary system pre‐andpost‐natally. We describe 13 children investigated with ultrasound during the perinatal period. In 10, pathology was identified in utero, confirmed after birth and treated surgically within 1 month. This indicates that perinatal ultrasonography is a valuable technique.
Posterior Urethral Valve Masquerading as the Prune Belly Syndrome
Authors: AARONSON I. A.
Published: November 2008

Summary— Four infants are presented who in addition to having a posterior urethral valve showed striking clinical and radiological features usually associated with the prune belly syndrome. Evidence is presented which suggests that these two conditions may coexist.
Suprapubic Prostatectomy
Authors: O'SULLIVAN D. C.
Published: November 2008

Combined Technique1

Summary— Three hundred and fifty‐one consecutive prostatectomies have been carried out using a combined suprapubic approach for the enucleation of the adenoma and a transurethral approach to control bleeding. Removal of any residual tissue in the prostatic fossa and removal of a wedge from the bladder neck are done with the resectoscope. The procedure is reserved for larger adenomas not suitable for transurethral resection.
Combined Bipedal Lymphangiography, CT Scanning and Transabdominal Lymph Node Aspiration Cytology for Node Staging in Carcinoma of the Prostate
Authors: KHAN O. , PEARSE ELIZABETH , BOWLEY N. , WILLIAMS G. , KRAUSZ T.
Published: November 2008

Summary— Forty‐two patients with carcinoma of the prostate have been studied by bipedal lymphangiography, abdominal CT scanning and percutaneous transabdominal lymph node aspiration cytology to try to increase the accuracy of lymph node staging. The use of two independent radiologists to report the lymphangiograms did not improve the accuracy of reporting. CT scanning was of value only in patients in whom the lymph nodes were not opacified on lymphangiography.

Aspiration cytology was positive in 8 of the 40 patients who were studied. There was no morbidity. Six of these 8 patients had MO disease, three had TO tumours and were not on treatment. A poor correlation was found between the presence of lymph node metastases and the Gleason score. Percutaneous transabdominal lymph node aspiration cytology is a safe procedure. When positive, it avoids the need for a staging lymphadenectomy and so helps to identify those patients for whom local treatment is not applicable.
Chemotherapy of Primary (in situ) Testicular Tumours: Response in Advanced Metastatic Disease
Authors: CALVO F. , HODSON N. , BARRETT ANN , PECKHAM M. J.
Published: November 2008

Summary— Five patients in whom primary testicular tumours were left in situduring chemotherapy for extensive metastatic disease are described. In four patients, the response of the primary and secondary tumour was comparable. In the fifth a small tumour in the testis became palpable during chemotherapy at the same time as metastases, and regressed on treatment. One possible explanation for the latter observation is protection from chemotherapy of a small, possibly partly intratubular primary, by the blood‐testis barrier.
Microcomputers and Microprocessors in Urology: Present and Future
Authors: GLEN E. S.
Published: November 2008

Summary— Urology departments have a heavy outpatient workload requiring efficient secretarial, appointments and records services. Microcomputers are relatively inexpensive and can facilitate efficient routine clinical and research work. Unlike mainframe computers, formal training is not usually required, a simple introduction being sufficient for the enthusiast.

An Apple computer is used in this department for word processing incorporating standard letters, paragraphs and phrases. With more sophisticated programs urological screening by computer interrogation could be linked to an appointments system to coordinate investigations, minimising hospital visits.

Microprocessors can facilitate a wide variety of measurement recording and data handling. Urodynamic measurements can be computed and graphs superimposed to facilitate interpretation.
Management of Renal Carcinoma—A Questionnaire Survey
Authors: RITCHIE A. W. S. , CHISHOLM G. D.
Published: November 2008

Summary— Questionnaires on the management of renal carcinoma were returned by 134 British urologists. Analysis revealed that ultrasound is used, as a routine investigation, by 93% of the respondents, whereas abdominal CT scanning is used routinely by only 16%.

Renal arterial embolisation is used by 60% of respondents; a further 12% indicated that, having tried the technique, they had given it up. Of 81 surgeons using embolisation, 44% were hopeful that it offered systemic benefit to the patient and 54% delay nephrectomy after embolisation. Regression of metastases following treatment was reported by 58 surgeons.

Details of metastatic regression in 60 patients revealed that pulmonary metastases were involved in 83%. Embolisation featured in the management of only 11 such patients.
A Non‐Steroidal Anti‐inflammatory Drug (Flurbiprofen) to Control Idiopathic Hypercalciuria Resistant to Dietary Manipulation
Authors: RAO P. N. , BLACKLOCK N. J.
Published: November 2008

Summary— Twenty‐three calcium stone formers with idiopathic hypercalciuria were entered into an open study to examine the effects of flurbiprofen (Froben) on urinary calcium excretion. Five patients were withdrawn because of side effects. A statistically significant reduction in urinary calcium excretion was noted after 2 (P =0.004) and 6 (P =0.001) weeks' treatment. There was a significant increase in urinary calcium excretion after stopping the treatment (P =0.0006). The results suggest that flurbiprofen reduces calcium excretion in the urine but the high incidence of side effects may limit its use in routine treatment of hypercalciuria.
Inhibition of Experimental Nephrocalcinosis with a Prostaglandin Synthetase Inhibitor
Authors: BUCK A. C. , DAVIES R. LI. , LEAKER B. , MOFFAT D. B.
Published: November 2008

Summary— Nephrocalcinosis was induced in a group of experimental rats by means of intraperitoneal injections of 10% calcium gluconate. Two further groups of rats were treated with indomethacin and flurbiprofen (Froben) before receiving the i.p. calcium gluconate, to study the effects of prostaglandin inhibition on the process of renal parenchymal calcification. Tissue calcification was studied by means of contact microradiography and histology. Quantitative calcium analysis was by means of energy dispersive analysis of X‐rays (EDAX).

There was a marked inhibition of cortical nephrocalcinosis and a significantly reduced calcium concentration (P0.005) in the animals treated with a prostaglandin inhibitor compared with the animals given i.p. calcium gluconate alone.

This study suggests that prostaglandins are involved in the process of renal parenchymal calcification and may be aetiologically significant in the pathogenesis of stone formation.
The Indwelling Ureteric Stent—the Bristol Experience
Authors: BALL A. J. , GINGELL J. C. , CARTER S. S. , SMITH P. J. B.
Published: November 2008

Summary— Indwelling ureteric stents have been used for upper urinary tract drainage in 17 patients. The advantages over traditional methods in terms of endoscopic insertion, avoidance of external diversion and potentially lengthy periods of drainage are described. Patients requiring ureteric splintage following open procedures can also benefit from internal stenting rather than external drainage. Withdrawal is performed as a minor aut‐patient endoscopic procedure.
Vasoactive Intestinal Polypeptide in the Normal and Unstable Bladder
Authors: GU J. , RESTORICK J. M. , BLANK M. A. , HUANG W. M. , POLAK J. M. , BLOOM S. R. , MUNDY A. R.
Published: November 2008

Summary— The possible involvement in idiopathic detrusor instability of a newly discovered type of autonomic nerve containing vasoactive intestinal polypeptide (VIP) has been studied. Immunocytochemistry and radioimmunoassay, using specific antibodies against VIP, were carried out on 20 biopsy specimens from the bladders of patients with detrusor instability and 20 specimens from control patients.

The concentration of VIP in the unstable bladders was found to be markedly reduced from 36.52 ± 4.8 pmol/g (mean ± SEM) to 7.62 ± 1.84 pmol/g (P0.01). The number of VIP immunoreactive nerves was greatly decreased in all of the layers but particularly in the muscle layer of the unstable bladder in comparison with the controls. These findings may provide important information about the mechanism of this disorder.
Bladder Instability. is the Primary Defect in the Urethra?
Authors: HINDMARSH J. R. , GOSLING P. T. , DEANE A. M.
Published: November 2008

Summary— The urethral response to bladder filling has been studied by synchronous measurement of four points in the proximal urethra and bladder using microtip transducers. Twelve male patients with urodynamically proven bladder instability had falls in urethral closure pressure of 30 cm of water 3 s before the unstable detrusor contraction. There was a lack of awareness of the urethral relaxation, the sensation of urgency occurring only when the detrusor contracted.

The suggestion is made that the sequence of events occurring in these patients with bladder instability is fundamentally no different from a normal voiding sequence and that it may be more appropriate to re‐educate the muscles of the proximal urethra than to treat the detrusor instability.
Non‐obstructive Detrusor Failure. A Urodynamic, Electromyographic, Neurohistochemical and Autonomic Study
Authors: KIRBY R. S. , FOWLER CLARE , GILPIN SALLY‐ANN , HOLLY ELIZABETH , MILROY E. J. G. , GOSLING J. A. , BANNISTER R. , TURNER‐WAHWICK R.
Published: November 2008

Summary— Twenty‐eight patients presenting with persistent loss of the voiding reflex have been evaluated. Those with cauda equina lesions or pelvic nerve injury were distinguished from a group with idiopathic detrusor failure by their abnormal urethral behaviour during filling, and by urethral sphincter electromyography (EMG). Bladder muscle biopsies revealed the presence of presumptive cholinergic fibres in all three groups, indistinguishable in quantity and distribution from normal controls. The implications of these findings for the diagnosis and management of these patients is discussed.
Progress in Transrectal Ultrasonography for Prostatic Disease
Authors: OKAFOR P. I. S. , WILD S. R. , BEYNON L. L. , CHISHOLM G. D.
Published: November 2008

Summary— The accuracy of ultrasonographic measurement of volumetric changes within the prostate was assessed using a hand‐held transrectal probe. This was effected by comparing the ultrasonically calculated weight change following TURP with the measured weight of resected prostatic tissue in a group of 30 patients with benign prostatic hypertrophy. A high correlation was found (r =0.978) in BPH, but potential difficulties were found in applying the method to the malignant prostate.

In the 30 benign cases studied, ultrasound indicated the presence of calculi in 60% of patients and an echo pattern consistent with malignant tissue in 23%. These findings suggest a poor diagnostic accuracy for the technique.
Incidental Carcinoma of the Prostate: Selection for Deferred Treatment
Authors: BEYNON L. L. , BUSUTTIL A. , NEWSAM J. E. , CHISHOLM G. D.
Published: November 2008

Summary— Fifty‐one of 212 consecutive patients with prostatic cancer presented with incidentally diagnosed (TO) cancer. The average age at presentation was 73 years and follow‐up ranged from 1 to 62 months. Deferred treatment was selected in 39 cases, 10 of which progressed. Of 15 deaths only 3 were related to prostate cancer and these were patients who had presented with metastases.

Histological grading by the Gleason system demonstrated a significant correlation with metastatic stage at presentation and tumour bulk, but not with age or progression in deferred treatment cases.

It is concluded that there is a need to subdivide patients presenting with incidental carcinoma, that tumour bulk correlates with histological grade and that future treatment protocols for TO disease should stratify for histological grade.
Treatment of Advanced Prostatic Cancer with Buserelin, an Analogue of Gonadotrophin Releasing Hormone
Authors: WAXMAN J. H. , WASS J. A. H. , HENDRY W. F. , WHITFIELD H. N. , BARY P. , BESSER G. M. , MALPAS J. S. , OLIVER R. T. D.
Published: November 2008

Summary— Twenty‐two consecutive patients with newly diagnosed symptomatic, locally advanced or metastatic prostate cancer were treated with intranasal buserelin, a long‐acting analogue of gonadotrophin releasing hormone, in divided dosages of between 600 and 1000 pg daily. Suppression of testosterone occurred in 1 of 5 patients treated with 600 μgdaily and in all 17 patients receiving 1000 μgdaily. Two of 5 patients treated with the 600 μg regimen and 16 of 17 patients receiving the 1000 μg regimen showed subjective and objective evidence of disease regression. Follow‐up was from 1 to 16 months (mean 7.1 months); 6 patients have relapsed during this period.

Buserelin offers an effective alternative medical treatment of carcinoma of the prostate and, apart from impotence, does not have the side effects of oestrogens.
Prostatic Cancer: Treatment with Long‐acting LHRH Analogue
Authors: WILLIAMS GORDON , ALLEN JANET M. , O'SHEA J. P. , MASHITER K. , DOBLE A. , BLOOM S. R.
Published: November 2008

Summary— Fifteen patients with advanced carcinoma of the prostate were treated with a luteinising hormone releasing hormone agonist ICI 118 630. Three of 5 patients who had failed conventional hormone therapy have had a marked alleviation of bone pain, though no objective evidence of disease regression. Nine of 10 patients previously untreated have shown objective evidence of disease response. This drug appears to have advantages over conventional hormone therapy.
Carcinoma in Situin Testicular Biopsies from Men Presenting with Infertility
Authors: PRYOR J. P. , CAMERON KATHARINE M. , CHILTON C. P. , FORD T. F. , PARKINSON M. CONSTANCE , SINOKROT J. , WESTWOOD C. A.
Published: November 2008

Summary— This study concerns 2043 male partners of irifertile marriages who underwent testicular biopsy in the 28 years from 1955 to 1982. In a review of the pathological material carcinoma in situ(CIS) was diagnosed in 8 men (0.39%). Six of these men were later found to have invasive germ cell tumours; one has remained tumour‐free and one is lost to follow‐up. The implication of these findings in relation to the selection of patients for biopsy and the treatment of CIS when diagnosed is discussed.
Does Perfusion Equal Diuresis in the Upper Urinary Tract?
Authors: THACHIL J. V. , STRUTHERS N. W.
Published: November 2008

Summary— Pressures occurring in the upper urinary tract during perfusion and diuresis were compared in an unsedated dog preparation. Perfusion pressures were significantly higher, suggesting that a product of diuresis actively reduces upper tract tone.
“The Distal Nephron Index”: a Measure of Obstructive Nephropathy in Experimental Hydronephrosis
Authors: BULLOCK K. N.
Published: November 2008

Summary— An experimental model is described in rabbits where chronic partial ureteric occlusion and permanent renal pelvic cannulation were performed. For periods of up to three months, parameters of distal nephron function were measured repeatedly and pressure‐flow studies performed. Fractional water clearance, free water clearance/GFR ratio and the relative intrapelvic pressure (IPP) on perfusion were increased (P < 0.01) as a result of partial ureteric occlusion. A new parameter, “the distal nephron index”, is described which is also raised in obstruction (P < 0.01) and which exhibits a linear correlation with relative IPP (r =+0.40; P < 0.05) not demonstrated by the other distal nephron function measurements. The implications of this relationship in the assessment of upper tract dilatation are discussed.
Urinary Retention without Organic Cause in Children
Authors: BALDEW I. M. , GELDEREN H. H. VAN
Published: November 2008

Summary— Acute urinary retention without organic explanation is well known in adults but has only rarely been described in children. Six cases (four boys and two girls) of non‐organic acute urinary retention are reported. The diagnosis was based on negative findings on extensive urological examination. So‐called psychogenic urinary retention in children is associated with constipation and infrequent voiding.
Too Many Cystograms in the Investigation of Urinary Tract Infection in Children?
Authors: CAVANAGH P. M. , SHERWOOD T.
Published: November 2008

Summary— We report on 62 children referred for a first micturating cystourethrogram (MCU) and intravenous urogram (IVU) because of suspected or proven urinary tract infection (UTI). The study represents 1 year's experience of a district hospital, but excludes children below the age of 6 months and those with a diagnosis of urinary drainage anomaly. The IVU proved a good predictor of gross vesicoureteric reflux, which affected 11 children, all with suspect IVUs. Lesser grades of reflux can occur in the presence of a normal IVU but are unlikely to damage the kidney. They can be managed by treating symptoms of infection rather than by the need to protect nephrons. In our study a suspect IVU implied a 79% chance of gross reflux, and a normal IVU excluded such reflux. It is suggested that children over 6 months of age with a clinically important infection should be spared an MCU unless the IVU is abnormal, or troublesome infections recur.
Phenacetin‐Containing Analgesics and Cancer of the Bladder or Renal Pelvis in Women
Authors: McCREDIE MARGARET , STEWART J. H. , FORD JOYCE M. , MacLENNAN R. A.
Published: November 2008

Summary— In a case‐control investigation of 154 women with cancer of the bladder and 440 female population controls spanning the same age range, the relative risk for this cancer was 2.6 in consumers of phenacetin‐containing analgesics and 2.7 in tobacco smokers. The relative risks for cancer of the renal pelvis, determined for 31 cases, were 5.4 with phenacetin and 4.7 with tobacco. Increasing consumption of either agent increased the risk for cancer at each of the two sites, while a synergistic rather than purely additive effect was apparent when both phenacetin‐containing analgesics and tobacco had been taken. Consumption of analgesic preparations which contained no phenacetin did not increase the risk of developing cancer at either site.

The evidence indicates that phenacetin is a clinically important carcinogen for the lower as well as for the upper urinary tract.
Strictures of the Penile Urethra
Authors: BHANDARI M. , PALANISWAMY R. , ACHREKAR K. L. , RAJAGOPAL V.
Published: November 2008

Summary— One hundred and eighty‐seven patients with urethral strictures have been treated over a period of 24 years. In nearly 50%, strictures were confined to the penile urethra, involving the meatus, the fossa navicularis or varying lengths of the urethra up to the bulb. Of these, 95.3% were inflammatory in nature. Overall, 85.5% were managed with a single surgical procedure. The single‐stage technique using a skin inversion pedicled flap was done in 15 cases and was found to be useful, with less morbidity than the staged procedure.
Urothelium and the Specific Red Cell Adherence Test
Authors: GUNTER P. A. , ABELA‐BORG J. DE , PUGH R. C. B.
Published: November 2008

Summary— The Specific Red Cell Adherence Test (SRCAT) has been modified to produce clearer, more consistent, permanent preparations. Normal urothelium, inflammatory lesions, squamous metaplasia, papillomata, flat in situ and papillary tumours and invasive neoplasms of the bladder have been studied. Inflammatory and squamous changes did not corrupt the test results. The SRCAT was found to be a highly significant test for identifying those patients at risk from invasive bladder tumour. ABH antigens in carcinoma in situ appeared to be non‐uniformly distributed throughout the bladder urothelium; it is suggested that all subsequent biopsies from these patients should be tested.
The Use of Urinary Flow Rates Obtained from Voided Volumes Less than 150 ml in the Assessment of Voiding Ability
Authors: MARSHALL V. R. , RYALL ROSEMARY L. , AUSTIN M. L. , SINCLAIR G. R.
Published: November 2008

Summary— The initial slope of the curve relating peak urinary flow rate to voided volume was found to predict an individual's flow rate at bladder volumes of 200 ml or more in normal subjects and Those with symptoms of outflow obstruction. The numerical value of this initial slope was found to decline in a hyperbolic fashion with increasing age. A similar decrease was observed for peak urinary flow rates at bladder volumes between 200 and 300 ml.

The use of initial slope as an index of voiding ability would appear to be just as effective in discriminating between normal and obstructed men as a single flow rate determination at a large volume and would be of most benefit in those patients unable to void large volumes of urine.
Ureaplasma urealyticum and Upper Urinary Tract Stones
Authors: Hedelin H. , Brorson J.‐E. , Grenabo L. , Pettersson S.
Published: November 2008

Summary—
The occurrence of bacteria and Ureaplasma urealyticum in the upper urinary tract was studied in 50 patients operated on for renal stones. Cultures were performed on voided urine, pelvic urine obtained during surgery and the stone. The chemical composition of the stones was analysed.

Twenty‐six stones were of metabolic origin and 24 infection‐induced, i.e. composed of struvite and/or carbonate‐apatite. Ureaplasma urealyticum was cultured from the upper urinary tract in 1 patient with metabolic stones, and in 7 with infection stones. In 4 of these 7 patients no other urease‐producing micro‐organism was detected, suggesting that Ureaplasma urealyticum may have been associated with stone formation in these patients.
Effects of High Intake of Dietary Animal Protein on Mineral Metabolism and Urinary Supersaturation of Calcium Oxalate in Renal Stone Formers
Authors: Fellström B. , Danielson B. G. , Karlström Brita , Lithell H. , Ljunghall S. , Vessby B. , Wide L.
Published: November 2008

Summary—
The metabolic effects of a high protein diet (HPD) were studied in eight patients with idiopathic recurrent calcium oxalate stones.

On the HPD there was a 35% increase in urinary calcium concomitant with increased excretion of cyclic AMP and hydroxyproline. These findings point to an enhanced resorption of bone, possibly secondary to increased renal loss of calcium. The urinary citrate decreased by 25% along with reduced serum standard bicarbonate and urinary pH. The high formation of acid metabolites might also have adverse effects on calcium balance and bone.

Urinary oxalate excretion was not affected nor were there any significant changes in the calculated urinary supersaturation of calcium oxalate, if changes in urinary citrate, pH, sulphate, sodium, phosphate and volume were also considered.

This study suggests that the possible negative influence on the propensity to form renal stones of a diet rich in animal protein is probably due to reduced urinary inhibitory activity.
Repeated Bladder Distension by the Cystomat in the Treatment of Detrusor Instability
Authors: Stimpel H. , Aagaard J. , Reuther K.
Published: November 2008

Summary—
Treatment of idiopathic detrusor instability with drugs and prolonged distension of the bladder is often unsatisfactory. Some amelioration of symptoms has previously been described by using the Cystomat. The present study showed that 1 week's treatment with the Cystomat produced convincing subjective improvement as well as an increase in bladder capacity. The improvements were statistically significant and persisted for 3 months. Although the mechanism by which bladder distension exerts its effect is poorly understood, the technique of repeated distension offers an alternative in the treatment of patients with idiopathic detrusor instability.
A New Operation for Phimosis: Prepuce‐saving Technique with Multiple Y‐V‐plasties
Authors: Hoffman S. , Metz P. , Ebbehøj J.
Published: November 2008

Summary—
The operation for phimosis aims at achieving normal preputial retractability and the prepuce need not be removed. A method is described in which multiple Y‐V‐plasties relieve the phimosis without resecting any preputial tissue.
A Comparison Between Diuresis Renography and the Whitaker Test in 64 Kidneys
Authors: HAY A. M. , NORMAN W. J. , RICE M. L. , STEVENTON R. D.
Published: November 2008

Summary— Fifty‐seven patients have provided 64 dilated pelvicaliceal units for study by diuresis renography and the Whitaker test. Of 45 kidneys showing a type I or type Illa renographic response (unobstructed), 32 were, according to Whitaker's criteria, obstructed, 8 fell into an equivocal zone and only 5 were unobstructed. Thirty‐five of these kidneys—33 of which were associated with moderate or severe loin pain—were operated on for presumed obstruction with generally excellent symptomatic and renographic result. Thus the detection of a type I or type Illa response in a dilated, painful system cannot be taken to exclude obstruction. Better correlation was obtained between renography and the Whitaker test in patients exhibiting a type 1Mb or type Il renographic response. Diuresis renography is a sensitive indicator of urodynamic disturbance in the upper urinary tract and an ideal means of evaluating post‐operative progress. The Whitaker test provides a reliable means of selecting patients who will benefit from pyeloplasty.
Renal Pelvic Pressures in Human Chronic Obstructive Uropathy
Authors: HOLDEN D. , GEORGE N. J. R. , RICKARDS D. , BARNARD R. J. , O'REILLY P. H.
Published: November 2008

Summary— Resting renal pelvic pressure and premicturition bladder pressure have been measured by direct percutaneous puncture in 12 male patients with established chronic obstructive uropathy related to high pressure chronic retention. In 10 technically satisfactory cases the subtracted renal pelvic pressure was less than the intrinsic bladder pressure, showing that upper tract dilatation and diminished renal function in these patients were not due to direct extension of high resting bladder pressure into the upper tract. The mean resting upper tract pressure in chronic human obstructive uropathy was 10.7 cm of water.
Review of Accessories for Percutaneous Renal Surgery
Authors: MILLER R. A. , PAYNE S. R. , WICKHAM J. E. A.
Published: November 2008

Summary— Adequate accessory equipment is a prerequisite for successful percutaneous nephrolithotomy. The advantages of the Amplatz tube used in combination with the new sheathless nephroscopes are described. The design, action and efficiency of forceps are detailed. Triradiate rigid forceps have been shown to be superior to other types of forceps. All accessories are liable to be damaged and therefore must be regarded as semi‐disposable.
Endoscopic Bladder Transection
Authors: PARSONS K. F. , MACHIN D. G. , WOOLFENDEN K. A. , WALMSLEY B. , ABERCROMBIE G. F. , VINNICOMBE J.
Published: November 2008

Summary— Endoscopic bladder transection has been performed in 30 patients with symptoms as a result of unstable bladder activity. The symptomatic improvement produced justifies the use of this new operation which should replace the open procedure.
Hyponatraemia During Transurethral Resection—its Practical Prevention
Authors: WATKINS‐PITCHFORD J. M. , PAYNE S. R. , RENNIE C. D. , RIDDLE P. R.
Published: November 2008

Summary— Haemodilutional consequences of transurethral resection of the prostate (TURP) can present clinical problems during or in the immediate period following this procedure. Recognition of large and rapid changes in the plasma sodium by inference from an ion selective electrode may avert the development of this potentially life‐threatening complication.
Incidental Carcinoma of the Prostate: Treatment Selection by Second‐look TURP
Authors: FORD T. F. , CAMERON KATHARINE M. , PARKINSON M. CONSTANCE , O'DONOGHUE E. P. N.
Published: November 2008

Summary— Twenty consecutive patients, aged under 70 years, with an incidentally diagnosed (TONXMO) carcinoma of the prostate were studied to determine the value of a repeat (second‐look) TURP in assessing the accuracy of the estimates of tumour grade and volume following a first resection and in selecting patients for deferred or definitive treatment. In 8 of the 20 cases no tumour was present in the second specimen and in three cases the quantities were insignificant. All patients were treated expectantly and none has developed disease progression. Appreciable residual tumour was still present in nine patients, four of whom have developed local progression despite treatment (radiotherapy or stilboestrol). It is concluded that a second‐look TURP adds to the accuracy of the definition of the T‐category and as such is a valuable adjunct in determining appropriate therapy in such patients.
High Serum Prolactin Associated with Poor Prognosis in Carcinoma of the Prostate
Authors: MEE A. D. , KHAN O. , MASHITER K.
Published: November 2008

Summary— Seventy patients with carcinoma of the prostate have had regular estimations of serum prolactin levels during a 10‐month period, and were followed up for a further 6 months. Of 21 patients who recorded at least one high serum prolactin, 10 (48%) died during these 16 months, while of 50 with normal prolactin, only 2 (4%) died. Ten (21%) of the 47 patients on oestrogen or anti‐androgen therapy died, and 9 of these had a high prolactin. This contrasts with 2 (14%) deaths of 14 who had had either bilateral orchiectomy or radiotherapy to the prostate. One of the 2 who died had a high prolactin.

It is concluded that an elevated serum prolactin in treated carcinoma of the prostate is associated with progression of the disease and a poor prognosis.
Antisperm Antibodies and Male Infertility
Authors: UPADHYAYA MEENA , HIBBARD B. M. , WALKER SHEILA M.
Published: November 2008

Summary— Two hundred males attending a fertility clinic and 65 men who had fathered one or more children were screened for sperm antibodies using sperm agglutination and immobilisation tests. The incidence of sperm antibodies was significantly higher in the former group.

Agglutinin and immobilisin were not related to sperm concentration, morphology, ejaculate volume, seminal plasma zinc, magnesium, acid phosphatase and fructose. However, sperm motility and viability were significantly reduced in the presence of sperm antibodies.

There appeared to be no relationship between the presence of antisperm antibodies and Mycoplasma, aerobic or anaerobic organisms. There was a positive correlation between agglutinating and immobilising antibodies in serum and seminal plasma. This study suggests that sperm antibodies at a significant titre may lower male fertility.
Malignant Phaeochromocytoma
Authors: LEWI H. J. E. , REID R. , MUCCI B. , DAVIDSON J. K. , KYLE K. F. , MACPHERSON S. G. , SEMPLE P. , KAYE S.
Published: November 2008

Summary— Malignant phaeochromocytoma is a rare tumour and experience in its management is therefore limited. Five patients are discussed in whom the development of metastases was associated with rapidly progressive disease.
A Simple Loop Catheter for Ureteric Calculus Retrieval
Authors: KOTWAL S. V. , KOCHHAR G. S. , GUPTA N. P. , SINGH S. M.
Published: November 2008

Summary— The fabrication and use of a simple looped catheter for ureteric stone retrieval are reported. In a series of 46 patients the loop was passed successfully in 28 and the stone dislodged in 20 (71.4%). This device can be made by any urologist, using cheap, readily available materials. Complications are few and the success rate is high.
Chemotherapy before Radiotherapy for T3 Bladder Cancer; A Pilot Study
Authors: KAYE S. B. , MacFARLANE J. R. , McHATTlE I. , HART A. J. L.
Published: November 2008

Summary— Seventeen patients with stage T3 bladder cancer were treated in a pilot study of initial chemotherapy (four courses of cyclophosphamide, methotrexate and 5‐fluorouracil) followed by megavoltage radiotherapy 6000 cGy) to the bladder. Chemotherapy was well tolerated and did not lead to any increase in toxicity from the radiotherapy.

Assessment of response in all cases was not possible because of the variable extent of the initial biopsy. Of the 12 patients in whom assessment was possible, there was no objective change in 9 (4 cases of T3a; 5 cases of T3b) and there was objective evidence of disease progression in 3 (2 cases of T3a; 1 case of T3b).

Thirteen patients have now died and the median survival for patients in this study was 27 months, with a 3‐year survival rate of 26%. Three patients died with recurrence in the pelvis, 5 with both local and metastatic disease, 2 with metastases only, and 3 from other causes.

These data indicate that this particular form of chemotherapy given as initial treatment for T3 bladder cancer does not appear to lead to an improvement in the results obtainable from radiotherapy alone.
Haemoglobin F Levels in Patients with Testicular Tumours
Authors: AKDAS A. , KANSU E. , KALI Z. KiR , REMZI D. , FIRAT D.
Published: November 2008

Summary— This study was designed to examine haemoglobin F levels prior to therapy in 39 patients with testicular tumours (10 seminoma, 29 non‐seminomatous tumours) and 20 controls. HbF levels were significantly increased in the group with testicular tumours (1.66 ± 0.12%) compared with normal controls (0.99 T 0.08%) (P < 0.001). Non‐seminomatous tumours had more pronounced levels than seminomas (P < 0.001). No correlation was found between HbF level and stage of the disease. We suggest that HbF production could be significantly reactivated in adult patients with testicular tumours and may be a useful marker.
Xanthogranulomatous Pyelonephritis in Childhood
Authors: KIERCE F. , CARROLL R. , GUINEY E. J.
Published: November 2008

Summary— Eleven children with xanthogranulomatous pyelonephritis are reported. The left side was affected in all patients. It is suggested that the diagnosis can be made pre‐operatively. The condition is characterised by the fact that it is always unilateral and that renal calculi are found in a kidney with gross impairment of function; associated anaemia, leucocytosis and raised ESR are also present. The cause is unclear, but an obstructive element with infection is usually found.
The Effect of Trimethoprim on Serum Creatinine
Authors: KASTRUP J. , PETERSEN P. , BARTRAM R. , HANSEN J. M.
Published: November 2008

Summary— The influence of trimethoprim on renal function has been investigated in two groups of volunteers, both without a history of either acute or chronic urinary tract disease. All had normal serum creatinine. They were treated with trimethoprim 200 mg bd for 14 days. In group A (median age 78 years), serum creatinine increased significantly from median 89 to 134 μmol/l (P < 0.01) during the first week and returned to normal 1 week after termination of treatment to median 90 μm/l (P < 0.02). After 1 week's treatment in group B (median age 29 years), serum creatinine had increased significantly from median 87 to 107 μmol/l (P < 0.05), remained stable in the second week and returned to the pre‐treatment level 1 week after cessation of treatment: 87 μmol/l (P < 0.05). The glomerular filtration rate determined by 51Cr‐EDTA clearance did not change. There was a significant decrease in the 24‐h endogenous creatinine clearance after 14 days' treatment from 111 to 87 ml/min/l.73 m2 (P < 0.05). Our results are consistent with an age‐independent reversible trimethoprim‐induced inhibition of the tubular secretion of creatinine.
Vasoactive Intestinal Polypeptide in the Hyper‐reflexic Neuropathic Bladder
Authors: KINDER R. B. , RESTORICK J. M. , MUNDY A. R.
Published: November 2008

Summary— The distribution of nerves containing vasoactive intestinal polypeptide (VIP) in the hyper‐reflexic neuropathic bladder was investigated using immunocytochemistry and radioimmunoassay. Biopsy specimens were taken from the bladders of 21 patients with urodynamically proven detrusor hyperreflexia and from 20 control patients with no urodynamic abnormality. The results showed a reduction in the number of VIP immunoreactive nerves and a reduction in VIP concentration in the hyper‐reflexic bladder when compared with control samples.
Cystectomy for Carcinoma of the Bilharzial Bladder 126 Patients 10 Years later
Authors: GHONEIM M. A. , ASHAMALLA A. , GABALLA M. A. , IBRAHIM E. I.
Published: November 2008

Summary— Our experience with 126 cases of bilharzial bladder cancer treated by radical cystectomy and followed up for at least 10 years is outlined.

The operative mortality rate was 13.5%. The 5‐ and 10‐year survival rates were 32.6 and 23% respectively. The difference between the two figures can be attributed to mortality from natural ageing rather than recurrence of cancer. Analysis of survival figures revealed that the tumour grade was the most important prognostic factor. Most treatment failures were due to local recurrence which developed soon after treatment.
Rat Peritoneal Implantation Test: A New Method for Tissue Toxicity Testing of Urinary Catheters
Authors: TALJA M.
Published: November 2008

Summary— Severe urethral inflammatory reactions followed by strictures have been reported after short‐term catheterisation with latex catheters since 1982. In this study a new method for assessing tissue toxicity is presented. It is based on the degree of inhibition of rat peritoneal foreign body reaction. Because the results are easier to interpret and more quantitative than those of the rabbit muscle implantation test, the rat peritoneal implantation test is recommended as a standard in vivo toxicity test.
Bladder Electromyograms and Function in Monkeys after Atropine
Authors: CRAGGS M. D. , STEPHENSON J. D.
Published: November 2008

Summary—Voiding induced in conscious monkeys by infusion of sterile saline into the bladder via a chronically implanted bladder catheter was stable over many months. Artefact‐free recordings of electrical activity were obtained from the bladder neck and dome of these animals during bladder filling and voiding. Characteristic voiding electromyograms were recorded from both sites but were seen first in the record from the neck. Small doses of methyl‐atropine abolished both voiding and the electromyograms; evoked responses to sacral ventral root stimulation were similarly prevented. Therefore the bladders of both man and monkey are very sensitive to atropine, unlike the bladders of most other animals.
Ultrasound Examination of the Scrotum
Authors: MICHELL M. J. , THOMPSON P. M. , BELL A. J. YATES , PRYOR J. P. , PACKHAM D. A.
Published: November 2008

Summary— The technique of real time ultrasound examination of the scrotum is described. The examination was performed on 120 patients and was found to be a helpful diagnostic aid in scrotal swelling and in the acute painful scrotum. It is recommended as a useful investigation for scrotal abnormalities.
A Comparison of Diuresis Renography, the Whitaker Test and Renal Pelvic Morphology in Idiopathic Hydronephrosis
Authors: LUPTON E. W. , RICHARDS D. , TESTA H. J. , GILPIN S. A. , GOSLING J. A. , BARNARD R. J.
Published: November 2008

Summary— Diuresis renography and the Whitaker test are established methods of diagnosing obstruction in dilated renal pelves. These techniques have been compared in 36 patients with radiologically demonstrated idiopathic hydronephrosis and evaluated, where possible, against renal pelvic morphological features. The agreement between the results of the tests was as follows: diuresis renography/Whitaker test 67%; diuresis renography/renal pelvic morphology 74%; Whitaker test/renal pelvic morphology 58%. Both diuresis renography and the Whitaker test are indicated in some cases of idiopathic hydronephrosis.
Management of Patients with Renal and Ureteric Calculi Presenting with Chronic Renal Insufficiency
Authors: Gupta N. P. , Kochar G. S. , Wadhwa S. N. , Singh S. M.
Published: November 2008

Summary— Of 403 patients with renal and ureteric calculi treated during the last 4 years, 64 presented with features of chronic renal insufficiency: 59 of these underwent surgery. Good pre‐operative preparation and conservative renal surgery restored normal renal function in 14 patients and 27 improved significantly. The remainder either did not improve or continued to have progressive renal failure. It is emphasised that these patients are considerably worse off compared with their counterparts with normal renal function. The overall mortality rate was 17%. Patients whose post‐operative serum creatinine levels did not stabilise to less than 884 pmol/l seemed to make poor progress in the follow‐up period.
Monoclonal Antibodies to Detect A, Band H Blood Group Isoantigens in Superficial Transitional Cell Carcinoma of the Bladder: a Means of Predicting Invasive Recurrences
Authors: STEPHENSON T. J. , WILLIAMS J. L. , GELSTHORPE K.
Published: November 2008

Summary— Monoclonal antibodies to A, B and H blood group isoantigens (Bgi) have been used in an indirect immunoperoxidase technique to study the expression of BGI in both normal and malignant transitional epithelium in patients of all blood groups.

BGI was detectable in all 15 biopsies of normal transitional epithelium and in 28 of 50 (56%) stage pTa and pTI transitional cell carcinomas of the bladder (Tccb). In the tumours failing to express BGI there was a 55% invasive recurrence rate at 5 years compared with 14% in those tumours expressing BGI. The difference was significant at the P < 0. 01 level.

The recent availability of a monoclonal antibody to H isoantigen expressed in group O patients, in addition to monoclonal anti A and anti B, has made possible the inclusion of patients of all blood groups into a study using a standard immunoperoxidase technique without the need for specially processed biopsy material. The advantages of this technique compared with the earlier methods are discussed with reference to its possible role in identifying those patients at highest risk of developing invasive recurrence of their tumour.
Ejaculation and Sexual Function after Endoscopic Bladder Neck Incision
Authors: HEDLUND H. , EK A.
Published: November 2008

Summary— Endoscopic incision of the bladder neck, performed to relieve outflow obstruction, was evaluated as regards effects on ejaculation and orgasm in 61 men (mean age 48 years) by analyses of seminal fluid and a questionnaire. Relief of obstruction was confirmed by post‐operative normalisation of urinary flow. In 47 cases there was unchanged antegrade ejaculation, while reduced semen volume was reported by 11 men and retrograde ejaculation by only 3. The quality of orgasm and sexual satisfaction were not permanently changed by the operation. Post‐operative analysis of seminal fluid was performed in 27 patients, with normal results in 26. In 16 men who provided specimens both before and after bladder neck incision, no consistent change was found in the semen. An incision completely splitting the bladder neck but not extending distal to the verumontanum will relieve outlet obstruction. Maintenance of antegrade ejaculation can be expected in most patients undergoing this operation.
A Comparison Between Ultrasonography and Laparoscopy in Localising the Impalpable Undescended Testis
Authors: MALONE P. S. , GUINEY E. J.
Published: November 2008

Summary— in 11 boys, 3 of whom had bilateral and 8 unilateral impalpable testes, ultrasonography was used to identify the location of the testes. The results of ultrasonography are compared with those of laparoscopy in the same patients.

The testes were absent in two instances. The remaining 12 testes were accurately located by laparoscopy. Ultrasonography demonstrated the testes in only two cases.
Abdominal Pain as a Presenting Symptom of Male Germ Cell Tumour
Authors: HOGAN PATRICIA , SMEDLEY H. , SIKORA K.
Published: November 2008

Summary— Twenty‐three patients who presented with abdominal pain and were found to have germ cell tumours have been reviewed. The overall survival of these patients was no different from the survival of those presenting with testicular swellings. Intra‐abdominal germ cell tumour remains an important differential diagnosis of abdominal pain in men.
Post‐treatment Fertility in Patients with Testicular Cancer.: II. Influence of Cis‐platin‐based Combination Chemotherapy and of Retroperitoneal Surgery on Hormone and Sperm Cell Production
Authors: FOSSÅ SOPHIE D. , OUS S. , ÅBYHOLM T. , NORMAN N. , LOEB M.
Published: November 2008

Summary— Active sperm production was observed in 20 of 35 patients with testicular cancer 1 year after discontinuation of all treatment (retroperitoneal surgery only: 13; cis‐platin‐based chemotherapy (CVB) ± other treatment: 22). The percentage of patients who regained spermatogenesis increased slightly after a further 1 to 2 years. Fourteen patients (of 121 under observation) impregnated their wives (after retroperitoneal surgery: 9; after CVB ± other therapy: 5). The individual serum FSH values correlated significantly with the results of sperm analysis: an FSH value ≥20 iu/l indicated azoospermia in 8 of 12 patients, whereas only 5 of 30 patients with FSH levels ≤12 iu/l were azoospermic. Serum testosterone and pituitary serum LH were virtually unaffected by the treatment.

In conclusion, 1 to 3 years after cis‐platin‐based multi‐modality treatment for testicular cancer, 50 to 60% of patients have active spermatogenesis and fatherhood can be achieved by a significant number of them.
Vasography, its Indications and Complications
Authors: PAYNE S. R. , PRYOR J. P. , PARKS C. M.
Published: November 2008

Summary— A retrospective study was undertaken of the results of vasography in 440 male partners of infertile marriages who had undergone scrotal exploration and in a group of 42 men with a variety of genital tract disorders. Abnormalities were observed in 10% of 265 azoospermic men and in 4% of 175 other men with infertility. There was no evidence that vasography caused damage to the vas deferens and no oligozoospermic man became azoospermic. A high incidence radiological of abnormalities was seen in haemospermia but the incidence of abnormalities in selected men with ejaculatory problems or testicular pain was low.