bluuebunny/crossref_metadata_2025_split huggingface dataset:
Structure and Per‐rectal Ultrasonography of Prostatic Disease using Cadaver Specimens
Authors: JONES D. R. , GRIFFITHS G. J. , PARKINSON M. C. , EVANS K. T. , ROBERTS E. E. , DAVIES R. LI. , HARRISON T. J. , PEELING W. B. 
Published: November 2008

Summary— One hundred cadaver prostates were examined by per‐rectal ultrasound and the findings correlated with the microradiographic and histopathological features of whole sections taken at the levels of scanning.The normal gland consists of both periurethral muscle and glands. The periurethral muscle has little structure on microradiography and is therefore hypoechoic (low amplitude echoes) on ultrasound scanning. The gland itself, both central and peripheral zones, has a lattice appearance on microradiography (reticular structure) and therefore produces mid‐range amplitude echoes on ultrasound.Benign hypertrophy develops at the edge of the periurethral muscle and is microadenomatous in structure. This produces mid‐range amplitude echoes which are coarser than in the normal gland. Associated calcification has a characteristic distribution around the adenomas.Cancer produces an amorphous structure resulting in loss of ultrasonic echoes (hypoechoic). In a few cancers irregular calcification is present, resulting in high echoes in the ultrasound scan (hyperechoic) which are not in the typical benign distribution.The internal structure of the prostate was therefore demonstrated in its histopathological states by the technique of microradiography and seen to relate to its representation by ultrasound.
The Treatment of Sphincter Strictures
Authors: MUNDY A. R. 
Published: November 2008

Summary— A group of 25 patients with strictures of the membranous urethra following transurethral resection of the prostate (TURP) were investigated and treated initially by careful urethral dilatation. This controlled the stricture in 14 patients, 6 of whom continued with occasional dilatation or self‐catheterisation to maintain control; 8 required an artificial urinary sphincter (AUS) and 2 required a “clam” ileocystoplasty for detrusor instability. Eleven had persistent or recurrent strictures requiring urethroplasty. Nine underwent bulbo‐prostatic anastomotic urethroplasty, 4 with simultaneous bladder neck reconstruction and 5 with subsequent implantation of an AUS; 2 had a preputial patch urethroplasty with subsequent implantation of an AUS. Four of the 9 patients with a urethroplasty and an AUS are satisfactory, 1 developed a recurrent stricture and 2 developed erosions. Two of those with a bulbo‐prostatic anastomosis and bladder neck reconstruction are satisfactory and 2 are incontinent.These results were compared with those of 18 other patients who underwent bladder neck reconstruction and 12 who had a urethroplasty in conjunction with an AUS for reasons other than a post‐TURP sphincter stricture. The success rate of bladder neck reconstruction was 55% and the success rate of urethroplasty in conjunction with an AUS was 83%, but the main complication of AUS implantation, erosion, was a more serious problem than failure of bladder neck reconstruction. However, the much higher success rate makes AUS implantation a more satisfactory procedure. Surgery should be avoided if at all possible and reliance placed on urethral dilatation.
Acquired Ventral Penile Curvature: Spongiofibrosis Caused by Urethral Manipulation
Authors: YACHIA D. 
Published: November 2008

Summary— Fibrosis of the corpus spongiosum, caused by urethral manipulation, and the resulting ventral penile curvatures are known as the urethral manipulation syndrome. This acquired, largely iatrogenic deformity is noticed only by sexually active patients.Partial, gradual disappearance of glans engorgement and irregularities palpable along the penile urethra associated with ventral curvature are constant findings. The post‐manipulative ventral curvature can be transient, disappearing when the inflammatory process subsides or the repeated urethral manipulation ceases. Since fibrosis of the corpus spongiosum begins with urethral inflammation, patients in whom irregularities of the penile urethra are observed during urethrography should be questioned about any erectile deformity.Surgical treatment is indicated when the deformity interferes with sexual intercourse or is accompanied by severe urethral strictures.
Neurophysiological Aspects of Penile Erection: the Role of the Sympathetic Nervous System
Authors: JÜNEMANN K.‐P. , PERSSON‐JÜNEMANN CHARLOTTA , LUE T. F. , TANAGHO E. A. , ALKEN P. 
Published: November 2008

Summary— Recent studies have revealed that the initiation, maintenance and rigidity of penile erection are under parasympathetic and somatotopic control. The mechanism of penile detumescence is still under debate. Single and combined cavernous and hypogastric nerve stimulation was used to study the influence of the sympathetic nervous system on penile erection and to indentify the mechanism of penile detumescence.Penile arterial flow and intracorporeal pressure recordings during various stimulation patterns indicated that erection induced by stimulation of the cavernous nerve could be blocked by excitation of the upper hypogastric nerves. Venous outflow studies demonstrated that the inhibitory effect of the sympathetic nervous system was due to active vaso‐ and corporeal smooth muscle constriction. It was concluded that subsidence and suppression of erection is a sympathetic function.Previous studies have shown that the neurophysiology of erection can be explained by 3 major inhibitory (sympathetic). Our findings are of clinical importance, since a better appreciation of the basic erectile mechanism is essential for successful management of erectile dysfunction.
The Value of Intravesical Echography Combined with Double‐surface Coil Magnetic Resonance Imaging in Staging Bladder Cancer
Authors: HENDRIKX A. J. M. , BARENTZ J. O. , STAPPEN W. A. H. v.d. , DEBRUYNE F. M. J. , RUIJS S. H. J. 
Published: November 2008

Summary—
Correct staging of bladder tumours is essential for planning the best therapeutic strategy and is therefore directly related to the prognosis. In this study of 15 patients with bladder cancer, a new method using magnetic resonance imaging (MRI) with a newly developed double‐surface coil was tested for bladder cancer staging and compared with other existing techniques.Ultrasonography produced 2 cases of overstaging and 2 of understaging. This was due to the inability of this method to evaluate muscular infiltration accurately. All superficial bladder tumours were staged correctly with ultrasound with the exception of 1 case that was overstaged because of superficial tumour calcification. Double‐surface coil MRI correctly staged all infiltrating tumours. Two small superficial tumours were missed by MRI, while another superficial tumour was overstaged.It is suggested that double‐surface coil MRI and intravesical ultrasonography are good complementary examinations in the pre‐operative staging of bladder tumours. Larger studies are necessary to prove the reliability of this conclusion.
High Dose Polyoestradiol Phosphate with and without Acetosalicylic Acid versus Orchiectomy in the Treatment of Prostatic Cancer
Authors: ARO J. L. V. , HAAPIAINEN R. K. , RANNIKKO S. A. S. , ALFTHAN O. S. 
Published: November 2008

Summary—
The clinical efficacy of high dose (160 mg) polyoestradiol phosphate (PEP) was compared with that of orchiectomy in a prospective randomised multicentre study including 200 prostatic cancer patients. The effect of daily low dose (75 mg) acetosalicylic acid (ASA) on possible cardiovascular complications during the first 6 months of therapy was also evaluated.Oestrogen‐treated patients had more progressions, but follow‐up was too short to draw any definite conclusions on the efficacy of treatment. There was no cardiovascular mortality and there were no thromboembolic complications in any treatment group. It was concluded that parenteral high dose PEP is not associated with an increased risk of cardiovascular complications and there is no need for daily low dose ASA.
Initial Management of Acute Urethral Injuries
Authors: LIM P. H. C. , CHNG H. C. 
Published: November 2008

Summary—
A study was made of 30 cases of acute urethral trauma treated over a 7‐year period. There were 10 anterior and 20 posterior urethral injuries, the majority of these being partial ruptures. Posterior urethral injuries were caused by road traffic accidents in 75% of cases while 80% of the anterior urethral injuries were of the “straddle” type. There was only 1 case of iatrogenic injury to the anterior urethra.During follow‐up, all patients required periodic dilatations for stricture except for the single case of iatrogenic injury. An average of 5 dilatations controlled all of the strictures except for 2 that required urethroplasties.
Treatment and Complications of Fournier's Gangrene
Authors: WOLACH M. D. , MacDERMOTT J. P. , STONE A. R. , WHITE R. W. deVERE 
Published: November 2008

Summary—
Ten patients with Fournier's gangrene were seen over an 11 ‐month period; 3 had indwelling urethral catheters, 3 had preceding perineal infection and 6 had a history of alcohol abuse.An average of 2.1 operations was required per patient and the average hospital stay was 41 days. The mortality rate was 20%; 7 patients developed acute renal failure and 5 developed adult respiratory distress syndrome. Early treatment of these complications should help to reduce the mortality of this disease.
Detection of Recurrent Bladder Tumours by Transrectal and Abdominal Ultrasound Compared with Cystoscopy
Authors: DAVIES A. H. , CRANSTON D. , MEAGHER T. , FELLOWS G. J. 
Published: November 2008

Summary—
Transrectal and transabdominal ultrasound was used to detect the recurrence of bladder tumours and compared with conventional cystoscopy. Forty patients with a previous history of bladder tumour were examined by these methods; 50% had a recurrence.Transabdominal and transrectal ultrasound together identified 95% of recurrences; 1 tumour (diameter 1 mm) was missed. The false positive rate was 5% and these areas, identified wrongly by ultrasound as tumour, were shown to be scars on cystoscopy. Combination ultrasound may be used as an alternative to check cystoscopy in certain categories of bladder tumour.
Desmopressin in Elderly Women with Increased Nocturnal Diuresis
Authors: ASPLUND R. , ÅBERG H. 
Published: November 2008

Summary—We report the changes in the pattern of diuresis in 20 women (average age 71 years) with increased nocturnal diuresis who were treated with 20 ng desmopressin (Minirin). Before treatment, antidiuretic hormone levels were measured every 4 h over a 24‐h period and 75% of the levels were found to be beneath the lowest detectable limit (<0.4 pmol/l).Nocturnal diuresis decreased by 355 ± 208 ml and in 8 cases the decrease exceeded 400 ml. Diurnal diuresis, on the other hand, increased by 226 ± 331 ml. Side effects were mild and occurred in only 2 women.
Prostate Specific Antigen in Screening for Recurrence following Radical Prostatectomy for Localised Prostatic Cancer
Authors: BENTVELSEN F. M. , OUDEN D. VAN DEN , SCHRODER F. H. 
Published: November 2008

Summary— Eighty‐five patients treated by radical prostatectomy for clinically localised prostatic cancer were followed up for 1 to 4 years with measurement of prostate specific antigen (PSA). Six patients with recurrences had elevated levels (cut‐off level was 1.0 ng/ml). PSA is therefore considered an excellent tool for monitoring treatment failures. Levels exceeding 1.0 ng/ml preceded evidence of tumour recurrence by a mean interval of 11 months.PSA offers the possibility of detecting residual prostatic cancer after surgery. It is not known, however, whether these patients would have benefited from adjuvant endocrine or early radiotherapy.
Intracorporeal lithotripsy with the Swiss lithoclast
Authors: WADHWA S.N. , HEMAL A.K. , SHARMA R.K. 
Published: November 2008

Objective To evaluate the use of the Swiss lithoclast in the management of urinary calculi. Patients and methods Between January and November 1993, 60 patients with a total of 61 urinary calculi were treated with the Swiss lithoclast. Forty patients had a ureteric calculus, two had a ureterocele with a calculus, one a steinstrasse, 16 a vesical stone and two a urethral calculus. Eighty per cent of patients were treated on a day‐care basis. Results Fragmentation of the urinary calculi was successful in 59 of the 60 patients. Both patients with a urethral calculus and 15 of 16 with a vesical calculus were stone‐free after the procedure. All those with a ureteric calculus were stone‐free at 6 weeks. There were no intra‐operative or long‐term complications directly related to the use of the Swiss lithoclast. Conclusion The results of this study show that the Swiss lithoclast is a simple, safe, reliable and economical method of endoscopic lithotripsy for the treatment of urinary tract calculi. Although the lithoclast's use is limited to rigid or semi‐rigid endoscopes there is now a suction facility for the immediate removal of small stone fragments
Excitatory neurotransmission in the mammalian bladder and the effects of suramin
Authors: CREED K. E. , CALLAHAN S. M. , ITO Y. 
Published: November 2008

Objective To compare the electrical and mechanical activity, and assess the effect of suramin on strips of detrusor from various species. Materials and methods Bladder muscle strips from guinea‐pigs, rabbits, monkeys and sheep and detrusor strips from humans (obtained at operation) were studied. The mechanical responses to nerve stimulation were recorded with a force transducer and electrical activity was recorded with the double sucrose gap. Results In all species acetylcholine was released from the nerves and a prolonged contraction was produced. A second transmitter, possibly adenosine triphosphate, produced a rapid transient contraction, the amplitude of which varied with the species. In the rabbit and guinea‐pig the phasic contraction and accompanying depolarization were large, whereas in primates they were small and in sheep were intermediate. At high concentrations, suramin reduced the contraction and accompanying depolarization in rabbit and guinea‐pig muscle but not in sheep. Suramin enhanced the late cholinergic responses and increased spontaneous mechanical activity in all species. These latter effects were not seen after desensitization of the receptors with the ATP analogue α, β‐ methylene ATP. Conclusion Although suramin reduces the excitatory effect of nerve activity in some species, it would produce little beneficial effect in the human hyperexcitable bladder as any inhibitory effect might be offset by the increase in spontaneous activity.
Urolthelial cancer and cigarette smoking: findings from a regional case‐controlled study
Authors: SORAHAN T. , LANCASHIRE R. J. , SOLE G. 
Published: November 2008

Objective To quantify the risks of urothelial cancer associated with smoking cigarettes. Subjects and methods Histories were taken from 989 patients diagnosed with urothelial cancer, 2059 electoral register controls and 1599 General Practitioner controls. Histories of patients and controls were compared by means of logistic regression. Results Statistically significant trends were observed for the risk of urothelial cancer to increase with estimated lifetime consumption of cigarettes. Among ex‐smokers, risks reduced with time since quitting, and ex‐smokers who quit 20 or more years ago experienced risks similar to lifelong non‐smokers. Type of cigarette was not an important predictor of risk. The two control series provided estimates of 45% and 33% respectively for the percentage of cancers in the series attributable to cigarette smoking. Conclusion Cigarette smoking is the single most important cause of urothelial cancer, but stopping smoking leads quickly to reductions in risk.
Quantification of angiongenesis as an independent predictor of prognosis in invasive bladder carcinomas
Authors: DICKINSON A. J. , FOX S. B. , PERSAD R. A. , HOLLYER J. , SIBLEY G. N. A. , HARRIS A. L. 
Published: November 2008

ObjectiveTo evaluate angiogenesis as a prognositic marker of transitional cell carcinoma of the bladder and to assess its relationship to established variables for survival. Materials and methods Forty‐five tumours (two G2T2, seven G3T2 and 36 G3T3) from 36 men and nine women with a mean age of 73 years (range 50–91), who has been fokllowed‐up for a median of 37 months (range 1–50), were examined, Wessels w ere immunohistochemically highlighted using an antibody to the platelet endothelial cell adhesion molecule, CD31. Microvessel density was quantified using a Chalkley point eyepiece graticule. Results Univariate analysis of survival showed stage, grade and vascular count were significant inducatiors of prognosis (P=0.002. P=0.007, P=0.019 respectively). No relationship was observed between stage and grade and vascular count. In a Cox proportional hazard model, adjiusted for age and stage, microvessel d ensity not only remained a significant prognositc indicator (P=0.026) but was as informative as stage in predicting overall survival. A high vascular count conferred a 2.5 increased risk of mortality. Conclusions These findings suggest that assessment of anigogenesis by microvessel quantification is an independent predictor of survival in patients with invasive bladder carcinoma and might be useful in selecting those who would benefit from adjuvant therapy.
Partial bladder reconstruction with pedicled rectus and gracilis muscle flaps: an experimental study in dogs
Authors: EROL A. , ÖZGÜR S. , EROL U. , ÖZGÜR F. , AMKIAN Y. , ÖZGÜVEN V. , HAZIROǴLU R. , CETIN S. 
Published: November 2008

Objective To investigate the functional, anatomical and histopathological results of partial bladder reconstruction with skeletal muscle flaps. Materials and methods Partial bladder reconstruction with gracilis or rectus muscle flaps was performed in 10 mongrel dogs, Bladder compliance and uninhibited contractions were investigated in five female dogs. Pre‐Operative and post‐operative cystograms were performed in four female dogs. The dogs were killed 8–125 weeks after the operation. Bladders and muscle flaps were grossly examined and removed for histopathological examination. Results There was no extravasation on post‐operative cystography. Bladder compliance was normal and uninhibited contractions were not present. Severe contracture and atrophy of the muscle flaps were observed in all dogs at necropsy. Bladder volumes were not changed significantly (p > 0.05). Histo‐pathological examination revealed severe mesenchymal metaplasia in all of the flaps. Conclusion Partial reconstruction of the bladder with skeletal muscle flaps did not result in extravasation and bladder function was not altered. However, bladder volume could not be increased because of contracture and atrophy of the flaps.
Transverse colon conduit urinary diversion in patients treated with very high dose pelvic irradiation
Authors: RAVI R. , DEWAN A. K. , PANDEY K. K. 
Published: November 2008

Objective To study the results of transverse colon conduit urinary diversion in patients receiving very high dose pelvic irradiation (≥ 65 Gy).Patients and methods Records were reviewed for 30 such patients who underwent transverse colon conduit as a primary form of urinary diversion between January 1986 and June 1992. Most of the conduits were constructed using refluxing ureterocolic anastomoses with stents.Results There was no operative mortality. Although the procedure was associated with a complication rate of 37% and a re‐operation rate of 20%, there were no bowel or urinary anastomotic leaks. The operation could be safely performed on patients with renal failure, with 83% of such patients showing normal or improved serum creatinine levels post‐operatively.Conclusion The advantages of transverse colon conduit urinary diversion are the use of non‐irradiated bowel and ureters for diversion. We recommend it as a primary form of urinary diversion in these high risk cases.
The Mitrofanoff principle for urethral failure
Authors: WOODHOUSE C. R. J. , GORDON E. M. 
Published: November 2008

Objective To assess the outcome of surgery for urethral failure.Patients and methods Patients undergoing lower urinary tract reconstruction are recorded prospectively by protocol. Thirty‐four are presented whose urethra had failed as a conduit; in 23 the urethra was incontinent and in 11 it was spastic causing chronic retention. The incontinent patients had failed a variety of reconstructions, in five including insertion of an artificial sphincter. Those with chronic retention were unable to self‐catheterize the urethra.Results A continent supra‐pubic diversion using the Mitrofanoff principle was performed. In two patients a new technique was used in which a detrusor tube formed the continent conduit. Ninety‐four per cent of patients were continent. Two patients voided to completion, the remainder emptied by self‐catheterization. Five minor revisions were required to allow easy catheterization. There was one death. The complication rate was 17%.Conclusion This type of reconstruction is preferable to the formation of an ileal conduit in this difficult group of patients.
Complications and length of hospital stay following stented and unstented paediatric pyeloplasties
Authors: HUSSAIN S. , FRANK J. D. 
Published: November 2008

Objectives To ascertain the necessity for the use of nephrostomies and ureteric stents after paediatric pyeloplasties.Patients and methods Seventy children with a pelviureteric junction obstruction underwent a dismembered pyeloplasty between March 1983 and March 1991 at The Bristol Royal Hospital for Sick Children. A nephrostomy and stent were not used routinely except for the first few months of the survey. Indications for their use were: surgery on a single kidney, an inflamed renal pelvis or a revision pyeloplasty. Urinary catheters were only used for those patients with proven or suspected vesicoureteric reflux.Results Thirteen patients had a nephrostomy and stent inserted (Group 1) of whom three patients (23%) developed complications. Fifty‐seven patients had only a wound drain inserted (Group 2) of whom nine (16%) developed complications. The hospital stay of 12.1 days for patients in Group 1 was significantly longer than the 5.4 days for Group 2 (P value <0.05). Long‐term radiological and/or radio‐isotopic follow‐up showed improvement in function and/or drainage in 95% of both groups.Conclusions These findings support the concept that paediatric pyeloplasties can be safely performed at any age without the insertion of a nephrostomy tube or stent and that hospital stay is therefore significantly reduced.
Serum immunosuppressive acid protein predicts lymph node metastases in patients with renal cell carcinoma
Authors: PUMMER K. , PÜRSTNER P. , AUNER H. L. , STETTNER H. , TRUMMER H. , PENKOFF H. , RAUCHENWALD M. 
Published: November 2008

Objective To evaluate the usefulness of serum immunosuppressive acid protein (IAP) as a marker for lymph node metastases in patients with renal cell carcinoma.Patients and methods Serum IAP levels were studied in 73 patients with renal cell carcinoma, prior to therapy. Serum IAP levels were correlated with the clinical and the post‐operative histopathological stage. A threshold value of 800 μg/ml was applied.Results Statistical analysis revealed a better correlation between IAP concentration and disease than with any other variable. Sensitivity and specificity were 94% and 84%, respectively, thus providing good positive (65%) and negative (98%) predictive values regarding lymph node involvement.Conclusion Measuring serum IAP levels can be a valuable contribution to lymph node staging in patients with renal cell cancer. The choice of cut‐off value of 800 μg/ml has yet to be supported by a larger series.