bluuebunny/crossref_metadata_2025_split huggingface dataset:
Treatment of Outflow Tract Obstruction due to Benign Prostatic Hyperplasia with the Pollen Extract Cernilton
Authors: BUCK A. C. , COX R. , REES R. W. M. , EBELING L. , JOHN A. 
Published: November 2008

Summary— Whilst prostatectomy remains the “gold standard” for the treatment of outflow tract obstruction due to benign prostatic hyperplasia, medical treatment–if only for symptomatic relief–appears to be an attractive alternative. Most of the pharmacological agents in use block the hormonal or the sympathetic neurological pathways that influence prostate growth and function. All of these drugs are known to have side effects.Sixty patients with outflow obstruction due to benign prostatic hyperplasia (BPH) were entered into a double‐blind, placebo‐controlled study to evaluate the effect of a 6‐month course of the pollen extract, Cernilton. There was a statistically significant subjective improvement with Cernilton (69% of the patients) compared with placebo (30%). There was a significant decrease in residual urine in the patients treated with Cernilton and in the antero‐posterior (A‐P) diameter of the prostate on ultrasound. However, differences in respect of flow rate and voided volume were not statistically significant. It is concluded that Cernilton has a beneficial effect in BPH and may have a place in the treatment of patients with mild or moderate symptoms of outflow obstruction.
Prostatic Carcinoma: Histological and Immunohistological Factors Affecting Prognosis
Authors: COHEN R. J. , GLEZERSOIM G. , HAFFEJEE ZENOBIA , AFRIKA D. 
Published: November 2008

Summary— Neuroendocrine or paracrine cells of the human prostate and urethra have been identified by various methods, predominantly silver stains and immunocytochemistry. The incidence of neuro‐endocrine differentiation in prostatic carcinoma has varied considerably from 10 to 100%, but has not been studied previously as an independent factor affecting prognosis.Nucleolar organiser regions (NORs) are loops of ribosomal RNA occurring in the nucleoli of cells which ultimately process RNA genes. NORs have been demonstrated by silver (Ag) staining techniques and have been studied in numerous malignant tumours. A pilot study from this laboratory has shown a distinct and significant difference in AgNOR staining between prostatic carcinoma and benign prostatic epithelial hyperplasia.A retrospective study was performed with at least 6 years' follow‐up. This confirmed the presence of neuro‐endocrine cells in more than half of the patients under investigation. A significant correlation between survival and the absence of neuro‐endocrine cells was demonstrated. AgNOR staining was shown to be of no prognostic value.
Mobile Extracorporeal Shockwave Lithotripsy
Authors: RAJAGOPAL V. , BAILEY M. J. 
Published: November 2008

Summary— During the last 18 months, extracorporeal Shockwave lithotripsy (ESWL) has been provided at Epsom District Hospital using a mobile unit containing a Dornier HM4 lithotriptor. Patients with upper ureteric and renal stones were selected for treatment, which was performed without anaesthesia or sedation as a day‐case procedure; 83 patients were treated, 5 of them with bilateral stones. Seventy patients required 1 treatment session, 17 required 2 and 1 patient required 3. There were no serious complications but 3 patients needed ureteroscopy to remove obstructing stones. The overall success rate was 86%. The cost to treat each NHS patient was £253.Mobile lithotripsy as a day‐case procedure is a safe and cost‐effective means of treating urolithiasis and can be performed in a District General Hospital.
The Impact of Extracorporeal Piezoelectric Lithotripsy on the Management of Ureteric Calculi: an Audit
Authors: PARR N. J. , RITCHIE A. W. S. , MOUSSA S. A. , TOLLEY D. A. 
Published: November 2008

Summary— The presentation and management of 153 patients with ureteric calculi requiring active treatment over a 12‐month period were reviewed; 74% of patients had primary ureteric calculi and 26% had ureteric calculi composed of fragments resulting from extracorporeal piezoelectric Shockwave lithotripsy (EPL) to renal calculi; 32 patients (21%) had more than 1 calculus or a steinstrasse.The primary procedures included were in situ EPL (n = 54), push‐bang (44), retrograde ureteroscopy (40), Dormia basket extraction (6), push‐pull (1), antegrade ureteroscopy (1) and combinations of these (7). The success of the primary procedure could not be predicted from stone size, site or duration in the ureter, but upper tract dilatation was significantly less (p<0.01) in the successful group. The overall success rate for complete stone extraction was 97%, but 54 patients (35%) required more than 1 procedure to achieve this. In situ EPL and push‐bang, as either primary or secondary procedures, were successful in treating 79 patients (52%); 2 patients required ureterolithotomy (1.3%). The overall complication rate was 18%.Since EPL is only successful in treating approximately half of ureteric calculi, a range of other treatments should be available to maintain a low rate of open surgery.
Upper Tract Tumours following Cystectomy for Bladder Cancer. Is Routine Intravenous Urography Worthwhile?
Authors: HASTIE K. J. , HAMDY F. C. , COLLINS M. C. , WILLIAMS J. L. 
Published: November 2008

Summary— The incidence and presentation of upper tract tumours were studied in 180 patients who had previously undergone cystectomy for transitional cell carcinoma of the bladder. Intravenous urography was performed routinely 3 months after cystectomy, 1 year later and at 3‐yearly intervals thereafter. Ten patients developed upper tract tumours; 1 presented with loin pain and the remainder with haematuria.Six patients underwent nephroureterectomy and 5 of them lived for at least 4 years; 4 were inoperable and only 1 survived longer than 6 months.In this series, all patients with upper tract tumours presented with symptoms and routine intravenous urography failed to detect any asymptomatic lesions. Routine radiological assessment of the upper tracts to detect tumours is not justified following cystectomy.
Clinical Significance of the “Palpable Mass” in Patients with Muscle‐infiltrating Bladder Cancer Undergoing Cystectomy after Pre‐operative Radiotherapy
Authors: FOSSÅ SOPHIE D. , OUS S. , BERNER A. 
Published: November 2008

Summary— Between 1976 and 1985, 132 patients with T2/T3/T4a bladder cancer underwent cystectomy after pre‐operative radiotherapy (46 Gy: 67 patients; 20 Gy: 65 patients). After a median time of 41 months, 62 patients were alive; 51 had died from recurrent bladder cancer and 19 from intercurrent disease without recurrence of their malignancy. Distant metastases developed in 40 patients, accompanied in 5 cases by local recurrence. Local recurrence was the first sign of relapse in 11 patients. In 3 patients the localisation of the relapse remained unknown.The corrected 5‐year survival rate was 60%. T category and a palpable bladder tumour were independent pre‐treatment prognostic factors in a Cox regression analysis, together with the interval between initial diagnosis and cystectomy. The presence of a palpable tumour before the start of treatment was associated with a particularly poor prognosis in T3/T4a tumours, whereas the survival of patients with non‐palpable T3/T4a tumours was similar to that of patients with T2 bladder cancer. Another important prognostic factor was post‐irradiation stage reduction (no residual muscle infiltration in the cystectomy specimen). Significantly more patients with nonpalpable bladder tumours experienced post‐radiation stage reduction than did those with a palpable tumour. However, the prognostic value of stage reduction was statistically significant only in patients with palpable bladder tumours.
Urethral Blood Circulation during Cardiopulmonary Bypass
Authors: TALJA M. , LEHTOLA A. , SALMENPERÄ M. , RUUTU M. , KARONEN S.‐L. , ALFTHAN O. 
Published: November 2008

Summary— The haemodynamic changes induced by extracorporeal circulation (ECC) are thought to be important in the induction of urethral strictures in open heart surgery when indwelling latex catheters are used.In the present study, 6 piglets were cannulated and connected to extracorporeal perfusion apparatus. Pump flows correlated with human ECC values with non‐haemic prime were used. The mucosal and submucosal blood circulation in the urethra reduced by 66% during ECC (P<0.05). The brain and hepatic arterial flows increased. A significant reduction was seen in renal blood circulation.The changes in the urethral blood circulation during ECC correlated with previous findings. The reduced wash out levels of chemicals leaching from the indwelling latex catheters as a result of reduced local blood circulation are the main trigger for the induction of urethral strictures during ECC and in other shock‐like circulatory disturbances in the human body.
Bladder Compliance in Myelodysplastic Children: Effect of Anti‐reflux Surgery and Conservative Treatment
Authors: KONDO A. , KATO K. , GOTOH M. , NARUSHIMA M. , ITOH Y. 
Published: November 2008

Summary— Little is known about changes in bladder compliance and bladder capacity in myelodysplastic patients following anti‐reflux surgery. A study group of 70 patients was divided as follows: group A included 20 myelodysplastic patients who had been operated on for reflux and whose subsequent treatment was conservative. Group B comprised 31 myelodysplastic patients who had been treated conservatively; a third group of 19 non‐myelodysplastic patients, treated by anti‐reflux surgery because of primary reflux, formed the control group. The follow‐up period for group A averaged 61 months (extending from a urodynamic study 3 months after surgery to the most recent test). In group B the mean follow‐up period between the initial test and the latest test was 86 months.Bladder compliance in group A patients did not increase significantly (from 5.5 to 6.9), but patients in group B did show a significant increase (from 5.9 to 10.7). Compliance in the 19 non‐myelodysplastic patients decreased only marginally 6 months after surgery (from 29.6 to 26.3). Changes in bladder capacity showed a similar trend. In their most recent test, however, the bladder capacity of group A patients increased to the same volume as that of group B. A high correlation between radiological bladder deformity and bladder compliance was found. We propose a bladder compliance of 10.0 as the lower limit for myelodysplastic patients' preferred range.It was concluded that anti‐reflux operations prevent any improvement in bladder compliance (but not in bladder capacity) compared with conservative treatment.
Long‐term Effect of Pelvic Floor Exercises on Female Urinary Incontinence
Authors: MOURITSEN L. , FRIMODT‐MØLLER C. , MØLLER M. 
Published: November 2008

Summary In order to assess the permanent effect of pelvic floor exercises on female stress incontinence, 76 incontinent women, referred for incontinence surgery, underwent a 3‐month exercise programme conducted by an experienced physiotherapist.The patients were followed up for 1 year. At the last assessment 30% were cured and 17% improved. Altogether 47% avoided surgery.No relapses were seen during the follow‐up period. Patients with mild incontinence benefited from intensified training, since 72% could expect to be cured, while patients with severe incontinence and no immediate effect did not benefit from further exercises. Patients with a positive hormone status and those with normal weight had a significantly higher cure rate.The subjective results were confirmed by the 24‐h pad test. Anal pressure profilometry was a valid method for instruction and objective control of pelvic floor function. It was concluded that pelvic floor exercises should precede surgery, since exercises had a permanent effect in half of the patients.
Treatment of Recurrent Urethral Strictures Using Clean I ntermittent Self‐catheterisation
Authors: ROBERTSON G. S. M. , EVERITT N. , LAMPRECHT J. R. , FRCS M. BRETT , FLYNN J. T. 
Published: November 2008

Summary The treatment of urethral strictures has been greatly improved by the use of the optical urethrotome. However, there remains a group of patients with recurrent strictures for whom the alternatives remain long‐term dilatation/urethrotomy or urethroplasty.Over the last 3 years we have treated 65 such patients using clean intermittent self‐catheterisation as a method of self‐dilatation. This has resulted in a dramatic decrease in the number of operations performed on these patients, with no significant reduction in urinary flow rate over an average follow‐up period of 20 months.The method offers the possibility of long‐term cure and should be offered to all such patients, reducing still further the number of patients who require urethroplasty.
Carcinoma in situ as a Prognostic Factor for G3pT1 Bladder Tumours
Authors: VICENTE J. , LAGUNA M. P. , DUARTE D. , ALGABA F. , CHÉCHILE G. 
Published: November 2008

Summary G3pT1 bladder cancer has traditionally been regarded as a superficial tumour with a high risk of progression. We have studied 37 patients with initial G3pT1 bladder tumours treated between January 1981 and December 1985. They were divided into 2 groups according to the association with carcinoma in situ (Cis) at the time of diagnosis.Clinical behaviour was analysed at 5 years. The first group (without Cis) showed progression and recurrence rates similar to those of low grade, low stage bladder tumours. The second group (with Cis) had a similar rate of recurrence but their progression rate was 65%.
Late Complications of Prostakath Treatment for Benign Prostatic Hypertrophy
Authors: ROSENKILDE P. , PEDERSEN J. F. , MEYHOFF H.‐H. 
Published: November 2008

Summary The self‐retaining intra‐urethral device “Prostakath” was inserted in a consecutive series of 29 men with obstructive benign prostatic hypertrophy.Fifteen patients were relieved of prostatic symptoms for an observation period of 22 weeks (range 2–60). The spiral was removed in 14 cases (48%) at an average of 14 weeks (range 1–82) after insertion; in 9 patients this was because of urinary retention and in 5 it followed dislocation of the stent into the bladder. Five stents removed after 44 weeks of treatment (range 21–82) were severely calcified. Light microscopic investigation of the Spirals that were removed revealed no damage to the gold‐plated surface. All patients with calcification had chronic urinary infection resistant to antibiotic treatment. We believe that infected urine is the major factor responsible for the calcification. We suggest that patients with recurrent urinary infection after insertion of the Prostakath should be closely followed up and checked for stone formation by a plain X‐ray of the bladder region. It may be advisable to change the Prostakath in patients with resistant urinary tract infection at 6‐monthly intervals.
A Comparison of Aspiration, Antazoline Sclerotherapy and Surgery in the Treatment of Hydrocele
Authors: ROOSEN J. U. , LARSEN T. , IVERSEN E. , BERG J. B. S. 
Published: November 2008

Summary Of 98 hydroceles (mean volume 125 ml) in a consecutive series of 92 patients, treated initially by aspiration, 14% (mean volume 70 ml) were cured.The 76 recurring hydroceles (mean volume 146 ml) were then randomised to either antazoline sclerotherapy on an out‐patient basis or surgery. Cure rates were 89 and 100%, respectively, at follow‐up 6 months later. Operated patients were admitted for a mean duration of 2.5 days.The results indicated that aspiration alone was inadequate, and sclerotherapy is advocated as the first choice of treatment for hydrocele.
The Role of Colour Duplex Ultrasonography in the Diagnosis of Vasculogenic Impotence
Authors: PICKARD R. S. , OATES C. P. , SETHIA K. K. , POWELL P. H. 
Published: November 2008

Summary Colour duplex ultrasonography was used to obtain peak systolic velocity (PSV) readings from cavemosal arteries at rest and during papaverine‐induced tumescence. Results from 31 men with vasculogenic impotence were compared with those from 17 men with non‐vasculogenic impotence and a control group of 6 potent men.In the flaccid state no significant differences in PSV readings were found between the vasculogenic and control groups. Following the injection of papaverine, men from the vasculogenic group without venous leakage were alone in having significantly lower PSV readings compared with the potent controls.All 23 men with normal penile haemodynamics had a mean PSV ≥ 20 cm/s during tumescence. This was also the case for 19 (61%) of the vasculogenic group, including 9 (69%) of the 13 patients with venous leakage. The remaining 12 men in the vasculogenic group (39%) had a mean PSV <20 cm/s, this being diagnostic of an inadequate arterial inflow.Colour duplex ultrasonography can identify patients who have marked arterial insufficiency as the major cause of their impotence and hence allows more rational selection for angiography and revascularisation. Lesser degrees of arterial deficit are difficult to characterise using mean PSV readings alone.
Bladder Augmentation and Replacement
Authors: ROBERTSON A. S. , DAVIES J. B. , WEBB R. J. , NEAL D. E. 
Published: November 2008

Summary— Bladder augmentation has a role in the management of patients with neuropathic bladder dysfunction and in urinary undiversion. Several reports attest to its clinical value, but there have been few detailed urodynamic studies of its effects. We have carried out a prospective review over a 4‐year period of 25 patients undergoing bladder augmentation or substitution assessed by conventional and ambulatory urodynamic studies. All patients had a detubularised reservoir made of ileum in 6, and of the ileocaecal segment in the remainder. Six patients also had an artificial sphincter fitted and 2 underwent colposuspension.There was no mortality. After operation, bladder capacity increased from 122 ± 91 ml to 659 ± 431 ml and there were significant decreases in the pressure rise during filling and increases in bladder compliance. Hyper‐reflexia was present in 74% before operation and 23% after operation. Regular phasic activity was observed in 77% of patients at the end of filling after operation, probably due to bowel activity despite detubularisation. Four patients described urge incontinence associated with this activity.After operation, one man had persistent major stress incontinence. He has since undergone insertion of an artificial urinary sphincter (AUS) and is now completely dry. Of the remainder, 10 patients had minor, infrequent defects in continence, 9 patients with leakage when the bladder was full and 4 with occasional leakage at night. With the exception of the patient with major stress incontinence, all but one felt the operation had been worthwhile—40% reporting complete success and 52% excellent improvement. Reconstruction of the neuropathic lower urinary tract is a major surgical procedure, but the final clinical outcome is very satisfactory.
Effect of Catheter Material on the Incidence of Urethral Strictures
Authors: ROBERTSON G. S. M. , EVERITT N. , BURTON P. R. , FLYNN J. T. 
Published: November 2008

Summary— The aetiology of urethral strictures in patients catheterised for short periods at the time of surgery is the subject of some debate. The occurrence of epidemics of strictures associated with certain batches of latex catheters, and the demonstrable in vitro cytotoxicity of latex in general, have supported the suggestion that catheter material (and in particular latex) has an important role.We have looked retrospectively at 299 patients undergoing transurethral resection of the prostate gland by 1 urologist, 135 of whom had a latex catheter and 164 a plastic one; 19 patients developed strictures over the next 12 months with no proven difference attributable to the catheter material.The study provides no evidence that the short‐term use of latex catheters is associated with stricture formation.
Unusual Hyperechoic Appearance of Prostate Cancer on Transrectal Ultrasonography
Authors: EGAWA S. , WHEELER T. M. , GREENE D. R. , SCARDINO P. T. 
Published: November 2008

SummaryA series of 157 patients with prostate cancer underwent transrectal ultrasonography prior to radical prostatectomy. In 112 patients (71.3%) the tumours appeared hypoechoic relative to the echo pattern of the normal peripheral zone; in 43 (27.4%) they appeared isoechoic, and in only 2 (1.3%) did they appear purely or predominantly hyperechoic. These 2 hyperechoic tumours were unusual ductal adenocarcinomas with central necrosis and dystrophic calcification within solid tumour nests, a pattern similar to that of comedo‐carcinoma of the breast. Calcification within prostate cancer was found in 4 of the 157 radical prostatectomy specimens, including 2 other hypoechoic cancers which contained intraluminal or psammomatous calcification. Although the most common sonographic appearance of localised prostate cancer is hypoechoic, a predominantly hyperechoic pattern is seen occasionally and suggests the presence of a high grade ductal adenocarcinoma.
Intravesical Instillation of Beta‐Interferon in the Treatment of Bladder Cancer
Authors: MIGLIARP R. , DEMIRY M. EL , MUSCAS G. , USAI E. 
Published: November 2008

Summary— A total of 36 patients with single superficial bladder cancer TNM stage Ta‐T1/G2 was studied over a 24‐month period before entering the study to evaluate the efficacy and tolerance of high doses of beta‐interferon (beta‐INF); 24 patients had a primary tumour (group 1)and 12 had had more than 3 recurrences (group 2). They received 8 intravesical doses of beta‐INF, 50,000,000 IU in 50 ml sterile water, at weekly intervals, 15 days after transurethral resection of the bladder (TURB).Efficacy was estimated by simple recurrence rate and by the person‐years method. The recurrence rate was 25% in group 1 with a mean follow‐up of 21.6 months. Comparison with the recurrence rate of a historical control group treated only by TU R showed that there was a slight statistically significant difference. Group 2 had a recurrence rate of 100% in the period before beta‐INF (follow‐up 24 months) and 91% after INF administration (mean follow‐up 20.5 months).Patients were questioned about side effects before and after each treatment; tolerance of the drug was excellent. The results suggest that beta‐interferon could be safely used as a prophylactic agent against the recurrence of primary superficial bladder cancer. Its efficacy seems comparable to that obtained with other current chemoprophylactic agents.
Localised Deep Microwave Hyperthermia in the Treatment of Benign Prostatic Hyperplasia: Long‐term Assessment
Authors: YERUSHALMI A. , SINGER D. , KATSNELSON R. , LEVY E. , SHANI A. 
Published: November 2008

Summary— A group of 133 patients with benign prostatic hyperplasia who were either poor operative risks or who had refused surgery underwent localised deep microwave hyperthermia, without supplementary drugs. In 59% of patients who had had an indwelling catheter, freedom from urological obstruction and satisfactory voiding were maintained for 7 years and catheterisation was not required. In patients with severe prostatic symptoms, 65% showed general improvement and satisfactory voiding for 8 years.There were no side effects. Patients who relapsed were given a second course of treatment and 75% responded positively.This positive response and the lack of side effects suggest that localised deep microwave hyperthermia may be an effective alternative to surgery in the management of high risk patients and those who are reluctant to undergo surgery.