bluuebunny/crossref_metadata_2025_split huggingface dataset:
Venous leak surgery: long‐term follow‐up of patients undergoing excision and ligation of the deep dorsal vein of the penis
Authors: VALE J.A. , FENELEY M.R. , LEE W.R. , KIRBY R.S. 
Published: November 2008

Objective To review the long‐term results and satisfaction of patients after venous leak surgery for the management of impotence caused by a failure of passive venous occlusion.Patients and methods Twenty‐seven patients (mean age 56 years, range 26–63) with erectile failure due to venous leakage, diagnosed on colour Doppler imaging (CDI) and pharmacocavernosometry and cavernoso‐graphy, underwent venous leak surgery. In all cases the deep dorsal vein of the penis was excised and ligated along with any other large accessory veins. Patients were reviewed in out‐patients at 3 months and asked to complete a questionnaire 1 year after surgery.Results Three months after surgery, 19 of 27 patients (70%) had been able to resume sexual intercourse, 17 (63%) had spontaneous erections and two (7%) required papaverine/prostaglandin Ej. One year aftersurgery, 14 of 22 patients were able to achieve erections sufficient for sexual intercourse, although four of these required self‐injection with papaverine. There were no serious complications, and when asked whether or not they would undergo the operation again, 13 of 20 said they would.Conclusions We conclude that venous leak surgery is a useful treatment modality in patients with pure venous leakage proven by pharmacocavernosometry and/or cavernosography, and in whom arteriogenic impotence has been excluded using CDI. These are often desperate patients who would rather accept the risk that this relatively minor procedure may fail in preference to undergoing implant surgery in the first instance or use a vacuum device. However, well‐informed consent is essential.
Surgical management of elephantiasis of male genitalia
Authors: OLLAPALLIL J.J. , WATTERS D.A.K. 
Published: November 2008

Objective To assess the outcome of the surgical management of severe elephantiasis of male external genitalia.Patients and methods Twelve patients with gross oedema of their penis and scrotum were managed by excision of the lymphoedematous skin and subcutaneous tissue and a split‐skin graft.Results The cosmetic and functional results were satisfactory in all cases. There was no recurrence and all patients were able to resume sexual activity.Conclusion Surgical excision of affected tissue and split‐skin graft is an effective management for severe lymphoedema of the scrotum and penis.
Serum intercellular adhesion molecule (ICAM‐1), a marker of renal scarring in infants with vesico‐ureteric reflux
Authors: MIYAKITA H. , PURI P. , SURANA R. , KOBAYASHI H. , REEN D.J. 
Published: November 2008

Objective To determine if serum intercellular adhesion molecule (ICAM‐1) levels correlate with renal scarring in children with vesico‐ureteric reflux (VUR).Patients and methods Serum ICAM‐1 levels were measured in 81 children (29 boys and 52 girls, age range 2 months‐13 years) with VUR using an enzyme‐linked immunosorbent assay (ELISA) and compared with levels in a control group of 24 children (16 boys and eight girls, age range 2 days‐13 years) with no urological abnormalities.Results The mean serum ICAM‐1 level in the control group was 202±79 ng/mL (mean±l SD) compared with 347±96 ng/mL in children with VUR (P<0.001). Fifteen of 26 children under 2 years of age demonstrated renal scarring while 18 of 44 children older than 2 years exhibited renal scarring. The mean serum ICAM‐1 level in patients who were <2 years of age and had renal scarring was 408 +ng/mL, significantly higher than in those who had no renal scarring (296± 68 ng/mL, P > 0.01). In contrast, there was no difference in serum ICAM‐1 levels in patients > 2 years of age with or with no renal scarring (353 + 87 and 325 + 91 ng/mL, respectively).Conclusion Serum ICAM‐1 levels are significantly higher in children with VUR and may represent a valuable marker of tubular damage in younger children with VUR.
Experience with the Memotherm™ permanently implanted prostatic stent
Authors: WILLIAMS G. , WHITE R. 
Published: November 2008

Objective To evaluate the Memotherm™ (Angiomed) permanently implantable prostatic stent.Patients and methods Forty‐eight men (mean age 70.3 years, range 57–86) with symptoms and urodynamics suggestive of bladder outflow obstruction had a Memotherm™ stent inserted into the prostatic urethra. Subjective and objective follow‐up was performed at 1, 3 and 6 months.Results All but one patient was eventually able to void. Ten stents have been removed and three patients are awaiting stent removal. Subjective benefits bore no correlation with the maximum urinary flow rate and the findings on cystoscopy. Only 15 of the 48 patients had a satisfactory result.Conclusion Permanently implanted prostatic stents should be considered experimental and only marketed after intensive investigation. As a result of this study, the Memotherm™ stent is to undergo significant modifications.
Effect of age, comorbidity and type of surgery on perioperative complications and mortality of prostatectomy
Authors: IBRAHIM A.I.A. , EL‐MALIK E. , GHALI A.M. , MURAD N. , SAAD M. 
Published: November 2008

Objective To study the effect of age, type of surgery and comorbidities (cardiovascular diseases, chronic lung diseases, diabetes mellitus and renal impairment) on the peri‐operative complications and mortality of prostatectomy.Patients and methods A series of 236 consecutive patients who underwent prostatectomy (171 by transurethral resection, TUR, and 65 by open procedure) were reviewed. Ninety patients at risk with one or more of the comorbidities were grouped together and compared with the remaining 146 fit patients. Also, 148 patients aged ≤ 70 years were compared with 88 patients aged > 70 years. The peri‐operative morbidity variables compared were haemorrhage, ≥ 3 units of blood transfusion, bacteriuria, orchitis, pyrexia, uraemia and bed‐stay.Results Mean post‐operative bed‐stay for patients at risk was significantly longer than that for fit patients (12 ± 7 and 9.7 ± 6 days, respectively). Mortality and the other morbidity variables, apart from postoperative bacteriuria which was more frequent in diabetics, were not significantly different between the groups. Similarly, comparing age groups revealed no significant differences. However, open surgery was associated with more haemorrhage, blood transfusion, post‐operative pyrexia and a longer bed‐stay.Conclusion The comorbidities studied and age did not significantly influence the complications and mortality of prostatectomy. However, comorbidities prolonged post‐operative bed‐stay. Open surgery was associated with more bleeding and pyrexia and a longer bed‐stay than TUR.
Immunological infertility among Nigerian men: incidence of circulating antisperm auto‐antibodies and some clinical observations: a preliminary report
Authors: EKWERE P.D. 
Published: November 2008

Objectives To (i) establish the incidence of circulating antisperm auto‐antibodies among infertile men; (ii) relate this incidence to the high prevalence of sexually‐transmitted diseases (STDs) in sub‐Saharan Africa and; (iii) elucidate the effect of steroid and other therapy on semen quality and subsequent fertility of the patients.Patients and methods Serum samples from 50 infertile men and 50 age‐matched controls were assayed by two agglutination techniques for anti‐sperm antibodies. Mean sperm concentrations were determined before and after steroid treatment of patients having antibody titres of 1:64 or above. Serum levels of follicle‐stimulating hormone, luteinizing hormone, testosterone and prolactin were also determined by radioimmunoassay in 38 patients. Seminal fluid analysis and culture were performed in 35 patients and testicular histology determined in 21.Results Agglutination was demonstrated in 22 of 50 sera (44%), whilst non‐agglutinating cytotoxic antibodies were detected in two. Only two of the 50 control sera (4%) were positive. After steroid therapy, antibody titres were significantly decreased and there was a sixfold improvement in mean sperm concentration and a threefold improvement in motility and morphological characteristics. Bacterial (46%) and non‐bacterial (17%) infection were recorded in 22 of 35 patients, 13 of whom showed the presence of antisperm antibodies in their sera. Staphylococcus aureus was the commonest single bacterial isolate. Overall, 13 of 29 patients (45%) improved, nine accounting for 12 pregnancies. Pregnancies and/or improvements in semen quality were observed only among patients with mild histological changes. Low testosterone and prolactinaemia occurred in 29% and 21% of the patients, respectively. Among these, anti‐sperm antibodies were also recorded in 18% and 13%, respectively.Conclusion The incidence of antisperm antibodies among infertile men is high in Nigeria and may be related to high prevalence of STDs. Immunologically infertile men can be treated successfully with steroids. Concomitant antibiotic and hormone therapy may also be essential in appropriate cases. Clinicians are advised to adopt a multimodal approach to the treatment of male infertility in sub‐Saharan Africa. The presence of non‐agglutinating cytotoxic antibodies calls for further investigation of the role of complement in the pathogenesis of immunological infertility.
Temporary reappearance of sperm 12 months after vasectomy clearance
Authors: O'BRIEN T.S. , CRANSTON D. , ASHWIN P. , TURNER E. , MACKENZIE I.Z. , GUILLEBAUD J. 
Published: November 2008

Objectives To determine the incidence of positive semen analysis 12 months after vasectomy clearance.Subjects and methods A prospective study was undertaken, starting in 1990, of men undergoing vasectomy. Azoospermia was confirmed by two successive semen analyses 16 weeks after vasectomy. One year later a further sample was analysed for the presence of sperm.Results Of 1000 men who provided a sample for analysis, six men (0.6%) have had positive semen analyses 1 year after the initial tests showed azoospermia. In all six the sperm count was < 10 000 per mL. Five of the six men produced a repeat sample 1 month later which, in all five cases, showed azoospermia. No pregnancies have been reported to date.Conclusion Transitory reappearance of sperm following successful vasectomy occurs in about 0.6% of men. This incidence is 18 times greater than the reported pregnancy rate following successful vasectomy.
An open, in‐patient incremental safety and efficacy study of desmopressin in women with multiple sclerosis and nocturia
Authors: ECKFORD S.D. , CARTER P.G. , JACKSON S.R. , PENNEY M.D. , ABRAMS P. 
Published: November 2008

Objectives To examine the safety and efficacy of desmopressin in three doses given to women with multiple sclerosis to treat nocturia with or without enuresis.Patients and methods Eight women with clinically confirmed multiple sclerosis and nocturia with or without enuresis were entered as in‐patients into an open, non‐randomized, placebo‐controlled study of incremental doses of 20, 40 and 60 μg desmopressin. Urinary and serum sodium, plasma arginine vasopressin and urine osmolality were monitored every 4 h for 24 h. A single dose of placebo or desmopressin was given during each of four 24‐h periods.Results There was a significant decrease in nocturnal urinary volumes and a significant increase in nocturnal urinary osmolalities in patients taking desmopressin when compared with those taking a placebo, but there was no difference among the desmopressin doses. There was no significant difference in serum sodium level between the desmopressin doses. However, at the end of the 24‐h period with the 60 μg dose, serum sodium was decreased significantly.Conclusions Neither a significant decrease in nocturnal urinary volumes nor an increase in urinary osmolality was achieved by doses of desmopressin > 20 μg. A dose of 60 g was associated with a decreased serum sodium level at the end of the 24‐h period but there was no biochemical hyponatraemia. Because there were no benefits and a possibility of clinical hyponatraemia with higher doses, doses of > 20 μg desmopressin cannot be recommended.
Impact of tumour grade, stage, number and size, and smoking and sex, on survival in patients with transitional cell carcinoma of the bladder
Authors: RAITANEN M.P. , NIEMINEN P. , TAMMELA T.L.J. 
Published: November 2008

Objective To evaluate the impact of the grade, stage, number and size of the tumour and of smoking and sex of patient on survival, and the relationship between smoking and tumour grade, stage, number and size, and sex of patient in patients with transitional cell carcinoma (TCC) of the urinary bladder.Patients and methods The study comprised 252 consecutive patients with histologically verified TCC of the bladder reporting to Oulu University Central Hospital between 1978 and 1986. The average duration of follow‐up was 6.7 years. The association between smoking and other covariates was analysed by cross‐tabulation and standard chi‐squared analyses. The Kaplan‐Meier method was used to obtain estimated survival curves and significant differences determined using log rank statistics.Results Smoking had no impact on tumour grade, stage, size and number or aggressiveness of metastases. Prognosis was noticeably better if the patient did not smoke, as 27% of the non‐smokers and 40% of the smokers had died during the first 10 years after diagnosis. Survival was also better in patients with low grade (I, II), non‐invasive (Ta/T1) and small (± 3 cm) tumours.Conclusion In addition to the well‐known prognostic factors (histological grade and stage of the tumour), smoking is a risk factor for bladder cancer and also has an impact on prognosis, leading to higher mortality from the disease in the longer term.
Does delayed diagnosis or scrotal incision affect outcome for men with non‐seminomatous germ cell tumours?
Authors: HARDING M. , PAUL J. , KAYE S.B. 
Published: November 2008

Objective To ascertain whether delayed diagnosis or type of orchidectomy affected outcome for men with non‐seminomatous germ cell tumours (NSGCT).Patients and methods The case notes of 454 men resident in the west of Scotland with a diagnosis of NSGCT between 1975 and 1989 were retrospectively reviewed. The clinical record was available for 442 (97%) and included information on time to diagnosis in 92% and diagnostic surgery in 97%. The study end‐point for orchidectomy was loco‐regional recurrence and for diagnostic delay was survival.Results A significant minority of men (10.4%) underwent a scrotal orchidectomy or had a scrotal incision before an inguinal orchidectomy (9.4%). More scrotal incisions were performed on patients under the care of general surgeons (28%) than of urologists (12.1%). Of the men who had scrotal surgery, one of 78 (1.3%; 95% CI, 0–4%) developed loco‐regional disease as the initial site of recurrence, compared with none of 318 men undergoing inguinal orchidectomy. The median time to diagnosis was 3 months. There was no relationship between time to diagnosis and tumour extent at presentation. A diagnostic delay of >3 months was associated with inferior survival in univariate analysis, but delayed diagnosis was not an independent influence on survival after adjustment for the major prognostic factors—tumour extent, year of diagnosis and treatment unit.Conclusions These results suggest that scrotal incision is unlikely to affect the risk of loco‐regional recurrence and that effective cytotoxic therapy has probably reduced the prognostic importance of delayed diagnosis on survival of men with NSGCT.
Clinical outcome and quality of life following enterocystoplasty for idiopathic detrusor instability and neurogenic bladder dysfunction
Authors: HASAN S.T. , MARSHALL C. , ROBSON W.A. , NEAL D.E. 
Published: November 2008

Objective To study the long‐term outcome of patients undergoing enterocystoplasty.Patients and methods The study comprised 48 patients (17 men and 31 women; mean age 46 years) who underwent enterocystoplasty for idiopathic detrusor instability (DI, 35 patients) or neurogenic bladder dysfunction (13 patients). Symptoms were scored from 0 to 14 and the overall outcome and generic quality of life were assessed using a Visick grading system (groups A to E) and the Nottingham Health Profile (NHP). These assessments were carried out before, 3 months after operation and at the final follow‐up (38 ± 18 months, range 13–78). Urodynamic studies were performed before and after operation.Results No patient died after operation and there was minimal early morbidity. Late complications (>30 days) included incisional hernia (3), anastomotic perforation (1), calculus formation (1) and urethral stricture (1). Clean intermittent self‐catheterization (CISC) was performed by 36 (75%) patients. Early symptomatic outcome was good in 40 (83%) patients, moderate in seven (15%) and unsatisfactory in one (2%) patient. The mean symptom scores before and 3 months after surgery were 10 (range 2–14) and 3 (range 2–14), respectively (P < 0.001). There was a significant increase in total bladder capacity (307±140 to 588±217 mL; P < 0.001) and bladder compliance (37±50 to 169±162 mL/cm H2O; P < 0.001). DI persisted in 15 (31%) patients. NHP scores revealed significant improvements in all domains. Final assessment showed a less satisfactory situation, with recurrent urinary tract infection (UTI) in 17 (3 7%) patients, a need for long‐term antibiotic therapy in seven (15%) and a change in bowel habit in 15 (33%) (13 DI, two with neurogenic bladder dysfunction). CISC was performed by 39 (85%) patients. The long‐term outcome was good or moderate in 12 patients (92%) with neurogenic bladder dysfunction and good or moderate in only 19 patients (58%) with DI.Conclusion Clam enterocystoplasty remains an effective management option in some patients with DI, but most patients with neurogenic bladder dysfunction do well. The procedure is, however, associated with long‐term complications such as disturbance of bowel habit and recurrent UTIs, which impair the outcome in the long‐term in patients with DI despite general improvements in irritative bladder symptoms.
Transurethral microwave thermotherapy versus transurethral resection for symptomatic benign prostatic obstruction: a prospective randomized study with a 2‐year follow‐up
Authors: DAHLSTRAND C. , WALDÉN M. , GEIRSSON G. , PETTERSSON S. 
Published: November 2008

Objective To compare the outcome of transurethral resection of the prostate (TÜRP) and transurethral microwave thermotherapy (TUMT) on symptomatic benign prostatic hyperplasia (BPH).Patients and methods Patients with symptomatic BPH were treated by either TÜRP (32 patients; mean age 70±6 years) or TUMT (37 patients; mean age 67±9 years) and assessed using the Madsen‐Iversen symptom score, measurements of urinary free flow rate and post‐void residual urine volume, digital rectal examination, transrectal ultrasonography, cystometry and pressure‐flow measurement, ultrasonography or intravenous pyelography (IVP) of the upper urinary tract, urine analysis and routine blood chemistry including serum prostate‐specific antigen (PSA) level. Examinations were repeated at fixed intervals for up to 24 months after treatment.Results After both TURP and TUMT there was an improvement in symptom score, residual urine volume, free flow rate and infravesical obstruction. The improvements of free flow rate and obstruction were more pronounced after TURP. Serious complications, such as bleeding requiring a re‐operation, occurred only in patients who underwent TURP.Conclusion Satisfactory results were obtained after both treatments and the improvements with either treatment lasted for at least 24 months.
Non‐traumatic rupture of the urinary tract during pregnancy
Authors: WOLFF J.M. , JUNG P.K. , ADAM G. , JAKSE G. 
Published: November 2008

Objective To review published cases of rupture of the urinary tract during pregnancy and illustrate the clinical manifestations of this serious complication of pregnancy.Methods Reported cases of urinary tract rupture were reviewed and a new case described.Results Spontaneous rupture of the urinary tract during pregnancy is rare; a review of the literature revealed only 24 cases, most commonly occurring in diseased kidneys. In the majority of cases the rupture was associated with underlying diseases of the kidney, the most common being renal tumours. Of the 25 cases examined, 12 had ruptures of the collecting system and 13 had ruptures of the renal parenchyma; 21 were diagnosed during pregnancy in the second and third trimester and four within the first 24 h postpartum.Conclusion Pregnancy‐induced changes in the urinary tract exaggerate any weakness of the parenchyma or collecting system. Pregnant patients with overdistension of the upper urinary tract should undergo routine ultrasonography and be observed carefully for infection or haematuria.
Elevated mast cell tryptase in the urine of patients with interstitial cystitis
Authors: BOUCHER W. , EL‐MANSOURY M. , PANG X. , SANT G.R. , THEOHARIDES T.C. 
Published: November 2008

Objective To investigate the number of tryptase positive bladder mast cells and the level of urine tryptase in interstitial cystitis (IC), a bladder disorder which occurs mostly in women and is characterized by suprapubic pain, frequency and nocturia.Patients and methods Bladder biopsies from 37 women with IC and 15 control women with other bladder conditions (age range 18–63 years) were obtained during diagnostic bladder distension and frozen immediately. Mast cells positive for tryptase were identified by immunohistochemistry and evaluated by light microscopy. Tryptase was measured by solid phase radioimmunoassay in urine samples, collected immediately (spot) and during a period of 24 h, obtained from normal women volunteers, controls and patients with IC. To adequately quantify tryptase, the physiologically active tetramer was dissociated to inactive monomers with supersaturated NaCl (6.0 M), and then dialysed.Results The patients' spot urine sample tryptase levels were indistinguishable from those of controls, which included the normal women volunteers. However, the tryptase levels in 24 h urine samples were greatly elevated only in patients with IC, both before (P < 0.005), and especially after NaCl treatment and dialysis (P < 0.001).Conclusion These results indicate that the tryptase levels of 24 h urine samples, combined with methyl‐histamine levels and the clinical criteria presently used, may possibly help to better identify IC.