bluuebunny/crossref_metadata_2025_split huggingface dataset:
Müllerian Duct (Prostatic Utricle) Cyst: Diagnosis and Treatment in Subfertile Males
Authors: HENDRY W. F. , PRYOR J. P. 
Published: December 2008

Summary— Müllerian duct cysts causing ejaculatory duct obstruction were discovered in 26 subfertile males; 21 patients had either azoospermia or very severe oligozoospermia. Characteristic seminal findings were a small volume ejaculate with acid pH and little or no fructose. The lesions were demonstrated by vasography and treated by endoscopic incision.After surgery there was a distinct improvement in volume of the ejaculate and sperm concentration in 10 patients, although another 10 patients continued to have azoospermia or severe oligozoospermia due to either persisting obstruction or secondary epididymal blocks. Eight female partners became pregnant.
PAEDIATRIC UROLOGY Gastrocystoplasty in Children
Authors: DYKES EVELYN H. , RANSLEY P. G. 
Published: December 2008

Summary— We report our experience of gastrocystoplasty in 8 children (mean age 10.1 years) with compromised renal function (mean creatinine 186 mmol/l, mean glomerular filtration rate 39 ml/min/ 1.73 m2).Current follow‐up ranges from 11 to 35 months (mean 21). The physiological outcome of the procedure has been excellent, with improved biochemical and urodynamic parameters in all cases. Six patients are off H2‐receptor blockers and are asymptomatic. In 2 children we have encountered significant symptoms related to acid secretion in the bladder.Detailed investigations suggest that the excess aciduria is related to the size of the gastric patch in 1 patient. The second child underwent renal transplantation 5 months after gastrocystoplasty and it is postulated that his immunosuppressive regimen (which includes prednisolone) may be responsible for the increased acid secretion.It is concluded that gastrocystoplasty is a very satisfactory alternative to intestinal segment bladder enhancement in children with compromised renal function, but the size of the gastric patch is critical in determining the resultant acid secretion. Post‐transplantation immunosuppressive therapy may increase acid production from the gastric patch; since the children most suitable for gastrocystoplasty are also those likely to require transplantation, this aspect requires further study.
Role of the Artificial Urinary Sphincter in the Treatment of Stress Incontinence in Women
Authors: DUNCAN H. J. , NURSE DIANE E. , MUNDY A. R. 
Published: December 2008

SummaryThe artificial urinary sphincter (AUS) is rarely indicated in the treatment of women with stress incontinence because most of these women have deficient urethral support rather than pure sphincter weakness and the AUS is a treatment specifically for pure sphincter weakness. The procedure is contraindicated after pelvic radiotherapy and after previous sling surgery because of the high incidence of cuff erosion. Otherwise the artificial sphincter gives excellent results comparable to those seen in men with post‐protatectomy incontinence and much better than in neuropathic bladder dysfunction.
Analysis of Continent Versus Standard Urinary Diversion
Authors: BENSON M. C. , SLAWIN K. M. , WECHSLER M. H. , OLSSON C. A. 
Published: December 2008

SummaryThe seemingly high complication and re‐operation rates associated with continent urinary diversion have led some to criticise its morbidity and question its role in reconstructive urological surgery. We therefore reviewed our experience with all patients undergoing either continent or standard urinary diversion performed by 3 urological surgeons during a specified 3‐year period. In 73 consecutive patients (22 continent urinary diversion, 51 standard urinary diversion), no significant difference was demonstrated with respect to the number of post‐operative in‐hospital days, complication rate, re‐operation rate and operative mortality rate between the 2 groups. While those undergoing continent diversion were on average younger and healthier than their counterparts receiving standard diversion, stratification of patients in each group according to age and a pre‐operative “fitness” score showed no significant difference in operative mortality or major morbidity between comparable patients in each group. The mean post‐operative length of hospital stay was, however, 3 days shorter for the youngest and fittest patients receiving standard versus continent urinary diversion.
A Prostatectomy Audit: Phase I–Insights and Questions
Authors: McKELVIE G. B. , MORISON M. , HEHIR M. , ROGERS A. C. N. 
Published: December 2008

SummaryA local prostatectomy audit is being undertaken to gain some insight into the pre‐and peri‐operative factors that inffuence post‐operative outcome and length of post‐operative stay. The aims of the first phase of the audit, involving 150 prostatectomy patients, have been to attempt to define the minimum data set required to meet the study's objectives, and to devise a data‐collecting tool that can be completed by the medical and nursing staff as part of the routine work. A tentative model has been devised to forecast post‐operative stay. The audit has raised a number of questions which will form the basis of further studies.
Detection of Lymph Node Invasion in Prostatic Carcinoma with Iliopelvic Lymphoscintigraphy
Authors: HORENBLAS S. , NUYTEN M. J. C. , HOEFNAGEL C. A. , MOONEN L. M. F. , DELEMARRE J. F. M. 
Published: December 2008

SummaryEleven patients, ranging in age from 58 to 79 years and referred for 125I implantation because of localised prostatic carcinoma, were subjected to iliopelvic lymphoscintigraphy (IPL) prior to lymph node dissection. Scintigraphy was performed by perianal injection into the ischiorectal fossa of 0.2 ml 99mTc radio‐labelled antimony sulphide colloid. The sensitivity of IPL was 100% and the specificity 13%, with a prevalence of positive nodes of 27%. It was concluded that IPL is not useful as a non‐surgical method of detecting lymph node invasion in localised prostatic carcinoma because of the low specificity.
Ureteric Stone Management Using a Second Generation Lithotriptor
Authors: MISHRIKI S. F. , WILLS M. I. , MUKHERJEE A. , FENELEY R. C. L. , GINGELL J. C. 
Published: December 2008

SummaryA series of 209 consecutive patients with ureteric calculi underwent 296 extracorporeal shock wave lithotripsy treatments on the Siemens Lithostar over a 25‐month period; 123 stones were upper ureteric, 30 mid‐ureteric and 56 lower ureteric; 46.9% were right‐sided stones, 53.6% were left‐sided and 0.5% (1 patient) were bilateral. On referral, 60 patients had stents and 15 had nephrostomies for obstruction. All treatments were performed without anaesthesia except for 9 patients in whom stent insertion or ureteroscopic manipulations were attempted concomitant to ESWL.The average number of treatments was 1.42, with 27.5% of patients requiring more than 1 treatment. The average number of shocks per treatment was 3995 and the average hospital stay was 1.79 days. Complete clearance of the stone was achieved in 82% of upper ureteric stones, 89% of mid‐ureteric and 80% of lower ureteric stones.The facility for X‐ray localisation of stones allows a high proportion of ureteric calculi to be treated successfully by ESWL, including the more taxing middle and lower ureteric calculi.
Age‐related Variation in Urinary Flow Variables and Flow Curve Patterns in Elderly Males
Authors: JØRGENSEN J. BALSLEV , JENSEN K. M. ‐E. , MOGENSEN P. 
Published: December 2008

SummaryA group of randomly selected males, over 50 years of age, was examined with regard to history and urinary flow rate. Originally, the group had comprised 93 men without voiding problems, 15 who, although suffering from voiding problems, had not yet contacted their doctor, and 4 who had contacted their doctor because of voiding problems. Five years later the data were re‐examined and 61 men were fully investigated again; in the remaining 51 patients only the history was updated. The 2 sets of data were evaluated separately as 2 cross‐sectional investigations and as paired data sets by means of non‐parametric statistical analysis.All uroflow variables were considered, i. e. Qmax, Qave, Qmax‐time, Q “corrected”, volume and the ratio Qmax/Qmax‐time. In addition, the flow curve configuration was classified as normal or abnormal.When compared as 2 cross‐sectional investigations, the latter confirmed the results of the first. Qmax, Qave, Q“corrected” and volume decreased with advancing age, but no correlation could be demonstrated between Qmax‐time and age. The flow curve pattern altered, so that a normal flow curve was seldom seem at an advanced age. Uroflow variables tended towards the abnormal with advancing years and symptoms increased concurrently. These changes were largely accepted by the elderly males. Thus the decision to operate for benign prostatic hyperplasia should be based on both history and urinary flow.
Identification of Metastatic Disease by T Category, Gleason Score and Serum PSA Level in Patients with Carcinoma of the Prostate
Authors: RANA A. , KARAMANIS K. , LUCAS M. G. , CHISHOLM G. D. 
Published: December 2008

SummaryPre‐operative serum prostate specific antigen (Tandem‐R assay), T category, Gleason score and the metastatic (M 1) status of a consecutive series of 60 patients with newly diagnosed carcinoma of the prostate were studied prospectively. The results revealed that, of these variables, pre‐operative serum PSA (> 100 ng/ml) was the single most important indicator of metastatic disease, with 100% predictive value. With this alone, 83.3% of M1 disease could be correctly identified. For the remaining 17%, however, we advocate a high index of suspicion if the tumour is T3‐T4 category on digital rectal examination (predictive value = 71.4%) and has a high grade with a Gleason score 8–10 (predictive value = 81%).
Value of Testicular Ultrasound in the Evaluation of Blunt Scrotal Trauma without Haematocele
Authors: MARTINEZ‐PIÑEIRO L. , CEREZO E. , COZAR J. M. , AVELLANA J. A. , MORENO J. A. , MARTINEZ‐PIÑEIRO J. A. 
Published: December 2008

SummaryThe value of ultrasound in testicular trauma with haematocele has been questioned inasmuch as the injured testis should always be explored surgically. Ultrasonography, however, plays an important role in the diagnosis and follow‐up of patients with blunt scrotal trauma without haematocele.We have evaluated 17 such patients with real‐time ultrasound. In 9 cases the testis and epididymis were normal to palpation, although in 6 of them parenchymal lesions, mainly subcapsular haematomas and parenchymal contusions not amenable to surgical intervention, were detected with ultrasonography. Seven patients presented with changes in the testicular or epididymal morphology at palpation and in 1 case the testes were not palpable.Ultrasonography was of great value, indicating surgery in 6 of these patients where physical examination alone was not sufficient to establish the need for surgical exploration.
Routine Radio‐imaging in Filarial Chyluria–Is it Necessary in Developing Countries?
Authors: DALELA D. , KUMAR A. , AHLAWAT R. , GOEL T. C. , MISHRA V. K. , CHANDRA H. 
Published: December 2008

SummaryChyluria is a common presentation of filariasis in developing countries and mostly affects economically poor classes. The judicious use of investigations is mandatory to keep the cost of treatment acceptable. A modified plan is suggested for managing such patients without using retrograde pyelography or lymphangiography.A total of 54 patients were studied at 2 separate institutions, with retrograde pyelography being carried out at one institution but not at the other. All patients were treated primarily by the instillation of 1% silver nitrate, with an initial success rate of 70%. Eight patients who failed to respond underwent pyelolymphatic disconnection, the success rate being 88%. The omission of retrograde pyelography and lymphangiography had no effect on either treatment or outcome. The value of these radio‐imaging techniques is discussed.
Fixation of a Single Testis: Always, Sometimes or Never
Authors: MISHRIKI S. F. , WINKLE D. C. , FRANK J. D. 
Published: December 2008

SummaryIf it is necessary to perform an orchiectomy for an intravaginal testicular torsion it is the usual practice of surgeons to fix the contralateral testis. When faced with a child with only one testis for another reason it is our practice to fix this single testis to eliminate the small but disastrous risk of a torsion. We were interested to see whether this practice was usual and therefore sent out a questionnaire to the 67 consultant paediatric surgeons and urologists in Great Britain. Sixty‐six surgeons replied. Seven surgeons (11%) always fix the single testis, 28 (42%) sometimes and 31 (47%) never fix a single testis. Five surgeons had looked after 6 patients who had a torsion of a second unfixed testis after losing the first for a reason other than intravaginal torsion. Four of these patients had initially had a neonatal supravaginal torsion, 1 had a torsion of an undescended testis and the sixth had severe testicular atrophy following an inguinal herniotomy.In our opinion the devastating loss of these solitary testes makes contralateral testicular fixation after an orchiectomy for whatever reason mandatory.
Delayed Linear Growth in Children with Enterocystoplasties
Authors: WAGSTAFF KAREN E. , WOODHOUSE C. R. J. , DUFFY P. G. , RANSLEY P. G. 
Published: December 2008

SummaryA series of 60 children whose urine was stored in pouches formed in whole or in part from bowel were reviewed to establish the effect on growth in height and weight. The mean age at operation was 7.8 years (range 0.9–14.1). Patients were included only if there were at least 2 measurements of both parameters pre‐operatively and 2 post‐operatively over a minimum follow‐up of 2.5 years. Delayed growth in height alone occurred in 12 children (20%), with a mean loss of 25 percentile points (range 10–50). Delayed growth in height and weight occurred in 4. Accelerated growth in height alone, weight alone and in both occurred in 2,7 and 7 respectively. There was no difference in a wide range of laboratory data between any of these groups.Although changes in growth rate (for better or worse) may occur for a variety of reasons after major surgery, delayed linear growth in isolation is an unusual and worrying finding that suggests a major alteration in bone development.
Pulsed Dye Laser Lithotripsy–the Toa Payoh Hospital Experience
Authors: NG F. C. , RAVI T. , LIM P. H. C. , CHNG H. C. 
Published: December 2008

Summary— We report our experience with pulsed dye laser lithotripsy in the treatment of 100 ureteric stones in 95 patients over a 14‐month period from July 1989 to September 1990.The overall rate of successful stone fragmentation was 97%. There was a low incidence of minorcomplications–mild haematuria, ureteric colic and urinary tract infection; ureteric perforation occurred in only 3 patients, all of whom were successfully treated conservatively.Pulsed dye laser lithotripsy is a safe and effective mode of treatment for ureteric stones. Currentindications for laser fragmentation of stones are ureteric stones, impacted pelviureteric junction stones and Steinstrasse.
Percutaneous Nephrolithotripsy for Renal Stones in over 1000 Patients
Authors: EL‐KENAWY M. R. , EL‐KAPPANY H. A. , EL‐DIASTY T. A. , GHONEIM M. A. 
Published: December 2008

Summary— Over a period of 5 consecutive years, 1039 renal units were treated by percutaneous nephrolithotripsy for stone disease of the kidney. The success rate was 93.7%. Residual stones remained in 4.2% of patients and in 2.1% we failed to remove the stones. The complication rate was 17.8%. Complications were treated conservatively in most cases but nephrectomy was required on one occasion to control severe bleeding. The average hospital stay was 6.9 days.Follow‐up of 339 renal units (333 patients), for a minimum of 60 months, revealed minor late sequelae such as pelviureteric junction obstruction in 1 patient (0.3%) and post‐catheterisation strictures of the anterior urethra in 4 (1.2%). Stone recurrence was observed in 9.1% of patients.Percutaneous nephrolithotripsy is an effective, safe treatment for renal stones with minimal late sequelae and is still required even in the era of extracorporeal shock wave lithotripsy.
Natural History and Prognosis of Prostate Carcinoma in Adolescents and Men under 35 Years of Age
Authors: SANDHU D. P. S. , MUNSON K. W. , BENGHIAT A. , HOPPER I. P. 
Published: December 2008

Summary— Prostate cancer is extremely rare in men under 35 years of age. The tumour is invariably poorly differentiated and aggressive, with rapidly growing bulky soft tissue metastases and negative tumour markers. Bone metastases develop late and are usually osteolytic. The disease responds poorly to radiation or hormonal therapy and is too advanced at presentation for radical surgery. Chemotherapy appears to be of some benefit, though in the majority of cases death occurs within a year.We describe a 3 1‐year‐old man with carcinoma of the prostate. A review of the literature is presented. This is the first patient in whom the epithelial origin of the prostate cancer was confirmed by immunoperoxidase staining with prostatic specific antigen. Plasma prostatic specific antigen was normal despite a large tumour burden and widespread metastases. He did not respond to conventional treatment.The phenotypic expression and biological behaviour of these tumours are distinct from those occurring in men beyond the fourth decade.
Effect of Vaginal Ultrasound Probe on Lower Urinary Tract Function
Authors: WISE B. G. , BURTON G. , CUTNER A. , CARDOZO LINDA D. 
Published: December 2008

Summary— Vaginal ultrasonography has been advocated as an alternative to videocystourethrography. Ultrasound avoids the potential risks of X‐rays and reduces the cost of equipment. We have investigated the effect of the vaginal probe on the physiology of the bladder and urethra. A series of 24 women underwent urethral pressure profilometry, with and without a vaginal probe in situ. There was a significant increase in maximum urethral pressure, functional urethral length and area under the profile curve both at rest and during stress in the presence of the device. This was due to stretching and compression of the urethra by the probe. Transmission pressure ratios were significantly increased for the first 3 quartiles of the urethra.Twenty women underwent lateral bead chain urethrocystography with and without a vaginal probe. At rest, the probe resulted in elevation of the bladder neck and apposition to the symphysis pubis, and during a Valsalva manoeuvre the descent of the bladder neck was restricted by the presence of the probe. These results indicate that a vaginal probe alters the position and function of the lower urinary tract. We postulate that incontinence is reduced as a result of the probe. The use of vaginal ultrasonography in the assessment of women with urinary incontinence is therefore not recommended.
Detrusor Mast Cells in Refractory Idiopathic Instability
Authors: MOORE KATE H. , NICKSON P. , RICHMOND D. H. , SUTHERST J. R. , MANASSE P. R. , HELLIWELL T. R. 
Published: December 2008

Summary— The diagnosis of interstitial cystitis (IC) is not usually considered in patients with idiopathic instability. Because histamine provokes detrusor contractions in vitro, we assessed detrusor mast cell counts in 29 females with refractory instability. Raised mast cell counts (> 28/mm2 of detrusor muscle, consistent with a histological diagnosis of IC) were found in 29% of such cases. Thus cystoscopy and bladder biopsy should be considered in patients with idiopathic instability which fails to respond to anticholinergic drugs, as alternative therapy may be useful.Patients with refractory instability and normal detrusor mast cell counts often gave a history of prolonged childhood nocturnal enuresis (55% of cases); in contrast, patients with intractable instability and abnormally high mast cell counts seldom gave such a history (12%). These trends may give some insight into the aetiology of idiopathic instability—“congenital” or acquired?
Male and Female Sexual Function and Activity Following Ileal Conduit Urinary Diversion
Authors: NORDSTRÖM G. M. , NYMAN C. R. 
Published: December 2008

Summary— A group of 66 patients (40 males, 26 females) underwent an ileal conduit urinary diversion because of bladder cancer (44 patients) or incontinence/bladder dysfunction (22). They were questioned about pre‐and post‐operative sexual function and activity and it was found that 90% of the males (26/29) who were sexually active before surgery lost the ability to achieve erection following radical cystectomy. Although they were unable to achieve penile erection, 41% were able to experience orgasm by means of masturbation. Five of the 29 males received penile implants. Five of the 6 females treated by cystectomy, who were sexually active before the operation, reported either a decrease or cessation of sexual activity (i.e. coitus) post‐operatively.The main problems were a decrease in sexual desire, dyspareunia and vaginal dryness. One women reported the inability to experience orgasm after surgery. Compared with women with bladder cancer, those with incontinence/bladder dysfunction were more likely to have an active sexual life after urostomy surgery. Seven females in this group, of whom 4 were sexually inactive before surgery, increased their sexual activity after the operation. For these women the conduit operation removed the need to use incontinence pads or indwelling catheters.
Vacuum constriction devices in erectile dysfunction: acceptance and effectiveness in patients with impotence of organic or mixed aetiology
Authors: VRIJHOF H.J.E.J. , DELAERE K.P. J. 
Published: December 2008

Objective To investigate the value of vacuum constriction devices in the treatment of erectile dysfunction.Patients and methods A total of 67 patients were treated with vacuum constriction devices. The impotence was of organic origin in 36 men (54%) while in the remaining 31 (46%) it was of mixed aetiology (organic and psychological factors). Forty‐seven patients continued to use the device at home for the duration of the practice period.Results All 67 patients underwent a vacuum test which resulted in nearly half of them achieving an erection sufficient for intercourse. Adequate erections were achieved in 34 of 47 (72%) patients who used the device at home during the practice period. In the group of patients with organic impotence (venous leakage), rigidity was better and the frequency of' intercourse higher than in patients with diabetes and in those with neurogenic disorders.Conclusion These findings support further the role for vacuum devices for the treatment of erectile dysfunction in carefully selected patients.
Fathers’ narratives of reducing and quitting smoking
Authors: Bottorff Joan L. , Radsma Jenny , Kelly Mary , Oliffe John L. 
Published: December 2008

AbstractDespite much attention on women's efforts to reduce or stop smoking during pregnancy and postpartum, less attention has been directed to fathers’ experiences in modifying their smoking. Using narrative methods, interviews with 29 new fathers were examined to identify different ways in which men approached reducing or quitting smoking. Four storylines were identified: the cold turkey storyline framed quitting smoking as a snap decision with no need for support or smoking cessation aids; the planned reduction storyline focused on building up reasons to quit and developing detailed strategies to enhance the likelihood of success; the baby as the patch storyline dramatised how the baby displaced the need to smoke, increased motivation for cessation and enhanced success; and, finally, a story of forced reduction that highlighted difficulties with smoking cessation for a highly addicted smoker and the tension and conflict this created in his relationship with his partner. Common to all the storylines was the men's reluctance to rely on smoking cessation resources; instead, self‐reliance, willpower, and autonomy figured more prominently in their narratives. The findings from this study support developing gender‐sensitive tobacco reduction interventions for fathers who smoke.