bluuebunny/crossref_metadata_2025_split huggingface dataset:
Should Stamey colposuspension be our primary surgery for stress incontinence?
Authors: O'Sullivan D.C. , Chilton C.P. , Munson K.W. 
Published: November 2008

Objective To evaluate the outcome of the Stamey procedure for stress incontinence and to decide if it is an acceptable first‐line option for the treatment of patients. Patients and methods Between June 1987 and March 1993 67 women had Stamey bladder neck suspension carried out for the treatment of stress incontinence. In September 1993 all patients received a detailed questionnaire to ascertain their present status. Results Immediately after surgery 70% of patients were dry and 15% were much improved. At 6 months 56% of patients were dry and 21% were much improved. More than 1 year following surgery, of 58 patients responding only 31% were dry and 28% were much improved. More than 5 years after surgery only 18% of the 28 women responding were dry. The factors which were significantly associated with failure were obesity (P< 0.005) and the number of pads used per day (P<0.05). Previous surgery may also be an important factor. Conclusion The Stamey vesical neck suspension has a good early success rate but the results in the longer term are not acceptable. This operation should not be used as a first‐line treatment for stress incontinence and should be reserved for specific patient subgroups.
Correlation of morphometry, nucleolar organizer regions, proliferating cell nuclear antigen and Ki67 antigen expression with grading and staging in urinary bladder carcinomas
Authors: Krüger S. , Müller H. 
Published: November 2008

Objective To investigate the correlation of four different indicators of proliferation — mean nuclear area (MNA) morphometry, nucleolar organizer region (NOR) count, proliferating cell nuclear antigen (PCNA) and Ki67 antigen expression — in specimens of invasive and non‐invasive urinary bladder carcinomas with the grading and staging of the tumour and to determine which indicator is most suitable for discriminating between non‐invasive and invasive carcinomas. Materials and methods Biopsies of 58 urinary bladder carcinomas of different grade and stage (38 invasive, 20 non‐invasive) and 11 carcinomata in situ were included in the study. Ten specimens of normal bladder mucosa served as controls. Analysis of indicators was performed on sequential serial paraffin sections of the same tissue, applying each test once to one of four serial sections. Results In comparison to normal bladder mucosa the values of the four indicators were significantly greater (P<0.001) in all carcinomata in situ and in carcinomas. Values also increased from grade 1 to grade 3 carcinomas, but indicator values were similar for carcinomata in situ and grade 2 carcinomas. All indicators correlated with each other and allowed a significant discrimination between grade 1 and 2 or grade 2 and 3 carcinomas. Non‐invasive carcinomas (Ta) showed a significantly lower proliferative activity (P< 0.001) than invasive carcinomas but there were overlapping values within the invasive carcinomas (T1, T2 and T3/4). Conclusions MNA, NOR count, PCNA index and Ki67 index could be correlated with tumour grade, but not with stage, of transitional bladder carcinoma. Of the indicators studied the Ki67 antigen was the most useful in differentiating between invasive and non‐invasive carcinomas. This could be of prognostic relevance, especially for the heterogeneous group of grade 2 carcinomas.
Computerized analysis of transrectal ultrasonography images in the detection of prostate carcinoma
Authors: de la Rosette J.J.M.C.H. , Giesen R.J.B. , Huynen A.L. , Aarnink R.G. , Debruyne F.M.J. , Wijkstra H. 
Published: November 2008

Objective To report on the use of automated image analysis in the interpretation of transrectal ultrasono‐graphic images of the prostate. Patients and methods During transrectal ultrasonography, images were recorded from biopsies performed in 127 patients. Subsequently in the image, the puncture place was marked and analysed. Analysis of the images was performed with the Automated Urologic Diagnostic Expert (AUDEX) system, consisting of a personal computer connected to the ultrasound machine. From the images collected, parameters can be calculated for image classification. The parameters obtained with this procedure were correlated with the histological result. Results Evaluation showed a sensitivity of 84.8% and specificity of 87.5%. The positive and negative predictive values, to predict prostate carcinoma, were 84.8% and 87.5%, respectively. Conclusion Automated image analysis can help in the diagnosis of prostate carcinoma. In patients with non‐palpable lesions or with poorly visualized tumours, image analysis is superior to the standard current diagnostic techniques.
Nitric oxide and cyclic GMP formation following relaxant nerve stimulation in isolated human corpus cavernosum
Authors: Pickard R.S. , Powell P.H. , Zar M.A. 
Published: November 2008

Objective To investigate further the role of the nitric oxide (NO)‐cyclic GMP pathway as the mediator of relaxant neurotransmission in human corpus cavernosum and to establish whether impaired activity of this pathway contributes to the pathophysiology of impotence. Patients and methods Samples of cavernosal tissue were obtained from 59 men undergoing penile operations. The controls comprised four men with penile carcinoma and 17 with Peyronie's disease. Of the impotent men, 35 had clinical evidence of penile vascular disease on pre‐operative investigation, whilst three had non‐vascular impotence. Each biopsy was divided into two strips which were then suspended under tension in organ bath chambers. The relaxant inner‐vation of one strip of each pair was stimulated electrically whilst the other strip was left unstimulated. The formation of NO and cyclic GMP was calculated by comparing their respective tissue content in the stimulated and unstimulated strips. Results Overall, stimulation of the relaxant innervation produced significant increases in the tissue content of both NO and cyclic GMP. Incubation with an inhibitor of NO biosynthesis abolished the mechanical relaxant response and the formation of both NO and cyclic GMP. The magnitude of relaxant response and the formation of NO was diminished in tissue from men with vascular impotence compared to controls. The increase in cyclic GMP content was similar in both these groups. Relaxant response, NO formation and cyclic GMP formation in tissue from men with non‐vascular impotence was similar to controls. Conclusions This study provides further evidence that the NO‐cyclic GMP pathway acts as the mediator of nerve‐evoked smooth muscle relaxation in human corpus cavernosum. Diminished NO formation following relaxant nerve stimulation may account for impaired relaxant responses found in tissue from men with vascular impotence and may contribute to the cause of their erectile dysfunction.
‘Congenital’ hydronephrosis: limitations of diagnosis by fetal ultrasonography
Authors: Rickwood A.M.K. , Harney J.V. , Jones M.O. , Oak S. 
Published: November 2008

Objective To determine whether children presenting clinically with pelvi‐ureteric junction obstruction had fetal hydronephrosis. Patients and methods Forty‐three children, born during or after 1985, presented clinically with pelvi‐ureteric junction obstruction. Records of the maternal pregnancies were reviewed with reference to the findings of any fetal ultrasonography. Results In 25 patients fetal ultrasonography was per‐formed at or beyond 30 weeks' gestation (mean 33.2). None had significant fetal hydronephrosis. Conclusion Hydronephrosis due to pelvi‐ureteric obstruction is not necessarily congenital and patients presenting clinically may differ inherently from those detected fetally.
Percutaneous cryosurgery for renal tumours
Authors: Uchida M. , Imaide Y. , Sugimoto K. , Uehara H. , Watanabe H. 
Published: November 2008

Objective To evaluate the use of percutaneous cryosurgery in the treatment of renal tumours. Materials and methods A cryoprobe using liquid nitrogen was designed. The tolerance of renal cancer cells to cooling was tested. Freezing tests on two extirpated kidneys involved with hypervascular tumour were performed in water at 40d̀C. A clinical trial of percutaneous cryosurgery was carried out in two patients with advanced renal carcinoma. Results The cooling function of the new probe was similar to that of a conventional probe. The tolerance test on renal cancer cells showed that the cooling temperature should be below — 20d̀C to render them necrotic. Freezing tests on two nephrectomized kidneys with hypervascular renal cancer suggested that embolization of the renal artery might be advisable before treatment. The clinical trial in two patients with advanced renal carcinoma showed that the whole kidney, including the tumour, became necrotic and shrunken post‐operatively. The patients' Karnofsky performance scale showed a marked improvement 3 months after the operation, but their general condition gradually deteriorated. Patient 1 died 10 months and patient 2 died 5 months after the procedure. Conclusion Percutaneous cryosurgery was performed successfully in two patients with hypervascular renal tumours. Cryo‐immunological activity was assumed to have contributed to the temporary improvement in their condition. These results suggest that percutaneous cryosurgery might be useful as minimally invasive treatment in a limited number of patients with advanced renal carcinoma.
The persistence of bacille Calmette‐Guerin in the bladder after intravesical treatment for bladder cancer
Authors: Bowyer L. , Hall R.R. , Reading J. , Marsh M.M. 
Published: November 2008

Objective To determine the incidence of bacille Calmette‐Guerin (BCG) bacilli persisting in the urinary tract of patients treated previously with intravesical BCG for carcinoma in situ or multiple Ta.T1 transitional cell carcinoma. Patients and methods One‐hundred and twenty‐five patients were treated at the Freeman Hospital, Newcastle upon Tyne, UK over an 8‐year period, 90 of whom submitted early morning urine samples for culture for acid‐fast bacilli at varying intervals following BCG treatment. The records of all patients were reviewed to determine the incidence of caseating granulomata containing acid‐fast bacilli together with the incidence of toxicity and the outcome of treatment. Results Five patients were found to have persisting acid‐fast mycobacteria in their urine or bladder up to 16.5 months after completing intravesical instillations of BCG. In one patient this probably accounted for bladder symptoms that required palliative cystectomy. In four patients the ‘infection’ was not severe. Two patients were treated with antituberculous chemotherapy without complication. Three years after intravesical BCG therapy 36 of 69 patients (52%) had remained tumour free. Conclusion BCG organisms can persist in the urinary tract for at least 16.5 months after the completion of intravesical BCG instillation therapy.
Superficial bladder cancer: for how long should a tumour‐free patient have check cystoscopies?
Authors: Morris S.B. , Gordon E.M. , Shearer R.J. , Woodhouse C.R.J. 
Published: November 2008

Objective To determine the probability of a patient with superficial bladder cancer developing a recurrent tumour after having remained tumour free for 2 or more years. Patients and methods One‐hundred and seventy‐nine patients with Ta or T1 tumours at diagnosis, a minimum follow‐up of 3 years and a minimum of 2 years remaining tumour free were identified. Thirteen patients had more than one episode that was eligible for inclusion and there were therefore 192 tumour‐free episodes for analysis. Survival curves of the probability of being recurrence‐free against time were constructed for the whole group, for subgroups of Ta and T1 tumours and for subgroups with characteristics at diagnosis suggesting a good, intermediate and poor prognosis. Results The probability of a patient developing a recurrence after 2, 5 and 10 years of being tumour free was 43, 22 and 2% respectively. No patient had a recurrence after remaining tumour free for 12 years. No patient who had been tumour free for at least 2 years progressed to muscle invasion or metastases. There was no significant difference in the probability of recurrence between Ta and Tl tumours after 2 years of remaining tumour free. Conclusion The optimum length of cystoscopic follow‐up for patients with superficial bladder cancer is unknown, but patients continue to develop recurrences even after many years of being tumour free. If a patient is to discontinue cystoscopic follow‐up, then alternative methods of assessment should be applied.
Use of the rectus abdominis myocutaneous flap in treating advanced carcinomas of the penis
Authors: Thomas J.A. , Matanhelia S.S. , Dickson W.A. , Rees R.W.M. , Matthews P.N. 
Published: November 2008

Objective To examine the methods used to obtain skin closure after radical surgery for carcinomas of the penis, with special reference to the rectus abdominis myocutaneous flap. Patients and methods Over a 20 year period, 21 patients underwent surgery for carcinomas of the penis. Seven had advanced tumours, requiring radical surgery for complete local tumour control. The resulting wounds were repaired with scrotal skin transfer in three patients and with a rectus abdominis myocutaneous flap in the other four. Results These methods of repair were a 100% reliable, all wounds being healed within 10 days. Conclusions Scrotal skin transfer is a simple and effective method of achieving wound closure. Where removal of the scrotum is required along with curative or palliative surgery, and after ilio‐inguinal lympha‐denectomy, a rectus abdominis myocutaneous flap is useful for skin closure.
The role of histamine in human penile erection
Authors: Cará A.M. , Lopes‐Martins R.A.B. , Antunes E. , Nahoum C.R.D. , De Nucci G. 
Published: November 2008

ObjectiveTo investigate the relaxant action of histamine on human corpus cavernosumin vitroand the erectile response caused by the intracavernous injection of histamine in patients with psychogenic impotence.Patients and methodsHuman corpus cavernosum (HCC) tissue was cut into strips of approximately 2 cm and suspended in a cascade bioassay. The strips were then superfused with oxygenated and warmed Krebs solution and precontracted with nor adrenaline (3 μm). Glyceryl trinitrate, acetylcholine and histamine were injected as a single bolus in the absence or in the presence of mepyramine and cimetidine. For the in vivo studies, histamine (30–60 μg) was injected intra‐cavernously as a single bolus into the right corpus cavernosum 1 cm from the balamo‐preputial sulcus. Similar protocols were carried out for papaverine (50 mg). The erectile response was divided into four grades: no response, tumescence, partial and full erection.ResultsIn vitrostudies demonstrated that histamine (3–100 μg) caused dose‐dependent relaxation of the HCC strips which was significantly inhibited by cimetidine (5–10 μm). The histamine H1receptor antagonist mepyramine (1 μm) potentiated histamine‐induced relaxation. The co‐infusion of both mepyramine and cimetidine did not abolish histamine‐induced relaxation. When injected intracavernously in humans, histamine (30 μg) caused full erection in 13% of the patients, whereas 87% had partial erection or tumescence. A higher dose of histamine (60 μg) caused full erection in 26% of the patients and 74% had partial erection or tumescence. Papaverine induced full erection in the majority of patients (66%). In contrast to papaverine, the duration of erection induced by histamine was markedly shorter (mean 200 and 6.5 min, respectively). The penile erections induced by papaverine were associated with complications such as pain, haematoma and priapism. Histamine did not induce any complications. Treatment of eight male patients with psychogenic impotence with the histamine H1receptor antagonist astemizol (10 mg orally once daily for 1 week) did not affect histamine‐induced erectile responses.ConclusionThese results indicate that histamine may play a role in human penile erection. The erection‐promoting action of histamine is probably due to H2receptor activation, although another histamine receptor, possibly H3, also seems to be involved. This study suggests that histamine could be a valuable tool in the diagnosis of erectile dysfunction.
Clinical and anatomopathological study of 2000 cryptorchid testes
Authors: Gracia J. , González N. , Gómez M.E. , Plaza L. , Sáanchez J. , Alba J. 
Published: November 2008

Objective To establish whether age at the time of surgery and location of the testes help to determine the anatomopathological lesions. Patients and methods Between 1972 and 1992 surgery was performed on 2000 testes in 1342 children, 658 of whom had bilateral cryptorchidism. The clinical, surgical and anatomopathological records were reviewed. Results Parametric and non‐parametric tests failed to reveal any relation between the tubular fertility index or tubular diameter and the time of surgery or testicu‐lar location. Conclusion We cannot recommend a particular age at which surgery should be performed, in relation to the anatomopathological damage.
Congenital testicular maldescent: significance of the complete hernial sac
Authors: Donnell S.C. , Rickwood A.M.K. , Jee L.D. , Jackson M. 
Published: November 2008

Objective To test the hypothesis that testicular maldescent is rarely congenital in the absence of a complete hernial sac. Patients and methods The study comprised 110 boys undergoing orchidopexy. Operative findings (complete hernial sac versus no hernial sac) were compared with recorded testicular descent at birth. Results Among 70 testes recorded as maldescended neonatally there was no example without a complete hernial sac at orchidopexy. Among 60 recorded as descended neonatally, 43 had no sac at orchidopexy. Conclusions The findings are consistent with the hypothesis, though not with the proposition, that the presence of a complete hernial sac at orchidopexy constitutes proof of congenital testicular maldescent.
Early catheter removal: a prospective study of 100 consecutive patients undergoing transurethral resection of the prostate
Authors: Dodds L. , Lawson P.S. , Crosthwaite A.H. , Wells G.R. 
Published: November 2008

Objective To determine whether early catheter removal after transurethral resection of the prostate (TURP) leads to early hospital discharge with no increase in complications. Patients and methods From October 1992 50 consecutive patients undergoing TURP in each of two hospitals were catheterized for <24 h or > 36‐48 h after the operation. Patients were followed up to assess the frequency and extent of post‐operative complications. Results The two groups, which were standardized as far as possible, had a similar outcome whether the catheter was removed within 24 h or >36 h after TURP. Conclusion Brief catheter drainage after TURP is safe and allows an earlier discharge from hospital than the standard duration of catheterization.
High failure rate associated with long‐term follow‐up of neoadjuvant androgen deprivation followed by radical prostatectomy for stage C prostatic cancer
Authors: Cher M.L. , Shinohara K. , Breslin S. , Vapnek J. , Carroll P.R. 
Published: November 2008

Objective To evaluate whether neoadjuvant androgen deprivation before radical prostatectomy decreases tumour stage in patients with stage C prostatic cancer and to estimate the efficacy of cancer control achieved with this form of treatment. Patients and methods Thirty men (mean age 65 years, range 52‐74) with clinical stage C adenocarcinoma of the prostate were included in a phase II trial of neoadjuvant androgen deprivation (luteinizing hormone‐releasing hormone agonist and an anti‐androgen) before radical prostatectomy. The timing and extent of the changes in serum prostate specific antigen (PSA) levels and both prostate and cancer volume were recorded. Twenty‐six men underwent radical prostatectomy with pelvic lymphadenectomy, two had pelvic lymphadenectomy alone, one had pelvic lymphadenectomy with radiotherapy and one refused additional treatment despite significant reductions in tumour volume and PSA while undergoing androgen deprivation. Results The toxicity of the treatment was low. Significant reductions in prostatic volume (mean 35%), tumour volume (mean 50%) and PSA concentrations (mean 96%) occurred in all patients, with the maximum reductions recorded during the first 2 months of androgen deprivation. However, despite significant physiological changes in prostate and tumour volume, tumour stage was reduced in only four patients. Of the patients who were surgically staged 41% were ultimately identified as having more advanced disease, including lymph node metastases in 21%. Overall, with a mean follow‐up of 32.7 months, 72% of patients had evidence of disease recurrence, including detectable PSA. Of 26 patients who underwent radical prostatectomy, local recurrence occurred in five (19%), distant recurrence in one (4%) and both local and distant recurrence in one (4%). Conclusions This study suggests that tumour stage reduction is uncommon in patients with stage C prostatic cancer treated with neoadjuvant androgen deprivation followed by radical prostatectomy, Furthermore, local and distant recurrences, as well as detectable levels of PSA, are common after such treatment.
Bladder transection revisited
Authors: Crooks J.E. , Khan A.B. , Meddings R.N. , Abel B.J. 
Published: November 2008

Objective To ascertain the safety and effectiveness of bladder transection for the treatment of enuresis and urinary frequency.Patients and methods Twelve patients who had an open bladder transection performed at the Victoria Infirmary, Glasgow, were followed up for a mean of 37 months.Results Of the 12 patients, three were ‘cured’, seven were better, two were no better and none were worse than before the operation. All six patients with pre‐operative enuresis were cured of this by the procedure.Conclusions Bladder transection remains a useful procedure in selected patients and avoids the problems associated with enterocystoplasty.
Electrolyte homeostasis in urothelial neoplasia: the effects of amiloride
Authors: Cartman M.L. , Morris J.A. , Huddart H. , Staff W.G. 
Published: November 2008

Objective To investigate the effect of amiloride pre‐incubation on the intracellular electrolyte levels in neoplastic and non‐neoplastic urothelium.Materials and methods Samples of papillary transitional cell carcinomas (grades 1 and 2) and non‐neoplastic human urothelium were either frozen immediately or after pre‐incubation with Krebs saline alone or with Krebs saline containing amiloride. The frozen samples were planed in a cryo‐ultramicrotome and then examined by low temperature scanning electron microscopy. Intracellular electrolyte levels were measured using X‐ray microanalysis.Results In the cells frozen immediately the ratios K+/Na+, K+/P and K+/Cl‐ were significantly increased in neoplastic compared with non‐neoplastic urothelial cells (P<0.001). This difference was also found in the cells pre‐incubated with Krebs saline alone but was not present in the cells pre‐incubated with amiloride.Conclusions These results were consistent with the concept that activation of the amiloride‐sensitive Na+/H + membrane exchanger is a primary event in neoplasia.