bluuebunny/crossref_metadata_2025_split huggingface dataset:
Treatment of Vesicoureteric Reflux in the Neurogenic Bladder
Authors: MERLINI E. , BESEGHI U. , DE CASTRO R. , PERLASCA E. , PODESTA E. , RICCIPETITONI G. 
Published: November 2008

Summary A retrospective co‐operative study was conducted among 6 Italian paediatric surgical departments to assess the results of different forms of treatment of vesicoureteric reflux in patients with neurogenic bladder.Between January 1980 and December 1989 we studied 641 neurogenic bladders in children, mainly due to spina bifida; reflux was detected in 199 patients with 263 refluxing ureters. Details of treatment were available for only 170 patients and they were divided into 2 main groups: conservative medical treatment (n = 127) and primary surgical treatment (n = 43). Medical treatment consisted mainly of clean intermittent catheterisation and the administration of appropriate drugs. In the surgical group 36 reimplantations, 6 cystostomies and 1 STING were performed. Fifteen patients underwent surgery as a secondary procedure.The results showed that approximately 50% of patients with reflux were cured by clean intermittent catheterisation and drug therapy. Ureteric reimplantation can be safely performed in patients with neurogenic bladder provided that a normally compliant, non‐hyper‐reflexic bladder can be achieved by means of drugs or by bladder augmentation with bowel.
The effects of various indwelling JJ stents on renal pelvic pressure and renal parenchymal thickness in the pig
Authors: CORMIO L. , KOIVUSALO A. , MAKISALO H. , WOLFF H. , RUUTU M. 
Published: November 2008

Objective To determine whether indwelling JJ stents significantly alter renal pelvic pressure and consequently have deleterious effects on renal function.Materials and methods Thirteen piglets were used totalling 26 renal units. Using an open, sterile surgical procedure, 23 renal units were stented with 6F JJ catheters of eight different types; three renal units were not stented and served as controls. Intra‐pelvic pressure values during diuretic stress were measured before and after 6 weeks of intubation. The kidneys were then removed and sent for pathological evaluation of renal parenchymal thickness.Results A marked increase in intra‐pelvic pressure values was found in two of the 19 stented renal units suitable for this measurement. A significant reduction (more than one third with respect to the control values) in renal parenchymal thickness was found in six of the 21 stented renal units suitable for this measurement, three of which had been intubated with a Cook polyurethane stent and three with an Angiomed Puroflex stent.Conclusion In the present experimental study some JJ stents seemed to cause long‐lasting changes in renal pelvic pressure and consequently to have deleterious effects on renal function. Although experimental findings are not always fully related to clinical practice, a knowledge of the potential effects of these prostheses is essential to minimize complications related to their use.
Autoaugmentation gastrocystoplasty: early clinical results
Authors: DEWAN P.A. , STEFANEK W. 
Published: November 2008

Objective To assess the urodynamic and clinical outcome of five patients following an autoaugmentation gastrocystoplasty.Patients and methods Four patients, two boys and two girls aged between 8 and 16 years, with a neuropathic bladder and incontinence, and one boy, aged 16 years, with an ileal conduit were included in the study. The bladder augmentation technique combined autoaugmentation and the addition of a demucosalized patch of gastric muscle to the created bladder diverticulum.Results All patients have improved bladder function, although one may require further surgery. Three had temporary difficulty tolerating full meals.Conclusions This new technique seems to have a place in the management of the neuropathic bladder, but further laboratory study and cautious clinical application is required to ascertain its role in bladder augmentation.
Interferon as adjunctive treatment for non‐metastatic renal cell carcinoma
Authors: TAKAHASHI S. , TANIGAWA T. , IMAGAWA M. , MIMATA H. , NOMURA Y. , OGATA J. 
Published: November 2008

Objective To investigate the effect of recombinant α2binterferon therapy on natural killer (NK) activity and antibody‐dependent cell‐mediated cytotoxicity (ADCC) in the peripheral blood in patients with renal cell carcinoma who had undergone radical nephrectomy.Patients and methods Between January 1988 and June 1989, 20 patients (14 men and six women, mean age 59 years, range 43–80) received interferon (IFN) therapy following radical nephrectomy for renal cell carcinoma. Thirteen patients had stage I disease, one had stage II and six had stage III; none had metastases.Results There was a significant increase in NK activity at 5 and 7 months after starting IFN therapy but there was no increase in ADCC.Conclusions Low doses of IFN administered long‐term increased NK activity in patients with renal cell carcinoma. This finding should be helpful in designating protocols for randomized studies of post‐operative IFN administration as adjuvant therapy.
The influence of banana stem extract on urinary risk factors for stones in normal and hyperoxaluric rats
Authors: POONGUZHALI P. K. , CHEGU H. 
Published: November 2008

Objective To study the effect of banana stem (Family Musaceae) extract on urinary risk factors in an animal model of hyperoxaluria.Materials and methods Thirty male rats were divided into five groups of six rats each. The rats in Group I acted as the control, in Group II rats hyperoxaluria was induced using sodium glycollate, Group III were given aqueous banana stem extract alone, Group IV were given both sodium glycollate and aqueous banana stem extract and Group V were given sodium glycollate alone followed by aqueous banana stem extract. Urine analysis (24 h) was carried out to determine the levels of calcium, phosphorous, oxalate, glycollic acid and glyoxylic acid in each of the five groups.Results In the rats treated with aqueous banana stem extract, urinary oxalate excretion was significantly reduced when compared with the controls. The extract reduced urinary oxalate, glycollic and glyoxylic acid and phosphorus excretion in the hyperoxaluric rats. The extract appeared to have no effect on urinary calcium excretion.Conclusion Banana stem extract from the Musaceae family may be a useful agent in the treatment of patients with hyperoxaluric urolithiasis.
Chronic hydronephrosis: renographic drainage patterns and renal morphology in an animal model
Authors: BOWEN J. , SHARMA H. , GOUGH D.C.S. 
Published: November 2008

Objective To develop an animal model of chronic progressive hydronephrosis; to establish patterns of diuretic renography during development of the condition; and to relate renographic abnormality to morphological change in the renal parencyma.Materials and methods The cellophane sclerosis technique was used to produce a hydronephrosis in the left kidney of six rabbits. Post‐operatively MAG3 diuretic renography was performed at weekly intervals. When a steady renographic trend was noted the rabbits were killed and the kikneys examined histologically.Results Four rabbits had persistent type II renogrphic curves on the left for 12 weeks. The measured split renal function fell steadily to <20% in this time. Morphologically there was hydronephrosis with marked structural changes in the parenchyma seen on histological examination. Two rabbits had stable type IIIa renographic drainage patterns on the left with preserved renal function. Morphologically there was hydronephrosis but histologically the kidneys were normal. There were no renographic or structural changes in a control rabbit after a sham laparotomy.Conclusions The cellophane sclerosis technique can be used to create a reproducible chronic progressive hydronephrosis. In this animal model hydronephrosis and a persistent type II curve are associated with renographic evidence of deteriorating renal function and disruption of renal architecture histologically. Hydronephrosis and a type IIIa curve are associated with preservation of normal renal function and histological structure.
The invaginated sleeve technique for a continent cystostomy — five years' clinical experience
Authors: GARDINER R.A. 
Published: November 2008

Objective To evaluate the invaginated sleeve technique for continent cystostomy in humans.Patients and methods Over the past 5 years six patients have undergone this operative procedure. An essential principle utilized in the technique is the property of partial thickness bladder grafts to stretch longitudinally, so that each tubularized pedicle graft could be directed transmurally and extended extravesically to reach the skin of the lower abdominal wall. As a consequence a urothelial‐lined tract, both extravesically and through the bladder wall, was provided for intermittent self‐catheterization.Results A part from one woman, whose cystostomy tract was disrupted by inappropriate catheterization in the immediate post‐operative period to attempt to stop leakage through exposed fenestrations in the suprapubic stent, this procedure provided robust, continent catheterizing routes for all patients for periods of 63, 52, 12, 7 and 1.5 months respectively. Two patients developed discrete stenoses at their mucocutaneous junctions at 3 and 5 months which were corrected easily.Conclusion This simple, minimally morbid technique, which avoids the use of non‐urinary tract epithelial structures and maintains bladder capacity, is strongly recommended for patients who need to practise clean intermittent self‐catheterization and for whom the urethral route is impracticable.
A new, large calibre, self‐expanding and self‐retaining temporary intraprostatic stent (ProstaCoil) in the treatment of prostatic obstruction
Authors: YACHIA D. , BEYAR M. , ARIDOGAN I. A. 
Published: November 2008

Objective To determine the benefits of a new selfexpanding and self‐retaining large calibre temporary intraprostatic coil stent in patients with bladder outflow obstruction due to benign prostatic hypertrophy.Patients and methods Sixty‐five patients with bladder outflow obstruction have been studied with a followup period of 3–28 months (mean 16).Results Thirty patients became eligible for surgery and had their stent removed without difficulty 3–12 months after stent insertion. Only one stent was removed because of urgency and incontinence. Stent repositioning was required in five patients and 14 complained of temporary dysuria or perineal pain. Twenty‐seven patients continue to pass urine through their stent without difficulty.Conclusion Because of its large diameter and its temporary nature this new stent allows endoscopic examination of the bladder and has few side effects. This stent should be considered as an alternative to a urethral catheter or other temporary stents in patients who are unfit for surgery.
A three month double‐blind study of doxazosin as treatment for benign prostatic bladder outlet obstruction
Authors: CHAPPLE C.R. , CARTER P. , CHRISTMAS T.J. , KIRBY R. S. , BRYAN J. , MILROY E. J. G. , ABRAMS P. 
Published: November 2008

Objective To evaluate the efficacy and tolerability of doxazosin in the treatment of bladder outflow obstruction resulting from benign prostatic hyperplasia (BPH).Patients and methods One‐hundred and thrity‐five patients with symptomatic urodynamicaly confirmed obstructive BPH ware treated for 12 weeks with either doxazosin (67 patients) or placebo (68 patients) after an initial 2 week baseline evaluation. The main outcome measures were urodynamic and symptomatic evaluation for efficacy. Blook pressre and adverse events were monitored.Results Date were obtained in 122 patients (60 doxazosin, 62 placebo). Doxazosin produced increases in both mean and maximum urinary flow rates of 1.01 ml/s and 3.2 ml/s rspectively, compared with 0.21 ml/s and 2.2 ml/s on placebo. The increase in mean flow rate was statistically significant (P=0.04). While that for maximun flow rate approached significance (P= 0.09). The maximum subracted voiding pressure was substantially reduced (P=0.007) and 19 of 53 (36%) patients had an increase in maximum flow rate of 50% or more compared with 9 of 54 (17%) on placebo (P=0.024). Twelve weeks' therapy with doxaosin resulted in significant improvements (compared with placebo) in: hesitancy 9doxazosin 26 of 46. placebo 11 of 43; P=0.003), impaired urinary stream (doxazosin 31 of 55, placebo 16 of 48; P=0.019). nocturia (doxazoshin 22 of 56, placebo 10 of 54; P=0.017) and urgency (doxazosin 27 of 45, placebo 16 of 42; P=0.041). Frequency improved with doxazosin therapy (doxazosin 26 of 59, placebo 15 of 55; P=0.062). Adverse events, most frequenly dizziness and headache, were usually mild and transient and led to a discontinuation of doxazosin therapy in one patient. No clinically significant changes in sexual function or blood pressure were seen.Conclusion Doxazosin was well‐tolerated and produced both urodynamic and symptomatic improvement in men with BPH. thereby providing a satisfactory alterntive to existing drugs with the additional benefit of one dily dosage.
The anatomy of a prostate waiting list: a prospective study of 132 consecutive patients
Authors: SCHOU J. , POULSEN A. L. , NORDLING J. 
Published: November 2008

Objective To report the results of a standard evaluation programme performed prior to transurethral resection of the prostate (TURP) for benign prostatic hypertrophy (BPH).Patients and methods all 132 patients with symptoms of prostatism on the waiting list for surgery were invited to attend the hospital to undergo a physical examination, symptom evaluation and routine blood sampling. Of these, 117 attended. If the suspicion of BPH was sustained a transrectal ultrasound examination of the prostate and a urodynamic evaluation, including a pressure‐flow study, were performed.Results Urodynamic evaluation was carried out in 80 of the 117 patients who attended the clinic. Infravesical obstruction was present in 61 patients while in 19 (24%) there was no obstruction. An operative procedure to relieve obstruction was performed in 65 patients (49%).Conclusions In a population of patients scheduled for TURP. 24% were found not to have an obstruction. This is in accordance with other reports. As the patients with few symptoms and those who did not have an obstruction were treated conservatively only 49% of the referred cases underwent prostatic surgery.
Early catheter removal following transurethral prostatectomy–impact on length of hospital stay
Authors: KOH K.B.H. , MacDERMOTT J.P. , SMITH P.H. , WHELAN P. 
Published: November 2008

Objective To investigate whether early catheter removal following transurethral prostatectomy (TURP) is safe and whether it has any effect on the length of hospital stay.Patients and methods Following transurethral prostatectomy 59 patients were randomized into one of two groups: those whose catheter was removed on day 1 after surgery and those whose catheter was removed on day 2. The incidence of complications and the duration of post‐operative hospital stay were assessed.Results Catheter removal on day 1 led to a significantly shorter post‐operative hospital stay (2.3 days versus 3.3 days) and did not incur a higher incidence of complications.Conclusion Removal of the catheter on the first day following TURP is safe in selected patients and leads to a shorter post‐operative hospital stay.
Screening for carcinoma of the prostate: a GP based study
Authors: KIRBY R.S. , KIRBY M.G. , FENELEY M.R. , McNICHOLAS T. , McLEAN A. , WEBB J.A.W. 
Published: November 2008

Objective To examine the feasibility and acceptability of screening for cancer of the prostate by digital rectal examination (DRE), prostate specific antigen (PSA) determination and subsequent transrectal ultrasound (TRUS) in selected patients in a single general practice in Hertfordshire.Subjects and methods A total of 568 of 856 men aged 55 to 70 accepted an invitation for a health check which included screening for prostate cancer. Of these, 80 individuals with either a raised PSA level or an abnormal DRE underwent TRUS. In 29 individuals biopsies were taken, 11 of which confirmed the presence of adenocarcinoma of the prostate giving an overall detected prevalence of 2%. Of the 11 tumours identified by screening, two were T1Mo, four were T2Mo, two were T3Mo and three were T3M1.Results To assess the acceptability of the screening exercise a postal questionnaire was sent to all 568 participants: 83% replied and 69% reported no concern. Of the 67 individuals who had undergone TRUS, 69% reported discomfort. A total of 448 (95%) of respondents declared that they would be prepared to undergo the screening exercise again.Conclusion Screening for prostate cancer would seem to be technically feasible and generally acceptable. However, there is a considerable false positive rate in the PSA range 4 ng/ml to 10 ng/ml, particularly among men with clinical evidence of benign prostatic hyperplasia. To establish the true benefit of screening a large‐scale prospective controlled study will be necessary.
The nutcracker syndrome: an uncommon cause of haematuria
Authors: SHAPER K.R.L. , JACKSON J.E. , WILLIAMS G. 
Published: November 2008

Objective To increase the awareness of this rare cause of haematuria and to describe the operative techniques available for its treatment.Patients and methods The investigation and treatment of five patients with the nutcracker syndrome have been reviewed.Results A new variant of the nutcracker syndrome is described. Using a combination of venolysis, Gortex graft renal vein interposition and an anterior nephropexy, the haematuria of four patients has ceased and improved in one.Conclusion The nutcracker syndrome is a rare cause of haematuria which responds successfully to surgical treatment. Successful treatment does not appear to be related to lowering of the renal vein pressure.
Risk factors for calculus formation in patients with renal transplants
Authors: HARPER J. M. , SAMUELL C. T. , HALLSON P. C. , WOOD S. M. , MANSELL M. A. 
Published: November 2008

Objective To investigate the risk factors for stone formation in patients with functioning renal transplants in whom renal calculi develop.Patients and methods Renal calculi developed in six of 178 patients with functioning renal transplants under current review, an incidence of 3%. Risk factors for stone formation were investigated in five of these patients and compared with a randomly selected control group of 41 transplant patients with no stone problems.Results Patients with transplant calculi typically passed smaller volumes of significantly more concentrated and alkaline urine with greater urinary excretion of uric acid (P <0.05). Urine calcium excretion was also increased. Crystalluria was present in three of five stone formers compared with two of 25 controls. Overall, metabolic abnormalities included hypocitraturia (75%), hyperparathyroidism (36%), hypophosphataemia (24%), and hyoercalcaemia (10%), Urinary infection was common, (50%), and urinary output of magnesium and phosphate was at the lower end of normal for all patients.Conclusion These results suggest a multifactorial aetiology for stone formation in renal transplant recipients. Approaches to prevention and management are discussed.
A population study of renal disease in patients with tuberous sclerosis
Authors: KABALA D. W. WEBB. J. , OSBORNE J. P. 
Published: November 2008

Objective To establish prevalence of renal disease, asympotoamtic renal lesions and possible renal symptoms in geographically defined population of individuals with tuberous sclerosis.Patients and methods The study involved 131 patients (64 men, 67 women) with tuberous sclerosis who were resident in nine of the districts within the Wessex Region and three Bristol Health Districts and who had been identified by a prevalence study [1]. The patients' been identified by a prevalence study [1]. The patients' mean age was 22 years (range 6 months‐74 years). Established renal disease was identified by history. Where possible individuals were seen were examined. Specific enquiry was made for flank pain and macroscopic haematuria. Renal ultrasound, blood pressure measurement and urine analysis was offered to all individuals with tuberous sclerosis who were resident in the Bath Health District.Results Eight patients (6%) had a history of either renal polycystic kidney disease (two patients) or haemorrhage from renal angiomyolipomas (five female patients, one male patient). A further 21% of female and 3% of male patients had a history of severe flank pain or haematuria. Renal ultrasound screening revealed abnormalities in 10 of 21 individuals; angiomyolipoma > 1 cm were found in seven and were twice as common in female patients.Conclusions Regular clinical review of individuals with tuberous sclerosis should include enquiry for renal symptoms and abdominal examination. Lesions >4cm are most likely to be symptomatic but sound screening of adolescents or adults can be recommended.
Renal cell carcinoma: prognostic factors
Authors: ROOSEN J.U. , ENGEL U. , JENSEN R.H. , KVIST E. , SCHOU G. 
Published: November 2008

Objective To establish the prognostic value of a series of pre‐operative, per‐operative and histopathological parameters in relation to renal cell carcinoma (RCC).Patients and methods This retrospective study involved a consecutive series of 76 patients (46 men and 30 women with a mean age of 65.3 years [range 44–91]) with a histologically confirmed diagnosis of RCC. Patients who were admitted over the period 1980–1984 were included. Data such as erythrocyte sedimentation rate (ESR). alkaline phosphatase level, histological tumour grade, degree of necrosis and presence of tumour vessels were evaluated in relation to actuarial survival.Results The ESR and alkaline phosphatase level at the time of diagnosis of RCC, the histological tumour grade, degree of necrosis and presence of tumour vessels on angiography were all found to affect the actuarial length of survival significantly (P < 0.05 logrank test). Macroscopic tumour demarcation estimated per‐operatively by the surgeon or after surgery by the pathologist, microscopic demarcation, vascular density on histological examination. tumour diameter and vascular density on angiography were found not to affect actuarial survival significantly.Conclusion The value of establishing simple and reliable diagnostic indicators for patients with RCC is stressed.