bluuebunny/crossref_metadata_2025_split huggingface dataset:
Future Directions in the Management of Benign Prostatic Hyperplasia
Authors: KHOURY S. 
Published: November 2008

Summary— A meeting of the International Consultation on Benign Prostatic Hyperplasia (BPH) in June 1991 provided an update on the management of BPH. It is recognised that the development of complications in what may be regarded as a relatively well tolerated disease may necessitate surgical intervention. Current treatment is directed towards circumventing or ameliorating the complications of BPH and perhaps to find minimally invasive or non‐invasive alternatives to surgery that could eliminate this modality altogether. Anticipated changes in the management of BPH include establishment of an improved scoring system and response criteria; implementation of stenting techniques, physical modalities such as hyperthermia and laser therapy to replace transurethral resection of the prostate; development of more specific alpha blockers with fewer adverse effects; and administration of hormonal therapy, possibly as an eventual preventative of BPH.The 1991 International Consultation on Benign Prostatic Hyperplasia (BPH), which took place in Paris, France, under the joint sponsorship of the World Health Organization and the major international and national societies of urology, provided an excellent opportunity to review current knowledge on the subject of BPH and to explore future trends in its management. Most of the information included in this report is drawn from the conclusions of the consultation participants.
Is Pre‐operative Imaging of the Urinary Tract Worthwhile in the Assessment of Prostatism?
Authors: WILKINSON A. G. , WILD S. R. 
Published: November 2008

Summary— The reports of routine pre‐operative imaging investigations performed on patients presenting with symptoms of uncomplicated benign prostatic hypertrophy were compared with management decisions and clinical outcome. In 175 patients with prostatism no urological abnormality which altered management was discovered on plain films of the abdomen and pelvis and ultrasound of the urinary tract which were performed routinely.Post‐micturition residual volume (PMRV), estimated by ultrasound, was compared with the maximum urine flow rate (Q max) in 57 patients. PMRV showed negative correlation with Q max. Both high PMRV and low Q max were associated with the urologist's decision to operate, but multiple logistic regression revealed that ultrasound residual volume was not a significant predictor of operation when adjusted for Q max. Urologists in this hospital therefore use flow rates as the primary indication of the need to operate.We suggest that no routine pre‐operative imaging need be performed in patients presenting with prostatism.
Retrograde Balloon Dilatation for Pelviureteric Junction Obstruction
Authors: McCLINTON S. , STEYN J. H. , HUSSEY J. K. 
Published: November 2008

Summary— A total of 49 retrograde balloon dilatations for pelviureteric junction (PUJ) obstruction were carried out on 43 pelviureteric junctions in 42 patients from 1986 to 1991. The majority (34/ 43) were performed as primary treatment for PUJ obstruction, with 9 patients having a history of previous open pyeloplasty. Follow‐up ranged from 3 months to 4 years (mean 18 months). Clinical improvement, as assessed by absence of symptoms, was seen in 34 cases (80%). There was either no change or an improvement in renographic findings (t1/2 time and/or split function) in 40 patients (93%). Of the 9 patients who were undergoing secondary treatment, 5 showed clinical improvement and 8 showed no change or renographic improvement. Nine patients required 12 further procedures, of which 5 were interval nephrectomy.Balloon pyelolysis is a simple procedure with good results over a 4‐year follow‐up period. It is less effective for the treatment of secondary pelviureteric junction obstruction. It has a low morbidity and no mortality, involves a short hospital stay and allows an immediate return to full activity. It is therefore an attractive alternative to open pyeloplasty as first‐line treatment for PUJ obstruction.
Two Years' Experience with Photodynamic Therapy of Bladder Carcinoma
Authors: WINDAHL T. , LOFGREN L. A. 
Published: November 2008

Summary— Eleven patients with intractable bladder carcinoma who were either unfit for radical surgery, or had refused it, were treated with whole bladder photodynamic therapy. Seven patients had carcinoma in situ and 4 had papillary tumours.Four of the 11 patients had recurrent tumours after a full course of radiotherapy for invasive bladder cancer.A complete local response was initially achieved in 9 patients with a mean follow‐up of 12 months. The patients previously treated with radiotherapy had a remarkable response, with local control in all cases, but they had severe local side effects and a pronounced reduction in bladder capacity. In the non‐irradiated group, bladder capacity was reduced permanently in only 1 of 7 patients.
The Incidence of Bladder Cancer in the Black Foot Disease Endemic Area in Taiwan
Authors: CHIANG H. S. , GUO H. R. , HONG C. L. , LIN S. M. , LEE E. F. 
Published: November 2008

Summary— A high incidence of bladder cancer (23.53/100,000 population per annum from 1981–1985) was found in an endemic area of peripheral vascular disease known as black foot disease (BFD) on the southwest coast of Taiwan. The average incidence of bladder cancer in the whole of the Taiwan area was 2.29/100,000 during the same period.The incidence of female bladder cancer (21.10/100,000) in this area was also high. The ratio of male to female bladder cancer in the BFD endemic area and the neighbouring area was 1.24 and 1.09, lower than that in the whole Taiwan area (2.75) and elsewhere around the world. The high content of arsenic and the high concentration of a “fluorescent substance” in artesian well water in this area are the only 2 related factors identified so far. Determination of the actual carcinogen requires further investigation.
Bromodeoxyuridine Labelling of Transitional Cell Carcinoma of the Bladder—an Index of Recurrence?
Authors: POPERT R. J. M. , JOYCE A. D. , THOMAS D. J. , WALMSLEY B. H. , COPTCOAT M. J. 
Published: November 2008

Summary— Nineteen patients with newly diagnosed transitional cell carcinoma of the bladder consented to receive an intravenous bolus of bromodeoxyuridine (BrdUrd) 3 to 6 h prior to transurethral resection of bladder tumour. Routine paraffin embedded sections were stained with anti‐BrdUrd monoclonal antibody in order to determine the S phase fraction of the bladder tumours and to correlate this with tumour grade, category and the development of recurrence during follow‐up.BrdUrd labelling of nuclei was reliably detected in 100% of the tumours. The mean labelling index of Ta tumours (n = 8) was 3.14%; in T1 tumours (n = 7) it was 8.6% and in T2‐3 tumours (n = 4) it was 16.4%. A similar correlation was found in association with tumour grade. The patients were followed up for a mean of 23 months (range 18–30). Seven of the 15 superficial tumours recurred during the period of follow‐up. These tumours had a mean labelling index (at diagnosis) of 8.4%, whereas the tumours that did not recur had a mean labelling index of 3.4%.The in vivo determination of BrdUrd uptake in transitional cell carcinoma of the bladder may be useful in predicting which superficial tumours are likely to recur following resection and so rationalise both the time to follow‐up and intravesical chemoprophylaxis.
Multivariate Analysis of Progression in Superficial Bladder Cancer
Authors: MUELA P. SANCHEZ DELA , ROSELL D. , AGÜERA L. , DE CASTRO F. , ISA W. , ROBLES J. E. , ZUDAIRE J. J. , BERIÁN J. M. 
Published: November 2008

Summary— A total of 217 patients with superficial bladder cancer (SBC) category Ta‐T1 were retrospectively analysed for tumour progression and prognostic factors; 46% of patients presented with recurrences, 13% with increasing grades of anaplasia and 12% with progression in tumour category. The mean annual index of recurrences was 0.7 ± 0.1; 4% of patients died from tumour progression and the overall 5‐year survival rate was 88% ± 5.3. Factors that influenced progression significantly were peritumoural dysplasia, inflammatory infiltrate, residual tumour following transurethral resections, increasing grade of anaplasia and index of recurrences >0.7. Multivariate statistical analysis revealed that only tumour category and increasing grade of anaplasia had significant prognostic value. Increasing grade of anaplasia predicts the likelihood of tumour progression with a 91% global predictive capacity. Thirty percent of patients with tumour progression did not have an increasing grade of anaplasia. Among these 87% were Ta, 50% were Gl and the mean index of recurrences was 0.9. All were conservatively treated and 87% are alive.Among the patients with an increasing grade of anaplasia and tumour progression the mean index of recurrences was 1.7; 67% developed muscle infiltrating cancer and 7% metastatic spread without local progression; 64% of these patients died from cancer.An increasing grade of anaplasia affects prognosis. It defines patients with a high risk of tumour progression and tumour‐related death, especially those with T1 bladder cancer.
New, Self‐expanding, Self‐retaining Temporary Coil Stent for Recurrent Urethral Strictures near the External Sphincter
Authors: YACHIA D. , BEYAR M. 
Published: November 2008

Summary— Strictures near the external sphincter are a cause for concern. They can be managed by manipulation (e.g. urethral dilatation) or by anastomotic urethroplasty.Permanently implanted metallic stents have recently been used to treat recurrent urethral strictures. This report presents the results of using a temporary metallic coil stent (UROCOIL‐S) in 20 patients with recurrent bulbomembranous strictures. In 13 patients the stent was left in place for 10 months and was then removed by a simple manipulation. After a mean follow‐up of 10 months (range 3–14), the stricture recurred in only 1 patient.The use of a temporary (but long‐term) stent for the treatment of urethral stricture is a new approach and the results are encouraging.
Results and Complications of Urethroplasty and its Future
Authors: MUNDY A. R. 
Published: November 2008

Summary— A consecutive series of 200 patients undergoing urethroplasty has been reviewed to assess the results and complications of surgery and thereby assess the role of urethroplasty in the treatment of urethral strictures with particular reference to the current interest in intraluminal “stenting” of strictures.Anastomotic urethroplasty for post‐traumatic strictures and “patch” urethroplasty for post‐infective strictures give satisfactory results which at present do not seem to be bettered by any other form of treatment. Urethroplasty for so‐called “ischaemic” strictures gives less satisfactory results which could almost certainly be improved upon by intraluminal “stenting” or some other novel form of treatment.The incidence of impotence, temporary and permanent, after urethroplasty is probably greater than is generally realised and the aetiology of this complication warrants serious investigation as this is the single most important limiting factor in urethroplasty.
Treatment of Vesicoureteric Reflux Results of a Prospective Study
Authors: SCHOLTMEIJER R. J. 
Published: November 2008

Summary— Between 1982 and 1986, 96 children with non‐obstructive vesicoureteric reflux were included in a prospective study. Three patients withdrew from the study and results are therefore presented on 93 children with 135 refluxing ureters who were followed up for at least 5 years.Initially, all children with reflux grade III or less received antibiotic treatment only. Those with reflux grade IV were randomised to antibiotic treatment alone versus surgery plus antibiotic treatment; the primary treatment of reflux grade V was reimplantation.In 85 ureters treated by antibiotics only, reflux disappeared in 64 cases and was reduced in 12. In 50 ureters treated by reimplantation, reflux was cured in 46 cases and no severe ureteric obstruction was seen. Conservative management of reflux grade IV was less successful than surgery. The results of conservative, non‐surgical treatment of reflux grades I‐III were satisfactory, but for grades IV and V surgery should be the treatment of choice if detrusor instability has been excluded.
Prophylactic Role of Extracorporeal Shock Wave Lithotripsy in the Management of Nephrocalcinosis
Authors: VANDEURSEN H. , BAERT L. 
Published: November 2008

Summary— Electromagnetic extracorporeal shock wave llithotripsy (ESWL) was performed with a standard Siemens Lithostar on parenchymal calcifications in 10 medullary sponge kidneys in order to evaluate the eventual benefit of preventive lithotripsy.The results of shock wave lithotripsy on precaliceal calcifications were disappointing and have been related to the lack of expansion during shock wave interaction and to the impaired drainage of particles. Three patients also had large impacted ureteric stones and in such cases ESWL remains the treatment of choice.
Results of Treatment with Pollen Extract (CerniltonR N) in Chronic Prostatitis and Prostatodynia
Authors: RUGENDORFF E. W. , WEIDNER W. , EBELING L. , BUCK A. C. 
Published: November 2008

Summary— We report the results of a prospective study with the pollen extract, CerniltonR N, in a dose of 1 tablet tid for 6 months for the treatment of chronic prostatitis syndrome in 90 patients. The factors documented before and after 3 and 6 months' treatment were digital rectal examination (DRE) of the prostate, uroflowmetry, bacterial studies, leucocyte counts in urine and measurement of complement C3/coeruloplasmin in the seminal fluid.The patients were divided into 2 groups: those without associated complicating factors (CFs) (n = 72) and those with complicating factors, i.e. urethral strictures, prostatic calculi, bladder neck sclerosis (n = 18). In the group without CFs, 56 (78%) had a favourable response; 26 (36%) were cured of their symptoms and signs and 30 (42%) improved significantly with an increase in flow rate, a reduction in leucocyturia in the post–prostate massage urine (VB3) and a decrease in complement C3/coeruloplasmin in the ejaculate. In the patients with CFs only 1 patient showed a response. Complicating factors should be considered in patients who fail to respond to treatment within 3 months. CerniltonR N was well tolerated by 97% of patients.
Relative Indications for Orthotopic Lower Urinary Tract Reconstruction, Continent Urinary Diversion and Conduit Urinary Diversion
Authors: NURSE DIANE E. , BRITTON J. P. , MUNDY A. R. 
Published: November 2008

Summary— Continent urinary diversion has become increasingly popular in the last few years and there are now several situations in which ileal conduit diversion, continent diversion and orthotopic reconstruction of the Lower urinary tract are equally valid options. This review was intended to determine specific indications for each.Of 513 patients treated for severe Lower urinary tract problems in the last 10 years, 399 underwent orthotopic reconstruction, 68 underwent continent diversion and 46 had an ileal conduit. Problems occurred 2 to 3 times more commonly in the continent diversion group than in either of the other groups.Given a free choice, most patients would choose an orthotopic reconstruction and this should probably be regarded as the gold standard. Continent diversion is specifically indicated in male patients who require a total cystourethrectomy for bladder cancer, in severe post‐radiotherapy problems, and in patients with neuropathic bladder dysfunction in whom, for various reasons, self‐catheterisation is impossible. Ileal conduit diversion remains the simplest and safest technique in high‐risk patients and does not preclude a subsequent continent diversion or orthotopic reconstruction.
Choosing a Powerful Lithotriptor
Authors: MISHRIKI S. F. , COHEN N. P. , BAKER A. C. , WILLS M. I. , WHITFIELD H. N. , FENELEY R. C. L. 
Published: November 2008

Summary— Clinicians have no yardstick to help them choose the most efficient lithotriptor. Their leading priority is a system allowing complete disintegration of the stone with the minimum number of shocks and a low re‐treatment rate. One of the prerequisites of this system is a powerful shock wave generator. “Power” is as yet ill defined in lithotripsy. Therefore clinicians' choice depends upon other factors.Acoustic output measurements were recorded on 3 commercial lithotriptors representing the 3 main shock wave generating systems. These were the Dornier MPL 9000 (standard and X‐155 electrodes), the Siemens (Lithostar, Lithostar Plus and System C) and the Wolf Piezolith 2300. The shock wave measurements were correlated to the capability of the lithotriptors to disintegrate standard stone models in vitro.Two factors were identified. The pulse intensity integral in the focus and the size of the focal zone proved to be the most important factors to assess and compare the efficacy or “power” of different lithotriptors. Together they can help clinicians to identify and choose the most efficient shock wave generating systems.
Relief of Pain following Intravesical Capsaicin in Patients with Hypersensitive Disorders of the Lower Urinary Tract
Authors: BARBANTI G. , MAGGI C. A. , BENEFORTI P. , BAROLDI P. , TURINI D. 
Published: November 2008

Summary— We have extended our earlier observations on pain relief produced by intravesical instillation of capsaicin (10 μ.M in saline) in patients with hypersensitive disorders of the lower urinary tract.Patients in group A (n = 15) received intravesical capsaicin on days 0, 14 and 28: on each occasion the drug produced a warm or burning sensation, reduction in bladder capacity and a delayed, transient improvement or disappearance of symptoms. Patients in group B (n = 5) received intravesical capsaicin (10 μ M at cystometry) 3 times on day 0. The initial sensation of warmth was experienced on each occasion, indicating that no significant desensitisation has been produced by the first instillation. Clinical improvement similar to that found in group A was observed. Three patients (group C) received warm saline (42°C) at cystometry. This produced a pricking sensation, no change at cystometry and no subjective clinical improvement. Apart from the initial sensation of warmth, no patient in group A or B experienced side effects, either local or systemic.These findings confirm that intravesical instillation of capsaicin has a beneficial effect on patients with hypersensitive bladder disorders. Counter‐irritation rather than desensitisation of primary afferents could be a possible mechanism of action. Further studies are needed to establish whether the intravesical administration of capsaicin or capsaicin‐like agents represents a new form of treatment for relief of bladder pain.
Long‐term Results of Pelvic Floor Training in Female Stress Urinary Incontinence
Authors: HAHN I. , MILSOM I. , FALL M. , EKELUND P. 
Published: November 2008

SummaryOne hundred and seventy women with genuine stress urinary incontinence participated in a pelvic floor exercise (PFE) programme (duration 4.7 ± 0.2 months, range 1–18). Twenty‐seven women awaiting surgery for genuine stress urinary incontinence constituted the control group. The women were evaluated using a provocation test, vaginal palpation and subjective assessment before and after treatment. After the PFE programme, 23% of the women considered themselves cured, 48% were improved and 29% unchanged. According to the provocation test used in this study 64% were cured or improved following PFE. The long‐term results of PFE were assessed by means of a postal questionnaire 2 to 7 years after completion of the supervised training period (response rate 152/170; 89%). During this time 38 women (25%) had undergone operative treatment. Of the remaining patients, 13 (11%) reported that they were still cured, 50 (44%) continued to be improved, 35 (31%) were unchanged and 16 (14%) had deteriorated. However, the frequency of PFE training during the follow‐up period was unsatisfactory, as only 15% were training several times a day. This indicates that continued guidance from a physiotherapist could improve the long‐term efficacy of PFE training.
Prostatic Sarcoidosis Review of Genitourinary sarcoidosis
Authors: MORRIS S. B. , GORDON E. M. , CORBISHLEY C. M. 
Published: November 2008

SummarySarcoidosis is seen by the urologist only rarely but it may present a diagnostic and therapeutic dilemma. We describe a rare case of prostatic sarcoidosis. The literature relating to sarcoidosis throughout the genitourinary system is reviewed.
Anatomical and Clinical Correlation with Histological and Histometric Patterns in Cryptorchism
Authors: GUTIERREZ A. , CAMPOS A. , CANIZARES F. J. , CRESPO P. V. , SANCHEZ C. 
Published: November 2008

SummaryOne feature rarely included in studies on cryptorchism is an adequate correlation between anatomical and clinical data and histological patterns of the testis. The present study correlates anatomical and clinical data from 50 patients (age range 2 months‐14 years) using 4 different histological and histometric patterns established previously. Three different patterns of progressively severe histological changes corresponding to increasingly marked dysgenetic alterations in the anatomical and clinical patterns were detected. Less severe changes were correlated with mature anatomical and clinical features, whereas testes showing severe histological‐histometric changes were correlated with immature anatomical and clinical features. Non‐abdominally located testes with Sertoli cell hyperplasia were not significantly correlated with any of the anatomical and clinical features.The histometric patterns described should facilitate the diagnosis of the stage of testicular development on the basis of anatomical and clinical data.
Early Removal of Catheter following Transurethral Resection of the Prostate
Authors: AGRAWAL S. K. , KUMAR A. S. V. 
Published: November 2008

Summary This study was conducted on 83 patients who underwent an uncomplicated transurethral resection of the prostate for carcinoma or benign hyperplasia. In all cases the urethral catheter was removed within 24 h of surgery. Only 2 patients failed to void because of clot retention.The total hospital stay was 3 days in 67 patients. There were no significant complications due to early removal of the catheter.
Suppurative Epididymo‐orchitis in Young “High Risk” Patients‐A New Problem?
Authors: PARR N. J. , PRASAD B. R. P. , HAYHURST V. , McMILLAN A. , LEEN C. S. , FOWLER J. W. 
Published: November 2008

Summary During a 4‐year period we have treated 3 young patients with severe epididymo‐orchitis which progressed to suppuration (despite treatment with a range of antibiotics) and necessitated orchiectomy. All gave a history of “high risk” activity (2 homosexual, 1 sexual partner of intravenous drug user). One patient was suffering from acquired immune deficiency syndrome and another presented during seroconversion to HIV‐positive status. Cytomegalovirus was the infective organism in one patient, but the pathogenesis in the others remains obscure.Investigations for atypical pathogens should be performed when young patients present with refractory epididymo‐orchitis. These patients should also be counselled with regard to HIV testing.