bluuebunny/crossref_metadata_2025_split huggingface dataset:
A Physiological Approach to the Investigation of Chronic Urinary Retention
Authors: MACHIN D. G. , GARDNER B. P. , WOOLFENDEN K. A. , DESMOND A. D. , PARSONS K. F. 
Published: November 2008

Summary— Twenty‐six male patients with chronic urinary retention were investigated by self filling cystometry, followed by fast filling cystometry.Fast filling cystometry tended to increase the end filling pressure and to indicate a smaller bladder capacity than did self filling cystometry.Inadequate filling of the bladder may lead to an unrepresentative detrusor voiding contraction and an incorrect diagnosis of detrusor failure.Fast filling cystometry masks detrusor instability, which may be a factor producing upper tract dilatation and renal impairment.It is suggested that chronic retention of urine should be investigated by self filling cystometry.
“Clam” Ileocystoplasty for the Treatment of Refractory Urge Incontinence
Authors: MUNDY A. R. , STEPHENSON T. P. 
Published: November 2008

Summary— Forty patients with refractory urge incontinence were treated by “clam” ileocystoplasty. Thirty patients were cured of their symptoms and are voiding spontaneously, six were cured of their symptoms and are on clean intermittent self‐catheterisation and four had their symptoms significantly improved by the operation.Bladder compliance is usually improved by the operation and detrusor instability is either abolished or reduced to an insignificant level, but voiding dysfunction is a common post‐operative problem and must be identified and treated.
Sphincter Behaviour in Myelomeningocele
Authors: MUNDY A. R. , SHAH P. J. R. , BORZYSKOWSKI M. , SAXTON H. M. 
Published: November 2008

Summary— Four hundred and two videourodynamic studies were performed on 207 children with neuropathic vesicourethral dysfunction due to myelomeningocele. The children were divided into three groups (contractile, intermediate and acontractile) according to the urodynamic behaviour of their bladders, and the behaviour of the bladder neck and distal sphincter mechanism was assessed in each group.The bladder neck may be competent or incompetent in children with contractile bladders but is never obstructive, and is always incompetent in children with either intermediate or acontractile bladders at their usual bladder volumes. The distal sphincter mechanism is nearly always dynamically obstructive (detrusor‐sphincter dyssynergia) in children with contractile bladders but is rarely if ever incompetent, whereas in children with intermediate or acontractile bladders, both (static) distal sphincter obstruction and sphincter weakness incontinence exist to some degree, although the predominance of one of these may mask the existence of the other unless it is specifically looked for or some therapeutic manoeuvre unmasks it.The main conclusion from this study is that, with the possible exception of those few children with more minor partial cord lesions, dysfunction of one or both sphincter mechanisms is the rule in congenital cord lesions.
Oncogenes and Bladder Cancer
Authors: MALONE P. R. , VISVANATHAN K. V. , PONDER B. A. J. , SHEARER R. J. , SUMMERHAYES I. C. 
Published: November 2008

Summary— We screened a series of 15 superficial and invasive transitional cell carcinomas of the bladder for transforming activity on the NIH/3T3 transfection assay. In addition, by obtaining tumour DNA and normal lymphocyte DNA from the same patients we looked for evidence of gene amplification or rearrangement of the c‐H‐ras‐I gene by Southern blot analysis.One patient (with a grade 2 T1 tumour) was shown to have an activated oncogene on the NIH/ 3T3 transfection assay and this was identified as a c‐H‐ras‐I gene. We could find no evidence of gene amplification or rearrangement of this gene in any tumour.The significance of activation of ras oncogenes in the pathogenesis of human bladder carcinoma is unclear.
Prediction of Response to Radiotherapy for Localised Prostatic Cancer
Authors: RITCHIE A. W. S. , SMITH G. , PRESTON C. , BEYNON L. L. , DUNCAN W. , CHISHOLM G. D. 
Published: November 2008

Summary— Fifty‐one patients with TO‐4 NX MO carcinoma of the prostate were treated by external beam radiotherapy. Comparison with 40 patients with TO‐3 NX MO disease, whose treatment was deferred initially, showed a higher incidence of local progression in the untreated patients.Age at presentation and initial T category did not have a significant influence upon the probability of disease progression after radiotherapy, whereas all but one of the irradiated patients with Gleason sum scores ≥ 6 progressed.Treatment‐related morbidity was appreciable and prolonged proctitis occurred in 31 patients. There was one treatment‐related death. Biopsy 1 year after treatment did not yield information of prognostic significance.It is recommended that the selection of patients with localised carcinoma of the prostate for treatment by radiotherapy is based on histological grade. The Gleason score is a practical method for identifying those who would best be treated by other methods.
Surveillance or Lymph Node Dissection in Clinical Stage I Non‐seminomatous Germinal Testis Cancer?
Authors: PIZZOCARO G. , ZANONI F. , SALVIONI R. , MILANI A. , PIVA L. 
Published: November 2008

Summary— Surveillance following orchiectomy alone has gained popularity in the management of clinical stage I non‐seminomatous germ cell tumours (NSGCT) of the testis. However, long‐term follow‐up of the retroperitoneal nodes can be difficult.We analysed the results of 71 consecutive patients followed for more than 1 year. Fifty men (70.5%) remain disease‐free and 21 (29.5%) have relapsed. Relapses occurred 2 to 36 months after orchiectomy (median 6 months). Retroperitoneal nodes were involved in 12 cases (17%). In only one patient were retroperitoneal metastases diagnosed when smaller than 2 cm and in four they were diagnosed when larger than 5 cm. Furthermore, the late relapses occurred in the retroperitoneal nodes. After treatment of metastases, 69 patients (97%) are alive, disease‐free and off therapy.As retroperitoneal relapses do not occur after a properly executed retroperitoneal lymph node dissection (RPLND) and ejaculation problems can be avoided with unilateral RPLND, it is suggested that RPLND can be used for clinical stage I NSGCT of the testis in experienced surgical centres, with the advantage of an easier follow‐up.
Pyeloureterostomy or Ureteroneocystostomy in Renal Transplantation?
Authors: LANDAU R. , BOTHA J. R. , MYBURGH J. A. 
Published: November 2008

Summary— A retrospective comparison of pyeloureterostomy and external ureteroneocystostomy as methods of reconstructing the urinary tract in 128 renal transplants is presented. There was one urological complication in 52 pyeloureterostomies (1.9%) compared with 4 in the 76 ureteroneocystostomies (5.3%). 6/0 Polydioxanone (PDS) is preferred to Prolene for the anastomosis because of possible calculus formation on the latter.Wound sepsis is commoner in pyeloureterostomies undergoing concomitant nephrectomy, despite prophylactic antibiotics, though this is not statistically significant and the overall sepsis rate is higher for ureteroneocystostomy. Nephrectomy was avoided in 17 selected cases by simply ligating the recipient ureter where the pre‐transplant urine output was low. Two of these patients developed hydronephrosis in the isolated kidney and required later nephrectomy.
Bilateral Malignant Testicular Germ Cell Cancer
Authors: KRISTIANSLUND S. , D. FOSSÅ SOPHIE , KJELLEVOLD K. 
Published: November 2008

Summary— Twenty‐six of approximately 1300 patients (1.9%) with unilateral testicular cancer developed a second primary germ cell cancer (seminoma 18; non‐seminoma 8). Patients with previous seminoma had a significantly higher risk of developing a new seminoma than those with a previous non‐seminoma. The diagnosis of second primary was made within 3 years of the first diagnosis in only 50% of the patients. In patients with a history of undescended and/or atrophic testes the interval significantly decreased between the diagnosis of the two testicular cancers.The prognosis of bilateral testicular cancer is generally good. Patients in whom the second testicular cancer is at clinical stage I (no metastases) at diagnosis can safely be observed without further treatment after orchiectomy.A patient with unilateral testicular cancer should be informed of the increased risk of developing a second primary germ cell tumour and should be encouraged to perform regular examination of the remaining testis. The need for life‐long follow‐up visits for patients with testicular cancer is questionable.
Influence of Serotonin on Lower Urinary Tract Smooth Muscle in Vitro
Authors: KLARSKOV P. , HØRBY‐PETERSEN J. 
Published: November 2008

Summary—The influence of serotonin (5‐hydroxytryptamine) on human detrusor and on pig detrusor, trigone, bladder neck and urethral smooth muscle was explored in a series ofin vitroexperiments. Serotonin evoked a dose‐dependent and reversible contraction of the detrusor. The reverse response was triggered in trigone, bladder neck and urethral smooth muscle‐a dose‐dependent and reversible relaxation. The maximum amplitude of this relaxation was 85 ± 15% of the relaxation produced by electrical nerve stimulation.The effect of serotonin was unaltered by blockade of ganglia, alpha‐ and beta‐adrenergic receptors, cholinergic receptors and prostaglandin synthesis. The serotonin antagonists ketanserin, methysergide and cyproheptadine partly inhibited the effect of serotonin. The antagonism differed in potency on strips of different origin. The antagonists were ineffective or minimally effective in blocking responses to nerve stimulation.The effect of serotonin was probably mediated by specific serotonin receptors different from the serotonin‐s,‐receptors predominating in vascular smooth muscle. Serotonin is a potential neurotransmitter in lower urinary tract smooth muscle, but its importance in micturition physiology and pathophysiology is unknown.
Endoscopic Correction of Primary Vesicoureteric Reflux
Authors: O'DONNELL BARRY , PURI PREM 
Published: November 2008

Summary—
One hundred and three children with primary vesicoureteric reflux treated by endoscopic injection of Polytef paste between March 1984 and February 1986 have been followed up for periods ranging from 3 to 23 months. Seventy‐five per cent of refluxing ureters showed absence of reflux after one injection of Polytef paste; 14% of ureters required two to four sub‐ureteric injections of Polytef paste for the correction of vesicoureteric reflux; 8% of ureters showed improvement in the grade of reflux after the initial injection of Polytef paste.Duplex systems were more difficult to correct and recurrence of reflux was much higher than in primary reflux. Follow‐up intravenous urograms showed no evidence of ureteric obstruction in the treated ureters.The procedure is safe, simple and effective in correcting all grades of vesicoureteric reflux. To obtain best results, attention should be paid to minute details of the technique and the injection made with pinpoint accuracy.
Reduction of Post‐operative Bleeding after Transurethral Resection of the Prostate by Local Instillation of Fibrin Adhesive (Beriplast)
Authors: LUKE M. , KVIST E. , ANDERSEN F. , HJORTRUP A. 
Published: November 2008

Summary—
A method for instilling a two‐component fibrin adhesive into the prostatic cavity after transurethral resection of the prostate is described. In a prospective, controlled study, 30 consecutive patients undergoing transurethral prostatectomy (TURP) were randomised either to receive treatment with the local instillation of fibrin adhesive into the prostatic cavity or to a control group that received no special treatment post‐operatively. There were no complications either during application of the fibrin adhesive or in the follow‐up period.Post‐operative blood loss was significantly reduced in the fibrin group (P < 0.01).
Urinary Fibrin/Fibrinogen Degradation Products in Transitional Cell Carcinoma of the Bladder
Authors: EWING R. , TATE G. M. , HETHERINGTON J. W. 
Published: November 2008

Summary— Urinary fibrin/fibrinogen degradation products (FDPs) were measured in 210 specimens from 174 patients with newly or previously diagnosed transitional cell carcinoma of the bladder. They were detected in 94% of patients with deeply invasive bladder tumours (pT2‐4) compared with 17% of superficial tumours. Microalbuminuria (> 50 μg/g creatinine) was also found in 80% of patients with pT2‐4 lesions. Both were compared with urine cytology.Urinary FDPs are markers of bladder tumour invasion. Our results suggest that urinary FDPs are not of value in screening for the presence of bladder neoplasia but their role may be in following patients with superficial bladder tumours to detect those tumours which become invasive. The mode of excretion of the FDPs in the urine is discussed.
Gynaecomastia Following Cytotoxic Therapy for Testicular Cancer
Authors: SAETER G. , FOSSA SOPHIE D. , NORMAN N. 
Published: November 2008

Summary— Sixteen patients in complete remission after chemotherapy or radiotherapy for testicular cancer developed gynaecomastia which appeared 2 to 9 months after the end of therapy and had a mean duration of 4.8 months. These patients had statistically significant higher levels of oestradiol, FSH and oestradiol/ testosterone ratio than a control group without gynaecomastia that had received similar treatment. Both groups tended to have testosterone levels in the lower normal range and all patients had normal levels of β‐HCG, prolactin and progesterone.The gynaecomastia in our patients was probably the result of an absolute increase in oestradiol or an increase relative to testosterone. Cytotoxic therapy affects both spermatogenesis and Leydig cell function, with a resultant rise in gonadotropins which may in turn increase testicular oestrogen secretion.In testicular cancer patients, gynaecomastia may be a sign of tumour activity but it may also be caused by hormonal changes resulting from cytotoxic therapy. It is our experience that the latter treatment‐related type is harmless, transient and unrelated to the patient's prognosis.
Urinary Tract Infection with Anaerobic Bacteria Following Endoscopic Urethral Instrumentation
Authors: SUTTON R. , CHEETHAM P. , BULLOCK D. W. , MUNSON K. W. 
Published: November 2008

Summary— A prospective study of the pathogenic role of anaerobic bacteria was undertaken by suprapubic bladder aspiration in 100 patients prior to routine endoscopic urethral instrumentation.Anaerobic and/or micro‐aerophilic bacteria were isolated from the suprapubic specimens of 11 patients (>105/ organisms/ml from 8), with identical species growing heavily from corresponding cystoscopic specimens and/or urethral swabs. Previous cystoscopies in all 11 patients and the presence of bladder tumour at the time of sampling in six were significantly and independently associated with the isolation of anaerobic bacteria from suprapubic specimens.It was concluded that transurethral instrumentation entails a definite risk of anaerobic urinary infection in addition to the recognised risk of aerobic urinary infection. The findings suggest that the antibiotics used as prophylaxis for or treatment of patients undergoing transurethral procedures should be effective against anaerobic bacteria.
The Effect of Pentosanpolysulphate and Carbenoxolone on Bacterial Adherence to the Injured Urothelium
Authors: PANTAZOPOULOS D. , LEGAKIS N. , ANTONAKOPOULOS G. , SOFRAS F. , DIMOPOULOS C. 
Published: November 2008

Summary— The effect of the glycosaminoglycan (GAG) layer on the adherence of Escherichia coli to the bladder urothelium of rats has been studied. The study was performed by destroying the GAG layer and the changes were observed using the electron microscope. Bacterial adherence to the bladder with a destroyed GAG layer was much higher than to the normal bladder.Following the destruction of the GAG layer, the instillation of sodium pentosanpolysulphate significantly reduced the adhesion of bacteria. Prophylactic intramuscular administration of carbenoxolone increased the speed of regeneration of the destroyed GAG layer.
Tissue Alpha‐fetoprotein and Human Chorionic Gonadotrophin in Non‐seminomatous Testicular Tumours A Comparative Study with Serum Levels
Authors: ALTUG M. U. , AKDAS A. , RUACAN S. , ÖZEN A. H. , REMZI D. 
Published: November 2008

Summary— The correlation between tissue localisation and serum levels of alpha‐fetoprotein (AFP) and human chorionic gonadotrophin (HCG) was studied in 20 tissue samples from 18 patients with non‐seminomatous testicular tumours. Specific immunoperoxidase stains were used for tissue staining and serum measurements were made by radioimmunoassay.There was a close correlation between the tissue demonstration of AFP and HCG and elevated levels of serum markers. The cellular localisations of AFP and HCG were different and no cell stained concomitantly for both AFP and HCG.From these results and from the demonstration of tumour markers in the tissue of some patients with normal serum marker levels, it was concluded that immunocytochemical localisation of the tumour markers was more sensitive than serum measurements.
Autonomic Innervation of the Canine Penile Artery and Vein in Relation to Neural Mechanisms Involved in Erection
Authors: KIMOTO Y. , ITO Y. 
Published: November 2008

Summary—Neural control of the penile artery and vein of dogs was investigated using isometric tension recording and microelectrode methods. Field stimulation evoked twitch‐like contractions of these two vessels and these contractions were blocked by guanethidine. In the artery, twitch‐like contractions were more effectively blocked by yohimbine than by prazosin. During high tone of arterial and venous tissues evoked by noradrenaline (NA) in the presence of guanethidine, field stimulation evoked muscle relaxation that was not affected by atropine but was abolished by tetrodotoxin. In parallel to the mechanical responses, field stimulation evoked excitatory junction potentials (EJPs) in both arterial and venous smooth muscle cells. In the case of the artery, an action potential was superimposed on the EJP. The NA‐induced contraction was suppressed by vasoactive intestinal polypeptide (VIP), dose‐dependently. On the other hand, α,β‐methylene‐ATP did not affect the muscle relaxation induced by field stimulation.These results indicate that the penile artery and vein of the dog are innervated by adrenergic excitatory nerves and non‐adrenergic, non‐cholinergic inhibitory nerves. The transmitter possibly involved in the latter is discussed.
Penile Function Following Intracavernosal Injection of Vasoactive Agents or Saline
Authors: KIELY E. A. , IGNOTUS P. , WILLIAMS GORDON 
Published: November 2008

Summary— Few studies on the pharmacological assessment or treatment of impotence have included controls. In a double‐blind crossover study, 18 impotent men received either a 2 ml injection of a solution containing 30 mg papaverine and 1 mg phentolamine or a similar volume of normal saline into the corpus cavernosum. The immediate and delayed effects (4 weeks later) were assessed independently and the alternative injection then given. All injections with papaverine and phentolamine were followed by an immediate increase in penile length and rigidity, and 70% of these patients were able to have sexual intercourse for periods of 1 to 4 weeks. No change in penile length or rigidity occurred following the saline injection and only one patient showed some improvement in erection over the next 4 weeks. In the crossover study, no patient developed any increase in length or rigidity of the penis following injection of saline, and improvement in spontaneous erection occurred in only two cases. In contrast, all patients who received papaverine and phentolamine had an increase in penile length and rigidity, and 50% were able to have normal sexual intercourse over the next 4 weeks.This study confirms the value of a combination of vasoactive agents in the management of impotence, irrespective of its aetiology, and suggests that any placebo effect is minimal in this group of patients with considerable psychological overlay.
Polymer Treatments Reduce Adhesion of Comminuted Stone in Rat Bladder
Authors: MAROUDAS N. G. , LINDENBAUM E. S. 
Published: November 2008

Summary— A method for inhibiting the adhesion of stone fragments in comminution is presented. Surfaces are coated with a molecular layer of so‐called “excluding” polymer.In experimental tests, rat bladders were injected with comminuted urinary stone (phosphate or oxalate) in saline which contained small amounts of excluding polymer (0.1% hyaluronic acid or polyvinyl pyrrholidone). The urinary tract was then irrigated with fresh polymer solution and examined for residual stone. A ten‐fold reduction in particle count was obtained, compared with irrigation with normal saline.The possible applications in percutaneous and extracorporeal lithotripsy are discussed. It seems that the “coagulum” and “exclusion” types of polymer irrigant might find complementary uses: the former for manual extraction of coarse particles and the latter for flushing out after fine comminution.
Digital Angiography of Erectile Failure
Authors: NESSI R. , DEFLAVIIS L. , BELLINZONI G. , FRERI F. , SALVINI A. 
Published: November 2008

Summary— Digital angiography of pudendal and penile arteries was performed in 44 consecutive patients with erectile failure of suspected vascular origin. Intra‐arterial injection of contrast medium via selective catheterisation of the hypogastric arteries was used in six cases. In 39 patients, one of whom had already had arterial catheterisation, contrast medium was administered by the intravenous route, using a single, large volume, high speed bolus.In 12/44 cases (27%), digital angiography showed a normal vascular picture at the pudendal and penile level but the remaining 32 patients (73%) had steno‐occlusive lesions of different degrees of severity.The pictures obtained after administration of intravenous contrast were diagnostically as good as the studies with selective arterial catheterisation. In addition, the intravenous route allowed the simultaneous representation of the arterial network on both sides and was quicker and less invasive.In 31/44 patients (79%), functional determinations of nocturnal penile tumescence and of penile blood flow with Doppler ultrasonography were performed for comparison. Nocturnal penile tumescence results correlated well with the angiographic picture. Penile blood flow measurements with the Doppler technique were less sensitive than digital angiography.
Does the Severity of Presentation in Children with Vesicoureteric Reflux Relate to the Severity of the Disease or the Need for Operation?
Authors: OZEN H. A. , WHITAKER R. H. 
Published: November 2008

Summary— The presenting symptoms, number of previous urinary tract infections, grade of reflux and incidence of renal scarring, together with an analysis of the need for reimplantation of the ureters, were assessed retrospectively in 222 patients with vesicoureteric reflux. The grade of reflux was found to be as severe in patients presenting after a single urinary tract infection as in those presenting after more than one infection. Regardless of whether patients presented with mild, moderate or severe symptoms, the degrees of reflux and renal scarring remained similar. There was no relationship between the severity of presenting symptoms and the eventual need for ureteric reimplantation.All children should be investigated when they present for the first time with a urinary tract infection, irrespective of age, sex or severity of symptoms.
A New Technique for the Management of Urethral Injuries
Authors: TOWLER J. M. , EISEN S. M. 
Published: November 2008

Summary— A new technique for the management of urethral trauma is described. Initial suprapubic catheterisation is followed by endoscopic assessment after approximately 2 weeks. Realignment over a splinting catheter may then be achieved by instrumentation and endoscopy via both suprapubic and urethral routes.The development of the technique and the early results of a small series of patients are presented.