bluuebunny/crossref_metadata_2025_split huggingface dataset:
Urinary basic fibroblast growth factor in patients with bladder cancer and benign prostatic hypertrophy
Authors: O'BRIEN T.S. , SMITH K. , CRANSTON D. , FUGGLE S. , BICKNELL R. , HARRIS A.L. 
Published: November 2008

Objective To investigate the role of urinary measurements of an angiogenic factor, basic fibroblast growth factor (bFGF), in the assessment of patients with bladder cancer.Patients and methods Urine from 83 patients was assayed using a commercially available ELISA for bFGF. Thirty‐eight patients had a bladder tumour and 21 had a history of bladder cancer but no disease at the time of testing. Twenty‐four patients acted as controls, 16 of whom were about to undergo transurethral resection of the prostate (TURP) for benign prostatic hypertrophy (BPH) and eight who had no urological disease.Results Median urinary bFGF was higher in patients with active bladder cancer than in those with a clear cystoscopy (5.20 and 2.13 ng/g creatinine, respectively; P < 0.005). Median urinary bFGF was also elevated in patients about to undergo TURP (4.52 ng/g creatinine). Using a threshold value of 6.0 ng/g creatinine, the sensitivity of the test for detecting cancer was 42% and specificity was 88%. At a threshold value of 4.0 ng/g the sensitivity was 62% and the specificity 70%.Conclusion The relationship between urinary basic FGF and the presence of bladder cancer was significant. The test is not sufficiently sensitive or specific to use as a screening test for bladder cancer but may be very useful in monitoring the effectiveness of systemic therapies in bladder cancer. Elevated levels of bFGF in the urine of patients about to undergo TURP suggests a role for bFGF in the pathogenesis of BPH.
Exenteration as palliation for patients with advanced pelvic malignancy
Authors: WOODHOUSE C.R.J. , PLAIL R.O. , SCHLESINGER P.E. , SHEPHERD J.E. , HENDRY W.F. , BREACH N.M. 
Published: November 2008

Objective To examine the place of pelvic exenteration in the palliation of advanced and recurrent pelvic tumours.Patients and methods The notes of patients referred for palliative exenteration were reviewed retrospectively. Fourteen patients (three men, mean age 52 years, and 11 women, mean age 61 years) with a variety of pelvic tumours associated with severe symptoms, had a laparotomy with a view to pelvic exenteration and 10 underwent total or anterior exenteration.Results Eight patients achieved excellent or good palliation based on survival and quality of life assessment, and two received no benefit. Four of eight patients were alive and apparently free of tumour at a mean of 17 months after surgery. Four were alive, symptom‐free but with evidence of malignancy at a mean of 19 months. Two patients who received no benefit died at 2 and 7 months after surgery. The planned exenteration was abandoned in four patients; three of these four patients were dead at a mean of 13 months and one was alive at 12 months.Conclusion Our results confirm that with careful selection and appropriate multi‐speciality care, aggressive pelvic surgery is of value in the palliation of some tumours.
Tamsulosin, a selective α1c‐adrenoceptor* antagonist: a randomized, controlled trial in patients with benign prostatic ‘obstruction’ (symptomatic BPH)
Authors: ABRAMS P. , SCHULMAN C.C. , VAAGE S. 
Published: November 2008

Objective To evaluate the efficacy and safety of tamsulosin 0.4 mg once daily (as a modified‐release formulation) compared with placebo in patients with benign prostatic enlargement, lower urinary tract symptoms and prostatic ‘obstruction’ (symptomatic benign prostatic hyperplasia [BPH]).Patients and methods Of 313 patients with symptomatic BPH enrolled in a 2‐week placebo run‐in period, 296 were subsequently randomized to receive either placebo (98 patients) or tamsulosin 0.4 mg once daily (198 patients) for 12 weeks. The primary variables assessed to determine efficacy were maximum urinary flow rate (Qmax) from free‐flow measurements and the total Boyarsky symptom score.Results Tamsulosin produced greater improvements in Qmax(1.4 mL/s, 13.1%) than did placebo (0.4 mL/s, 3.8%) (P= 0.028) and a greater decrease in total symptom score (3.4 points, 35.8% reduction) than did placebo (2.2 points, 23.7% reduction) (P= 0.002). Significantly more tamsulosin‐treated patients (67%) than placebo‐treated patients (44%) had a ≥ 25% decrease in total symptom score after 12 weeks (P< 0.001). Treatment with tamsulosin for 12 weeks also produced significant improvements in average urinary flow rate (P= 0.040), irritative (P= 0.013) and obstructive (P= 0.014) symptom scores and symptoms of nocturia (P= 0.022) and hesitancy (P= 0.004). Tamsulosin was tolerated well by the patients. The incidence of adverse events emerging during treatment was comparable in the tamsulosin‐and placebo‐treated groups (34% and 24% respectively,P= 0.109), as was the incidence of cardiovascular‐related adverse events (5% and 7% respectively;P= 0.596). There were no significant differences in changes in blood pressure or pulse rates between the tamsulosin‐and placebo‐treated groups.Conclusion Tamsulosin 0.4 mg once daily is safe, well tolerated and clinically effective in improving symptoms and urinary flow rate in patients with symptomatic BPH.
The significance of prostatic intra‐epithelial neoplasia
Authors: ABOSEIF S. , SHINOHARA K. , WEIDNER N. , NARAYAN P. , CARROLL P.R. 
Published: November 2008

Objective To investigate the relationship between the detection of prostatic intra‐epithelial neoplasia (PIN) on initial prostate biopsy and subsequent invasive prostatic adenocarcinoma.Patients and methods Thirty‐six men (mean age 67 years, range 52–82) with PIN underwent digital rectal examination (DRE), serum prostate‐specific antigen (PSA) measurement and transrectal ultrasonography (TRUS) before the initial biopsy and documentation of PIN. They were followed up with serial PSA, TRUS and a repeat biopsy every 6 months until either invasive carcinoma was identified or 2 years had elapsed.Results The initial biopsy revealed Grade I PIN in 33%, Grade II in 22%, and Grade III in 45% of the men. The repeat biopsy showed evidence of invasive carcinoma in 21 patients (58%; Group I), while 15 (42%) showed persistence of PIN (Group II). In Group I, 19 had had high‐grade PIN (Grade II/III) on initial biopsy compared with one in Group II. The findings on DRE, and age, were not significantly different between groups. TRUS revealed a hypoechoic lesion in 15/21 patients in Group I compared with 7/15 patients in Group II. There was an increase in PSA level in 18 patients in Group I (from 8.4 to 11.6 ng/mL).Conclusions PIN and invasive adenocarcinoma of the prostate were closely associated, and the likelihood for coexistence was higher in patients with high‐grade PIN, increasing PSA level or positive findings on TRUS. We recommend that all patients who show high‐grade PIN on prostate biopsy be followed very closely with serial PSA measurements and repeat biopsies from both the area of PIN and other areas of the prostate.
Decreased immunoreactive androgen receptor levels are not the cause of isolated hypospadias
Authors: BENTVELSEN F.M. , BRINKMANN A.O. , VAN DER LINDEN J.E.T.M. , SCHRÖDER F.H. , NIJMAN J.M. 
Published: November 2008

Objective To elucidate whether diminished levels of androgen receptor (AR) are the underlying cause for the development of hypospadias by determining AR levels in the foreskins of boys with hypospadias.Patients and methods The content of AR was determined by a sensitive immunoblotting technique in extracts from preputial tissue obtained from 15 patients (mean age 2.5, sd± 1.5 years) with hypospadias and from seven controls (mean age 2.5, sd± 1.5 years). Immunoreactivity of the protein was measured by densitometry.Results No significant difference in mean AR content was found between those boys with hypospadias (2.1 ± 0.9 fmol/mg protein, ±sd) and the age‐matched control group (2.2 ± 0.3 fmol/mg protein). Stratification by the severity of hypospadias (distal and proximal on the shaft, and penoscrotal hypospadias) showed that the severity was not related to tissue AR levels.Conclusion It is unlikely that hypospadias is caused by a decreased expression of AR.
Urological community nursing: a new concept in the delivery of urological care
Authors: GROSE K. , BROOMAN P.J.C. , O'REILLY P. H. 
Published: November 2008

Objective To investigate the impact of a urological community nursing service on the mode of practice, efficiency, and quality of care in a urological practice.Methods A urological community nurse was appointed to investigate the possibility of performing various urological procedures in the community rather than in hospital, with a prospective audit of the results for a period of 1 year. The setting was a busy urological unit serving a mixed urban and rural catchment area of 300 000 people. The outcome was assessed by the number and type of procedures successfully transferred from hospital to community practice.Results In 1 year, 464 urological episodes were performed in the patients' homes which otherwise would have required transfer or admission to hospital for treatment or, in some cases, a cancelled operation. These episodes included tuition in clean intermittent self‐catheterization and dilatation, changes and insertions of urethral, suprapubic and nephrostomy catheters, bladder instillations to treat cancer and interstitial cystitis, voiding trials with no catheter, urosheath fittings, and pre‐operative visits and follow‐up visits to avoid attendance at the clinic.Conclusions The urological community nursing service transferred a significant number of routine urological procedures from hospital to community with considerable financial savings and improvement in the quality and efficiency of urological care.
Nottingham health profile measurement in the assessment of clinical outcome after prostatectomy
Authors: THORPE A.C. , CLEARY R. , COLES J. , NEAL D.E. ,   (on behalf of the Northern Regional Prostate Audit Group)
Published: November 2008

Objective To compare the changes in pre‐and post‐operative symptom scores with changes in Nottingham health profile (NHP) scoring, and thus determine whether NHP scoring offers a reliable assessment of outcome after transurethral resection of the prostate (TURP), and whether NHP scoring could usefully supplement the more traditional method of symptom scoring in this assessment.Patients and methods An 8‐month audit of 1396 TURPs, involving 12 hospital sites, was performed in the Northern region between April 1 and November 31, 1991. A cohort of 371 of these patients, for whom pre‐and post‐operative NHPs and irritative and obstructive voiding symptoms had been recorded, were investigated.Results There was a significant decrease in both obstructive and irritative voiding symptom scores 3 months after TURP and a significant fall in the NHP scores for all stations except social isolation. There were significantly higher irritative symptom scores both before and after operation in men with prostate cancer compared with those with benign prostatic hypertrophy, and significantly higher post‐operative obstructive symptom scores in men with prostate cancer. However, there were no significant differences in the pre‐and post‐operative NHP scores for these two subgroups of patients. In patients who had a good outcome on symptom scoring, there was a significant reduction in NHP scores for all stations except social isolation. However, in those patients who had a poor outcome on symptom score, there was no correlation with changes in the NHP scores, with some NHP stations showing a significant reduction after operation.Conclusion NHP quality‐of‐life scoring cannot replace symptom scoring in the assessment of outcome after TURP and when used alone, added little further information. However, for a comprehensive assessment of outcome, symptom scores and quality‐of‐life assessments should be used together.
Validation of the self‐administered Danish Prostatic Symptom Score (DAN‐PSS‐1) system for use in benign prostatic hyperplasia
Authors: HANSEN B.J. , FLYGER H. , BRASSO K. , SCHOU J. , NORDLING J. , ANDERSEN J. THORUP , MORTENSENM S. , MEYHOFF H‐H. , WALTER S. , HALD T. 
Published: November 2008

Objective To validate the Danish Prostatic Symptom Score (DAN‐PSS‐1), a self‐administered quality‐of‐life questionnaire comprising 12 questions related to voiding problems and the perceived bother of each individual symptom.Methods Using published results from several comparisons of other symptom scoring systems with DAN‐PSS‐1, the test‐retest reliability, internal consistency, construct and content validity, and responsiveness of the DAN‐PSS‐1 system were assessed.Results The system was internally consistent (Cronbach's alpha = 0.73), the median test‐retest reliability of answers to each question was 83.5% (range 0–99.7%) and the questionnaire was well understood by the patients. The DAN‐PSS‐1 system demonstrated a high degree of construct validity, correlating with the extensively used Madsen‐Iversen score system (Spearman's correlation coefficient, rs= 0.51) and with the patients' answers to questions about how bothersome their symptoms were (rs= 0.71). The DAN‐PSS‐1 system discriminated clearly between patients with benign prostatic hyperplasia (BPH) and control subjects (an area under the receiver operating characteristic curve of 0.94). Finally, the DAN‐PSS‐1 was sensitive to changes following intervention, with scores decreasing from a median of 20 to zero 4 months after patients underwent transurethral prostatectomy and from a median of 11.5 to 7.5 (65%) after patients had received 4 months treatment with an alpha‐blocker.Conclusions The DAN‐PSS‐1 system is reliable, valid and responsive, and therefore can be recommended for assessing the severity of symptoms among patients presenting with lower urinary tract complaints suggestive of BPH and in the follow‐up after intervention.
Treatment of stress incontinence by vaginal cones: short‐and long‐term results and predictive parameters
Authors: KONDO A. , YAMADA Y. , NIIJIMA R. 
Published: November 2008

Objective To evaluate prospectively the short‐and long‐term results of treatment with vaginal cones for women with urinary stress incontinence and to assess predictive parameters.Patients and methods Fifty women (mean age 49 years, range 28–76) with differing severities of stress incontinence (mean parity 2.4 and mean 60‐min pad‐test 20.7 g) were treated with cones for 15 min twice a day for 8 weeks. Treatment results were evaluated immediately after and at a mean of 3 years after the treatment. Parameters were analysed to determine those with predictive value for a successful outcome.Results Physiotherapy was assessed as being successful, i.e. a complete cure or a reduction of > 50% of the original severity, in seven patients (14%), while in 43 patients (86%) the treatment failed. After 3 years, 13 (30%) reported that the treatment was successful, 27 (61%) reported failure and four (9%) underwent surgery for stress incontinence. Those with lesser amounts of urinary loss and those with less frequent incontinence would be most likely to benefit from treatment with vaginal cones.Conclusion The treatment had a low success rate and we recommend that the vaginal cones should be used only for those with a slight or moderate degree of stress incontinence.
Prostate‐specific antigen levels in patients receiving long‐term dialysis
Authors: HARPER L. , MCINTYRE C.W. , MACDOUGALL I.C. , MEYER P. , RAINE A.E.G. , BAKER L.R.I. 
Published: November 2008

Objective To investigate the effect, if any, of renal failure upon prostate‐specific antigen (PSA) levels and the validity of PSA estimation as a marker of prostatic disease in renal failure.Patients and methods PSA was measured in 65 men (median age 67 years, range 39–84) on regular haemodialysis and 37 men (median age 70 years, range 42–77) on continuous ambulatory peritoneal dialysis (CAPD). Patients with a PSA level >4 ng/mL underwent prostatic biopsy guided by transrectal ultrasonography.Results There was no evidence of an artefactual elevation of PSA attributable solely to renal failure. All eight patients with a PSA level > 4 ng/mL had prostatic disease.Conclusion PSA measurements in patients with end‐stage renal failure treated by dialysis remain a useful marker of prostatic disease.
Urethral anaesthesia with topical bupivacaine. A role for a longer‐acting agent
Authors: DAWKINS G.P.C. , HARRISON N.W. , ANSELL W. 
Published: November 2008

Objective To assess the efficacy and toxicity of bupivacaine as a topical urethral anaesthetic.Patients and methods This prospective two‐part study comprised a pilot study of 10 men (mean age 73 years, range 39–86), to determine the toxicology, pharmocokinetics and suitable preparation of bupivacaine gel, and a study of 40 men (mean age 76 years, range 59–92) to compare the efficacy of bupivacaine with lignocaine gel. All patients were undergoing treatment for benign prostatic hyperplasia by transurethral radiofrequency heating using the Direx Thermex II system.Results There were no major adverse events. Bupivacaine provided good topical anaesthesia with a mean duration of 141 min, compared with 29 min for lignocaine. Serum samples taken from patients showed that the drug was absorbed slowly, and with a dose of 50 mg there was a wide margin between serum drug concentrations and toxic levels.Conclusion Bupivacaine is safe and effective as a topical anaesthetic agent in the urethra in circumstances where prolonged duration of action is desirable. For lower urinary tract procedures 20–22 mL of anaesthetic gel is required, giving 2–3 h of analgesia/anaesthesia with no significant toxicity or adverse effect. The application of longer‐acting anaesthetic agents need not be only during surgical intervention, but might usefully be extended post‐operatively to provide early management of pain.
Aspiration sclerotherapy for hydroceles in the tropics
Authors: MUSA M.T. , FAHAL A.H. , ARABI Y.E. EL 
Published: November 2008

Objective To assess the usefulness of aspiration sclerotherapy in the treatment of hydroceles in the tropics.Patients and methods This prospective study included 82 patients with 94 primary vaginal hydroceles of which 62 hydroceles were treated by aspiration and tetracycline hydrochloride sclerotherapy as an outpatient procedure (mean age of patients 56.5 years, range 40–82) and 28 were treated surgically and included as controls (mean age 52.4 years, range 40–70). All patients were followed for a year.Results In the sclerotherapy group, the overall cure rate after a year was 95%. Few complications were encountered in this group: six patients (10%) experienced pain during the procedure, seven patients (12%) had local infection and three patients (5%) developed haematoma. No recurrence was encountered in the surgical group, seven patients (25%) had infection and two patients (7%) developed haematoma. The mean hospital stay for the surgical group was 3.4 ± 1.3 days (range 1–7). Four patients with thick‐walled hydroceles had persistent swelling after sclerotherapy, the recurrence of which dissatisfied the patients.Conclusions Aspiration sclerotherapy for thin‐walled hydroceles proved to be a curative, simple, safe and cost‐effective out‐patient procedure. It can be an alternative to surgery in developing countries where resources are limited.
The incidence of testicular cancer in Royal Air Force personnel
Authors: FOLEY S. , MIDDLETON S. , STITSON D. , MAHONEY M. 
Published: November 2008

Objectives To review the incidence of testicular cancer within the Royal Air Force (RAF) compared with the national incidence.Methods The medical statistics for RAF personnel (supplied by the Central Statistics Office, categorized by occupation) were reviewed for the incidence of testicular cancer and compared to the national rate.Results A significantly elevated incidence of testicular neoplasm was detected in RAF personnel, which was well above the national rate. The increased incidence appeared most marked in those personnel working directly with aircraft.Conclusion The only cause of the significantly higher incidence of testicular cancer in RAF personnel is probably related to working with aircraft. This concurs with a finding that aircraft technicians in the US Navy had an increased incidence of testicular cancer, and the exposure to hydrocarbon carcinogens in the workplace was implicated.
Further clinical experience with the ileal W‐neobladder and a serous‐lined extramural tunnel for orthotopic substitution
Authors: ABOL‐ENEIN H. , GHONEIM M.A. 
Published: November 2008

Objective To report on the functional results following orthotopic substitution using an ileal W‐neobladder with an extramural serous‐lined tunnel for reflux prevention.Patients and methods Sixty men (mean age 46 years) underwent a one‐stage radical cystoprostatectomy and an ileal W‐neobladder for invasive bladder cancer. The technique entails the creation of two serous‐lined extramural tunnels in a detubularized ileal W‐bladder fashioned from 40 cm of the terminal ileum. Fifty‐one patients were evaluable, with a minimum follow‐up of 2 years. Evaluation of patients included clinical, radiographic and urodynamic studies.Results There was no operative mortality and no gross morbidity. The upper tracts remain unchanged or improved in 97% of the implanted renal units. Reflux was not observed in any patient. The incidence of day and night continence was 90 and 80%, respectively.Conclusion The technique provides a non‐obstructed unidirectional uretero‐ileal re‐implantation, in a low‐pressure system constructed from a short ileal segment. No staples were required.
Urinary tract obstruction and nephrostomy drainage in pelvic malignant disease
Authors: LAU M.W.M. , TEMPERLEY D.E. , MEHTA S. , JOHNSON R.J. , BARNARD R.J. , CLARKE N.W. 
Published: November 2008

Objective To determine the survival of patients after percutanous nephrostomy drainage (PND) for obstructive uropathy secondary to pelvic malignant disease.Patients and methods The records of 77 patients undergoing PND for obstructive uropathy were reviewed. Patients were classified according to the nature of the obstructing lesion: Group I (primary untreated malignancy. 31 patients); Group II (recurrent malignancy with further treatment. 15 patients): Group III (recurrent malignancy with no further treatment. 12 patients): and Group IV (benign disease as a consequence of previous treatment, 19 patients). Outcome was assessed by survival over a mean follow‐up of 20 months (range 2 days‐8.3 years).Results Overall median survival was 26 weeks, with a 5‐year survival of 22%. The survival in Groups I and II was not significantly different (median survival 27 and 20 weeks, respectively; 5‐year survival, 10% and 20%. respectively). Group III patients had a poor prognosis (median survival 6.5 weeks) with no patient surviving beyond one year, whilst Group IV patients fared best with a 5‐year survival of 64%. The commonest primary tumour type was carcinoma of the cervix (42 patients), and these patients were analysed as a subset. Benign post‐radiation fibrosis was found in 16 of 27 patients (59%). Survival was related to the diagnostic group.Conclusion The nature and extent of the obstructing lesion and its potential for further treatment are the major determinants of post‐nephrostomy survival. Every effort should therefore be made to identify the nature of the obstruction before deciding on PND.