bluuebunny/crossref_metadata_2025_split huggingface dataset:
Direct Vision Internal Urethrotamy. A Critical Review of 365 Operations
Authors: Holm‐Nielsen A. , Schultz A. , Møller‐Pedersen V. 
Published: November 2008

Summary—
Internal urethrotomy under direct vision for urethral strictures in the male was employed on 369 occasions in 225 patients during a 4‐year period.A retrospective review of results showed an overall cure rate of 77% but the cure rate after each individual operation was less than 50%. Operations for recurrence carried a significantly lower cure rate than initial operations but even after several recurrences there were reasonably good results considering the relatively minor procedure.An active post‐operative follow‐up employing routine urethroscopy showed significantly better results than mictiographic follow‐up.The post‐operative period of catheterisation and positive urine culture at the time of follow‐up had no significant influence on the results.
Prostaglandin Synthetase Inhibitors and their Effect on Urinary Calcium Excretion and other Parameters in Idiopathic Hypercalciuria
Authors: SHAH P. J. R. , ROSE G. A. 
Published: November 2008

Summary— The treatment of idiopathic hypercalciuric stone formers with the prostaglandin synthetase inhibitors flurbiprofen and indomethacin has been studied in two phases. Ten patients were studied in a metabolic unit for 14 days that included a control period of 7 days on a controlled intake of dietary calcium, followed by treatment with flurbiprofen 50 mg tds. Three patients were studied along similar lines and were treated with indomethacin 25 mg tds.A significant reduction in urinary calcium excretion was noted during the 7‐day control period during which dietary calcium intake was reduced to 700 mg daily. No further significant reduction in urinary calcium excretion was observed during the treatment with either flurbiprofen or indomethacin.Thirteen patients then continued to take flurbiprofen 50 mg tds for between 1 and 12 months. A small but not statistically significant reduction in urinary calcium excretion was noted by the third month of treatment, but this was not sustained.This study confirms the benefit of dietary restriction of calcium as the primary approach to the treatment of idiopathic hypercalciuria. Neither flurbiprofen nor indomethacin reduced urinary calcium excretion to significant levels. Their routine use for the treatment of idiopathic hypercalciuria cannot be recommended from the evidence of this study.
Practical Management of Patients with Dilated Upper Tracts and Chronic Retention of Urine
Authors: GEORGE N. J. R. , O'REILLY P. H. , BARNARD R. J. , BLACKLOCK N. J. 
Published: November 2008

Summary— Patients with chronic retention of urine associated with dilated upper tracts have been investigated by means of combined lower tract urodynamics and upper tract renography. It has been shown that minor alterations in bladder volume lead to marked changes in isotope washout from the upper tracts. It is concluded that the practice of slow decompression of the bladder in these patients is clinically impractical, and attention should be directed to the management of the post‐obstructive diuretic state.Further observations have suggested that upper tract drainage in such patients may be dependent upon postural factors, and the practical implication of this finding is discussed.
Vesico‐uterine Fistula
Authors: ILOABACHIE G. C. , NJOKU O. 
Published: November 2008

Summary— Nine cases of vesico‐uterine fistula caused by injury to the bladder at Caesarean section or by rupture of the uterus and bladder following obstructed labour are described.Symptoms depend on the level of the lesion, menstruation into the bladder and menouria occurring when the fistula is above the internal cervical os: whatever the level, most patients with vesico‐uterine fistula present with incontinence of urine.A transperitoneal approach appears to give better results than a transvesical repair.
An Experimental Model of Detrusor Instability in the Obstructed Pig
Authors: SIBLEY G. N. A. 
Published: November 2008

Summary— Bladder outflow obstruction was produced in 18 young male pigs using either a silver ring or a silk ligature placed around the proximal urethra. Normal growth of the animals resulted in progressive obstruction. This was monitored by urodynamic studies in conscious animals, using either long‐term indwelling bladder cannulae or by intermittent suprapubic catheterisation.At urodynamic assessment 3 to 5 months later, the obstructed pigs voided at an elevated pressure and with a diminished flow rate compared with control animals. Sixty‐four per cent of the obstructed pigs developed detrusor instability, with spontaneous contractions exceeding 15 cm H2O during bladder filling; another 14% had decreased bladder compliance. In control animals the filling cystometrogram was stable, with little pressure rise during filling and no spontaneous contractions.This animal model provides the opportunity to study the physiological changes responsible for the development of detrusor instability in the obstructed bladder. It may also be useful for evaluating new treatment regimes for detrusor instability.
Transurethral Resection of the Prostate and Bladder Neck Incision: a Review of 700 Cases
Authors: EDWARDS L. E. , BUCKNALL T. E. , PITTAM M. R. , RICHARDSON D. R. , STANEK J. 
Published: November 2008

Summary— Transurethral resection (TUR) is regarded as the treatment of choice for relief of outflow tract obstruction in the male, but bladder neck incision (BNI) is an acceptable alternative when the gland is small.Seven hundred cases of TUR/BNI have been reviewed (TUR = 388; BNI = 312). BNI was performed when the gland was less than 35 g and where there was no clinical suspicion of malignancy. The operative details of our single incision technique are given.While the patients in the BNI group were younger, catheter stay was shorter, there was less infection, a significantly reduced need for blood transfusion and a satisfactory outcome in terms of control and need for further surgery.BNI is a technically simpler procedure than TUR and is easy to teach and learn. Results show it is safe and effective for patients in acute retention as well as those treated electively and it is the operation of choice for small benign prostates.
Cord Compression and Carcinoma of the Prostate: is Laminectomy Justified?
Authors: IACOVOU J. W. , MARKS J. C. , ABRAMS P. H. , GINGELL J. C. , BALL A. J. 
Published: November 2008

Summary— Metastatic carcinoma of the prostate is a common cause of spinal cord compression. In this review of 37 men who underwent laminectomy for this condition this was the first presentation of previously undiagnosed cancer in 11 (29%).One year after decompression 17 (50%) were alive. Twenty patients (59%) could walk after laminectomy. All but 8 were relieved of pain and bladder function was improved in 1 3 (38%). Those ambulant before laminectomy (7) and those with occult prostate cancer did particularly well. Poor results were associated with a rapid onset of paraparesis and pre‐operative progression to paraplegia. A delay in diagnosis was detrimental to outcome.A high index of suspicion in patients with carcinoma of the prostate is essential so that early diagnosis can be made before paraplegia is established. Carcinoma of the prostate must always be excluded in men with cord compression of unknown aetiology.
Fracture of the Penis and Long‐term Results of Surgical Treatment
Authors: ÖZEN H. A. , ERKAN I. , ALKIBAY T. , KENDI S. , REMZI D. 
Published: November 2008

Summary— Twenty‐five patients with fracture of the penis were treated surgically between 1 968 and 1984. Long‐term follow‐up was obtained in 17. In no case were there any early post‐operative complications.All patients stated that they were achieving normal, painless erections; two patients developed a slight penile curvature but this did not affect their sexual activities. We strongly recommend early surgical intervention because of these encouraging results. Urethral injury associated with the fracture did not occur in this series.
Comparison of Long‐term Monitoring and Standard Cystometry in Chronic Retention of Urine
Authors: A. STYLES ROSEMARY , NEAL D. E. , RAMSDEN P. D. 
Published: November 2008

Summary—
Twenty‐eight men with chronic retention of urine were investigated by means of a standard medium fill cystometrogram and by long‐term monitoring of bladder pressure whilst the bladder filled naturally.Effective cystometric capacity was greater in each patient during standard cystometry (297 ± 180 ml) than during long‐term monitoring (99 ± 100 ml; p < 0.002). The incidence of detrusor instability was also greater during long‐term monitoring than during standard cystometry (p < 0.02).During filling, the detrusor pressure increased significantly both in standard cystometry (27.9 ± 22.8 cm H2 O; p < 0.002) and in long‐term monitoring (4.9 ± 6.5 cm H2 O; p < 0.002). The detrusor pressure rise during filling was significantly greater during the standard cystometrogram than during long‐term monitoring (p < 0.00). Even when the detrusor pressure rise was corrected to take account of the different cystometric capacities this difference persisted (p < 0.05).High end filling pressures are common in men with chronic retention investigated by means of a standard cystometrogram but are not observed during long‐term monitoring. Such high pressures are probably due to the unphysiological rates of filling and the large volumes of fluid instilled during standard cystometry.
Biochemical Monitoring of Carcinoma of Prostate Treated with an LH‐RH Analogue (Zoladex)
Authors: SIDDALL J. K. , HETHERINGTON J. W. , COOPER E. H. , NEWLING D. W. W. , ROBINSON M. R. G. , RICHARDS B. , DENIS L. 
Published: November 2008

Summary—
The levels of prostatic specific antigen (PSA) and prostatic acid phosphatase (PAP), both measured by radioimmunoassay, and two cancer indices given by the ratio of serum alpha‐I acid glycoprotein to prealbumin (AGP: Palb) and alpha)‐1 acid glycoprotein to alpha‐2 HS globulin (AGP:HS) were evaluated as markers to assess the response of prostatic cancer to treatment with Zoladex, an LH‐RH agonist.A rise in PSA and PAP occurred in 8/65 patients (12%) during the initial induction phase. In metastatic disease prior to treatment none of these indices was significantly different between patients who attained a sustained response and those whose response was nil or only transient. Responders and non‐responders could, however, be distinguished by the levels of various analytes after treatment. At 6 months the median PSA in those who responded was 2.5 ng/ml compared with 51.5 ng/ml in the non‐responders. At 12 months the figures were 3.0 and 155 ng/ml respectively. The corresponding median PAP levels were 1.4 and 19 ng/ml at 6 months and 1.3 and 18 ng/ml at 12 months. The AGP: Palb ratio was also significantly different in these two groups at 6 and 12 months.PSA appears to be the most sensitive indicator of the response to treatment. The likelihood of obtaining a prolonged clinical response can be assessed within 6 months of the start of treatment.
An Ecological Study of Infected Urinary Stone Genesis in an Animal Model
Authors: NICKEL J. C. , OLSON M. , McLEAN R. J. C. , GRANT S. K. , COSTERTON J. W. 
Published: November 2008

Summary— Direct molecular and morphological techniques of modern microbiology were used to monitor the sequential development of bacterial microcolonies and biofilms in a rat model of urinary infection and to demonstrate that the urease activity of the infecting organisms sets in course a series of reactions in which struvite and apatite crystals develop within the matrix of the enlarging bacterial aggregate. This forms multiple stone nidi on the uroepithelial surface upon which succeeding bacterial biofilms develop and with the incorporation of other urine components, such as urinary mucroproteins, establishes a matrix skeleton that becomes mineralised, thus allowing for the growth of the stone in concentric layers.To arrive at this hypothesis, we studied infection stone genesis using a newly developed model for infection‐induced bladder stone formation in the rat. We examined in detail the sequential events in the evolving microbial ecology of progressive struvite calculogenesis, using conventional microbiological techniques, direct ultrastructural observation, newly developed ultrastructural cytochemical localisation techniques and immunological procedures for stabilisation of the biofilm glycocalix and stone matrix in the rat model. It was concluded that the organic glycocalix material secreted by the associated bacteria comprises a substantial and aetiologically important part of the infection stone calculogenesis and matrix production.
Bilharziasis in Malignant Tumours of the Urinary Bladder
Authors: AL‐SHUKRI S. , ALWAN M. H. , NAYEF M. , RAHMAN A. A. 
Published: November 2008

Summary— In a review of 2248 cystoscopic examinations conducted over 10 years, malignant tumours of the urinary bladder were found in 172 patients. In 128 of these the condition was associated with bilharziasis. The lateral wall of the bladder was the commonest site (52.3%).Squamous cell carcinoma occurred in 78.1%. Forty‐nine patients refused surgery and eight were found to have advanced inoperable tumours. Seventy‐one patients had a total cystectomy. There were no operative deaths but post‐operative complications occurred in nine cases. Eight patients died within 2 years but 21 were well and tumour‐free at 5 years.It was concluded that there is a marked association between bilharziasis and bladder cancer. When the tumour is operable, cystectomy is the treatment of choice.
Experience with Intracorporeal Injection of Papaverine and Duplex Ultrasound Scanning for Assessment of Arteriogenic Impotence
Authors: COLLINS J. P. , LEWANDOWSKI B. J. 
Published: November 2008

Summary— We present our experience with the intracorporeal injection of papaverine and duplex sonography in the assessment of 47 patients with suspected vasculogenic impotence. Sonography and Doppler analysis were performed before and after the papaverine injection. The anatomy of the penis was easily seen. Flow in the deep arteries was obtained in most patients in both the flaccid and erect state. Patients with a good erectile response to papaverine injection had a larger increase in the inner diameter of the deep cavernosal artery than did those with a poor response. However, the percentage change in the diameter did not correlate with the degree of clinical response. Following injection, the systolic peak flow rates and diastolic minimum flow rates were higher in patients with some clinical response but only the increase in diastolic flow rates correlated in a stepwise fashion with the degree of clinical response.This technique provides a method for the objective assessment of response to intracorporeal papaverine injection. Its potential as a diagnostic test will only be determined after normal values are established. At present it appears most useful in patients responding poorly to papaverine injection by indicating the possible area of vascular impairment and the direction for further evaluation.
Urinary Excretion of a Metabolite of Histamine (1,4‐methyl‐imidazole‐acetic‐acid) in Painful Bladder Disease
Authors: HOLM‐BENTZEN M. , SØNDERGAARD I. , HALD T. 
Published: November 2008

Summary— Thirteen patients with interstitial cystitis (detrusor mastocytosis) and 12 other patients with painful bladder disease without mastocytosis collected 24‐h urine specimens that were analysed for the major metabolite of histamine, 1,4‐methyl‐imidazole‐acetic‐acid (1,4‐MIAA), by reversed phase ion‐pair high performance liquid chromatography. The median urinary excretion of 1,4‐MIAA was 3.34 mg/24 h (range 1.47–4.66) in the patients with detrusor mastocytosis and 1.75 mg/24 h (range 0.18–4.30) in the other patients with a painful bladder (P<0.01).It was concluded from this study that patients with a painful bladder and detrusor mastocytosis had a significantly elevated urinary excretion of 1,4‐MIAA compared with other painful bladder patients without mastocytosis, whose urinary excretion of 1,4‐MIAA was within the normal range (0.72–2.34 mg/24 h). We suggest that the urinary excretion of 1,4‐MIAA might be useful in the diagnosis of interstitial cystitis.
Prediction of Pyelocaliectasis in Follow‐up of Patients with Spinal Cord Injury
Authors: LLOYD L. K. , KUHLEMEIER K. V. , FINE P. R. , McEACHRAN A. B. , STOVER S. L. 
Published: November 2008

Summary— Two hundred and fifty spinal cord injury patients were studied on each of two occasions, 12 to 24 months apart, to determine which urological findings could be used to predict the subsequent development of clinically significant pyelocaliectasis. An equation was developed which correctly classified 90% of the patients who remained free of clinically significant pyelocaliectasis and 82% of the patients who subsequently developed clinically significant pyelocaliectasis.The statistically significant risk factors were renal calculi, bladder diverticula and a decrease in effective renal plasma flow. This study suggests that the presence of these risk factors warrants careful monitoring of renal function in these patients and appropriate management of bladder dysfunction.
Are Biopsies from the Prostatic Urethra Useful in Patients with Superficial Bladder Carcinoma?
Authors: RIKKEN C. H. M. , HELSDINGEN P. J. R. O. VAN , KAZZAZ B. A. 
Published: November 2008

Summary— Fifty male patients entered a Mitomycin C trial for superficial bladder cancer and biopsies in the prostatic urethra were taken with a cold cup biopsy forceps. In one patient this procedure failed. In 21 of 49 patients no abnormalities were detected but in the remaining 28 patients (57.1%) histological changes were found in the prostatic urethra. In 13 of these patients (26.5%) the changes were either carcinoma in situ (CIS) or superficial bladder carcinoma.Carcinoma in situ in the prostatic urethra was found in nine patients (18%) and in all but one it was combined with CIS in the bladder.These results indicate that biopsies from the prostatic urethra must be taken routinely in order to plan adequate therapy.
Urological Trauma and Severe Associated Injuries
Authors: MONSTREY S. J. M. , vander WERKEN C. , DEBRUYNE F. M. J. , GORIS R. J. A. 
Published: November 2008

Summary— Our experience with 212 cases of urinary tract injury in multiple trauma patients treated between 1972 and 1983 has been analysed and compared with data collected from 441 cases of isolated urinary tract injury during the same period.The following points are emphasised: (1) incidence and severity of urological trauma in multiple injured patients; (2) obstacles in diagnosis and the need for immediate radiographic assessment; (3) lower urinary tract injuries and the need for urinary diversion; (4) differences in therapeutic approach to renal injuries in multiple trauma patients. We paid special attention to the indication for surgical exploration in patients with a renal laceration and severe associated injuries.
Extracorporeal Shock Wave Lithotripsy. Is Sessional Access Worthwhile?
Authors: RAMSAY J. W. A. , MILLER R. A. , WHITEWAY JANET A. , WHITFIELD H. N. 
Published: November 2008

Summary— One hundred and fifty‐three patients with renal stones referred to one teaching hospital have received extracorporeal shock wave lithotripsy (ESWL) treatment as a result of a monthly sessional arrangement organised with a neighbouring lithotripter unit. The results of treatment, assessed 3 months after lithotripsy, showed results comparable with those from any lithotripter centre.Sessional access for lithotripsy may provide a satisfactory way of increasing the number of patients who are treated with lithotripsy by reducing the demand for beds at the hospitals where a lithotripter is sited.
Pathophysiology of Idiopathic Detrusor Instability and Detrusor Hyper‐reflexia
Authors: KINDER R. B. , MUNDY A. R. 
Published: November 2008

Summary— Muscle strips from urodynamically normal bladders and from bladders exhibiting idiopathic detrusor instability or detrusor hyper‐reflexia were compared under isometric conditions in an organ bath. Spontaneous contractions developed more often in unstable and hyper‐reflexic muscle and were of greater amplitude, frequency and basal tension.Electrical field stimulation caused a frequency‐dependent contraction which was largely abolished by both tetrodotoxin (TTX) and atropine in all three muscle types. Comparison of their frequency response curves demonstrated a significantly greater sensitivity than that of unstable and hyper‐reflexic muscle to low stimulation frequencies.Acetylcholine caused a dose‐related contractile response in all muscle types. There were no significant differences between the dose response curves of unstable and hyper‐reflexic muscle, and those of normal muscle.The results suggest that the pathophysiology of the involuntary detrusor contraction is common to both idiopathic detrusor instability and detrusor hyper‐reflexia and that this is related to a disorder of an intrinsic neuromodulatory mechanism within the detrusor muscle.
The Role of Prostate Specific Antigen in the Baseline Assessment of Patients undergoing Hormone Therapy for Advanced Prostate Cancer
Authors: EMTAGE L. A. , LEWIS P. W. , BLACKLEDGE G. R. P. 
Published: November 2008

Summary— One hundred and thirty‐nine patients with advanced prostate cancer were entered into a randomised trial to test the efficacy and tolerance of goserelin 3.6 mg depot (Zoladex) versus stilboestrol 3 mg/day. As well as the usual clinical and radiological assessments of extent of disease, we used an immunoradiometric assay of prostate specific antigen (PSA) (Hybritech Europe) and normal laboratory enzymatic assays of acid phosphatase (AP) and alkaline phosphatase (ALKP) for biochemical assessment. The upper limit of normal for PSA was taken as 10 μg/l.The range of PSA was wide and differed significantly from that of AP and to a lesser extent ALKP in metastatic cases. PSA outperformed both AP and ALKP in both the local and advanced groups in terms of sensitivity. There was no correlation, however, between histological grade and level of PSA, AP or ALKP (the latter in cases with bone disease). In patients with metastatic disease diagnosed by bone scan, nine patients had one abnormal site/one “hot spot”, and all of these had a PSA greater than twice the normal upper limit. Early death due to prostate cancer was noted in four patients with levels of PSA > 2500 μ/l.PSA is more sensitive than either enzymatic AP or ALKP in both locally advanced and metastatic prostate cancer and is useful in identifying those advanced cases who have single lesions on bone scan. In this series PSA gave an overall sensitivity of 89%, compared with 63% for AP and 64% for ALKP in patients with metastatic disease.
Treatment of Massive Haematuria with Aluminous Salts
Authors: ARRIZABALAGA M. , EXTRAMINA J. , PARRA J. L. , RAMOS C. , GONZÀLEZ R. DIAZ , LEIVA O. 
Published: November 2008

Summary—
Fifteen patients with massive vesical haematuria were treated with a 1% aluminium potassium sulphate solution in sterile distilled water, using continuous intravesical lavage with a double channel catheter. The haematuria was caused by vesical tumours in 13 patients, radiation cystitis in one and transurethral resection in one. Immediate side effects were few and none were noted in the long term, as judged by randomised biopsies from vesical mucosa. A complete response was noted in 66% of the patients, partial response in 15% and failure in 20%.This treatment is recommended for intractable bleeding from radiation cystitis and bladder