bluuebunny/crossref_metadata_2025_split huggingface dataset:
Out‐patient Sclerotherapy of Idiopathic Left‐sided Varicocele in Children and Adults
Authors: BRAEDEL H. U. , STEFFENS J. , ZIEGLER M. , POLSKY M. S. 
Published: November 2008

Summary— Between 1983 and 1989, 334 patients with idiopathic left‐sided varicocele were referred for transfemoral sclerotherapy; 323 were adults and 11 were children.The standard site of injection of the sclerosing solution (Varicocid‐Natriummorrhuat 55 mg, Benzylalkohol 20 mg) was the mid‐portion of the spermatic vein. The upper third was injected only in cases where the catheter could not be negotiated further (e.g. abnormalities in the course of the spermatic vein or its drainage into the intrarenal veins). The amount of sclerosing material was predetermined fluoroscopically using contrast material. Occasionally, in cases of high catheter positioning, the Varicocid was injected fractionally. The amount injected was always between 1 and 3 ml. Of 80 patients studied 1 year later, varicoceles were still present in 3 (4%).The best results were achieved in patients with small varicoceles (Grade 1), normal testicular volume and normal FSH levels; 29% showed an improvement in sperm count and 27% an increase in sperm motility, while sperm morphology improved in only 7%. The conception rate was 11%.
Lithotripsy for Calculi in Caliceal Diverticula?
Authors: RITCHIE A. W. S. , PARR N. J. , MOUSSA S. A. , TOLLEY D. A. 
Published: November 2008

Summary— There is continuing debate about the optimum management of patients with calculi in caliceal diverticula. Extracorporeal piezoelectric lithotripsy (EPL) has the advantage of being noninvasive, whereas endourological management can treat the underlying anatomical problem. A total of 20 patients with calculi in caliceal diverticula were treated with EPL. Twelve of 16 patients with symptoms (75%) were rendered symptom‐free but only 5 (25%) became stone‐free.This information should be of value in counselling patients before selecting the appropriate treatment.
Clinical Significance of the Antibody‐coated Bacteria Test in Patients with Candiduria
Authors: OHKAWA M. , TOKUNAGA S. , SHODA R. , HISAZUMI H. 
Published: November 2008

Summary— The clinical significance of the antibody‐coated bacteria (ACB) test was evaluated with urine from 20 patients with candiduria. The relationship between the in vitro antibody‐coating test for Candida albicans, urinary immunoglobulin (Ig) levels and serum antibody titres was evaluated in 40 patients without candiduria, 23 of whom had bacterial urinary tract infection (UTI). Urine specimens from 19 of the 20 patients with candiduria gave a positive result regardless of clinical symptoms; 12/23 specimens of urine from patients with bacterial UTI were positive for antibody‐coated C. albicans cells, but there were no positive samples in the patients without UTI. All of the coating‐positive patients had serum antibody titres ≤ 1:160, the class of antibody being dependent on the urinary Ig levels.The ACB test for candiduria is of little clinical value in indicating invasive Candida UTI as the Candida cells appear to adhere to antibodies in urine contaminated with circulating fluids.
What on Earth are we Drinking?
Authors: MAYNE P. D. , EDWARDS L. 
Published: November 2008

Summary During the past few years there has been a considerable increase in the number and variety of still and carbonated bottled drinking waters, which have an enormous variation in calcium content ranging from 0 to over 500 mg/l.Patients with upper urinary tract stones are often advised to maintain a high fluid intake in order to achieve an increased urinary output. If they find tap water unpalatable and drink bottled water instead, they could significantly increase their daily calcium intake by as much as 1.5 g. The majority of bottled waters presently available in this country, together with tap water samples from throughout the British Isles, have been analysed and the results suggest that there are some waters which stone formers should avoid.
Asonic Imaging for Extracorporeal Shockwave Lithotripsy: Analysis of Factors in Successful Treatment
Authors: KIELY E. A. , MADIGAN D. , RYAN P. C. , BUTLER M. R. 
Published: November 2008

Summary The emergence of real‐time ultrasonic imaging for extracorporeal Shockwave lithotripsy poses questions regarding the factors and techniques which facilitate stone imaging for clinicians with no previous practical experience in ultrasonography. The ability of these clinicans to assess when stone disintegration has been achieved also needs to be confirmed. A wide range of data was recorded from each of 2688 lithotripsy treatments performed over a 2‐year period using the EDAP LT.01 ultrasound‐imaged piezoelectric lithotriptor. An analysis of these data was performed using a comprehensive microcomputer‐based statistics package.The mean time taken for stone imaging and positioning was reduced from 11.2 to 7.5 min over the 2‐year period. Obese patients and those with renal pelvic stones were best imaged in a lateral position. Overall there was no difference in percentage stone disintegration or clearance between treatments in the supine or lateral positions, but a significant reduction in the clearance of small caliceal stones resulted when the lateral position was used.Factors associated with a significantly greater percentage of stone disintegration and clearance included pain experienced by the patient during fine adjustment of the processing head during treatment, acoustic focus attenuation and widening and acoustic shadow widening as detected by the urologist at the end of treatment.Among the factors not associated with significant alterations in the percentage of stone disintegration or clearance were the lithotriptor operator, the side or site of the calculus, obesity and Shockwave frequency or power.This study confirmed the ability of urologists to develop expertise in ultrasonography for renal stone imaging and to interpret successfully the subtle signs of stone disintegration.
Cobb's Collar–a Forgotten Entity
Authors: CRANSTON D. , DAVIES A. H. , SMITH J. C. 
Published: November 2008

Summary— Cobb's collar or Moormann's ring is a stricture of the bulbar urethra which is largely unrecognised but has considerable relevance urologically as the site of congenital or post‐instrumental strictures. The history, anatomy, embryology and surgical importance are reported.Based on a Poster Demonstration at the 45th Annual Meeting of the British Association of Urological Surgeons inStHelier, June!989
Chronic Dehydration Stone Disease
Authors: EMBON O. M. , ROSE G. A. , ROSENBAUM T. 
Published: November 2008

Summary— A study was made of 819 patients attending a metabolic stone clinic. A firm diagnosis was made in 708 (86%) and in 132 of these (19%) the diagnosis was thought to be chronic dehydration. The records were available for study for 87 males and 11 females in the chronic dehydration group. The mean age at presentation was 43 years. The causes of chronic dehydration were hot climate (62%), with hot occupation and low water intake almost equal in second place. In patients with a single cause of chronic dehydration, 57% also had a dietary risk factor for urolithiasis and this was most commonly high oxalate intake.Following dietary advice, the mean urinary volume increased from 1720 to 2475 ml/24 h. This was accompanied by a rise in mean urinary calcium from 6.02 to 6.96 mmol/24 h, presumably due to the calcium in the additional water drunk. Urinary oxalate did not change significantly. The mean follow‐up time was 4.85 years and the stone recurrence rate was low.It was concluded that chronic dehydration is a common cause of urolithiasis; this can be treated satisfactorily by increasing water intake plus dietary advice in certain cases.
Ureteric Substitution with Boari Bladder Flap
Authors: MOTIWALA H. G. , SHAH S. A. , PATEL S. M. 
Published: November 2008

Summary— Between 1986 and 1989,12 patients underwent ureteric substitution with a Boari bladder flap at this Institute. The indications were ureteric injury following hysterectomy, difficult forceps delivery, difficult ureterolithotomy, ureteric strictures caused by a Dormia basket and previous ureteric surgery, tuberculosis, retroperitoneal fibrosis and a post‐ureteric reimplantation fistula.There were 2 patients with a solitary kidney and 2 in acute renal failure. Double J stenting was carried out in 11 patients and the stent was removed 3 to 6 weeks post‐operatively. Good results, with no morbidity or mortality, were achieved in all but 1 patient where a simple Silastic stent had migrated to the pelvis and required open surgery to remove it. We attribute our success to the tension‐free anastomosis, a wide based posterior flap with preservation of its vascular supply, the use of a double J stent and vicryl suture material.
Increased Survival of Patients with Massive Lymphadenopathy and Prostate Cancer: Evidence of Heterogeneous Tumour Behaviour
Authors: SANDHU D. P. S. , MAYOR P. E. , SAMBROOK P. , GEORGE N. J. R. 
Published: November 2008

Summary— The survival of patients with prostate cancer and radiologically detectable lymph node enlargement has been studied prospectively over an 8‐year period. Computed tomography in 108 patients presenting with symptoms, signs or biochemical results suggesting lymphatic spread revealed pelvic or abdominal node masses in 60 patients; in 29 (48%), the masses measured more than 4 cm and the maximum node diameter was 15 cm. Two‐thirds of patients had advanced (T3/T4) tumour stage.Following treatment, actuarial survival in all 60 patients with nodal enlargement was 40% at 5 years. Within this group, survival in 22 patients with lymphadenopathy but negative bone scans at diagnosis was significantly better than that of 38 patients with both node and bone disease (70% vs 20% at 5 years). This improvement was related both to an apparent inability of certain tumours initially to progress and seed within bone and to a marked sensitivity of the node masses to subsequent hormonal manipulation. Primary tumour grade was proportionally similar in both groups. Unexpectedly, 6 of the 38 patients with combined disease obtained a complete remission after treatment.The reason for this heterogeneous biological behaviour remains unclear; but these observations underscore the importance of vigorous treatment in all patients with advanced lymph node disease.
The Importance of Prognostic Factors in the Individual Treatment of Patients with Disseminated Germ Cell Tumours
Authors: MULDERS P. F. A. , OOSTERHOF G. O. N. , BOETES C. , DE MULDER P. H. M. , THEEUWES A. G. M. , DEBRUYNE F. M. J. 
Published: November 2008

Summary— Following chemotherapy for disseminated testicular cancer, 55 patients underwent surgery because of residual tumour. The histological findings were viable tumour in 12 patients, mature teratoma in 12 and fibrosis and/or necrosis in 31. Retroperitoneal abdominal masses were evaluated radiographically before and after chemotherapy. The reduction in size of these masses after chemotherapy appeared to have prognostic significance. A decrease of more than 70% was always associated with fibrosis. A residual mass over 50 mm indicated viable tumour or mature teratoma. Seminoma or embryonal carcinoma was more likely to result in fibrosis/necrosis in the resected tissue. Both the Indiana and the EORTC classification models can be used for prognosis.Radiographic measurements before and after chemotherapy are of considerable prognostic significance. These objective indicators help in planning treatment and so diminish the side effects of therapy and maintain or even increase the high cure rate in disseminated testicular cancer.
Foley Catheter Balloon Puncture and the Risk of Free Fragment Formation
Authors: CHRISP J. M. , NACEY J. N. 
Published: November 2008

Summary— The incidence of free fragment formation following balloon puncture or spontaneous bursting was examined in 294 Foley catheters immersed for 48 h in urine. The catheters were divided into 3 groups: 100 were inflated to the manufacturer's recommended volume, 100 to twice the volume and 94 to 3 times the recommended volume. The catheter balloons were punctured by pricking with a hypodermic needle.The overall incidence of free fragment formation was 27.3%. For both types of catheter examined, increasing balloon volume was not associated with an increased risk of free fragment formation following puncture. However, increasing volume was associated with increased free fragment formation when the balloon burst spontaneously.In view of the high risk of free fragment formation, cystoscopy should be performed in all cases of spontaneous catheter balloon rupture or after percutaneous balloon puncture.
The Effect of Post‐pubertal Varicocele on Testicular Volume
Authors: ERKAN I. , ÖZEN H. A. , ERGEN A. , REMZI F. 
Published: November 2008

Summary— Paediatric varicocele is a well known entity but its effect on adult infertility has not been adequately clarified. Since measurement of testicular volume is currently the best method of estimating the male reproductive potential, 945 boys aged between 13 and 18 years were examined with regard to testicular volume and the incidence of varicocele.The average volumes for right and left testes were 15.087 ±0.237 and 14.514 ± 0.347 ml respectively, and the incidence of varicocele was 16.7%. The incidence increased from 14.5 to 21.7% as the ages increased from 14 to 18.The differences in volume of the 2 testes in boys with varicocele were statistically significant when compared with the normal group, but this significance failed to become more pronounced when the slight varicocele group (grade I) was included with the normal group and compared with the severe varicocele group (grades II and III).There may be no significant differences between the volumes of the 2 testes in boys with varicocele when careful measurement and strict statistical analyses are applied.However, some boys in the varicocele group were found to have testicular volumes below the confidence interval (mean ‐ SE) or under 1 SD, and the 2 testicular volumes differed in certain age groups. This group requires further follow‐up.The results of this study have added further contradictory findings to the issue of paediatric varicocele in terms of testicular atrophy, estimation of potential fertility and the indications for immediate surgery. There is a need for further prospective controlled trials.
Adjuvant Topical Chemotherapy versus Immunotherapy in Primary Superficial Transitional Cell Carcinoma of the Bladder
Authors: FLAMM J. , BUCHER A. 
Published: November 2008

Summary— In a prospective randomised controlled study, the efficacy of ethoglucid was compared with that of keyhole‐limpet haemocyanin (KLH) in preventing recurrent tumours following transurethral resection of primary superficial transitional cell carcinoma of the bladder. Patients treated with ethoglucid (n = 39) received 0.565 g (1% solution) ethoglucid weekly for 6 weeks and then monthly for 1 year. Patients treated with KLH (n = 38) were immunised subcutaneously with 1 mg KLH; bladder instillations of 30 mg were then given weekly for 6 weeks and thereafter monthly for 1 year.The recurrence rates, disease‐free intervals and tumour progression rates were evaluated. The end‐point of the study was either progression in stage or grade or more than 1 recurrence during the observation period. The minimum length of follow‐up was 1 year. The recurrence rates, mean disease‐free intervals and progression rates in the 2 groups snowed no statistically significant differences.
Vasal Injuries during Childhood and their Effect on Subsequent Fertility
Authors: PARKHOUSE HELEN , HENDRY W. F. 
Published: November 2008

Summary— Thirty subfertile males had testicular obstruction following inguinal or pelvic surgery in childhood. All 13 patients with bilateral obstruction were azoospermic and 6 had developed antibodies to spermatozoa. Of 17 patients with unilateral obstruction, 11 had oligozoospermia and 6 had normal sperm counts: all had high titres of antibodies to spermatozoa (a significant difference from the men with bilateral obstruction). This indicates that male infertility can result from vasal or epididymal injuries in childhood due either to the obstruction itself or its immunological consequences.Following corrective surgery and prednisolone treatment for the antibodies, where appropriate, 5/17 patients with unilateral blocks and 1/11 with bilateral blocks successfully produced pregnancies.
Outcome of Antenatally Diagnosed Periureteric Junction Hydronephrosis
Authors: NAJMALDIN A. S. , BURGE D. M. , ATWELL J. D. 
Published: November 2008

Summary— Over a 6‐year period, in a series of 107 consecutive patients with antenatally detected urological anomalies, 45 had periureteric junction (PUJ) hydronephrosis (66 units). Of these, 24 units (36%) had obstructive (group I) and 42 (64%) non‐obstructive hydronephrosis (group II). Significantly compromised renal function was found only in group I. Treatment in group I was by an early pyeloplasty; in group II the patients were kept under close review. During the 6‐year period, 2 units (5%) in group II, deteriorated, 13 (31%) improved and 27 (64%) were unchanged.These results suggest that early in life, antenatally diagnosed PUJ hydronephrosis without obstruction may be a relatively benign condition but will require long‐term follow‐up in order to determine the natural history of the condition.
Prognostic Factors in the Conservative Treatment of Ureteric Stones
Authors: IBRAHIM A. I. A. , SHETTY S. D. , AWAD R. M. , PATEL K. P. 
Published: November 2008

Summary— A prospective study was made of 125 ureteric stones in order to detect factors which would predict the successful outcome of conservative treatment. The factors studied were the duration of pain prior to presentation, pyuria, haematuria, surface regularity of the stone and the degree of obstruction as seen radiologically.In stones ≤ 10 mm in size, conservative treatment was successful when the duration of pain was < 30 days (39/45), when there was no significant pyuria (53/82), when the stones had an irregular surface (44/65) and when obstruction was only partial (55/88). Since most of these factors were interactive, further statistical analysis showed that duration of pain was the only significant factor in predicting the outcome of conservative treatment.In stones >10 mm in size these factors had no predictive value and only 2/23 were passed spontaneously on conservative treatment.
Interpretation of Biopsies of “Normal” Urothelium in Patients with Superficial Bladder Cancer
Authors: RICHARDS B. , PARMAR M. K. B. , ANDERSON C. K. , ANSELL I. D. , GRIGOR K. , HALL R. R. , MORLEY A. R. , MOSTOFI F. K. , RISDON R. A. , USCINSKA B. M. 
Published: November 2008

Summary— In the course of a Medical Research Council trial of intravesical chemotherapy, biopsies were taken from apparently normal bladder urothelium near to newly diagnosed superficial bladder cancers in 417 patients. Differences were noted in the rates at which histological features were described in different centres. To gain more information about the reproducibility of the pathological findings, a group of 6 pathologists (5 from the UK and 1 from the USA), all having a special interest in urological pathology, were asked to examine a representative sample of 92 slides. They were then asked to re‐examine 30 of them after an interval of at least 6 months. At first examination and at reexamination the slides were assessed using a standard proforma. However, the definitions of the categories were left unspecified for the pathologists to use their own criteria. The 5 UK pathologists then met to establish a consensus view of each slide.The results indicated that: (1) The reporting of non‐dysplastic changes varied so much between pathologists as to render it of little value to clinical practice. (2) There were wide variations between different pathologists in the reported incidence of dysplastic change. (3) On a second review the pathologists reproduced their own assessment on only 62% of occasions. (4) Even after discussion between pathologists there was no consensus on the diagnosis of mild as opposed to moderate dysplasia. Consensus was reached on all biopsies which showed either severe dysplasia or carcinoma in situ. (5) In adopting a policy of taking urothelial biopsies, urologists should be aware of the imprecision and lack of reproducibility in the interpretation of such biopsies. (6) Biopsies of cystoscopically normal urothelium may not be a useful guide in defining therapy.
Optical Urethrotomy under Local Urethral Anaesthesia
Authors: GREENLAND J. E. , LYNCH T. H. , WALLACE D. M. A. 
Published: November 2008

Summary— A series of 46 patients underwent 76 optical urethrotomies under local urethral anaesthesia in the out‐patient clinic; in 70% of patients the strictures were controlled by local anaesthetic urethrotomy alone; 61% felt either no pain or mild pain during the procedure; 72% expressed a preference for local anaesthesia should the procedure have to be repeated and 82% were happy with the result of their treatment.Optical urethrotomy under local urethral anaesthesia produces results comparable to those reported by others using general anaesthesia. If large numbers of patients are to be treated, possibly repeatedly, then out‐patient urethrotomy may result in more efficient use of resources.
Flexible Cystoscopy Compared with Ultrasound in the Detection of Recurrent Bladder Tumours
Authors: DAVIES A. H. , MASTORAKOU IRENE , DICKINSON A. J. , CRANSTON D. , O'KELLY T. J. , TURNER W. H. , FELLOWS G. J. 
Published: November 2008

Summary— A combination of transrectal and transabdominal ultrasound was compared with flexible cystoscopy as a means of detecting recurrent bladder tumours. The study group comprised 50 patients who had previously had rigid cystoscopy. They underwent combination ultrasound in the out‐patient department 1 week before flexible cystoscopy. Combination ultrasound identified 25 patients with recurrent tumours and flexible cystoscopy identified 26.Thirty‐four patients (68%) preferred ultrasound, 10 (20%) preferred flexible cystoscopy, 3 (6%) preferred general anaesthesia and rigid cystoscopy and 3 (6%) had no preference. The main objection to ultrasound was the use of the transrectal probe.
Value of the Patient's Case History in Diagnosing Urinary Incontinence in General Practice
Authors: LAGRO‐JANSSEN A. L. M. , DEBRUYNE F. M. J. , Van WEEL C. 
Published: November 2008

Summary— What is the value of the case history in diagnosing urinary incontinence in general practice? A total of 103 women with urinary incontinence presented to their general practitioner (GP) and underwent a standard history‐taking, physical examination and urodynamic testing. The urodynamic diagnoses were analysed against symptoms and symptom complexes. Symptoms of stress incontinence in the absence of symptoms of urge incontinence had a sensitivity of 78%, specificity of 84% and predictive value of 87%. Symptoms of urge incontinence in the absence of symptoms of stress incontinence excluded genuine stress incontinence.Information on age, parity, enuresis, nocturia, frequency, urgency, cystocele, prolapse and hysterectomy did not contribute to a correct diagnosis.It was concluded that urodynamics are unnecessary in most women presenting with urinary incontinence in general practice.