bluuebunny/crossref_metadata_2025_split huggingface dataset:
Experience with Beta‐HCG‐Positive Seminoma
Authors: KUBER W. , KRATZIK CH. , SCHWARZ H. P. , SUSANl M. , SPONA J. 
Published: November 2008

Summary— The clinical findings, diagnosis and course of disease of eight patients with histological pure seminoma of the testis and positive serum P‐HCG levels are presented. In addition to routine investigations, immunohistochemical examination of the formalin‐fixed specimen by the immunoperoxidase technique was also carried out. Serum afeto‐protein levels of all eight patients remained normal. There was no correlation between serum P‐HCG level and tumour stage. The longest period of observation was 48 months, the shortest 11 months. All patients were treated primarily by radiotherapy. One patient also received chemotherapy and one patient underwent bilateral lymphadenectomy 13 months after radiotherapy.
The Patient with Exstrophy in Adult Life
Authors: WOODHOUSE C. R. J. , RANSLEY P. G. , WILLIAMS D. I. 
Published: November 2008

Summary— One hundred and one cases of classical exstrophy with at least 18 years of follow‐up are reported. There were 29 girls and 72 boys. Nine have died but only 3 of urological causes; 19 have been lost to follow‐up at various times. In patients born before 1953 and in later patients with small bladders, primary diversion was done. In other patients primary closure was attempted with an 18% continence rate.Successful bladder closure produced a 25% incidence of any kind of renal damage. With diversion the incidence was 30% (colonic loop) and 75% (ileal loop).Sexual function is good. Six men have initiated pregnancies; 8 girls had 11 pregnancies, producing 9 normal children.Education, employment and family life have not been substantially affected.
Optical Urethrotomy—a 3–Year Experience
Authors: STONE A. R. , RANDALL J. R. , SHORROCK K. , PEELING W. B. , ROSE M. B. , STEPHENSON T. P. 
Published: November 2008

Summary— One hundred and thirty‐seven patients underwent optical urethrotomy and have been followed up over a period of 3 years. The overall improvement rate was 66%. The results were unrelated to the length of history, the number of previous dilatations or the site of the lesion. However, traumatic strictures did significantly less well than the others. Although the procedure can be repeated, the chance of failure following the third or subsequent urethrotomy was much greater than after the first or second procedure.Urethrotomy for post‐prostatectomy membranous strictures was followed by incontinence in 31% of patients. Otherwise the procedure was safe and should be the first choice of treatment for most patients with urethral strictures.
Disrupting Injuries of the Membranous Urethra—the Case for Early Surgery and Catheter Splinting
Authors: AL‐ALI I. H. , HUSAIN I. 
Published: November 2008

Summary— We reviewed the outcome following primary definitive repair by catheter splinting in 16 patients presenting with total posterior urethral disruption following pelvic injury. There were two deaths in the early post‐operative period due to pulmonary embolism associated with other serious injuries. Five patients were judged to have a siginificant stricture at the site of injury, but all proved amenable to management with endoscopic treatment or periodic dilatation. None required a urethroplasty.The two cases with stress incontinence were related to concomitant injury of the bladder neck. Impotence persisted in 2 of 5 patients followed for longer than 12 months. Complications from catheter traction were not seen using the system of light interrupted traction described. A case is made for primary management by catheter splinting of such urethral injuries.
Justification of the Use of Surveillance in the Management of Stage I Germ Cell Tumours of the Testis
Authors: OLIVER R. T. D. , HOPE‐STONE H. F. , BLANDY J. P. 
Published: November 2008

Summary— Analysis of patients with germ cell tumours of the testis treated at the London Hospital during the last 30 years has shown that the incidence of pure seminoma has fallen from 69 to 39%. Coincident with this, the incidence of patients with metastases detectable at presentation in all other types of germ cell tumour has increased from 19 to 62%.These observations may explain why the relapse rate of the most recently treated patients with Stage 1 malignant teratoma was the same whether or not they received prophylactic radiotherapy and substantially less than that reported in the literature 30 years ago for orchiectomy alone.These changes justify the use of a surveillance policy for Stage 1 tumour in studies by specialist centres.
Autologous Renal Transplantation with Direct Pyelocystostomy in the Treatment of Recurrent Renal Calculi
Authors: PETTERSSON S. , BRYNGER H. , HENRIKSSON Ch. , NILSON A. E. , RANCH T. 
Published: November 2008

Summary— Six male patients with severe recurrent urinary calculus disease underwent renal autotransplantation with direct pyelocystostomy to allow spontaneous passage of stones. The only serious complication was an early renal vascular thrombosis with graft loss in one patient who had been operated on three times before with ipsilateral partial resections for nephrolithiasis. The other five patients did well (observation time 4–34 months). Their renal function has remained unchanged.Autotransplantation with direct pyelocystostomy should be considered in patients with multiple recurrent stones of the upper urinary tract, especially when some degree of obstruction has developed or when other predisposing anomalies prevail.
The Effect of Oral Acetohydroxamic Acid on Urinary Saturation in Stone‐forming Spinal Cord Patients
Authors: BURR R. G. , NUSEIBEH I. 
Published: November 2008

Summary— Chronic urinary infection is thought to be a major factor in the causation of urinary calculi in paraplegic patients. Acetohydroxamic acid is reported to be effective in some patients for the management of this type of stone disease, but there have been no studies of urinary saturation levels during therapy with this drug.In this study 10 patients received oral acetohydroxamic acid for seven days. Marked lowering of urinary pH and ammonium levels were observed, but decreases in urinary saturation were small. The administration of acetohydroxamic acid resulted in increased urinary excretion of magnesium and phosphate, effects that have not previously been reported.
Distigmine Bromide and Post‐Prostatectomy Voiding
Authors: SHAH P. J. R. , ABRAMS P. H. , CHOA R. G. , ASHKEN M. H. , GACHES C. G. C. , GREEN N. A. , WILES ANN 
Published: November 2008

Summary— Distigmine bromide (Ubretid) is a long‐acting anticholinesterase which is thought to improve detrusor function, restoring normal voiding patterns which may have been disturbed by autonomic overactivity, particularly after surgery.Ninety‐three patients entered a double‐blind study of the effect of distigmine bromide versus placebo on voiding after prostatectomy. The results demonstrated that there was a trend towards improvement but no statistically significant increase in post‐operative flow rates, in reduction in bladder volume, and in the incidence of re‐catheterisation in the patients treated with distigmine bromide.
Placebo—the Drug of Choice in Female Motor Urge Incontinence?
Authors: MEYHOFF H. H. , GERSTENBERG T. C. , NORDLING J. 
Published: November 2008

Summary— In a randomised double‐blind cross‐over trial of 19 females with motor urge incontinence but without bladder suspension defect, the effects of 14 days' treatment with emepronium bromide 200 mg qid, flavoxate chloride 200 mg qid or placebo qid were compared by means of micturition charts, the patients' drug preferences and evaluation of side effects.Placebo was the only drug giving rise to a statistically significant decrease in the frequency of voidings, incontinence and nocturia. Forty‐seven per cent of the patients preferred placebo and side effects were less frequent during treatment with this medication. No differences could be demonstrated between the effects of emepronium bromide and flavoxate chloride.Perhaps detrusor instability is not always the main reason for the voiding dysfunction in these patients, in whom the effect of placebo was equal or superior to the effect of “active drugs” and superior to no treatment at all.
Blood Concentration of Lignocaine after Application of 2% Lignocaine Gel in the Urethra
Authors: AXELSSON K. , JOZWIAK H. , LINGÅRDH G. , SCHONEBECK J. , WIDMAN B. 
Published: November 2008

Summary— In 35 patients undergoing topical anaesthesia with lignocaine (lidocaine) get (2% Xylocaine gel) the concentration of lignocaine base was measured in repeated venous blood samples. Twenty patients (group I) were given 20 ml of 2% lignocaine gel (400 mg lignocaine) and 5 patients (group II) received 40 ml (800 mg lignocaine) endourethrally. These 2 groups of patients underwent either dilatation of the urethra or urethrocystoscopy. Ten patients (group Ill), undergoing transurethral resection of the prostate or a bladder tumour, were given 20 ml of gel (400 mg lignocaine) plus spinal anaesthesia with 2 ml of 5% lignocaine (100 mg lignocaine) with 7.5% glucose (Xylocaine “heavy”).The mean peak blood concentrations of lignocaine in these 3 groups were 0.06, 0.15 and 0.36 μg/ml respectively. Patients undergoing urethral dilatation had significantly higher blood concentrations than cystoscopy patients. The blood concentrations in group III were not higher than the expected value when spinal anaesthesia and lignocaine gel were given simultaneously. There was no statistically significant difference in the blood concentration between patients undergoing different types of transurethral resection (prostate and cancer of the bladder).Lignocaine applied endourethrally gives an extremely low blood concentration which is far below the level which can cause general toxic symptoms.
Fluphenazine/Nortriptyline in the Irritable Bladder Syndrome. A Double‐blind Placebo Controlled Study
Authors: Martin M. R. , Schiff A. A. 
Published: November 2008

Summary— A double‐blind, placebo controlled, randomised order crossover study was carried out on the effect of Motival (0.5 mg fluphenazine with 10 mg nortriptyline) 3 times daily on the bladder function and psychiatric morbidity of 13 women without evidence of infection, complaining of recurrent dysuria and frequency. Bladder function was assessed symptomatically and by ambulatory urodynamics, and patients completed the General Health Questionnaire, a validated instrument for the detection of psychiatric disturbance.Correction of the urodynamic abnormalities was associated with Motival treatment in 5 of the 8 patients with unstable bladders, compared with none of 7 patients receiving placebo (P < 0.02). Motival was also associated with a greater frequency of symptomatic improvement. Only 2 patients were classified as psychiatrically disturbed, suggesting that the therapeutic effect of Motival is not related to its psychotropic properties.
The Meatal Problem with TUR Prostate: the Value of Post ‐ operative Self ‐ dilatation
Authors: Walton J. K. , Wright W. L. , Robinson R. G. , Nacey J. N. 
Published: November 2008

Summary— In a preliminary retrospective study, we found that 37% of patients about to undergo a transurethral resection of the prostate had an external meatus too small to admit a 26 F resectoscope sheath.In a prospective study, a formal meatotomy was compared with an Otis urethrotomy for patients with narrow meatus. This study was stopped because 71% of cases having a meatotomy developed strictures compared with 29% having an internal urethrotomy.In a further study of 59 patients, regular self ‐ dilatation of the meatus with a plastic spigot was compared with internal urethrotomy of the meatus alone. Seven per cent of cases having self ‐ dilatation developed strictures compared with 34% having internal urethrotomy.It was concluded that in those patients with a narrow external meatus meatotomy should not be carried out, but self ‐ dilatation following internal urethrotomy greatly reduces the incidence of meatal strictures.
Urinary Tract Undiversion
Authors: Sheehan S. J. , Duff F. , Guiney E. J. , Kelly D. G. , Smith J. 
Published: November 2008

Summary—
Nine children underwent urinary diversion for lower urinary tract obstruction and were followed for periods of 2.5 to 15 years (median 10 years). Eight had cutaneous ureterostomies and the ninth had an ileal conduit. Undiversion was performed because of the return of normal function, the possibility of renal transplantation and ileal conduit stomal obstruction.The patients have been followed for periods ranging from 6 months to 9 years (median 2.5 years) after undiversion. To date, eight have moderate to good renal function. The remaining child has progressive renal failure. Eight are continent and one has mild stress incontinence.
The Natural History of Ureteric Bilharzia
Authors: NAUDE J. H. 
Published: November 2008

Summary— A prospective study of apparent obstruction of the ureter by Bilharzia was undertaken.Over a 2‐year period, 130 patients with active Bilharzia and 58 patients with inactive or chronic Bilharzia, all of whom had apparently obstructive lesions of the ureter, were studied.Ureteric lesions were examined for true mechanical obstruction by post‐micturition erect radiography, erect diuresis renography and, in selected cases, by perfusion pressure flow studies.Of the 130 patients with active Bilharzia, 32 ureters were found to be mechanically obstructed and in each case the obstruction resolved with anti‐bilharzial medication.Of the 58 patients with chronic or inactive lesions, only 5 ureters were found to be truly obstructed and required surgery.It is concluded that surgery is unnecessary for ureters obstructed by active Bilharzia within 2 months of starting treatment because the obstruction will resolve in most patients. In the so‐called chronic bilharzial stricture, obstruction is more apparent than real and thorough investigation will save many patients from unnecessary surgery.
Urological Problems Following Treatment of Carcinoma of the Cervix
Authors: JONES C. R. , WOODHOUSE C. R. J. , HENDRY W. F. 
Published: November 2008

Summary— One thousand one hundred and sixty‐one cases of carcinoma of the cervix presenting over a 20‐year period to 1982 were considered: 326 (28%) of these women developed urological problems, of whom 82 (7%) had major complications. Fistula formation occurred in 46 cases (4%), and was associated with active malignant disease in 33. Significant progressive ureteric obstruction occurred in 15 patients, 11 of whom had active malignancy. Overall, 35 (43%) of 82 patients with major urological problems had no evidence of active disease.Urinary diversion by ileal conduit proved to be a relatively simple and effective way of dealing with the serious problems, especially for patients with fistula formation and progressive ureteric obstruction, 67% and 73% of whom, respectively, underwent this procedure. More complex reconstructive surgery proved successful in a small number of selected patients, in whom there was no evidence of active tumour. Attempts to compromise with less definitive or over‐ambitious procedures resulted in further complications and prolonged hospitalisation.
Stamey Endoscopic Bladder Neck Suspension for Stress Incontinence
Authors: ASHKEN M. HANDLEY , ABRAMS P. H. , LAWRENCE W. T. 
Published: November 2008

Summary— Sixty female patients with clinically demonstrable stress incontinence of urine have had a Stamey operation during the last 3 years. The results have been good in curing stress incontinence, whilst the majority of the failures have been in patients with severe detrusor instability or a chronic cough.There have been few post‐operative complications and urodynamic studies have shown improved cough urethral profiles and no evidence of bladder outflow obstruction. The Stamey procedure can be recommended as the initial operation for surgically curable incontinence. Mild bladder instability is not a contraindication to the operation and it is also useful in elderly, unfit or obese patients.
Urodynamic Evaluation of Bladder Neck Obstruction in Chronic Prostatitis
Authors: MURNAGHAN G. F. , MILLARD R. J. 
Published: November 2008

Summary— Urodynamic assessment was performed in 50 patients with symptoms which supported a diagnosis of chronic prostatitis and commonly suggested outflow obstruction. Twenty‐three patients had bladder instability with an equal incidence with or without obstruction; this was demonstrated in 30 patients and was localised to the bladder neck in 24 and to the prostate in 6. A sensory problem presented on urodynamic testing in 26 patients (52% of the entire series), with a lower incidence (43%) in the obstructed group.Posterior urethritis was found in 28 (78%) of 36 patients subjected to cystourethroscopy. Endoscopic findings were suggestive of obstruction in 20 (95%) of 21 patients with urodynamic evidence of outflow obstruction and the sites of obstruction generally corresponded. The studies have provided urodynamic evidence that bladder neck obstruction could be a significant though not a predominant factor in the aetiology of the clinical syndrome of chronic prostatitis.
Selection of Patients For Implantation of the Brantley Scott Artificial Urinary Sphincter
Authors: MUNDY A. R. , STEPHENSON T. P. 
Published: November 2008

Summary— The Brantley Scott artificial urinary sphincter (AUS) is a safe, effective and relatively trouble‐free device for the control of sphincter weakness incontinence. Suitable patients should have no other urodynamic dysfunction or have had such a dysfunction corrected or controlled.Patients with post‐prostatectomy incontinence pose no problems in selection, although as a group they are the most prone to develop complications.Pure stress incontinence does not warrant implantation of an AUS except in very rare instances.In neuropathic dysfunction the AUS is one of several treatment options for the correction of incontinence and is most effectively used as such.In all patients, thorough pre‐operative videourodynamic evaluation is essential to get the best results and therefore to justify the infective and mechanical risks and the expense of the device.
Scanning Electron Microscopy of Human Bladder Mucosa in Acute and Chronic Urinary Tract Infection
Authors: ELLIOTT T. S. J. , SLACK R. C. B. , BISHOP M. C. 
Published: November 2008

Summary— The morphological response of the bladder surface to acute and chronic urinary tract infection (UTI) was investigated using both scanning and transmission electron microscopy of bladder biopsies taken during routine cystoscopy. Acute bacterial infection only minimally altered bladder epithelium, whereas in chronic infections the surface layers showed gross changes which included loss of the outer layers of epithelial cells and alteration of the bladder contour. In addition, more erythrocytes and polymorphonucleocytes were present in chronic infection. In both acute and chronic urinary infection, bacteria were confined to a limited number of sites on the bladder surface and appeared to be arranged in microcolonies, but more bacteria were attached to bladder surfaces in chronic than in acute UTI. These findings were confirmed by studying epithelial cells shed from patients with proven urinary infections.A few patients who had been treated with antibiotics before cystoscopy and biopsy were also studied. These antibiotics included cephalosporins which had been previously shown to produce bacterial morphological variations in vitro. Some of these changes were subsequently observed in the biopsies and the results suggest mechanisms whereby bacteria involved in urinary tract infection can survive exposure to antibiotics.
Sexual Function in Prostatic Cancer Patients Treated with Radiotherapy, Orchiectomy or Oestrogens
Authors: BERGMAN B. , DAMBER J.‐E. , LITTBRAND B. , SJÖGREN K. , TOMIĆ R. 
Published: November 2008

Summary— Sexual function in prostatic carcinoma patients was studied in 12 patients from each of three treatment groups: radiotherapy, orchiectomy and oestrogen treatment. Significant deterioration occurred in all groups. Although erectile potency was preserved in 9 of 12 patients treated with radiotherapy, 7 of these had a marked reduction in the frequency of sexual activity. Men subjected to orchiectomy or oestrogen treatment were seldom capable of having intercourse or of experiencing orgasm. However, oestrogen‐treated men continued sexual activity with their partner more often than orchiectomised subjects.Patients receiving oestrogen treatment scored significantly higher for mental depression than those in the other two treatment groups.
Survey of Antibiotic Prophylaxis in British Urological Practice
Authors: WILSON N. I. L. , LEWI H. J. E. 
Published: November 2008

Summary— Guidelines for the use of prophylactic antibiotics to cover operative procedures on the urinary tract have been suggested, but the extent to which these have been adopted into routine practice has not been assessed.This survery documents the use of prophylactic antibiotics in urological surgery in Britain. It demonstrates that awareness of the potential role of antibiotic prophylaxis is increasing. Most urologists now adopt a selective approach in the use of prophylactic agents.
Biochemical Studies in Paraplegic Renal Stone Patients: 2. Urinary Excretion of Citrate, Inorganic Pyrophosphate, Silicate and Urate
Authors: BURR R. G. , NUSEIBEH I. , ABIAKA C. D. 
Published: November 2008

Summary— The urinary excretions of citrate, inorganic orthophosphate and pyrophosphate, silicate and urate were measured in 17 paraplegic patients with renal calculous disease associated with urinary infection, in 16 paraplegics with no history of urinary calculus and in 14 healthy control subjects.The paraplegics excreted less citrate, orthophosphate and pyrophosphate than the control subjects. The stone‐formers excreted more urate than the paraplegics without stone disease, but less than the control subjects. There were significant positive correlations between urinary orthophosphate and pyrophosphate and between urinary silicate and 24‐ h urine volume.The possible roles of increased urate and diminished excretion of citrate and inorganic pyrophosphate in the aetiology of renal calculosis in paraplegic patients deserve further investigation.
Long‐term Follow‐up, Further Experience with and Modifications of the Transverse Colon Conduit in Urinary Tract Diversion
Authors: SCHMIDT J. D. , BUCHSBAUM H. J. , NACHTSHEIM D. A. 
Published: November 2008

Summary— In the past 6 years, an additional 22 patients with extensive pelvic irradiation have had their upper urinary tracts diverted employing the transverse colon conduit. Most procedures were performed with radical cystectomy following high dose radiotherapy in patients with bladder cancer or with pelvic exenteration for recurrent cervical cancer. The operative mortality rate was unchanged at 4%. Upper urinary tracts and renal function have remained stable or improved in 88 and 95% of patients respectively. Although most conduits were constructed with refluxing ureterocolic anastomoses and without stents, the more recent procedures have employed both antireflux submucosal tunnel anastomoses and stents.Nineteen of 25 patients diverted by this method between 1970 and 1976 have been followed for up to 155 months. All patients with recurrent or persistent malignancy have died (mean survival 44 months). Seven patients (37%) are living and well (mean survival 104 months). Upper urinary tracts remain normal in two‐thirds of those with the longer follow‐up.Major complications requiring additional surgery continue to occur in one‐third of this highly selected group of patients in whom the transverse colon conduit remains the preferred diversionary technique.