bluuebunny/crossref_metadata_2025_split huggingface dataset:
Chronic Retention of Urine. The Relationship between Upper Tract Dilatation and Bladder Pressure
Authors: A. STYLES ROSEMARY , RAMSDEN P. D. , NEAL D. E. 
Published: November 2008

Summary—
Twenty‐five men with chronic retention of urine were studied in order to investigate the relationship between upper tract dilatation and bladder pressure. Each underwent assessment of upper tract dilatation and urodynamic investigation before bladder drainage. Patients were reassessed 3 or more months after operation. Residual urine and detrusor contraction pressure decreased significantly after operation (P < 0.000l: P < 0.0l). A significant increase in effective cystometric capacity and a significant decrease in pressure rise during filling led to an improvement in compliance.At pre‐operative assessment, patients with upper tract dilatation had a significantly greater resting bladder pressure (P < 0.05), end filling pressure (P < 0.002) and pressure rise during filling (P < 0.02) than those without upper tract dilatation. In addition, statistically significant correlations were found between serum creatinine and end filling pressure (P < 0.05) and between upper tract dilatation and both high end filling pressure (> 25 cm H2O) and high pressure rise during filling (> 15 cm H2O: both P < 0.05).Whilst high end filling pressure and high pressure rise during filling were found to be closely associated with upper tract dilatation (sensitivity 93 and 100%), there was a high false positive rate (specificity 64 and 45%). Furthermore, statistical analysis demonstrated that these data had a continuous though skewed distribution, suggesting that it is not possible to make a clear distinction between high and low pressure chronic retention.
Restriction of Long‐term Indwelling Urethral Catheterisation in the Elderly
Authors: COOLS H. J. M. , MEER J. W. M. VAN DER 
Published: November 2008

Summary—
Eighty‐nine (16%) of 543 patients admitted to a chronic care centre in 1983 had an indwelling urethral catheter. Of the 89, 51 patients (57%) received the catheter in a general hospital, 4 (5%) at home and 34 (38%) in the centre. More than half of the catheters that were inserted in the hospital could be removed within 4 weeks of admission to the centre, implying that a more restricted use of indwelling catheters in hospitals is possible. Only 18% of the indwelling catheters remained in situ for the designated period of 1 month. The other catheters were changed before that time, mainly because of obstructed drainage or leakage of urine around the catheter.The incidence of bacteriuria among catheterised patients was 90%. The bacteria were multiresistant in 37% of these cases, compared with 25% of non‐catheterised patients. Multiresistant microflora were present significantly more often in the urine of patients admitted from hospitals (irrespective of whether they had a catheter) and the catheterised residents of the centre than in that of the other patients (P<0.001). When all patients of the centre were considered, it was found that 30.6% were treated with antimicrobial agents in the course of the year; 10.9% were treated more than once a year. This latter group of patients received 58% of all prescribed antimicrobial drugs; 37% of them had an indwelling catheter. The majority of catheterised patients (65%) did not need antimicrobial treatment.No significant influence of catheterisation on mortality could be demonstrated.
Diagnosis of Testicular Torsion Using Doppler Ultrasonic Examination
Authors: LEAHY P. F. 
Published: November 2008

Summary—
The differential diagnosis of acute scrotum in an emergency is difficult and the diagnosis is rarely certain. Moreover, torsion is often diagnosed too late to save the testis involved.The Doppler ultrasonic flowmeter has enabled us to make a correct and rapid diagnosis of acute scrotum and has reduced the number of negative scrotal explorations. It seemed logical to use the Doppler flowmeter in the diagnosis of torsion of the testis, since testicular blood flow should be diminished in torsion and unaffected in most other intrascrotal conditions. one testis can be used as a control in the qualitative evaluation of the sound of the testicular blood flow.The testes lend themselves to the use of this instrument because they are accessible and because one testis can be used as a control in the qualitative evaluation of the sound of the testicular blood flow.
Modified Method of Diuresis Renography for the Assessment of Equivocal Pelviureteric Junction Obstruction
Authors: ENGLISH P. J. , LAWSON R. S. , CARROLL R. N. P. , EDWARDS E. C. 
Published: November 2008

H. J. TESTASummary— Thirty‐ive hydronephrotic kidneys, in which diuresis renography showed either an equivocal (13) or non‐obstructive (22) response pattern, were studied by a modified method in which intravenous frusemide was given 15 min before the start of the renogram so as to assess elimination during the period of maximum diuresis. Thirteen kidneys were identified as obstructed, including three in which the standard diuretic renogram appeared to exclude obstruction. These results indicate that the modified method increases the specificity of diuresis renography when used to assess patients with equivocal pelviureteric junction obstruction.
Enkephalin Inhibits Presynaptically the Contractility of Urinary Tract Smooth Muscle
Authors: KLARSKOV P. 
Published: November 2008

Summary— The influence of methionine‐enkephalin and leucine‐enkephalin on human detrusor and on pig detrusor, trigone, bladder neck and urethral smooth muscle was investigated in vitro. The enkephalins inhibited the smooth muscle contractility presynaptically. Methionine‐enkephalin was about 40% more potent than leucine‐enkephalin.Phentolamine‐resistant contractions were less inhibited by the enkephalins than atropine‐resistant contractions and contractions that were not blocked. The inhibitory nerve responses of the trigone, bladder neck and urethra were unaffected.
Detection of Blood Group Antigens in Frozen Sections of Prostatic Epithelium
Authors: ABEL P. D. , MARSH C. , HENDERSON D. , LEATHEM A. , POWELL P. H. , WILLIAMS GORDON 
Published: November 2008

Summary— The detection of blood group antigens (BGA) in non‐malignant prostates by previous workers has been at best inconsistent. BGA have not before been detected in prostatic carcinomas. In this preliminary study, a variety of anti‐BGA reagents, with known specificities that involve the carbohydrate backbone in addition to the BGA specific terminal monosaccharides, were used to study the expression of the A and H(O) BGA in cryostat sections of 16 patients with benign prostatic disease and nine with prostatic cancer.Positive staining, appropriate to the patients' blood group, was seen in all of the benign tissues when anti‐BGA reagents that included specificity against type 2 backbone structures were used. Staining was absent, however, if the reagent had only type 1 specificity. The anti‐A and anti‐H(O) reagents which gave the best staining patterns in benign tissues were used in malignant tissues. No cancer was found to express A antigen but eight of the nine prostatic cancers were positive for the H (0) antigen irrespective of blood group.Using fresh frozen material and appropriate reagents, BGA may be reproducibly detected in the epithelium of all non‐malignant prostates, suggesting that a significant component of BGA is probably lipid‐based on type 2 carbohydrate backbone chains. Further studies of changes in BGA expression in prostatic cancer are warranted.
Incontinence in Female Neurogenic Bladders. Resolution by Endoscopic Bladder Neck Suspension
Authors: KATO K. , KONDO A. , TAKITA T. , GOTOH M. , TANAKA J. , MITSUYA H. 
Published: November 2008

Summary— Five incontinent females with neurogenic bladder diseases underwent endoscopic vesical neck suspension (Stamey procedure). Four patients have become dry on clean intermittent catheterisation and one has shown improvement. Bladder capacity was increased to a reasonable size in all patients. There has been no upper tract deterioration during the follow‐up period of 3 to 25 months.We believe that the Stamey procedure is useful in alleviating urinary incontinence in neurogenic bladders provided that the bladder is drained regularly by intermittent catheterisation and that low detrusor compliance or detrusor hyper‐reflexia is adequately managed.
Vasoactive Intestinal Polypeptide Concentration in Human Bladder Neck Smooth Muscle and its Influence on Urodynamic Parameters
Authors: KLARSKOV P. , HOLM‐BENTZEN M. , NØRGAARD T. , OTTESEN B. , WALTER S. , HALD T. 
Published: November 2008

Summary— Three human studies were performed to evaluate the influence of vasoactive intestinal polypeptide (VIP) on bladder and urethral function.Bladder neck smooth muscle biopsies were obtained from nine men with functional bladder neck obstruction, from 10 men with medium sized benign prostatic hypertrophy and from four patients with a normal infravesical outlet. The biopsies were analysed for VIP by radioimmunoassay and by immunohistochemistry. No differences were found between the groups.Pressure‐flow‐EMG studies were performed in five men and urethrocystometry was performed in six women at rest, repeated coughing and at squeezing before, during and after VIP 3 μg/kg x h intravenously. No systematic changes developed in any of the urodynamic parameters.
Prazosin in the Treatment of Prostatic Obstruction A Placebo‐controlled Study
Authors: KIRBY R. S. , COPPINGER S. W. C. , CORCORAN M. O. , CHAPPLE C. R. , FLANNIGAN M. , MILROY E. J. G. 
Published: November 2008

Summary— Eighty patients with prostatic obstruction were entered into a double‐blind parallel study of prazosin versus placebo. There were 25 withdrawals or exclusions, leaving 55 patients for analysis. Mean maximum flow rates increased significantly more in patients treated with prazosin than in those treated with placebo (P <0.005), but there was no significant reduction in maximum voiding pressure. The mean number of voids, recorded on diary cards, was reduced from an initial 10.0/24 h by 2.1 in the final week, a significantly greater reduction than in the placebo group (P <0.01). However, there were no statistically significant changes in the filling cystometrograms. When patients were classified as responders or non‐responders in terms of bladder filling, urine flow, bladder emptying, weekly average of voids/24 h and nocturia, the proportion of patients responding to prazosin was significantly greater in all categories except bladder filling and emptying.It was concluded that prazosin at a dose of 2 mg bd is a safe and effective treatment for prostatic obstruction and may be used in patients awating surgery and those who are unfit for operation.
Oral Ciprofloxacin as Prophylaxis in Transurethral Resection of the Prostate
Authors: MURDOCH D. A. , BADENOCH D. F. , GATCHALIAN E. R. 
Published: November 2008

Summary— A new quinolone antibacterial, ciprofloxacin, was evaluated as oral prophylaxis for transurethral resection of the prostate in a randomised controlled trial. A 3‐day course of peri‐operative ciprofloxacin 250 mg twice daily reduced the post‐operative infection rate, the post‐operative hospital stay and the frequency of infective complications.Ciprofloxacin was well tolerated and no significant haematological or biochemical side effects were detected.
Relationship between Voiding Pressures, Symptoms and Urodynamic Findings in 253 Men undergoing Prostatectomy
Authors: NEAL D. E. , STYLES R. A. , NG T. , POWELL P. H. , THONG J. , RAMSDEN P. D. 
Published: November 2008

Summary— Two hundred and fifty‐three men (age 69.2pL7 years) undergoing prostatectomy for bladder outflow obstruction were studied. The aims were to determine the distribution of voiding pressures and their relationship to presenting symptoms and urodynamic findings. Symptoms were scored by means of a standardised questionnaire and urodynamic studies were performed.Within this study group, high obstructive symptom scores were associated with low flow rates and high urethral resistance. However, high voiding pressures were not associated statistically with low flow rates or obstructive symptoms. Voiding pressures followed a unimodal, parametric distribution and a significant number of men had voiding pressures within the normal range: 9.1% had voiding pressures less than 55 cm H2O and 27.7% less than 75 cm H20.Irritative symptoms, on the other hand, correlated significantly with obstructive symptoms, high voiding pressures and urethral resistance. Furthermore, high voiding pressures were associated with small cystometric bladder capacities, low compliance and detrusor instability.Whilst these clinical and urodynamic parameters were associated statistically with voiding pressures, none proved specfic in being able to identify men with vioding pressures in the high or low end of the range.
Relationship between Detrusor Function and Residual Urine in Men undergoing Prostatectomy
Authors: NEAL D. E. , STYLES ROSEMARY A. , POWELL P. H. , RAMSDEN P. D. 
Published: November 2008

Summary— Two hundred and fifty‐three men undergoing prostatectomy were studied by means of urodynamic investigation to determine the relationship between the volume of residual urine and detrusor function.Increased volumes of residual urine were associated significantly with increasing age, low peak flow rate and high urethral resistance. However, weak voiding pressures were uncommon and did not correlate with increased residual volumes. Increased residual volumes also correlated significantly with a high resting detrusor pressure and a high detrusor pressure rise during the filling phase, but there was a wide scatter of the results for pressure rise and patients could not be classified into groups on the basis of this parameter.Whilst detrusor decompensation was not manifest by weak voiding pressures in patients with increased residual volumes, impairment of the ability of the detrusor to empty the infused cystometric capacity during the subsequent voiding study correlated with increased residual volumes. These data are consistent with theories relating bladder outflow obstruction to the development of increased volumes of residual urine in men undergoing prostatectomy.
The Vagina as an Alternative to the Rectum in Measuring Abdominal Pressure during Urodynamic Investigations
Authors: JAMES E. D. , NIBLETT P. G. , MacNAUGHTON J. A. , SHALDON C. 
Published: November 2008

Summary—
Pressure in the vagina as well as within the bladder and rectum was measured during urodynamic investigations. Rectal pressure is normally used to represent changes in abdominal pressure which, when subtracted from the total bladder pressure, provides a method of assessing detrusor function.This study showed that vaginal pressure represented changes in abdominal pressure more accurately and consistently than did rectal pressure, and the vagina is therefore recommended as an alternative site in conducting urodynamic studies.
Intraperitoneal Rupture of the Bladder Causing the Biochemical Features of Renal Failure
Authors: HEYNS C. F. , RIMINGTON P. D. 
Published: November 2008

Summary—
A group of 20 patients with intraperitoneal rupture of the bladder was compared with a group of 20 patients with haematuria due to renal injury. In patients admitted to hospital within 24 h of sustaining an intraperitoneal bladder rupture, the mean serum levels of creatinine and potassium were increased and the mean serum sodium level was decreased. However, the individual serum creatinine values were within normal limits in six of the 11 patients in this group. Patients presenting more than 24 h after intraperitoneal bladder rupture had an increased mean serum urea, creatinine and potassium level and a decreased mean serum sodium and CO2 content. The individual serum urea and creatinine values on admission to hospital were higher than normal in all nine patients in this group but the serum urea/creatinine ratio was not significantly elevated. A dramatic decrease in serum urea and creatinine levels was seen within 24 h after laparotomy and suturing of the bladder rupture.In patients with abdominal symptoms and signs, haematuria and the biochemical features of renal failure (elevated serum urea, creatinine and potassium, decreased serum sodium and CO2 content), the clinician should suspect an intraperitoneal rupture of the bladder.
Invasive Bladder Cancer. Should Patients who Respond to Radiotherapy be Treated by Cystectomy?
Authors: LANGEMEYER T. N. M. , PEER P. G. M. , JANKEGT R. A. , LEERS W. H. 
Published: November 2008

Summary—
A retrospective study was carried out on the long‐term survival (5–12 years) of 160 patients with invasive transitional cell cancer of the bladder treated with irradiation between 1972 and 1980. Follwing 40 Gy irradiation of the lower abdomen, treatment consisted of cystectomy or continued irradiation of the bladder region only. A full urological examination of the baldder established whether a patient was arespondr or non‐responder. The patients were divided into four groups: 27 responders treatd with cystectomy and diversion; 48 responders treated with continued radiotherapy up to 65 Gy; 24 non‐responders treated with cystectomy and diversion; 42 non‐responders treated with continued radiotherapy up to 65 Gy. Survival and complications of treatment were compared with regard to category and grade of the tumours and sex and age of the patients.It was concluded that the responders who underwent cystectomy after 40 Gy irradiation survived longer than those who received a full course of radiotherapy. The responders had a better survival rate than non‐responders, regardles of further treatment. Salvage cystectomy was rarely carried out and proved to be an unsatisfactory alternative, with a high operative risk and short survival.
Should pT1 Transitional Cell Cancers of the Bladder still be Classified as Superficial?
Authors: ABEL P. D. , HALL R. R. , WILLIAMS GORDON 
Published: November 2008

Summary— Of 171 patients consecutively presenting with newly diagnosed transitional cell cancer (TCC) of the bladder, 107 were “superficial”; 98 have been followed up for 2 years and 84 for 3 years. No patient with pTa TCC developed muscle infiltrating recurrences, although 15% progressed to pT1 category by 3 years. At 2 and 3 years respectively, 33 and 46% of the pT1 TCC had progressed to infiltrate muscle.The use of the term “superficial” to describe pTa and pT1 category TCC together in one grouping should be reconsidered.
Lack of Gonadal Protection by Medroxyprogesterone Acetate‐induced Transient Medical Castration during Chemotherapy for Testicular Cancer
Authors: FOSSÅ SOPHIE D. , KLEPP O. , NORMAN N. 
Published: November 2008

Summary— The serum FSH levels were analysed in 24 testicular cancer patients 3 to 9 years after intensive chemotherapy. Sperm cell counts were performed in 12 patients. In all cases a temporary medical castration had been achieved during intensive chemotherapy by the use of medroxy‐progesterone acetate (MPA) (500 mg daily per os). The hormone treatment was initiated on day 1 of the first chemotherapy cycle. Thirteen additional patients did not receive this hormone treatment but were treated by similar chemotherapy. The latter patients served as a control group.There was a tendency towards higher FSH levels in the MPA‐treated patients than in the controls. Following treatment, serum testosterone was significantly lower in patients who had received MPA during their intensive chemotherapy than in the controls. There was no difference between the groups with regard to recovery of sperm cell production after chemotherapy.An MPA‐induced medical castration during intensive chemotherapy in testicular cancer patients is ineffective in protecting the remaining testis against treatment‐induced damage to spermatogenesis, at least if hormone treatment is started simultaneously with chemotherapy.
Detrusor Behaviour Followng Implantation of the Brantley Scott Artificial Urinary Sphincter for Neuropathic Incontinence
Authors: MURRAY K. H. A. , NURSE D. E. , MUNDY A. R. 
Published: November 2008

Summary— During a 3‐year period, 102 Brantley Scott artificial urinary sphincters were implanted to control urinary incontinence. Nineteen patients underwent endoscopic sphincterotomy and artificial sphincter implantation for the control of sphincter weakness incontinence due to congenital neuropathic bladder dysfunction. None had previous augmentation or substitution procedures. Nine patients (47%) subsequently showed a deterioration in detrusor function, resulting in either recurrent incontinence or upper tract dilatation. Eight of these (89%) had previously been shown to have an intermediate pattern of neuropathic bladder abnormality.All patients implanted with an AUS require long‐term surveillance including videourodynamic studies, and patients with intermediate neuropathic bladders should be considered for augmentation or substitution at the time of implantation.
Prostatectomy or Conservative Management in the Treatment of Benign Prostatic Hypertrophy?
Authors: KADOW C. , FENELEY R. C. L. , ABRAMS P. H. 
Published: November 2008

Summary— A randomised, prospective trial comparing transurethral prostatectomy with conservative management was carried out in 38 men with proven bladder outflow obstruction. Patients were assessed urodynamically before treatment and 6 months later. All 21 patients who had a prostatectomy showed a significant improvement in peak flow rate, voiding pressures and residual urine volume, but only 71 % were symptomatically better. Of the 17 patients treated conservatively, 56% noted an improvement in their symptoms, although their peak flow rates and residual urine volume were virtually unchanged. Following prostatectomy, the incidence of detrusor instability fell by 78%, whereas in the conservatively treated group the reduction was only 50%.Patients who had done well or badly after treatment were analysed as separate subgroups. The single feature which distinguished between these two groups was the high incidence of reversion to bladder stability in those who had a good symptomatic response to treatment.
Lack of Relationship of Conus Reflexes to Bladder Function after Spinal Cord Injury
Authors: LUCAS M. G. , THOMAS D. G. 
Published: November 2008

Summary— A series of 20 patients with acute complete suprasacral cord lesions underwent serial urodynamic assessment of vesicourethral function and serial measurement of sacral reflex latency times (SRL) and reflex threshold throughout a follow‐up period of 42 to 83 weeks (mean 50).No correlation was found between any pattern of SRL latencies or reflex thresholds and subsequent bladder behaviour. The reproducibility of sacral reflex latencies was found to be poor (mean variation of serial measurements from initial reading 21%) and could not be explained on the basis of “dynamic” neurological recovery. Studies using the bladder as a stimulus site were unreliable. The value of SRL studies in detecting subtle neurophysiological changes is discussed.