bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effects of External and Direct Pudendal Nerve Maximal Electrical Stimulation in the Treatment of the Uninhibited Overactive Bladder
Authors: OHLSSON B. L. , FALL M. , FRANKENBERG‐SOMMAR S. 
Published: November 2008

Summary—
Maximal electrical stimulation (MES) administered from a laboratory device designed to deliver stimulation pulses of relatively high voltages and currents was performed in 29 patients. All had suffered from bladder overactivity for several years, either idiopathic detrusor instability or an uninhibited overactive bladder, and all had failed to respond to conservative treatment.MES was performed in female patients by means of intravaginal and intra‐anal electrode carriers and in males by anal electrodes only. In some cases additional stimulation was administered by means of a single needle bipolar electrode inserted directly into the pudendal nerve. Maximal amplitude was attained after gradual increases in amplitude and the patient's adaptation to this. Stimulation was administered by the therapist but the amplitudes were determined by the patient and limited by his/her pain threshold. Alternating rectangular constant voltage pulses at a repetition rate of 10 Hz were used. Treatment consisted of 4 sessions of stimulation with intervals of 1 week between each application.All patients showed a significant increase in functional bladder capacity and 11 reported a 30% decrease in the frequency of micturition. Two patients were unaffected by stimulation with external electrodes but responded well to direct pudendal nerve stimulation. MES seems to be an effective first‐line treatment for the uninhibited overactive bladder.
Urinary Retention after Renal and Ureteric Surgery
Authors: DEMIREL A. , POLAT Ö. , SIYEZ E. , BAYRAKTAR Y. 
Published: November 2008

Summary— A retrospective study was carried out on 200 patients who underwent surgery between January 1989 and September 1991. The aim was to investigate the development of urinary retention following renal and ureteric surgery. The incidence of urinary retention was 55% for patients in the renal group and 26% for those in the ureteric group. In a control group of 100 patients undergoing cholecystectomy the incidence was 5%.The results showed that bladder function was inhibited greatly after renal surgery. Catheterisation in the pre‐operative period may help to prevent post‐operative urinary retention.
Recurrent symptoms of urinary tract infection in eight patients with refluxing ureteric stumps
Authors: PERSAD R. , KAMINENI S. , MOURIQUAND P. D. E. 
Published: November 2008

Objectives To evaluate and discuss the recurrent symptoms presented by eight patients with refluxing ureteric stumps. Patients and methods Eight patients (three boys, five girls: mean age: 8 years, range 11 months‐14 years) with refluxing ureteric stumps presented with recurrent urinary tract infections. Six developed symptoms mimicking pyelonephritis, even though the kidney had been partially [5] or totally [3] removed. The stump was removed in all patients. Results The stumps that were excised measured between 5 and 10 cm in length and were always dilated and inflamed. The results of histological examination and follow‐up are reported. Conclusions A dual approach is recommended when complete excision of the kidney and ureter is required. Symptoms of pyelonephritis are not pathognomonic of parenchymal infection but reflect infection above the vesico‐ureteric junction. The distinction between supra‐junctional and infra‐junctional urinary tract infections seems more appropriate and is discussed.
Significance of the evaluation of asymptomatic microscopic haematuria in young men
Authors: SPARWASSER C. , CIMNIAK H. U. , TREIBER U. , PUST R. A. 
Published: November 2008

Objective To evaluate the extent of diagnostic evaluation that is necessary in young men with asymptomatic microscopic haematuria. Patients and methods A group of 157 men (mean age 24.8 years [range 18–53]) who presented with asymptomatic haematuria were investigated with repeated urine analysis, Addis count, urinary cultures, blood tests, ultrasonography, pyelography, cystourethroscopy and finally renal biopsy. Results The results showed pathological findings in 31.2% of patients. Of the 157 individuals, 33.1% did not complete the study. In 14.6% urological disease was found, including two patients with urothelial cancer. Renal biopsy detected glomerulopathy in 16.5% of all patients. IgA nephritis being the most common diagnosis (42% of all biopsies). Conclusion Even in young patients, microscopic haematuria should be investigated and followed thoroughly. Renal biopsy seems to be optional: once a diagnosis is established repeated and unnecessary examinations can be avoided.
Extent of blood transfusion and cancer‐related mortality after cystectomy and urinary diversion for bladder cancer
Authors: JAHNSON S. , BERGSTRÖM R. , PEDERSEN J. 
Published: November 2008

Objective To assess the possible adverse effect of peri‐operative blood transfusion on cancer‐relates survival after radical cystectomy for bladder cancer. Patients and methods The hospital records of 130 patients treated with cystectomy and urinary diversion for bladder cancer between 1967 and 1986 were retrospectively reviewed. Results Standard proportional hazards estimation revealed tumour stage and radiation response after pre‐operative irradiation to be significantly associated with cancer‐relates mortality, whereas age, tumour grade or the extent of peri‐operative blood transfusion were not. In models which allowed time varying effects a significantly changed effect of blood transfusion(≥ 7 versus ≤ 6 units) was observed, from an initially insignificantly increased relative hazard (RH) (RH=1.44 at 6 months) to an insignificantly decreased effect after longer follow‐up (RH=0.53 after 2 years). Conclusion Although no overall association between blood transfusion and cancer‐related mortality was found, a tendency towards an increased risk early in the follow‐up period was observed if more than 6 units were transfused. However, these results need confirmation in further studies before a restrictive attitude towards peri‐operative blood transfusion is recommended.
Mercapto‐acetyltriglycine (MAG 3) renography and indirect radionuclide cystography in posterior urethral valves
Authors: DINNEEN M. D. , DUFFY P. G. , LYTHGOE M. F. , RANSLEY P. G. , GORDON I. 
Published: November 2008

Objective To assess dynamic isotope renography with 99mTc‐labelled mercapto‐acetyltriglycine (MAG 3) in conjunction with indirect radionucleide cystography (IRC) in the follow‐up of boys with posterior urethral valves. Patients and methods Fifty‐one boys (95 renal units: mean age=89 months range 65–118) with previously treated posterior urethral vales underwent MAG 3 renography followed by IRC. Glomerular filtration rate (GFR) was estimated form the plasma clearance of 51Cr‐ethylenediamine tetra‐acetic acid following single intravenous injection. Renographic paramenters noted were renal function based on the quality of renal visualization and background activity as well as renal drainage and the appearance of isotope in ureter and bladder. Following the dynamic 20 min MAG 3 renogram the child was allowed to leave the department and to return when he wished to void. IRC was then performed. Diuretics were not administered. Results Initial drainage from 30 kidneys was normal in 36 drainage was delayed and in 25 drainage did not occur during the renogram phase. In four kidneys function was so poor as to preclude assessment. After the IRC, drainage was noted in 17 of 25 units which had not drained during the renogram, six units did not drain and in two drainage was equivocal due to the presence of vesico‐ureteric reflux. The quality of the scan was good or very good in 42 patients (mean GFR=92 ml/min/1.73 m2 SA) and moderate or poor in nine patients (median GFR=20 ml/min/1.73 m2 SA) (P < 0.001), A residual urine was noted following micturition in 35 boys; this was due to incomplete bladder emptying in 14 and to immediate secondary refilling from dilated upper tracts in the remainder. Conclusion IRC in conjunction with traditional dynamic renography using MAG 3 provides valuable additional information about upper tract drainage. The necessity for diuresis renography is obviated in the majority of patients. IRC also allows an excellent non‐invasive, physiological assessment of both upper and lower urinary tract function which is superior to conventional single examination techniques. We recommend the use of MAG 3 with IRC in the routine follow‐up of boys with posterior urethral valves.
Long‐term results of intermittent low‐friction self‐catheterization in patients with recurrent urethral strictures
Authors: HARRISS D. R. , BECKINGHAM I. J. , LEMBERGER R. J. , LAWRENCE W. T. 
Published: November 2008

Objective To ascertain the duration of intermittent low‐friction self‐catheterization (ILSC) required to cause stricture stabilization. Patients and methods Over a 4 year period, 101 patients with a median age of 62 years (range 16–85) with recurrent urethral strictures were recruited the trial. All the strictures were treated by internal urethrotomy and the patients were then randomized to perform ILSC twice weekly for either 6 months (group 1) or 36 months (group 2). Out‐patient follow‐up with urinary flow rate was initially at 1 month and then at 3 monthly intervals. Stricture recurrence rates were compared between the two groups. Results Of 101 patients, seven failed to attend after the first out‐patient appointment. A further 21 died of unrelated disease whilst on ILSC (although 13 had been followed up for at least 24 months and so were included in the analysis). The median follow‐up was 67 months (range 24–78). Ten patients in group 2, who has suffered from recurrent strictures, refused to stop catheterizing at the appointed time and all remain stricture‐free on permanent ILSC, Of the remaining 76 patients, 48 catheterized for 6 months and 28 patients performed ILSC for 6 months and 28 patients performed ILSC for 12 to 36 months (nine stopped earlier than intended). Forty per cent of patients who stopped at 6 months developed a recurrence compared with 14% who catheterized for more than 12 months (P<0.05) (chi‐square test with Yates' correction). Conclusions Our results indicate that ILSC is safe and effective in preventing stricture recurrence in the long term. The recurrence rate of urethral strictures was significantly lower when ILSC was continued for more than 12 months compared with ILSC that was stopped at 6 months. We conclude that catheterization for at least 1 year required to achieve adequate urethral stabilization.
Combination of lymphokine‐activated killer cells and interleukin‐2 in treating metastatic renal cell carcinoma
Authors: FUJIOKA T. , NOMURA K. , HASEGAWA M. , ISHIKURA K. , KUBO T. 
Published: November 2008

Objective To study the properties of lymphokine‐activated killer (LAK) cells and the effect of immunotherapy with a combination of autologous LAK cells and interleukin‐2 (IL‐2) [LAK therapy] in 10 patients with metastatic renal cell carcinoma (RCC).Materials and methods The LAK cells were generated from peripheral blood lymphocytes (PBL) by incubation in a serum‐free medium (AIM‐V) supplemented with IL‐2 for 4 days and killer cells were administered intravenously twice a week. The LAK cells showed cytotoxicity against allogenic RCC cell lines and augmented NK and LAK activities. Their phenotypes were CD25 ‐, HLA‐DR+, CD3+, and CD16+. Furthermore, LAK cells released IFN‐γ, IL‐1β and TNF‐α. The total number of LAK cells administered ranged from 3.8 × 109 to 52.6 × l09 cells and the total amount of IL‐2 ranged from 150 times 105 to 900 times 105 U. The effect on pulmonary metastasis in response to LAK therapy was studied.Results The outcome was complete response (1), partial response (1), minor response (2), no change (4) and disease progression (2). Toxic effects were transient and no serious side‐effects occurred. Evaluation of host immune parameters indicated that a clinical response was expected in patients with increasing proportions of CD16‐, CD25+, CD57+, HLA‐DR+ and CD3+ DR‐ cells among PBL and with augmentation of NK and LAK activities. Brain metastases were detected in three patients during or after treatment.Conclusion LAK therapy appears to be effective in treating some patients with RCC and pulmonary metastasis. The potential for inducing brain metastasis, however, should be taken into account.
Retrograde manipulation for proximal ureteric stones before extracorporeal Shockwave lithotripsy: technique, observations and results
Authors: BIYANI C. S. , BHATIA V. 
Published: November 2008

Objective To determine the factors affecting the success of retrograde manipulation (RM) of upper ureteric stones.Patients and methods A total of 601 patients with upper ureteric calculi underwent attempted RM. In 216 patients, RM was performed irrespective of the respiratory phase, stone characteristics and ureteric anatomy (group 1). In the remaining 385 patients RM was performed at the height of expiration (group 2). Patients with large or impacted stones, ureters with a fusiform or funnel shape appearance on urography and grade IV hydronephrosis were not included in group 2.Results The success rate was significantly greater in group 2. The rates of fever and perforation in groups 1 and 2 were 6.9/2.3% and 3.2/0.2% respectively. The incidence of residual fragments was also less in group 2.Conclusion RM at the height of expiration is associated with a higher success rate and lower complication rate.
Small cell carcinoma of the urinary bladder. A clinicopathological study of six cases
Authors: LOPEZ J. I. , ANGULO J. C. , FLORES N. , TOLEDO J.D. 
Published: November 2008

Objective To study the clinical, histological, and immuno‐histochemical findings of small cell carcinoma (SCC) of the urinary bladder, and also to delineate its behaviour in comparison with transitional cell carcinomas of the bladder.Materials and methods A retrospective review of 552 patients with bladder cancer yielded six cases (1%) of small cell carcinoma which were histologically identical to pulmonary small cell anaplastic carcinoma. Clinical data and follow‐up were collected. Aside from the conventional histological parameters, an immunohistochemical study with AE1–AE3 and Cam 5.2 keratins, epithelial membrane antigen, neuron‐specific enolase, chromogranin, synaptophysin, ACTH, calcitonin, and prostatic specific antigen was performed.Results The clinical presentation did not differ from conventional transitional cell carcinoma, haematuria being the most frequent complaint (four cases). All the cases presented as flat tumours. On light microscopy, there were oat cell (four cases), intermediate (one case) and mixed oat‐cellJintermediate (one case) variants. Three cases were associated with transitional cell carcinoma. Dysplastic changes were observed in the adjacent urothelium in one case only. At the time of diagnosis, all tumours were deeply invasive (pT3). Three cases were Stage III and three Stage IV, with involvement of regional lymph nodes and metastases to the liver (two cases) and lung (one case). Immunohistochemically, epithelial markers were variably expressed as AE1‐AE3 keratin (5J6), Cam 5.2 keratin (2/6) and epithelial membrane antigen (3/6). Neuron specific enolase was demonstrated in every case. Chromogranin, however, was expressed in only one case. Synaptophysin, ACTH, calcitonin, and prostatic specific antigen all gave negative results. All the patients died of the disease and the overall length of survival was very poor (range 5–2 5 months, mean 13.3).Conclusion Small cell carcinomas show the same histological patterns as their pulmonary counterpart. Immunohistochemistry reveals a wide spectrum of activity, enolase and keratins being the most constant. The present study confirms that the overall prognosis of this tumour is very poor.
Combined bladder neck suspension and augmentation cystoplasty for neuropathic incontinence in female patients
Authors: FREEDMAN E. R. , SINGH G. , DONNELL S. C. , RICKWOOD A. M. K. , THOMAS D. G. 
Published: November 2008

Objective To perform bladder neck suspension simultaneously with augmentation cystoplasty in female patients where sphincteric incompetence was not the sole cause of impaired functional bladder capacity.Patients and methods During an 8‐year‐period, 26 female patients (mean age 14, range 5–39) were treated with a Marshall‐Marchetti plus cystoplasty (Liverpool) or a colposuspension plus clam cystoplasty (Sheffield). All had marked sphincteric incompetence compounded by detrusor hyper‐reflexia and/or non‐compliance. The patients were followed up for a mean period of 30 months (range 8–80).Results There were no major complications. At follow‐up 23 (88%) were dry by day on a regime of intermittent self‐catheterization. Nine patients were taking adjuvant medication, usually for prevention of nocturnal enuresis.Conclusion The results compare tolerably with those of all alternative procedures, including the more elaborate reconstructions (e.g. Kropp procedure) and the expensive artifical urinary sphincter.
Characterization of biofilm and encrustation on ureteric stents in vivo
Authors: KEANE P.F. , BONNER M.C. , JOHNSTON S.R. , ZAFAR A. , GORMAN S.P. 
Published: November 2008

Objective To examine the relationship between encrustation and microbial biofilm formation on indwelling ureteric stents.Patients and methods Ureteric stents from 40 patients were examined for the presence of a microbial biofilm and encrustations. Bacteria in stent biofilms were isolated and identified.Results A profuse biofilm (> 104 c.f.u. cm3–3) was identified on 1J (28%) stents. Enterococcus faecalis was the most common biofilm organism identified and Proteus spp. were not present. Encrustation was seen in 23 (58%) of stents and was not associated with the level of urinary calcium. The major risk factor for stent encrustation was the presence of urolithiasis. Importantly, there was no causative link between stent biofilm formation and encrustation. Both biofilm formation and encrustation increased with the duration of stenting.Conclusion The results indicate that polyurethane is readily encrusted and colonized by bacteria in vivo despite antibiotic prophylaxis. Newer materials must be sought if effective long‐term stenting is to be achieved.
Alkali citrate prophylaxis in idiopathic recurrent calcium oxalate urolithiasis — a prospective randomized study
Authors: HOFBAUER J. , HÖBARTH K. , SZABO N. , MARBERGER M. 
Published: November 2008

Objective To assess the efficacy of alkali citrate therapy in patients suffering from recurrent idiopathic calcium oxalate stone formation. Patients and methods Fifty patients suffering from active stone formation who had had at least one stone annually over the previous 3 years were recruited and randomly divided into two groups. They were given either general prophylactic instructions, i.e. abundant liquid intake and dietary restrictions (group I, n = 25) ‐ or were additionally treated with alkali citrate (group 11, n=25). Results In group I, the rate of stone formation was reduced from 1.8 to 0.7 stones per patient per year. Similar results were obtained for group 11, the corresponding figures being 2.1 and 0.9. There was a statistically significant higher urinary citrate excretion in group I1 than in group I. No difference was seen between the two groups regarding recurrent stone formation (Student's t‐test). Stone formation decreased in both groups (group I 27% group I1 31%). Subjectively, 56% of group I1 patients, all of whom had previously experienced severe colic, reported spontaneous stone elimination to be painless, whereas in group I all but one patient suffered pain. Conclusion An objective benefit of alkali citrate could not be established.
Radiographer‐performed abdominal and pelvic ultrasound: its value in a urology out‐patient clinic
Authors: NARGUND V. H. , LOMAS K. , SAPHERSON D. A. , FLANNIGAN G. M. , STEWART P. A. HAMILTON 
Published: November 2008

Objective To assess the efficacy of radiographer performed ultrasound examination as a routine investigative procedure in a urological out‐patient clinic. Patients and methods A total of 151 patients attending a District General Hospital Urological Out‐patient Department underwent an ultrasound examination in the clinic. Results Diagnosis by ultrasound was achieved in 93% of patients. The remaining patients underwent further investigations. Two (1%) patients with normal scans had small bladder tumours. Subsequent intravenousurography in these individuals showed normal upper tracts. Conclusion Abdominal and pelvic ultrasound examination performed in the urological out‐patient clinic on unprepared patients was the only investigation necessary for evaluation of common problems such as non‐specilk urinary symptoms, recurrent urinary tract infections and bladder outlet obstruction.
Histological response to injected Polytef and Bioplastique in a rat model
Authors: DEWAN P. A. , BYARD R. W. 
Published: November 2008

Objective To study, using a rat model, the tissue reaction in response to the migration of particulate plastics injected into the lungs and subcutaneous sites. Materials and methods A total of 50 rats were included in the study. Histological examination of 30 rats was carried out up to 6 months after the subcutaneous injection of 0.1 ml of either Polytef or Bioplastique. Specimens from a further 18 rats underwent histologi‐ cal examination up to 3 months after the intravenous injection of 0.01 ml of either Polytef or Bioplastique. Two rats were injected with normal saline to act as controls. Representative sections of multiple organs were taken from each animal. Results No systemic migration from the site of initial implantation was detected. This may have been due either to the animal used or to the limited number of sections taken. However, the intravenously injected plastics were found adjacent to the pulmonary arterioles 3 months after injection. The histological reaction at the local injection and lung sites was similar, with the giant cells being larger and the degree of fibrosis greater for Bioplastique than for Polytef. Conclusion The histological reaction to Polytef and Bioplastique was similar in both the subcutaneous and lung sites. No migration or malignant change was seen.
Use of a eutectic mixture of local anaesthetics in the release of preputial adhesions: is it a worthwhile alternative?
Authors: LIM A. , SAW Y. , WAKE P. N. , CR0T0N R. S. 
Published: November 2008

Objective To see if a eutectic mixture of local anaesthetics (EMLA) could be used effectively for the release of preputial adhesions as a day case procedure. Patients and methods A total of 36 consecutive symptomatic children had their preputial adhesions separated under local anaesthetic with EMLA. Results The procedure was successful in 2 7 children. Of these, 16 remained symptom free at 9 to 12 months follow up although five children had slight recurrence of adhesions. The other 11 children were listed for circumcision at 2 weeks following the procedure because of marked recurrence of adhesions. Conclusion EMLA cream is a good alternative to general anaesthetics in the separation of preputial adhesions. The technique is operator‐dependant and better results were obtained when one person was using it regularly. Separation of adhesions is a worthwhile procedure in boys with symptomatic non‐retractile foreskins.