bluuebunny/crossref_metadata_2025_split huggingface dataset:
Comparison of Reagent Strip (Dipstick) and Microscopic Haematuria in Urological Out‐patients
Authors: GLEESON M. J. , CONNOLLY J. , GRAINGER R. , McDERMOTT T. E. D. , BUTLER M. R. 
Published: November 2008

Summary Dipstick (reagent strip) and microscopic urine analysis for haematuria was performed prospectively on 1000 consecutive urine samples taken from urological out‐patients. Haematuria was present in 185 samples (18.5%) and absent in 687 (68.7%) using both tests; 98 samples (9.8%) had dipstick haematuria that was not confirmed by microscopy and 30 samples (3%) had microscopic haematuria that was missed on dipstick urine analysis. Dipstick urine analysis had a sensitivity of 86.1% and a specificity of 85%.This study confirms that reagent strip testing for haematuria has both false positive and false negative results and indicates that cytoscopy should be considered in all patients with suspected haematuria.
Histological and Histochemical Study of the Vesicoureteric Junction in Infancy and Childhood
Authors: GEARHART J. P. , CANNING D. A. , GILPIN SALLY A. , LAM E. E. , GOSLING J. A. 
Published: November 2008

Summary The morphology of the vesicoureteric junction was compared using 19 post mortem specimens obtained from male and female Afro‐American and Caucasian children with an age range of 1 to 72 months (mean 4). All specimens were serially sectioned and the tissues processed using standard histological and histochemical techniques (acetylcholinesterase (AChE) and pseudocholinesterase (PChE)).The results failed to reveal any differences in the structure of the vesicoureteric junction with respect to age, sex and ethnic origins. The vesicoureteric junction comprised 3 histologically and histochemically distinct smooth muscle components. Ureteric muscle formed a complete inner layer rich in PChE which continued beyond the ureteric orifices to merge distally with the superficial trigone. An intermediate layer of muscle was also demonstrated whose constituent muscle cells possessed specific histological features and which was rich in both AChE and PChE, which is distinct from that derived from the ureter and detrusor. The presence of detrusor muscle on the outer aspect of the juxtavesical segment of ureter rich in AChE was also confirmed.While this study, using histochemical studies in infants and children, did not reveal any differences in the structure of the vesicoureteric junction with respect to age, sex or ethnic origin, an intermediate layer of muscle was identified with histochemical characteristics more like that of the male genital tract than that derived from the ureter or detrusor muscle.
The Contribution of Magnetic Resonance Imaging of the Pelvic Floor to the Understanding of Urinary Incontinence
Authors: KIRSCHNER‐HERMANNS R. , WEIN B. , NIEHAUS S. , SCHAEFER W. , JAKSE G. 
Published: November 2008

Summary The anatomy of urinary incontinence and the underlying pathology is still under discussion.We examined 24 stress incontinent patients and 6 healthy volunteers. Magnetic resonance imaging (MRI) clearly shows that the urethra is not connected to the levator ani. The urethra is not fixed to deep perineal muscle layers. In stress incontinence the sharp angulation of the levator ani of healthy volunteers is lost in 65%. MRI shows degeneration of the levator ani muscle in 45% of stress incontinent patients. The extent of damage to the levator can clearly be identified with the aid of MRI.
Intravesical Oxybutynin Chloride and Clean Intermittent Catheterisation in Patients with Neurogenic Vesical Dysfunction and Decreased Bladder Capacity
Authors: PRASAD K. V. R. , VAIDYANATHAN S. 
Published: November 2008

Summary Oral administration of oxybutynin chloride is effective in increasing bladder capacity in patients with neurogenic bladder dysfunction who are practising clean intermittent catheterisation, but it is often associated with systemic side effects. The effect of intravesical instillation of oxybutynin chloride was studied in 14 patients who were practising clean intermittent catheterisation and in whom the maximum cystometric capacity was < 250 ml and/or vesical compliance <5. A 5‐mg tablet of oxybutynin chloride was crushed and suspended in 10 ml of boiled and cooled water and instilled into the bladder after emptying it completely; this was carried out thrice daily either by the patient or by his carer. During follow‐up (6–12 months) no local or systemic side effects were observed and patient compliance was excellent in 12 patients, who snowed an increase in maximum cystometric capacity and vesical compliance. One patient could not retain the drug intravesically because of reflex detrusor contraction and he was excluded from the study. One patient was lost to follow‐up.The results suggest that the intravesical instillation of oxybutynin chloride is safe and effective in the treatment of selected patients with neurogenic bladder dysfunction whose bladder capacity is small and who are practising clean intermittent catheterisation.
Growth Fractions in Bladder Cancer Defined by Ki67: Association with Cancer Grade, Category and Recurrence Rate of Superficial Lesions
Authors: STAVROPOULOS N. E. , IOACKIM‐VELOGIANNI E. , HASTAZERIS K. , KITSIOU E. , STEFANAKI S. , AGNANTIS N. 
Published: November 2008

Summary Predicting future tumour behaviour has always been a major task when treating bladder cancer. Ki67 monoclonal antibody has been reported to be a good marker of proliferative activity in a variety of tumours. We have studied the association of growth fractions defined by the monoclonal antibody with tumour grade, category and recurrence rate of superficial lesions in 34 patients with bladder cancer and 15 normal controls.Mean Ki67 indexes (% stained cells) were 0.07 ± 0.02% in normal urothelium, 1.27 ± 1.55% in grade 1, 12.23 ± 8.32% in grade 2 and 16.42 ± 11.82% in grade 3 tumours, while the values were 5.45±5.87%, 12.66±9.81%and 17.18± 12.41%in categoriespTa, pT1 andT2‐T3 respectively. Recurrence and non‐recurrence groups of patients showed indexes of 13.29 ± 9.49% and 4.15 ± 5.0% respectively. Statistically significant differences in Ki67 values between normal urothelium and tumour, between tumours of different grades and categories as well as between recurrence and non‐recurrence groups of patients led to the conclusion that Ki67 monoclonal antibody is a good tool in defining tumour behaviour in bladder cancer.
Prostatic Surgery for Benign Prostatic Hyperplasia: Meeting the Expanding Demand
Authors: DUNCAN B. M. , GARRAWAY W. M. 
Published: November 2008

Summary We describe changes in the pattern of surgery for benign prostatic hyperplasia (BPH) in Scotland between 1971 and 1989. The data are based on an analysis of routinely collected Scottish hospital in‐patient statistics for primary prostatic operations on men with a diagnosis of BPH (ICD Code 600.0).Primary operation age‐adjusted rates for BPH increased from 8.9 to 15.8 per 10, 000 male population from 1971 to 1989. This was accompanied by a reduction in bed day use for BPH surgery from 49, 500 bed days in 1971 to 36, 000 in 1989. Case fatality for all surgery for BPH also fell steadily and can no longer be regarded as a relevant measure of prostatectomy outcome. Virtually all surgical intervention is now transurethral resection (TUR), forming 94% of surgery for BPH in 1989 compared with only 32% in 1971. The increase in surgical procedures carried out for BPH has been greater in younger age groups.If the pattern of increasing surgical intervention in the management of BPH over the past few years continues and there is an increased demand for treatment, and if the reported demographic changes occur, there will be a need for an additional 9 new consultant urologists in Scotland by 2001. Even if present operation rates hold steady, population changes alone will produce enough work for 2 more urologists.
Ultrasonic Detection of Non‐palpable Seminal Vesicle Invasion: A Clinicopathological Study
Authors: OHORI M. , SHINOHARA K. , WHEELER T. M. , AIHARA M. , WESSELS E. C. , CARTER S. ST C. , SCARDINO P.T. 
Published: November 2008

Summary In an effort to identify reliable criteria for detecting seminal vesicle invasion (SVI) with transrectal ultrasonography (TRUS) in patients with clinically localised prostate cancer, we reviewed the pre‐operative sonograms in 230 patients who underwent radical retropubic prostatectomy; 49 patients (21%) had pathologically confirmed SVI. Conventional sonographic criteria for SVI (asymmetry, distension, atrophy, abnormal echogenicity and irregularity in outline) were present in 58 patients, but only 16 (28%) had pathologically confirmed SVI.On the basis of the results of a preliminary comparison of radical prostatectomy specimens and TRUS, we had revised our criteria for the recognition of SVI: (1) a hypoechoic lesion at the base of the prostate (within 10 mm of the seminal vesicle); (2) an “adhesion sign” resulting from the loss of the echo reflections from the normal fat plane between the prostate and the seminal vesicle; (3) “posterior convexity” of the seminal vesicles. When we reviewed the 230 sonograms retrospectively, we found a hypoechoic tumour at the base in 70 patients, of whom 37 had SVI (positive predictive value (PPV) 53%). An adhesion sign was found in 16 patients, 12 of whom had SVI (PPV 75%). Posterior convexity was present in 4 patients, all of whom had SVI. If any one of our sonographic signs was present, the overall accuracy (83%), sensitivity (90%) and positive predictive value (51%) were significantly better than with any one of the conventional criteria. Patients with SVI were also more likely to have a high serum prostate specific antigen (PSA) level. The PPV for SVI of a PSA level ≤ 10 ng/ml was 38%. If the PSA was > 10 ng/ml and TRUS was positive (≤ 1 of our sonographic criteria), 16 (62%) of 26 patients had SVI. If the PSA was < 10 ng/ml and TRUS was negative, only 3 (3%) of 86 patients had SVI.It was concluded that the conventional criteria for detecting SVI on ultrasonography are not accurate in patients with early stage prostate cancer. There are, however, reliable criteria that predict SVI with reasonable accuracy and these criteria, combined with the serum PSA levels, can stratify patients into those with a low risk and those with a high risk of SVI.
The effects of acute and chronic JJ stent placement on upper urinary tract motility and calculus transit
Authors: RYAN P.C. , LENNON G.M. , McLEAN P.A. , FITZPATRICK J.M. 
Published: November 2008

Objective To determine the pathophysiological changes in upper urinary tract motility and calculus transit which may occur following JJ stent insertion.Materials and methods The acute and chronic effects of JJ stent placement were studied in 24 canine renal units. Intrarenal and intraureteric pressures and motility were measured, in addition to transit times for complete passage of synthetic calculi from the upper ureter into the bladder.Results Acute effects included raised renal intrapelvic pressure, reduced pelvic and ureteric motility and delayed calculus transit time. Prolonged JJ stent placement was associated with return of intrapelvic pressure to normal but persistent changes in both renal and ureteric motility and also calculus transit time.Conclusion In situ JJ stents impair upper urinary tract motility and experimental calculus transit time and may delay passage of ureteric calculi or calculus fragments following extracorporeal shock wave lithotripsy.
The Mitrofanoff principle: expanding upon a versatile technique
Authors: WOODHOUSE C.R.J. , MACNEILY A.E. 
Published: November 2008

Objective To illustrate how the original principle of an appendicovesicostomy can be expanded upon and applied successfully to numerous urological conditions utilizing a variety of surgical techniques.Materials and methods Over the 8‐year period 1985‐1993 the Mitrofanoff principle was utilized 105 times in 100 consecutive patients. Seven different types of catheterizing conduit were constructed in conjunction with six varieties of urinary reservoir for patients falling into one of seven different categories of uropathy.Results At a median follow‐up of 30 months, the continence rate for patients was 91%. The re‐operation rate for conduit complications was 33%. Neither continence rates nor complications specific to the Mitrofanoff were related to the underlying uropathy, the type of conduit constructed, the urinary reservoir employed, and the patient's age at surgery.Conclusion The Mitrofanoff principle of continent urinary diversion is a versatile technique with a predictable success rate applicable to a wide variety of urological conditions. Patients and surgeons should be aware of the significant rates of revision required on the catheterizing conduit to enable continence to be ultimately achieved.
Steroid abuse in athletes, prostatic enlargement and bladder outflow obstruction – is there a relationship?
Authors: WEMYSS‐HOLDEN S.A. , HAMDY F.C. , HASTIE K.J. 
Published: November 2008

Objective To evaluate the effects of exogenous andro‐genic‐anabolic steroids on the human prostate gland.Subject and methods A white male athlete, who was routinely using anabolic steroids, volunteered for the study. He was studied during a 15‐week period of steroid self‐administration. Both objective and subjective parameters were measured, including: prostatic volume (transrectal ultrasound), digital rectal examination, urine flow rate, serum acid phosphatase and prostate specific antigen, symptom scoring for bladder outflow obstruction and other associated symptoms.Results During the period of steroid self‐administration, prostatic volume increased and urine flow rate decreased. The man also noticed an increase in nocturnal urinary frequency, libido and aggression.Conclusion In this pilot study, the administration of exogenous androgenic‐anabolic steroids has been demonstrated to have profound effects on the human prostate gland, including an increase in prostatic volume, reduction in urine flow rate and an alteration in voiding patterns. These findings warrant further investigation.
Congenital and acquired curvature of the penis treated surgically by plication of the tunica albuginea
Authors: KLEVMARK B. , ANDERSEN M. , SCHULTZ A. , TALSETH T. 
Published: November 2008

Objective To evaluate the effectiveness of plication surgery for patients with congenital and acquired curvature of the penis.Patients and methods Forty‐eight patients with congenital curvature of the penis and 57 with induratio penis plastica were treated by plication of the tunica albuginea. Their average age was 23 and 56 years, respectively. The operation was performed under local anaesthesia, using 2/0 Prolene arid a specially designed suture. The average observation time in the two groups was 24 and 20 months, respectively.Results Nineteen per cent of patients in the first group and 8% in the second group reported normal intercourse pre‐operatively. Post‐operatively, the numbers increased to 81% and 82%, respectively, and all were able to perform intercourse. Although 18–19% experienced slight discomfort, mostly related to the cut ends of the suture, this minor problem was accepted by all. Five patients needed more than one operation. No impotence was recorded post‐operatively and no patient complained of reduced sensibility of the skin.Conclusion Satisfactory results were obtained with the plication technique in the first 105 patients. Since the follow‐up study was completed more than 2 years ago, another 70 patients have been treated by the same procedure.
The preventive role of chemical sympathectomy on contralateral testicular hypoxic parameters encountered during unilateral testicular torsion
Authors: KARAGÜZEL G. , TANYEL F.C. , KILINC K. , BUYUKPAMUKCU N. , HICSONMEZ A. 
Published: November 2008

ObjectiveTo evaluate the effect of chemical sympathectomy on lactic acid and hypoxanthine concentrations in both testes during unilateral testicular torsion in a rat experimental model.Materials and methodsFour groups, comprising 10 rats each, were studied. Group I was the control group, Group II rats received a placebo and underwent unilateral testicular torsion, Groups III and IV received guanethidine monosulphate and 6‐OH‐dopamine hydrobromide respectively, and underwent unilateral testicular torsion. The levels of lactic acid and hypoxanthine in both testes were measured.ResultsIn rats in Group II the levels of lactic acid and hypoxanthine in both testes were significantly elevated when compared to the control group. In the groups of rats that had undergone chemical sympathectomy, the levels of lactic acid and hypoxanthine were significantly decreased in the contralateral testes compared to rats in Groups I andII.ConclusionChemical sympathectomy prevents the elevation of lactic acid and hypoxanthine levels in the contralateral testis of rats with unilateral testicular torsion. Therefore, we conclude that contralateral testicular damage during unilateral testicular torsion may result through a reflex activating sympathetic system.
The radionuclide assessment of pre‐natally diagnosed hydronephrosis
Authors: UPSDELL S. M. , GUPTA S. , GOUGH D.C.S. 
Published: November 2008

Objective To determine if a pre‐operative non‐invasive radionuclide study can predict the results on surgery in infants with pre‐natally diagnosed hydronephrosis.Patients and methods Eight male infants with prenatally diagnosed hydronephrosis were treated by pyeloplasty within the first 4 months of life. All infants underwent a pre‐operative diuresis renogram and a dimercapto‐succinic acid (DMSA) scan, followed by a further renogram 6 months after surgery to assess renal function an drainage.Results There was a significant difference between the resutls of the relative renal function estimates obtained by the pre‐operative renogram and the pre‐operative DMSA scan (P=0.001). In all patients the recovery in renal function following surgery was accurately predicted by the pre‐operative DMSA scan.Conclusion The results of this preliminary study suggest that a pre‐operative DMSA scan could replace the use of invasive nephrostomy drainage to assess the potential for recovery in the poorly functioning neonatal kidney and give an indication of those kidneys most likely to benefit from recontructive surgery.
Altered saccharide sequences in two groups of patients with metastatic prostatic carcinoma
Authors: McMAHON R.F.T. , McWILLIAM L.J. , CLARKE N.W. , GEORGE N.J.R. 
Published: November 2008

Objective To investigate the hypothesis that primary prostatic carcinomas with metastases to different sites (lymph nodes or bone) show varying expression of cell surface and cytoplasmic glycoconjugates.Patients and methods A group of 14 patients with primary prostatic carcinoma with lymph node metastases but no bone metastases has previously been shown to have an increased survival time. This group was compared with a control group of 14 patients with lymph node‐negative, bone metastasis‐positive primary prostatic carcinoma using a panel of biotinylated lectins revealed by the avidin‐biotin peroxidase complex method. The results were analysed semiquantitatively and differences in binding patterns between the two groups were sought.Results No significant differences were seen using the LCA, LTA, UEA‐1, WFA, VVA or SBA lectins. The group with bone metastases but no lymph node involvement showed significantly increased binding for the ECA and AHA lectins, both before and after neuraminidase pre‐treatment, compared with the lymph node‐positive group.Conclusions These results suggest that tumours lacking or having a reduced affinity for binding sites for both Galβl‐3GalNac (Type I oligosaccharide structures‐ AHA) and Galβl‐4GlcNac (Type I1 oligosaccharide structures‐ECA) sequences are more likely to develop lymph node metastases and less likely to develop bone metastases and thereby increasing the patient's chances of survival. This is further evidence that the metastatic potential of tumours per se and the ultimate site of distal metastases from such tumours is affected in part by the glycoconjugates expressed on their cell surfaces and indicates that metastatic phenotypes for prostatic carcinoma exists.
The effect of pharmacological stimulation and blockade of autonomic receptors and of pudendal blockade on urethral stress relaxation in healthy women
Authors: THIND P. , LOSE G. , COLSTRUP H. , ANDERSSON K.‐E. 
Published: November 2008

Objective To examine the influence of autonomic receptor stimulation and blockade (noradrenaline, prazosin, terbutaline, propranolol, carbachol and atropine), and of pudendal nerve blockade on urethral stress relaxation.Subjects and methods Forty healthy women were evaluated. The stress relaxation parameter was defined as the relative rate of pressure decrease during a fixed period of time following a rapid dilatation of the urethra. The dilatation was performed by waterinfusion into a small rubber cylinder placed in the urethra.Results The drugs did not affect stress relaxation significantly, whereas the pudendal blockade produced a significant change along the length of the urethra characterized by a faster pressure decay following dilatation.Conclusion In women, stress relaxation in the urethra relies significantly on the pudendal nerve‐innervated striated muscles.
Ureteric stricture formation following ureteric instrumentation in patients with a nephrostomy drain in place
Authors: O'SULLIVAN D. C. , LEMBERGER R. J. , BISHOP M. C. , BATES C. P. , DUNN M. 
Published: November 2008

Objective To determine what effect the presence of a nephrostomy, left on free drainage, might have on the rate of occurrence of ureteric strictures after ureteric instrumentation.Patients and methods Eighteen patients were identified in this unit who had had ureteric instrumentation while a nephrostomy was in place.Results Eight of 11 patients in whom the nephrostomy was left open developed ureteric strictures. None of seven patients in whom the lumen was maintained by stenting and and/or clamping of the nephrostomy developed strictures. The strictures needed dilatation and stenting in seven patients and ureter had to be reimplanted in the other.Conclusion In patients in whom a nephrostomy is in place, the opening should be occluded after ureteric instrumentation or a stent should be inserted if it is to be left on free drainage.
A prospective randomized trial comparing a modified needle suspension procedure with the vagindobturator shelf procedure for genuine stress incontinence
Authors: GERMAN K.A. , KYNASTON H. , WEIGHT S. , STEPHENSON T.P. 
Published: November 2008

Objective To compare two procedures for the treatment of genuine stress incontinence in patients selected randomly.Patients and methods Fifty patients with proven genuine stress incontinence were randomized prospectively over a 3 year period to be treated either by a modified needle suspension (MNS) (n=26) or by a vagina/obturator shelf (VOS) (n= 24) procedure.Results In patients who had not undergone previous surgery for incontinence, the VOS procedure was superior with 12 of 14 patients achieving continence compared with eight of 15 patients in the MNS group (P<0.05). In women who had undergone previous surgery seven of 11 were continent following MNS compared with five of 10 after a VOS procedure. Both techniques had a much lower continence rate when compared with a classical colposuspension operation which was reported in a previous series [1].Conclusion As a primary procedure VOS was more successful than MNS. In patients who had undergone previous surgery for incontinence neither procedure gave acceptable results.