bluuebunny/crossref_metadata_2025_split huggingface dataset:
Transurethral microwave thermotherapy: first experiences in Poland
Authors: Jakubczyk T. , Stoklosa A. , Borkowski A. , Habrat W. , Dobrowolski Z. 
Published: March 2003

Objective To present early experiences in Poland with high‐energy transurethral microwave thermotherapy (HeTUMT), considered as a serious alternative to surgery in managing benign prostatic hypertrophy (BPH). Patients and methods Sixty‐one patients were treated in two centres using a commercial TUMT system. The patients were assessed at 5–6 weeks, 3 and 6 months after treatment, evaluating subjective complaints, the International Prostate Symptom Score (IPSS), urinary flow rate and postvoid residual volume. Results A complete follow‐up was available in 44 patients; most had symptomatic improvement 3 months after HeTUMT but it was slightly less pronounced after 6 months. The improvement in objective variables increased up to 6 months after HeTUMT. There was  50% improvement in subjective complaints in 43% of the patients, in urinary flow rate in 25% and in residual urine in half. Two patients required re‐treatment for a urethral stricture and ineffective HeTUMT. Conclusions HeTUMT may be a useful treatment for BPH but the outcome for an individual patient seems to be unpredictable. The indications for TUMT should be reviewed individually for each patient.
Delay and survival in bladder cancer
Authors: Wallace D.M.A. , Bryan R.T. , Dunn J.A. , Begum G. , Bathers S. ,   on behalf of the West Midlands Urological Research Group
Published: March 2003

Objective To assess in detail and evaluate the effect on survival of delays in the diagnosis and treatment of cancer (which might lead to a worse prognosis), dividing the delay from onset of symptoms to first treatment into several components, comprising patient delay, general practitioner (GP) delay, and two or more periods of hospital delay.Patients and methods Data were prospectively collected on 1537 new cases of urothelial cancer in the West Midlands from 1 January 1991 to 30 June 1992. Death information was obtained from the West Midlands Cancer Intelligence Unit and censored at 31 July 2000. The influence of delay times on survival was explored.Results The median delay from onset of symptoms to GP referral was 14 days (Delay 1), from GP referral to first hospital attendance was 28 days (Delay 2), and from first hospital attendance to first transurethral resection of bladder tumour was 20 days (Delay 3). The median hospital delay (Delay 2 + 3) was 68 days and the median total delay (Delay 1 + 2 + 3) was 110 days. Patients with a shorter Delay 1 had a lower tumour stage and a 5% better 5‐year survival. Patients with a shorter hospital delay had worse survival; total delay had no effect on survival.Conclusions There was significantly better survival for patients referred to hospital within 14 days of the onset of symptoms. The relationship between delay and survival in bladder cancer is complex. Hospital delays may be influenced more by comorbidity than by the characteristics of the tumour. However, the adverse effects of delay seem to be most pronounced for patients with pT1 tumours.
High initial efficacy of full‐spectrum therapy for nocturnal enuresis in children and adolescents
Authors: Van Kampen M. , Bogaert G. , Feys H. , Baert L. , De Raeymaeker I. , De Weerdt W. 
Published: March 2003

Objective  To investigate the initial efficacy and predictive factors of full‐spectrum therapy in the treatment of children and young adolescents with nocturnal enuresis (NE). Patients and methods  Combined therapy for NE comprises an enuresis alarm, bladder training, motivational therapy and pelvic floor muscle training, and is more effective than each of the components alone or than medical intervention. A total of 60 children and adolescents (aged 4–20 years) with NE were treated once a week with full‐spectrum therapy for a maximum of 6 months. Results  Overall the therapy was successful (14 consecutive dry nights) in 52 of 60 patients. At 30 days the cure rate was 33%, after 60 days 72% and after 98 days, 87%. The remaining 13% did not achieve 14 consecutive dry nights; seven patients improved, having fewer dry nights/week. One patient discontinued the treatment because of lack of motivation. In children with an initial maximum bladder capacity less than normal for age, the capacity increased from 53% of the normal maximum bladder capacity in week 1 to 88% at the end of treatment. Neither age, gender, sleep arousal, bladder capacity, family history and pathophysiological profile had any association with the success rate. Conclusion  The short‐term success rate of full‐spectrum therapy for NE is high. Age, gender, sleep arousal, bladder capacity, family history and pathophysiological profile of enuresis are unrelated to the success of the intervention.
Diuretic Doppler ultrasonography in chronic unilateral partial ureteric obstruction in dogs
Authors: Yokoyama H. , Tsuji Y. 
Published: March 2003

Objective  To compare the effects of diuresis induced by a loop diuretic (frusemide), an osmotic diuretic (mannitol) and a high‐osmolar radio‐contrast medium (sodium iothalamate) on the intrarenal resistive index (RI) in dogs with chronic unilateral partial ureteric obstruction (UPUO). Materials and methods  The split renal clearance and intrarenal RI were estimated in 11 dogs with chronic UPUO. Doppler ultrasonography measurements of the interlobar arteries were obtained before and 10 min after the intravenous infusion of 1 mg/kg frusemide, 1 g/kg mannitol or 20 mL 60% sodium iothalamate. The same experimental protocol was repeated with another drug at 1‐week intervals. Results  There was a significant difference between the intrarenal RI of obstructed and unobstructed kidneys in the chronic phase of UPUO. While mannitol and sodium iothalamate significantly increased the RI in both kidneys, differences in RI between the kidneys decreased after infusing the two drugs. However, while frusemide insignificantly increased the RI in the obstructed kidney, it decreased the RI in unobstructed one. Consequently, the difference in RI between the kidneys increased significantly after administering frusemide. There were no significant differences in urinary volume after administering each of the drugs. Conclusions  As there were no significant differences in the diuretic effects of the drugs, frusemide may have additional effects on the RI of unobstructed kidneys other than diuresis. Frusemide increased the difference between the intrarenal RI of the kidneys and therefore may improve the detection of unilateral urinary obstruction in humans.
Prognostic significance of the mode of detection in renal tumours
Authors: Patard J.‐J. , Rodriguez A. , Rioux‐Leclercq N. , Guillé F. , Lobel B. 
Published: March 2003

Objective  To evaluate the mode of detection of 400 renal tumours as a prognostic factor compared with the usual clinical and pathological prognostic variables. Patients and methods  The data were reviewed for 400 patients operated for a renal tumour at our institution between 1984 and 1999, analysing the prognostic value of age, sex, tumour size, stage, grade, vein invasion, adrenal gland invasion, lymph node invasion, metastasis, and mode of detection (incidental or not). The survival rates were assessed using the Kaplan‐Meier method and log‐rank test, and the data evaluated using multivariate analysis with the Cox proportional‐hazard model. Results

In all, 151 (38%) renal tumours were discovered incidentally. There was no significant difference in the percentage of renal cell carcinoma found between the groups of patients discovered incidentally or not (94.4% vs 93.9%). Tumours were smaller in the incidental group (5.7 cm vs 8.7 cm,
P

< 0.001). In the incidental group, 15.2% of the tumours were treated with partial nephrectomy, against 1.2% in the symptomatic group (
P

< 0.001). The specific survival was significantly better in patients with renal tumours discovered incidentally (log‐rank test,
P

< 0.001). The multivariate analysis showed that the mode of detection, stage, grade, metastasis (all
P

< 0.001), and lymphatic extension (
P   =  0.005) were independent prognostic factors. Conclusion  The incidental discovery of renal tumours gives a supplementary benefit to patients in terms of survival, and should be considered as a prognostic factor in addition to stage and grade.
Laparoscopic radical cystectomy with intracorporeal ileal conduit diversion: five cases with a 2‐year follow‐up
Authors: Gupta N.P. , Gill I.S. , Fergany A. , Nabi G. 
Published: March 2003

Objective  To assess the feasibility and intermediate‐term outcome of laparoscopic radical cystectomy (LRC) with ileal conduit urinary diversion in patients with organ‐confined muscle‐invasive carcinoma of the urinary bladder, the entire procedure undertaken intracorporeally only using laparoscopic techniques. Patients and methods  Five patients (four men and one woman) underwent LRC with intracorporeal ileal conduit diversion in February 2000, using a six‐port transperitoneal technique. LRC, ileal conduit exclusion, restoration of ileo‐ileal continuity, and bilateral stented uretero‐ileal anastomoses were completed intracorporeally in all patients. The follow‐up data up to 2 years are reported. Results  All procedures were completed laparoscopically with no open conversion or intraoperative complications. The mean duration of surgery was 7.5 h; the blood loss was 360 mL and no patient required perioperative blood transfusion. The mean (range) hospital stay was 7 (6–22) days; the specimen weight was 225–400 g. The surgical margins of the bladder specimen were negative in each patient. One patient developed intestinal obstruction after surgery, requiring a diverting ileostomy for 12 weeks. At a follow‐up of 2 years, two patients died, both from unrelated causes (myocardial infarction and septicaemia from pulmonary infection in one each). The three surviving patients are asymptomatic with normal upper tracts and no evidence of local recurrence or metastatic disease. Conclusion  LRC with ileal conduit diversion undertaken completely intracorporeally is a feasible option for muscle‐invasive organ‐confined carcinoma of the urinary bladder, with good outcomes over a 2‐year follow‐up.
Recurrence and progression in stage T1G3 bladder tumour with intravesical bacille Calmette‐Guérin (Danish 1331 strain)
Authors: Kulkarni J.N. , Gupta R. 
Published: March 2003

Objective  To report recurrence and progression rates in patients with T1G3 superficial bladder carcinoma treated with intravesical bacille Calmette‐Guérin (BCG, Danish 1331 strain) after complete transurethral resection. Patients and methods  Data from the records of 111 patients with T1G3 bladder carcinoma treated between January 1991 and December 1999 were analysed for recurrence, progression, salvage therapy and survival. Results  Of the 111 patients with T1G3 bladder tumours, 69 had intravesical BCG therapy, 20 radical cystectomy and 22 only transurethral resection (TUR). Of the 69 patients receiving BCG therapy 37 (54%) had no recurrence, and 24 (35%) had a recurrence that was not muscle‐invasive (Ta/T1) and were treated with TUR only. The remaining eight (12%) progressed to muscle invasion and had salvage cystectomy. During the follow‐up six patients died, four from disease and three from other causes, while the remaining 63 are alive and well. Of the other 42 patients, 15 are alive after radical cystectomy and 18 after TUR. Conclusion  This series further confirms the benefits of intravesical BCG (Danish 1331) in an adjuvant setting; furthermore, this treatment facilitates bladder preservation by reducing recurrences and delaying the progression in many patients.
Antimicrobial prophylaxis for transrectal prostatic biopsy: a prospective study of ciprofloxacin vs piperacillin/tazobactam
Authors: Cormio L. , Berardi B. , Callea A. , Fiorentino N. , Sblendorio D. , Zizzi V. , Traficante A. 
Published: March 2003

Objective  To compare the efficacy of short‐term parenteral prophylaxis with piperacillin/tazobactam (P/T) with long‐term oral prophylaxis with ciprofloxacin in preventing infective complications after transrectal prostatic biopsy (TPB).Patients and methods  Patients scheduled for TPB were randomized to receive P/T (2250 mg intramuscular) twice daily for 2 days (Group 1), or ciprofloxacin (500 mg orally) twice daily for 7 days (Group 2), beginning on the evening before the procedure in both groups. All patients received a 100‐mL phosphate enema 3 h before TPB. Evaluation included self‐recording of body temperature in the 3 days after TPB, and culture of mid‐stream urine (MSU) samples taken before and 3 and 15 days after TPB. Patients with indwelling urethral catheters or taking antibiotics or immunosuppressive drugs were excluded, as were patients with positive MSU cultures before TPB.Results  Of the 138 evaluable patients, 72 received parenteral P/T and 66 oral ciprofloxacin. Bacteriuria (> 105 c.f.u./mL) after TPB occurred in two of 72 (2.8%) patients in Group 1 and in three of 66 (4.5%) patients in Group 2; this difference was not statistically significant (P > 0.1). However, of the five patients with bacteriuria, two were symptomatic and both were in Group 2. Pyrexia occurred in only one patient in Group 2 with symptomatic urinary tract infection, and required hospitalization. No other patient reported a body temperature openface> 37.5°C or drug‐related side‐effects.Conclusions  This prospective study showed that short‐term prophylaxis with P/T was associated with a low rate of asymptomatic bacteriuria, requiring no further treatment, whereas although the rate was similar on long‐term prophylaxis with ciprofloxacin patients required further treatment, with one needing hospitalization. We recommend short‐term prophylaxis with P/T despite its disadvantages of cost and parenteral administration.
Benign prostatic hyperplasia: the opposite effects of alcohol and coffee intake
Authors: Gass R. 
Published: March 2003

Objective  To assess several lifestyle factors influencing benign prostatic enlargement and therefore the severity of benign prostatic hyperplasia (BPH).Subjects and methods  In age‐stratified cohorts from population‐based random samples of 882 men (aged 65, 70, 75 and 80 years) each participant completed a standardized questionnaire, including weight, height, socio‐economic status, use of cigarettes, alcohol and coffee consumption. The questionnaire also elicited detailed information on the medical history of prostatic and (over the past month) lower urinary tract symptoms, applying all questions from the American Urology Association instrument. The lifestyle variables were evaluated for confounding by multiple logistic regression, controlling for age, relative weight and professional education, with those classified as having BPH analysed as the dependent variable.Results  The prevalence of surgery for BPH increased with age from 15% at 65 years to 41% at 80 years. There was a strong inverse association between alcohol intake and men treated surgically for BPH or in ‘watchful waiting’ for surgical intervention, but a positive correlation with coffee consumption, and although not significantly, with the number of cigarettes smoked. Nevertheless, those who had never smoked have a slightly greater risk of BPH than current smokers. The body mass index and professional education were not associated with the risk of BPH.Conclusions  Given the opposite effects of coffee and moderate alcohol consumption, together with the increased risk for clinical BPH in men with coronary heart disease, coffee constituents, which increase the serum concentration of low‐density lipoprotein cholesterol, may be involved in the pathophysiology of BPH. Further epidemiological studies are needed to evaluate whether avoiding coffee intake reduces the risk of BPH.
Nocturia in the Dutch adult population
Authors: Van Dijk L. , Kooij D.G. , Schellevis F.G. 
Published: March 2003

Objective  To estimate the prevalence of nocturia in the Dutch adult population, its association with sociodemographic and health characteristics, and to assess problems experienced by persons with nocturia.Subjects and methods  In spring 2001 a telephone survey was conducted among a representative sample of 4721 Dutch respondents (response 53%). Using questions from the Bristol Lower Urinary Tract Symptoms questionnaire respondents were asked about having nocturia and the problems they experienced. In addition, questions were asked about sociodemographic and health characteristics.Results  The prevalence of nocturia (a mean of twice or more/night) among Dutch men and women over 18 years old was 13%, standardized for age and sex. Women had nocturia more often than men (16% vs 9%) and the prevalence was positively associated with age, poor health status and use of medication.Conclusion  The prevalence of nocturia in Dutch men and women differs more than reported in earlier studies. The prevalence in the Netherlands seems slightly higher than in other Western countries, but Dutch persons with nocturia report fewer problems. Nocturia does not occur in isolation and is associated with sleep disturbances. It is worthwhile for general practitioners to routinely check whether patients who contact them for lower urinary tract symptoms or sleeping disorders have nocturia.
Does pericapsular lignocaine reduce pain during transrectal ultrasonography‐guided biopsy of the prostate?
Authors: Walker A.E. , Schelvan C. , Rockall A.G. , Rickards D. , Kellett M.J. 
Published: March 2003

Objective  To evaluate whether injection with pericapsular lignocaine before transrectal ultrasonography (TRUS)‐guided biopsy reduces the perceived pain of prostatic biopsy.Patients and methods  The study included 121 patients referred for TRUS‐guided biopsy of the prostate; 27 underwent biopsy with no previous injection and 94 were randomized to pericapsular injection with either 1% lignocaine or a placebo (saline). Both patient and operator were unaware of the content of the injection. The injection was delivered under TRUS guidance to the apex of the prostate. Routine sextant biopsies were taken using an 18 G needle in a spring‐loaded biopsy gun. A validated pain scale, the NRS11 (0, no pain, to 10, unbearable pain), was used to record the pain of each biopsy.Results  No significant placebo effect was detected between the ‘no injection’ and the placebo‐injection group, with mean (95% confidence interval) pain scores of 3.58 (2.77–4.39) and 4.01 (3.46–4.51), respectively, using the unpaired Student's t‐test (P = 0.409). There was a statistically significant lower mean pain score in the lignocaine group, at 2.54 (2.00–3.10), than in the placebo‐injection group (P < 0.001).Conclusion  Pericapsular injection with 1% lignocaine significantly reduces the perceived pain of TRUS‐guided prostatic biopsy.
Laparoscopic radical prostatectomy: the initial UK series
Authors: Eden C.G. , Cahill D. , Vass J.A. , Adams T.H. , Dauleh M.I. 
Published: March 2003

Objective  To test the reproducibility of other series of laparoscopic radical prostatectomy (LRP) for safety, efficacy and early oncological and functional results.Patients and methods  One hundred consenting patients with clinically localized adenocarcinoma of the prostate and a Gleason sum of ≤ 8 opting for surgery underwent LRP undertaken by one surgeon. Their mean (range) age was 62.2 (52–72) years, weight 78.8 (65–100) kg, prostate specific antigen (PSA) level 8.0 (2–32) ng/mL, and Gleason sum 6.0 (4–8). A five‐port antegrade transperitoneal technique was used in all cases.Results  The mean (range) operative duration was 245 (145–600) min, blood loss 313 (50–1300) mL, parenteral morphine sulphate administration 20.2 (0–160) mg and hospital stay after LRP 4.2 (3–13) nights. Bilateral neurovascular bundle preservation was attempted in 58% of patients. The transfusion rate was 3%. The conversion and re‐intervention rates were 1% and 2%, respectively. There were eight complications, six of which were in the initial 26 cases, i.e. bladder neck stenosis (two), and rectal injury, laparotomy for bleeding, premature drain removal leading to urinary peritonitis, ulnar nerve neuropraxia, port‐site hernia and paralytic ileus in one each. The positive surgical margin rate was 16%. All patients had a PSA level of ≤ 0.1 ng/mL at 3 months. By 1 year 90% of patients were pad‐free and 62% operated on using a bilateral nerve‐sparing technique had erections. There were no biochemical failures. The mean (range) follow‐up was 9.8 (1–24) months.Conclusion  The present results are similar to those reported by other centres with greater experience and confirm that LRP is an effective, safe and precise technique. Once intial experience has been gained it offers advantages over open surgery in the form of a dry and magnified operative site, and a lower likelihood of blood transfusion, in addition to the generic advantages of laparoscopy.
Testicular growth and gonadotrophin response associated with varicocele repair in adolescent males
Authors: Fisch H. , Hyun G. , Hensle T.W. 
Published: March 2003

OBJECTIVETo measure testicular volume and the gonadotrophin response to gonadotrophin‐releasing hormone (GnRH) stimulation in adolescents undergoing left varicocelectomy.PATIENTS AND METHODSThirteen adolescents undergoing varicocelectomy had their testicular volume and endocrine function evaluated before and after surgery.RESULTSThe initial left testicular volume was consistently smaller than the right but after surgery both increased. Baseline follicle‐stimulating hormone (FSH) levels and the FSH response to GnRH stimulation increased after surgery. There were no differences in luteinizing hormone and testosterone levels, and no changes in Tanner staging.CONCLUSIONSUnilateral varicocelectomy with ipsilateral testicular atrophy results in bilateral testicular growth and increased FSH levels. In adolescent development, elevated FSH levels in conjunction with an increased response to the GnRH stimulation test represent a normal physiological response. The GnRH stimulation test cannot be used to determine which adolescent would benefit from surgical repair.