bluuebunny/crossref_metadata_2025_split huggingface dataset:
Paratesticular sarcomas revisited: a review of cases in the British Testicular Tumour Panel and Registry
Authors: Soosay G.N. , Parkinson M.C. , Paradinas J. , Fisher C. 
Published: November 2003

Objective To assess differences in the histopathological diagnoses of a series of paratesticular sarcomas following changes in the morphological classification of these tumours and the availability of investigations to define their immunophenotype, and to consider the impact of these changes on clinical management.Materials and methods Thirty‐six soft tissue tumours of the paratesticular region, originally submitted to the British Testicular Tumour Panel and Registry between 1958 and 1967 were re‐examined histologically using modern diagnostic criteria, including immunohistochemical features. Where possible, follow‐up was brought up to date.Results Thirteen (35%) of the diagnoses made in 1967 were changed; of these, seven changes were attributable to the results of immunohistochemical tests and one involved the identification of an entity not recognized in 1967 (spindle cell rhabdomyosarcoma).Conclusion The changes in diagnoses of major clinical relevance involved three neoplasms (8%) in which the recent opinion was rhabdomyosarcoma, a tumour for which successful treatment protocols are currently available.
Accumulation of p53 and expression of CD44 in human prostatic cancer and benign prostatic hyperplasia: an immunohistochemical study
Authors: Zhang X.‐H. , Sakamoto H. , Takenaka I. 
Published: November 2003

Objective To investigate the expression of mutant p53 and wild‐type CD44 in human benign and neoplastic prostate. Patients and methods The accumulation of p53 and the expression of CD44 were investigated immunohistochemically in formalin‐fixed and paraffin‐embedded tissue specimens (obtained by transurethral resection and open prostatectomy) from 16 patients with primary prostatic cancer (median age 65 years, range 54–75) and six patients with benign prostatic hyperplasia (BPH) (median age 67 years, range 58–75). Results Positive immunoreactivity for p53 and CD44 was detected in six and eight samples of prostatic cancer tissue, respectively. Additionally, all six prostatic cancer samples showing positive immunoreactivity for p53 were also positive for CD44. There were more samples expressing p53 and CD44 in prostatic cancer with a high Gleason grade score than in samples from cancer with a lower score. In samples from six patients with BPH, positive immunoreactivity for p53 and CD44 was observed in one and two, respectively; stained cells were restricted to the secretory cell layer of the gland. Conclusions There was an association between prostatic tumour grade and the increasing expression of p53 and CD44, although there were too few samples for statistical significance. The staining pattern of cells expressing p53 and CD44 may be different between prostatic cancer and BPH tissues.
Microwave ablation of the adrenal gland: experimental study and clinical application
Authors: Kigure T. , Harada T. , Satoh Y. , Fujieda N. , Wakayama Y. 
Published: November 2003

Objective To evaluate the heating effect of microwave irradiation on the dog adrenal gland and to assess the clinical feasibility of microwave ablation of adrenal tumours. Materials and methods The thermal distribution and histology were evaluated after dog adrenal glands were irradiated at different intensities with microwaves. Irradiation at 70 W for 30 s was also performed, after laparotomy, on the adrenal tumour of a patient with primary aldosteronism. Results Microwave irradiation at 70 W for 30 s provided a sufficiently high temperature to produce coagulation within a 5mm radius of the microwave electrode. The adrenal tumour in the patient with primary aldosteronism was coagulated successfully by this dose of microwave irradiation. Conclusion Microwave ablation of the adrenal gland may be clinically applicable in the treatment of adrenal tumours.
Vasoactive intestinal peptide and impotence in experimental diabetes mellitus
Authors: Maher E. , Bachoo M. , Elabbady A. , Polosa C. , Bégin L.R. , Collier B. , Elhilali M. , Hassouna M. 
Published: November 2003

Objective To determine whether a defect in vasoactive intestinal peptide (VIP)‐mediated vasodilatation underlies diabetic impotence Materials and methods Rats treated with streptozotocin for 8 weeks developed diabetes, as shown by hyperglycaemia and glycosuria, and had significant impairment of sexual function, as determined by tests of sexual behaviour. The VIP content of the penis and major pelvic ganglion, the VIP release by the penis in vitro and the responsiveness of the vasculature of the penis in vivo to intracavernous VIP injection were determined. Results In diabetic rats, the VIP content of the major pelvic ganglion and penis was markedly increased, while the acetylcholine content of the penis was normal. The amount of VIP released in vitro by high potassium concentration or veratridine was similar for penile tissue slices of normal and diabetic rats. Intracavernous injection of VIP induced erection in the control rats but not in diabetic rats, whereas intracavernous injection of the adenylate‐cyclase activator forskolin produced erection in both control and diabetic rats. Conclusion Because VIP induces vasodilatation by activating adenylate cyclase, and forskolin produced erection in the diabetic rats, the failure of VIP to produce erection in these rats is unlikely to be due to a defect in the second‐messenger mechanism or in the properties of vascular smooth muscle. Thus, a defect at the level of the VIP receptor or of the associated G‐protein possibly explains the failure of intracavernous VIP to produce erection in the diabetic rats. Hence, an abnormality in VIP is a component of sexual dysfunction in the diabetic rat and the defect is at the level of the VIP receptor or associated G‐protein.
How complete is a transurethral resection of the prostate ?
Authors: Green J.S.A. , Bose P. , Thomas D.P. , Thomas K. , Clements R. , Peeling W.B. , Bowsher W.G. 
Published: November 2003

Objective To determine the completeness of transurethral resection of the prostate (TURP). Patients and methods The prostate volume of 432 patients was measured by transrectal ultrasonography (TRUS) before they underwent a TURP performed by one of three consultant urological surgeons. The prostate tissue collected at resection was weighed, multiplied by 1.2 to compensate for ‘shrinkage’, and the amount of tissue removed expressed as a percentage of the pre‐operative prostate volume determined by TRUS (resection ratio). The patients were categorized into groups based on pre‐operative prostate size. Results The mean weight of prostate tissue resected was 25.6 g. Resection ratios increased with prostate size, with the largest occurring in prostates of 71–110 g. The surgeon did not resect more than 50% of the gland volume in any group. Conclusion This study counters the theory that a complete resection of the prostate is routinely achieved. The endoscopic appearances probably imply a complete resection of the adenoma but a considerable volume of the gland remains. This has important implications for the detection of prostate carcinoma at TURP and for the staging of the disease.
Microsurgical vasoepididymostomy in the treatment of occlusive azoospermia
Authors: Boeckx W. , van Helden S. 
Published: November 2003

Objective To evaluate the practice and outcome of the end‐to‐end and end‐to‐side techniques of vasoepididymostomy for the treatment of occlusive azoospermiaPatients and methods This retrospective study comprised 31 unselected patients (mean age 32 years, range 22–59) operated on with one of two techniques, more usually a modified end‐to‐side technique. Sperm quality and paternity were assessed in 24 patients during a 2‐year follow‐upResults Of the 15patients in whom sperm were found at anastomosis, sperm were retrieved from 11. Of 24 patients, 11 had patent anastomoses and paternity was achieved in three cases.Conclusion Although performed by a proficient microsurgeon the operative success rate was low, partly because the operation was technically demanding but largely because of the difficulty in assessing intra‐operatively the level of occlusion and the quality of the sperm. Better techniques for the evaluation of sperm during the operation should be developed.
Lower urinary tract function in ambulatory children with spina bifida
Authors: Mevorach R.A. , Bogaert G.A. , Baskin L.S. , Lazzaretti C.C. , Edwards M.S.B. , Kogan B.A. 
Published: November 2003

Objective To investigate lower urinary tract function in ambulatory children with myelomeningocele.Patients and methods The urological course of 45 children with myelomeningocele who walked either independently (19 children) or with ankle‐foot orthotics (26 children) was reviewed. Follow‐up ranged from 9 months to 13.5 years (mean 4.75 years).Results A normal pattern of voiding was observed both clinically and during urodynamic evaluation in only three of the 45 children, with the remainder displaying neurogenic lower urinary tract dysfunction. The independent walkers and those with orthotics did not differ in the spectrum of lower urinary tract dysfunction or other variables. Those patients with persistent incontinence underwent an initial urodynamic evaluation when older (mean 3.7 years versus 6.4 weeks in those who were continent).Conclusion Ambulatory children with myelomeningocele suffer the full spectrum of lower urinary tract dysfunction. Given the potential danger of untreated lower urinary tract dysfunction, ambulatory children with myelomeningocele should receive the same diagnostic and therapeutic attention as their peers with more overt neurological deficits.
Posterior urethral injuries in children
Authors: Avanogˇlu A. , Ulman I. , Herek Ö. , Özok G. , Gökdemir A. 
Published: November 2003

Objective To review the results of the operative treatment of posterior urethral injuries in children.Patients and methods A total of 29 children (25 boys and two girls, age range 3–14 years) with injuries to the posterior urethra were admitted to this department over 14 years. Twenty‐three patients presented immediately after trauma and six were referred after unsuccessful attempt(s) at surgical repair.Results Fourteen patients underwent suprapubic diversion and primary realignment over a catheter. Urethral continuity with normal urinary continence was achieved in seven of these patients. Four patients underwent a re‐operation; urethral reconstruction was successful in these patients, but one patient remained incontinent. Primary realignment with anastomosis was performed in nine patients; the results were satisfactory in six. Urethral stricture developed in all of four patients who were managed with a suprapubic cystostomy alone; a staged repair using the transpubic approach was carried out in two of them and one improved. Partial urethral tears in two patients healed with urethral catheterization alone.Conclusion Primary realignment of the urethra with anastomosis and suprapubic diversion resulted in the highest rate of success for normal urethral continuity. Urethral strictures or urinary incontinence were not major problems in this group. Therefore, we recommend this approach for the initial management of urethral injuries in childhood. Transpubic urethroplasties may be reserved for secondary repair.
The effects of chemical sympathectomy on contralateral testicular histology, fertility and fecundity in unilateral abdominal testes
Authors: Karnak I. , Gedikoglu G. , Tanyel F.C. , Büyükpamukçu N. , Hiçsönmez A. 
Published: November 2003

Objective To evaluate the effects of abdominal testis on ipsilateral and contralateral testicular histology, fertility and fecundity in rats which were chemically sympathectomized neonatally.Materials and methods The study comprised 60 male albino rats, 30 receiving a placebo and 30 a chemical sympathectomic agent neonatally. When 21 days old, the two groups of 30 rats were each divided into three groups and underwent a control operation or abdominal fixation of one or both testes. After they were 8 weeks old, each male rat was housed with two fertile female rats for 25 days, after which their testes were harvested. Females were observed for an additional 25 days and any pregnancies and the number of offspring were recorded. Mean seminiferous tubular diameters and mean testicular biopsy scores were determined for each testis.Results Although fertility and fecundity rates and mean testicular biopsy scores were not significantly different, chemical sympathectomy prevented the decrease in mean seminiferous tubular diameters which occurred in the contralateral testis.Conclusion Chemical sympathectomy protected contralateral testicular histology to some degree. Therefore, the sympathetic system may play a role in contralateral testicular deterioration.
Late failure of the reconstructed exstrophy bladder
Authors: Woodhouse C.R.J. , Redgrave N.G. 
Published: November 2003

Objective To establish whether successful bladder closure and bladder neck reconstruction in patients with exstrophy is durable into adulthood and whether bladder outlet obstruction, created during bladder‐neck tightening procedures, may lead ultimately to detrusor or urethral failure.Patients and methods The outcome of 57 patients born with exstrophy between 1965 and 1974 was reviewed.Results Of the 32 babies who underwent reconstruction, 19 failed in childhood and 13 still retained a native bladder into their second decade. Eight of 13 children with successful bladder closures and bladder neck reconstructions required further reconstruction or continent diversion in the second decade of life, most commonly because of poorly compliant, low‐capacity bladders associated with incontinence. Six had an augmentation cystoplasty (five with a continence procedure as well) and two had an artificial sphincter alone. Two patients have retained their native bladder but require self‐catheterization.Conclusion Long‐term follow‐up of patients with initially successful exstrophy closures is required, as late detrusor or urethral failure may occur. This detrusor failure may be related to bladder outlet obstruction associated with bladder neck reconstruction.
Peyronie curvature treated by plication of the penile fasciae
Authors: Geertsen U.A. , Brok K.E. , Andersen B. , Victor Nielsen H. 
Published: November 2003

Objective To evaluate the results of plication of the penile fascia in patients with penile curvature secondary to Peyronie's disease. Patients and methods Twenty‐eight men with Peyronie curvature underwent plication of the penile fascia. Before operation, the deviation of the penis was so severe (median 60°) in 24 men that they were unable to perform sexual intercourse. Follow‐up was based on hospital records, one postal questionnaire sent to all patients and a clinical evaluation of the men in the out‐patient clinic. Results After an uncomplicated operation and a median follow‐up of 34 months, 20 of the 28 men were able to perform sexual intercourse and 23 were satisfied with the result of the operation. The most frequent reasons for dissatisfaction with the outcome of the operation were insufficient straightening, pain from sutures and uncharacteristic pain related to the penis and/or scrotum. Conclusion The technique is simple to perform and the method gives functional and cosmetic results equal to those of more invasive procedures. The provision of adequate information to patients before the operation is important to ensure their satisfaction with the outcome.
Increased nerve growth factor levels in the urinary bladder of women with idiopathic sensory urgency and interstitial cystitis
Authors: LOWE E.M. , ANAND P. , TERENGHI G. , WILLIAMS‐CHESTNUT R.E. , SINICROPI D.V. , OSBORNE J.L. 
Published: November 2003

Objectives To determine whether nerve growth factor (NGF) is elevated in painful conditions of the urinary bladder (idiopathic sensory urgency, interstitial cystitis and painful chronic cystitis).Patients and methods Sixteen women patients were recruited from the Urodynamic Clinic at The Elizabeth Garrett Anderson Hospital, London. Four each had idiopathic sensory urgency (mean age 34 years, range 24–51), chronic cystitis (mean age 51 years, range 40–79) and interstitial cystitis (mean age 41 years, range 29–53). Four women who had genuine stress incontinence on cystometry but with no irritative symptoms were used as controls (mean age 45 years, range 35–54). The levels of NGF were determined in bladder biopsies from all women and biopsy sections were immunostained to detect NGF.Results The levels of NGF were higher in samples from all three painful bladder conditions than in samples from controls. Immunostaining showed increased NGF expression in the urothelium, most marked in patients with idiopathic sensory urgency.Conclusions The increased level of NGF may explain several clinical and pathological features in these conditions, including sensitization of nociceptor fibres and increased numbers of mast cells. We propose that anti‐NGF treatment may be a rational and effective treatment in intractable bladder pain.
The striated urethral sphincter: muscle fibre types and distribution in the prostatic capsule
Authors: LIGHT J.K. , RAPOLL E. , WHEELER T.M. 
Published: November 2003

Objective To clarify the muscle fibre types in the striated urethral sphincter and the pattern of distribution of this muscle in the prostatic capsule.Materials and methodsTwenty‐three prostate glands obtained at radical prostatectomy were studied using a whole‐organ technique. Each gland was sectioned from prostatic apex to base, including the bladder neck and seminal vesicles. The slides were then traced on paper after staining with haematoxylin and eosin and the distribution of striated muscle mapped. Two prostates were studied after sectioning with a cryostat and staining with adenosine phosphatase at pH 4.2, 4.6 and 4.93 to distinguish between the subclassification of Type 2 fibres. Other sections were stained for nicotinamide adenine dinucleotide phosphate with nitroblue tetrazolium, to distinguish fast from slow twitch fibres.ResultsStriated muscle was present within the anterolateral aspect of the prostatic capsule, extending from the prostatic apex to the bladder neck. Three different fibre types were present; fast‐twitch fatigue‐sensitive, fast‐twitch fatigue‐resistant and slow‐twitch.ConclusionThere are three distinct fibre types in the prostatic capsular striated muscle, representing displaced muscle fibres from the striated urethral sphincter. The composition of three types makes it eminently suitable to function as a sphincter muscle.
Ejaculation‐retarding properties of paroxetine in patients with primary premature ejaculation: a double‐blind, randomized, dose‐response study
Authors: WALDINGER M.D. , HENGEVELD M.W. , ZWINDERMAN A.H. 
Published: November 2003

Objective To compare the influence of a daily dose of 20 or 40 mg of the serotonergic antidepressant drug paroxetine in delaying ejaculation in patients with primary premature ejaculation.Patients and methods Thirty‐four patients with primary premature ejaculation were randomly assigned to receive 20 mg or 40 mg daily of paroxetine for 7 weeks in a double‐blind fixed‐dose trial after an initial dose of 20 mg/day in the first week. Patients and their female partners were interviewed separately. In the group receiving 20 mg, one of two capsules consisted of placebo and in the group receiving 40 mg, both capsules contained active drug.Results The trial was completed by 27 men; both groups showed a statistically significant difference from the baseline values of ejaculation latency (P<0.001) and a clinically relevant improvement in ejaculation time. The increase in the intravaginal ejaculation latency time was not statistically significant different between the groups. The patient’s assessments were confirmed independently by their partners.Conclusions The daily use of 20 mg paroxetine may be considered as an adequate treatment for primary premature ejaculation. Increasing the dose may lead to a further increase in ejaculation latency.
Written consent is haphazard for minor urological procedures
Authors: HROUDA D. , EMBERTON M. , HAMPSON S.J. 
Published: November 2003

Objective To determine the current practice among British urologists for obtaining written consent for flexible cystoscopy and other minor procedures under local anaesthesia.Methods Postal questionnaires were sent to full members of The British Association of Urological Surgeons practising in the UK asking if they obtained written informed consent for local anaesthetic procedures, e.g. flexible cystoscopy, urethral dilatation, and urethral catheterization for retention, for urodynamics or for intravesical chemotherapy. They were also asked whether they recorded that the risks and benefits of the procedure had been explained to the patient.Results Respondents were divided on whether they obtained written consent for flexible cystoscopy and urethral dilatation. Most did not obtain written consent for catheterization for retention, urodynamics, intravesical chemotherapy or suprapubic catheterization. The policy was inconsistent both between and within urologists.Conclusion Given the medicolegal importance of informed consent, consensus among urologists is required so that national guidelines can be developed and a more rational policy applied.
Neuroanatomical ontogeny of the human fetal penis
Authors: BASKIN L.S. , LEE Y.T. , CUNHA G.R. 
Published: November 2003

Objective To determine the development of the human penis, and hence the cause of congenital anomalies, using an immunohistochemical analysis of fetal penile ontogeny.Materials and methodsIn 25 human fetal penile specimens (gestational age 8 to 23 weeks) various tissues were localized immunohistochemically using stains for α‐actin (smooth muscle), cytokeratin 8 and 14 (epithelium) and protein gene‐product (PGP) 9.5 (neurons).ResultsNerves were identified in the penis with anti‐PGP in specimens of all ages, prominent dorsally at the 11 and 1 o’clock positions but also extending around the tunica to the junction of the corpus spongiosum and corpora cavernosa, suggesting that these structures may be injured in procedures which straighten the penis. The nerves continued into the glans on the dorsal aspect, suggesting that glans reduction in feminizing genitoplasties should be performed on the ventral aspect. Smooth muscle was first noted at 10 weeks’ gestation, with epithelial differentiation occurring in the earliest specimens studied (8 weeks’ gestation). With time, smooth muscle density was highest in the corpus spongiosum, especially between it and the corpora cavernosa. Smooth muscle also developed close to the urethral epithelium. The tunica albuginea showed consistent variations in thickness, with the mid‐dorsal 12 o’clock position being the thickest, followed by the 5 and 7 o’clock periurethral positions.ConclusionA better knowledge of penile development and of the relationship of the nerves to the corpora cavernosa is useful in the strategic design of penile straightening procedures and feminizing genitoplasties.