bluuebunny/crossref_metadata_2025_split huggingface dataset:
Schistosoma haematobium infection in children in Britain
Authors: Samuel M. , Misra D. , Larcher V. , Price E. 
Published: March 2003

Objective To highlight the existence of Schistosoma haematobium in certain ethnic minority groups in Britain and in English citizens who have recently visited Africa and the Middle East, so that general practitioners and paediatric nephrologists/urologists are aware of its occurrence and consider it among the differential diagnoses in children presenting with haematuria. Patients and methods Over a 2‐year period, six consecutive boys (mean age 13.5 years, range 8–15) presented with haematuria and were subsequently diagnosed to be infected with S. haematobium. All patients were from Africa and had recently visited their native country. There had all reported paddling in freshwater lakes and streams. Results Dysuria and haematuria was noted 2–3 months after the infection. Terminal urine samples taken after exercise at midday were positive for S. haematobium ova. Praziquantel anti‐schistosomal chemotherapy was effective in treating the infection. Conclusion S. haematobium infection is treatable in the early stages and the changes are reversible before the development of fibrotic lesions, which may result in anatomical obstruction. A terminal urine sample taken at midday after exercise was diagnostic in showing Schistosoma ova in all cases. This infection must be considered in the differential diagnoses of haematuria in some ethnic minority British citizens and in those Britons who have visited Africa or the Middle East in the recent past.
Effects of an extract from Herniaria hirsuta on calcium oxalate crystallization in vitro
Authors: Atmani F. , Khan S.R. 
Published: March 2003

Objective To evaluate the effectiveness of an extract obtained from Herniaria hirsuta on calcium oxalate crystallization in vitro. Materials and methods An extract was prepared from H. hirsuta at different concentrations (0.0625–1 mg/mL). Crystallization was induced in whole normal human urine samples in the absence or presence of the extract. Crystals generated in the urine were harvested and analysed by scanning electron microscopy. The nucleation and aggregation of calcium oxalate crystals were measured separately using spectrophotometric methods. The nucleation rate was followed at 620 nm after mixing calcium chloride and sodium oxalate solution at 37 °C, with stirring. The induction time in the presence of herb extract was compared with that of the control. The aggregation rate was also followed at 620 nm in a buffered solution containing calcium oxalate monohydrate crystals after stopping the stirring. The rate was evaluated by comparing the slope of turbidity in the presence of the extract with that of the control. Results The herb extract promoted the precipitation of calcium oxalate particles in whole urine.
sem showed that there were more crystals with increasing concentration of extract but that they were proportionally smaller. Moreover, the presence of herb extract favoured the formation of calcium oxalate dihydrate rather than monohydrate crystals. The extract inhibited calcium oxalate crystal aggregation. In an independent experiment, the herb extract was dialysed and filtered before inducing crystallization, to eliminate any fibrous particles and oxalate. The treated herb extract promoted more crystallization, especially at high concentrations. Conclusion An extract of H. hirsuta promoted the nucleation of calcium oxalate crystals, increasing their number but decreasing their size. It also promoted the formation of calcium oxalate dihydrate crystals, despite the presence of calcium oxalate monohydrate particles. The extract may contain substances that inhibit calcium oxalate crystal aggregation. These properties of H. hirsuta might be beneficial in preventing kidney stone formation.
Is only meatoplasty a legitimate surgical solution for extreme distal hypospadias? A long‐term follow‐up after adolescence
Authors: Mor Y. , Ramon J. , Jonas P. 
Published: March 2003

Objective To review the long‐term outcome of glanular hypospadias repair for extreme distal hypospadias based on simple dorsal Browne meatoplasty and circumcision, with particular attention to patient satisfaction.Patients and methods A review of medical records identified 124 patients who underwent surgery for hypospadias between 1970 and 1979. Their age at operation ranged from 3 months to 13 years. The operation, performed as a day‐case, included dorsal Browne meatoplasty for meatal advancement, based upon the Heineke‐Mikulicz principle, using three absorbable sutures and often circumcision. There were no immediate complications. A questionnaire was sent to 111 patients whose present address was available. Two patients had died since the operation and of the 109 remaining patients, 43 (39%) replied.Results The patients were aged 16–31 years at the time of assessment, giving a follow‐up of 18 (13–23) years. Seven of the 43 patients were married. Seven patients had complained of some difficulties with urination, four reporting a poor urinary flow. The stream was directed forward in 32 patients and to some degree downwards in 11, still enabling all the patients to urinate while standing with a single stream. Thirty‐two patients had had sexual experience, with no functional problems. Twenty‐three defined their penile appearance as normal and 20 as abnormal. Overall, 24 (56%) reported complete satisfaction, 11 (25%) partial satisfaction and eight (19%) were dissatisfied with the surgical result.Conclusion As there are few published reports about the long‐term outcome and patient satisfaction after hypospadias repair, it is difficult to draw clear conclusions. However, this simple procedure is a legitimate surgical option for extremely distal glanular hypospadias.
A randomized double‐blind placebo‐controlled crossover trial of the efficacy of l‐arginine in the treatment of interstitial cystitis
Authors: Cartledge J.J. , Davies A.‐M. , Eardley I. 
Published: March 2003

Objectives To determine, in a double‐blind placebo‐controlled crossover study, whether l‐arginine improves the symptoms of interstitial cystitis (IC), a chronic condition in which nitric oxide (NO) may be important, as previous open pilot studies suggested that l‐arginine reduced the pain and frequency associated with IC.Patients and methods Patients fulfilling the standard diagnostic criteria for IC were randomized to receive l‐arginine (2.4 g/day) or placebo for one month. After a 2‐week ‘washout’ period they received the other medication. Patients were assessed at each stage using a validated symptom index, a voiding diary, urine analysis and records of adverse events. Patients were asked about overall efficacy at the close of the study. The results were compared using a t‐test, with significance indicated at P < 0.05.Results Sixteen (16) patients (mean age 51.3 years) were enrolled; the mean duration of IC was 5.4 years, the IC symptom index score 29.1, their nocturnal frequency 3.5 (voided volume 182 mL) and daytime frequency 12.7 (124 mL). Patients on placebo showed no differences in any recorded variable over the baseline values. l‐arginine caused a statistically significant reduction in the overall symptom score of 2.2 over baseline, but there was no difference in voided volume, frequency or nocturia. As there was no significant difference for any variable between l‐arginine and placebo, this reduction in score should be regarded with caution. Three patients withdrew because of side‐effects (severe headaches, night sweats and flushing).Conclusion Oral l‐arginine produces a statistically significant improvement in the IC symptom index in patients with IC, but the effect is small. This effect may not be clinically significant as there were no improvements in the other variables assessed and no significant difference between the response to l‐arginine and placebo. From these results the use of l‐arginine cannot be recommended for treating IC.
The Mitrofanoff procedure: does it last?
Authors: Fishwick J.E. , Gough D.C.S. , O’Flynn K.J. 
Published: March 2003

Objective To examine the long‐term effectiveness of the Mitrofanoff principle and establish if the catheterizing channel is sufficiently robust for long‐term use.Patients and methods Ten patients who had undergone Mitrofanoff reconstruction between 1989 and 1991 (minimum follow‐up 10 years) were offered reinterview by one of the authors (J.F.), which involved a structured questionnaire assessing catheterization, continence and complications.Results One patient had died; nine patients were alive and eight agreed to the structured interview. All the patients had their original stoma and all were completely continent. Four of the patients had experienced stenosis, four had had stones and four had been ill with urinary tract infection(s).Conclusion Despite the complications of infection, stones and some episodic stenosis, the Mitrofanoff channel remains functional for long periods without sustaining structural damage.
Photodynamic therapy of rat bladder and urethra: evaluation of urinary and reproductive function after inducing protoporphyrin IX with 5‐aminolaevulinic acid
Authors: Chang S.‐C. , Chern I. , Bown S.G. 
Published: March 2003

Objective To assess the urinary and reproductive function of rats after inducing protoporphyrin IX with 5‐aminolaevulinic acid (ALA) and subsequent intraurethral photodynamic therapy (PDT). Materials and methods Twelve female Wistar rats were given ALA orally or intravesically (four each), followed by intraurethral PDT through a 10‐mm cylindrical fibre at 100 mW for 500 s (argon laser, 632 nm). Urinary frequency, the number of gestations and histological changes were then evaluated and compared with a group of eight control rats. Results There was only a slight increase in urinary frequency during the first 2 weeks after PDT in the group given oral ALA, while the same degree of urinary frequency was evident for up to 4 weeks in those given intravesical ALA. Despite the occurrence of urinary incontinence from undefined causes in two rats, reproductive function remained unchanged. There was no histological evidence of damage to the reproductive system adjacent to the bladder. Conclusions PDT of the urethra with ALA is relatively safe and carries few risks of inducing permanent urological complications.
The development and validation of a quality‐of‐life measure to assess partner morbidity in benign prostatic enlargement
Authors: Sells H. , Donovan J. , Ewings P. , Macdonagh R.P. 
Published: March 2003

Objective To investigate morbidity in the partners of patients with benign prostatic enlargement (BPE) by developing and validating a disease‐specific questionnaire.Patients and methods Phase 1 of the study comprised preliminary interviews with 15 patients who had newly diagnosed BPE, and with their partners, to determine the relevant issues for the partners. In phase 2, using these issues, a questionnaire was produced and tested on the 15 partners. In phase 3 the questionnaire was completed by 90 further partners, 50 at interview and the next 40 by post. As part of the validation process, the partners were also asked to complete the Short‐Form‐36 questionnaire, and the patients the Internation Prostate Symptom Score (IPSS) and the ICSmale questionnaires.Results In phase 1 all 15 of the partners were affected by the patients’ disease and nine issues were identified. In phase 2, of the 90 partners, only one had no morbidity from the patient’s symptoms; 71% were worried that the patient may have cancer and 69% concerned that the patient may require an operation. Only six partners were present at the patients’ urological consultation. The partners’ questionnaire scores were related significantly to the Mental Health and Vitality domains of the SF36 and with the patients’ IPSS.Conclusions The study confirmed the presence of significant morbidity in the partners of patients with BPE. The degree of partner morbidity was related to the severity of the patients’ symptoms. Many of the questionnaire issues can be addressed in the consulting room by open discussion with patient and partner.
Differential response of prostate specific antigen to testosterone surge after luteinizing hormone‐releasing hormone analogue in prostate cancer and benign prostatic hyperplasia
Authors: Agarwal D.K. , Costello A.J. , Peters J. , Sikaris K. , Crowe H. 
Published: March 2003

Objective To investigate any differences in changes in serum prostate specific antigen (PSA) levels in patients with benign and malignant prostatic disease in response to the testosterone surge after administering a luteinizing hormone‐releasing hormone (LHRH) analogue. Patients and methods The study included 54 patients referred to the urology clinic with intermediate PSA levels (4–10 ng/mL) or an abnormal digital rectal examination. Forty‐five patients received a single injection of LHRH analogue depot each at one week before prostate biopsy and nine served as a control group. Changes in PSA levels in response to the testosterone surge from the LHRH analogue were recorded after 5 and 7 days, and were correlated with the biopsy results. The PSA changes were compared with basal PSA levels and the free/total PSA ratio(f/tPSA). Results Of the 45 patients who underwent prostate biopsy, histopathology showed prostate cancer in 11, benign prostatic hyperplasia in 33 and prostatic intraepithelial neoplasia in one. Patients with cancer had a significantly greater increase in serum PSA levels during the first week after LHRH injection than those in the benign and control groups. Receiver operating characteristic curves showed that the percentage change in PSA level on day 5 was more diagnostic than total PSA and f/tPSA. Conclusions There was a marked difference in the PSA response of patients with benign or malignant disease to the testosterone surge produced by the LHRH analogue. Although a larger study would be needed before LHRH‐induced provocation could be proposed as a clinical test, in this small series the response was better than that for total PSA or f/tPSA in differentiating benign and malignant disease.
Twelve prostate biopsies detect significant cancer volumes (> 0.5 mL)
Authors: Brössner C. , Bayer G. , Madersbacher S. , Kuber W. , Klingler C. , Pycha A. 
Published: March 2003

Objectives To compare, in a retrospective study, pathological specimens of prostate cancer detected in additional areas of a 12‐core biopsy with tumours detected using traditional sextant biopsy. Patients and methods The study included 27 patients who had undergone radical prostatectomy (RP) for prostate cancer. Prostatectomy specimens of cancers detected using standard sextant biopsies were compared with those detected using six additional core biopsies. The RP specimens were analysed for cancer volume, Gleason score, tumour grade (Mostofi) and pathological stage. Results Of the 27 patients, six (29%) had cancer detected in the extra six biopsy cores which would have otherwise have been undetected using sextant biopsy. Only two insignificant cancers were detected. The mean Gleason score was 6.1 for cancer detected by the sextant or 12‐core method (P = 0.907); the mean grade (Mostofi) was 2.1 and 2.33, respectively (P = 0.29). The final tumour stage in the 21 patients undergoing sextant biopsy was pT2 in 13 and pT3 in eight, compared with six pT2 tumours in the six patients diagnosed using extra biopsies. The mean (median, range) tumour volume was 5.7 (3.5, 0.312–23.75) mL for cancers detected on sextant biopsy and 1.99 (1.85, 0.4–3.6) mL in the six cancers detected using extra cores (P = 0.0138). Conclusion The detection of prostate cancer was increased using extra biopsy cores. There was a significant difference in tumour volume but not in Gleason score, Mostofi grade or final pathological tumour stage between tumours diagnosed using 12 cores and those detected on sextant biopsy.
Antibiotic prophylaxis for transrectal needle biopsy of the prostate: a randomized controlled study
Authors: Aron M. , Rajeev T.P. , Gupta N.P. 
Published: March 2003

Objectives To determine the effect of antibiotic prophylaxis on infective complications after transrectal needle biopsy of the prostate. Patients and methods Between June 1996 and September 1998, 231 patients who satisfied the inclusion and exclusion criteria entered the study; the patients were randomized into three groups. Each patient underwent transrectal needle biopsy of the prostate after a cleansing enema at 06:00 hours. Patients in group 1 (75) then received a placebo tablet twice a day for 3 days; those in group 2 (79) were given a single dose of ciprofloxacin (500 mg) and tinidazole (600 mg), while those in group 3 (77) were given the same combination twice a day for 3 days. Urine cultures were obtained 48 h after the biopsy and blood cultures only from patients who developed fever. The complications (categorized as infective or noninfective) occurring in the three groups were compared using the chi‐square test. Results Noninfective complications included were lower urinary tract symptoms, rectal bleeding, haematuria and perineal pain. The infective complications included urinary tract infection and fever. There was no significant difference among the three groups in noninfective complications (27, 29 and 31 in groups 1–3, respectively) but the incidence of infective complications (19, six and eight, respectively) was significantly higher in group 1 (P = 0.003). However, the difference was significant only for urinary tract infection (P = 0.01) and not for fever. Conclusions In selected patients a single dose of ciprofloxacin‐tinidazole is adequate prophylaxis for transrectal needle biopsy of the prostate. The present urinary infection rate was higher if no antibiotics were used. Continuing the antibiotic prophylaxis for 3 days offered no benefit over single‐dose prophylaxis.
An epidemiological study of enuresis in Korean children
Authors: Lee S.D. , Sohn D.W. , Lee J.Z. , Park N.C. , Chung M.K. 
Published: March 2003

Objective To estimate the prevalence of enuresis in children of elementary school age, to evaluate the impact of enuresis on these children and their parents, and to identify the methods and effectiveness of managing enuresis. Subjects and methods A randomly selected cross‐sectional study was conducted in one elementary school in each urban ward (nine schools) in Pusan, Korea. The parents of these 12 570 children aged 7–12 years were asked to complete questionnaires which included items about the presence and frequency of enuresis, its perceived impact and management. Enuresis was defined as an episode of wetting occurring at least once per month. Results The overall response rate to the questionnaire was 55.8% (girls 28.2%, boys 27.6%). The prevalence of nocturnal, diurnal and combined enuresis was 9.2%, 2.2% and 1.4%, respectively. The overall prevalence of enuresis declined with age from 20.4% at 7 years old to 5.6% at 12 years old; 342 (57.0%) parents and 318 (55.6%) children were concerned about enuresis. The common self‐help strategies were waking the child at night to void (38.1%) and restriction of water intake (25.7%). Of the enuretic children, only 13.7% had consulted a health worker. Conclusion The prevalence rates for enuresis in Pusan are similar to those reported from European countries. Enuretic children and their parents were moderately concerned about enuresis and the parents primarily used self‐management within the family.
Epididymectomy is an effective treatment for scrotal pain after vasectomy
Authors: West A.F. , Leung H.Y. , Powell P.H. 
Published: March 2003

Objective To investigate the efficacy of epididymectomy in patients with significant scrotal pain after vasectomy.Patient and methods Sixteen patients were identified retrospectively to have undergone epididymectomy for pain after vasectomy; 19 epididymectomies were performed (three bilateral and 13 unilateral). Details from the preoperative investigations, histological examination and follow‐up of symptoms were analysed and correlated. Outcomes were initially assessed at the routine outpatient clinic review 3 months after surgery and the long‐term outcomes were assessed by a telephone interview 3–8 years after epididymectomy (mean 5.5 years).Results Of the 16 patients, 14 had excellent initial symptomatic benefit from epididymectomy. At 3–8 years afterward, nine of 10 patients interviewed had a sustained improvement of their scrotal pain. The following were indicators of a poor outcome: atypical symptoms including testicular or groin pain; erectile dysfunction and normal appearance of the epididymis on ultrasonography. Patients with bilateral scrotal pain can have a good outcome after epididymectomy.Conclusion Epididymectomy in well‐selected patients is a reliable and effective treatment for pain after vasectomy.
A prospective pilot evaluation of urinary and immunohistochemical markers as predictors of clinical stage of urothelial carcinoma of the bladder
Authors: Krupski T. , Moskaluk C. , Boyd J.C. , Theodorescu D. 
Published: March 2003

Objective To determine, in patients newly diagnosed with bladder cancer, whether p53, epidermal growth factor receptor (EGFR), microvessel density (MVD), urinary bladder tumour antigen (BTA TRAK™, Bion Diagnostic Sciences, Redmond, WA) and cytology were predictive of clinical stage, evaluated as a function of the clinical stage obtained at transurethral resection of the bladder tumour with and without the addition of clinical grade, a known strong predictor of clinical stage.Patients and methods Between December 1997 and September 1998, 22 men and seven women with a cystoscopic diagnosis of urothelial bladder carcinoma were prospectively enrolled in the study. Urine was collected for cytological and BTA TRAK evaluation before transurethral resection. Tumour grade and clinical stage were obtained from the transurethral resection specimen. MVD was evaluated by computerized calculations of ‘optimal MVD’ (OMVD) and ‘area‐weighted MVD’ (AWMVD) while p53 and EGFR information was obtained by manual immunohistochemical techniques; 21 patients had sufficient tissue for all immunohistochemical assessments and comprised the study group. Univariate and multivariate comparisons were carried out to determine the contribution of each variable to the prediction of clinical stage.Results Although there was a trend, cytological analysis and p53 and MVD immunoreactivity did not significantly correlate with clinical stage, while tumour grade, BTA TRAK and EGFR immunoreactivity did. In a univariate analysis, tumour grade and BTA TRAK were related to clinical stage. In a multivariate analysis, grade was the single best predictor of clinical stage. This analysis also showed that the addition of BTA TRAK and MVD information to grade incrementally improved the predictive ability of grade.Conclusions This pilot study suggests that BTA TRAK and MVD contribute incremental information to tumour grade in predicting the clinical stage of urothelial carcinomas of the bladder; grade remains the most important predictor. These results suggest that further work with BTA TRAK and MVD in more patients and on biopsy material obtained during clinic cystoscopy is warranted for the future development of less invasive methods of identifying patients with invasive bladder cancer.