bluuebunny/crossref_metadata_2025_split huggingface dataset:
Photodynamic therapy of bladder cancer cell lines
Authors: DATTA S.N. , ALLMAN R. , LOH C.S. , MASON M. , MATTHEWS P.N. 
Published: November 2003

Objective To determine the effect of photodynamic therapy mediated by 5‐aminolevulinic acid (ALA) on a range of bladder cancer cell lines, including a squamous cancer cell line and a multi‐drug resistant cell line.Materials and methods Experiments were performed on cells growing in culture; the cell lines studied were the transitional cell cancer lines RT112, T24 and EJ138, the squamous cancer cell line, SCaBER, and the multi‐drug resistant transitional cancer cell line, MGH‐U1(R), together with its non‐resistant parent line, MGH‐U1. The kinetics of the ALA‐mediated generation of fluorescent photosensitizer were determined using flow cytometry. Photodynamic therapy was performed by incubating cells in ALA followed by exposure to various doses of white light.Results The response of the various transitional cancer cell lines to photodynamic therapy depended on dose. The squamous cell line was relatively resistant to photodynamic therapy. There was some cross‐resistance of the MGH‐U1(R) cell line to photodynamic therapy, although the mechanism of cross‐resistance appeared not to be necessarily a property of the drug‐resistant phenotype.Conclusion This study suggests that ALA‐mediated photodynamic therapy may be effective in transitional cell carcinoma of the bladder. Based on these findings, this therapeutic method should be further evaluated clinically.
Spermatic‐cord block improves analgesia for day‐case testicular surgery
Authors: BURDEN R.J. , O’KELLY S.W. , SUTTON D. , CUMMING J. 
Published: November 2003

Objective To assess whether the use of a spermatic‐cord block contributes any additional analgesia to that of a conventional analgesic regimen in day‐case testicular surgery.Patients and methods In a randomized, double‐blind controlled study, 48 patients undergoing day‐case testicular surgery received general anaesthesia together with fentanyl and diclofenac for analgesia. In addition, 22 of these patients received 10 mL of 0.5% plain bupivacaine into the spermatic cord at the conclusion of surgery. Visual‐analogue pain scores were recorded for each group over the following 24 h.Results The visual‐analogue pain scores were significantly lower in the immediate recovery period in patients receiving the spermatic‐cord block.Conclusion The spermatic‐cord block reduced discomfort in the immediate post‐operative period in patients undergoing testicular surgery and the procedure should be encouraged to improve the quality of post‐operative pain management in such procedures.
The characteristics of primary vesico‐ureteric reflux in male and female infants with pre‐natal hydronephrosis
Authors: YEUNG C.K. , GODLEY M.L. , DHILLON H.K. , GORDON I. , DUFFY P.G. , RANSLEY P.G. 
Published: November 2003

Objective To examine the characteristics of primary vesico‐ureteric reflux (VUR) in young infants following prenatal hydronephrosis.Patients and methods The study comprised 155 consecutive infants with VUR detected at a mean age of 8.7 weeks (sd 6.3). Reflux units (n=236) were analysed for relationships between gender, severity of reflux, exposure to urinary tract infection (UTI) and the presence of focal and generalized types of kidney damage on imaging. Bladder wall thickness (from ultrasonography) was examined in comparison with a further group of 29 males without VUR.Results Male infants predominated (117 of 155, 75%); bilateral VUR affected the same proportion (52%) of males and females. Most kidneys exposed to VUR (158 of 236, 67%) were normal and of the 78 abnormal kidneys (57 without UTI), 53 showed generalized damage (only eight exposed to UTI) and 71 (91%) were associated with severe (grades IV and V) reflux that predominantly affected males (P<0.001). Grade V reflux was almost exclusively a male disorder. Most female units (45 of 58, 78%) compared with 46% (82/178) of male units had mild (grades I to III) reflux that was independently associated with normal kidneys. The mean bladder wall thickness was significantly greater for males with VUR than for females with VUR and for males without VUR.Conclusions Two distinct but not exclusive patterns of VUR were identified: (i) mild reflux associated with normal kidneys that affected most females and a proportion of males; (ii) severe reflux combined with kidney damage, most likely fetal in origin, that is almost exclusively a male disorder.
Is open pyeloplasty still justified?
Authors: ARUN N. , KEKRE N.S. , NATH V. , GOPALAKRISHNAN G. 
Published: November 2003

Objective To determine the success rate, complications and morbidity from open pyeloplasty.Patients and methods The study included 63 patients with confirmed pelvi‐ureteric junction (PUJ) obstruction who underwent 66 pyeloplasties. Their records were analysed retrospectively for age, clinical presentation, serum creatinine level, presence of infection, surgical technique, and pre‐ and post‐operative isotopic renography. The mean (range) follow‐up was 15.5 (3–60) months.Results Pain was the most common presenting symptom; most pyeloplasties were dismembered and 77% of the procedures were performed by urological trainees. Retrograde pyelography did not alter the management in any patient. The complications were persisting PUJ obstruction in four, urinary leakage in two, transient vesico‐ureteric obstruction in two and meatal stenosis in one. There were no complications in non‐intubated pyeloplasties. Pain was successfully relieved in 98% of patients, renal function improved or remained stable in 92% and deteriorated in 7.7%. One patient underwent a revision pyeloplasty and another required nephrectomy. A younger patient, absence of urinary tract infection and absence of palpable mass were favourable factors.Conclusion Pyeloplasty is the most effective and permanent treatment for PUJ obstruction. Newer endoscopic procedures currently used must be carefully assessed against this ‘gold standard’ before becoming widespread.
Balloon‐occluded arterial infusion as a useful neoadjuvant chemotherapy for bladder cancer
Authors: ARIMA K. , TOCHIGI H. , SUGIMURA Y. , KAWAMURA J. 
Published: November 2003

Objective To evaluate the balloon‐occluded arterial infusion (BOAI) of cisplatin and adriamycin as a pre‐operative adjuvant chemotherapy in patients with bladder cancer of stage ≥T2 or in those with stage T1 and multiple large tumours.Patients and methods The study comprised 120 patients with bladder cancer who underwent BOAI from November 1984 to December 1995. BOAI chemotherapy (adriamycin and cisplatin) was administered under ischaemia through a 7 F torque‐control balloon catheter, both sides of which were inserted into the contralateral internal iliac artery. The regression rate of tumours and any improvement in tumour stage was assessed.Results The clinical response rate (complete or partial) was 66% and the tumour stage improved in 39% of the patients after BOAI. Of 26 patients with stage T3a diagnosed before BOAI, 12 were diagnosed as T2 or less after treatment. Of 27 patients who underwent total cystectomy because the tumour was diagnosed as T2 after BOAI, the post‐operative histopathological examination showed that 22 (82%) were stage pT1 or below. The features associated with a good response to BOAI in patients with up to pT3a disease were grade 3, non‐papillary tumours with a diameter of <3 cm.Conclusion In patients diagnosed as stage T2 and T3a, or stage T1 with multiple large tumours difficult to be treat by transurethral resection, BOAI should be considered as the first choice to decrease the stage or to confirm the pathological staging.
A case‐control study of percutaneous nephrolithotomy versus extracorporeal shock wave lithotripsy
Authors: Saxby M.F. , Sorahan T. , Slaney P. , Coppinger S.W.V. 
Published: November 2003

Objectives To assess the relative efficacy of percutaneous nephrolithotomy (PCN) and extracorporeal shock wave lithotripsy (ESWL) in clearing stones and to examine factors which affected the results from each treatment. Patients and methods The study comprised 390 patients treated with PCN who were compared to 618 patients treated with ESWL. Unconditional logistic regression analysis was used to compare the odds of success and failure in the PCN group with those in the ESWL group, whilst controlling for any potential effects of age, sex, laterality, presence of other stones, previous stone history, pre‐operative treatment and centre. Results PCN was more successful in obtaining satisfactory results than ESWL, with an odds ratio of 2.67 (P<0.001, 95% confidence intervals 1.84–3.87). The odds ratio in favour of PCN was increased after controlling for differences by centre (odds ratio 5.18, 95% confidence intervals 2.89–9.16). No other factors significantly influenced the odds ratio. ESWL was less successful in treating stones >2 cm in diameter compared to treating stones <2 cm in diameter(P=0.001). ESWL results were also affected by re‐treatment rates, which were influenced by distance of the local hospital from the lithotripter. The results with PCN improved with experience. The results of ESWL were satisfactory and the treatment cheaper, with a lower morbidity and hospital stay than after PCN for stones <2 cm in diameter, making it the treatment of choice. However for stones >2 cm, the results of ESWL were not as good and costs of treatment, morbidity and hospital stay were much closer to those of PCN for similar sized stones. Conclusions PCN is more effective than ESWL in clearing stones. However, ESWL is an effective treatment and is usually the treatment of choice for most stones. Nevertheless, PCN remains an important and extremely effective method of treatment. The choice of treatment for stones will be influenced by the distance of a centre from a static lithotripter, and the potential availability of a mobile lithotripter.
The use of salivary stimulant pastilles to improve compliance in women taking oxybutynin hydrochloride for detrusor instability: a pilot study
Authors: HOOPER P. , TINCELLO D.G. , RICHMOND D.H. 
Published: November 2003

Objective To assess the efficacy of salivary stimulant pastilles in improving tolerance of and compliance with oxybutynin chloride for detrusor instability.Patients and methods Thirty women with detrusor instability were treated with oxybutynin in either a fixed or variable dose. After 3 weeks, patients were given salivary stimulant pastilles (Salivix, Thames Laboratories, Clwyd, UK) to chew as often as required. Symptom diaries were used to record episodes of dry mouth (xerostomia) together with a 100 mm visual analogue scale (VAS) score of the severity of xerostomia.Results The frequency of xerostomia was unchanged but there was a significant decrease in median severity from 71 to 39 on the VAS (P<0.05, Mann–Whitney U‐test). Nine patients on the variable‐dose regimen tolerated a higher dose of oxybutynin when taking the pastilles (P<0.01, Wilcoxon’s matched‐pairs test).Conclusion Salivary stimulant pastilles appear to be a useful adjuvant therapy for patients receiving oxybutynin chloride for detrusor instability, allowing higher doses of oxybutynin to be tolerated.
A comparative study of guidewire electrical resistance
Authors: DESGRANDCHAMPS F. , PEDRON P. , HOFFMANN P. , TEILLAC P. , LE DUC A. 
Published: November 2003

Objective To evaluate the electrical resistance to current conduction of different guidewires used routinely in endourology and thus determine the risk of short circuits between the active electrode and the guide.Materials and methods Using a standard resistance meter, the electrical resistance of four different types of guidewires was measured. Pure stainless‐steel, polytetrafluoroethylene (PTFE)‐painted, PTFE‐sheathed and hydrogel‐sheathed guidewires were tested, both when new and after mechanical abrasion of the external layer to reproduce their condition after use.Results The pure stainless‐steel guidewire had no resistance to electrical current. The electrical insulation of the PTFE‐painted guidewires was poor and was eliminated by mechanical abrasion of the paint. New PTFE‐sheathed and hydrogel‐sheathed guidewires had a safe electrical resistance (>10 k&Omega;) but this insulation was easily eliminated by mechanical abrasion of the external layer.Conclusions To minimize the risk of electrosurgical adverse effects during a guidewire‐assisted endoscopic procedure, the operator should preferably use a new guidewire for each procedure, use sheathed guidewires and ensure that the guidewire is in good condition, or cover it with a ureteric catheter, before applying current.
Clinical comparison of selective and non‐selective &agr;1A‐adrenoreceptor antagonists in benign prostatic hyperplasia: studies on tamsulosin in a fixed dose and terazosin in increasing doses
Authors: LEE E. , LEE C. 
Published: November 2003

Objective To compare the efficacy and safety of a fixed dose (0.2 mg) of tamsulosin, a selective &agr;1A‐adrenoreceptor antagonist, with an increasing dose (1–5 mg) of terazosin, a non‐selective antagonist, in the treatment of urinary outflow obstruction associated with benign prostatic hyperplasia (BPH) in Korean patients.Patients and methods The study comprised a single‐blind and randomized design with tamsulosin or terazosin taken once daily for 8 weeks. A total of 98 patients was enrolled, with 72 patients included in the analyses after 4 and 8 weeks. The primary variables assessed were changes in the maximum urinary flow rate (Qmax ) and the total International Prostate Symptom Score (IPSS), with the post‐void residual urine volume, ‘obstructive’ and ‘irritative’ questions in the IPSS, and the investigators’ global assessment of efficacy also determined. The number of patients with a clinically significant response to treatment with tamsulosin or terazosin was determined and defined as those with >20% improvement from the baseline Qmax or >20% decrease in total IPSS. Adverse reactions possibly or probably related to study medication were recorded throughout the treatment period.Results Both tamsulosin and terazosin produced similar significant improvements in subjective and objective symptoms of urinary outflow obstruction (P>0.05). Systolic and diastolic (standing) blood pressures decreased significantly in patients treated with terazosin (P<0.05). The adverse reactions, most frequently dry mouth and dizziness which were usually mild and transient, were significantly higher in patients on terazosin (18 patients, versus one on tamsulosin, P<0.001). The changes led to discontinuation of therapy in two patients on terazosin.Conclusion Tamsulosin was as effective as terazosin in treating urinary outflow obstruction associated with BPH, but had a markedly better safety profile.
Histology of the upper pole in complete urinary duplication — does it affect surgical management?
Authors: ABEL C. , LENDON M. , GOUGH D.C.S. 
Published: November 2003

Objective To review the histological change in the upper pole of excised duplex kidneys and assess whether ante‐natal diagnosis might predispose to more conservative surgical management of this abnormality.Patients and methods Fifty consecutive patients undergoing upper pole hemi‐nephroureterectomy for ectopic ureter or ectopic ureterocele between 1980 and 1992 had their histology reviewed and assessed for dysplastic, inflammatory and obstructive change.Results Segmental scarring and chronic and acute inflammatory change occurred consistently and the degree of inflammation seemed unaffected by ante‐natal diagnosis. Dysplasia was seen in 70% of patients with ureterocele and in only 30% of those with ectopic ureter. One patient had normal histology.Conclusion There was no evidence of reversible histological change in patients with ectopic ureter and ectopic ureterocele who were diagnosed ante‐natally. Preservation of the upper pole of the kidney does not seem justified in the light of the histological evidence.
Kinetics of peptide‐induced release of inflammatory mediators by the urinary bladder
Authors: SABAN M.R. , SABAN R. , BJORLING D.E. 
Published: November 2003

Objective To investigate the release of inflammatory mediators by the urinary bladder in response to exposure to pro‐inflammatory peptides.Materials and methods Isolated guinea pig urinary bladder was incubated with 10 &mgr;mol/L each of substance P (SP), neurokinin A (NKA), calcitonin gene‐related peptide (CGRP), vasoactive intestinal peptide (VIP), octreotide acetate (a long‐acting analogue of somatostatin, SOM), or bradykinin (BK), and the release of histamine, prostaglandin (PG) E2 , PGF2&agr; and leukotriene B4 (LTB4 ) was determined during 0–5, 5–30 and 30–120 min after addition.Results Substance P, NKA, VIP and BK stimulated the release of histamine, while CGRP and SOM suppressed the release to below the spontaneous rates. All peptides, except CGRP and SOM, stimulated the release of PGE2 between 0 and 30 min, and only VIP failed to stimulate the release of PGF2&agr; within 5 min of exposure. Substance P, NKA, VIP and BK stimulated the release of LTB4 and this required >5 min of exposure.Conclusion These results indicate that the peptides evaluated induce an immediate and transient release of histamine and activation of cyclooxygenase and delayed activation of 5‐lipoxygenase. These actions may directly regulate the participation of these peptides in the pathogenesis of cystitis.
Pitfalls of measuring residual urine volume in orthotopic neobladders
Authors: OKADA H. , GOTOH A. , FUJISAWA M. , HARA I. , GOHJI K. , ARAKAWA S. , KAMIDONO S. 
Published: November 2003

Objective To investigate the pitfalls of measuring post‐void residual urine volume (PVR) in patients with orthotopic neobladders, in an out‐patient clinic.Patients and methods Fifteen patients with orthotopic neobladders were enrolled in the study; five patients had a colonic neobladder, five an ileocolic neobladder and five a sigmoid neobladder. The PVR was compared after measuring by catheterization under fluoroscopic monitoring after normal or forced voiding.Results The PVR after forced voiding was always less than that after natural voiding, regardless of the type of neobladder.Conclusions Patients with orthotopic neobladders may have a higher PVR after voiding naturally at home than when the PVR measured in hospital.
Transurethral prostatectomy: a prospective randomized study of conventional resection and electrovaporization in benign prostatic hyperplasia
Authors: SHOKEIR A.A. , AL‐SISI H. , FARAGE Y.M. , EL‐MAABOUD M.A. , SAEED M. , MUTABAGANI H. 
Published: November 2003

Objective To compare transurethral electrovaporization of the prostate (TUVP) with conventional transurethral resection of the prostate (TURP) in the treatment of men with benign prostatic hyperplasia (BPH).Patients and methods Seventy consecutive patients with symptomatic BPH and a prostate size of <60 g were prospectively randomized between equal treatment groups; one group underwent standard TURP and the other TUVP. Patients were assessed at baseline and 1, 3, 6 and 12 months after treatment, giving a mean (sd) duration of follow‐up of 14.4 (1.9) months (range 12–17). Variables evaluated included the duration of operation, catheterization and hospital stay, and changes in blood levels of haemoglobin, haematocrit and sodium 1 h after the operation. The American Urologic Association (AUA)‐7 symptom score, peak urinary flow rate (Qmax ), post‐voiding residual urine volume (PVR) and sexual function were also evaluated during the follow‐up.Results Patients of both groups were balanced for the different baseline variables. The mean (sd) operative duration of TUVP was 52 (12.5) min, significantly longer than that of TURP, at 39.7 (8.8) min (P<0.001). One hour after TURP, patients had significantly lower levels of haemoglobin, haematocrit and Na. The mean (sd) duration of catheterization after TURP was 2 (0.8) days, significantly more than after TUVP, at 1.1 (0.4) days (P<0.001). The mean (sd) hospital stay was 2.5 (1) days after TURP and 1.5 (0.7) after TUVP (P<0.001). Compared with baseline values, the AUA‐7 symptom score, Qmax and PVR improved significantly in both groups at all intervals of follow‐up and there were no significant differences between the groups during the follow‐up. None of 15 potent men undergoing TURP and two of 18 potent men undergoing TUVP complained of impotence during the follow‐up.Conclusions TUVP is as effective as TURP in the treatment of BPH in men with a prostate size of <60 g. TUVP has the advantages of less blood loss, less absorption of irrigant and a shorter hospital stay, but it had a significantly longer operative duration.
A possible explanation of wet and dry nights in enuretic children
Authors: HANSEN A.F. , JØRGENSEN T.M. 
Published: November 2003

Objective To clarify the relationship between nocturnal urine production and the occurrence of both wet and dry nights in patients with nocturnal enuresis and to estimate the effect on nocturnal urine production of treatment with the antidiuretic hormone desmopressin in a group of enuretics with none or only a partial reduction in the number of wet nights in response to desmopressin treatment.Patients and methods The nocturnal urine production of 60 children with monosymptomatic nocturnal enuresis was measured for 14 nights with no treatment (baseline) and for 14 nights with desmopressin treatment. Sixteen children having both wet and dry nights in the two periods were chosen for the subsequent analysis.Results There was significantly less nocturnal urine production during desmopressin treatment (202 mL/night) than during the baseline period (279 mL/night; P<0.001) and a corresponding decrease in the number of wet nights, from 10 during baseline to five during desmopressin treatment. When expressed as mL/kg body weight per hour, the urine production during baseline was 0.89 on wet and 0.625 on dry nights (P<0.001), and during desmopressin treatment was 0.716 and 0.535, respectively (P<0.01).Conclusion In this group of enuretics there was a clear reduction in the number of wet nights and in nocturnal urine production during desmopressin treatment, even though none became totally dry on desmopressin. There was a markedly higher nocturnal urine production on wet nights during both the baseline period and during desmopressin treatment. The higher urine production on wet nights could explain the enuretic episode, with urine production exceeding bladder capacity.
Preliminary experience with a urinary control device in the management of women with genuine stress incontinence
Authors: TINCELLO D.G. , BOLDERSON J. , RICHMOND D.H. 
Published: November 2003

Objective To evaluate the efficacy and acceptability of the FemAssist™ urinary control device (Insight Medical UK Ltd).Patients and methods Twenty‐seven women with cystometrically confirmed genuine stress incontinence performed a perineal 1 h pad‐test; the pad test was then repeated with the FemAssist device in place and the difference in pad weights compared with and without the device in place. Patients were given 100 mm visual analogue scales (VAS) to measure discomfort, acceptability and embarrassment associated with using the device.Results The median (range) loss with and without the FemAssist device was 4.9 (0–65) mL and 21 (1–94), respectively (P<0.01); 20 patients were less wet when using the device. The median (range) VAS scores were; discomfort 35 (4–93), embarrassment 11 (0–75), and acceptability 65 (3–100). Discomfort was greater among the women with a greater loss. The acceptability correlated negatively with discomfort (r=–0.53) and negatively with embarrassment (r=−0.39); 15 patients (56%) reported that they would use the device in the long‐term.Conclusion The FemAssist device produced a significant reduction in urine loss. The magnitude of benefit could not be predicted for an individual and the device was ineffective in some women. The use of the device was influenced by discomfort and associated embarrassment. The device has a role in the management of stress incontinence but patients must be assessed individually for suitability.