bluuebunny/crossref_metadata_2025_split huggingface dataset:
Does bone anchor fixation improve the outcome of percutaneous bladder neck suspension in female stress urinary incontinence?
Authors: Schultheiss  , HÖfner  , Oelke  , GRÜnewald  , Jonas  
Published: March 2003

Objective To evaluate the outcome of a new modification of percutaneous needle suspension, using a bone anchor system for fixing the suture at the pubic bone, and to compare the results with those published previously.Patients and methods From March 1996, 37 patients with stress urinary incontinence (>2 years) were treated using a bone anchor system. On each side the suture was attached to the pubocervical fascia and the vaginal wall via a broad ‘Z’‐stitch. A urodynamic investigation performed preoperatively in all patients confirmed stress incontinence and excluded detrusor instability. The outcome was assessed either by a clinical follow‐up investigation or using a standardized questionnaire, over a mean follow‐up of 11 months (range 6–18).Results In the 37 patients, the procedure was successful in 25 (68%), with 16 (43%) of the patients completely dry and nine (24%) significantly improved. Removal of the bone anchor and suture was necessary in two patients, because of unilateral bacterial infection in one and a bilateral soft tissue granuloma in the other. One bone anchor became dislocated in a third patient. In two cases where the treatment failed, new detrusor instability was documented urodynamically. Minor complications were prolonged wound pain in 10 (26%) and transient urinary retention or residual urine in 12 patients (32%).Conclusion The poor success rate in this study corresponds with the long‐term results of conventional or modified needle suspension procedures and does not reinforce the optimistic results of bone anchoring published recently. Because of the poorer long‐term results from percutaneous needle suspension than from other techniques of open retropubic bladder neck suspension, it remains questionable whether percutaneous needle suspension should be considered a first‐line procedure for the treatment of female stress urinary incontinence.
In vivo evaluation of serotonergic agents and α‐adrenergic blockers on premature ejaculation by inhibiting the seminal vesicle pressure response to electrical nerve stimulation
Authors: Hsieh  , Chang  , Law  , Hsieh  , Cheng  
Published: March 2003

Objective To evaluate the effect of drugs on premature ejaculation using a rat animal model in which the seminal vesicle was electrically stimulated via its lesser splanchnic nerve and changes in the pressure response monitored.Materials and methods Male Wistar rats (aged 12–14 weeks) were injected intravenously with prazosin and serotonergic agents (serotonin, clomipramine, fluoxetine, imipramine and indatraline) at various concentrations 10 min before electrical nerve stimulation (ENS) of the lesser splanchnic nerve; the initial increase in seminal vesicle pressure in response to ENS was then compared.Results The pressure response to ENS was reduced in the presence of prazosin or serotonergic agents. The mean (SEM) maximum inhibition values were 84.1 (8.9)% by fluoxetine at 0.1 mg/kg, 67.9 (8.7)% by prazosin at 0.1 mg/kg, 60.9 (11.0)% by serotonin at 3 mg/kg, 54.9 (4.6)% by clomipramine at 3 mg/kg, 30.0 (11.0)% by imipramine at 0.1 mg/kg, and 20.9 (4.3)% by indatraline at 0.1 mg/kg. From the concentration‐response curve, the potency of prazosin was lower than that of fluoxetine, but was higher than that of serotonin or clomipramine.Conclusions Like serotonin, fluoxetine and clomipramine can reduce the pressure response of the seminal vesicle to ENS. Among these inhibitory agents, including prazosin, fluoxetine was the most effective and may be valuable for the clinical treatment of ejaculatory dysfunction in man.
A histological study of Denonvilliers’ fascia and its relationship to the neurovascular bundle
Authors: Kourambas  , Angus  , Hosking  , Chou  
Published: March 2003

Objective To evaluate the anatomical relationship between the nerves and fasciae at the site of dissection in a radical retropubic prostatectomy.Materials and methodEight adult male (autopsy) en bloc specimens of bladder and rectum were examined histologically after staining with either haematoxylin and eosin or S‐100 protein (as a specific nerve stain).ResultsAll specimens showed Denonvilliers’ fascia to have no clearly defined layers and no definable lateral edge. No distinct neurovascular bundle was seen but nerves were scattered throughout the fasciae, including medially towards the midline.ConclusionIn radical retropubic prostatectomy, a piece of Denonvilliers’ fascia is taken with the specimen, thus removing these nerves. The loss of these nerve fibres may explain the significant rate of erectile dysfunction after ‘nerve‐sparing’ surgery.
The role of power Doppler ultrasonography in the diagnosis of prostate cancer: a preliminary study
Authors: Sakarya  , Arslan  , Unal  , Atilla  , Aydin  
Published: March 2003

Objective To determine the role of transrectal power Doppler ultrasonography (PDU) in the diagnosis of prostate cancer.Patients and methods Thirty‐six patients (mean age 66.4 years, sd 7.7, range 59–82) with possible prostate cancer, suspected from an abnormal digital rectal examination or elevated prostate specific antigen level, underwent transrectal ultrasonography, transrectal PDU and biopsy. The vascularity on PDU was graded on a scale of 0–2, where grade 1–2 was considered positive and grade 0 negative.Results The vascularity was grade 2 in 11 patients, grade 1 in 11 and grade 0 in 14; 20 of the 36 (56%) patients had prostate cancer. Of the 22 patients positive on PDU, 18 had malignant disease and four benign; two of 20 patients with histopathologically confirmed malignancy had a normal PDU. The sensitivity of PDU was 90%, the specificity 75% and the positive predictive value 82%.Conclusion Focal hypervascularity on PDU was associated with an increased likelihood of prostate cancer. Although ultrasonography alone cannot detect all cancers, even using PDU, the technique appears to increase the sensitivity and to help identify appropriate sites for biopsy.
Holmium:YAG lasertripsy for ureteric calculi: an experience of 300 procedures
Authors: Devarajan  , Ashraf  , Beck  , Lemberger  , Taylor  
Published: March 2003

Objective To assess the success of holmium:YAG lasertripsy in the management of ureteric calculi and to audit the complications of the procedure, with special reference to strictures in the ureter.Patients and methods A total of 300 ureteroscopic laser procedures were carried out on 265 patients (204 male and 61 female, median age 51 years, range 2–95) with ureteric calculi. At ureteroscopy, the calculi were present in the upper ureter in 44%, mid‐ureter in 37% and lower ureter in 19% of patients; most calculi were >5 mm. A 7.5 F Wolf semi‐rigid ureteroscope was used and the holmium:YAG laser energy delivered using the Sharplan ML210 device at 0.8–1.0 J/pulse. The patients were followed up at ≈6 weeks with limited intravenous urography or ultrasonography to assess clearance and the incidence of strictures.Results Stones were completely cleared in 90% of the patients, with the best results in the lower and mid‐ureter (97% and 96%, respectively) followed by the upper ureter (89%). Alternative procedures were required in only 17 (7%) patients; extracorporeal shock‐wave lithotripsy in 13, percutaneous nephrolithotomy in two and open pyelolithotomy in two patients. Complications with ureteric perforation in 11 patients, including laparotomy for peritonitis in one, serious sepsis in two and strictures in 10 patients. Strictures were more common in association with impacted calculi in the upper ureter early in the series.Conclusions Holmium:YAG lasertripsy is a highly effective treatment for ureteric calculi, with strictures related to the treatment of difficult upper ureteric calculi.
Influence of free‐to‐total prostate specific antigen variability on the early diagnosis of prostate cancer: a comparative study of three immunoassays
Authors: de la Taille  , Houlgatte  , Houdelette  , Goluboff  , Berlizot  , Ricordel  
Published: March 2003

Objective To compare three immunoassays for total prostate specific antigen (tPSA), free PSA (fPSA), free‐to‐total PSA ratio (f/tPSA), and the f/tPSA thresholds for optimal differentiation between benign prostatic hypertrophy (BPH) and prostate cancer in 141 consecutive patients referred for prostatic disease.Patients and methods The study included 43 patients with prostate cancer and 98 with BPH, all confirmed histologically. PSA levels were assessed using the following assay kits just before histological analysis of the prostate; Hybritech (Tandem‐R PSA, normal values, NV, <4 ng/mL, and Tandem‐R free PSA), Cis Bio (PSA‐RIACT, NV <2.5 ng/mL and fPSA‐RIACT) and Immunocorp (PSA‐IRMA, NV <4 ng/mL and Free PSA‐IRMA). The results were assessed to determine the sensitivity, specificity and threshold values of the different assays to differentiate patients with BPH and cancer.Results The mean tPSA and f/tPSA ratio were statistically different in assays with different NVs. The mean fPSA values differed significantly between the Hybritech and Cis Bio, between the Hybritech and Immunocorp but not between the Cis Bio and Immunocorp assays. With receiver operator curve analysis, there were no statistically significant differences among the three immunoassays in f/tPSA (0.72 for Hybritech, 0.73 for Cis Bio and 0.64 for Immunocorp) or between the tPSA and fPSA curves for each manufacturer. With the sensitivity fixed at 90%, different f/tPSA thresholds were defined (0.22, 0.34 and 0.25 for Hybritech, Cis Bio and Immunocorp, respectively). The specificities (i.e. the percentage of unnecessary biopsies spared) were 22%, 21% and 31%, respectively (not significantly different).Conclusion Each immunoassay could be used to distinguish prostate cancer and BPH at different f/tPSA thresholds, with 21–30% of unnecessary biopsies spared. There was no difference in overall performance among the different assays. Further studies are needed to better define the exact use of the f/tPSA ratio in the routine diagnosis of prostate cancer.
The expression of mdr‐1‐related gp‐170 and its correlation with anthracycline resistance in renal cell carcinoma cell lines and multidrug‐resistant sublines
Authors: YU  , Chang  , MA  
Published: March 2003

Objectives To clarify the role of the membranous glycoprotein gp‐170 in renal cell carcinoma (RCC) cell lines and their multidrug resistant (MDR) sublines, and to correlate gp‐170 with the natural and acquired drug resistance of these cell lines to anthracyclines.Materials and methods The expression of gp‐170 in five cultured RCC cell lines and serial RCC8701 MDR sublines was analysed by immunofluorescent flow cytometry. The chemosensitivity of these tumour cells to the anthracycline anticancer drugs adriamycin and epirubicin was measured using the microplate tetrazolium (MTT) cytotoxicity assay, and the results correlated with gp‐170 expression.Results All six natural RCC cell lines showed a variably increased expression of gp‐170, with the A704 and Caki‐1 cell lines the highest. In contrast, gp‐170 expression increased and then was suppressed in acquired MDR sublines of RCC8701 cultured in increasing concentrations of adriamycin. The A704 and Caki‐1 cells were much more resistant to adriamycin and epirubicin than the A498, ACHN and RCC8701 cell lines, in parallel with the expression of gp‐170. The resistant cell line cultured long‐term in 800 ng/mL adriamycin, RCC8701/ADR800, was 122 times more resistant to adriamycin and 238 times more resistant to epirubicin than the parent cell line; the pattern differed from that in native RCC cell lines and was unrelated to the expression of gp‐170.Conclusion Membranous gp‐170 plays an important role in MDR of native RCC cell lines, while acquired MDR cells have different mechanisms of obtaining drug resistance in addition to gp‐170. This phenomenon may be applicable to the clinical treatment of patients newly diagnosed with RCC or those with disease refractory to chemotherapy.
The evaluation of sexual function in men presenting with symptomatic benign prostatic hyperplasia
Authors: Namasivayam  , Minhas  , Brooke  , Joyce  , Prescott  , Eardley  
Published: March 2003

Objective To evaluate quantitatively and qualitatively the degree of sexual dysfunction in an unselected population of men attending a prostate‐assessment clinic using a sexual‐function inventory, and to ascertain the degree of correlation between sexual dysfunction, urinary symptoms and age.Patients and methods In all, 168 men with symptomatic BPH attending a prostate assessment clinic were investigated prospectively using the International Prostate Symptom Score (IPSS), BPH Impact Index (BPHII), a measurement of urinary flow rate and residual urine volume, and a sexual function questionnaire. The results were assessed using Spearman’s rank order correlation to discern any correlations between the measured variables.Results The data from 140 patients were available for analysis; of these, low scores were obtained in 59% for sexual drive, in 56% for erections (with 46% of men satisfying the National Institute of Health criterion for impotence) and in 38% for ejaculation. There was a statistically significant rank order correlation between age and the sexual symptom scores for each of the three categories (sexual drive, erection and ejaculation), but no correlation between age and the problem assessment scores for these domains, suggesting that the older patients are just as bothered by their sexual dysfunction as the younger men. Furthermore, the BPHII scores correlated weakly but significantly with all aspects of sexual function, including overall sexual satisfaction, in contrast to the poor correlation seen with the total IPSS and sexual function scores.Conclusion There is a significant number of patients with symptomatic BPH who have sexual dysfunction, with the proportion increasing with advancing age and with the older men still showing a high degree of bother from their symptoms. Sexual function scores were better correlated with BPHII scores than with the total IPSS, although some of the individual IPSS questions correlated well.
Effect of calcium and calcium chelator on the response of the bladder to in vitro ischaemia
Authors: Levin  , Leggett  , Whitbeck  , Horan  
Published: March 2003

Objective To examine the effect of different concentrations of calcium on the contractile responses of isolated strips of rabbit bladder detrusor to various forms of stimulation after 2 h incubation in the presence of substrate and oxygen depletion (in vitro ischaemia), followed by 1 h of recovery. The resultant contractile responses were correlated with the level of lipid peroxidation as determined by malonedialdehyde (MDA) concentration.Materials and methods Isolated strips of rabbit bladder detrusor smooth muscle were incubated in Tyrode’s solution containing different concentrations of calcium (0–5.4 mmol/L). The effect of 2 h of incubation in oxygen‐ and substrate‐free medium (in vitro ischaemia), followed by a 1‐h incubation in the presence of oxygen and substrate, on the contractile responses to field stimulation, carbachol and KCl were determined. The effects of repetitive stimulation (15 s of stimulation at 32 Hz applied every 5 min during the 2‐h experimental period) were also assessed.Results The contractile responses to all stimuli increased as the extracellular calcium concentration was increased from 0.6 to 5.4 mmol/L. A 2 h exposure to in vitro ischaemia, followed by a return to normal solution, resulted in a diminished response to all stimuli. This contractile dysfunction was least in the presence of calcium chelator (EGTA) and greatest in the presence of 5.4 mmol/L calcium. Repetitive stimulation during in vitro ischaemia also exacerbated the contractile dysfunction. Lipid peroxidation increased during in vitro ischaemia in proportion to the calcium concentration and was enhanced by repetitive stimulation during this period. Regardless of the incubation conditions, the reduction in the contractile response was significantly greater for field‐stimulated tissues than for those stimulated with carbachol or KCl.Conclusions These results show that the magnitude of contractile dysfunction induced by incubation in the presence of substrate and oxygen depletion is reduced in the presence of low calcium concentrations, increased in the presence of high calcium levels and increased in the presence of repetitive stimulation. In addition, the level of lipid peroxidation after the recovery period was proportional to the magnitude of contractile dysfunction present.
Heat‐induced membrane damage combined with adriamycin on prostate carcinoma PC‐3 cells: correlation of cytotoxicity, permeability and P‐glycoprotein or metallothionein expression
Authors: Moriyama‐Gonda  , Igawa  , Shiina  , Wada  
Published: March 2003

Objective To assess heat‐induced membrane damage in a prostate cancer cell line when combined with adriamycin treatment.Materials and methods The changes in intracellular adriamycin accumulation, cell proliferation and cell‐cycle fractions were examined after human prostate carcinoma PC‐3 cells were exposed to heat and/or further treatment with adriamycin. Proliferation and the cell cycle were determined using adherent cell analysis and sorting laser cytometry (ACAS) or flow cytometry. P‐glycoprotein (PGP) and metallothionein (MT) expression, which may have a physiological role in the transport of or reduction in cytotoxicity of some anticancer drugs, were also analysed after cells were exposed to heat, using immunohistochemical or flow cytometric methods.Results There was a significant increase in intracellular adriamycin accumulation, related to both influx (P<0.05) and efflux (P<0.01), in cells treated with adriamycin, especially after heating them at 44°C for 1 h. There was a significant decrease in cell proliferation of preheated cells when exposed to adriamycin, especially at 44°C (P<0.05). In the cell‐cycle analysis, cells preheated at 44°C showed partial accumulation in the debris or apoptotic fraction at 24 h, and many cells accumulated in these fractions at 48 h. There was significantly less PGP or MT expression in cells preheated at 44°C than in control cells or cells preheated at 41°C (P<0.01). This reduction in PGP or MT level by heating may inhibit drug efflux and thus increase intracellular drug level at elevated temperatures.Conclusions These results suggest that hyperthermia may damage the drug‐exclusion mechanism in these cells and thus increase the effectiveness of drug action.
Does the endoscopic incision of ureteroceles reduce the indications for partial nephrectomy?
Authors: Petit  , Ravasse  , Delmas  
Published: March 2003

ObjectiveTo determine whether the endoscopic incision of ureteroceles reduces the indications for partial nephrectomy.Patients and methodsBetween 1987 and 1996, endoscopic incision was used as the first‐line treatment of 18 children (13 boys, five girls, aged 8 days to 6 months) with a duplex‐system ureterocele diagnosed antenatally (15) or in the first weeks of life during the course of a urinary infection (three). Of the 19 ureteroceles (one bilateral), four were intravesical and 15 ectopic, according to the American Academy of Paediatrics classification. Vesico‐ureteric reflux into the inferior pole of the kidney was present in 10 children, seven of whom had an ectopic ureterocele. A functioning upper pole was detected by intravenous pyelography (IVP) in half the intravesical and in a third of the ectopic ureteroceles.ResultsEndoscopic incision resulted in decompression and reduction of dilatation in 16 cases; three with inferior pole reflux resolved on control cystography, whilst in seven with an ectopic ureterocele, reflux into the upper urinary tract was induced by endoscopic incision. In three children with an ectopic ureterocele, renal function had improved at 3 months, as assessed by IVP. Endoscopic incision was the only treatment for half the intravesical and six of 15 ectopic ureteroceles. Overall, nephrectomy was required in four of 18 patients (three partial nephrectomies for persistent dilatation and one total nephrectomy). Five nonfunctioning, undilated upper poles with no reflux were left in place. Nine vesico‐ureteric reimplantations for persistent or induced reflux were carried out using the Cohen technique.ConclusionEndoscopic incision can allow the deferral of nephrectomy, facilitate lower urinary tract reconstruction and reduce the indications for partial nephrectomy, if it is accepted that a nonfunctioning, undilated renal pole with no reflux can safely be left in place.
Patients’ tolerance of transrectal ultrasound‐guided prostatic biopsy: an audit of 104 cases
Authors: Crundwell  , Cooke  , Wallace  
Published: March 2003

ObjectiveTo determine the frequency and severity of complications following transrectal ultrasonography (TRUS) guided prostatic biopsy, and of pain during the procedure.Patients and methodsThe study included 129 men undergoing TRUS‐guided prostatic biopsy who were asked to complete a questionnaire about pain and complications one week after biopsy.ResultsOf the 104 men who completed the questionnaire, 24% found the procedure moderately to extremely painful and 19% felt that they had had significant complications afterward, the commonest of these being painful or difficult voiding (13%) and haematuria (11%). Systemic symptoms of fever or ‘sweats’ occurred in 6%, with a diagnosis of septicaemia in three men, despite antibiotic prophylaxis. However, acute urinary retention occurred in only one man. Of all patients, 20% saw their general practitioner within a week, all of whom were prescribed antibiotics in addition to those given prophylactically in hospital.ConclusionTRUS‐guided biopsy is often a painful experience for patients and is commonly associated with complications, particularly voiding difficulties. Of particular concern were the three patients with septicaemia, and that one in five men felt sufficiently unwell to visit their doctor within a week of the procedure.
A KATP‐channel opener as a potential treatment modality for erectile dysfunction
Authors: Moon  , Byun  , Kim  
Published: March 2003

ObjectivesTo assess the effects of pinacidil (a KATP‐channel opener) for the treatment of penile erectile dysfunction and to examine the role of the K+‐channel in cavernosal smooth muscle contractility.Materials and methodsUsing a feline model, the magnitude of penile erection caused by pinacidil was compared with that caused by erectogenic drugs, e.g. acetylcholine, prostaglandin E1 (PGE1) and l‐arginine. The effects of K+‐channel blockers (4‐aminopyridine, glibenclamide and tetraethylammonium) and pinacidil on penile erections induced by the drugs were investigated.ResultsThe intra‐arterial injection of pinacidil caused a dose‐dependent increase in intracavernosal pressure (ICP) and the increase in ICP induced by pinacidil with acetylcholine, PGE1 or l‐arginine was more pronounced than with the compounds alone. Furthermore, pinacidil (1 mmol/L) effectively reversed the inhibitory effects of the K+‐channel blockers on the cavernosal relaxation induced by acetylcholine, PGE1 or l‐arginine (P<0.01). Notably, pinacidil induced cavernosal relaxation after injecting the drugs even in cases refractory to higher concentrations (0.1 mol/L) of the drugs (n=11, P<0.01).ConclusionsThese results suggest that pinacidil is effective in relaxing feline erectile tissue in vivo, probably via increased K+ permeability and subsequent hyperpolarization. Further comparative studies with erectogenic compounds on human erectile tissue and clinical testing are required to determine whether K+‐channel openers can be used in the diagnosis and treatment of erectile dysfunction. However, pinacidil seems promising as an intracavernosal agent combined with PGE1 to produce synergistic effects.