bluuebunny/crossref_metadata_2025_split huggingface dataset:
The epidemiology of benign prostatic hyperplasia: a study in Greece
Authors: Signorello  , Tzonou  , Lagiou  , Samoli  , Zavitsanos  , Trichopoulos  
Published: March 2003

ObjectiveTo assess the epidemiology of benign prostatic hyperplasia (BPH) in a case‐control study in greater Athens, Greece.Patients and methodsThe study comprised 184 patients surgically treated for BPH within one year of its diagnosis (cases) and 246 patients with no symptoms of BPH who were treated in the same hospitals for minor diseases or conditions (controls). All cases and controls were permanent residents of the greater Athens area, Greece. The data were assessed using unconditional logistic regression.ResultsAfter controlling for age and education, cases and controls had similar distributions for height, body mass index, sibship size and birth order in the parental family, marital status, number of offspring and a series of previous medical diagnoses or surgical operations. The sole exception was surgery for haemorrhoids, that appeared to be related to the incidence of BPH, possibly by chance. There was no evidence that vertex baldness, tobacco smoking, alcohol consumption or coffee drinking increased the risk for BPH. Men who had spent most of their lives in a rural rather than an urban environment appeared to be at reduced risk for BPH.ConclusionThe lifestyle factors assessed here have no major effect on the aetiology of BPH.
Safer circumcision in patients with haemophilia: the use of fibrin glue for local haemostasis
Authors: Avanoglu A. , Çelik A. , Ulman İ. , Özcan C. , Kavakli K. , Nişli G. , Gökdemir A. 
Published: March 2003

ObjectiveTo evaluate the efficacy and the reduced costs of factor concentrates in circumcision by using fibrin glue in patients with haemophilia.Patients and methodsEleven patients with haemophilia (age range 6–14 years, 10 with haemophilia A, one with haemophilia B) were circumcised using fibrin glue for local haemostasis and to reduce the duration of clotting factor replacement after surgery. Circumcision was carried out under general anaesthesia; the prepuce was incised circumferentially and excised using the Gomco clamp technique. Haemophiliac patients were divided into two groups: in group 1 (four patients, three with haemophilia A and one with haemophilia B) the factor levels were assessed every 8 h and bolus injections of factor repeated during the first 4 days after surgery; in group 2, the seven remaining haemophilia A patients received a postoperative bolus injection and ≈4 U/kg per hour of factor substitution for the first 2 days after surgery by continuous infusion. Eleven other patients with haemophilia A underwent circumcision using same surgical procedure but were given only factor substitution without fibrin glue, and served as a control group (group 3).ResultsNone of the patients had significant bleeding or complications. The total costs were significantly reduced, to $8898 per patient in group 1 and $4866 per patient in group 2, when compared with $12875 per patient in group 3 (both P<0.05).ConclusionFibrin glue is a useful treatment for circumcision in patients with haemophilia; it lessens the need for factor substitution after circumcision and thus reduces the high cost of treatment.
Treatment of idiopathic and postvaricocelectomy oligozoospermia with oral tamoxifen citrate
Authors: Kadioglu  , Köksal  , Tunç  , Nane  , Tellaloglu  
Published: March 2003

ObjectiveTo identify a subgroup of men who may benefit from tamoxifen citrate (a widely prescribed drug for male infertility) among those with normogonadotrophic and hypergonadotrophic oligozoospermia, either idiopathic or after varicocelectomy.Patients and methodsThe study included infertile men with oligozoospermia, 136 referred to our outpatient clinic and 84 infertile after varicocelectomy. All patients received tamoxifen citrate (10 mg twice daily); semen analysis and hormone tests were repeated at the end of 3 and 6 months of treatment, the values being compared with those before treatment.ResultsThe levels of follicle‐stimulating hormone, luteinizing hormone and testosterone increased in all groups receiving tamoxifen citrate. Normogonadotrophic patients had a significant increase in sperm count and concentration, while the slight increase detected in the hypergonadotrophic group was statistically insignificant.ConclusionIn patients with normogonadotrophic oligozoospermia, tamoxifen citrate may be offered as a practical and economic alternative before using any assisted reproduction techniques. However, double‐blind placebo‐controlled trials are needed to confirm the findings of this preliminary study.
Outpatient flexible cystoscope‐assisted insertion of ureteric catheters and ureteric stents
Authors: Adeyoju  , Collins  , Brooman  , O’Reilly  
Published: March 2003

ObjectiveTo examine the feasibility of inserting ureteric catheters (before retrograde ureterography) and JJ ureteric stents (both traditionally performed under general anaesthesia on inpatients) using local anaesthesia in an outpatient setting and with no patient selection bias, thus providing procedures to ease the demand on inpatient lists.Patients and methodsAll patients presenting with an appropriate clinical indication for either of the procedures underwent insertion during a scheduled flexible cystoscopy session in the outpatient department; information was collected on a standard proforma. Antibiotic prophylaxis and a nonsteroidal analgesic were administered 30 min before the procedure.ResultsTo date, 20 patients (seven men, age range 32–74 years, and 13 women, age range 23–86 years) have undergone one of the two procedures. Fourteen patients had attempted retrograde catheter insertion, with success in 12, and six other patients underwent attempted JJ ureteric stent insertion, with success in five. The three failures were caused by an inability to see the relevant ureteric orifice. The mean duration of each procedure was 11 min; 14 of the 17 patients who had a successful procedure had no significant pain or discomfort, while the remaining three experienced significant pain and discomfort. There were no infective complications.ConclusionThese two procedures are suitable for the outpatient/day‐case situation, and are well tolerated and accepted by most patients.
The role of a clinical score in the assessment of ambiguous genitalia
Authors: Ahmed S.F. , Khwaja O. , Hughes I.A. 
Published: March 2003

Objective To improve the initial assessment of ambiguous genitalia in infants. Subjects and methods Using a specially devised scoring system, the external genitalia (external masculinization score, EMS, range 0–12) and internal reproductive structures (internal masculinization score, IMS, range 0–10) were assessed in 426 male newborns and 291 cases of ambiguous genitalia. Results In normal male newborns, the median (10th centile) EMS was 11 (10). In the affected infants, the sex of rearing was male in 202 and female in 89 cases, respectively. The median (10–90th centile) EMS in those cases reared male, at 3.5 (2–8), was significantly higher than in cases reared as females, at 2 (1–6) (P < 0.001). The median IMS in cases reared as males and females was the same, at 10, but the scatter of values was higher for males (10–90th centile, 4–10) than for females (0–10) (P = 0.01). Infants reared as females were more likely to have a micropenis, a uterus and/or a urogenital sinus, but there were 12 cases where the sex of rearing was male despite the presence of a uterus; five infants without micropenis were reared as female and 23 with a urogenital sinus were reared as male. Conclusion The masculinization score provides a standardized format to summarize clinical features in newborn infants with ambiguous genitalia. Gender assignment does not solely depend on the appearance of the external genitalia and the nature of internal sexual organs.
A magnetic device for increasing the urethral resistance to flow: an experimental study in female dogs
Authors: Ali‐el‐dein B. , El‐demerdash R. , Kock N.G. , Ghoneim M.A. 
Published: March 2003

Objective To test a new magnetic device for increasing the urethral resistance to flow in a dog model, and thus provide a potential mechanical device for the treatment of incontinence in women. Materials and methods The study comprised 12 female mongrel dogs; three dogs were used to study the effect on urethral resistance of inserting a vaginal magnet (control experiment) and five were assessed in a urodynamic study. With the animals under general anaesthesia, the bladder and the urethra were exposed by a low midline incision. One magnet, embedded in a silicon layer, was placed on the anterior side of the urethra 3 cm distal to the bladder neck and fixed with a few sutures. To increase the urethral resistance as required, a second magnet was inserted into the vagina and the device activated. Urethral pressure profiles and leak‐point pressures were recorded in the anaesthetized animals under resting conditions and after the urethra was compressed between the magnets. Recordings were also made after pharmacological blockade of the urethral musculature. In four additional dogs, chronic experiments were conducted to evaluate the effect of continuous compression of the urethra and the vaginal wall for 14 days. Results Urethral compression between the magnets resulted in a doubling of the maximal pressure in the proximal urethra and in a threefold increase of the leak‐point pressure. After pharmacological denervation of the urethra the differences between the control pressures and those after activating the device were even greater, although not significantly so. After 2 weeks of continuous compression of the vaginal wall and the urethra between the magnets there was no detectable tissue damage. Conclusion These results suggest that the magnetic device can efficiently increase urethral pressure and that prolonged compression caused no apparent damage to the urethra or vagina. It may therefore be a useful potential method of providing urinary continence in women.
Unilateral pedal lymphography in patients with filarial chyluria
Authors: Koga S. , Nagata Y. , Arakaki Y. , Matsuoka M. , Ohyama C. 
Published: March 2003

Objective To evaluate the usefulness of unilateral pedal lymphography in patients with filarial chyluria. Patients and methods Of 114 patients with filarial chyluria, all underwent lymphography (unilateral pedal in 106) and 55 underwent selective ureteric sampling for chyle. Results Unilateral pedal lymphography in the 106 patients detected lymphaticorenal fistulae (LRF) in 104 (98%). Lymphatic crossover was seen in all 106 patients, from the second sacral segment to the first lumbar segment. The most frequent crossover site was at the L5 level (87%). There was complete correlation between the side of LRF and the side of chyluria as assessed by selective ureteric sampling. Conclusion Unilateral pedal lymphography can detect LRF via lymphatic crossover even when it is on the opposite side from that injected with contrast agent. The advantages of unilateral lymphography over bilateral procedures are that it is easy to identify crossover channels, and the discomfort for the patient is reduced because there are fewer incisions and it is quicker. Unilateral lymphography is recommended as the initial method when lymphography is indicated in filarial chyluria.
Quality of life after radical cystectomy and orthotopic bladder substitution: a comparison between Italian and Swedish men
Authors: Månsson Å. , Caruso A. , Capovilla E. , Colleen S. , Bassi P. , Pagano F. , Månsson W. 
Published: March 2003

ObjectiveTo investigate possible differences between Italian and Swedish men in health‐related quality of life (HRQL) after cystectomy and orthotopic bladder substitution for bladder cancer. Patients and methodsThirty‐three men in Padua, Italy and 33 in Lund, Sweden were assessed after respective mean postoperative periods of 42 and 52 months. Three questionnaires were used: (i) dealing with view‐of‐life issues; (ii) the core questionnaire QLQ‐C30(+3) from the European Organization for Research and Treatment of Cacncer, with added questions on urinary symptoms and sexuality; and (iii) one focusing on postoperative psychosocial and sexual adjustment. ResultsWhile Italian and Swedish men did not differ in their central values, they differed significantly in belief‐related values, such as religion. Urinary prob‐lems and erectile dysfunction were common in both groups, the former possibly commoner in the Swedish men and the latter in the Italians. Changes in mood and self‐esteem were common in both groups. On a visual analogue scale, the Italian men reported a worse present mood than the Swedish men, but expressed a more favourable outlook on their future. ConclusionDespite differences in philosophical attitudes between Italian and Swedish men, there were no major differences in HRQL. Caution is required in interpreting these findings because there were few participants and the possible inadequacy of the methods used to evaluate the complex concept of quality of life.
Continence and some properties of the urethral striated muscle of male greyhounds
Authors: Van Der Werf B.A. , Hidaka T. , Creed K.E. 
Published: March 2003

Objective To determine the properties of the striated muscle of the greyhound (dog) urethra and to consider its role in maintaining continence. Materials and methods The thickness of the muscle layers and the muscle types were determined by examining sections stained with haematoxylin and eosin or Masson’s trichrome. These factors were correlated with the mechanical and electrical responses of muscle strips to nerve stimulation, and compared with muscle from other breeds of dog and other parts of the animal. Results The striated muscle formed ≈70% of the membranous urethra and was predominantly (68%) type IIa muscle (i.e. fast but fatigue‐resistant). The mean resting membrane potential was –74 mV; nerve stimulation produced an action potential with a mean amplitude of 97 mV and contraction lasting about 200 ms. All responses were abolished by
d‐tubocurarine. The contractions were well maintained with continuous or intermittent stimulation. The properties were intermediate between those of the anconeus (slow) and the extensor carpi radialis (fast) muscles. Conclusions The distribution, fibre type and contractile characteristics would enable the striated urethral muscle to maintain tension for continence at rest and provide additional continence during sprints.
Elevated serum vascular endothelial growth factor in patients with hormone‐escaped prostate cancer
Authors: Jones A. , Fujiyama C. , Turner K. , Fuggle S. , Cranston D. , Bicknell R. , Harris A.L. 
Published: March 2003

Objective To investigate the role of serum vascular endothelial growth factor (VEGF) in the assessment of patients with prostate cancer.Patients, subjects and methods Serum from 78 men was assayed for VEGF using a commercially available enzyme‐linked immunosorbent assay kit. Forty‐eight patients had a histopathological diagnosis of prostate cancer (16 local disease, 32 metastatic), nine had benign prostatic hyperplasia (BPH) and 21 were healthy controls.ResultsThe mean serum VEGF level was significantly higher in patients with hormone‐escaped prostate cancer than in all other groups (P  0.02). There were no significant differences in serum VEGF levels among the other groups. In 18 patients with serial measurements there was no significant difference in serum VEGF level during either response to or escape from hormonal therapy.Conclusions The significantly higher serum VEGF level in patients with hormone‐escaped prostate cancer suggests a role in the pathogenesis of advanced disease. However, the lack of significant differences among the other groups and the failure to indicate either response to or escape from hormonal therapy suggests that serum VEGF in this setting is of limited use.
In vitro contractile responses of detrusor to carbachol and neurokinin A, in children with recurrent urinary tract infection or day wetting
Authors: Werkstrom V. , Lam D.S.H. , Farnsworth R.H. , Awad N. , Burcher E. , Moore K.H. 
Published: March 2003

Objective To investigate whether a history of recurrent urinary tract infection (UTI) and/or the presence of day‐wetting/urge symptoms might influence the contractile responses to the cholinergic agonist carbachol or to the sensory neuropeptide neurokinin A (NKA) in the urinary bladder in children. Patients and methods Small detrusor strips were taken from the margin of the cystotomy incision of the bladder dome during surgery to correct vesico‐ureteric reflux (VUR) in 62 children (aged 4 months to 12 years) or for unrelated bladder conditions in five controls (aged 3 months to 13 years). Concentration‐response curves to carbachol and NKA were constructed using organ‐bath techniques, and results compared for age, sex, weight of the detrusor strip, UTI history or day‐wetting syndrome. Results The contractile responses to NKA were no different for any of the features investigated. The contractile response to carbachol and NKA in detrusor from control and VUR patients was not significantly different. The children with a history of UTI were significantly older than those without. The contractility in response to carbachol was greater in older girls (aged 4–12 years) than younger girls (< 4 years) and than in all boys (< 4 years and 4–12 years;
anovaP = 0.013). The mean (
sem) maximum contractile response to carbachol in the group of 20 young children (4–30 months) with previous UTI was 3.0 (0.3) g, whereas the maximum response in the age‐matched group of 11 without UTI was 1.8 (0.3) g (P = 0.046). There were no significant differences in maximum responses between those with day‐wetting and those without (aged > 4 years), although there was a significant difference in pD2 value, at 6.19 (0.13) and 5.58 (0.14), respectively (P = 0.018). Conclusion Carbachol produced a larger contractile response in detrusor from children with a history of UTI than from those without, indicating possible alterations in muscarinic receptor characteristics. An increased sensitivity to muscarinic stimulation in day‐wetting children was also suggested, whereas NKA is unlikely to be involved in any of these pathophysiological conditions.
The dietary habits of idiopathic calcium stone‐formers and normal control subjects
Authors: Al Zahrani H. , Norman R.W. , Thompson C. , Weerasinghe S. 
Published: March 2003

Objectives To examine the relationship between 12 macro‐ and micro‐nutrients and the risk of recurrent calcium stone formation by comparing the diets of a large outpatient clinic‐based group of patients who had formed calcium‐based urinary tract calculi with that of a population‐based control group matched for age, gender and body mass index. Patients, subjects and methods The dietary intake of 500 patients (cases) randomly selected from the adult population attending an outpatient renal‐stone clinic and being evaluated and/or treated for biochemically or radiologically diagnosed calcium‐based upper urinary tract calculi were compared with those of 500 control subjects selected to match for age, sex and body mass index from a stratified probability sample of 2212 adults (not institutionalized) living in the same geographical area. Results Comparing the mean nutritional intakes showed a statistically higher consumption of energy, carbohydrates, sodium, fibre, vitamin C, fat and folic acid among cases than in controls. The intake of calcium, alcohol and vitamin A was significantly higher among the controls. There were no significant differences in the intake of protein, niacin or iron. The results of these comparisons varied when the groups were stratified by sex, age and body mass index. Conclusions Dietary risk factors for calcium‐based urinary tract calculi are many and complex, and a detailed consideration of sex, age and body mass index is important in interpreting such data. While it is difficult to draw firm conclusions about causes and effects of individual nutrients from the available data, this study indicates a possibly more important role for dietary fat in stone formation than has been previously recognized. This relationship needs to be further explored in relation to urinary risk factors, as it may be possible to advise patients to reduce dietary fat as a prophylactic measure for stone formation. As dietary fat has been associated with cardiovascular diseases and possibly cancer, an overall recommendation to these patients for a low dietary fat intake may be easier to follow.
Nonhomologous bioinjectable materials in urology: ‘size matters’?
Authors: Solomon L.Z. , Birch B.R. , Cooper A.J. , Davies C.L. , Holmes S.A.V. 
Published: March 2003

Objective To assess the factors that influence how particles might become fixed in tissues or migrate from them, by measuring the size of the injectable particles, their susceptibility to phagocytosis and their affinity for fibroblast attachment in culture. Materials and methods The particle size of three types of particulate unphysiological bioinjectable material, i.e. Urocol (Genesis Medical, Ltd., London), Macroplastique™ (Uroplasty Ltd., Reading, UK) and Urethrin (Mentor Medical Systems, Wantage, UK) was analysed using phase‐contrast light microscopy and confocal microscopy. Human monocytes from peripheral blood were incubated with the three materials in phagocytic studies, where ingestion was determined by confocal microscopy. A fibroblast cell line was used to ascertain the ability of the particles to act as a substrate for cell attachment in culture. Results The mean (
sem) maximum particle diameters of Macroplastique, Urethrin and Urocol were 209 (5.10) µm, 49 (1.52) µm and 14 (0.39) µm, respectively. Rat peritoneal macrophages and human peripheral blood monocytes commonly ingested Urocol particles; the phagocytosis of Urethrin was rare and that of Macroplastique was not detected. Fibroblasts adhered to Urocol paste and Urethrin particles, but not to Macroplastique. Conclusion Published reports of particle size and phagocytosis are confusing, but a relationship clearly exists. Macroplastique is the largest particle and is least likely to be phagocytosed by human mononuclear phagocytes. Urocol paste is the slowest to dissipate in culture conditions; the flat surfaces of Urethrin, but not Macroplastique, can serve as a substrate for fibroblast anchorage.
A comparison of six commercial assays for total and free prostate specific antigen (PSA): the predictive value of the ratio of free to total PSA
Authors: Patel D. , White P.A.E. , Milford Ward A. 
Published: March 2003

Objective To evaluate the clinical utility of six commercial assays for free prostate specific antigen (fPSA) and the derived ratio of fPSA to total PSA in distinguishing between patients with prostate cancer or benign prostate hyperplasia (BPH). Materials and methods Each assay was evaluated against a panel of serum samples comprising those from patients with prostatic disease, other malignancies, normal subjects and sera containing substances which might interfere with the immunoassay. Results The levels of total (tPSA), fPSA and their ratio (f/tPSA) were compared among the different samples. All assays showed similar specificities for prostate carcinoma but differed in the positive predictive values of f/tPSA. Conclusions Although all six assays were equimolar, there were differences in calibration, particularly for fPSA. The ability of f/tPSA to discriminate between benign and malignant prostatic disease depended on the assay used. The f/tPSA is not valid when the tPSA and fPSA assays are obtained from different manufacturers.