bluuebunny/crossref_metadata_2025_split huggingface dataset:
Lack of neuropeptide Y receptor detection in human bladder and prostate
Authors: Davis B. , Goepel M. , Bein S. , Chess‐williams R. , Chapple C.R. , Michel M.C. 
Published: March 2003

Objective To investigate the presence of functional neuropeptide Y (NPY) receptors in human bladder and prostate (both richly endowed with NPY‐containing nerve fibers) using peptide YY (PYY) as the agonist. Materials and methods Binding studies were conducted using [125I]PYY as the radioligand. Organ‐bath studies were performed on isolated tissue strips for direct (postjunctional) contractile effects and for (prejunctional) inhibition of field stimulation effects. Any possible degradation of PYY was determined using high‐performance liquid chromatography (HPLC). Results In the radioligand binding studies no quantifiable specific [125I]PYY binding was detected in human bladder or prostate, while specific high‐affinity binding was readily seen in rat cerebral cortex. In organ‐bath experiments, PYY (up to 1 µmol/L) caused no contraction of human prostate or bladder, whereas noradrenaline and carbachol, respectively, were effective; the potency or efficacy of noradrenaline and carbachol were not altered by PYY. Field stimulation‐induced contraction was not affected by PYY in either human bladder or prostate, but was readily inhibited in rat vas deferens. HPLC detected no relevant PYY degradation by human bladder or prostate homogenates. Conclusion Human bladder and prostate express only very few if any functional NPY receptors.
Bilateral germ cell cancer of the testis: a report of 11 patients with a long‐term follow‐up
Authors: Tekin A. , Aygun Y.C. , Aki F.T. , Ozen H. 
Published: March 2003

Objective To describe the incidence, clinical characteristics, treatment methods and long‐term follow‐up of bilateral germ cell tumours of the testis (GCTT) in patients treated at one institution. Patients and methods Of 552 patients with GCTT, 11 (2%, mean age 26.9 years) developed bilateral disease; all 11 underwent radical orchidectomy. Additional treatment was planned according to the histological type and clinical stage of the tumour, and previous treatments. Intramuscular testosterone was administered periodically after total castration. The data on survival, sexual status and treatment complications were reviewed. Results Of the 11 patients, seven developed a second tumour metachronously (median interval 87 months) and four had synchronous bilateral GCTT. Cryptorchidism, infertility or atrophic testis was associated with the development of bilateral GCTT in seven of the 11 patients. All synchronous tumours and most of the sequential tumours had identical histology on both sides. Although all sequential tumours presented at an early clinical stage, three of four synchronous bilateral GCTTs presented at an advanced stage. Five patients received platinum‐based chemotherapy; three patients underwent post‐ chemotherapy resection of the retroperitoneal residual mass. Sexual libido and potency were conserved in all patients. No significant morbidity was recorded as being caused by any of these treatments. At a median follow‐up of 11.6 years, all patients were alive with no evidence of cancer. Conclusions All patients with unilateral GCTT have an increased risk of developing a contralateral testicular tumour, even decades after diagnosis. Management should be adapted to each patient. As all patients in this series survived in the long‐term, developing a second germ cell cancer does not necessarily predict a poor prognosis.
Mean time to cancer‐specific death of apparently clinically localized prostate cancer: policy implications for threshold ages in prostate‐specific antigen screening and ablative therapy
Authors: Horan A.H. , McGehee M. 
Published: March 2003

Objective To assess the mean time to cancer‐specific death in patients with prostate cancer, using a minimum follow‐up of 14 years at one institution, and thus evaluate the minimum life‐expectancy for eligibility for radical surgery, radiotherapy and, implicitly, prostate specific antigen (PSA) screening.Patients and methods The tumour registry of the authors’ institution was searched for the records of patients with prostate cancer (stages T1 and nonmetastatic T2–3) over the period 1976–1983, chosen to give a maximum follow‐up with sufficient numbers of patients. Kaplan–Meier curves and the mean time to death to 1995 for palpable and impalpable cancers were calculated. Deaths not from cancer and from unknown causes were censored. Patients still alive were also censored, except for in the calculation of mean time to death.Results Patients with both stages of disease had a steep increase in mortality at 16 years. The mean (sem) time to prostate cancer‐specific death for T1 disease was 17 (1.8) years and for T2‐T3 (palpable) was 11.7 (1.2 years).Conclusion These results suggest that, if there is to be one at all, the upper age limit for prostate cancer screening should be 62 years.
Comparison of modified one‐ and two‐layer microsurgical vasovasostomy
Authors: Fischer M.A. , Grantmyre J.E. 
Published: March 2003

Objective To compare the outcome of a modified one‐layer and two‐layer vasovasotomy (VV) in two groups of similar men undergoing vasectomy reversal.Patients and methods The charts and surgical records of all surgical procedures performed on men undergoing a modified one‐ or two‐layer VV between June 1992 and July 1994 were retrospectively reviewed. A successful outcome (patency) was defined as sperm present at follow‐up (mean follow‐up 8 weeks). A modified one‐layer VV was used in 17 men (group 1) and a two‐layer VV in 23 (group 2).Results Sperm were present in both groups if surgery was undertaken after vasal obstruction lasting < 36 months. The modified one‐ and two‐layer VV had equal patency (88% and 90%, respectively) when undertaken after an obstructed interval of 36–96 months; outcomes were poorer if surgery was performed after > 96 months. The mean operative duration was 96 min for a modified one‐layer VV and 167 min for the two‐layer VV.Conclusions The simpler and faster modified one‐layer VV provides sufficient accuracy for successful vasectomy reversal in most cases. For most patients, both procedures have equivalent patency.
Renal transplantation in patients with an augmentation cystoplasty
Authors: Power R.E. , O'Malley K.J. , Khan M.S. , Murphy D.M. , Hickey D.P. 
Published: March 2003

Objective To retrospectively review our experience over a 10‐year period of renal transplantation in patients with augmented bladders and thus assess the safety of this procedure. Patients and methods Ten transplant recipients who had previously undergone augmentation cystoplasty were reviewed; a cadaveric kidney was transplant in each case. The donor ureter was anastomosed to the augment bladder in six patients, in three to the native ureter and in one the donor renal pelvis was anastomosed to the native ureter. Results No patients died and nine of the 10 grafts were functioning at a mean follow‐up of 27 months. The mean (sd) serum creatinine level at the follow‐up was 100.8 (27.25) mmol/L. Four patients had 10 episodes of urosepsis requiring hospital admission, with only one graft lost. Conclusion Renal transplantation can be performed safely in patients with an augmentation cystoplasty.
Ethanol‐glycine irrigating fluid for transurethral resection of the prostate in practice
Authors: Okeke A.A. , Lodge R. , Hinchliffe A. , Walker A. , Dickerson D. , Gillatt D.A. 
Published: March 2003

Objective To evaluate the usefulness of a tracer of 1% ethanol in 1.5% glycine in the early detection of irrigation fluid absorption during transurethral resection of the prostate (TURP). Patients and methods Patients (120) undergoing TURP were irrigated with 1% ethanol in 1.5% glycine solution and their expired air tested for alcohol every 10 min during the procedure. Results In all, 112 patients were assessed; over half of the patients absorbed the irrigation fluid and they had a significantly lower postoperative serum sodium concentration (P < 0.002). Fourteen patients (12.5%) absorbed over 500 mL and two (1.8%) developed clinical features of the TUR syndrome. The experience of the surgeon, the weight of resected chips and the operative duration were not significantly predictive of absorption. Conclusion A tracer amount of ethanol in the irrigant is reliable for detecting absorption. Irrigating fluid absorption was unpredictable, thus supporting the case for routine monitoring.
The management of children with complete ureteric duplication: selective use of uretero‐ureterostomy as a primary and salvage procedure
Authors: Choi H. , Oh S.‐J. 
Published: March 2003

Objective To determine the optimum management of duplex urinary tracts with refluxing or obstructed units. Patients and methods Sixty‐three children (19 boys and 44 girls) with complete duplex‐system anomalies (84 duplex system units) who underwent corrective surgery by one surgeon (H.C.) between March 1983 and June 1997 were reviewed, analysing their diagnosis and treatment. Results Most children had presented with urinary tract infection; a ureterocele was found in 26 renal units, reflux in 12 and a combined anomaly in 18. Ectopic insertion of the ureter causing incontinence was found in six and ureteric obstruction in nine ureteric units. Patients were managed so that whenever possible, functional renal tissue was preserved; thus surgical strategies were basically staged, conservative, and planned preoperatively on the basis of renal function. Initial surgery was undertaken in 71 units (all patients; ureterocele incision in 12, upper pole nephrectomy in 30, ureteric reimplantation in 14, uretero‐ureterostomy in 13 and others in two). The median (range) follow‐up was 7.6 (2.1–16) years. Secondary procedures were undertaken in 24 units (34%); ureterocele incision (11 of 12 units) was the most common procedure of additional surgery, followed by ureteric reimplantation (six of 27 units), upper pole nephrectomy (eight of 37 units) and uretero‐ureterostomy (two of 18 units). Conclusions Uretero‐ureterostomy was the most successful nephron‐sparing additional operation. When the upper pole is salvageable, uretero‐ureterostomy may be the preferred alternative for managing complete duplex system anomalies.
The role of colour Doppler ultrasonography in detecting prostate cancer
Authors: Shigeno K. , Igawa M. , Shiina H. , Wada H. , Yoneda T. 
Published: March 2003

Objective To determine the usefulness of colour Doppler ultrasonography (CDUS) in detecting prostate cancer, by comparing CDUS with grey‐scale transrectal ultrasonography (TRUS) and magnetic resonance imaging (MRI). Patients and methods In all, 278 patients who underwent prostate biopsies because of an abnormal digital rectal examination, elevated prostate specific antigen levels, and/or abnormal TRUS between May 1998 and November 1999 were evaluated. The diagnostic accuracies of TRUS, CDUS, MRI and combinations of these imaging techniques in detecting prostate cancer were compared, based on the biopsy results. Results Carcinoma was detected in 233 of 1696 specimens, and 87 patients were diagnosed with prostate cancer. For each detected cancer site, the sensitivity of CDUS was lower than those of other imaging techniques, but CDUS had high a specificity and positive predictive value. The combination of grey‐scale TRUS and CDUS or MRI improved the sensitivity and negative predictive value. The specificity and positive predictive value of the combination of grey‐scale TRUS and MRI were less than those for grey‐scale TRUS alone, while those for the combination of grey‐scale TRUS and CDUS were higher than those for grey‐scale TRUS alone. Five tumours were isoechoic but seen as hypervascular lesions with CDUS. Conclusion CDUS provides information useful for detecting prostate cancer when used in combination with grey‐scale TRUS, and should be included in the routine examination for prostate cancer.
Elevation of sensory thresholds in the prostatic urethra after microwave thermotherapy
Authors: Brehmer M. , Nilsson B.Y. 
Published: March 2003

Objectives To determine whether transurethral microwave thermotherapy (TUMT) affects the sensory threshold in the posterior urethra and whether such an effect influences urinary storage symptoms. Patients and methods The sensory threshold was measured before and at 3 and 12 weeks after TUMT in 13 men with minor obstructive symptoms caused by benign prostatic hyperplasia. Sensations were evoked by electrical stimulation at different frequencies, using a bipolar ring‐electrode mounted on a urethral catheter. Changes in sensory thresholds were evaluated in the patients both as a group and individually. The patients were interviewed about their symptoms at each measurement. Results After TUMT, 12 patients were satisfied and reported decreased irritative symptoms, primarily less frequent nocturnal micturition; two patients were cured of urgency incontinence. In 11 of the satisfied patients, and the unsuccessful patient, decreased urge accompanied increased sensory thresholds. Thresholds elevated by  30% were correlated with decreased irritative symptoms. Conclusions TUMT decreases sensitivity in the posterior urethra, which may alleviate storage symptoms.
Patient self‐injection: a new approach to administering luteinizing hormone‐releasing hormone analogues
Authors: Hamm R. , Patel B. , Whittlestone T. , Persad R. 
Published: March 2003

Objective To investigate the feasibility and advantages of self‐injection of a depot dose of luteinizing hormone‐releasing hormone (LHRH) analogue in patients with prostate cancer. Patients and methods Twenty patients (mean age 70.9 years, range 53–85) with locally advanced or metastatic prostate cancer were recruited from urology clinics and, using a defined protocol, were taught to perform self‐injection of a depot LHRH analogue (Prostap SR® or Prostap 3®, leuprorelin acetate, Wyeth Laboratories, Berks, UK). Patients were then followed for 1 year. Results Of the 20 patients, 11 successfully learned to use self‐injection and administered injections for the duration of the study. Ten of the patients chose self‐injection and continued to self‐inject after the end of this study. Conclusions This pilot study of 20 patients showed that it is feasible for a selected group of patients to be taught self‐injection of an LHRH analogue, and that some patients prefer this mode of drug administration.
Towards a minimum dataset in urology
Authors: Thomas K. , Emberton M. , Mundy A.R. 
Published: March 2003

Objective To establish and prospectively collect data for a minimum dataset in urology by agreeing a dataset amongst a group of urologists, designing structured forms around the data items and implementing them in clinical practice. Methods Consultant urologists decided the initial dataset. Structured forms, which incorporated the dataset items, were designed. These forms were piloted before implementation in two urology departments. They were used to document clinical information instead of writing this in the traditional medical record. After use forms were ‘scanned’ before being filed in the medical record, thus storing the data in an electronic format. Results Nine forms were designed; inpatient and outpatient activity was captured separately. There were six outpatient forms; a generic new patient form and five specific follow‐up forms (lower urinary tract symptoms, oncology, erectile dysfunction, female urology and stones). Three generic inpatient forms were designed. The forms were used by nine registrars, five senior house officers and six clinical nurse practitioners, who required minimal training. Conclusion It is possible to agree a minimum dataset amongst a relatively small group of urologists. The information can be acquired prospectively using structured forms instead of the traditional medical record. This locally agreed dataset could form the basis for a national consensus on a minimum dataset in urology.
Urological cancers: do early detection strategies exist?
Authors: Webb V. , Holmes A. 
Published: March 2003

Objective To determine the perceptions of healthcare professionals and the general public about the symptoms, diagnosis and available treatment of urological cancers, and thus the perceived value of screening for their early detection. Subjects and methods Two questionnaires were developed, based on semi‐structured interviews, and distributed to 288 healthcare professionals, comprising 182 general practitioners (GPs), 56 practice nurses and 50 urology nurses, and to 250 members of the general public in three different socio‐economic groups. The questionnaires asked about the symptoms, diagnosis and treatment of prostate, bladder and testicular cancer, and whether the respondents considered that screening for these cancers would be useful in ameliorating morbidity or death from these diseases. Results The response rate was very poor (13 of the GPs, 7%; 34 of the nurses, 32%; and 58 members of the general public, 23%). This severely limited the interpretation of the results, but the responses highlighted areas which need addressing. Obvious symptoms were well understood by all the groups but less well‐known symptoms could be missed. No GP supported screening for prostate cancer and only seven of the GPs believed in teaching testicular self‐examination, but practice nurses were considerably more active in all aspects of patient education. The general public felt that they needed more information to make decisions about urological cancers, although there was a general feeling that ‘screening saved lives’. Conclusion This survey showed that no healthcare professional seems to have a clearly defined role in informing potential patients about screening. The general public, who seem to perceive from the media that early detection is beneficial, are confused by the lack of clarity about policies for urological cancers.
Prognostic evaluation of transcatheter arterial embolization for unresectable renal cell carcinoma with distant metastasis
Authors: Onishi T. , Oishi Y. , Suzuki Y. , Asano K. 
Published: March 2003

Objective To evaluate the efficacy of transcatheter arterial embolization (TAE) in patients with unresectable renal cell carcinoma (RCC) and distant metastasis at the time of diagnosis. Patients and methods The study included 54 patients with histologically defined RCC (by biopsy in 28 and autopsy in 26) who were unable to undergo nephrectomy mainly because their performance status was poor (score  2). The patients were classified into two groups; 24 patients who underwent TAE with ethanol and 30 patients who did not. The two groups were compared for several clinical factors, mainly focusing on the prognosis. Results There were no significant differences in the clinical factors, including performance status, tumour diameter, vascular invasion, lymph node involvement, adjuvant therapy, metastatic organs or the number of metastases between the groups. However, the proportion of patients with para‐neoplastic signs in those undergoing TAE was greater than that in those not, and the difference was significant (chi squared 0.35, P < 0.05). The median survival of the two groups was 229 days (TAE) and 116 days (no TAE). The 1‐, 2‐ and 3‐year survival rates in the TAE group were 29%, 15% and 10%, respectively, and in those not undergoing TAE were 13%, 7% and 3%, respectively. Those undergoing TAE had a significantly better prognosis than those who did not (P = 0.019). The adverse effects in patients undergoing TAE with ethanol included fever, back pain on the affected side, nausea and vomiting, but all the patients recovered from these adverse effects. Conclusion TAE with ethanol is a safe and effective treatment for patients with unresectable disseminated RCC and a poor performance status; TAE with ethanol not only induces ablation of the primary tumour, but also prolongs survival.
A conservative approach to major blunt renal lacerations with urinary extravasation and devitalized renal segments
Authors: Moudouni S.M. , Patard J.J. , Manunta A. , Guiraud P. , Guille F. , Lobel B. 
Published: March 2003

Objectives To determine the feasibility of a conservative (expectant) approach to major blunt renal laceration with urinary extravasation and devitalized renal segments. Patients and methods All patients treated conservatively who presented between 1990 and 1999 with major renal laceration (grade 4 and 5) were retrospectively reviewed to determine whether urinary extravasation and devitalized segments adversely affected the outcome. For each patient the data collected included the initial emergency department evaluation, findings on computed tomography, associated injuries, duration of hospital stay, transfusion requirements, complications and follow‐up imaging. Results Of 20 patients who sustained blunt trauma resulting in a major renal laceration (five grade 5 and 15 grade 4) with urinary extravasation, 11 had coexisting devitalized segments. There was a statistically significant difference in the length of hospital stay (16.3 vs 7.3 days), blood transfusions (six vs two patients, P < 0.08) and the need for delayed surgical intervention (nine vs two, P < 0.01) between patients with and with no devitalized segments, respectively. Urinary extravasation spontaneously resolved in two of 11 patients with and in seven of nine with no devitalized segment, respectively (P < 0.05) Conclusions Urinary extravasation will resolve spontaneously in most patients with blunt renal trauma, and expectant treatment does not adversely affect the outcome or prolong hospitalization. In patients who present with a major renal laceration associated with devascularized segments, conservative management is feasible in those who are clinically stable with blunt trauma. However, the physician must be especially aware of the probable complications within this subset of patients.
Effective daily treatment with clomipramine in men with premature ejaculation when 25 mg (as required) is ineffective
Authors: Rowland D.L. , De Gouveia Brazao C.A. , Koos Slob A. 
Published: March 2003

Objective. To determine whether men with premature ejaculation who fail to respond to 25 mg clomipramine as needed improve when taking 10–30 mg clomipramine daily. Subjects and methods Four men with premature ejaculation whose ejaculation latencies increased minimally or not at all when taking 25 mg clomipramine as needed participated in a prospective 12‐week study consisting of four treatment phases, beginning with baseline (0 mg) and progressing through increasing daily doses of 10, 20, and 30 mg clomipramine. The subjects maintained daily logs of their sexual activities and estimated their ejaculatory response, sexual arousal and penile rigidity during intercourse. The subjects were contacted 8–15 weeks after the experiment to assess their satisfaction with and continued use of clomipramine. Results There was a dose‐response effect on ejaculatory latency with increasing levels of clomipramine; 30 mg increased the latency from 25 s to 220 s, a clinically significant increase. In addition, 30 mg taken daily was significantly more effective than 25 mg as required. Other variables of sexual response (sexual interest, arousal and penile rigidity) were unaffected. At follow‐up all four subjects expressed satisfaction and three continued the dose. Conclusion Men with premature ejaculation who do not respond to clomipramine ‘as required’ are probably not insensitive to pharmacological treatment, but may simply require higher doses or a different regimen. All four subjects improved when taking daily clomipramine at varying doses. These results suggest that if initial treatment is unsuccessful, 20–30 mg daily clomipramine should be considered.