bluuebunny/crossref_metadata_2025_split huggingface dataset:
Increasing the number of biopsy cores improves the concordance of biopsy Gleason score to prostatectomy Gleason score
Authors: Coogan Christopher L. , Latchamsetty Kalyan C. , Greenfield Jason , Corman John M. , Lynch Barlow , Porter Christopher R. 
Published: July 2005

OBJECTIVETo evaluate taking more biopsy cores for predicting the radical prostatectomy (RP) Gleason score compared with the biopsy Gleason score, as although random sextant biopsies are the standard for a tissue diagnosis of prostate cancer, and taking more biopsies increases the detection rate, it is uncertain whether taking more cores improves the prediction of the RP Gleason score.PATIENTS AND METHODSWe analysed retrospectively 404 patients from three centres (Seattle 162, Washington 107 and Chicago 135) who had RP for prostate cancer. Six, eight or 10 biopsies were taken based on the physician's preference and the patient's characteristics.RESULTSBefore RP, 158 (39%) patients had six, 65 (16%) had eight and 181 (45%) had 10 biopsy cores taken. The accuracy of the Gleason sum of the three groups was 65/158 (41%), 26/65 (40%) and 104/181 (57.5%), respectively (P < 0.004, 10‐core vs six‐core). However, when comparing the Gleason score separately (i.e. 4 + 3 is not equal to 3 + 4), the accuracy of the three groups was 48/158 (30%), 20/65 (31%), and 95/181 (52.5%), respectively (P < 0.001, 10‐core vs six core).CONCLUSIONSTaking more biopsy cores improves the accuracy of the biopsy Gleason score in predicting the final Gleason score at RP; the predictive accuracy of the final Gleason score may be increased from 41% to 58% by increasing the number of biopsies from six to 10.
Serum thyroid‐stimulating hormone is elevated in men with Gleason 8 prostate cancer
Authors: Lehrer Steven , Diamond Edward J. , Stone Nelson N. , Stock Richard G. 
Published: July 2005

OBJECTIVETo measure the levels of serum thyroid‐ stimulating hormone (TSH) in men with prostate cancer, as those with a Gleason score of ≥ 8 are at high risk of skeletal metastases (and should be considered for bone scintigraphy at diagnosis), and because the structural integrity of the skeleton depends on constant remodelling controlled by many local and systemic factors, including TSH, an important regulator of this process.PATIENTS AND METHODSWe evaluated 51 men referred for treatment of localized prostate cancer and 10 with biopsy‐confirmed benign prostatic hypertrophy. Serum TSH was determined with a chemoluminescent immunoassay and a commercially available instrument (Immulite, Diagnostic Products Corporation, Los Angeles).RESULTSThere was significant variation in TSH levels with Gleason score (P = 0.004); men with Gleason 8 tumours had the highest serum TSH levels. Because serum TSH levels increase with age, we used a multivariate analysis of variance with both age and Gleason score as covariates. The effect of Gleason score on TSH level was significant (P = 0.036) and independent of the effect of age (P = 0.392).CONCLUSIONWe propose that the high serum TSH levels in men with Gleason 8 prostate cancer is a result of the elaboration of TSH by cancer cells. Bone mineral density in the face of normal levels of thyroid hormone depends on an intact response to TSH, which ordinarily suppresses both osteoblast and osteoclast differentiation, thereby exerting control over bone remodelling. However, with abnormally high TSH levels this process may become deranged, promoting the development of bone metastases. If TSH production by prostate cancer cells could be suppressed, the incidence of bone metastases might be reduced.
Inguinal hernia repair with polypropylene mesh during radical retropubic prostatectomy: an easy and practical approach
Authors: Antunes Alberto Azoubel , Dall’oglio Marcos , Crippa Alexandre , Srougi Miguel 
Published: July 2005

OBJECTIVETo report the results of the simultaneous inguinal hernia repair during radical retropubic prostatectomy (RRP) with the preperitoneal tension‐free Stoppa technique, using a polypropylene mesh.PATIENTS AND METHODSDuring 855 consecutive RRPs, 40 (5%) patients (median age 66.9 years, range 52–81) with 49 inguinal hernias had a simultaneous inguinal hernioplasty. The RRP was performed according to the Walsh modified technique. After the prostate and seminal vesicles were removed and the urethrovesical anastomosis completed, a polypropylene mesh of maximum size 15 × 7.5 cm and a small slit on its medial side was then created and placed in the preperitoneal space, embracing the spermatic cord and covering the myopectinal orifice. Preoperative risk factors, e.g. constipation, pulmonary disease or urinary obstructive symptoms, were collected retrospectively from the files. Complications after surgery, including wound infection, pelvic collections, urinary fistula and recurrence of the hernia, were assessed.RESULTSPreoperative risk factors for hernia development were identified in 23 (58%) patients; three had recurrent hernias. With a median 23.1 months of follow‐up period two (4%) hernias recurred. There were no complications after surgery.CONCLUSIONPreperitoneal hernia repair with polypropylene mesh is safe, effective and practical. The procedure simultaneous with RRP gave a 96% success rate and with no significant increase in operating time or additional complications.
An office‐based immunodiagnostic assay for detecting urinary nuclear matrix protein 52 in patients with bladder cancer
Authors: Attallah Abdelfattah M. , Sakr Hanem A. , Ismail Hisham , Abdel‐Hady El‐Sayed K. , El‐Dosoky Ibrahim 
Published: July 2005

OBJECTIVETo report the rapid (5 min) and simple detection of a nuclear matrix protein (NMP) in the urine of patients with bladder cancer, using a newly developed office‐based dot‐enzyme‐linked immunosorbent assay (ELISA).PATIENTS AND METHODSWestern blot and specific immunoglobulin‐G antibody were used to identify the urinary NMP marker. Urine samples from 149 patients with bladder cancer and 72 controls were evaluated using the developed dot‐ELISA. The initial responses of 43 patients treated by irradiation were followed using the assay.RESULTSThe NMP marker was identified in the urine of patients with bladder cancer at 52 kDa (NMP‐52) by Western blot. The dot‐ELISA detected the urinary NMP‐52 marker in 92% of patients with squamous cell carcinoma, 98% with transitional cell carcinoma, and all six of those with adenocarcinoma of the bladder, with a specificity of 94%. The positive and negative predictive values (97% and 94%, respectively) and efficiency (96%) of the dot‐ELISA were high. In addition, the NMP‐52 tumour marker was not detected in the urine of patients who showed a response after radiotherapy.CONCLUSIONDetecting the urinary NMP‐52 marker using dot‐ELISA would be helpful in the rapid diagnosis and follow‐up of patients with bladder cancer.
Detrusor myectomy: long‐term results with a minimum follow‐up of 2 years
Authors: Kumar Sunil P.V. , Abrams Paul H. 
Published: July 2005

Detrusor myectomy was introduced as an alternative to enterocystoplasty for refractory detrusor overactivity. The early results of this procedure were described by the authors from Bristol as encouraging, and they now present their long‐term follow‐up with a median of 79 months. They found that the results were sustained in a significant group of these patients. The value of frequency‐volume urinary diaries is undoubted in patients of either sex who have LUTS, particularly in those with symptoms suggestive of overactive bladder. Authors from Chicago compare such diaries between asymptomatic controls and women with symptoms of overactive bladder. A whole range of diary variables was compared, and the interesting findings used as a potential method to define important outcome goals in therapeutic trials. OBJECTIVESTo assess the long‐term results of detrusor myectomy, which has obvious theoretical advantages over enterocystoplasty for refractory detrusor overactivity (DO), and for which the early results have been encouraging.PATIENTS AND METHODSThe medical records were reviewed of 30 consecutive patients (median age 33 years, range 10–62) who had a detrusor myectomy between November 1992 and April 2002 in our unit. Twenty‐four patients (80%) had idiopathic DO (six males and 18 females) and six (20%) had neurogenic DO (four males and two females). The median (range) follow‐up was 79 (28–142) months. All patients were confirmed to have DO on urodynamics before surgery and 26 (87%) had urodynamics afterward.RESULTSNineteen (79%) of those with idiopathic DO and two with neurogenic DO showed a continued overall improvement. The cystometric capacity improved in 80% of patients after surgery, whilst the detrusor pressure at maximum flow and the bladder contractility index decreased in 60% and 78% of the patients, respectively. Ten patients (45%) had to start clean intermittent self‐catheterization after surgery.CONCLUSIONSDetrusor myectomy is successful in ≈ 80% of patients with idiopathic DO, although detrusor contractility is affected in most and almost half of the patients required clean intermittent self‐catheterization afterward. This procedure should be offered as an alternative to enterocystoplasty as it is less morbid and does not preclude subsequent surgery if required. However, further evaluation of this technique is required in neuropathic patients.
Are conventional pressure‐flow measurements dependent upon filled volume?
Authors: Sahadevan Kanagasabai , Leonard Ann S. , Pickard Robert S. 
Published: July 2005

OBJECTIVETo determine, in a prospective study, whether detrusor pressure (pdet.Qmax) and maximum urinary flow rate (Qmax) measurements obtained after filling to maximum cystometric capacity (MCC) differ from those obtained with filling restricted to average voided volume (Vvoid), as standard protocols for pressure flow studies (PFS) mandate bladder filling until the subject has a strong desire to void, which aids standardization but further divorces the test from real‐life experience.PATIENTS AND METHODSAfter calculating the appropriate sample size, 84 patients attending for PFS with an adequately completed 3‐day frequency‐volume chart were recruited. Each underwent two consecutive PFS with filling to MCC and average Vvoid in a random order, and measurements of pdet.Qmax and Qmax were compared. For men, the agreement for a diagnosis of obstruction between the tests was also assessed.RESULTSComplete data were obtained from 76 (90%) of the patients, with a mean (range) age of 64 (20–94) years. The mean (sd) difference between MCC and average Vvoid was 134 (113) mL (P < 0.01). There were no significant differences between estimates of Qmax, at − 0.1 (3) mL/s (P = 0.75), and of pdet.Qmax, at − 1 (13) cmH2O (P = 0.91), obtained within each patient. For men there was 91% agreement (32 of 35) in the classification of obstruction.CONCLUSIONSRestriction of filling to the average Vvoid during PFS allows a closer approximation to normal voiding and results in no clinically relevant change to the value of standard pressure‐flow measurements or alters individual classification of obstruction.
Validation of a patient‐administered questionnaire to measure the severity and bothersomeness of lower urinary tract symptoms in uncomplicated urinary tract infection (UTI): the UTI Symptom Assessment questionnaire
Authors: Clayson Darren , Wild Diane , Doll Helen , Keating Karen , Gondek Kathleen 
Published: July 2005

OBJECTIVETo develop and validate a self‐administered questionnaire to assess the ‘severity’ and ‘bothersomeness’ of the most frequently reported signs and symptoms of uncomplicated urinary tract infection (uUTI).SUBJECTS AND METHODSThe UTI Symptoms Assessment questionnaire (UTISA) is a 14‐item instrument asking about the severity and bothersomeness of seven key uUTI symptoms. It was developed after comprehensive literature and data review and administration in draft form to a sample of 30 women with uUTI. The final questionnaire was completed by 276 women with uUTI who participated in a noncomparative clinical trial of ciprofloxacin. The women completed the questionnaire in electronic format at baseline (before the first dose of ciprofloxacin once‐daily), at 3‐h and 8‐h intervals until all UTI symptoms were resolved, and at the test‐of‐cure visit. Baseline scores on the King's Health Questionnaire (KHQ) were used to assess convergent and divergent validity; responses to the Global Rating of Change (GRC) were used to assess both responsiveness and the ‘minimally important difference’. Discriminant validity and responsiveness were assessed by comparing UTISA scores with a clinical evaluation of UTI symptoms performed by the investigator at baseline and at the test‐of‐cure visit.RESULTSThe UTISA was found to comprise three four‐item domains named ‘urination regularity’, ‘problems with urination’, and ‘pain associated with UTI’. Two questions asking about haematuria loaded on a fourth factor. The three domains were homogeneous (with high inter‐item correlations) and internally consistent. Convergent validity was shown by high correlations between similar UTISA and KHQ domains (all rs > 0.40), and divergent validity by small correlations between unlike domains (all rs < 0.15). In general, the UTISA domains showed excellent discriminant validity, with scores on selected domains discriminating between women with different clinical evaluations. The responsiveness of the UTISA was also excellent, with high correlations between changes in domain scores and the clinical evaluation and GRC items. Symptom improvement was highest in the first 3 h, leading to greater responsiveness and minimally important difference during this period. However, the UTISA could detect even small subsequent changes.CONCLUSIONThe three‐domain UTISA has excellent psychometric properties and it is likely to prove an excellent tool for assessing uUTI outcome from a patient's perspective, both in research and clinical settings.
A novel midstream urine‐collection device reduces contamination rates in urine cultures amongst women
Authors: Jackson Simon R. , Dryden Mathew , Gillett Paul , Kearney Paddy , Weatherall Rosemary 
Published: July 2005

OBJECTIVETo evaluate a novel urine‐collection device (UCD) that automatically collects a midstream urine (MSU) sample, and compare contamination rates to those of the conventional MSU sampling method, as the contamination of urine samples for microbiological analysis in women leads to diagnostic ambiguity and unnecessary costs, and may result in part from an incorrect collection procedure.PATIENTS AND METHODSIn all, 2823 women from four centres, most from antenatal clinics, were randomized to two urine‐collection methods: conventional MSU collection and collection with a novel MSU UCD (the Whiz®, JBOL Ltd, Oxford, UK). Semi‐quantitative growth and user acceptability were compared between the collection methods.RESULTSMSU samples collected with the UCD had significantly fewer mixed growth samples (9% vs 14%, P = 0.001; 36% relative reduction), significantly fewer heavy mixed growth samples (1.2% vs 3.0%, P = 0.004; 60% relative reduction) and required significantly fewer re‐tests (11% vs 16%, P = 0.002; 31% relative reduction). There were more samples with clinically insignificant growth than the conventional MSU group (86% vs 82%, P = 0.005). Those using the UCD preferred it to the conventional method (67.5%) and experienced significantly less spillage during sample collection (27% vs 46%, P = 0.001; relative reduction 41%).CONCLUSIONThe UCD reduced contamination rates in urine samples and improved the predictive value of the urine culture in a manner acceptable to patients and staff.
How do urinary diaries of women with an overactive bladder differ from those of asymptomatic controls?
Authors: Fitzgerald Mary P. , Ayuste Deborah , Brubaker Linda 
Published: July 2005

OBJECTIVETo quantify clinically important differences in common diary variables between asymptomatic controls and women with symptoms of overactive bladder (OAB), controlling for the effects of age and race.PATIENTS, SUBJECTS AND METHODSThe 24‐h urinary diaries of 49 women with symptoms of OAB were compared to those of age‐ and race‐matched asymptomatic controls. Control subjects did not have a physical examination.RESULTSThe 49 patients with OAB symptoms had a median (range) age of 51 (20–85) years, a body mass index of 25 (17–46) kg/m2 and a parity of 2 (0–5). The median number of voids was significantly greater in women with OAB than asymptomatic controls (P < 0.001). The median value for mean voided volume was significantly lower in women with OAB than asymptomatic controls (P = 0.014). There was no difference in the maximum voided volume, total voided volume, daytime or night‐time diuresis rates, voids per litre intake, or total fluid intake.CONCLUSIONSThis preliminary study suggests that a median reduction of three voids/24 h and an increase of 70 mL in the mean voided volume might be clinically important goals in therapeutic trials for treating OAB symptoms. This remains to be confirmed by further studies linking improvements in quality of life and the overall impression of bladder health with these quantitative diary variable changes.
A comparison of the effect of 1.5% glycine and 5% glucose irrigants on plasma serum physiology and the incidence of transurethral resection syndrome during prostate resection
Authors: Collins Justin W. , MacDermott Seamus , Bradbrook Richard A. , Keeley Francis X. , Timoney Anthony G. 
Published: July 2005

OBJECTIVETo examine changes in the pathophysiology and frequency of the transurethral resection (TUR) syndrome with two irrigation fluids, as variable amounts of irrigation fluid are absorbed during TUR of the prostate (TURP), and although polar solutes are required to prevent an effect on diathermy, the solutes may have effects when absorbed.PATIENTS AND METHODSBetween December 2001 and March 2003, 250 patients were included in a prospective randomized trial comparing glycine 1.5% with 5% glucose irrigation fluids. We measured blood loss, fluid absorption, temperature change, biochemistry including a glycine assay, and peri‐operative symptoms. Blood samples were taken immediately before and immediately, 5 and 24 h after TURP. Irrigating fluid absorption during TURP was measured with 1% ethanol as a marker and breath ethanol measurements. Operative details were recorded, including the type of anaesthesia (with or with no sedation), resection time and weight of resected tissue. Peri‐operative symptoms were documented prospectively. TUR syndrome was defined as a serum sodium level of ≤ 125 mmol/L with two or more associated symptoms or signs of TUR syndrome.RESULTSFive (2%) patients had TUR syndrome; all five were irrigated with glycine, although this difference was not statistically significant (P = 0.06). Of the five men, three had hypotension, four were tired, one was nauseous, two had parasthesia, two had ‘uneasiness’, one had blurred vision and two were confused; none had chest pain. There was a large variation between the groups in the level of glycine assayed immediately after TURP; a high glycine level was associated with the TUR syndrome (P = 0.01). There was no difference between the groups in levels of sodium, potassium, urea, creatinine, osmolality, calcium, haematocrit, albumin serum levels or peri‐operative blood loss (defined as a change from before to after TURP in haemoglobin level, accounting for transfusions).CONCLUSIONSAn increase in serum glycine was associated with TUR syndrome; there were large variations in the amounts of glycine absorbed, reaching levels many times the upper limit of normal. In other studies, glycine was reportedly toxic, and that the levels recorded were many times the upper limit of normal may have both immediate and long‐term effects.
The management of penile fracture based on clinical and magnetic resonance imaging findings
Authors: Abolyosr Ahmad , Moneim Alaa E. Abdel , Abdelatif Atef M. , Abdalla Medhat A. , Imam Hisham M.K. 
Published: July 2005

Associate Editor Michael G. Wyllie Editorial Board Ian Eardley, UK Jean Fourcroy, USA Sidney Glina, Brazil Julia Heiman, USA Chris McMahon, Australia Bob Millar, UK Alvaro Morales, Canada Michael Perelman, USA Marcel Waldinger, Netherlands OBJECTIVETo present our experience with repairing penile fracture, based on clinical and magnetic resonance imaging (MRI) findings.PATIENTS AND METHODSBetween December 2002 and October 2004, 14 men (19–64 years old) presented to our centre with a penile fracture. Two patients had urethral bleeding. MRI was used before surgery in all patients, and the repair comprised a localized longitudinal penile incision in 13 men. This incision was designed according to the tunical tear site and size already depicted by MRI. One case was managed conservatively, as MRI confirmed an intercavernosal haematoma with no tunical tear. The follow‐up was 4–21 months.RESULTSThe tear involved one corpus cavernosum in 11 patients; two were associated with urethral injury. The course after repair was uneventful in all men; the follow‐up showed no erectile dysfunction in any. The patients reported neither pain nor penile curvature during erection.CONCLUSIONMRI is a simple and informative investigation for evaluating and documenting a penile fracture, and it improves the management plan.
Outcome from percutaneous nephrolithotomy in patients with spinal cord injury, using a single‐stage dilator for access
Authors: Lawrentschuk Nathan , Pan David , Grills Richard , Rogerson John , Angus David , Webb David R. , Bolton Damien M. 
Published: July 2005

The use of percutaneous nephrolithotomy to treat renal calculi in patients with spinal cord injury is described by authors from Melbourne. This is the first contemporary series reported for over 13 years, and the authors describe various unique features about their series and compare their results to previously reported studies. Authors from London describe the largest single series of renal transplant patients in adults and children with urolithiasis, study risk factors associated with this condition in renal transplant recipients, and report on their multimodal management by endourological and open procedures. OBJECTIVETo present our experience of percutaneous nephrolithotomy (PCNL) for treating urolithiasis in patients with spinal cord injury (SCI) using a single‐stage dilator for percutaneous access.PATIENTS AND METHODSA prospective database of patients with SCI having PCNL using the single‐stage dilator was assessed, analysing patient data, stone‐free rates, morbidity and the follow‐up outcome.RESULTSIn all, 26 patients had 54 PCNLs on 32 kidneys; 20 had unilateral and six bilateral stone disease; there were many staghorn calculi (24/54). Major complications occurred in three of 54 PCNLs (6%). The complete stone‐clearance rate was 87% for PCNL alone, rising to 29 of 32 kidneys (91%) or 24 of 26 patients (92%) with adjuvant procedures. A further three kidneys required no further treatment and were monitored, having residual fragments of ≤ 2 mm.CONCLUSIONSPCNL has a high success rate and acceptable complication rate compared to extracorporeal shock‐wave lithotripsy, and remains a valid first‐line treatment option for kidney stones in patients with SCI.