bluuebunny/crossref_metadata_2025_split huggingface dataset:
The efficacy of laparoscopic mesh colposuspension: results of a prospective controlled study
Authors: El‐Toukhy T.A. , Davies A.E. 
Published: March 2003

Objective To investigate the efficacy of laparoscopic mesh colposuspension as an equivalent approach to the ‘gold standard’ open Burch colposuspension. Patients and methods A prospective controlled study of laparoscopic mesh colposuspension was conducted over 2 years; 87 patients with genuine stress incontinence (GSI) were recruited. The preoperative evaluation included a history, examination, midstream urine analysis, urinary voiding diary, a Urilos pad test, and twin‐channel subtracted cystometry, including urethral profilometry and measurement of the postvoid residual volume. The study included patients who had undergone previous incontinence surgery, but those with detrusor instability or neurogenic bladder were excluded. The patients were assessed at 6 weeks, 6 months and 1 year after surgery and then yearly thereafter. The urodynamic assessment was repeated 3 months after surgery. Results Forty‐nine patients underwent laparoscopic colposuspension using Prolene mesh and titanium tacks to elevate the bladder neck, while 38 patients had open Burch colposuspension. There was no difference between the groups in age, parity, body mass index, menopausal status, medical history, previous bladder neck surgery and prolapse. At 6 weeks the cure rate was similarly high in the two groups (91% laparoscopic and 94% open). After a mean follow‐up of 32 months, both groups showed a decline in efficacy, which was more marked in the laparoscopic group. Cure rates were 62% for laparoscopy and 79% for open surgery, and the improvement rates were 77% and 89%, respectively (P < 0.05). Conclusion Laparoscopic colposuspension using a mesh and tacker technique reduces the technical difficulty and operating time of the endoscopic procedure, but the long‐term cure rates are inferior to open Burch colposuspension.
Fears, sexual disturbances and personality features in men with prostatitis: a population‐based cross‐sectional study in Finland
Authors: Mehik A. , Hellström P. , Sarpola A. , Lukkarinen O. , Järvelin M.‐R. 
Published: March 2003

Objective To determine the occurrence of mental distress related to prostatitis in Finnish men. Subjects and methods A population‐based cross‐sectional survey was conducted of 2500 men aged 20–59 years living in the two northernmost provinces of Finland (Oulu and Lapland). The final response rate was 75% (1832 men). Results The fear of undetected prostate cancer was reported by 17% of the men in the population who had had prostatitis, a value significantly higher (P < 0.001) than in healthy men. Fears of having a sexually transmitted disease and suicidal thinking were also slightly more common. The men who had had prostatitis preferred to be alone in a public toilet during voiding (58% vs 44%, P < 0.001). Erectile dysfunction was reported by 43% of the men with symptomatic prostatitis and decreased libido by 24%. Self‐assessment of personality, adjusted for age, showed that the men with prostatitis were more often busy and nervous than the healthy controls (P < 0.001), and that they had a more meticulous attitude to life and its problems. Marital difficulties were reported by 17% of the men who had had prostatitis at some point in their lives, and 4% were convinced that their illness had caused their divorce. Socio‐economic status and social well‐being had no apparent influence on the occurrence of prostatitis. Conclusions This survey showed that psychological stress is common in men with prostatitis. Urologists and general practitioners should consider that a consultation with a psychiatrist may be appropriate for selected men with prostatitis.
The self‐expanding metallic ureteric stent in the long‐term management of benign ureteric strictures
Authors: Arya M. , Mostafid H. , Patel H.R.H. , Kellett M.J. , Philp T. 
Published: March 2003

Objective To evaluate and assess the long‐term complications of using the thermo‐expandable, nickel‐titanium alloy stent (Memokath™ 051, Engineers & Doctors A/S, Hornbaek, Denmark) for managing benign ureteric strictures. Patients and methods Over a 3‐year period, 13 Memokath stents were inserted in 11 patients (mean age 58 years, range 35–85) with 12 lower ureteric strictures. The cause of the stricture was benign in all cases, i.e. radiation fibrosis in three, retroperitoneal fibrosis, ischaemic uretero‐ileal anastomosis and scarring after ureteroscopy in two each, and diathermy damage, extraluminal endometriosis and stone passage in one each. Four stents were 9 F with proximal expansion to 17 F and the other nine used were 10.5 F with proximal expansion to 20 F. The patients were followed for a mean (range) of 18 (1.5–33) months. Results No complications or side‐effects occurred with nine stents; four stents were removed at a mean (range) of 16.3 (4–33) months. Three of these had become encrusted, two of which had been placed in patients who had either a history of stone disease or recurrent urinary tract infection. The other stent had migrated. Conclusion The Memokath stent appears to have a useful role in managing benign ureteric strictures, but it must be closely monitored in patients who are predisposed to encrustation.
Coated catheters for intermittent catheterization: smooth or sticky?
Authors: Fader M. , Moore K.N. , Cottenden A.M. , Pettersson L. , Brooks R. , Malone‐Lee J. 
Published: March 2003

Objective To evaluate the current range of hydrophilic‐coated catheters for intermittent self‐catheterization, focusing on the adherence of the catheter to the urethral mucosa at the end of catheterization. Subjects and methods In a prospective randomized study, 61 community‐based men tested each of four different hydrophilic‐coated catheters available in the UK at the time. Subjects used each of the four test catheters for 1 week in a random order, and were provided with the number and size of catheter they normally used. To assess the products, the subjects: (i) timed seven catheterizations using a stop‐watch to determine the time taken from extracting the catheter from the water‐filled package, to removing the catheter from the penis, having emptied the bladder; (ii) recorded the severity of ‘sticking’ on catheter removal on a three‐point scale (not at all, a little, a lot); and (iii) completed a product‐performance questionnaire. Results There were no significant differences in ratings of ‘sticking’ between the ‘Easicath’ and ‘Lofric’ (P > 0.05), but there were significant differences between these two products and the ‘Aquacath’ and the ‘Silky’, which were found to ‘stick’ more (P < 0.001). The ‘Silky’ was reported to stick significantly more than the ‘Aquacath’ (P < 0.001). Conclusions Adherence to the urethral mucosa on catheter removal was a common problem, occurring with all catheters, but two products were significantly more likely to stick than the other two. The clinical importance of ‘sticking’ and the long‐term implications are currently unknown. The relative ‘sticking’ of uncoated catheters has also not been established.
The Barbagli procedure gives the best results for patch urethroplasty of the bulbar urethra
Authors: Andrich D.E. , Leach C.J. , Mundy A.R. 
Published: March 2003

Objective To compare the surgical outcome using buccal mucosal free grafts in the Barbagli procedure (dorsal stricturotomy and patch technique) with the traditional ventral approach, for long bulbar urethral strictures. Patients and methods Over a period of 6 years, a total of 71 patients with bulbar urethral strictures underwent buccal mucosal graft urethroplasty. Twenty‐nine patients had a traditional ventral urethroplasty and 42 were managed by the Barbagli procedure with the stricturotomy and patch on the dorsal aspect of the urethra. Results At 5 years of follow‐up 5% of patients who underwent the Barbagli procedure developed recurrent strictures, compared to 14% in the traditional ventral stricturotomy group. All patients developed postmicturition dribble of urine to some degree, which was troublesome in 17% in the Barbagli group and 21% in the ventral stricturotomy group. Complications attributable to out‐pouching of the graft were not seen in either group. Conclusions The dorsal stricturotomy and patch (Barbagli) procedure had a higher success rate than the traditional ventral urethroplasty. Comparing these results with our experience of skin inlay urethroplasty, buccal mucosal grafts seem to have advantages however they are used.
Renal calcium phosphate and oxalate deposition in prolonged vitamin B6 deficiency: studies on a rat model of urolithiasis
Authors: Di Tommaso L. , Tolomelli B. , Mezzini R. , Marchetti M. , Cenacchi G. , Foschini M.P. , Mancini A.M. 
Published: March 2003

Objective To determine the effect on kidney oxalate‐salt deposition of a prolonged diet which induced vitamin B6 deficiency in adult rats, as there are reports of the pathogenic involvement of vitamin B6 deficiency in the formation of renal calcium oxalate calculi. Materials and methods The study comprised 24 6‐month‐old male albino Wistar rats; 12 were fed with a purified vitamin B6‐deficient diet and the others provided with the same diet but supplemented with 6 mg/kg of vitamin B6. After 12 weeks, all rats were killed, and their kidneys fixed in formalin and routinely processed to paraffin for morphological examination; some fragments were fixed in glutaraldehyde and prepared for ultrastructural examination. From each rat consecutive sections of both kidneys were cut and stained with haematoxylin and eosin, periodic‐acid Schiff, Sirius red and the Von Kossa method for calcium. Sections were examined in polarized light and by electron microscopy. Results The histopathological and ultrastructural features of the kidney of vitamin B6‐deficient rats were those of tubular‐interstitial nephritis, characterized by tubular atrophy, interstitial fibrosis and chronic inflammatory infiltration. Oxalate and phosphate crystals were present in the papillary and parenchymal connective tissue. Ultrastructural features confirmed severe tubular epithelial lesions and the presence of an interstitial and intraepithelial inflammatory infiltrate; there was mild interstitial fibrosis. None of these features were apparent in the kidney of control rats. Conclusions Histopathological and ultrastructural data indicate that a prolonged vitamin B6‐deficient diet may contribute to the formation and deposition of calcium phosphate and oxalate crystals, which lead to severe damage of the renal parenchyma. This phenomenon may occur not only in growing rats, which have more active protein metabolism and consequently higher vitamin B6 requirements, but also in adult rats.
Does site‐specific labelling and individual processing of sextant biopsies improve the accuracy of prostate biopsy in predicting pathological stage in patients with T1c prostate cancer?
Authors: Tombal B. , Tajeddine N. , Cosyns J.‐P. , Feyaerts A. , Opsomer R. , Wese F.X. , Van Cangh P.J. 
Published: March 2003

Objective To evaluate whether individual labelling and processing of the sextant of origin improves the accuracy of prostate biopsy in predicting the final pathological stage after radical prostatectomy in patients with T1c prostate cancer. Patients and methods The charts of 386 patients treated for prostate cancer by radical prostatectomy between January 1996 and June 1999 were reviewed. In all, 124 patients fulfilled the following inclusion criteria: no abnormality on digital rectal examination (DRE) or transrectal ultrasonography, a prostate specific antigen (PSA) level before biopsy of  20 ng/mL, and prostate cancer diagnosed after one set of random sextant biopsies, with the cores being submitted in six separate containers individually labelled for the sextant of origin. Results Within this series of patients with a low tumour burden, the preoperative PSA, biopsy Gleason score and unilateral vs bilateral involvement were not significant predictors of disease extension. The percentage of positive cores and the number and topography of positive sextants were both statistically significant predictors of organ‐confined disease. Although these two variables appeared to be statistically equivalent on a first analysis in the overall series, a subgroup of patients was identified who benefited from the complete topographical information, i.e. those 52 (42%) patients with a Gleason score of < 7, 25–75% positive biopsies and 3 positive sextants. Conclusion These results support the individual labelling of biopsy cores in selected patients with a normal DRE and a moderately elevated PSA, as it helps to better predict the final pathological stage. This substantial benefit outweighs the additional effort by the pathologist.
Vascular angiographic asymmetry on three‐dimensional transrectal power Doppler ultrasonography in patients with organ‐confined prostate cancer
Authors: Dobrowolski Z.F. , Jaszczynski J. , Drewniak T. , Habrat W. , Kusionowicz J. 
Published: March 2003

Objective To assess whether organ‐confined prostate cancer not detected on routine transrectal ultrasonography (TRUS) can be detected using three‐dimensional (3‐D) power Doppler methods. Patients and methods A preliminary trial of the use of TRUS with 3‐D power Doppler image reconstruction was conducted in 116 patients being evaluated for lower urinary tract symptoms. Using a microbubble enhancing agent, an adequate horizontal plane allowed the simultaneous visualization and assessment of the symmetry of echogenicity and vascularization of the peripheral area of both prostate lobes, which is not possible in standard TRUS. The peripheral zone vascular asymmetry in the horizontal plane was also assessed retrospectively in those patients with pT2a,b prostate carcinoma. Results Stage pT2a,b prostate carcinoma was confirmed in 26 patients; in this group, two independent investigators confirmed the vascular asymmetry between the left and right peripheral zone, in the horizontal plane, in 22 patients, giving a sensitivity of 85%. Conclusions Vascular asymmetry allows guided biopsy in lesions that are invisible using standard TRUS. Microbubble agents are an effective method of increasing the acoustic signals from small vessels of the prostate.
Does the tension‐free vaginal tape procedure affect the voiding phase? Pressure‐flow studies before and 1 year after surgery
Authors: Sander P. , Møller L.M.A. , Rudnicki P.M. , Lose G. 
Published: March 2003

Objective To evaluate the voiding phase before and 1 year after surgery in women who underwent a tension‐free vaginal tape (TVT) procedure for stress incontinence. Patients and methods The study comprised 45 women with genuine stress urinary incontinence. To assess the voiding phase, patients were asked if their voiding had changed after surgery, and objectively the uroflowmetry, residual urine measurements and pressure‐flow data were compared. Results At 1 year after surgery 39 women (87%) were subjectively cured and six (13%) improved. The objective cure rate was 88%; the pad‐test leakage and the number of leakage episodes decreased significantly after surgery. Subjectively, 78% of the patients reported that the voiding phase had become more difficult, and the spontaneous flow curve changed to a more obstructive pattern in 40%, with the mean urinary peak flow rate (Qmax), the corrected Qmax and the mean average flow rate decreasing significantly. The residual urine volume increased significantly, although no patient had volumes of > 25% of their bladder capacity. During the pressure‐flow study the Qmax decreased and the urethral resistance factor increased significantly. However, only one patient could be classified as obstructed. Two patients had clinical problems and used self‐catheterization once daily 1 year after surgery. Conclusion There were subjective and objective changes in the voiding phase 1 year after the TVT procedure. The significance of these findings remains to be determined. Longitudinal studies are warranted to clarify whether the patients at risk can be characterized from subjective and objective findings.
Effects of the chronic use of finasteride on testicular weight and spermatogenesis in Wistar rats
Authors: Rhoden E.L. , Gobbi D. , Menti E. , Rhoden C. , Telöken C. 
Published: March 2003

Objective To evaluate spermatogenesis in rats chronically exposed to finasteride, as the recent use of finasteride in young men to prevent hair loss has raised concerns about chronic use and fertility. Materials and methods Male Wistar rats (4 months old) were selected and divided into two groups. Group 1 (17 rats) received a finasteride suspension of 2 mg/kg/day in saline solution, 5 days/week for 10 months; group 2 (eight rats of the same age) were treated with placebo for the same period. At the end of the exposure the testes were weighed and processed for histological analysis. Spermatogenesis was evaluated as the mean number of seminiferous tubules with and without spermatozoids in their lumen, in five random fields on the same slide. Student's t‐test was used to assess differences in the groups. Results In group 1, the mean (sd) weight of the testes was 1.55 (0.29) g and in group 2 1.58 (0.34) g (P>0.05). The histological analysis showed a mean of 13.35 (1.66) seminiferous tubules per field and 1.20 (3.30) tubules with no spermatozoids in group 1; in group 2 the respective values were 13.53 (1.46) and 0.06 (0.14) (P>0.05). Conclusion Finasteride had no detectable effects on the quantitative and qualitative analysis of spermatogenesis in rats.
Intestinal and renal handling of oxalate in magnesium‐deficient rats. Evaluation of intestinal in vivo14C‐oxalate perfusion
Authors: Straub B. , Müller M. , Schrader M. , Goessl C. , Heicappell R. , Miller K. 
Published: March 2003

Objectives To clarify in vivo, using isolated small intestinal loops perfused with radioactive 14C‐oxalate, whether intestinal hyperabsorption or reduced secretion is important in magnesium deficiency (MgD), as this is a potential cause of calcium oxalate urolithiasis. Materials and methods Twenty‐four Sprague‐Dawley rats were either fed a standard diet (control, 12 rats) or a magnesium‐deficient diet (MgD, 12 rats) for 19 weeks. One hour before the animals were killed, a defined length of a small intestinal loop was isolated and filled with 5 mL of 0.9% NaCl and a defined amount of intravenous 14C‐oxalate applied. Using this method it was possible to determine the secretion of unlabelled oxalate into the intestinal lumen, from the specific activity in plasma. Results Plasma oxalate levels doubled under MgD; urinary calcium and phosphorus also increased significantly, while urine oxalate tended to decrease. The secretion of oxalate into the intestinal lumen of MgD animals increased significantly, by five times that of the control. The relative supersaturation for calcium oxalate remained constant. Elementary analysis of renal tissue showed an increase in calcium and phosphorus under MgD, in the sense of nephrocalcinosis, but no concretions were detected (no nephrolithiasis). Conclusion In contrast to earlier studies, there is no evidence that hyperoxaluria is responsible for the possible development of urolithiasis in MgD. This was confirmed by calcium phosphate deposits in renal tissue, even though there was no evidence of oxalate urolithiasis. The increase in plasma oxalate seems to be completely compensated by strongly increased oxalate secretion into the intestinal lumen.
Distal hypospadias: which repair?
Authors: Samuel M. , Capps S. , Worthy A. 
Published: March 2003

Objective  To compare the function, complications and cosmesis after a modified Thiersch‐Duplay and Mathieu unstented urethroplasty. Patients and methods  Over a 5‐year period 381 consecutive patients (not randomized) with distal hypospadias were evaluated. A modified Thiersch‐Duplay with dorsal incised urethral plate tubularization (group A) was undertaken in 170 (45%) and a parameatal based flip‐flap Mathieu hypospadias repair (group B) in 211 (55%). No urinary diversion or stent was used in any of the 381 patients. Results

In both groups the mean (
sd
) follow‐up was 3.1 (1.4) years. All 381 patients voided spontaneously after surgery and none developed urinary retention needing catheterization. In groups A and B, respectively, the overall late complications were 12 (7.1%) and 32 (15.2%) (
P

=0.001), with urethrocutaneous fistula in six (3.5%) and 26 (12.3%;
P

=0.001); secondary surgery for fistula repair was successful in all boys in A and 89% in B. The glanular meatus was a vertical slit in all in group A and 86% in B (
P =0.02). In both groups, 71% of the children who are now toilet‐trained and standing to void have a good calibre, single and straight urinary stream in a forward direction. Conclusions  Stenting or urinary diversion is unnecessary after distal hypospadias surgery. The functional results were good in those standing to void. A more natural vertical slit‐like glanular meatus was easily created using the modified Thiersch‐Duplay urethroplasty, with a lower fistula rate.
An oxalate‐binding protein with crystal growth promoter activity from human kidney stone matrix
Authors: Govindaraj A. , Selvam R. 
Published: March 2003

Objective To fractionate renal‐stone matrix proteins, identify the presence of oxalate‐binding protein and assess its effect in a calcium oxalate (CaOx) crystal growth system. Materials and methods Proteins were isolated from the matrix of kidney stones containing CaOx as the major constituent, using EDTA as a demineralizing agent. The solubilized proteins were subjected to cellulose‐column chromatography by eluting with increasing sodium chloride concentrations in Tris‐HCl buffer. Three protein fraction peaks were eluted, i.e. fraction I in buffer, fraction II in 0.05 mol/L NaCl in buffer and fraction III in 0.3 mol/L NaCl in buffer. The protein fractions were tested for their effects on CaOx crystal growth. Results All three fractions had maximum CaOx binding activity at pH 7.4 but fraction II also had activity at pH 4.5. Fraction I promoted in vitro CaOx crystal growth, while fractions II and III were inhibitory. When fraction I was further separated on a Sephadex G‐200 column, two protein fractions (Ia and Ib) were obtained. Fraction Ia protein had high and fraction Ib low CaOx‐binding activity. Fraction Ia had a molecular weight of 48 kDa on gel electrophoresis and Western blotting. The 48 kDa protein did not cross‐react with crystal matrix protein antibody, band‐3 protein antibody, or albumin. The protein promoted CaOx crystal growth, with an optimum temperature of 37 °C and pH 6.5. The inhibitory effect of citrate on crystal growth was significantly lower in the presence of the 48 kDa protein. The protein promoted nucleation and aggregation of CaOx crystals in the in vitro crystallization system at pH 6.5, whereas fraction Ib (29 kDa) inhibited both nucleation and aggregation. Using the 48 kDa antibody, the yield of the protein from the stone matrix was 32% by EDTA extraction and only 3% with other methods. The protein was also detected in the nucleus and mitochondria, and in other matrix fractions of calcium phosphate and uric acid stones. Conclusions The 48 kDa protein isolated from stone matrix is a potent promoter of CaOx crystal growth with high oxalate‐binding activity; it is enriched in the nucleus and mitochondria.