bluuebunny/crossref_metadata_2025_split huggingface dataset:
Intramuscular tenoxicam to treat acute renal colic
Authors: Dawood Al‐Waili N.S. 
Published: November 2003

Objective To study the possible therapeutic effects on acute renal colic of a single 20 mg intramuscular dose of tenoxicam.Patients and methods The study comprised 30 patients (22 men and eight women, mean age 32 years, range 17–60) who presented with acute renal colic and were diagnosed by intravenous urography, a general urine examination and ultrasonography. Each patient was treated with 20 mg of tenoxicam given intramuscularly. The severity of pain was assessed on a verbal six‐point scale.Results Twenty‐four patients markedly improved within 1 h of receiving tenoxicam (P<0.001). No side‐effects were reported and the drug was tolerated well by all the patients.Conclusion Tenoxicam can be used successfully to treat acute renal colic.
The day‐to‐day variation (test‐retest reliability) of residual urine measurement
Authors: Dunsmuir W.D. , Feneley M. , Corry D.A. , Bryan J. , Kirby R.S. 
Published: November 2003

Objective To determine the variation in repeated measurements of post‐void residual urine volume (PVR), determined by transabdominal ultrasonography (TAUS), within an individual over time (test‐retest reliability). Patients and methods Forty men with symptomatic benign prostatic hyperplasia and awaiting transurethral resection of the prostate were studied over 3 months. Each underwent TAUS to determine both pre‐and post‐micturition residual volumes on six occasions within the study period. Results Although one‐third of the patients had approximately constant residual volumes (variation in range <120 mL), two‐thirds had wide intra‐individual variations over time (variation in range 150–670 mL). The values were log transformed to give a normal distribution and subjected to analysis of variance; there was a wide variation between and also within individuals. The larger the mean PVR, the larger was the overall variation in time. For those with a mean PVR of <100 mL, the variation was less marked and these patients showed a more consistent test‐retest repeatability. Conclusions Although the PVR determined by TAUS may be useful to indicate aspects of bladder dysfunction or outlet obstruction, the wide variation in repeated measurements in the same individual limits its use for any clinical purpose that requires repeated assessment, e.g. in monitoring the response to treatment. There is poor test‐retest reliability and PVRs cannot be determined reliably from a single measurement.
Restoration of the continuity of dog ureter after resection of its 5 cm middle segment
Authors: Kuzaka B. , Szymanska K. , Borkowski A. , Krus S. 
Published: November 2003

Objective To evaluate the restoration of the ureter of the dog after resection of a 5 cm‐long middle segment. Materials and methods Eight dogs underwent resection of the middle segment of the ureter, after which a 6–8 F Bard ureteric stent modelling catheter was inserted into both remaining portions of the ureter for 3 months. One month after removal of the stent the animals were killed and their ureters examined both grossly and microscopically. Paraffin‐embedded sections were subjected to microscopic and immunohistochemical studies. Results The continuity of the ureter was restored but the reconstructed segment was narrowed to a variable extent. The wall of the ureter was lined by normal urothelium but consisted of fibrous connective tissue which failed to produce a regular coat. The reconstructed segment showed no smooth muscle cells (negative staining with azan and a negative reaction with monoclonal antibodies against desmin). A few smooth myocytes were found only at the border with intact portions of the ureter. Conclusions The surgical procedure resulted in the restoration of ureteric continuity by repair and not by regeneration of its wall.
Overexpression of p53 protein and its significance for recurrent progressive bladder tumours
Authors: Underwood M.A. , Reeves J. , Smith G. , Gardiner D.S. , Scott R. , Bartlett J. , Cooke T.G. 
Published: November 2003

Objective To determine the prognostic value of the overexpression of p53 protein as determined by immunohistochemistry in recurrent progressive transitional cell carcinomas of the bladder. Patients and methods A total of 222 tumours from 86 patients with recurrent disease, 20 from patients with no evidence of recurrence after resection of initial tumour and 11 normal bladder (controls) were investigated. Using a microwave technique to expose antigens, formalin‐fixed sections were immunohistochemically stained for p53 using a polyclonal antiserum. Two independent observers scored the sections for evidence of overexpression of p53. Results Of 86 patients with recurrent disease, 51 demonstrated overexpression of p53 protein, as did six of 20 patients with non‐recurrent disease. Overexpression was not linked to recurrence (P=0.5) but was related to worsening histological stage (P<0.01) and increasing grade (P<0.01). Regression analysis showed that overexpression of p53 for the primary tumour was not of predictive prognostic value for death from bladder cancer, time to progression or time to recurrence. Tumour grade was the only variable of prognostic value in all the statistical models. Patients with overexpression of p53 showed no reduction in overall survival. Conclusion These findings suggest that overexpression of p53, as determined immunohistochemically, appears to have no predictive prognostic value over stage and grade in bladder tumours.
A urodynamic evaluation of patients with renal, upper and lower ureteric stones
Authors: Çetinkaya M. , Öztürk B. , Adsan Ö. , Ataman T. , Ulusoy E. , Güner E. 
Published: November 2003

Objective To investigate the urodynamic variables of the patients with renal, upper and lower ureteric stones and compare the results according to the location of the stone.Patients and methods Pre‐operatively, 49 patients with kidney, upper and lower ureteric stones were evaluated to determine bladder capacity, compliance and urine volume at first sensation. Patients with urinary tract infection, neurogenic pathology and bladder outlet obstruction were excluded. The patients were divided into two groups; 20 patients with kidney and upper ureteric stones and 29 patients with lower ureteric stones.Results The mean bladder compliance, bladder capacity and volume at first sensation were all significantly lower in patients with lower ureteric stones (P=0.026, P=0.005 and P=0.042, respectively). These patients also had more prominent irritative symptoms, urgency and frequency. However, the mean values of bladder capacity, compliance and volume at first sensation were within normal limits in both groups.Conclusion Lower ureteric stones cause more irritative bladder symptoms than do renal and upper ureteric stones and lower ureteric stones should be considered as a possible cause of sensory urgency.
Conservative management of penetrating and blunt Type III renal injuries
Authors: Thall E.H. , Stone N.N. , Cheng D.L. , Cohen E.L. , Fine E.M. , Leventhal I. , Aldoroty R.A. 
Published: November 2003

Objective To determine the optimal management, conservative or surgical, of patients with penetrating or blunt Type III renal injuries.Patients and methods This retrospective study comprised 122 patients with blunt abdominal or penetrating trauma with suspected significant renal injuries. Forty‐five patients (32 penetrating and 13 blunt trauma) with Type III injury were identified. Of these patients, 28 (17 penetrating and 11 blunt trauma) had their renal injuries treated conservatively while 14 patients, all with penetrating injuries, underwent immediate surgical repair. Three patients died from multiple trauma shortly after arrival in the emergency room.Results In the 42 surviving patients with Type III renal injuries, four required delayed intervention. These included two of those managed conservatively and two of the 14 who underwent initial surgical intervention. Three renal units were lost, all of which were in those treated surgically. Thus, of the 42 surviving patients with Type III renal trauma, 28 (67%) were successfully managed conservatively without renal loss.Conclusion This study suggests that Type III penetrating trauma may be successfully managed conservatively with a similar outcome to those patients with Type III blunt injuries. Initial surgical intervention may only be necessary in those with associated intra‐abdominal injuries or haemodynamic instability.
The value of the gonadotrophin‐releasing hormone test as a prognostic factor in infertile patients with varicocele
Authors: Atikeler K. , Yeni E. , Semercioz A. , Yalcin O. , Baydinc C. 
Published: November 2003

Objective To determine the value of the gonadotrophin‐releasing hormone (GnRH) test in selecting which infertile patients with varicocele would benefit from varicocelectomy. Patients, subjects and methods The study comprised 30 patients with varicocele who presented between November 1993 and May 1994, and 10 control subjects. The basal serum level of follicle‐stimulating hormone (FSH) and luteinizing hormone (LH) were determined and all participants given 100 μg of GnRH nasally. The levels of FSH and LH were then determined for up to 2 h. The patients then underwent varicolectomy and the response was evaluated by comparing sperm quality before and after treatment and between those with increased or normal FSH and LH levels in response to the GnRH test. Results Those patients who had increased FSH and LH levels after the GnRH test had a mean 121% increase in sperm density (P<0.001), a 23% increase in sperm motility (P<0.001) and a 40% decrease in sperm abnormality (P<0.05). The respective values for those with normal levels of FSH and LH were 15% (P<0.05), 11% (P>0.05) and 11% (P>0.05). Conclusion The GnRH test is useful for determining those patients who should benefit from varicocelectomy.
Male reproductive function in uraemia: efficacy of haemodialysis and renal transplantation
Authors: Prem A.R. , Punekar S.V. , Kalpana M. , Kelkar A.R. , Acharya V.N. 
Published: November 2003

Objective To evaluate the impact of maintenance haemodialysis and live‐related renal transplantation on the reproductive potential of men with end‐stage renal disease. Patients and methods The plasma levels of testosterone, follicle‐stimulating hormone (FSH) and luteinizing hormone (LH) were determined, and semen analysed, in 19 men (22–41 years old) with advanced uraemia after 6 months of dialysis and again 6 months after renal transplantation. Eight patients who had azoospermia or severe oligospermia underwent testicular biopsy after 6 months of dialysis and again 6 months after the transplant. Results Following dialysis, levels of testosterone were low in 17 patients and levels of LH and FSH were elevated in 15 and eight patients, respectively. Four patients each had azoospermia and severe oligospermia. The testicular tissue was hypospermatogenic in three patients, showed late‐maturation arrest in four and germ cell aplasia in one. After renal transplantation, testosterone and LH levels returned to normal in 15 and 13 patients, respectively, while FSH levels became normal in only two patients. The recovery of testosterone and LH levels after transplantation was statistically significant. Semen quality improved in 13 patients, with the improvement in sperm density and motility being statistically significant. Testicular histology revealed normal spermatogenesis in four patients, while three continued to show late‐maturation arrest. The wives of five of the transplanted patients conceived. Conclusions The impairment of testicular function seen in advanced uraemia is not reversible by maintenance haemodialysis. In contrast, after successful transplantation, steroidogenic function became almost normal while spermatogenic function showed a striking if incomplete recovery.
Antegrade endopyelotomy for pelvi‐ureteric junction obstruction in children
Authors: Rodrigues Netto Jr N. , Ikari O. , Esteves S.C. , D'Ancona C.A.L. 
Published: November 2003

Objective To compare the results of repairing pelvi‐ureteric junction (PUJ) obstruction by percutaneous endopyelotomy in children with a similar series carried out in adults. Patients and methods Nine children with primary (six) or secondary (three) PUJ obstruction were treated using a one‐stage cold‐knife percutaneous endopyelotomy. The success and morbidity rates were compared with a series of 61 adults with primary (46) or secondary (15) PUJ obstruction treated similarly. Results In children, endopyelotomy was successful in five of six with primary and two of three with secondary PUJ obstruction, with a mean follow‐up of 30 months (range 18–56). In the adults, endopyelotomy was successful in 38 of 46 (83%) with primary and 12 of 15 with secondary PUJ obstruction, an overall success rate of 82%, with a mean follow‐up of 42 months (range 9–86). There was no statistical difference in the success rates with primary and secondary endopyelotomy between adults and children (P=0.58). Failures were associated with high‐grade hydronephrosis, a stenotic segment >1.5 cm long and technical problems. Morbidity occurred in one of nine children and 3.2% of the adults. Conclusion This early experience suggests that percutaneous endopyelotomy can be performed safely and successfully in children with primary PUJ obstruction. However, in secondary stenosis, the results were less than optimal. Larger series should be analysed to form definitive conclusions on the role of endopyelotomy for the treatment of PUJ obstruction in children, given the high rate of success of open pyeloplasty and its minimal morbidity.
Management of invasive squamous cell carcinoma of the bulbomembranous male urethra with co‐ordinated chemo‐radiotherapy and genital preservation
Authors: Oberfield R.A. , Zinman L.N. , Leibenhaut M. , Girshovich L. , Silverman M.L. 
Published: November 2003

Objective To determine the success of chemo‐radiotherapy for squamous cell carcinoma (SCC) of the bulbar male urethra, an uncommon but aggressive cancer usually treated by radical deforming surgery. Patients and methods Two men, aged 42 and 49 years, with locally advanced SCC of the proximal deep urethra were treated with a modified Nigro chemo‐radiation protocol. The initial treatment was by suprapubic cystotomy urinary diversion followed by 45 Gy in 25 fractions over 5 weeks to the penis, perineum and regional lymphatics. Chemotherapy consisted of a single intravenous dose of mitomycin C (10 mg/m2 ) and an intravenous infusion of 5‐fluorouracil (1 g/m2 /day) for 96 h starting on the first day of radiation therapy and repeated 28 days later. Results Follow‐up evaluation with urethral biopsies, retrograde urethrography, computed tomography of the pelvis and cysto‐urethroscopy under anaesthesia showed no residual tumour in either patient but the development of a proximal urethral stricture at 1.5 and 4 years, respectively. Conclusion This report presents the first evidence of a successful reduction of tumour stage with the local eradication of invasive SCC and penile preservation with no recurrence of the tumour or the need to excise the urethra.
Do low molecular weight heparin and dextran increase the blood loss in transurethral resection of the prostate?
Authors: Hjertberg H. , Olsson J. , Ekström T. , Lisander B. 
Published: November 2003

Objective To evaluate whether the use of dextran or the combination of low molecular weight heparin and dextran increases the blood loss in elective transurethral resection for benign prostatic hyperplasia. Patients and methods This open randomized controlled study included 198 patients operated under spinal anaesthesia who were allocated to four groups differing in the combination of prophylactic treatment used for thrombosis and for the substitution of blood loss. The prophylactic treatment was either dalteparin sodium, continued each day until mobilization, or 3% Ringer dextran‐60 just before operation and continued with 6% dextran‐70 for 2 days post‐operatively, and the volume substitute was Ringer dextran or Ringer's acetate. Thus, the four treatments (by prophylaxis and volume substitute, respectively) were dalteparin and Ringer's acetate, dalteparin and dextran, dextran and Ringer's acetate, and dextran and dextran. The haemoglobin lost to the irrigation fluid was measured and used to calculate blood loss. Results Patients receiving dextran had a larger post‐operative and total blood loss than those who did not. The need for transfusion did not differ between the treatment groups. Conclusion The combination of dalteparin and dextran was not associated with an increased blood loss above that with dextran alone.
Urinary tract infections following laser prostatectomy: is there a need for antibiotic prophylaxis?
Authors: te Slaa E. , de Wildt M. J. A. M. , Debruyne F. M. J. , de Graaf R. , de la Rosette J. M. C. H. 
Published: November 2003

Objective To evaluate the incidence of urinary tract infections (UTIs) after transurethral laser therapy of the prostate and the need for peri‐operative antibiotics. Patients and methods One‐hundred and sixteen patients (mean age 65 years, range 51–85) with benign prostatic enlargement (BPE) were treated with a Nd:YAG laser, using either the TULIP device, the Urolase fibre or the Ultraline fibre. The incidence of voiding complaints, UTIs and the need for catheterization after treatment were assessed. The first 43 patients (Group I) received no antibiotics peri‐operatively and the next 73 patients (Group II) received co‐trimoxazole for 5 days. Results The patients treated using the TULIP device had more urinary complaints after treatment than those treated using the Ultraline and Urolase fibres. In Group I, 48% of the patients developed a UTI and in Group II the incidence of UTIs decreased to 30% after treatment. The incidence of UTIs was unrelated to the procedure performed. Although not statistically significant, peri‐operative antibiotics tended to reduce the incidence of UTIs. Prolonged catheterization was correlated with the incidence of UTI. In Group I, patients who were treated using the Ultraline procedure had their catheter removed after a mean of 24 days, compared with 21 days for those treated with the Urolase and 19 days with the TULIP device. In Group II, the patients needed catheterization for a mean of 17 days following Ultraline treatment and 16 days following the Urolase procedure. Conclusions Antibiotic prophylaxis tended to decrease the incidence of post‐treatment UTIs. However, there was no clear association between the presentation and duration of complaints and the presence of UTIs.
Long‐term follow‐up results with the Stamey operation for stress incontinence of urine
Authors: Mills R. , Persad R. , Handley Ashken M. 
Published: November 2003

Objective To assess the results of the Stamey operation for genuine stress incontinence in those patients with over 10 years of follow‐up.Patients and methods Of 46 patients who had undergone a Stamey procedure and had a follow‐up of over 10 years, 30 were willing to attend for a clinical review and pad testing.Results Of the 30 patients assessed, 20 were initially cured, a further eight were significantly improved and two were no better. At 10 years, the number totally dry had fallen to 10, but a further 15 were still symptomatically improved. Only three that had shown some initial benefit were subjectively no better than before the operation.Conclusion There appears to be a continuous decline in the cure rate with time from the Stamey procedure. However, most patients maintain some lasting benefit.
Post‐surgical recurrent varicocele: efficacy of internal spermatic venography and steel‐coil embolization
Authors: Punekar S.V. , Prem A.R. , Ridhorkar V.R. , Deshmukh H.L. , Kelkar A.R. 
Published: November 2003

Objective To delineate the venographic anatomy of the varicoceles which recur following conventional inguinal varicocele ligation and to determine the therapeutic efficacy of steel‐coil embolization as assessed by improvements in seminal parameters and paternity.Patients and methods Thirty‐nine patients with post‐surgical recurrent varicoceles underwent bilateral internal spermatic venography approached through the right femoral vein. The collateral venous channels were identified and occluded using appropriate sizes of steel coils.Results The procedure was technically successful in 33 patients (85%). Analysis of the 33 venograms showed a unilateral left‐sided recurrent varicocele in 28 patients (85%) and bilateral recurrent varicoceles in five patients (15%). The mid and lower parallel collateral channels were observed in 27 patients (82%). The recurrences were treated easily with stainless steel‐coil embolization. Five patients were lost to follow‐up. Of the remaining 28 patients the sperm count and motility became normal in 16 (57%); only the motility improved in three patients (10%) while in nine patients (33%) there were no changes in either of the seminal parameters. Five patients achieved paternity.Conclusions Internal spermatic venography allowed a precise anatomical definition of the recurrent varicocele and the use of steel‐coil embolization provided satisfactory improvements in sperm quality and paternity.
Comparison of anti‐desmin and anti‐actin staining for the computerized analysis of cavernous smooth muscle density
Authors: Sattar A. A. , Haot J. , Schulman C. C. , Wespes E. 
Published: November 2003

Objective To compare the staining properties of anti‐desmin and anti‐actin in cavernous biopsies and thus determine the optimal antibody for quantifying intracavernous smooth muscle content in the evaluation of erectile dysfunction. Patients and methods Twenty‐two penile biopsies were taken from five normal potent patients, seven with venous leak and 10 with arterial disease, with mean ages of 34.4, 48.8 and 54.8 years, respectively. Biopsies were sectioned and successive sections stained immunohistochemically with antibodies for actin or desmin. Image analysis was used to quantify the proportion of smooth muscle fibres in the cavernous tissue. Results There was a significant difference (P=0.0001) between the mean percentage of cavernous smooth muscle fibres in normal potent men, stained with anti‐desmin (38.5%,sd 3.2) or anti‐actin (45.2%, sd 3.2) and that in the venous group (anti‐desmin 27.4%, sd 4.0%; anti‐actin 34.2%, sd 5.3%) or the arteriogenic group (anti‐desmin 23.7%, sd 4.4, anti‐actin 28.9%, sd 4.9). There was no significant difference in the estimates with either staining method between the venogenic and arteriogenic patients. There was a direct relationship between the cavernous smooth muscle density estimated by anti‐desmin and anti‐actin staining (r=0.96). Conclusion The anti‐actin and anti‐desmin staining methods gave equivalent results for discriminating between normal and impotent patients on the basis of the percentage of cavernous muscle fibres. However, anti‐actin staining tended to be more sensitive than anti‐desmin.