bluuebunny/crossref_metadata_2025_split huggingface dataset:
The pathogenesis of cryptorchidism and splenogonadal fusion: a new hypothesis
Authors: Cortes D. , Thorup J.M. , Visfeldt J. 
Published: November 2003

Objective To obtain new information about the pathogenesis of cryptorchidism. Materials and methods Published reports of 111 males with splenogonadal fusion were examined and the presence and type of cryptorchidism and the degree of continuity between the spleen and gonads determined. Results Of the 111 cases, 31% had cryptorchidism and of these 59% were bilaterally cryptorchid; 26% and 65% had right and left intra‐abdominal testes, respectively. Of those with continuous splenogonadal fusion, 44% had cryptorchidism. Solely cryptorchid cases with splenogonadal fusion had reported bilateral absence of both legs, imperforate anus, spina bifida, diaphragmatic hernia and hypospadias. Conclusion An hypothesis is proposed that the abnormal development of the diaphragmatic ligaments of the testes may lead to lack of their involution, with consequent cryptorchidism. In the case of splenogonadal fusion, the abnormal ligaments are colonized by splenic cells, possibly because of an abnormal proximity to the splenic anlage, with the resulting abnormal ligament persisting as the splenic cord and thus resulting in cryptorchidism. The basic abnormality may be in the connections of the diaphragmatic ligaments, caused by abnormal midline development in the third to fourth week of gestation.
The role of pentoxifylline in the treatment of erectile dysfunction due to borderline arterial insufficiency
Authors: Peşkirciogˇlu L. , Karabulut A. , Deniz I.E. , Germiyanogˇlu C. , Erol D. 
Published: November 2003

Objective To investigate the effects of pentoxifylline on penile blood flow and potency in patients with erectile dysfunction due to borderline arterial insufficiency.Patients and methods Following a routine diagnostic evaluation, 36 patients with borderline arterial disease diagnosed using penile duplex ultrasonography were included in the study. Of these patients, 20 (mean age 54 years, range 40–66) received 1.2 g of pentoxifylline daily, divided into three doses orally, for 2 months and 16 (mean age 54 years, range 34–65) received a placebo. Peak systolic velocities (PSVs) before and after the treatment were compared with those in patients receiving a placebo. The clinical improvement in erectile function was also evaluated.Results Twelve of 20 patients receiving pentoxifylline had an increase in PSV at the end of the treatment period. The mean change in PSV achieved by pentoxifylline treatment (6.25 cm/s) was significantly higher than that achieved by the placebo (0.38 cm/s). Seven patients had a positive response (successful coitus achieved after treatment with pentoxifylline). No serious side‐effects occurred.Conclusion Pentoxifylline was well tolerated and could increase penile arterial inflow, shown objectively as an increase in PSV on penile duplex ultrasonography. These findings should encourage further studies of the efficacy of pentoxifylline in the treatment of impotence.
The use of RT‐PCR for prostate‐specific antigen assay to predict potential surgical failures before radical prostatectomy: molecular staging of prostate cancer
Authors: Olsson C.A. , de Vries G.M. , Benson M.C. , Raffo A. , Buttyan R. , Cama C. , O'Toole K. , Katz A.E. 
Published: November 2003

Objective To assess the potential role of a recently developed reverse transcriptase‐polymerase chain reaction (RT‐PCR) assay for prostate‐specific antigen (PSA), that detects circulating prostate cells in patients with prostate cancer, in the management of clinically localized cancer. Patients and methods A total of 138 men (mean age 62.5 years, range 49–70) scheduled for radical retropubic prostatectomy had an RT‐PCR assay before surgery. The results were compared with the final pathological stage of disease, the results from local imaging techniques, serum PSA levels, digital rectal examination (DRE) and Gleason score. Results Enhanced RT‐PCR for PSA was the best predictor of potential surgical failures; 70% of patients with positive surgical margins or invasion into the seminal vesicle were identified pre‐operatively by a positive RT‐PCR assay (odds ratio=12.0, positive predictive value=64%, negative predictive value=87%). RTPCR was able to identify pre‐operatively patients with adverse pathology, despite low serum PSA values (<4.0 ng/mL). In patients with high PSA level (>10 ng/mL), RT‐PCR discriminated between potentially curable candidates and those with established extraprostatic disease. Conclusions RT‐PCR for PSA adds unique prognostic information when considering patients for radical surgery. The final role for the RT‐PCR assay is as yet undefined; however, the ability to detect potential surgical failures pre‐operatively using a molecular approach should have a significant impact on the management of patients with prostate cancer.
The ICS–‘BPH’ Study: the psychometric validity and reliability of the ICSmale questionnaire
Authors: Donovan J.L. , Abrams P. , Peters T.J. , Kay H.E. , Reynard J. , Chapple C. , de la Rosette J.M.C.H. , Kondo A. 
Published: November 2003

Objective To assess the validity and reliability of the ICSmale questionnaire developed for the International Continence Society‐'Benign Prostatic Hyperplasia' (ICS–'BPH') study.Patients and methods Urology departments in 12 countries recruited 1271 consecutive men >45 years old, with lower urinary tract symptoms and possible benign prostatic obstruction, to the ICS–'BPH' study (the clinical group); 423 ambulent men were recruited from a general practice in the UK to provide a community group. Each individual was asked to complete the wide‐ranging ICSmale questionnaire, comprising questions concerned with urinary symptoms, the bother they cause, and issues of quality of life and sexual function. Content, construct and criterion validity of the symptom and problem questions were assessed by interviews with patients and urologists, testing hypotheses within sub‐studies, and in relation to frequency‐volume diaries and uroflowmetry. Reliability was assessed by measures of internal consistency and a test‐retest analysis.Results The ICSmale questionnaire was easy to complete. It was clearly able to differentiate between men in clinical and community populations, and detected the expected positive age gradient for most symptoms in the community group. There was reasonable agreement between relevant parts of the questionnaire and frequency‐volume charts when a relatively flexible approach was taken, but there was a very poor relationship between questions assessing strength of stream and the results of uroflowmetry. Internal consistency was high, and overall the questionnaire demonstrated good test‐retest reliability.Conclusion The self‐completed ICSmale questionnaire had high levels of psychometric validity and reliability.
Retroperitoneal surgery: its wider role in the management of malignant teratoma
Authors: Hollins G.W. , Thomas S. , Lanigan D.J. , Dahar N. , Jodrell D. , Kaye S.B. , Kirk D. 
Published: November 2003

Objective To review the results of the use of laparotomy to excise retroperitoneal metastases in patients with malignant teratoma of the testis.Patients and methods The results of surgery for retroperitoneal teratoma metastases in 37 patients during the 5‐year period from 1988 to 1993 were reviewed. Information on sexual dysfunction was obtained using a postal questionnaire.Results Patients were divided into three groups: the first comprised 28 patients who underwent elective surgery (excision of residual disease) after platinum and bleomycin‐based chemotherapy. The second group comprised four patients who underwent interventional surgery to excise disease not responding to treatment, after which they completed chemotherapy. The third group comprised five patients who underwent surgery for relapsed disease; two had suffered an early and three a late relapse. Overall, 34 patients are alive, four are considered to have residual disease and two have recently undergone re‐operation.Conclusions In addition to removing residual disease after primary chemotherapy, surgery has a wider role in the management of metastatic teratoma. Carefully timed interventional surgery for disease not responding to chemotherapy can be lifesaving. Surgery for early relapse should be preceded by chemotherapy but surgery alone is appropriate where relapse occurs several years after primary treatment, although raised levels of tumour markers or extensive recurrence might be an indication for preliminary chemotherapy.
The continence control pad—a new external urethral occlusion device in the management of stress incontinence
Authors: Eckford S.D. , Jackson S.R. , Lewis P.A. , Abrams P. 
Published: November 2003

Objective To assess the use of an external urethral occlusion pad (the continence control pad, CCP) in the management of stress incontinence.Patients and methods Nineteen women (median age 47 years, range 36–72) complaining of stress incontinence were taught to use the CCP. The patients were assessed during the week before, and again after using the CCPs for 2 weeks, by urinary diaries, pad‐tests and a review of their symptoms.Results Use of the CCP was associated with a cure or improvement in 17 women, as assessed by the number of incontinent episodes per week. There was a significant decrease in both the number of incontinent episodes (P<0.001) and pad‐test leakage (P=0.002) when using the CCP. Minor difficulties in placement and removal were described in a minority of women.Conclusion The CCP offers a simple, non‐invasive treatment for women complaining of stress incontinence. The short‐term success rate was better than that with other conservative methods of treatment, is independent of the general practitioner and safe. It is a promising home‐based method of managing stress incontinence.
Glycine 1.0%versus glycine 1.5% as irrigating fluid during transurethral resection of the prostate
Authors: Hahn R G. , Shemais H. , Essén P. 
Published: November 2003

Objective To evaluate the potential benefits of reducing the glycine concentration from 1.5% to 1.0% in the irrigating fluid used during transurethral resection of the prostate (TURP) when 1% ethanol is used as the tracer of absorption. Patients and methods The effect of 1% ethanol on the tendency for blood to haemolyse was tested in vitro and the optical condition of the irrigating fluids were studied during 10 TURPs. The breath ethanol level was monitored during 423 operations where these fluids were used in a randomized double‐blind study. The incidence of 13 symptoms was recorded in the 77 patients who absorbed irrigating fluid. Results Ethanol slightly lowered the tendency for blood to haemolyse. Reducing the glycine concentration did not alter the optical conditions during TURP. The incidence of symptoms increased significantly as more glycine solution was absorbed, arterial hypotension and nausea being the most usual. Bradycardia, prickling skin sensations and feelings of uneasiness were less common when 1.0% glycine was used, but the choice of irrigating fluid had no effect on the total incidence of symptoms. Conclusion We found no clear advantage in lowering the glycine concentration of the irrigating fluid used during TURP.
Severe cystitis associated with tiaprofenic acid
Authors: CRAWFORD M.L.A. , WALLER P.C. , WOOD S.M. 
Published: November 2003

Objective To review the UK spontaneous reports of urinary disorders associated with tiaprofenic acid and other non‐steroidal anti‐inflammatory drugs (NSAIDs) and put them into context of the usage of these preparations in the UK.Methods Suspected adverse drug reaction (ADR) reports of urinary disorders associated with tiaprofenic acid and other NSAIDs received by the UKs spontaneous ADR reporting scheme were analysed.Results Between 1982, when tiaprofenic acid was introduced in the UK, and August 1994, 69 cases of cystitis were reported, with a further 32 reports describing related urinary symptoms including frequency, dysuria and haematuria. Only eight cases of cystitis were reported for all other NSAIDs. The duration of treatment with tiaprofenic acid before the onset of urinary symptoms varied markedly (range 2 days to >3 years). In patients in whom a drug‐induced cause was suspected and the drug was stopped promptly, recovery usually occurred within weeks. However, many patients continued on long‐term treatment with tiaprofenic acid and underwent extensive investigations to determine the cause of their urinary symptoms. On cystoscopy and biopsy, the findings were similar to interstitial cystitis. Most patients with chronic cystitis recovered after withdrawal of tiaprofenic acid, but some patients had surgery before the drug was stopped.Conclusion Tiaprofenic acid can cause severe cystitis. These reports highlight the importance of taking a full drug history in patients with unexplained chronic cystitis. Tiaprofenic acid should be stopped immediately in all patients developing urinary symptoms.
Intra‐operative autotransfusion in radical cystectomy
Authors: PARK K.I. , KOJIMA O. , TOMOYOSHI T. 
Published: November 2003

Objective To assess the feasibility of intra‐operative autotransfusion (IAT) as a method of decreasing or avoiding homologous blood transfusion during radical cystectomy.Patients and methods IAT was performed in 10 patients with bladder cancer who underwent radical cystectomy. The patients were divided into two groups: group 1 consisted of six patients without and group 2 of four patients with pre‐deposited blood. Blood shed in the operative field was collected and processed with an IAT device.Results In group 1, the intra‐operative blood loss ranged from 1.08 to 2.67 L (mean 1.82) and homologous blood transfusion ranged from 0 to 1 L (mean 0.47). The amount of autologous blood processed and transfused by the IAT device ranged from 0.38 to 0.98 L (mean 0.64). Two patients did not require homologous blood transfusion. In group 2, the volume of pre‐deposited blood ranged from 0.8 to 1.2 L (mean 0.9). The intra‐operative blood loss ranged from 1.03 to 3.24 L (mean 1.8). The amount of processed autologous blood transfused ranged from 0.4 to 0.6 L (mean 0.45). None of the patients in group 2 required homologous blood transfusion.Conclusion Although there are theoretical risks with IAT, they were not substantiated by the clinical data. IAT seems to be a feasible method of reducing or avoiding homologous blood transfusion in radical cystectomy. These results suggest that IAT in combination with pre‐deposited blood will abolish the need for homologous blood transfusion during radical cystectomy.
Does vasectomy predispose to osteoporosis?
Authors: BYRNE P.A.C. , EVANS W.D. , RAJAN K.T. 
Published: November 2003

Objective To investigate whether vasectomy, which causes immunological and histological changes to the testes and changes to the hypothalamo‐pituitary axis, could influence bone mineral density (BMD) and predispose to osteoporosis.Patients and methods From patients referred to the Bone Densitometry Clinic, the BMD of L1–L4 and of the hip was analysed in 25 vasectomized men and compared with that in age‐matched controls, ensuring that both groups had no secondary causes which might predispose to osteoporosis.Results In the spine, the mean (standard deviation) BMD was 1.00 (0.19) g/cm2 for the vasectomized men and 0.96 (0.14) g/cm2 for the controls. In the hip (femoral neck and total, respectively) the means were 0.79 g/cm2 and 0.90 g/cm2 for the vasectomized men and 0.72 g/cm2 and 0.96 g/cm2 for the controls. None of the differences were statistically significant.Conclusion This study does not support the hypothesis that vasectomy may be a risk factor for osteoporosis.
Acute epididymitis in boys: are antibiotics indicated?
Authors: LAU P. , ANDERSON P.A. , GIACOMANTONIO J.M. , SCHWARZ R.D. 
Published: November 2003

Objectives To report the results of using supportive therapy only, rather than antibiotics, in managing boys with acute sterile epididymitis.Patients and methodsFrom 1991 to 1995, 48 boys presented with acute epididymitis. The diagnosis was confirmed by radionuclide scan in 43 cases, ultrasonography in one, surgical exploration in one and physical examination in three. Urine was collected for microscopy and culture; if pyuria was detected, antibiotics were prescribed. If the urine analysis was normal, the patient was advised to minimize physical activity and analgesics were prescribed.ResultsOf the 48 boys, five (10%) had pyuria; seven patients with either no urine tested or negative urine culture were given antibiotics. The remaining 36 were managed with supportive therapy only. The mean follow‐up was 87 days (with three patients lost to follow‐up). No boys showed any evidence of testicular atrophy or other complications.ConclusionOnly a minority of boys with acute epididymitis, as defined by increased flow on radionuclide scanning of the scrotum, have a bacterial aetiology. For those without pyuria or positive urine culture, the condition is self‐limiting and does not lead to testicular atrophy. We recommend that for boys with acute epididymitis who have no urinary abnormalities, antibiotics are not indicated. The aetiology of acute sterile epididymitis in boys remains obscure.
Urodynamic investigations in reversed ileal seromuscular enterocystoplasty: an experimental study in a rabbit model
Authors: CELAYIR S. , BÜYÜKÜNAL S.N.C. , KILIÇ N. , DERVISOGLU S. 
Published: November 2003

Objective To investigate the efficacy of the reversed ileal seromuscular enterocystoplasty (RISMEC) technique and assess the urodynamic findings.Materials and method A large bladder defect was created in 12 New Zealand White rabbits; in six the bladder was closed primarily (control group) and in the remaining six the bladder was augmented using the RISMEC technique combined with omentoplasty. The results were assessed using intravenous pyelography (IVP), voiding cysto‐urethrography (VCUG), histopathological investigations and urodynamic studies after 4 and 12 weeks.Results The IVP and VCUG revealed an apparently normal urinary system and voiding pattern in both groups. Histopathologically, in all rabbits undergoing RISMEC, the serosal surface of the reversed ileum was lined with transitional urinary epithelium; there was no evidence of severe fibrosis, inflammation, stone or mucus production. Urodynamic studies showed a significant decrease in the mean bladder capacity in the controls, but no significant change in the RISMEC group. The mean bladder compliance decreased from 5.85 to 1.36 mL/cmH2O in the controls (P<0.02) but there was no significant decrease in compliance in the RISMEC group.Conclusion The results suggest that in this rabbit model, the RISMEC technique combined with omentoplasty increases bladder capacity with minimal graft shrinkage; the peritoneal surface is rapidly covered with transitional epithelium and the integrity of the kidneys preserved. Urodynamic investigations showed neobladders with adequate storage capacity, low intravesical pressures and improved compliance rates.
Use of patient‐controlled analgesia in extracorporeal shockwave lithotripsy
Authors: CHIN C.M. , TAY K.P. , NG F.C. , LIM P.H.C. , CHNG H.C. 
Published: November 2003

Objective To assess the advantages of patient‐controlled analgesia (PCA) in patients undergoing extracorporeal shockwave lithotripsy (ESWL) for urinary stones.Patients and methods Between December 1995 and May 1996, a prospective study was carried out on 100 patients who underwent ESWL for urinary stones. The patients were assigned to two equal groups, one receiving PCA and the other pethidine (control). Patients in the PCA group self‐administered varying doses of intravenous alfentanil according to their pain tolerance, while those in the control group were given a single bolus dose of 1 mg/kg body weight intravenous pethidine by the attending urologist before the start of the procedure. The stone site, maximum energy level achieved, number of shock waves given, duration of procedure, pain scores, patient tolerance and acceptance were recorded to assess the efficacy of PCA compared with analgesia controlled by the physician.Results Both groups were matched for age, body weight, stone location and number of shocks given. The PCA group received a mean of 1.03 mg alfentanil while the control group received a mean of 62.5 mg pethidine. The maximum discharge voltage of 16 kV was achieved in all but one patient (98%) in the PCA group whereas only 21 patients (42%) in the control group attained this level. The mean treatment duration was less in the PCA group (32.8 min) than in the control group (44.5 min), the mean pain score lower (3.76 and 4.62, respectively) and the incidence of nausea and vomiting much less (22% and 60%, respectively). In addition, all 21 patients in the PCA group who had received intravenous pethidine during previous sessions of ESWL chose PCA as the better form of analgesia. There were no adverse effects in the PCA group except for one patient whose arterial oxygen saturation decreased transiently.Conclusion PCA enables the urologist to achieve better patient compliance through better pain control; its application has maximized the use of lithotripsy and the patients’ acceptability for this form of analgesia is confirmed. We recommend that this form of analgesia be used for ESWL.
Evaluation by magnetic resonance imaging of the inferior vena cava in patients with non‐seminomatous germ cell tumours of the testis metastatic to the retroperitoneum
Authors: NG C.S. , HUSBAND J.E.S. , PADHANI A.R. , LONG M.A. , HORWICH A. , HENDRY W.F. , DEARNALEY D.P. 
Published: November 2003

Objective To assess the role of magnetic resonance imaging (MRI) and magnetic resonance angiography (MRA) in evaluating suspected occlusion of the inferior vena cava (IVC) in patients with abdominal nodal metastases from non‐seminomatous germ cell tumours, thus giving information that may be helpful in planning surgery and for determining the need for anticoagulant therapy.Patients and methods Five patients with abdominal nodal metastases in whom occlusion of the IVC was suspected on computed tomography (CT) were imaged using a 1.5 T MRI scanner. The MRI findings were compared with those from CT.Results The MR images successfully and clearly detected partial and total occlusions of the IVC by both intraluminal thrombus and extrinsic compression. The technique also clearly detected extensive collateral venous circulation in several cases and in one a cavernous transformation of the IVC. In all patients, the MRI studies provided better information than that from CT.Conclusion MRI, and particularly MRA, is a comparatively new technique that is non‐invasive and offers the potential of evaluating vascular structures with no need for ionizing radiation or contrast media. This technique, if available, should be chosen for imaging the IVC in patients suspected of having compression or occlusion of the IVC.