bluuebunny/crossref_metadata_2025_split huggingface dataset:
Nephrogenic adenoma — a study with special reference to clinical presentation
Authors: PEEKER R. , ALDENBORG F. , FALL M. 
Published: November 2003

Objective To obtain information on the presenting symptoms, location, sex distribution, age, endoscopic appearance, histopathology, suitable treatment and recurrence of nephrogenic adenoma, a rare, benign lesion of the urinary tract mucosa.Patients and methods The records of 31 patients with nephrogenic adenoma diagnosed at the Sahlgrenska University Hospital between 1980 and 1996 were reviewed to determine the symptomatology, imaging investigations, endoscopic presentation, clinical outcome after resection and the frequency of recurrence.Results The lesions were found in the urinary bladder, bulbar urethra, urethral diverticula and the prostatic urethra. Eight patients presented with haematuria, 13 complained of urinary frequency and bladder pain and in 12 patients without subjective symptoms from the urinary tract, the lesion was found accidentally. Twenty‐seven of the patients had a history of previous urothelial trauma, either by instrumentation or inflammation. Seventeen of the lesions were polypoid at endoscopy, the remainder being flat except for two cases, in which they were not noted because they were concealed in another lesion to be resected. Seven patients had one or more recurrences. All patients with symptoms responded well to transurethral resection.Conclusion Nephrogenic adenoma mimics tumour or chronic cystitis and it is rarely suspected on clinical grounds; instead, the diagnosis is almost always histological. This study supports the view that nephrogenic adenoma may represent a metaplastic response to trauma of the urothelium and that transurethral resection provides a good method of relieving the symptoms in symptomatic nephrogenic adenoma.
Willingness to pay for reduced incontinence symptoms
Authors: JOHANNESSON M. , O’CONOR R.M. , KOBELT‐NGUYEN G. , MATTIASSON A. 
Published: November 2003

Objective To measure the willingness to pay for a reduction in the number of micturitions and urinary leakages for patients with urge incontinence.Patients and methods A self‐administered questionnaire with a binary willingness‐to‐pay question was administered to 541 patients in Sweden with urge or mixed incontinence; 461 questionnaires were returned. The reduction in micturitions and urinary leakages valued in the willingness‐to‐pay question was varied randomly between 25% and 50% in two different subsamples. Information was also collected about the number of micturitions and urinary leakages, health‐related quality of life and socio‐economic characteristics of the patients in the study.Results Quality of life was significantly related to the severity of the symptoms and was worse than that of the sex‐ and age‐matched general Swedish population. The median (mean) willingness to pay per month was 240 (530) Swedish krona (SEK, £1=SEK 11.50) for a 25% reduction in micturitions and leakages and SEK 470 (1030) for a 50% reduction in micturitions and leakages. As hypothesized, the willingness to pay was significantly related to the size of the reduction in micturitions and leakages, the initial number of micturitions and leakages, and income.Conclusions Patients with incontinence problems are willing to pay substantial amounts for a reduction in the number of micturitions and leakages.
Tumour progression and survival in patients with T1G3 bladder tumours: 15‐year outcome
Authors: HERR H.W. 
Published: November 2003

Objective To evaluate tumour progression and survival of patients with T1G3 bladder tumours who were followed for 15 years.Patients and methods A subset of 48 patients with T1G3 bladder tumours was entered into a randomized trial of transurethral resection (TUR) or TUR plus bacille Calmette‐Guèrin (BCG) therapy and followed for a minimum of 15 years. Thirty‐nine (81%) patients received one or more courses of BCG. The endpoints of the study were stage progression (defined as muscle invasion or metastasis) and disease‐specific survival.Results Of the 48 patients, 25 (52%) progressed and 15 (31%) died from the disease; 33 patients (69%) survived, including 24 (50%) with an intact bladder. The median progression‐free survival time was 151 months. Tumour progression occurred in 35% of the patients within the first 5 years, in 16% after 5–10 years and in 12% of those followed for 10–15 years. Deaths from cancer occurred in 25% of the patients in the first 5 years and in 10% of patients at risk from 5 to 15 years.Conclusions Patients with T1G3 bladder tumours who are treated conservatively are at life‐long risk of having a muscle‐invasive tumour and dying from bladder cancer.
The influence of colonic enema irrigation on urodynamic findings in patients with neurogenic bladder dysfunction
Authors: De KORT L.M.O. , NESSELAAR C.H. , VAN GOOL J.D. , De JONG T.P.V.M. 
Published: November 2003

Objective To evaluate whether colonic enema irrigation influences the urodynamic characteristics of patients with spina bifida, an overactive bladder and detrusor sphincter dyssynergia (DSD).Patients and methods Since 1991, 83 patients with spina bifida at our institution have treated their bowel dysfunction by colonic irrigation every 24–48 h. In 12 patients (seven boys and five girls, mean age 7.7 years, range 0.7–13.8) with an overactive bladder and DSD, urodynamic studies of the bladder before and after enema treatment were available with no intercurrent changes in urological therapy.Results There were no significant changes overall in bladder capacity, leak‐point pressure, bladder compliance and bladder instability in the selected group of children.Conclusion Although enema therapy for bowel treatment in patients with spina bifida gave good results for faecal incontinence, with good patient compliance, no favourable effect on bladder function should be expected in most patients with a high‐risk urinary tract dysfunction. Further study is needed to determine factors in patients who will benefit urologically from enema treatment.
Construction and validation of a short‐form benign prostatic hypertrophy health‐related quality‐of‐life questionnaire
Authors: LUKACS B. , COMET D. , GRANGE J.C. , THIBAULT P. ,   the BPH group in General Practice
Published: November 2003

Objective To construct and validate a short‐form benign prostatic hypertrophy (BPH) health‐related quality‐of‐life (HRQL) questionnaire which is more practical in use and as informative as the 20‐item visual analogue scale questionnaire (QOL20) previously validated in French.Patients and methods From the factorial structure of the QOL20, a nine‐item questionnaire (QOL9) was constructed using stepwise linear regression and factorial analysis. The feasibility and reliability of the QOL9 were analysed in a cross‐sectional case‐control study and a longitudinal cohort study, including symptomatic patients with BPH treated for 6 months with an &agr;1‐blocker (alfuzosin).Results The reduction of the QOL20 to QOL9 showed a minimal loss of information (90–95% of the variance of QOL20 was explained by QOL9) and lead to a three‐dimensional structure: well being, patients’ perceived sexual‐life status, and BPH interference with activities. The QOL9 was practical in use (completion rate 87–100%; duration of completion at inclusion 11.6, sd 2.0 min), consistent (Cronbach’s alpha>0.7), reliable (intraclass correlation coefficient >0.80) and responsive (effect‐size index 0.9, sd 0.01 in the longitudinal study).Conclusions The QOL9 is a good BPH HRQL questionnaire, including an assessment of patients’ perceived sexual‐life status; it easy to administer, accurate, reproducible and responsive to change with treatment. We suggest that the QOL9 be substituted for the QOL20 and administered in addition to the International Prostate Symptom Score to obtain a better assessment of the patients’ perception of their disease.
Prognostic implications of cytogenetic findings
Authors: ELFVING P. , MANDAHL N. , LUNDGREN R. , LIMON J. , BAK‐JENSEN E. , FERNÖ M. , OLSSON H. , MITELMAN F. 
Published: November 2003

Objective To evaluate the prognostic impact of cytogenetic findings in renal cell carcinoma (RCC).Patients and methods Tumour cytogenetics, histomorphology, DNA ploidy and S‐phase fraction, stage, size, and grade were related to survival in 50 consecutive patients with RCC. The mean follow‐up was 3.9 years (median 4.2, range 0–8.8).Results The predictive probability for recurrence‐free survival at 5 years (5‐year RFS) for all 50 patients was 0.54. There was a significant association between the degree of cytogenetic complexity and survival, in that patients with five or less aberrations had a better prognosis than those with more than five changes (5‐year RFS 0.71 and 0.43, respectively; P<0.05). Patients with del(8p)/‐8, +12, and +20 had a significantly worse prognosis compared with those without these aberrations. Of the well‐known prognostic variables grade and stage, the former was far better for predicting prognosis. A Spearman correlation test showed a significant covariation of grade with the S‐phase fraction, T‐stage, and cytogenetic complexity.Conclusion The degree of cytogenetic complexity and recurrent cytogenetic abnormalities affect the prognosis in RCC, although grade was the most reliable independent prognostic factor predicting disease recurrence.
Acute suppression of idiopathic detrusor instability with magnetic stimulation of the sacral nerve roots
Authors: McFARLANE J.P. , FOLEY S.J. , DE WINTER P. , SHAH P.J.R. , CRAGGS M.D. 
Published: November 2003

Objective To assess the effect of magnetic stimulation of the S3 nerve root on unstable contractions in patients with idiopathic detrusor instability.Patients and methods Twelve patients with idiopathic instability were studied. The S3 nerve root was localized by mapping the response of the toe flexor muscles and anal sphincter to magnetic stimulation at different sites. Unstable contractions were provoked by rapidly infusing saline into the bladder and the effect of magnetic stimulation of S3 on contractions was assessed.Results Magnetic stimulation relieved the sensation of urinary urgency and reduced the duration and amplitude of provoked contractions in all patients. Stimulation reduced the area under the pressure/time curve by 80–98%. In some patients there was a short‐lived residual suppressive effect lasting up to 90 s.Conclusions Magnetic stimulation of S3 acutely abolishes unstable contractions in patients with idiopathic detrusor instability.
A randomized controlled trial evaluating the use of sterile water as an irrigation fluid during transurethral electrovaporization of the prostate
Authors: GRUNDY P.L. , BUDD D.W.G. , ENGLAND R. 
Published: November 2003

Objective To compare the safety of sterile water and glycine when used as bladder irrigation during transurethral electrovaporization of the prostate (TUVP) in a randomized controlled trial.Patients and methods The study comprised 50 consecutive patients admitted for transurethral prostatic surgery who were randomly allocated to receive bladder irrigation with either sterile water or 1.5% glycine during TUVP. After surgery, serum electrolytes and the presence of free plasma haemoglobin (suggesting haemolysis) were determined and the patients observed for clinical evidence of the transurethral resection (TUR) syndrome.Results There was no significant difference in the level of free plasma haemoglobin between the groups and no difference in serum sodium levels. None of the patients developed any signs of the TUR syndrome.Conclusions Water is a safe irrigant for use during TUVP and has several advantages over 1.5% glycine.
Interstitial photodynamic therapy in the canine prostate
Authors: LEE L.K. , WHITEHURST C. , CHEN Q. , PANTELIDES M.L. , HETZEL F.W. , MOORE J.V. 
Published: November 2003

Objective To determine the depth of tissue destruction and the minimum light dose required for necrosis in interstitial photodynamic therapy (PDT), as a prerequisite for the investigational therapy of patients.Materials and methods Seven adult beagle dogs were given 2 mg/kg of the photosensitizer Photofrin™ intravenously and two controls received none. After 24 h, 450 J/cm of 630 nm wavelength laser light was delivered interstitially to the prostate via a 2 cm long diffuser fibre. Seven single‐fibre treatments were performed in five sensitized dogs and two single‐fibre treatments in the controls. The two remaining sensitized dogs had two fibres placed 10 mm apart within the prostate to determine the coalescence of PDT lesions. The penetration depth of light was measured in all prostates, and after PDT the extent of necrosis was assessed histologically.Results The mean (standard deviation, sd) radius of PDT destruction around each diffuser was 5.3 (1.4) mm and PDT lesions overlapped in prostates treated with two fibres placed 10 mm apart. There was no observable tissue damage in the controls. The mean (sd) minimum light dose required for PDT necrosis was 84 (64) J/cm2 . Differences among animals in the light penetration depth were small, with a mean of 2.14 (0.2) mm, and did not correlate with the depth of necrosis (P=0.07). Bleeding around the optical diffuser fibre impeded light penetration.Conclusion Interstitial PDT in the canine prostate using Photofrin™ produced modest volumes of tissue necrosis. The minimum light dose required to induce necrosis was variable because bleeding was unpredictable in relation to the optical fibre.
Using the ICSQoL to measure the impact of lower urinary tract symptoms on quality of life: evidence from the ICS–‘BPH’ study
Authors: DONOVAN J.L. , KAY H.E. , PETERS T.J. , ABRAMS P. , COAST J. , MATOS‐FERREIRA A. , RENTZHOG L. , BOSCH J.L.H.R. , NORDLING J. , GAJEWSKI J. B. , BARBALIAS G. , SCHICK E. , MENDES SILVA M. , NISSENKORN I. , DE LA ROSETTE J. J. M. C. H. ,   the ICS‐‘BPH’ Study Group
Published: November 2003

Objective To present and describe the validity and reliability of the International Continence Society–Benign Prostatic Hyperplasia study quality‐of‐life (ICSQoL) instrument, a new set of questions to assess the impact of lower urinary tract symptoms (LUTS) on quality of life (QoL) in middle‐aged and elderly men.Patients and methods The study comprised 1271 consecutive men over the age of 45 years, attending urology departments in 12 countries, with LUTS and possible benign prostatic obstruction who were recruited to the ICS‐‘BPH’ study (the clinic group); 423 ambulant men were recruited from a general practice in the UK to provide a community group. Each individual completed the ICS‐‘BPH’ study questionnaire which includes six items addressing general and specific aspects of QoL (the ICSQoL). Content and construct validity were assessed by interviews with patients and by testing hypotheses within the study groups, e.g. the relationships with age, individual LUTS (as measured on the ICSmale questionnaire) and generic health status, as measured by the Short Form (SF‐36) and EuroQol instruments. Reliability was assessed by measures of internal consistency and a test‐retest analysis.Results The ICSQoL items were easily understood by patients, were completed with low levels of missing data, and address some (but not all) concerns about the impact of LUTS on QoL. The ICSQoL items have good construct validity, showing expected differences between community and clinic samples, and expected relationships with each other and individual LUTS. Items had good test‐retest reliability, but their internal consistency was poor, confirming that ICSQoL questions should not be combined into a score. General ICSQoL items were closely related with most domains of the SF‐36 and the EuroQol.Conclusion ICSQoL items may be used individually or as a group in research studies or in clinical practice.
Effects of biodegradable self‐reinforced polyglycolic acid, poly‐dl‐lactic acid and stainless‐steel spiral stents on uroepithelium after Nd:YAG laser irradiation of the canine prostate
Authors: PÉTAS A. , KÄRKKÄINEN P. , TALJA M. , TAARI K. , LAATO M. , VÄLIMAA T. , TÖRMÄLÄ P. 
Published: November 2003

Objective To evaluate the safety and tissue effects on canine uroepithelium and prostate of biodegradable self‐reinforced polyglycolic acid (SR‐PGA) and self‐reinforced poly‐dl‐lactic acid (SR‐PLA) spiral stents compared to stainless‐steel (SS) spiral stents.Material and methods Twenty‐five dogs (median body weight 12 kg) underwent a one‐stage midline laparotomy and cystotomy. A side‐firing Nd:YAG laser fibre was placed in the prostatic urethra antegradely and laser power applied at a setting of 20 W for 10 s in each side lobe, followed by dilatation to 4 mm diameter and insertion of a spiral stent. Dogs were randomized to receive an SR‐PGA, SR‐PLA or SS stent and no catheter was placed post‐operatively. The dogs were killed after a follow‐up of 1, 3 or 6 months and the bladder, prostate and urethra removed. Routine histological sections were prepared from the bladder, prostate, the proximal urethra immediately below the prostate and the distal urethra.Results Histological examination showed a mild to moderate foreign‐body reaction and an acute inflammatory reaction after 1 month in the SR‐PGA and the SR‐PLA groups. The tissue effect was minimal in the SR‐PGA group after 6 and 12 months. The SS stent group had more fibrosis, chronic inflammation and oedema at all follow‐up assessments. There were erosions of the epithelium with subepithelial oedema in the animals with the SS stent. No dysplasia was detected and some remnants of the suture material were evident in the area of the cystotomy closure. There was one stricture at the apex of prostate in the SR‐PGA group at 3 months in one re‐operated dog.Conclusion The histopathological changes in tissues caused by SR‐PGA and SR‐PLA stents were generally minor and decreased during the follow‐up. The biocompatibility of SR‐PGA and SR‐PLA stents was good when combined with Nd:YAG laser treatment of the prostate.
A prospective randomized trial evaluating endoscopic Nd:YAG laser prostate ablation with or without potassium titanyl phosphate (KTP) laser bladder neck incision
Authors: LANGLEY S.E.M. , GALLEGOS C.R.R. , MOISEY C.U. 
Published: November 2003

Objective To investigate whether performing a potassium titanyl phosphate (KTP) laser bladder neck incision (BNI) in conjunction with a Nd:YAG endoscopic ablation of the prostate (ELAP) compared with an ELAP alone, improves early post‐operative voiding rates and clinical outcome.Patients and methods A prospective randomized trial that was both double‐blind and power‐determined (80%) compared 88 patients with benign prostatic enlargement undergoing ELAP and those undergoing KTP BNI and ELAP. A dual‐wavelength KPT/532TM (Laserscope) laser was used with Add/Stat side‐firing fibres. A urethral catheter was inserted post‐operatively and was removed after 18 h. Patients unable to void at this stage were then re‐catheterized, discharged and readmitted 2 weeks later for catheter removal. Patients were followed up at 3 month intervals.Results Post‐operatively, 80% of the patients undergoing KTP BNI and ELAP were able to void on catheter removal at 18 h, compared with only 57% of the patients undergoing ELAP alone (P<0.05, chi‐square). After 1 month, two patients from the former and four from the latter group failed to void and required further surgery. At 3 months, there was a significant improvement in the post‐void residual volume, maximum flow rate, symptom and quality‐of‐life scores compared to the pre‐operative values for both groups (P<0.005). However, there was a greater improvement in the flow rate and symptom score in patients undergoing KTP BNI and ELAP (P<0.05).Conclusion This study shows the benefit of performing a KTP BNI with ELAP in terms of early voiding rates and initial clinical outcome, and this treatment is recommended.
Post‐operative blood loss after transurethral prostatectomy is dependent on in situ fibrinolysis
Authors: NIELSEN J.D. , GRAM J. , HOLM‐NIELSEN A. , FABRIN K. , JESPERSEN J. 
Published: November 2003

Objective To evaluate whether post‐operative blood loss in patients with benign prostatic hyperplasia, undergoing transurethral resection of the prostate (TURP), depends on in situ fibrinolysis in urine, and to determine the relative contributions of the urokinase and tissue‐type plasminogen activator systems.Patients and methods TURP was performed in 24 men (median age 68.5 years, range 52–78) and the weight of resected tissue, the operative and post‐operative blood loss determined. The concentrations of the urokinase‐ (u‐PA) and tissue‐type plasminogen activator (t‐PA)‐related fibrinolysis in their urine was followed using sensitive and specific assays, and the changes related to post‐operative blood loss. Measurements of the urinary concentrations of free t‐PA activity, t‐PA antigen, free u‐PA activity, u‐PA antigen and fibrin degradation products (FbDP) were determined and the area under the curve for each of these quantities correlated with the post‐operative blood loss.Results The post‐operative blood loss correlated significantly with the per‐operative loss (P=0.047) and the weight of resected tissue (P=0.029). There was a highly significant correlation between the area under the curve of FbDP in the urine and the post‐operative blood loss (P<0.005), while there was no significant positive correlation between the PA concentration or activity in the urine and post‐operative blood loss. There was a significant correlation between the urinary t‐PA activity and the amount of FbDP in the urine (P=0.047), and a significant correlation between the weight of resected tissue and the amount of FbDP in the urine (P=0.014).Conclusion The post‐operative blood loss after TURP is significantly related to an increase of the urinary fibrinolytic activity and the enhanced fibrinolytic activity is probably caused by t‐PA.
Potentially useful materials for biodegradable ureteric stents
Authors: SCHLICK R.W. , PLANZ K. 
Published: November 2003

Objectives To develop and test materials that may be useful in the design and further development of biodegradable ureteric stents.Materials and methods Specimens of two plastics were placed in artificial urine of different pH for 30 days to examine the degree of dissolution of the plastic in alkaline and the stability in acidic conditions.Results The specimens remained stable in the artificial urine at pH <7.0 for 30 days and dissolved completely at a pH≥7 within 48 h.Conclusion Plastics can be designed which may be useful in the further development of biodegradable ureteric stents. The rate of dissolution could be changed by influencing urinary pH.