bluuebunny/crossref_metadata_2025_split huggingface dataset:
Validity and reliability of an interviewer‐administered questionnaire to measure the severity of lower urinary tract symptoms of storage abnormality: the Leicester Urinary Symptom Questionnaire
Authors: Shaw C. , Matthews R.J. , Perry S.I. , Assassa R.P. , Williams K. , Mcgrother C. , Dallosso H. , Jagger C. , Mayne C. , Clarke M. ,   the Leicestershire MRC Incontinence Study Team
Published: March 2003

Objective To develop a valid and reliable interviewer‐administered questionnaire to measure the presence and severity of storage abnormality symptoms of incontinence, urgency, frequency and nocturia. Subjects and methods Subjects were 930 men and women aged 40 years, taking part in a randomized controlled trial of a continence nurse practitioner (CNP) service. Criterion validity was tested by comparing questionnaire responses to 24‐h pad test and 3‐day urinary diary. Responsiveness was assessed by comparing questionnaire responses before and after treatment. Questions about urgency were investigated for construct validity in patients taking part in the trial who underwent urodynamic investigation (243). Test‐retest and inter‐rater reliability was measured at ≈ 6 days in subjects recruited to an associated epidemiological study (104 and 102, respectively). Results The questionnaire responses showed significant associations with pad‐test and diary measures. Questions about the severity of daytime incontinence performed better than those measuring night‐time incontinence. The response categories of soaked, wet, damp and almost dry had better associations with the pad test than other measures of the severity of incontinence. Test‐retest and inter‐rater reliability was good for all questions, and all were responsive to change in symptoms, showing significant differences before and after treatment. Conclusion There is a clear need for standardization of measurement using well‐validated instruments. This interviewer‐administered questionnaire is valid, reliable and sensitive to change in a wide range of severity of symptoms, and in both men and women aged 40 years. The questionnaire provides a useful assessment tool for primary and secondary care in research and clinical settings.
A modified intussuscepted nipple in the Kock pouch urinary diversion: assessment of perioperative complications and functional results
Authors: Soulié M. , Seguin P. , Martel P. , Vazzoler N. , Mouly P. , Plante P. 
Published: March 2003

Objective  To assess the complications and continence of a modified intussuscepted nipple in Kock pouch urinary diversions. Patients and methods  From February 1992 to December 2000, 40 patients (mean age 55.8 years, range 21–74) with bladder cancer (24), gynaecological tumours (eight) or previous lower tract reconstructive surgery (eight) underwent cystectomy and cutaneous continent urinary diversion using the Kock pouch procedure. The first 23 procedures (group I) used Henriet's technique, whereas a modified fixation of the intussuscepted efferent limb was applied in the last 17 (group II). Complications and functional results (focused on continence and the upper urinary tract) were reviewed. Results

The median (range) follow‐up was 47.6 (10–124) months; one patient died 4 weeks after surgery. Early complications occurred in 11 (28%) and re‐operation was required in two (5%). Of the late complications reported (38%), extussusception (8%) and efferent nipple prolapse (3%) only occurred in group I and required surgical revision. Late complications were minor (15%) including two asymptomatic refluxes and four with stoma sclerosis. The continence rate at 6 months in groups I and II were 78% and 94%, respectively (
P   =  0.13). Conclusion  Efferent limb prolapse and extussusception of the Kock pouch were the main complications requiring surgical revision. Applying the modified nipple fixation the complications can be reduced and reservoir continence improved.
Effects of vaginal distension on urethral anatomy and function
Authors: Cannon T.W. , Wojcik E.M. , Ferguson C.L. , Saraga S. , Thomas C. , Damaser M.S. 
Published: March 2003

Objective  To determine the effect of repeated and prolonged vaginal distension on the leak‐point pressure (LPP) and urethral anatomy in the female rat, as prolonged vaginal distension has been clinically correlated with signs of stress urinary incontinence (SUI). Materials and methods

Sixty female rats were placed into one of five groups; four groups underwent one of four vaginal distension protocols using a modified 10 F Foley catheter, i.e. prolonged (1 h), brief (0.5 h), intermittent (cycling inflated/deflated for 0.5 h) or sham distension. All animals had a suprapubic bladder catheter implanted 2 days after and were assessed urodynamically 4 days after vaginal distension. The fifth group of rats acted as controls and did not undergo vaginal distension, but did have a suprapubic bladder catheter placed and urodynamics assessed. To measure LPP the rats were anaesthetized with urethane, placed supine and the bladder filled with saline (5 mL/h) while bladder pressure was measured via the bladder catheter. LPPs were measured three times in each animal by manually increasing the abdominal pressure until leakage at the urethral meatus, when the external abdominal pressure was rapidly released. Peak bladder pressure was taken as the LPP and a mean value calculated for each animal. Immediately after measuring LPP the urethra was removed and processed routinely for histology (5 µm sections, stained with haematoxylin/eosin and trichrome). The means (
sem
) were compared using a Kruskal–Wallis one‐way
anova
on ranks, followed by a Dunn's test, with
P  < 0.05 indicating a significant difference. Results

Both LPP and the external increase in abdominal pressure were significantly lower after prolonged distension, at 31.4 (1.7) and 19.8 (1.2) cmH
2
O, than in the sham group, at 41.1 (3.2) and 32.0 (4.7) cmH
2 O, respectively. There were no significant differences in LPP or in the increase in abdominal pressure between the brief, intermittent and sham groups. Qualitative histology showed that prolonged distension resulted in extensive disruption and marked thinning of urethral skeletal muscle fibres. Brief and intermittent distension showed mild and focal disruptions, respectively. Conclusions  As observed clinically, prolonged vaginal distension results in a lower LPP, greater anatomical injury and increased severity of SUI. These results suggest that ischaemia is important in the development of SUI after prolonged vaginal distension.
Three‐month neoadjuvant hormonal therapy before radical prostatectomy: a 7‐year follow‐up of a randomized controlled trial
Authors: Aus G. , Abrahamsson P.‐A. , Ahlgren G. , Hugosson J. , Lundberg S. , Schain M. , Schelin S. , Pedersen K. 
Published: March 2003

Objective  To describe the outcome, assessed as the level of prostate specific antigen (PSA), of a mature (more than half the events recorded) prospective randomized study with a median follow‐up of 82 months of neoadjuvant hormonal therapy before radical prostatectomy, as this has been suggested to decrease the rate of positive surgical margins (i.e. provide greater potential to completely excise the tumour). Patient and methods  From December 1991 to March 1994, 126 patients with clinically localized prostate cancer were randomized between direct radical prostatectomy or a 3‐month course of a gonadotrophin‐releasing hormone analogue before surgery. The patients were followed by PSA determinations and a value of > 0.5 ng/mL used to define progression. Results
The incidence of positive surgical margins decreased from 45.5% to 23.6% (
P
= 0.016) with hormone treatment. Despite this there was no difference in PSA progression‐free survival at the last follow‐up; it was 51.5% for those undergoing radical prostatectomy only and 49.8% for those who received hormonal pretreatment (
P  = 0.588). Conclusions  Three months of neoadjuvant hormonal therapy before radical prostatectomy offers no benefit to the patient and cannot be recommended for routine clinical use.
125Iodine prostate brachytherapy: outcome from the first 100 consecutive patients and selection strategies incorporating urodynamics
Authors: Henderson A. , Cahill D. , Laing R.W. , Langley S.E.M. 
Published: March 2003

Objective
To report the results from the first 100 consecutive patients treated with
125 I transperineal interstitial prostate brachytherapy between March 1999 and June 2001, and to determine if the International Prostate Symptom Score (IPSS), prostate volume or urodynamic variables correlate with acute morbidity. Patients and methods  Patients were assessed prospectively by uroflowmetry, the IPSS, a physical examination and transrectal ultrasonography. Of the 100 patients, 57 had a full urodynamic assessment, 61 presented with lower urinary tract symptoms (LUTS), 25 were screen‐detected and 14 presented with other problems. The IPSS was recorded at 1, 6 and 12 weeks, and then at 3‐monthly intervals after treatment; significant events, e.g. acute urinary retention (AUR) and rectal symptoms, were recorded prospectively; the mean follow‐up was 16 months. Results  No patients were incontinent after treatment. There was a temporary deterioration in IPSS in 89% of patients. Peak symptoms occurred at 6 weeks and a statistically significant deterioration in IPSS persisted until 9 months, but continued to improve throughout the follow‐up. AUR affected seven patients, with a further 20 using clean intermittent self‐catheterization (CISC) for symptoms. In most patients the symptoms resolved spontaneously to the levels before treatment, with only two patients requiring surgery for bladder outlet obstruction. The IPSS before treatment did not predict urodynamic obstruction. Urodynamically unobstructed patients did not require catheterization. By 2 years after implantation the mean IPSS was better than before treatment. Five patients had mild, transient proctitis. Conclusion  Selecting patients with a low prostate volume and IPSS is likely to optimize the outcome of brachytherapy. Urodynamic studies may be helpful in predicting the risk of AUR and symptoms requiring CISC. Despite many patients presenting with LUTS, acute morbidity was no worse than that reported in large American series of predominantly screening‐detected cancers. Prostate brachytherapy is well tolerated and may be safely delivered to patients with prostate cancer in the UK.
Treating neuropathic incontinence in children with seromuscular colocystoplasty and an artificial urinary sphincter
Authors: González R. , Jednak R. , Franc‐Guimond J. , Schimke C.M. 
Published: March 2003

Purpose  To review the results of artificial urinary sphincter (AUS) implantation combined with seromuscular colocystoplasty (SCLU) in the treatment of mixed neurogenic urinary incontinence in children.Patients and methods  Patients (27, six females) who had undergone SCLU were interviewed, and their charts and imaging studies reviewed retrospectively. Their urodynamic data were analysed and bladder capacity, end‐filling pressure, safe capacity and percentage of expected capacity for age compared before and after surgery. Continence was defined as dryness between catheterizations or voiding with no need for protective pads.Results  The mean (sd) follow‐up since the SCLU was 1.7 (1.1) years; continence was achieved in 24 of the 27 (89%) patients with no additional procedures. No significant upper tract changes developed. Bladder capacity, safe capacity for age and end‐filling pressure were all improved significantly. There were two AUS erosions necessitating removal and in one patient the augmentation failed. Six patients early in the series developed an ‘hourglass’ deformity that required correction. Modifications to the technique to avoid this complication are discussed.Conclusions  For children with neuropathic incontinence who require both augmentation of outlet resistance and bladder storage capacity, the combination of the AUS and SCLU effectively achieves continence with no upper tract deterioration. SCLU is also the preferred method of augmentation when adverse bladder changes occur after implanting the AUS.
Patterns and trends in prostate cancer incidence, survival, prevalence and mortality. Part I: international comparisons
Authors: Quinn M. , Babb P. 
Published: March 2003

SummaryThe international patterns and trends in prostate cancer incidence, survival, prevalence and mortality were examined. Age‐standardized incidence and death rates among men in a variety of countries worldwide were obtained from various sources, survival rates from European sources and elsewhere, and prevalence estimates from the EUROPREVAL study. Results from many published studies were summarized. The incidence of prostate cancer varies widely around the world, with by far the highest rates in the USA and Canada. There has been a gradual increase in the incidence of prostate cancer since the 1960s in many countries and in most continents; there were large increases in the late 1980s and early 1990s in the USA, but increases have also occurred in countries with comparatively low incidence, e.g. India. Survival from prostate cancer improved during the 1970s and 1980s; further increases in the 1990s may be largely a result of earlier diagnosis. There were wide differences in survival across Europe, with rates in the UK well below the average, but all European rates were far below those in the USA. There was wide variation in the prevalence of prostate cancer in Europe; in some countries with high incidence and high life‐expectancy, prostate cancers formed ≈ 15% of all prevalent cancers in men. Mortality from prostate cancer has also increased in many countries, but to a lesser extent than incidence; this is consistent with the observed trends in survival. Mortality decreased slightly in the mid to late 1990s in several countries, including the USA, Canada, England, France and Austria. Part of the apparent increases in the incidence of prostate cancer has been associated with diagnostic artefacts (particularly detecting preclinical tumours through the increased use of transurethral resection) which may also have had an effect on death certification through the incorrect attribution of prostate cancer as the underlying cause of death. However, the greatest effect on the registration of new cases of prostate cancer has been the increased availability of prostate specific antigen testing during the early‐ to mid‐1990s. Possibly, in addition to the effect of attribution bias, the earlier diagnosis of prostate cancers has contributed to the recent slight decreases in mortality. However, this is unlikely to account for much of the reduction, given the slow development of the disease from onset to death. Changes in disease management are probably more important. There are many strong arguments against introducing population‐based screening for prostate cancer.
Transrectal colour Doppler ultrasonography for quantifying angiogenesis in prostate cancer
Authors: Shigeno K. , Igawa M. , Shiina H. , Kishi H. , Urakami S. 
Published: March 2003

OBJECTIVETo assess the correlation between angiogenesis and Doppler signal intensity using transrectal colour Doppler ultrasonography (CDUS) in patients with prostate cancer.PATIENTS AND METHODSThe study comprised 56 patients who underwent radical prostatectomy and had untreated tumours with a volume of> 0.1 mL in the peripheral zone. CDUS images were recorded on videotape before surgery. The Doppler signal intensity in tumours was evaluated using the colour pixel intensity (PI). Microvessel density (MVD) and vascular endothelial growth factor (VEGF) immunoreactivity were determined in the prostatectomy specimens. Microvessels were identified by immunohistochemical staining of endothelial cells for CD31.RESULTSThe PI in the tumour correlated with MVD (P < 0.001) and increased with higher levels of VEGF immunoreactivity (P = 0.004). There was no correlation between Gleason score and MVD or PI in the tumour.CONCLUSIONBlood flow assessed by CDUS may reflect the state of angiogenesis in prostate cancer. CDUS may be a useful technique for predicting tumour progression or prognosis, and may be useful for monitoring the effects of anti‐angiogenic agents in the future.
Intraprostatic ethanol chemoablation via transurethral and transperineal injection
Authors: Plante M.K. , Gross A.L. , Kliment J. , Kida M. , Zvara P. 
Published: March 2003

OBJECTIVESTo further assess the safety and feasibility of prostatic chemoablation with ethanol and to address previous concerns associated with transperineal injection using a canine model.MATERIALS AND METHODSThe study included 25 dogs; normal saline or 98% dehydrated ethanol were injected into the prostate using both routes, at volumes of 25–50% of the total prostate volume. The prostate and adjacent structures were examined grossly and histopathologically after the dogs were killed humanely at 4 h, 7 days and 12 weeks after injection.RESULTSTransperineal injection resulted in tissue necrosis in all prostates and significant extraprostatic necrosis in two of three animals treated. With transurethral injection, the control groups showed minimal change, whereas the group injected with ethanol resulted in lesions with variable necrosis and location.CONCLUSIONSIntraprostatic chemoablation is possible with ethanol injection both transperineally and transurethrally. Transperineal ethanol injections were associated with more extraprostatic necrosis. Transurethral injections resulted in larger amounts of necrosis in the prostatic parenchyma with minimal extraprostatic effects. However, the extent of prostatic necrosis/ablation was inconsistent and further research is warranted.
A novel testosterone gel formulation normalizes androgen levels in hypogonadal men, with improvements in body composition and sexual function
Authors: McNicholas T.A. , Dean J.D. , Mulder H. , Carnegie C. , Jones N.A. 
Published: March 2003

OBJECTIVETo compare the safety and efficacy of two doses of a new testosterone gel formulation (Testim™, Auxilium Pharmaceuticals, Inc., Norristown, PA, USA) to a permeation‐enhanced testosterone patch (Andropatch®, GlaxoSmithKline, UK) for treating men with confirmed low serum testosterone levels, and associated signs and symptoms of hypogonadism.PATIENTS AND METHODSIn all, 208 men were randomized and treated at 29 centres in Denmark, Germany, Netherlands, Sweden and the UK. The men were treated for 90 days, and the pharmacokinetics and treatment effectiveness of Testim at two doses (50 and 100 mg/day, delivering a daily dose of 5 and 10 mg testosterone, respectively) and Andropatch (2 × 2.5 mg patches, each delivering 2.5 mg testosterone and containing 12.2 mg of testosterone) were compared. Pharmacokinetic profiles were obtained, body composition measured, and mood and sexual function data recorded.RESULTSTestim produced dose‐dependent improvements in all pharmacokinetic variables compared with Andropatch. The mean increases from baseline to 90 days in testosterone were 12.41, 6.54 and 3.82 nmol/L for Testim 100 and 50 mg/day and the Andropatch, respectively. Both doses of Testim significantly improved positive and negative mood over baseline; Andropatch did not. All three treatments increased lean body mass, and the higher dose of Testim produced a significant decrease in percentage body fat. At all sample times both doses of Testim significantly improved sexual performance, sexual motivation, sexual desire and spontaneous erections. Andropatch provided insignificant improvements from baseline at all sample times for sexual desire, an inconsistent improvement in sexual motivation, but no effect on spontaneous erections. These results are similar to those previously reported for testosterone replacement therapy in hypogonadal men, suggesting that normalization of serum testosterone restores sexual function. However, the present data suggest that higher serum testosterone levels may further improve sexual function. Gel treatment was well tolerated, while patch treatment produced higher rates of application‐site reactions and study discontinuation.CONCLUSIONThe favourable pharmacokinetic profile and treatment outcome, combined with the enhanced tolerability of Testim, suggest that this new gel formulation is a safe and effective treatment in men with low serum testosterone levels and associated signs and symptoms of hypogonadism.
Estimation of glomerular filtration rate and bladder capacity: the effect of maturation, ageing, gender and size
Authors: Wahl E.F. , Lahdes‐Vasama T.T. , Churchill B.M. 
Published: March 2003

OBJECTIVETo show that glomerular filtration rate (GFR) and bladder capacity (BC) develop isometrically, and to provide graphs for estimating GFR and BC for specific individuals of any age, sex, height and weight, for cystometric purposes.MATERIALS AND METHODSGFR and BC data were collected from published reports; graphs relating GFR and BC to age, sex, height and weight were obtained by using a computerized curve‐fitting technique that minimizes the 1.1 power of the absolute error.RESULTSThe plots show the GFR and BC for individuals of 10th, 50th and 90th percentile height and weight as a function of age and sex for different physiological conditions. GFR increases up to age 20 years and thereafter declines, whereas GFR per unit body surface area reaches a maximum at 3.25 years old and declines thereafter.CONCLUSIONSThe clinical management strategy to preserve or enhance renal function in paediatric and adult nephrological disease should incorporate the present data on development, growth, ageing and deterioration of function. These data should be used when interpreting cystometrograms and evaluating compliance. The graphs are useful for clinically estimating GFR and BC, especially when estimating infusion rate and BC for individual patients. BC and GFR develop isometrically with a proportionality constant of 4.56 min, except from birth to 1.5 years of age. Accordingly, individuals with healthy urinary systems, irrespective of age, sex and size, in the same physiological conditions have, on average, the same time to reach BC, ranging from 7 h at a normal 1% GFR to 41 min at the maximum diuresis of 10% GFR.