bluuebunny/crossref_metadata_2025_split huggingface dataset:
The relationship between desmopressin treatment and voiding pattern in children
Authors: Hvistendahl G.M. , Rawashdeh Y.F. , Kamperis K. , Hansen M.N. , Rittig S. , Djurhuus J.C. 
Published: March 2003

Objective To collate data on voiding patterns at baseline (no treatment) and during short‐term desmopressin treatment, with special reference to the functional and the mean bladder capacity. Patients and methods The study included 120 children (aged 6–16 years) with monosymptomatic nocturnal enuresis. While at home they recorded their fluid intake and diuresis in two separate periods, i.e. 2 weeks as a baseline registration and another 2 weeks during desmopressin titration. On four study days the children recorded the time and volume of all voids and of fluid intake. From the diaries their functional and mean bladder capacities, 24‐h diuresis and day/night ratio of diuresis were determined. Results The mean 24‐h diuresis was significantly lower during short‐term desmopressin treatment. In most of the enuretics the mean day/night ratio increased on desmopressin treatment. The mean functional and mean bladder capacities were unaffected by desmopressin. Those not responding had bladder capacities of ≈ 100 mL less than full responders. Regardless of response, practically all the enuretics in the study had a smaller functional bladder capacity than expected for their age. Among responders the morning void was significantly larger than the following voids during the day, and among non‐responders the fourth void was significantly larger than the previous voids in the day. Desmopressin treatment did not influence these volumes significantly. Conclusions Short‐term desmopressin treatment does not affect functional and mean bladder capacity; 24‐h urine production was reduced significantly (P<0.01) during desmopressin treatment.
Factors influencing testicular volume in young men: results of a community‐based survey
Authors: Ku J.H. , Kim M.E. , Jeon Y.S. , Lee N.K. , Park Y.H. 
Published: March 2003

Objective To investigate the factors influencing testicular volume in young men in the community.Subjects and methods Between May and November 2001, 2700 men aged 20 years and dwelling in the community were randomly selected at a 10% sampling fraction after a sampling process by census district; 2080 men agreed to participate in the study. All volunteers underwent a standard evaluation, including a detailed medical history and physical examination. After excluding those with testicular diseases the study comprised 1792 men.Results There were significant but weak correlations between testicular volumes and height, body weight and body mass index. In a multivariate model, high environmental temperature was associated with a decreased likelihood (odds ratio, OR, 0.42; 95% confidence interval, CI, 0.29–0.60; P < 0.001) of a paired testicular volume being below the 25th percentile of all participants. The likelihood of a low paired testicular volume varied by area, with a 1.6‐fold greater risk in men dwelling in large rural areas than in those in major towns. Increasing height was associated with a decreased likelihood (OR 0.60; 95% CI 0.38–0.96; P = 0.032) and low body weight with an increased likelihood of a low paired testicular volume (OR 2.54; 95% CI 1.57–4.12; P < 0.001).Conclusion These results establish that demographic and environmental factors have an effect on testicular size and suggest that body size may be important in determining testicular size in late adolescents.
Determining the displacement of the pelvic floor and pelvic organs during voluntary contractions using magnetic resonance imaging in younger and older women
Authors: Constantinou C.E. , Hvistendahl G. , Ryhammer A. , Nagel L.L. , Djurhuus J.C. 
Published: March 2003

Objectives  To: (i) visualize the effect of sustained voluntary contractions on the anatomical configuration of the pelvic floor (PF) muscles using magnetic resonance imaging (MRI); (ii) examine the effect of ageing on the range of displacement of the PF contents secondary to contraction and simulating incontinence exercises; and (iii) introduce the concept of contractile change in volume (ΔPF‐V) using three‐dimensional (3D) reconstruction from axial, sagittal and coronal MRI. Subjects and methods

Two groups of continent women volunteers, familiar with correct PF contraction, were evaluated. The mean (
sd
) age in group I was 34 (6) years and that of group II 55 (9) years; the mean parities were 0.7 and 2.2, respectively. MRI was conducted with the women supine and data were obtained in the axial, sagittal and coronal planes. In each plane, images were obtained with the PF relaxed and subsequently with the PF contracted over 10–20 s. Image processing was used to enhance the anatomical boundaries of the pelvic organs and to measure the displacement produced by the contraction. Displacements, observed between each image pair, were colour‐coded to highlight the geometric differences between a relaxed and contracted PF and to facilitate measuring displacement. Data measured from each group were pooled and the range of motion expressed as the mean (
sd
), compared using Student's
t ‐test. Results

Digitally processed imaging allowed an accurate comparison between the relaxed and contracted PF, and highlighted the differences between them. From these views, the levator ani displaced the vagina asymmetrically in nine of the 11 older subjects, and in six of the 17 younger subjects. The values from the imaging in the sagittal and coronal plane for the two groups were: levator ani displacement, 7.4 (1.1) and 1.4 (0.2) cm (
P

< 0.002), superior bladder wall, 4.2 (0.5) and 1.0 (0.1) cm (
P

< 0.002). There were also significant differences in the range of displacement produced by voluntary PF contraction in the internal structures; external outlines did not reflect these changes. The maximum displacement of the gluteal surface in the coronal plane did not change significantly; in group I it was 3.9 (1.8) to 2.9 (0.7) cm. From the 3D re‐construction, ΔPF‐V for the younger women was significantly larger, at 23.3 (3.9) mL (
P  < 0.01) than in the older women, at 9.1 (4.4) mL. Conclusion  The range of motion over which voluntary PF contractions displace the bladder and vagina is age‐dependent, being higher in younger than in older subjects. It remains to be established whether range of movement is a limitation caused by neuronal factors, decrease in muscle strength/mass, or the substitution of spaces with fat (restricting free movement), or other factors.
Intra‐ureteric capsaicin in loin pain haematuria syndrome: efficacy and complications
Authors: Playford D. , Kulkarni H. , Thomas M. , Vivian J. , Low A. , Mander J. , Perlman D. , Finch P. 
Published: March 2003

Objective  To evaluate the safety and efficacy of intra‐ureteric capsaicin for loin pain haematuria syndrome (LPHS). Patients and methods  In an open prospective pilot study, four middle‐aged patients (three women and one man) with LPHS resistant to therapies such as splanchnic nerve block, psychological treatment or renal autotransplantation (one) were assessed. An intra‐ureteric infusion of capsaicin (30 mg/100 mL of 30% alcohol in saline) for 30 min with bladder irrigation was administered under general anaesthesia, with a subsequent intravenous patient‐controlled narcotic analgesic pump for pain control. Double‐concentration capsaicin was used for second infusions, if necessary when the response to the earlier infusion was inadequate or incomplete. Results  The first patient had experienced reduced pain levels for the first 3 months only, with no benefit from the subsequent treatments with higher doses of capsaicin (60 mg). The second patient with recurrent pain in an autotransplanted kidney had no benefit from either a 30 or 60 mg capsaicin infusion a month apart, but developed a fibrotic stricture at the transplant pelvi‐ureteric junction, requiring pyelocystoplasty. The third patient with concurrent depression had no benefit from a 30‐mg infusion of capsaicin. The fourth patient experienced no pain relief from a 30 mg infusion of capsaicin but developed proteinuria secondary to mesangial proliferative glomerulonephritis, ureteric inflammation needing stenting within 7 days of treatment and subsequently nephrectomy for a nonfunctioning kidney at 3 months. Conclusion  Intra‐ureteric capsaicin was neither effective nor safe in LPHS; the contribution of the alcohol diluent cannot be excluded.
Can shoe size predict penile length?
Authors: Shah J. , Christopher N. 
Published: March 2003

Objective  To establish if the ‘myth’ about whether the size of a man's penis can be estimated from his shoe size has any basis, infact. Subjects and methods  Two urologists measured the stretched penile length of 104 men in a prospective study and related this to their shoe size. Results  The median stretched penile length for the sampled population was 13 cm and the median UK shoe size was 9 (European 43). There was no statistically significant correlation between shoe size and stretched penile length. Conclusion  The supposed association of penile length and shoe size has no scientific basis.
Tissue reaction of the rabbit urinary bladder to tension‐free vaginal tape and porcine small intestinal submucosa
Authors: Rabah D.M. , Spiess P.E. , Begin L.R. , Corcos J. 
Published: March 2003

Objectives  To compare the histological tissue reactions of urinary bladder in close contact with polypropylene mesh tension‐free vaginal tape (TVT) or porcine small intestinal submucosal (SIS) grafts, as the commercial availability of various materials has considerably simplified sling procedures for treating urinary incontinence, but erosion and infection after using artificial sling materials remain an important concern. Materials and methods  Thirty female New Zealand rabbits were randomized to three groups, i.e. group A (TVT, 12 animals), group B (SIS, 12) and group C (surgical control, six). Through a laparotomy under anaesthesia and an aseptic technique, the bladder was approached at its dome, where a 0.5 × 1 cm piece of TVT or SIS was fixed in direct contact with the bladder wall. The control group underwent only bladder manipulation with no material applied. Half the animals in each group were killed after 6 weeks and the other half after 12 weeks. The urinary bladder was harvested and examined histologically. Results  The grafts in both groups were characterized by dense foreign‐body type reactions and were mostly attached loosely to the bladder wall by a thin layer of fibrovascular tissue. More importantly, the bladder wall reactions showed no inflammation in all 12 animals in group A (TVT) but three of them had various grades of fibrosis. There was severe transmural inflammation in one animal in group B (SIS); one rabbit had grade I and two had grade II fibrosis. The controls, as expected, showed no bladder wall reactions. Conclusion  In this descriptive analysis of reaction types elicited on the urinary bladder by these grafts, both materials appeared to be safe. Although TVT elicited fewer and less severe adverse reactions, no statistical conclusions can be drawn. The clinical significance of these findings should emerge from long‐term clinical data when they become available.
Lower urinary tract symptoms: social influence is more important than symptoms in seeking medical care
Authors: Wolters R. , Wensing M. , Van Weel C. , Van Der Wilt G.J. , Grol R.P.T.M. 
Published: March 2003

Objective  To determine associations among lower urinary tract symptoms (LUTS), symptom severity, subjective beliefs and social influences when seeking primary medical care in men aged ≥ 50 years.Subjects and methods  A population‐based survey was conducted among 5052 men aged ≥ 50 years, using patient registers of 22 general practitioners (GPs) in the Netherlands from November 1999 to May 2000. The questionnaire contained items concerning age, educational level, International Prostate Symptom Score (IPSS), bothersome score (BS), and questions from the Health Belief Model on attitude and social influences. The study population comprised men with an IPSS openface> 7. The odds ratios (ORs) corrected for the IPSS were calculated.Results  In all, 3544 questionnaires (70.2%) were returned. Two groups of men with an IPSS openface> 7 were compared: those who consulted their GP in the previous 2 years because of voiding problems (268 cases) and the controls (272) who did not visit a GP for these symptoms. Cases more often thought a physician could improve their condition (OR 2.85), appeared to be more often advised by others to seek medical care (OR 6.36) and thought more often that this advice influenced their decision (OR 13.95). They also had more frequently received information from the media (OR 2.66) which affected their attendance (OR 12.52). In a multiple regression analysis, advice from others or information from the media were stronger predictors of seeking care than the influence of symptoms on daily life, the IPSS or the BS.Conclusion  Social influences, i.e. advice from others or the media, were more important factors in the decision to seek medical care than symptom severity.
Magnetic resonance imaging‐guided laser thermal ablation of renal tumours
Authors: Dick E.A. , Joarder R. , De Jode M.G. , Wragg P. , Vale J.A. , Gedroyc W.M.W. 
Published: March 2003

Objective To test the hypothesis that magnetic resonance imaging (MRI)‐guided laser thermal ablation (LTA) of inoperable renal tumours is a safe, tolerable and potentially effective treatment.Patients and methods  Nine patients (aged 56–81 years) with malignant renal tumours underwent percutaneous LTA under MRI guidance in a 0.5 T open magnet. Real‐time colour thermal mapping was used to monitor tumour ablation, and the follow‐up was with gadolinium‐enhanced MRI at 6 weeks and (where appropriate) 3–4 months after the procedure. Tumour volume and percentage tumour enhancement before and after ablation were compared. The percentage of tumour ablated on real‐time T1‐weighted thermal maps was compared with that on gadolinium‐enhanced follow‐up MRI.Results  The mean (range) follow‐up was 16.9 (3–32) months after the first ablation. The mean tumour size did not change significantly, but the mean percentage of viable tumour decreased significantly from 73.7% before to 29.5% after ablation (P = 0.012, Wilcoxon signed‐ranks test). Thermal maps correlated moderately well with follow‐up MRI in predicting the extent of tumour ablation (Pearson correlation coefficient 0.55). There were two minor and one major complication.Conclusion  In this pilot study of patients unsuitable for surgery, MRI‐guided LTA of renal tumours was safe, feasible (being well tolerated by the patient) and significantly reduced enhancing tumour volume by a mean of 45%.
Transurethral interstitial laser coagulation of the prostate and transurethral microwave thermotherapy vs transurethral resection or incision of the prostate: results of a randomized, controlled study in patients with symptomatic benign prostatic hyperplasia
Authors: Nørby B. , Nielsen H.V. , Frimodt‐Møller P.C. 
Published: March 2003

Objective  To compare the efficacy and frequency of complications of transurethral interstitial laser coagulation (ILC) and transurethral microwave thermotherapy (TUMT) with transurethral resection or incision of the prostate (TURP/TUIP) in patients with symptomatic benign prostatic hyperplasia (BPH).Patients and methods  Forty‐eight patients were randomized to undergo ILC, 46 to TUMT and 24 to TURP/TUIP; they were followed for 6 months and the outcome analysed on an intention‐to‐treat basis.Results  At 6 months the symptom scores and maximum urinary flow rate (Qmax) had improved significantly in all groups. At 6 months the mean symptom score was 9.2 in both experimental groups and 6.8 in the control group (P > 0.05); the mean Qmax was 20.6 mL/s in the control group, 16.2 in the ILC group (P > 0.05 vs control) and 13.2 in the TUMT group (P < 0.05 vs. the control group). In the TUMT group patients developing urinary retention afterward had a significantly greater increase in Qmax than those who did not. The types of complications in the three groups varied. Urinary tract infection occurred frequently in the experimental groups, especially after ILC, whereas the ‘well‐known’ complications of TURP occurred in the control group. Overall, 36% in the ILC, 54% in the TUMT and 73% in the control group had no complications (retrograde ejaculation excluded) during the first 6 months. One patient in the TUMT group underwent TURP after 3 months, whereas no patients in the ILC or the con‐trol group were re‐treated for BPH within the first 6 months.Conclusion  In the short term both ILC and TUMT are reasonable alternatives to standard transurethral surgery for symptomatic BPH, where the reduction of symptoms is the primary goal of treatment. However, both ILC and TUMT were associated with morbidity, although the complication profiles differed from those after TURP/TUIP. Both ILC and TUMT seem advantageous in some patients because of the reduced risk of bleeding and the eliminated risk of TUR syndrome, and because TUMT only requires local anaesthesia. Thus, as neither treatment is better in all aspects, the advantages of one technique over the other must be weighed when deciding how to treat each patient.
The management of low‐flow priapism with the immediate insertion of a penile prosthesis
Authors: Rees R.W. , Kalsi J. , Minhas S. , Peters J. , Kell P. , Ralph D.J. 
Published: March 2003

Objective  To evaluate the outcome of patients undergoing the immediate insertion of a penile prosthesis as a treatment for acute low‐flow priapism.Patients and methods  Eight patients presenting with low‐flow priapism with a mean duration of 91 h (range 32–192)  were prospectively evaluated. All had failed conservative management with the instillation of α‐adrenergic agents, and four had already undergone shunt procedures elsewhere. Immediate management consisted of the insertion of a malleable prosthesis in six patients and an inflatable prosthesis in two. One of the malleable prostheses was subsequently changed to an inflatable device.Results  There were no early complications, with all patients being satisfied with the end result, and seven having sexual intercourse. One patient developed a penile deformity after surgery, cause by fibrosis around one inflatable cylinder. All patients have maintained their penile length.Conclusions  Prolonged low‐flow priapism results in a variable degree of cavernosal fibrosis and a subsequent loss of penile length. The delayed insertion of a penile prosthesis can be difficult, with high complication rates. The immediate insertion of a penile prosthesis in patients with prolonged low‐flow priapism is simple and maintains penile length. This should always be offered to the patient at initial presentation, as the complication rate is low and the subsequent outcome excellent.
The clinical implications of the difference between castration, gonadotrophin releasing‐hormone (GnRH) antagonists and agonist treatment on the morphology and expression of GnRH receptors in the rat ventral prostate
Authors: Tieva Å. , Bergh A. , Damber J.‐E. 
Published: March 2003

OBJECTIVETo examine the effects of castration and continuous gonadotrophin releasing‐hormone (GnRH) agonist and antagonist therapy on the expression of GnRH‐receptors type I (GnRH‐RI) in rat ventral prostate (VP) and pituitary tissue, and to compare the effects on prostate morphology.MATERIAL AND METHODSMature Sprague‐Dawley rats were assigned to four treatment groups: group 1, vehicle only; group 2, GnRH agonist goserelin (100 µg/rat/day); group 3, GnRH antagonist cetrorelix (100 µg/rat/day); and group 4, orchidectomy. After 4 weeks the body weights were recorded and VP and pituitary tissue analysed for GnRH‐RI expression using a competitive reverse transcriptase–polymerase chain reaction and immunohistochemistry.RESULTSGnRH antagonist and orchidectomy decreased testosterone secretion and VP volume similarly, but the effects were not identical. The involution of the glandular lumina was more pronounced after orchidectomy while the antagonist therapy was more effective in suppressing epithelial cell proliferation. In the VP, GnRH‐RI mRNA levels were increased after GnRH analogue therapy, but were unaffected by orchidectomy. In the pituitary, GnRH‐RI mRNA expression was higher in response to orchidectomy and decreased after GnRH analogue treatment.CONCLUSIONTreatment with a GnRH antagonist for 4 weeks is more effective than an agonist in suppressing testosterone and inducing VP involution. The GnRH antagonist was more effective in suppressing VP epithelial cell proliferation than was castration, suggesting that it induces reduced proliferation by interfering with effects of locally produced GnRH. These results suggest that different regulatory mechanisms may operate in the rat VP than in the pituitary to control GnRH‐RI mRNA expression.
The mesh wallstent in the treatment of detrusor external sphincter dyssynergia in men with spinal cord injury: a 12‐year follow‐up
Authors: Hamid R. , Arya M. , Patel H.R.H. , Shah P.J.R. 
Published: March 2003

OBJECTIVETo assess the long‐term effectiveness of the UroLume™ wallstent (Pfizer Inc., UK) in the treatment of detrusor external sphincter dyssynergia (DESD) in quadriplegic patients.PATIENTS AND METHODSTwelve patients with quadriplegia secondary to spinal trauma underwent external striated sphincter stenting with the UroLume wallstent instead of an external sphincterotomy for DESD (mean age 41.8 years, range 26–65). The level of injury was C4 in two, C5 in four, C6 in four, C7 in one and T6 in one. All patients were shown by preoperative video‐cystometrography (VCMG) to have DESD and high‐pressure, hyper‐reflexic bladders with incomplete emptying.RESULTSSeven of the 12 patients had a mean (range) follow‐up of 12.7 (12.17–13.6) years; two others were lost to follow‐up at 1 and 3 years and both remained free of complications during that time. Two patients developed encrustation causing obstruction, requiring stent removal within a year of insertion. Another patient with an adequately functioning stent died 7 years after surgery (chest infection). Urodynamic follow‐up of the seven patients showed a significantly sustained reduction in maximum detrusor pressure and duration of detrusor contraction at> 10 years of follow‐up. Five of the seven patients developed bladder neck dyssynergia of varying degrees, as shown on VCMG; all were successfully treated with bladder neck incision. There were no problems with stent migration, urethral erosion, erectile dysfunction or autonomic dysreflexia.CONCLUSIONPermanent urethral stenting using the UroLume wallstent is effective in managing DESD and provides an acceptable long‐term alternative to sphincterotomy. Subsequent bladder neck dyssynergia is the main complication but this can be managed successfully with bladder neck incision. Importantly, unlike sphincterotomy, there is no significant interference with erectile function. Also, the procedure is reversible, minimally invasive and requires a shorter hospital stay.