bluuebunny/crossref_metadata_2025_split huggingface dataset:
Developmental factors of urethral human papillomavirus lesions: correlation with circumcision
Authors: Aynaud  , Piron  , Bijaoui  , Casanova  
Published: March 2003

ObjectiveTo assess the relationship between circumcision and urethral human papillomavirus (HPV) lesions, and the influence of urethritis on the development of urethral HPV infections on inducing squamous metaplasia of the urethral epithelium.Patients and methodsThe study included 210 heterosexual, HIV‐negative men (median age 29 years) who all had female partners with genital HPV infection. The patients were divided into three groups according to clinical findings, i.e. 97 patients with no clinical HPV lesions on peniscopy and urethroscopy, 70 patients with balanopreputial lesions but no urethral lesions, and 43 patients with urethral HPV lesions, including 17 who had associated penile lesions. They all underwent meatopeniscopy for HPV screening, urethral biopsy for histological analysis, and bacterial cultures were taken. The results in each subgroup were compared between circumcised and uncircumcised men.ResultsThere was no significant difference in the incidence of HPV infection (58% vs 42%, odds ratio, OR, 1.8; 95% confidence interval, CI, 0.98–3.62) between uncircumcised and circumcised men, but this relationship differed with the developmental site of HPV lesions (shaft‐foreskin, P<0.02; urethra, not significant). There was also a significant difference in the prevalence of urethritis between uncircumcised and circumcised men (34.5% vs 19%, OR 2.35, 95% CI 1.08–5.11), and between HPV‐infected and uninfected men (41.5% vs 18%, OR 3.17, 95% CI 1.71–5.83). This positive relationship of the prevalence of urethritis for both factors (circumcision and HPV) depended on the type of organism (sexually transmitted disease, not significant; common organism, P<0.02). The frequency of urethritis was related to the site of HPV lesions; urethritis was present in 36% of the patients with preputial HPV lesions, compared with 51% of those with urethral HPV lesions. Chlamydia trachomatis was detected in 1% of the patients without and in 7% of those with HPV lesions. In 68% of the patients, histological analysis of the urethral mucosa showed a squamous metaplasia of the urethral epithelium associated with urethritis.ConclusionsBeing uncircumcised did not seem to increase the risk of HPV urethral infection in young men. Genital bacterial infections and urethral HPV lesions appear to be linked. Urethritis can induce squamous metaplasia of the urethral epithelium, which appears to favour the colonization of the anterior urethra by HPVs.
Symptom characteristics and the development of tolerance with time in patients with indwelling double‐pigtail ureteric stents
Authors: Irani  , Siquier  , Pirès  , Lefebvre  , Doré  , Aubert  
Published: March 2003

ObjectiveTo determine the symptoms of and factors predicting the tolerance to double‐pigtail ureteric stents, and the development of tolerance with time.Patients and methodsThe study included 39 patients (median age 49.0 years, range 26–74; 24 men and 15 women) who were treated in our department for ureteric obstruction caused by benign conditions, excluding pregnancy and associated open surgery. All patients received a polyether‐urethane double‐pigtail ureteric stent (7 F, 28 cm long). Tolerance to the procedure was assessed using a questionnaire and a 10‐cm linear visual analogue scale (VAS) at 24 h and again one week after placement, and on the day before stent removal.ResultsFrom the end of the first week to before removal of the stent, fewer patients reported dysuria, haematuria and having recourse to painkillers than during the first week. However, analysis of variance for repeated measures showed no significant difference between the VAS scores for first day, the first week and the day before removal, either overall or stratified by gender (P=0.15). A factorial analysis of variance analysing the VAS score for the first week as a function of gender, age and type of occupation (sedentary or mobile occupation) showed a significant effect only for gender (P=0.005) and gender‐age interaction (P=0.02): VAS scores were higher in men and particularly in younger men.ConclusionAlmost all patients with short‐term placement of indwelling double‐pigtail ureteric stents have untoward symptoms. Although some symptoms, e.g. dysuria and haematuria, significantly improve with time, the general tolerance remains unchanged. Tolerance in men, and particular in younger men, was significantly poorer.
The long‐term culture of porcine urothelial cells and induction of urothelial stratification
Authors: Ludwikowski  , Zhang  , Frey  
Published: March 2003

ObjectiveTo assess porcine urothelial cell cultures and the in vitro induction of urothelial stratification in long‐term cultures, to study their morphological, functional and genetic behaviour, and thus provide potential autologous urothelium for tissue‐engineered substitutes for demucosalized gastric or colonic tissue.Materials and methodsPrimary cultures of porcine urothelium were established and the cells passaged thereafter. Cell specificity was confirmed by cytokeratin analysis, cell membrane stability assessed using lactate dehydrogenase leakage, cell de‐differentiation by γ‐glutamyl transferase activity and genomic stability by karyotype investigations. Histology and scanning electron microscopy were performed to study the cultured cells and the stratified constructs. Furthermore, collagen matrices were tested as cell scaffolds.ResultsThe cells were cultured for 180 days; 10 subcultures were established during this period. Stratification was induced in a culture flask and on a collagen matrix. Cytokeratins 7, 8, 17 and 18 were expressed in all cultures, and cell membranes were stable, with no evident de‐differentiation. The cultures were stable in their genotype and no chromosomal aberrations were found. The histology and immunohistochemistry of the stratified porcine constructs, and cell membrane stability and cell de‐differentiation, were compared with those in the human system.ConclusionPig and human urothelial cells can be cultured over a long period with no signs of senescence. Urothelial stratification can be induced in vitro. The collagen matrix seems to be an excellent scaffold, allowing cell adherence and growth.
Pharmacological and urodynamic changes in rat urinary bladder function after multiple pregnancies
Authors: Grandadam  , Lluel  , Palea  , Martin  
Published: March 2003

Objective To investigate the changes in bladder function after multiple pregnancies and parturition in rats, and to establish links between the changes in voiding profiles and in vitro pharmacological responses.Materials and methods Cystometry was used in conscious virgin and multiparous female Wistar rats (2 weeks after the last parturition) with chronically implanted lines to continuously record bladder pressure during five reproducible voiding cycles. In vitro, detrusor muscle contractile responses induced by cumulative concentrations of KCl, carbachol, noradrenaline and α,β‐methylene‐ATP (mATP) were compared.Results In multiparous rats, there was a significant increase in the amplitude of voiding pressure (+31%), bladder capacity (+83%) and residual volume (about threefold); 60% of the multiparous rats but only 10% of the virgin rats showed bladder instability during the filling phase. Cumulative concentration‐response curves to KCl, expressed as the tension developed vs tissue weight, were identical in the two groups of rats. Contractile responses induced by carbachol (0.1–30 μmol/L) were significantly larger in multiparous than in virgin rats. Similarly, noradrenaline‐induced contractions (0.3–10 μmol/L) were significantly higher for multiparous animals. However, the sensitivity of the detrusor muscle to mATP was not modified by multiple pregnancies.Conclusion After multiple gestations, female rats develop bladder hypertrophy, bladder instabilities and a higher amplitude of voiding pressure associated with an increased residual volume. These altered patterns are similar to those found in rats after chronic infravesical outlet obstruction. We propose that pregnancies and parturition modify urinary bladder function, leading to a dysfunction similar to that induced by obstruction, and involving an increased sensitivity to adrenergic and cholinergic stimulation.
A comparison of the sperm mixed‐agglutination reaction test with the peroxidase‐labelled protein A test for detecting antisperm antibodies in infertile men with varicocele
Authors: Isitmangil  , Yildirim  , Orhan  , Kadiogˇlu  , Akinci  
Published: March 2003

Objective To compare the sperm mixed‐agglutination reaction (sMAR) with the peroxidase‐labelled protein A method (POPA) in infertile patients with varicocele.Patients, subjects and methodsThe study comprised 30 men with a history of varicocele‐associated infertility and 30 fertile men (control group). Antisperm antibodies against spermatozoa in the semen and against progenitor spermatozoa in testicular tissue were detected using the two methods.ResultsThe tests were positive in 15 (50%) of patients with both the sMAR and the POPA methods, while no autoantibodies were detected in the control group. There were no significant differences between the methods. The sensitivity and specificity of both tests was ≈93%, with no significant difference between them (P>0.05).ConclusionBoth methods may be used for detecting sperm autoantibodies in infertile patients with varicocele.
The effect of microsurgical varicocelectomy on serum follicle stimulating hormone, testosterone and free testosterone levels in infertile men with varicocele
Authors: Cayan  , Kadioglu  , Orhan  , Kandirali  , Tefekli  , Tellaloglu  
Published: March 2003

ObjectivesTo analyse the effects of varicocelectomy on serum follicle‐stimulating hormone (FSH), testosterone and free testosterone levels, and to investigate the interrelationships between seminal and hormonal variables.Patients and methodsThe records were retrospectively evaluated for 78 infertile patients who underwent microsurgical inguinal varicocelectomy, with documented serum FSH, testosterone, free testosterone levels, sperm concentration and sperm motility before and after surgery. Left and bilateral varicoceles were detected in 40 and 38 patients, respectively. In addition, serum hormonal values of 10 fertile men in whom physical examinations and Doppler ultrasonography revealed no evidence of varicocele were recorded and used as a control group.ResultsThe mean (sd) serum FSH levels of all patients decreased from 15.21 (3.34) before surgery to 10.82 (2.93) mIU/mL afterward (P=0.01), and serum testosterone levels increased from 5.63 (1.40) to 8.37 (2.2) ng/mL (P=0.01), whereas free testosterone levels increased from 23.13 (3.19) to 32.83 (4.37) pg/mL (P<0.001). In contrast to the significant difference in sperm motility before and after surgery of all patients (P<0.01), the difference in sperm count was insignificant (P>0.05). Thirty‐six patients with high serum FSH levels before surgery had significantly lower levels afterward (P=0.001). In this group, the sperm concentration and motility also increased, from 17.66 (4.35) to 20.76 (4.37) million/mL (P=0.05) and from 30.9 (4.4)% to 37.5 (4.34)%, respectively (P=0.01). In the remaining 42 patients who had normal preoperative serum FSH levels, there was a slight decrease after surgery (P=0.02). Their sperm concentration increased slightly (P=0.04), and motility also increased (P=0.001). Sixty patients had a significantly higher testosterone level after surgery; in this group the sperm concentration and motility increased (P=0.01).ConclusionVaricocelectomy promotes Sertoli and Leydig cell function. The significant increase in serum free testosterone level results in a significant improvement in sperm concentration and motility.
Focal changes in nerve, muscle and connective tissue in normal and unstable human bladder
Authors: Charlton  , Morley  , Chambers  , Gillespie  
Published: March 2003

ObjectiveTo compare and quantify, in a morphological study, the changes that occur in the connective tissue elements (elastin and collagen), muscle fibre diameters and nerve densities between normal, idiopathic and neuropathic bladders.Materials and methodsBladder tissue was obtained from 27 patients undergoing cystectomy for carcinoma, from 12 with idiopathic instability and from seven neuropathic patients who were undergoing ileocystoplasty. A combination of histochemical and immunohistochemical techniques were used to detect detrusor muscle, connective tissue and nerve profiles in the bladder tissue.ResultsIn both idiopathic and neuropathic bladder tissue the structural changes were highly punctate. From the density of nerve profiles, three areas were defined: (i) apparently unaffected normal fascicles with a high density of nerves, no hypertrophy of the muscle and no infiltration of elastin and collagen. The nerve density in these areas was similar to that in normal bladder tissue. (ii) Fascicles with a low density of nerve profiles, muscle hypertrophy but no connective tissue infiltration. (iii) Areas with few nerve profiles, muscle hypertrophy and extensive elastin and collagen infiltration within the fascicles. The mean (sem) density of nerve profiles in control tissue was 752 (53) nerves/mm2 and in the idiopathic bladders was 905 (91), 81 (20) and 74 (38) nerves/mm2 in the three defined areas, respectively. In the neuropathic tissues the nerve profile densities were 672 (249), 57 (23) and 37 (28) nerves/mm2 , respectively. Fibre diameter, elastin and collagen content and nerve density were measured in normal and unstable bladder tissue using these three defined areas. The mean (sem) fibre diameter was 6.81 (0.52) in normal bladder; in idiopathic bladder tissue the fibre diameters in the three areas were 6.72 (0.62), 7.06 (0.62) and 7.34 (1.15) μm, respectively, and in neuropathic bladders were 6.75 (0.62), 8.24 (0.62) and 9.35 (0.62) μm, respectively. The relative areas of elastin were 0.79 (0.70), 0.56 (0.45) and 18.3 (4.1)% for the control, normal and affected areas of the neuropathic bladders, respectively, and the relative areas of collagen were 3.5 (1.3), 6.15 (3.6) and 15.7 (5.0)%, respectively. The pattern was similar in idiopathic bladders.ConclusionThese observations suggest that the primary defect in the idiopathic and neuropathic bladders is a loss of nerves accompanied by a hypertrophy of the cells. These changes may continue with further hypertrophy of the cells and an increased production of elastin and collagen within the muscle fascicles.
A comparison of ambulatory and conventional urodynamic studies in men with borderline outlet obstruction
Authors: Rosario  , Macdiarmid  , Radley  , Chapple  
Published: March 2003

ObjectiveTo compare detrusor function and outlet behaviour on ambulatory urodynamic monitoring (AUM) with conventional cystometrography in symptomatic men with borderline evidence of bladder outlet obstruction (BOO), as determined by conventional cystometrography, and to assess the usefulness of AUM in reclassifying this population of patients into obstructed and unobstructed groups.Patients and methodsSixty‐nine consecutive men (mean age 59.6 years) with lower urinary tract symptoms (mean International Prostate Symptom Score 19.1) and borderline BOO on a medium‐fill conventional urodynamic study (CUS) were examined prospectively with AUM. Detrusor contractility, obstruction grade, maximal voiding detrusor pressure (pdetmax), detrusor pressure at peak flow (pdet Qmax) and peak flow rate (Qmax ) determined by both methods were compared. The incidence of detrusor instability (DI) detected by both modalities was also evaluated.ResultsThere was considerable disagreement between the investigations during the voiding phase. Detrusor contractility was higher on AUM than on CUS (P=0.003) and obstruction grade was significantly lower on AUM (P=0.018). There was no difference in pdetmax nor pdet Qmax . The mean (95% confidence interval) Qmax was higher on AUM, at 12.9 (1.3) mL/s, than on CUS, at 8.9 (0.8) mL/s. On the Abrams‐Griffiths nomogram the most significant changes were six men (10%) from equivocal to obstructed, seven (11%) from equivocal to unobstructed and two (3%) from obstructed to unobstructed on CUS and on AUM, respectively. Thus, in 24% of patients there was a potentially clinically significant change resulting from the information generated by AUM. DI was identified on CUS in 26 (41%) men and on AUM in 25 (40%); 35 men (56%) had evidence of DI on either AUM or CUS.ConclusionThe significant disagreement between the findings on CUS and AUM suggests that the conditions under which pressure‐flow investigations are carried out significantly affect findings in borderline cases. The reclassification of patients by AUM into obstructed and unobstructed groups occurs in 24% and may be clinically relevant. AUM appears to be complementary to CUS in the assessment of men who are borderline for obstruction on conventional testing, but the clinical implications of this have yet to be determined.
The responsiveness of the ICSmale questionnaire to outcome: evidence from the ICS‐‘BPH’ study
Authors: Donovan  , Brookes  , De La Rosette  , Peters  , Porru  , Kondo  , Dabhoiwala  , Millard  , Bosch  , Nordling  , Matos Ferreira  , Höfner  , Mostafid  , Walter  , Nissenkorn  , Frimodt Moller  , Mendes Silva  , Chapple  , Abrams  
Published: March 2003

Objective To evaluate the responsiveness of the ICSmale questionnaire to the outcome of treatments for lower urinary tract symptoms (LUTS). Patients and methods Consecutive men aged >45 years attending 23 urology centres in 12 countries, with symptoms suggestive of bladder outlet obstruction secondary to benign prostatic hyperplasia (BPH), were recruited to Phase I of the International Continence Society (ICS)‐‘BPH’ study. In Phase II of the ICS‐‘BPH’ study, 355 men in 15 centres in nine countries were followed up, having proceeded to treatment according to clinical practice. All men completed the ICS‐‘BPH’ study questionnaire at baseline and follow‐up, including the ICSmale which concerns LUTS and related problems. Results Patients included in Phase II were similar to those in Phase I according to age and levels of baseline symptoms. Patients received a range of treatments: 32% TURP, 29% drug therapies, 20% watchful waiting, 9% minimally invasive therapies and 10%‘others’ (including open prostatectomy). For patients who underwent TURP, most LUTS, including voiding and filling symptoms, were highly statistically significantly better at follow‐up than at baseline (P<0.0001). For drug, minimally invasive and ‘other’ treatments, fewer LUTS were highly statistically significantly better. For those undergoing watchful waiting, no symptoms were significantly different between baseline and follow‐up. Conclusion The ICSmale questionnaire, in addition to being psychometrically valid and reliable, is responsive to change in outcome.
The effects of experimental varicocele on testicular histology and fertility in monorchic adult rats
Authors: Asci  , Sarikaya  , Büyükalpelli  , Yilmaz  , Yildiz  
Published: March 2003

ObjectiveTo determine the effects of a left‐sided experimental varicocele on testicular morphology and fertility in right hemicastrated adult rats.Materials and methodsA double‐controlled experimental study was carried out using mature Sprague‐Dawley rats, with 12 rats in each treated group and five corresponding controls. Group 1 underwent right orchidectomy, group 2 right orchidectomy and a left varicocele, and group 3 only a left varicocele; each control group underwent a corresponding sham operation. Two months after surgery each rat was placed with two mature female rats for one month to assess fertility. All the rats were then killed and their testes weighed; the mean testicular weight was calculated for each group and the mean seminiferous tubule diameter (STD) measured. Johnsen scores and histological abnormalities were evaluated for each testis using light microscopy.ResultsThe mean (sem) testicular weight and STD in group 2 were significantly lower, at 1311 (100) mg and 225 (11) μm, respectively, than in group 1, at 1771 (28) mg and 255 (4) μm (P<0.05). The mean weights of both testes in rats in group 3 were significantly lower than those in group 1 (P<0.05) and although both mean STDs were less than in group 1, the differences were not significant (P>0.05). There were no differences between the Johnsen scores in groups 2 and 3. There were severe histological abnormalities in the left testes in three of nine and two of eight animals in group 2 and 3, respectively; in group 3, changes in the right testis were detected in one rat. Six of nine and seven of eight rats were fertile in group 2 and 3, respectively.ConclusionExperimental left varicocele decreased the left testicular weight and STD in both hemicastrated and intact adult rats. However, the presence of the right testis is important for preserving fertility.
The effects of long‐term oral administration of l‐arginine on the erectile response of rabbits with alloxan‐induced diabetes
Authors: Yildirim  , Ayan  , Sarioglu  , Gültekin  , Bütüner  
Published: March 2003

ObjectiveTo investigate the effects of the long‐term oral administration of l‐arginine on the impaired neurogenic and endothelium‐dependent relaxation responses of corpus cavernosum smooth muscle from alloxan‐induced diabetic rabbits.Materials and methodsThirty‐two New Zealand white rabbits were used in four groups of eight each. In group 1, the rabbits received no treatment after the induction of diabetes with alloxan hydrochloride given intravenously; in group 2, l‐arginine (1 mg/mL) was administered orally after the induction of diabetes; in group 3, 6 U/day of insulin was injected subcutaneously; group 4 was maintained with no treatment (as litter‐mate controls) for 8 weeks. Thereafter, the rabbits were killed by exsanguination and the penis removeden bloc. The reactivity of corpus cavernosum strips from the penis was then assessed in organ chambers.ResultsRelaxation and contraction responses of corpus cavernosum strips to sodium nitroprusside and potassium chloride, respectively, were similar in all groups. Relaxation responses of corpus cavernosum strips elicited by electrical field stimulation and carbachol from rabbits in group 1 were less than in controls; the responses to carbachol were not significantly impaired in group 2 and 3, whereas responses to electrical field stimulation were impaired in both groups when compared with the control group.ConclusionThe impairment of endothelium‐dependent and nerve‐mediated relaxation by diabetes appears to involve an alteration in nitric oxide/cyclic GMP pathway. Administration of oral l‐arginine increased endothelium‐dependent relaxation, probably through activating nitric oxide synthase. Additionally, decreasing elevated blood glucose concentration and advanced glycosylation products by insulin treatment protected endothelium‐dependent relaxation, whereas neither l‐arginine nor insulin treatment restored impaired neurogenic relaxation.