bluuebunny/crossref_metadata_2025_split huggingface dataset:
Long‐term outcome of antiandrogen monotherapy in advanced prostate carcinoma: 12‐year results of a phase II study
Authors: Serretta V. , Daricello G. , Dispensa N. , Allegro R. , Pavone C. , Pavone‐Macaluso M. 
Published: September 2003

OBJECTIVETo present the long‐term outcome of patients with locally advanced or metastatic prostate carcinoma treated by first‐line antiandrogen monotherapy.PATIENTS AND METHODSFrom 1983 to 1990, 41 patients with advanced prostate carcinoma were treated with flutamide monotherapy until progression or the appearance of toxicity. Twenty‐five patients (61%) had T3‐T4N0M0 and 16 (39%) T2–4N0–3M1 prostate carcinoma. Consensus criteria were adopted to evaluate the response. Plasma testosterone and sexual function were recorded for the first 3 years.RESULTSFlutamide was administered for up to 147 months; seven patients (17%) interrupted the treatment because of toxicity. There was an objective response in 17 (41%) patients; 20 (49%) had stable disease while four (10%) progressed. There were objective responses, lasting up to 150 months, in 82% of those with M0 and in 18% with M1 disease (P = 0.05). The median time to progression in patients with an objective response and stable disease was 45 and 16 months, respectively (P < 0.001). Thirty‐one patients (76%) died from prostate cancer and 10 (24%) from unrelated diseases. The median survival was 67 and 36 months in patients with an objective response and stable disease, respectively (P < 0.001). There was an improvement in performance status in 85% and reduction in bone pain in 83% of the patients; sexual activity was maintained in 63%.CONCLUSIONMonotherapy with flutamide is well tolerated. Objective responses are more frequent in patients with locally advanced disease. Patients with an objective response within 6 months have a prolonged progression‐free and overall survival.
Surface modification to improve in vitro attachment and proliferation of human urinary tract cells
Authors: Marcovich R. , Seifman B. , Beduschi R. , Wolf J.S. 
Published: September 2003

OBJECTIVETo evaluate the attachment and proliferation of cultured human urinary tract cells to culture plates surface‐modified by photochemical immobilization of extracellular matrix (ECM) proteins.MATERIALS AND METHODSHuman uroepithelial (UEC) and smooth muscle (SMC) cells were harvested from ureter and expanded in culture; 24‐well culture plates surface‐modified by photochemical covalent immobilization of ECM proteins were then seeded with UEC or SMC. To characterize cellular attachment, cells were incubated on surface‐modified plates for 30 and 90 min. For proliferation assays the cells were incubated for 3–12 days. Standard tissue culture plates with no surface modification and sham‐modified plates served as controls. Differential attachment and proliferation on the various surfaces were assessed using analysis of variance with Fisher's posthoc test for multiple comparisons.RESULTSAttachment at 30 and 90 min of both UEC and SMC on plates surface‐modified with ECM proteins was significantly greater than in control plates. Surface‐modification with collagen resulted in significantly greater cellular attachment than with either laminin or fibronectin. UEC proliferation was also significantly greater than in control plates by surface‐modification with collagen and fibronectin, but not with laminin. SMC proliferation was significantly better after surface modification than on sham‐ modified plates, but was no better than standard plates.CONCLUSIONSCovalent photochemical immobilization of ECM proteins to potential growth surfaces enhances the attachment of cultured UEC and SMC and the proliferation of UEC. This technique might be useful in modifying surface properties of synthetic polymer‐based materials in a controlled and defined manner, giving them the capacity to promote and sustain the growth of urinary tract cells. This may lead to development of alternative methods of tissue engineering in the urinary tract.
Bladder wall tension during physiological voiding and in patients with an unstable detrusor or bladder outlet obstruction
Authors: Bross S. , Braun P.M. , Michel M.S. , Juenemann K.P. , Alken P. 
Published: September 2003

OBJECTIVETo develop and evaluate a new clinical method for measuring bladder wall tension (BWT) on detrusor contraction during physiological voiding and under pathological conditions, as in experimental trials during subvesical obstruction the ability to generate pressure increases, whereas the contractile force per cross‐sectional area of detrusor muscle decreases.PATIENTS AND METHODSIn all, 24 patients were divided into three equal groups: group 1 (mean age 58, sd 8.6 years) comprised men with bladder outlet obstruction in accordance with the Abrams‐Griffiths nomogram; group 2 (four men and four women, 56, sd 7.2 years) had detrusor instability; and group 3 (54, sd 9.6 years) had normal bladder emptying. BWT, as the detrusor force per cross‐sectional area of bladder tissue (in N/cm2), was calculated after a urodynamic evaluation and ultrasonographic estimate of bladder wall thickness.RESULTSIn all patients it was possible to measure BWT; the mean (sd) maximum BWT in group 1 was 9.8 (3.9) N/cm2, in group 2 during bladder instability was 11.7 (2.6) N/cm2 and in group 3 was 2.8 (0.5) N/cm2.CONCLUSIONSEstimating BWT in humans is possible by combining a urodynamic evaluation with an ultrasonographic estimate of bladder wall thickness. Further clinical research should elucidate the clinical relevance of BWT under comparable conditions.
Holmium laser prostatectomy
Authors: Tan A.H.H. , Gilling P.J. 
Published: September 2003

There are three very different topics presented in this section. The authors from Tauranga, New Zealand, who write about holmium laser prostatectomy, have the largest series in the world and were the instigators of this type of treatment for BPH. They address the pros and cons of treating prostatic enlargement in this way and update the reader on the results.Urinary markers for urothelial cancer have been introduced in some numbers in recent years. That so many have been developed leaves one with the feeling that none is completely reliable. The importance to urologists of a urinary marker of any malignancy is clear, and the authors from Ankara review this interesting topic.The management of erectile dysfunction is gradually becoming less invasive and less complicated for patients, but is still very important to urologists worldwide. Many new types of treatment have been recently introduced, and there appear to be more on the way. The authors from New York review the newer agents used for the treatment of sexual dysfunction.
Mentored retroperitoneal laparoscopic renal surgery in children: a safe approach to learning
Authors: Farhat W. , Khoury A. , Bagli D. , McLorie G. , El‐Ghoneimi A. 
Published: September 2003

Minimally invasive surgery is not exclusive to the treatment of adult conditions. It has also been used in paediatric urology, and the authors from Toronto and Paris describe a mentorship‐training model for laparoscopic retroperitoneal surgery. They confirmed that a mentored approach is the way to develop this procedure. They also found that ablative procedures are learned relatively early, but that reconstructive procedures require a high degree of skill in laparoscopic techniques, requiring formal training focusing mainly on suturing techniques.OBJECTIVETo review the feasibility of introducing advanced retroperitoneal renal laparoscopic surgery (RRLS) to a paediatric urology division, using the mentorship‐training model. Although the scope of practice in paediatric urology is currently adapting endoscopic surgery into daily practice, most paediatric urologists in North America have had no formal training in laparoscopic surgery.METHODSThe study included four paediatric urologists with 3–25 years of practice; none had had any formal laparoscopic training or ever undertaken advanced RRLS. An experienced laparoscopic surgeon (the mentor) assisted the learning surgeons over a year. The initial phases of learning incorporated detailed lectures, visualization through videotapes and ‘hands‐on’ demonstration by the expert in the technique of the standardized steps for each type of surgery. Over 10 months, ablative and reconstructive RRLS was undertaken jointly by the surgeons and the mentor. After this training the surgeons operated independently. To prevent lengthy operations, conversion to open surgery was planned if there was no significant progression after 2 h of laparoscopic surgery.RESULTSOver the 10 months of mentorship, 36 RRLS procedures were undertaken in 31 patients (28 ablative and eight reconstructive). In all cases the mentored surgeons accomplished both retroperitoneal access and the creation of a working space within the cavity. The group was able to initiate ablative RRLS but the mentor undertook all the reconstructive procedures. After the mentorship period, over 10 months, 12 ablative procedures were undertaken independently, and five other attempts at RRLS failed.CONCLUSIONAlthough the mentored approach can successfully and safely initiate advanced RRLS in a paediatric urology division, assessing the laparoscopic practice pattern after mentorship in the same group of trainees is warranted. Ablative RRLS is easier to learn for the experienced surgeon, but reconstructive procedures, e.g. pyeloplasty, require a high degree of skill in laparoscopic technique, which may only be acquired through formal training focusing primarily on suturing techniques.
Urinary morbidity after 125I brachytherapy of the prostate
Authors: Mallick S. , Azzouzi R. , Cormier L. , Peiffert D. , Mangin PH. 
Published: September 2003

OBJECTIVETo assess urinary morbidity within the first 6 months after transperineal prostate brachytherapy (TPBT) with 125I for localized prostate adenocarcinoma.PATIENTS AND METHODSBetween September 2000 and July 2001, 50 consecutive patients with favourable early‐stage prostate cancer were treated with TPBT. Clinical and objective investigations, including uroflowmetry and postvoid residual urine measurements, were evaluated for short‐term urinary morbidity; predictive factors were also sought.RESULTSThirty‐eight (76%) patients developed urinary disorders, but severe urinary complications were exceptional. The International Prostate Symptom Score (IPSS) changed significantly during the first and third month after implantation and then improved during the sixth month. Concomitantly, the maximum and the average urinary flow rate deteriorated significantly. The variations in postvoid residual were less significant. An initial IPSS of> 8 and previous α‐blocker treatment were identified as significant predictive factors of urinary morbidity, as were the TPBT dose received by 90% of the target volume and by 30% of the urethra, and the volume of prostate receiving 144 Gy.CONCLUSIONUrinary morbidity after TPBT is frequent but rarely exceptionally severe; patients must therefore be given full information. Patients with a higher initial IPSS or having had previous α‐blocker treatment, with their associated dosimetric factors, are at greater risk of these urinary morbidity.
The role of self‐help groups in educating and supporting patients with prostate cancer and interstitial cystitis
Authors: Breau R.H. , Norman R.W. 
Published: September 2003

OBJECTIVESTo identify and compare the needs of patients with prostate cancer or interstitial cystitis (IC), and to evaluate the role of self‐help groups (SHGs) in meeting those needs, as SHGs are thought to be an important source of information and social support for such patients.METHODSThe authors attended SHG meetings for prostate cancer and IC from September 2000 to May 2001. Issues related to SHGs were addressed by combining their experiences with those published previously.RESULTSPatients with prostate cancer appear to use SHGs primarily as a medium for advocacy and information sharing about the disease, whereas patients with IC seem to use SHGs for social support and coping skills. Patients perceive SHGs as being useful, but many do not attend these meetings. Urologists’ attitudes toward SHGs are identified as a potential factor contributing to the under‐use of SHGs by both groups of patients.CONCLUSIONSThe inherent differences in disease and patient characteristics result in both groups of patients using SHGs for different reasons. The differences in therapeutic objectives are reflected in the format and content of SHG meetings. Issues related to not participating in SHGs and areas of future research are discussed.
Prostatic epithelial and luminal area in the transition zone acini: morphometric analysis in normal and hyperplastic human prostate
Authors: Babinski M.A. , Chagas M.A. , Costa W.S. , Sampaio F.J. 
Published: September 2003

OBJECTIVETo analyse quantitatively the acini and changes in the acinar epithelium and lumen in the transitional zone of normal and hyperplastic human prostates.PATIENTS AND METHODSTissue samples of the transitional zone were taken from prostates with benign prostatic hyperplasia (BPH) obtained from 20 patients with clinical symptoms of bladder outlet obstruction who underwent open prostatectomy. The control tissue comprised 20 transitional zones of prostates obtained during autopsy of adults aged < 30 years (killed in accidents). The following variables were measured; the number of acini, total acinar area, area of the lumen, epithelial area, and the median (range) epithelial height, using computerized histomorphometric techniques.RESULTSThe total area of the acini and the luminal area was statistically significantly greater in BPH. In normal and hyperplastic prostates, respectively, the total mean (sd) area (mm2) of the acini was 0.041 (0.007) and 0.056 (0.016), of the lumen was 0.016 (0.003) and 0.036 (0.013), and of the epithelium was 0.025 (0.004) and 0.019 (0.003) (all P < 0.001). There was no statistically significant difference in the number of acini between controls and BPH. The area and the height of the acinar epithelium was statistically significantly greater in BPH; for epithelial height (µm) in normal and BPH tissue, respectively the minimum height was 9.92 (1.67) and 6.45 (1.14), the maximum 54.38 (4.09) and 41.52 (4.51) and the median 27.89 (2.48) and 19.96 (2.20) (all P < 0.001).CONCLUSIONSThere was no significant difference in the number of acini between control and BPH tissue, but the area and the height of the acinar epithelium was significantly lower in BPH.
Disturbed pituitary‐testicular axis inhibits testicular descent in the prenatal rat
Authors: Shono T. , Suita S. 
Published: September 2003

OBJECTIVETo investigate whether prenatal stress affects the pituitary‐testicular axis in relation to testicular descent in rat fetuses, as maternal stress can alter the plasma testosterone concentration and inhibit testicular descent in male rat fetuses.MATERIALS AND METHODSPregnant rats were divided into two groups and kept in reverse light‐dark cycles, with lights‐off at 08.00 hours and on at 20.00 hours. In group 1, 15 pregnant females were placed three times daily for 60 min each session in plastic rat‐holders (13 × 6 × 8 cm) illuminated by two 150‐W flood lights during the dark phase, from day 14 to 18 of gestation. In group 2, 10 pregnant females were not handled and thus were used as controls. At 19 days of gestation, five pregnant rats had a Caesarean section in each group, and both testes and the pituitary gland were removed from male fetuses at 10.00–11.00 hours. The tissue homogenates were analysed for testicular testosterone and pituitary luteinizing hormone (LH) by a radioimmunoassay. Thereafter, at 21 and 30 days of age, testicular descent was assessed in the remaining male offspring. Student'st‐ and the chi‐square test were used to assess the results.RESULTSThe mean (sd) concentration of fetal testicular testosterone was significantly lower in group 1, at 312.9 (26.2) pg/mg, than in group 2, at 532.5 (18.2) pg/mg (P < 0.05); that of pituitary LH was also significantly lower in group 1, at 130.6 (22.7) and 295.6 (35.2) pg/mg, respectively (P < 0.05). The completion rate of testicular descent was 14% in group 1 (36 male rats) and 64% in group 2 (28 male rats) at 21 days old, and thereafter they were 81% and 100%, respectively, at 30 days old (P < 0.05).CONCLUSIONMaternal stress might inhibit the pituitary‐testicular axis, thereby resulting in abnormal testicular descent in male fetuses.
Urethrocutaneous fistula repair after hypospadias surgery
Authors: Cimador M. , Castagnetti M. , De Grazia E. 
Published: September 2003

OBJECTIVETo evaluate and compare the success rates of simple and layered repairs of urethrocutaneous fistulae after hypospadias repair.PATIENTS AND METHODSThe charts of 72 children who developed fistulae after hypospadias repair were reviewed; 39 had a simple closure of the fistula, whereas 32 had a ‘pants over vest’ repair, in all cases after excluding an impairment of urine outflow.RESULTSThe success rate at the first attempt was 74% for simple closure and 94% for the layered repair; at the second attempt it was 80% and 100%, the difference being statistically significant for both repairs.CONCLUSIONSAlthough probably far from an optimal technique for repairing urethrocutaneous fistulae, the pants‐over‐vest repair allows a good success rate for penile shaft fistulae.
Open mini‐access ureterolithotomy: the treatment of choice for the refractory ureteric stone?
Authors: Sharma D.M. , Maharaj D. , Naraynsingh V. 
Published: September 2003

OBJECTIVETo report the experience in one centre of the efficacy and safety of open mini‐access ureterolithotomy (MAU) and to discuss relevant current indications.PATIENTS AND METHODSMAU was undertaken in 112 patients (mean age 38 years, range 26–57) between 1991 and 2001; the details and outcomes are reviewed. The mean (range) stone size was 12 (8–22) mm, with 30 stones in the upper, 69 in the mid‐ and 13 in the lower ureter. In 15 cases the stones were impacted and there were signs of infection in the proximal ureter.RESULTSMAU was successful in 111 patients; the one failure was caused by proximal stone migration early in the series. The mean (range) operative duration was 28 (10–44) min and the hospital stay 42 (24–72) h; 33 patients were in hospital for 24 h, 72 for 48 h and seven for 72 h. The blood loss was minimal, at 50 (30–150) mL. The drain was removed after 5 (5–7) days. Patients reported using opioid or nonsteroidal anti‐inflammatory analgesia for a mean of 4 (1–7) days after surgery. The mean time to resumption of work was 16 (8–35) days.CONCLUSIONSMAU is a safe and reliable minimally invasive procedure; its role is mainly confined to salvage for failed first‐line stone treatments but in selected cases, where a poor outcome can be predicted from other methods, it is an excellent first‐line treatment.
Neurotrophic effects of vascular endothelial growth factor and neurotrophins on cultured major pelvic ganglia
Authors: Lin G. , Chen K.C. , Hsieh P.S. , Yeh C.H. , Lue T.F. , Lin C.S. 
Published: September 2003

In a study by researchers from San Francisco and Taiwan, a ganglial culture system is used to screen various growth factors. The aim was to assess these growth factors as possible therapeutic agents for pelvic floors nerve injuries. They found that vascular endothelial growth factor causes a marked neurotrophic effect.Other researchers from Ann Arbor describe a method of immobilising extracellular matrix proteins to potential growth surfaces, and found that this enhances the attachment of cultured cells. They felt that this might lead to the development of other methods of tissue engineering.The authors from Japan describe a study wherein they investigated whether prenatal stress affected the pituitary‐testicular axis and thus testicular descent in rat fetuses; they report that this may indeed be the mechanism.OBJECTIVETo investigate the feasibility of using a ganglial culture system to screen various growth factors as potential therapeutic agents for pelvic nerve injuries.MATERIALS AND METHODSThe major pelvic ganglia (MPG) were isolated from male rats and attached to culture dishes with the aid of MatrigelTM (Becton Dickinson, Mountain View, CA, USA). Alternatively, the dorso‐caudal region (DCR) of MPG, from which the cavernous nerves originate, was dissected and then attached to a Matrigel‐coated coverslip. The MPG or DCR was cultured in serum‐free medium supplemented with phosphate‐buffered saline (PBS, control), 50 ng/mL of vascular endothelial growth factor (VEGF), 20 ng/mL of a neurotrophin (BDNF, NT3, or NT4), or combinations of these growth factors. After 2 days of incubation, the ganglial tissues with their outgrowing nerve fibres were stained for the expression of NADPH‐diaphorase, tyrosine hydroxylase (TH) and acetylcholinesterase (AChE). The length and staining intensity of nerve fibres were analysed.RESULTSThe outgrowing fibres were significantly longer in MPG treated with any of the four tested growth factors than in PBS‐treated MPG. The combination of VEGF and NT3 induced the best fibre growth. Improvements to the culturing conditions allowed a histological examination of the outgrowing fibres for the expression of nitric oxide synthase (NOS), TH and AChE. VEGF and BDNF were equally capable of inducing NOS‐ and TH‐expressing fibres. BDNF was much weaker than VEGF for inducing AChE‐expressing fibres.CONCLUSIONSThis improved culturing system is potentially useful for screening nerve‐regenerating factors; VEGF had neurotrophic effects comparable with BDNF, NT3, or NT4.
Effectiveness of intravesical resiniferatoxin in treating detrusor hyper‐reflexia and external sphincter dyssynergia in patients with chronic spinal cord lesions
Authors: Kuo H.‐C. 
Published: September 2003

OBJECTIVETo investigate the therapeutic effect of resiniferatoxin in patients with chronic spinal cord lesions, as detrusor hyper‐reflexia and external sphincter dyssynergia (DESD) are common phenomenon in such patients.PATIENTS AND METHODSTwenty patients with chronic spinal cord lesions and DESD refractory to anticholinergic treatment were enrolled in a prospective study. They were treated with 30 mL of 10 µmol/L resiniferatoxin for 30 min. Four types of response were recorded during instillation: type 1, a sustained high‐pressure detrusor contraction followed by complete acontractility; type 2, a high‐pressure contraction followed by progressively lower contractions; type 3, intermittent high‐pressure detrusor contractions throughout the instillation; type 4, intermittent low‐pressure detrusor contractions. The changes in clinical symptoms and urodynamics at baseline, during resiniferatoxin instillation and 1 month after treatment were compared.RESULTSAll patients had DESD and 10 had autonomic dysreflexia; 18 had urinary incontinence and 13 had difficult urination. Continence and/or difficult urination improved in 12 patients, including all five with type 1, four with type 2, two with type 3 and only one with a type 4 response. Four patients became dry during the day and eight had less urgency and fewer incontinence episodes, and a significantly increased voided volume. Of the 13 patients who complained of difficult urination, eight had an improvement either by spontaneous voiding (five) or the Crede manoeuvre to voiding (three). The mean (sd) maximum cystometric capacity increased significantly after treatment, from 102.1 (31.5) to 236.6 (88.6) mL (P < 0.001), but the detrusor pressure showed no significant change, at 55.9 (23.2) to 47.5 (28.1) cmH2O. The external urethral sphincter showed intermittent activity during reflexic detrusor contractions at baseline.CONCLUSIONResiniferatoxin at 10 µmol/L has a clinical effect on two‐thirds of patients with a spinal cord lesion and detrusor hyper‐reflexia, but not on the DESD. The initial response to resiniferatoxin instillation might predict a favourable therapeutic outcome.