bluuebunny/crossref_metadata_2025_split huggingface dataset:
Urological complications of coitus
Authors: Eke N. 
Published: March 2003

Objective To ascertain the urological complications of coitus, as the proximity of the lower urinary tract to the organs of coitus exposes the tract to coital trauma. Materials and methods Medline was searched from 1966 to 2000 to identify reports on coital injuries. Publications and relevant references were retrieved. Those reporting urological complications were selected for analysis. Results In all, 1454 cases of reported coital injuries were reviewed; 790 occurred in men while 664 occurred in women, mainly in the genital area. Physical urological complications were more common in men than in women. The injuries were often sustained during voluntary coitus, but one penile fracture was sustained during an attempted rape. The presentations included penile swellings and deviations, haemorrhage, erectile dysfunction and urinary incontinence. Complications included vesicovaginal fistulae, bladder and cavernosal ruptures, and urinary tract infections. Rare complications included isolated rupture of the penile vasculature. Major risk factors included penovaginal disproportion, excessive force at coitus, urethral coitus, fellatio and anal intercourse. Urethral injuries were the commonest complications; in men these were associated with 10–38% of penile fractures. The treatments included cold compress and anti‐inflammatory agents in contusions, repairs of lacerations, closure of fistulae and urethral and vaginal reconstruction. The results of treatment were essentially good. Recurrent penile fractures were reported. Conclusion Coitus, although pleasurable, may be risky. The complications have been termed ‘faux pas’ implying that they are preventable. While the ultimate prevention is abstinence, this is an unrealistic prescription. Therefore, efforts are necessary to identify risk factors to enable preventive strategies.
Clinicopathological features of prostate cancer in Jamaican men
Authors: Shirley S.E. , Escoffery C.T. , Sargeant L.A. , Tulloch T. 
Published: March 2003

Objective To document the clinicopathological features of prostate cancer in a cohort of Jamaican men, and to determine which of these features are of prognostic significance in this population. Patients and methods The clinical and pathological findings in 99 patients with prostate cancer (diagnosed consecutively after biopsy, in the Department of Pathology at the University of the West Indies) between 1993 and 1997 were reviewed retrospectively. Biopsy specimens included 74 needle biopsies and 25 transurethral resection (TUR) specimens. Results The mean age at diagnosis was 72.3 years and 79 patients (80%) were symptomatic. The median (range, interquartile range) serum prostate‐specific antigen (PSA) value at diagnosis was 37 (1–2100, 2–750) ng/mL; 63% of the patients had clinical stage T1 or T2 disease. Most (60%) of the cancers had a Gleason score of 8–10. Perineural invasion was present in a third of cases overall; high‐grade prostatic intraepithelial neoplasia and periprostatic involvement were present in 18% and 8% of biopsies, respectively. The median percentage involvement of all biopsy samples was 37%, that for needle biopsies 47% and for TUR specimens 14%. Of the 90 patients with complete follow‐up data, 37 (41%) died; the cause was progressive disease in 19 (51%). The mean (sd, range) survival was 41.3 (19.7, 1–73) months. On univariate analysis, age, PSA level, tumour stage, Gleason score, perineural involvement and periprostatic involvement were significantly associated with an increased risk of dying from prostatic cancer; in a multivariate model, PSA and tumour stage (4 vs 1) were the only independent factors. Conclusions The mean PSA values at the time of diagnosis, the median percentage of biopsy involvement by cancer and the number of patients with tumours of high histological grade were comparatively high, probably reflecting the patients' relatively late clinical presentation. Established prognostic markers were predictive of the risk of death from prostate cancer.
Behavioural problems in children with urge incontinence and voiding postponement: a comparison of a paediatric and child psychiatric sample
Authors: Von Gontard A. , Lettgen B. , Olbing H. , Heiken‐Löwenau C. , Gaebel E. , Schmitz I. 
Published: March 2003

ObjectiveTo analyse prospectively the incidence of behavioural disorders and the subjective views of children with urge incontinence (defined by detrusor instability, sudden urge symptoms and frequent micturitions) and voiding postponement (characterized by delayed micturition in typical situations and a low voiding frequency) according to an identical protocol in a paediatric and a child psychiatric unit.Patients and methodNinety‐four consecutive or randomly selected children aged 5.0–10.9 years with either voiding postponement (52) or urge incontinence (42) were examined prospectively using an intelligence test (CFT1 or CFT20), the Child Behaviour Checklist (CBCL 4/18), the ICD‐10 child psychiatric diagnoses and a structured interview.ResultsIn the groups from both centres combined, those postponing voiding had a significantly higher incidence of externalizing behavioural symptoms (31% vs. 8%; P<0.01) and total problems (37% vs. 13%; P<0.05) in the clinical range (CBCL), and a higher rate of at least one ICD‐10 child psychiatric diagnosis (54% vs. 29%P<0.05) and of expansive disorders (31% vs. 5%; P<0.01). The incidence of children with behavioural symptoms was lower in the paediatric centre, being exceptionally low among urge incontinent children (only 6%, CBCL). In contrast, from the children’s subjective appraisal, there were no significant differences in concepts, explanations and implications of wetting; 79% of urge incontinent children and 64% of those postponing voiding suffered emotionally from the adverse effects of wetting. Only a minority (3% vs. 6%) saw any advantages at all.ConclusionChildren with voiding postponement had a significantly higher incidence of behavioural problems, especially expansive/externalizing behaviour, 3–4 times higher than in the normal population. Children with urge incontinence had a significantly lower incidence of behavioural problems, mainly emotional/internalizing behaviour, that was only slightly higher (1–2 times) than that in the normal population. Because of selection, similar trends but lower incidences were found in the paediatric setting, with very few problems among urge incontinent children. In contrast, the children’s subjective views did not differ; disadvantages associated with emotional suffering were reported by all children.
Increased expression of substance P receptor‐encoding mRNA in bladder biopsies from patients with interstitial cystitis
Authors: Marchand  , Sant  , Kream  
Published: March 2003

Objectives To determine whether substance P (SP, also known as neurokinin 1, NK1) receptors are differentially expressed in bladder biopsies from patients with interstitial cystitis (IC) compared with matched controls.Materials and methodsCold‐cup biopsies were taken during routine diagnostic cystoscopy. NK1‐receptor expression was assessed using a quantitative analysis of NK1‐receptor‐encoding mRNA in bladder biopsies from patients and controls using in situ hybridization histochemistry (ISHH) combined with autoradiographic image analysis.ResultsAutoradiographic signal indicating the presence of NK1‐encoding mRNA was localized to detrusor muscle, urothelium and vascular structures. In the bladder vasculature, the signal was predominantly associated with endothelial cells. NK1 receptor‐encoding mRNA within the vascular endothelium was increased in the biopsies obtained from patients with IC.ConclusionIncreased levels of NK1 receptor‐encoding mRNA within the bladder vascular endothelium suggests the up‐regulation of NK1 receptor as a putative factor in the pathogenesis of pain related to IC. Increased responsiveness to SP released from the perivascular sensory terminals may result in a local cascade of neurogenic inflammatory responses which trigger the pathophysiological changes, including pain, characteristic of IC.
Reducing artefacts in ambulatory urodynamics
Authors: Salvatore  , Khullar  , Anders  , Cardozo  
Published: March 2003

Objective To compare the diagnoses derived from a retrospective analysis of 50 ambulatory urodynamic recordings, unaware of the final diagnosis, and to evaluate the importance of the symptom diary and the presence of two transducers in the bladder rather than one.Patients and methods Fifty women underwent ambulatory urodynamics (duration 4 h) after video cysto‐urethrography. A single solid‐state microtip pressure catheter was inserted with both transducers inside the bladder, and another was inserted in the rectum. The women were asked to complete a symptom diary and the results were analysed with the active participation of the patient. Detrusor ‘instability’ was diagnosed on ambulatory urodynamics if there was a simultaneous increase in detrusor pressure and in the ‘urethral’ line in the presence of symptoms (urgency or leakage). All 50 recordings were analysed retrospectively in four combinations, i.e. with and without the additional ‘urethral’ line displayed on the screen and with and without the diary information. The total number of detrusor contractions was then calculated for each reading and ‘abnormal detrusor activity’ diagnosed when a contraction occurred with or without symptoms as recorded in the diary. The final diagnosis for each reading was then compared with that made at the time of the test with the patient present.Results Using the information from the diary reduced the number of pressure rises classified as ‘abnormal detrusor activity’ by 58%; using a second bladder pressure transducer further reduced the number of pressure rises classified as ‘abnormal’ by 19%. Overall, using both techniques together reduced the number of spurious pressure rises misclassified as ‘abnormal detrusor activity’ by 64%.Conclusions Both the symptom diary and the placement of two transducers in the bladder can decrease, by almost two‐thirds, the diagnosis of pathological detrusor activity on ambulatory urodynamics.
Immunotherapy of advanced prostate cancer: a phase I/II trial using Mycobacterium vaccae (SRL172)
Authors: Hrouda  , Baban  , Dunsmuir  , Kirby  , Dalgleish  
Published: March 2003

Objective To assess whether a new heat‐killed Mycobacterium vaccae preparation (SRL172), which enhances cell‐mediated immunity and has been proposed for use as an immunotherapeutic agent against cancer, is safe in patients with advanced hormone‐refractory prostate cancer, can stimulate desirable cytokine changes in these patients and modulate the progression of the disease.Patients and methods Ten patients were given SRL172 intradermally at regular intervals. The serum prostate specific antigen (PSA) level was used as a surrogate marker of response. The proportion of peripheral blood mononuclear cells (PBMC) secreting interleukin 2 (IL2), interferon gamma (IFNγ) and interleukin 4 (IL4) was measured by flow cytometry (FACS) before and after vaccination to assess whether the treatment induced a Th2 (predominantly humoral) to Th1 (predominantly cell‐mediated) switch.Results There were no significant adverse events. In five patients the serum PSA declined during the trial and in two of these there was no concomitant change of therapy apart from vaccination with SRL172. Before vaccination with SRL172 patients had a low proportion of PBMC producing IFNγ and IL2 (all 10) and a higher proportion secreting IL4 (all three tested), suggesting a predominantly Th2 cytokine profile. After vaccination the proportion of IL4 secreting PBMC fell in all three patients tested. The proportion of IL2 secreting PBMC increased in three patients whose PSA fell. The proportion of IFNγ‐secreting cells remained depressed in nine of 10 patients.Conclusion Two patients with advanced hormone‐refractory prostate cancer had a PSA response to the vaccination with SRL172. The proportion of PBMC secreting IL2 is a potential marker of response to immunotherapy.
The management of vesical calculi with combined optical mechanical cystolithotripsy and transurethral prostatectomy: is it safe and effective?
Authors: Asci  , Aybek  , Sarikaya  , Büyükalpelli  , Yilmaz  
Published: March 2003

ObjectivesTo investigate the effectiveness and reliability of the combination of optical mechanical cystolithotripsy (OMC) and transurethral prostatectomy (TURP) for the treatment of bladder calculi and obstructive benign prostatic enlargement (BPE).Patients and methodsFrom December 1990 to December 1996, 61 patients who had bladder stones and BPE or bladder neck contracture were treated with combined OMC and TURP; 32 patients who had bladder stones with no infravesical obstruction were treated with OMC alone. The records of a random selection of 97 patients with obstructive BPE who were treated with TURP only in the same period were used as the control. The operative duration time, the length of hospital stay, the duration of urethral catheterization, outcome and complications of the procedures for each patients were reviewed. The Mann–Whitney U‐test and chi‐square tests were used for statistical analysis.ResultsThe mean duration of surgery, hospital stay and urethral catheterization were significantly longer with combined OMC and TURP than with OMC alone (P<0.05). Stone‐free rates were 94% after OMC alone and 93% after combined OMC and TURP. The postoperative mean peak flow rates were 14.3 mL/s after the combined procedure and 15.2 mL/s after TURP alone. The complication rates were 21% for the combined procedure and 13% for OMC alone. The complication rate of TURP was 5%, significantly lower than that for the combined procedure (P<0.05).ConclusionBladder stones were associated with infravesical obstruction in two‐thirds of patients. Simultaneous treatment with OMC and TURP did not change the effectiveness of these procedures, but caused additional morbidity.
Thrombotic risk factors associated with transurethral prostatectomy
Authors: Bell  , Murdock  , Pasi  , Morgan  
Published: March 2003

ObjectiveTo ascertain the potential thrombotic risk associated with transurethral prostatectomy (TURP).Patients and methodsThe changes in coagulation variables were assessed in a prospective study of 40 patients undergoing TURP.ResultsThere was a significant increase in thrombin‐antithrombin complexes 6 h after TURP (anova, P=0.01) combined with a significant decrease in activated partial thromboplastin time (anova, P=0.006), suggesting a postoperative hypercoagulable state. The significant increase in d‐dimer 24 h after TURP (anova, P=0.015) in the absence of any significant rise in tissue plasminogen activator antigen levels perioperatively (anova, P=0.737) suggests a physiological fibrinolytic response to the developing procoagulant state. The absence of any significant increase in plasminogen activator inhibitor‐1 antigen perioperatively (anova, P=0.348) suggests the observed hypercoagulability is not due to a ‘fibrinolytic shutdown’ reported in other forms of surgery.ConclusionTURP is associated with a hypercoagulable prothrombotic state; aspirin withdrawal perioperatively may be hazardous, and low‐dose heparin prophylaxis for venous thrombosis should be considered.
The growth of the testes during the fetal period
Authors: Malas  , Sulak  , Öztürk  
Published: March 2003

Objective To determine the size and position of the fetal testes during gestation.Materials and methodsThe study comprised 48 testes obtained from 24 human fetuses with no congenital abnormalities, aged 14–40 weeks. The development of the fetuses was evaluated by measuring the crown‐rump length. Testicular size was assessed as the height, width, thickness and weight, and the position of testes determined during fetal development.ResultsThe testes in 11 fetuses (22 testes) aged 14–37 weeks were in the abdominal cavity; no testis had descended to the scrotum in any fetus until 27 weeks of gestation. Both testes had descended to the scrotum only in fetuses aged 33–40 weeks. There was no significant difference between right and left testicular size in 13 fetuses (26 testes) aged 27–40 weeks, but size correlated with gestational age (P<0.001).ConclusionAll testes had descended to the scrotum by 33 weeks of gestation, but there was considerable variation in position from 27 weeks.
The prognostic value of peripheral blood lymphocyte subsets in patients with bladder carcinoma treated using neoadjuvant M‐VEC chemotherapy
Authors: Soygür  , Bedük  , Baltaci  , Yaman Ö. , Tokgöz  
Published: March 2003

ObjectivesTo assess the prognostic value of peripheral blood lymphocyte subsets in patients with bladder cancer who were treated with neoadjuvant chemotherapy.Patients, subjects and methodsThirty patients with a histological diagnosis of invasive bladder transitional cell carcinoma and 30 age‐matched controls with no evidence of cancer and immunological disorders were evaluated. Peripheral blood samples were assessed in both groups using monoclonal antibodies. Patients with bladder cancer who achieved complete or partial responses and those who had progression of the disease after systemic chemotherapy with methotrexate, vinblastine, epirubicin and cisplatin were compared according to the pretreatment values of the peripheral blood lymphocyte subsets.ResultsThere were no significant differences in B lymphocyte levels between the groups. In patients with bladder cancer, the percentages of T lymphocytes (P<0.01), natural killer (NK) cells (P<0.05) and the CD4+/CD8+ ratio (P<0.05) were significantly lower than in the control group. In patients who responded to the chemotherapy regimen, the pretreatment values of T lymphocytes (P<0.001), the CD4+/CD8+ ratio (P<0.01) and NK cell levels (P<0.01) were significantly higher than in the patients who did not.ConclusionIn patients with invasive bladder carcinoma, cell‐mediated immunity may have a role in the resistance to this malignancy and in these patients the pretreatment levels of T lymphocyte subsets may be an indicator of the potential response to chemotherapy.
Latex allergy in subjects who had undergone multiple surgical procedures for bladder exstrophy: relationship with clinical intervention and atopic diseases
Authors: Ricci  , Gentili  , Di Lorenzo  , Righetti  , Pigna  , Masi  , De Castro  
Published: March 2003

ObjectiveTo evaluate the prevalence of latex sensitization in a group of patients with bladder exstrophy, and to determine the role of associated risk factors, e.g. atopy, and the number and duration of surgical and anaesthetic procedures.Patients and methodsThe study comprised 17 patients (15 children and two young adults) affected by bladder exstrophy who had undergone multiple surgical procedures. Skin‐prick tests and specific immunoglobulin‐E (IgE) assays against latex, food allergens cross‐reacting with latex and inhalant allergens were carried out.ResultsTwelve patients showed latex sensitization and five showed symptoms related to latex exposure, the most common of which was contact urticaria (four of the symptomatic patients). Intraoperative anaphylactic reaction had led to life‐threatening events in only one child. Latex‐specific IgE determined both by the prick test and assay was positive in all those with symptoms. Specific IgEs against inhalant allergens and foods were present in four of five symptomatic patients. In the seven sensitized patients with no clinical symptoms, the assay was positive in all, while the skin‐prick test was positive only in four; specific IgEs against inhalant allergens were present in three of the seven. In the five patients not allergic and not latex‐sensitized, only one showed allergic sensitization against grass pollen and mite allergen. None of the children without latex antibodies had symptoms of latex allergy. Symptomatic patients had a undergone significantly more hours of surgery, more cystography and had used intermittent catheterization for longer than those with no symptoms.ConclusionA third of patients with bladder exstrophy showed latex symptoms and another third had latex sensitization. Multiple surgical procedures and atopy play a major role in the development of latex hypersensitivity
Histopathological changes and nitric oxide synthase activity in corpus cavernosum from rats with neurogenic erectile dysfunction
Authors: Basar M.M. , Yildiz M. , Söylemezoglu F. , Sürücü H.S. , Basar H. , Akan H. , Basar R. 
Published: March 2003

ObjectiveTo investigate changes in histology and nitric oxide synthase (NOS) activity in cavernosal tissues from rats with neurogenic erectile dysfunction induced experimentally.Materials and methodsTwenty‐four adult male Sprague‐Dawley rats were divided equally into three groups and underwent a sham operation (control, group 1), unilateral (group 2) or bilateral (group 3) cavernosal nerve resection. Three months later they were killed and the cavernosal tissues analysed histologically by light and transmission electron microscopy, with NOS activity detected using an NADPH‐diaphorase staining technique.ResultsOn light and electron microscopy, while penile nerves and cavernosal smooth muscle cells had a normal morphological appearance in the eight control rats, there were degenerative changes of the myelinated penile nerves and axonal fibrosis in groups 2 and 3. However, these changes were not significant. Using NADPH‐diaphorase staining, NOS activity was detected in all three groups in endothelial cells and cavernosal structures. However, the staining was more intense in endothelial cells and cavernosal muscles of rats in group 2 than in the other groups.ConclusionNOS activity was increased in the cavernosal tissue after cavernosal denervation, but the pharmacological action of nitric oxide may be impaired.
NK‐2 is the predominant tachykinin receptor subtype in the swine ureter
Authors: Jerde  , Saban  , Bjorling  , Nakada  
Published: March 2003

ObjectiveTo determine which of the known tachykinin receptor subtypes is predominant in the swine ureter.Materials and methodsUreters from adult pigs were harvested, cut into longitudinal strips and placed in 10 mL tissue baths containing Krebs buffer, under 4 g of initial tension. The magnitude and frequency of contractions were recorded. Tissues were incubated with 1 μmol/L solutions of peptidase inhibitors (phosphoramidon and captopril) for 1 h to inhibit degradation of peptides and treated with either CP 96,345 (NK‐1 receptor antagonist), SR 48,968 (NK‐2 receptor antagonist) or saline (control). Concentration–response curves to the tachykinins substance P (SP), neurokinin A (NKA) and neurokinin B (NKB) were determined.ResultsUreteric segments showed a concentration‐dependent response to all tachykinins; NKA stimulated increased contractions at a lower concentration than either SP or NKB (P<0.05). This was reflected by the difference in the effective concentration required to obtain half the maximal response (EC50 ) for each of the peptides. The mean (sd) EC50 values were (μmol/L): NKA, 0.2 (0.02); SP, 3.5 (0.7); and NKB, 4.5 (1.7). In addition, the selective NK‐2 antagonist (SR 48,968) significantly reduced contractile responses to all peptides, as indicated by a 10‐fold rightward shift of the concentration–response curves (P<0.05), whereas the NK‐1 antagonist (CP 96,345) had no significant effect.ConclusionThese results indicate that NK‐2 is the predominant tachykinin receptor subtype responsible for contraction of ureteric smooth muscle. The use of mediators which act on NK‐2 receptors may have clinical applications for the treatment of ureteric disease.