bluuebunny/crossref_metadata_2025_split huggingface dataset:
Sexual factors and prostate cancer
Authors: Giles G.G. , Severi G. , English D.R. , McCredie M.R.E. , Borland R. , Boyle P. , Hopper J.L. 
Published: July 2003

OBJECTIVETo assess whether prostate cancer might be related to hormone levels and, by inference, to differences in sexual activity.PATIENTS, SUBJECTS AND METHODSIn a case‐control study of men with prostate cancer aged < 70 years at diagnosis and age‐matched control subjects, information was collected on two aspects of sexual activity; the number of sexual partners and the frequency of total ejaculations during the third to fifth decades of life.RESULTSThere was no association of prostate cancer with the number of sexual partners or with the maximum number of ejaculations in 24 h. There was a negative trend (P < 0.01) for the association between risk and number of ejaculations in the third decade, independent of those in the fourth or fifth. Men who averaged five or more ejaculations weekly in their 20s had an odds ratio (95% confidence interval) of 0.66 (0.49–0.87) compared with those who ejaculated less often.CONCLUSIONSThe null association with the number of sexual partners argues against infection as a cause of prostate cancer in this population. Ejaculatory frequency, especially in early adult life, is negatively associated with the risk of prostate cancer, and thus the molecular biological consequences of suppressed or diminished ejaculation are worthy of further research.
Health‐related quality of life and psychosocial factors in patients with prostate cancer scheduled for radical prostatectomy or external radiation therapy
Authors: Van Andel G. , Visser A.P. , Hulshof M.C.C.M. , Horenblas S. , Kurth K.H. 
Published: July 2003

OBJECTIVETo assess whether baseline health‐related quality of life (HRQOL) and psychosocial profiles differ in patients with prostate cancer scheduled for radical prostatectomy (RP) or external radiation therapy (ERT), as there is evidence that HRQOL is influenced by psychosocial factors (PFs), so that any variation at baseline should be considered when comparing the effect of therapy on HRQOL.PATIENTS AND METHODSBefore receiving therapy, HRQOL and PFs were assessed in 65 patients scheduled for RP and in 73 scheduled for ERT. To measure HRQOL (generic and disease‐specific) and PFs, an extended questionnaire was constructed, using validated and standardized instruments. Clinical data were collected from patients’ medical records. Comparisons adjusted for age and socio‐economic status (SES) were analysed using Student's t‐test and univariate analyses of variance and covariance.RESULTSPatients scheduled for ERT were 7.9 years older and had a lower SES (both P < 0.001), more often had stage T3 and T4 disease, had poorer histopathological differentiation and higher levels of prostate‐specific antigen (all P < 0.01). They also reported a worse physical, role, cognitive and social function, more fatigue, more pain, a lower overall HRQOL and worse sexual function than patients scheduled for RP. There were no differences in urinary and bowel function, nor in the PFs assessed.CONCLUSIONThe baseline HRQOL profile of patients scheduled for RP is better than in those scheduled for ERT. These results are in line with those from the few other studies on this subject. Knowing the impact of RP and ERT on HRQOL should therefore be based mainly on longitudinal studies including baseline measures, the analyses of which should be adjusted for age and SES. In the present small study, baseline PFs did not differ between the treatments.
Cryoablation of renal tumours in patients with solitary kidneys
Authors: Shingleton W.B. , Sewell P.E. 
Published: July 2003

OBJECTIVETo investigate the use of cryoablation for small renal tumours (≤ 5 cm) in patients with solitary kidneys, as the advantage of this technique might be to preserve nephrons for maintaining renal function with minimal morbidity.PATIENTS AND METHODSPatients with a radiographically documented solid renal mass in a solitary kidney were evaluated for treatment with percutaneous cryoablation. Under general anaesthesia the patients were placed in an interventional magnetic resonance imaging (MRI) unit. A gradient imaging technique was used to locate the tumour and one to four 3‐mm cryoprobes placed percutaneously into the tumour. An argon‐based cryoablation system was used to treat the tumour with three freeze‐thaw cycles, at a probe tip temperature of −120°C. Patients were admitted for 23 h observation and assessed for follow‐up at 1 week, 1, 3 and 6 months, and then every 6 months. Radiological imaging studies (computed tomography or MRI) were used at 1, 3 and 6 months and every 6 months afterward, to assess for recurrent or new tumour appearance.RESULTSTo date, 14 patients with renal masses in a solitary kidney have been treated; two were lost to follow‐up and excluded from the analysis, leaving 10 men and two women (mean age 62.5 years, range 29–76). In all, 15 tumours (mean diameter 3.1 cm) were treated; the mean (range) treatment time was 96.7 (30–143) min. There were no complications during treatment. Two patients had gross haematuria afterward that resolved within 24 h. The mean follow‐up was 17  (2–30) months, with three patients requiring re‐treatment for incomplete tumour ablation. There is no radiographic evidence of local tumour recurrence to date. In two patients the tumour was not completely ablated. There was no significant change in serum creatinine from preoperative values.CONCLUSIONPercutaneous cryoablation of tumours in solitary kidneys caused minimal morbidity and little change in serum creatinine levels. Although the follow‐up is brief there was no local recurrence. Cryoablation may be a treatment option for patients with tumour in solitary kidneys but a long‐term follow‐up is needed to confirm these results.
Effect of renal transplantation on sperm quality and sex hormone levels
Authors: Akbari F. , Alavi M. , Esteghamati A. , Mehrsai A. , Djaladat H. , Zohrevand R. , Pourmand G. 
Published: July 2003

OBJECTIVETo assess the effect of successful renal transplantation on semen variables, sexual function and sex hormone profiles in a clinical trial.PATIENTS AND METHODSThirty patients on haemodialysis underwent renal transplantation; before and after surgery, their sperm density, motility and morphology were analysed, follicle‐stimulating hormone (FSH), luteinizing hormone (LH), prolactin and testosterone levels measured and compared, and sexual function assessed using an abbreviated version of the International Index of Erectile Function (IIEF), with a successful outcome defined as a level of satisfaction of 4 or 5 on a 5‐point scale. The paired t‐test was used to assess the statistically significance of differences in all analyses.RESULTSSperm motility improved significantly (P < 0.001) but there were no significant changes in morphology or density (P = 0.33 and 0.068, respectively). Testosterone levels increased and FSH, LH and prolactin decreased significantly (P < 0.05) after renal transplantation. The IIEF showed that of the 30 patients, 14 were impotent before surgery and only six remained so afterward (P < 0.05).CONCLUSIONAlthough sperm morphology and density did not improve after renal transplantation, there were highly significant changes in sperm motility. Hormonal levels in patients on haemodialysis improved after transplantation and returned to nearly normal; sexual function was also significantly better. Further studies are needed to confirm these results.
Preference for oral sildenafil or intracavernosal injection in patients with erectile dysfunction already using intracavernosal injection for > 1 year
Authors: Kim S.C. , Chang I.H. , Jeon H.J. 
Published: July 2003

Authors from Seoul describe their experience with patients already on triple therapy by intracavernosal injection who changed to oral sildenafil. Rather surprisingly, they found that patients had had a greater preference than expected for triple therapy, feeling that they had a better quality of erection on intracavernosal injection.The subject of the effect of renal transplantation on sperm quality and sex hormone levels is discussed by authors from Teheran. They found that sperm morphology and density remained unchanged, but there were significant improvements in sperm mobility. There was also an improvement in hormone levels and sexual function.OBJECTIVETo investigate the efficacy and preference for oral sildenafil or intracavernosal injection (ICI) therapy in patients with erectile dysfunction (ED) already using ICI.PATIENTS AND METHODSIn all, 69 patients with ED (mean age 55.1 years, sd 12.3) on ICI therapy with triple solution (papaverine/phentolamine/prostaglandin‐E1) for > 1 year were recruited for the study. Their erection quality, adverse reactions and selection rate of oral sildenafil or ICI as treatment, after using sildenafil for 3 months, and the reasons for their preferences, were compared between the regimens,RESULTSOverall, 52 men (75%) responded to sildenafil; of these men, the erection quality with ICI was better than that with sildenafil in 46 (89%) and 16 (31%) preferred ICI as their treatment. Eighteen patients (35%) used each treatment alternately and 18 (35%) used sildenafil exclusively. The main reason given by patients for choosing ICI was a better quality of erection (74%).CONCLUSIONMore patients with ED and using ICI preferred it as their main treatment than was expected, even though they had a good response to oral sildenafil. A better quality of erection with ICI was the reason why experienced patients chose this method, differing from the choice of patients starting treatment for ED.
Treatment of vesico‐ureteric reflux: a new algorithm based on parental preference
Authors: Capozza N. , Lais A. , Matarazzo E. , Nappo S. , Patricolo M. , Caione P. 
Published: July 2003

Authors from Rome evaluated parental preference for treatment in children with grade III VUR. Parents were provided with detailed information about the three treatment options: antibiotic treatment, open surgery, endoscopic treatment. Most parents chose endoscopic management; with this in mind, the authors proposed a new treatment algorithm for VUR.OBJECTIVETo assess parental preference (acknowledged in treatment guidelines as important when choosing therapy) about treatments for vesico‐ureteric reflux (VUR, commonly associated with urinary tract infection and which can cause long‐term renal damage if left untreated), as at present there is no definitive treatment for VUR of moderate severity (grade III).SUBJECTS AND METHODSThe parents of 100 children with grade III reflux (38 boys and 62 girls, mean age 4 years, range 1–15) were provided with detailed information about the three treatment options available for treating VUR (antibiotic prophylaxis, open surgery and endoscopic treatment), including the mode of action, cure rate and possible complications, and the practical advantages and disadvantages. They were then presented with a questionnaire asking them to choose their preferred treatment.RESULTSMost parents preferred endoscopic treatment (80%), rather than antibiotic prophylaxis (5%) or open surgery (2%); 13% could not decide among the three options and endoscopic treatment was recommended.CONCLUSIONGiven the strong preference for endoscopic treatment we propose a new algorithm for treating VUR; endoscopic treatment would be considered as the first option for persistent VUR, except in severe cases where open surgery would still be recommended.
Neurovesical dysfunction in children after treating pelvic neoplasms
Authors: Mosiello G. , Gatti C. , De Gennaro M. , Capitanucci M.L. , Silveri M. , Inserra A. , Milano G.M. , De Laurentis C. , Boglino C. 
Published: July 2003

OBJECTIVETo evaluate 10 years of experience, and thus define the occurrence and causes, of neurogenic lower urinary tract dysfunction in children with pelvic neoplasms treated by surgery.PATIENTS AND METHODSFrom 1991 to 2000, 33 children were operated by the same surgeons for pelvic neoplasms; 11 were analysed, comprising four each with sacrococcygeal teratoma (ST) and ganglioneuroma, and one each with yolk sac tumour (YST), neuroblastoma and myofibroblastic bladder sarcoma (MBS). The other patients were not assessed because eight had died or were in severe progression, three were treated by bladder substitution and the others were lost to follow‐up or refused a urological evaluation. All 11 children were evaluated at ≥ 6 months after surgery with a questionnaire about bowel and voiding habits, a neurological and orthopaedic assessment, a noninvasive urodynamic study, renal ultrasonography and spinal and pelvic magnetic resonance imaging (MRI). All patients with signs of bladder dysfunction were evaluated by a pressure‐flow study. The results were analysed for surgical approach and anatomical involvement, i.e. group A, extensive surgery for complete tumour excision in the sacral area (ST and YST); group B, surgery for tumour resection in the paraspinal ganglia area (neuroblastoma and ganglioneuroma); and group C, bladder tumour with partial bladder resection (MBS).RESULTSEight patients had signs or symptoms related to bladder sphincter dysfunction. One child refused the invasive urodynamic evaluation, leaving seven for analysis (two each ST and ganglioneuroma, one each YST, neuroblastoma and MBS). The urodynamic findings were normal in three children. On spinal and pelvic MRI a presacral lipoma with syringomyelia was discovered in one child with ST. Eight children had bladder dysfunction and two had no neurogenic damage (which was only in sacral tumours); in one child it was related to an upper motor neurone lesion from spinal dysraphism and in the other to a lower motor neurone lesion from surgical injury to the splanchnic nerves. Patients operated for paraspinal tumours had more bladder dysfunction but no signs of neurogenic damage, as did the patient with partial bladder resection. However in Group B, there may have been a transient or incomplete nerve injury in one patient.CONCLUSIONSDeficits of parasympathetic, sympathetic and somatic innervation of the bladder and the urethra may occur in children after surgery for pelvic neoplasms, related to minor or major surgical trauma. In ST, a tethered cord may be associated with mixed neurogenic damage. Knowledge of bladder dysfunction in anorectal malformations, spinal dysraphism, etc. and the clinical protocol used in these patients also seemed to be useful for understanding the development of voiding dysfunction in patients with neoplasm.
Skeletal growth and long‐term bone turnover after enterocystoplasty in a chronic rat model
Authors: Gerharz E.W. , Gasser J.A. , Mosekilde L. , Moniz C. , Sitter H. , Barth P.J. , Thomsen J.S. , Ransley P.G. , Riedmiller H. , Woodhouse C.R.J. 
Published: July 2003

OBJECTIVETo investigate skeletal growth and bone metabolism in a chronic animal model of urinary diversion.MATERIALS AND METHODSYoung male Wistar rats (120) were allocated randomly to four groups undergoing: ileocystoplasty, ileocystoplasty and resection of the ileocaecal segment, colocystoplasty, and controls. All animals received antibiotics for 1 week after surgery; half of each group remained on oral antibiotics. Bone‐related biochemistry was measured in serum and urine. Dual‐energy X‐ray absorptiometry and peripheral quantitative computed tomography (pQCT) were used to determine bone mass ex vivo.RESULTSMost (90%) of the rats survived the study period (8 months); six rats died from bowel obstruction at the level of the entero‐anastomosis and four had to be killed because of persistent severe diarrhoea. Vital intestinal mucosa was found in all augmented bladders. There were no differences in bone length and volume. Loss of bone mass was almost exclusively in rats with ileocystoplasty and resection of the ileocaecal segment (−37.5%, pQCT, P < 0.01). There was no hyperchloraemic metabolic acidosis or gross impairment of renal function. Hypomagnesaemia, hypocalcaemia and decreased insulin‐like growth factor‐binding protein 3 were the only significant findings on blood analysis. Deoxypyridinoline crosslinks in urine were higher in rats with an enterocystoplasty than in controls.CONCLUSIONSEnterocystoplasty in rats neither impairs skeletal growth nor bone quantity, but leads to significant loss of bone mass when combined with resection of the ileocaecal segment. Rarefaction of the trabecular network is confined to the metabolically highly active cancellous compartment, most likely as a consequence of intestinal malabsorption.
Therapeutic transcatheter arterial embolization in the management of intractable haemorrhage from pelvic urological malignancies: preliminary experience and long‐term follow‐up
Authors: Nabi G. , Sheikh N. , Greene D. , Marsh R. 
Published: July 2003

OBJECTIVETo evaluate the feasibility, efficacy and complications of internal iliac artery embolization as a palliative measure in the control of intractable haemorrhage from advanced pelvic urological malignancies.PATIENTS AND METHODSSix patients (mean age 80 years, range 76–87) with advanced pelvic malignancies (three each with bladder carcinoma and prostate carcinoma) underwent embolization between September 1997 and July 2001, using permanent coils in the anterior division of internal iliac artery bilaterally.RESULTSAll patients had undergone conservative treatment before embolization for a mean of 2 days. The mean requirement for transfusion before embolization was 3.2 units. All patients except one were successfully embolized in a single setting with no complications. Bleeding was successfully controlled in one patient at the second attempt of embolization. There were minor complications, e.g. nausea, vomiting or fever, for a mean of 2 days, responding well to conservative treatment. At a mean follow‐up of 22 months, no patient had a recurrence of bleeding.CONCLUSIONInternal iliac artery embolization is a feasible, effective and minimally invasive option in managing advanced pelvic urological malignancies presenting with intractable bleeding; it should be bilateral and permanent.
Nerve‐sparing robot‐assisted radical cystoprostatectomy and urinary diversion
Authors: Menon M. , Hemal A.K. , Tewari A. , Shrivastava A. , Shoma A.M. , El‐Tabey N.A. , Shaaban A. , Abol‐Enein H. , Ghoneim M.A. 
Published: July 2003

OBJECTIVETo develop a technique of nerve‐sparing robot‐assisted radical cystoprostatectomy (RRCP) for patients with bladder cancer.PATIENTS AND METHODSRobotic assistance should enhance the ability to preserve the neurovascular bundles during laparoscopic radical cystectomy. Thus we undertook RRCP and urinary diversion using a three‐step technique. First, using a six‐port approach and the da Vinci Surgical System (Intuitive Surgical, Sunnyvale, CA, USA), one surgeon carried out a complete pelvic lymphadenectomy and cystoprostatectomy using a technique developed specifically for robotic surgery. The neurovascular bundles were easily identified and dissected away, the specimen entrapped in a bag and removed through a 5–6 cm suprapubic incision. Second, a different surgical team exteriorized the bowel through this incision and created a neobladder extracorporeally. Third, the neobladder was internalized, the incision closed and the primary surgeon completed the urethro‐neovesical anastomosis with robotic assistance.RESULTSRRCP was carried out in 14 men and three women by the primary surgeon (M.M.). The form of urinary reconstruction was ileal conduit in three, a W‐pouch with a serosal‐lined tunnel in 10, a double‐chimney or a T‐pouch with a serosal‐lined tunnel in two each. The mean operative duration for robotic radical cystectomy, ileal conduit and orthotopic neobladder were 140, 120 and 168 min, respectively. The mean blood loss was < 150 mL. The number of lymph nodes removed was 4–27, with one patient having N1 disease. The margins of resection were free of tumour in all patients.CONCLUSIONSWe developed a technique for nerve‐sparing RRCP using the da Vinci system which allows precise and rapid removal of the bladder with minimal blood loss. The bowel segment can be exteriorized and the most complex form of orthotopic bladder can be created through the incision used to deliver the cystectomy specimen. Performing this part of the operation extracorporeally reduced the operative duration.
Continent urinary tract reconstruction – the Lund experience
Authors: Månsson W. , Davidsson T. , Könyves J. , Liedberg F. , Månsson Å. , Wullt B. 
Published: July 2003

The Department of Urology in Lund, Sweden, has a long association with innovations in reconstructive urology. The authors from that department describe their experience over a long period with orthotopic bladder substitution and continent cutaneous urinary diversion. They conclude that continent urinary tract reconstruction is associated with a high incidence of early and late complications. They also found that for storage and emptying, their Lundiana pouch was superior to the Goldwasser neobladder.OBJECTIVETo assess the early and late complications and functional results in patients undergoing continent reconstruction of the urinary tract, i.e. orthotopic bladder substitution (OBS) or continent cutaneous diversion (CCD).PATIENTS AND METHODSThe medical records of all patients undergoing OBS (Goldwasser technique) or CCD (‘Lundiana’ technique) for malignant or benign disease during 1987–1999 and followed to December 2001 were reviewed. There were 67 patients with neobladders, 77 with a Lundiana pouch who had undergone radical cystectomy and 22 with a Lundiana pouch operated for benign disorders.RESULTSEarly complications requiring reoperation occurred in 12% of the cystectomy group, with no difference with type of reconstruction, and in 10% with benign diseases. Four patients (3%) undergoing radical cystectomy died from early cardiovascular complications, two after surgery for intra‐abdominal complications. Intestinally related complications and wound dehiscence requiring re‐operation occurred in nine and six patients, respectively. The incidence of late complications requiring open surgery was 22% and 23% after cystectomy with OBS and CCD, respectively. The value in patients with benign diseases undergoing CCD was also 23%. Stone formation in the pouch was common, occurring in 12% in patients with OBS and in 10% after CCD. The pouch perforated or ruptured in four patients. The incidence of uretero‐intestinal stricture using the Le Duc technique was 2.4% and renal function was well preserved. The incidence of revisional surgery of the Lundiana pouch outlet for incontinence was low and all patients but four were continent. The functional outcome in patients with OBS was less good; some needed pouch augmentation or an artificial urinary sphincter. Most patients used incontinence products and many needed clean intermittent self‐catheterization.CONCLUSIONContinent urinary tract reconstruction is associated with a high incidence of early and late complications. For storage and emptying, the CCD Lundiana pouch is superior to the OBS of Goldwasser.