bluuebunny/crossref_metadata_2025_split huggingface dataset:
Transcutaneous electrical nerve stimulation in the treatment of neurological patients with urinary symptoms
Authors: Skeil D. , Thorpe A.C. 
Published: March 2003

Objective To determine whether transcutaneous electrical nerve stimulation (TENS) benefits patients with urinary symptoms caused by neurological diseases. Patients and methods Patients with urinary symptoms from any kind of neurological disease were prospectively recruited between October 1996 and July 1998. Before attending the first assessment patients were asked to complete a week's diary recording the frequency of micturition, incontinence episodes, and frequency of pad and clothes changing. At the first assessment the patients completed the Frimodt–Moller urinary symptom questionnaire, and quality‐of‐life scales including the Nottingham Health Profile and Short‐Form 36. Demographic and disability data (Barthel Index and Frenchay Aphasia Screening Test) were recorded, and patients underwent a neurological examination and urodynamic studies. The placing of electrode pads on the sacral dermatomes 2.5 cm either side of and 2.5 cm above the natal cleft was demonstrated, and the patient instructed to use TENS for 90 min twice a day. The current strength applied was set to that which the patient could tolerate, at a square‐wave of 20 Hz and 200‐µs duration. Six weeks later the patients were further assessed, where the diary exercise, questionnaires and urodynamics were repeated. In all, 44 patients (13 men and 33 women, mean age 50.8 years) were recruited. Results The commonest disease was multiple sclerosis and the commonest impairments para/tetraplegia or hemiplegia. There was no change in the neurological status of the 34 patients completing the study. Irritative voiding symptoms were significantly decreased (0.68–0.61, P = 0.003) and diaries also showed significant improvements in the 24 h frequency of micturition (P = 0.01), incontinence episodes (P = 0.04) and clothes changes (P = 0.02). Urodynamics showed detrusor hyper‐reflexia in most patients. The only significant changes after TENS were an increased postvoid residual volume (from a mean of 134 mL to 160 mL, P = 0.03) and an increase in the volume leaked during the urodynamic study with TENS on (from a mean of 4.7 mL to 12 mL, P = 0.003). There were no significant changes in the quality‐of‐life scores. Of the 34 patients completing the study, half still reported a benefit from TENS at 1 year, although some patients found it took 3–4 weeks to work. Conclusion TENS applied to the sacral dermatomes of neurological patients with urinary symptoms had a minimal effect on urodynamic data but significantly improved irritative urinary symptoms, 24‐h urinary frequency, incontinence and clothes changing. The lack of effect on quality‐of‐life measures probably reflects the lack of sensitivity in the tools used in this group of patients. We therefore recommend using TENS in this often problematical group of patients.
Nitric oxide synthase patterns in normal and varicocele testis in adolescents
Authors: Santoro G. , Romeo C. , Impellizzeri P. , Ientile R. , Cutroneo G. , Trimarchi F. , Pedale S. , Turiaco N. , Gentile C. 
Published: March 2003

Objective To determine if the testes of normal adolescents can produce nitric oxide (NO), by assessing NO synthase (NOS) activity, and whether this activity changes in adolescents with left idiopathic varicocele. Patients and methods After obtaining informed consent, testicular biopsies were obtained from eight adolescents (mean age 16.4 years; controls) who underwent surgery for inguinal hernia or hydrocele, and from 20 adolescents (mean age 16.2 years) operated for left idiopathic varicocele. Inducible and endothelial NOS (iNOS and eNOS) isoforms were investigated in the biopsy specimens by immunohistochemical localization and Western blot analysis using specific fluorescein‐conjugated antibodies. Results Both normal and pathological samples expressed eNOS at the level of vessels and Leydig cells. The iNOS was expressed in Leydig cells of normal testes and over‐expressed in Leydig cells of varicocele testes. Conclusion Leydig cells of adolescent testes constitutively express iNOS. Under pathological conditions, e.g. varicocele, iNOS is up‐regulated and is a possible source of NO overproduction. These results could be useful in explaining the pathogenesis of both testis and sperm dysfunction in varicocele.
Primary enuresis: a urodynamic evaluation
Authors: Medel R. , Ruarte A.C. , Castera R. , Podesta M.L. 
Published: March 2003

ObjectiveTo assess urodynamic and clinical data in patients with primary enuresis for potential prognostic indicators of detrusor instability.Patients and methodsThe records of 33 patients (mean age 8.8 years, range 5–14) with monosymptomatic primary enuresis (MPE, bedwetting as the sole symptom) and 47 patients (mean age 7.1 years, range 5–12) with complicated primary enuresis (CPE, bedwetting associated with diurnal urinary loss, squatting and urge incontinence) were reviewed. The children underwent urodynamic studies to detect detrusor instability and the prevalence was compared with the type of enuresis.ResultsOf 33 patients with MPE, 17 (49%) showed either typical unstable detrusor contractions (16) or low‐compliance bladders (one); in the remaining 16 patients, filling cystometry was normal and micturition was normal in all. Of the 47 patients with CPE, 35 (79%) showed detrusor instability and two decreased bladder compliance; the remaining 10 had stable bladders and micturition was also normal in all patients.ConclusionThe type of primary enuresis and the maximum cystometric bladder capacity were good indicators of bladder dysfunction.
A modified Mitrofanoff procedure using the rectus abdominis muscle flap technique: a preliminary report in a rabbit model
Authors: Celayir  , Dervisoglu  , Büyükünal  
Published: March 2003

Objective To create a modified Mitrofanoff continent stoma in a rabbit model, using a rectus abdominis muscle flap (RAMF) with its intact vascular supply.Materials and methods Fifteen New Zealand White male rabbits underwent an operation to create a 6 cm long tube using a RAMF with its vascular pedicle from the inferior epigastric vessels. The internal orifice of the tube was anastomosed to the anterior bladder wall with 5/0 polyglactin sutures. The external orifice was directly sutured to the skin to fashion a catheterizable Mitrofanoff stoma. A 6 F catheter was left in the tube as a stent for 2 weeks. Radiography and histopathological investigations were carried out for 8 weeks after surgery.Results Intravenous pyelography and voiding cysto‐urethrography showed a normal looking urinary system; contrast studies showed an intact RAMF tube with no signs of stricture. Catheterization of the stoma was possible in each animal. Histopathologically, there was no evidence of severe fibrosis or inflammatory changes; the inner surface of the tube (proximal bladder side) was covered by transitional urinary epithelium in most of the animals.Conclusion It is possible to create a Mitrofanoff tube using a vascularized RAMF in a rabbit model. Using this technique there is no need to perform a major operation in the gastrointestinal system. The technique may provide a good alternative treatment in those patients who need a combination of Mitrofanoff and antegrade continence enema surgery, and in patients with previous appendectomy.
Retroperitoneal lymphadenectomy for post‐chemotherapy residual masses: is a modified dissection and resection of residual masses sufficient?
Authors: Rabbani  , Goldenberg  , Gleave  , Paterson  , Murray  , Sullivan  
Published: March 2003

Objective To determine if post‐chemotherapy retroperitoneal lymphadenectomy for residual masses can be limited to resection of the residual masses and a modified template dissection, without loss of therapeutic efficacy.Patients and methods Between 1985 and 1995, 50 patients underwent one of three types of retroperitoneal lymphadenectomy for a residual mass after cisplatin‐based chemotherapy for stages II and III testicular non‐seminomatous germ cell tumour. The pre‐operative imaging, operative record and pathology reports were reviewed to determine the location of the residual masses and whether tumour, defined as teratoma or viable carcinoma, was within the boundaries of the modified template and/or residual masses. The median (range) follow‐up was 56 (1–140) months.Results Of 39 patients undergoing a bilateral dissection, one (2.6%) with a left testicular cancer had teratoma identified outside the boundaries of the modified template and the residual masses. The nine patients who underwent resection of residual masses and a modified‐template dissection were relapse‐free at a median follow‐up of 55 months. One of two patients undergoing resection of residual mass alone had two recurrences arising from incomplete resection. Four of eight patients undergoing a modified dissection retained ejaculation, compared with seven of 25 (28%) undergoing a non‐nerve sparing bilateral dissection.Conclusion This retrospective study suggests that in patients whose tumour markers become normal and have a residual mass after chemotherapy, residual masses can be resected with a modified‐template dissection with no significant risk of leaving tumour in the retroperitoneum.
Efficacy of orchidopexy on spermatogenesis in the immature mutant ‘trans‐scrotal’ rat as a cryptorchid model by quantitative cytological analysis
Authors: Zhou  , Hutson  , Hasthorpe  
Published: March 2003

Objectives To determine whether cryptorchidism is a congenital malformation and whether the impaired spermatogenesis in immature testes can be reversed by early orchidopexy, using the mutant trans‐scrotal (T‐S) rat which is normally masculinized but has cryptorchidism in 85% of males.Materials and methods First, T‐S rats (six per group) with ectopic testes destined to be undescended were investigated histologically at 4, 7 and 14 days after birth. Secondly, 12‐day‐old T‐S rats were divided into four groups which underwent different procedures, i.e. 1, with normally descending testes (normal control, 10 rats); 2, with undescended testes (UDT) treated by orchidopexy (treated UDT, eight rats); 3, with UDT treated by a sham operation (sham‐operated UDT, six rats); and 4, with UDT left untreated (untreated UDT, six rats). Thirty days after operation the testicular anatomy was recorded; excised testes were examined histologically and different types of germ cells were counted per tubule cross‐section microscopically.Results There were no quantitative or morphological differences in the numbers of gonocytes, type‐A spermatogonia or Leydig cells in the seminiferous tubules between normal and ectopic testes in the first 14 days after birth. However, by 21 days of age spermatogenesis in the UDT had declined with transformation from primary leptotene spermatocytes to spermatids. There were significantly more Leydig cells in the untreated UDT at 30 days than in normal control testes. The impaired spermatogenesis in UDT was restored by early orchidopexy and there were significantly more seminiferous tubules at stage 3 (pachytene spermatocytes) and stage 4 (spermatids) than in the untreated or sham‐operated groups (P<0.001).Conclusions These results show that in the T‐S rat with cryptorchidism, the testicular damage is not a congenital malformation and can be reversed with early surgical correction.
Transforming growth factor‐β1 serum concentration
Authors: Wolff  , Fandel  , Borchers  , Brehmer Jr  , Jakse  
Published: March 2003

Objective To assess serum levels of transforming growth factor‐β1 (TGF‐β1), normally markedly elevated in prostate cancer tissue, in patients with cancer of the prostate, and to correlate these levels with tumour stage and serum prostate specific antigen (PSA) levels.Patients and methods Serum TFG‐β1 and PSA levels were determined in 32 patients with untreated prostate cancer. Patients were divided into: group 1, 14 patients with pT1–3pN0M0; group 2, four with T1–3pN+M0; and group 3, 14 with T1–4NxM+. Ten patients with histologically confirmed benign prostatic hyperplasia (BPH) served as controls.Results The median TGF‐β1 levels were no different between patients with cancer or BPH (30.7 ng/mL and 26.9 ng/mL, respectively; P>0.05). Furthermore, there was no increase in TGF‐β1 concentrations with advancing tumour stage (group 1, 34.1 ng/mL; group 2, 33.0 ng/mL; group 3, 28.3 ng/mL; P>0.05). There was no correlation with PSA levels (group 1, r=−0.42; group 2, r=−0.43; group 3, r=−0.23; BPH, r=0.38).Conclusion TGF‐β1 levels did not discriminate between patients with BPH and prostate cancer, and there was no increase in TGF‐β1 levels with advancing tumour stage.
The single ectopic ureter
Authors: Wakhlu  , Dalela  , Tandon  , Chandra  , Wakhlu  
Published: March 2003

Objectives To correlate renal function with the site of the ectopic orifice in patients with a single ectopic ureter and to evaluate the role of ureteric reimplantation in the preservation of renal function.Patients and methods Forty‐four patients (41 female, age 1.5 months to 20 years) with a single ectopic ureter have been managed in our institution in the last 21 years. The classical symptom of continuous wetting with intermittent normal micturition was reported in most of the female patients. The investigative evaluation included intravenous urography (IVU), cysto‐urethroscopy, vaginoscopy with retrograde ureteric catheterization, micturating cysto‐urethrography (MCU) and ultrasonography. Diuretic renography was carried out in four patients after it became available in 1992. Renal function was assessed in relation to urinary tract anomalies and with outcome after ureteric re‐implantation.Results Thirty‐eight patients (two males) had a unilateral ectopic ureter; the ectopic orifice was vaginal in 12, vestibular in 11, urethral in nine, at the bladder neck in two, the seminal vesicle in one and undetermined in three. Twenty‐one patients had renal and/or ureteric abnormalities, with reflux detected on MCU in three ureters. Associated anomalies included hypospadias (two, one female), skeletal anomalies (two), anorectal malformations (three), cryptorchidism (two), and unilateral cystic ovary (one). Two patients had preoperative hypertension. In 15 patients, renal function was considered sufficient to justify ureteric reimplantation, 14 of whom regained continence. One girl had suprapubic leakage from the bladder and died during secondary nephroureterectomy. Another girl had persistent incontinence; she was found to have contralateral duplex ureters with a vestibular ectopic orifice and was cured after upper polar hemi‐nephroureterectomy. IVU and renography carried out in two patients each within 4 weeks of surgery showed a moderate improvement in renal function. Eight patients reported for follow‐up after ureteric reimplantation (mean duration 11 months); none had hypertension or urinary infection. Twenty‐three patients with rudimentary kidneys underwent nephroureterectomy. Histopathological examination of the excised kidneys showed moderate to severe dysplasia with chronic pyelonephritis. Six patients (one male) had bilateral single ectopic ureters, with normal renal function in the five females. Unilateral reimplantation in the boy resolved the symptoms; one girl died before surgery and the other four underwent bilateral ureteric reimplantation, after which one was dry for up to 3 h while the other three were incontinent, one of whom subsequently underwent urinary diversion.Conclusions There was no clear correlation of renal function with the site of the ectopic ureteric orifice, as most of the patients with a vaginal ectopic ureter had sufficient renal function to justify renal preservation. Ureteric reimplantation preserved renal function, although the improvement after surgery was determined by the degree of renal dysplasia.
Evaluation of the potential of transferrin‐adriamycin conjugates in the treatment of bladder cancer
Authors: Munns  , Yaxley  , Coomer  , Lavin  , Gardiner  , Watters  
Published: March 2003

Objective To assess the ability of a transferrin‐adriamycin conjugate (Tf‐ADR) to target transferrin receptor (TfR)‐positive cancer cells selectively and to overcome drug resistance in bladder cancer cell lines.Materials and methods Two paired sets of cell lines were used: the first was Chinese hamster ovary (CHO) cells (TfR‐negative TRVb cells, as a model for normal resting cells, and TRVb‐1 cells which were transfected with human TfR), and the second was a pair of bladder cancer cell lines (ADR‐sensitive MGH‐U1 cells and ADR‐resistant MGH‐U1R cells). Cell survival curves were determined after treatment with ADR, Tf and Tf‐ADR.Results MGH‐U1, TRVb and TRVb‐1 cells required similar concentrations of ADR and Tf‐ADR for 50% inhibition of growth; MGH‐U1R cells were resistant to both ADR and TF‐ADR.Conclusion Tf‐ADR did not prevent toxicity to the TfR‐negative cells nor did it overcome the resistance of the ADR‐resistant cells. These results imply that Tf‐ADR does not provide a better cytotoxic drug delivery system for the treatment of bladder cancer.
Composition and biomechanical properties of the bladder acellular matrix graft: comparative analysis in rat, pig and human
Authors: Dahms  , Piechota  , Dahiya  , Lue  , Tanagho  
Published: March 2003

Objective To compare the composition and mechanical properties of the newly developed bladder acellular matrix graft (BAMG) with the normal urinary bladder in rat, pig and human.Materials and methodsRat, pig and human urinary bladders were harvested and divided into control and experimental groups. For the latter, BAMGs were prepared, and light and transmission electron microscopic studies performed. Strips from the normal bladders and the BAMGs (10 in each group) were tested under tension, and the ultimate tensile strength, maximum strain, and elastic modulus were determined from stress/strain curves.ResultsBoth types I and III collagen, as well as elastic fibres, were observed as major components of the matrix scaffold. There were more collagen type I fibres in the rat than in the pig and human BAMGs, whereas the pig, and particularly the human, both showed higher levels of type III collagen and elastic fibres. These different matrix scaffold patterns were confirmed by electron microscopy. Results from biomechanical testing showed no significant differences for strength, strain or elastic modulus between BAMG and control bladder strips, except in the rat where the maximum strain values were significantly lower.ConclusionThere are variations in the acellular matrix structure with similar biomechanical properties between the BAMG and the normal urinary bladder in three different species. These results may underscore the potential of the BAMG. Furthermore, this in vitro model provides a suitable method to study the mechanical properties of the urinary bladder and may serve as a diagnostic tool for various investigations.
High prevalence of voiding symptoms in Taiwanese women
Authors: YU  , Chen  , Lai  , Chan  , Chie  
Published: March 2003

Objective To describe the voiding symptoms of Taiwanese women using the International Prostate Symptom Score (IPSS).Subjects and methods A self‐administered questionnaire was used to collect information on demographic characteristics and the IPSS used to determine the voiding symptoms of 583 consecutive women undergoing a health examination. The symptom scores of different age groups were compared using a one‐way analysis of variance with a posteriori comparisons made using Scheffe’s test.Results The seven symptom scores could be separated by factor analysis into two factors which corresponded with obstructive (incomplete emptying, intermittency, weak stream, and hesitancy) and irritative (frequency, urgency, and nocturia) symptoms. Various degrees of frequency and nocturia were commonly reported by the respondents, whereas obstructive symptoms were infrequently reported, except in the elderly (age ≥65 years). The irritative scores, obstructive scores and total scores increased significantly with age (all P<0.001). The total symptom scores correlated significantly with the quality‐of‐life score (Pearson’s r=0.70, P<0.001). Overall, 124 (21%) of the respondents reported an IPSS of >7, and 98 (17%) of the respondents reported being ‘mostly dissatisfied’ with their urination. However, only nine (1.5%) of the respondents had ever consulted a urologist about their voiding problems.Conclusions There was an age‐dependent change in voiding symptoms in these Taiwanese women. The prevalence of voiding symptoms in women is much higher than encountered in clinical practice.
Dysfunctional voiding in women: which muscles are responsible?
Authors: Deindl  , Vodusek  , Bischoff  , Hofmann  , Hartung  
Published: March 2003

Objective To analyse the striated external urethral sphincter (EUS) and pelvic floor muscles using two different electromyography (EMG) techniques in women with dysfunctional voiding and/or urinary retention.Patients and methods Fifteen women (mean age 38.2 years, range 18–61) with dysfunctional voiding and/or unexplained voiding dysfunction associated with urinary retention were examined neurologically and urologically; urodynamics and kinesiological EMG of the bilateral pubococcygeal and external urethral striated sphincter muscles were obtained. In an additional neurophysiological session, concentric‐needle EMG of the external urethral sphincter was performed.Results Kinesiological EMG recordings revealed inappropriate pelvic floor muscle activation during voiding in 11 and EUS activation in four women. Concentric needle EMG of the EUS revealed complex repetitive discharges in the four women with inappropriate urethral sphincter activation recorded by kinesiological EMG during voiding. Biofeedback training led to improvement in women with inappropriate pubococcygeal activation but not in those with urethral sphincter complex repetitive discharges.Conclusion Urodynamic examinations in combination with kinesiological EMG examination of the pubococcygeal and external urethral sphincter muscles revealed two groups of women with dysfunctional voiding. Further diagnostic evaluation of such patients with concentric‐needle EMG is mandatory. The differentiation of the two groups is therapeutically relevant.
Effect of transurethral electrovaporization of the prostate on serum prostate specific antigen concentration
Authors: Küpeli  , Soygür  , Yilmaz  , Aytaç  
Published: March 2003

ObjectiveTo assess the effect of transurethral electrovaporization of the prostate (TUVP) on serum prostate specific antigen (PSA) concentration.Patients and methodsTwenty‐five men (mean age 61.7 years) with symptoms of prostatism underwent TUVP. Serum PSA levels were determined before any prostatic manipulation, and again at 1 and 24 h after TUVP. In the first 6 weeks after TUVP, serum PSA was measured every week. Prostatic size was measured by transrectal ultrasonography before and again at 6 weeks after TUVP.ResultsThe mean serum PSA concentration was significantly higher at 1 and 24 h after TUVP (P<0.001) than before. The PSA level returned to less than the value before TUVP at 2, 3 and 4 weeks afterwards in eight (32%), 13 (52%) and 20 (80%) patients, respectively; five (20%) patients reached the baseline value 6 weeks after TUVP. The mean reduction in prostatic volume 6 weeks after TUVP was 42% and the reduction in tissue volume was significantly correlated with the decrease in serum PSA concentration at 6 weeks (P<0.05).ConclusionTUVP increases serum PSA levels, the transient elevation persisting for up to 6 weeks but then declining to a stable, low PSA concentration. Therefore, it is important to wait at least 6 weeks to obtain an accurate and meaningful serum PSA level after TUVP.