bluuebunny/crossref_metadata_2025_split huggingface dataset:
Failed vasectomy reversal: is a further attempt using microsurgery worthwhile?
Authors: Fox M. 
Published: March 2003

Objective To determine, in failed vasectomy reversal, the usefulness of a revised anastomosis using microsurgery in achieving sperm in the ejaculate and fertility, and to relate the outcome to the site of the anastomosis, length of time from vasectomy, and presence or absence of sperm in the vas at surgery. Patients and methods In a series of 28 patients with confirmed anastomotic obstruction undergoing vasectomy reversal (over a 10‐year period), a microsurgical technique using an oblique end‐to‐end two‐layer interrupted anastomosis with 10/0 Nylon was used to establish vasal continuity. Subsequent seminal analysis at 3–6 months and ensuing paternity were related to several variables. The results were compared with those obtained after 137 cases of primary microsurgical vasovasostomy. Results Sperm was restored to the ejaculate in 16 (57%) of the patients and successful fertilization was reported in nine (32%). The interval between vasectomy and reversal surgery was relevant to the outcome, with four out of four men having sperm in the ejaculate within 5 years and three achieving paternity. However, the fertility rate was still moderate after an interval of 6–10 years (two of six) and at > 10 years (four of 18). The presence of sperm in the ejaculate was related to whether or not sperm were found in the testicular end of the vas at operation, but absence did not preclude a successful outcome. The overall results were not significantly different from those after primary microsurgical reversal surgery. Conclusion Microscopic vasovasostomy after previous obstructive failure provides the patient with a further reasonable chance of becoming fertile; although diminishing with time from vasectomy, even after a prolonged period there can be success. The absence of sperm at the time of vasovasostomy does not necessarily indicate failure, but in these cases the presence of thick creamy fluid in the vas predicts a poor outcome, and alternative methods of management should be considered. A microsurgical technique extending, if necessary, well into the convoluted part of the vas, is recommended. Microsurgical skills, relevant equipment and adequate time are required.
Fibroblast growth factor receptor‐2 mutation analysis in human prostate cancer
Authors: Mehta P. , Robson C.N. , Neal D.E. , Leung H.Y. 
Published: March 2003

Objective To assess whether mutations in the hot‐spots of the fibroblast growth factor (FGF) receptor‐2 gene (FGFR2, exons encoding the IIIa, IIIb, IIIc and transmembrane domain, TMD) are associated with the development of prostate cancer, as the IIIb variant is the specific receptor for FGF7/KGF, an androgen‐inducible paracrine factor regulating prostatic growth. Materials and methods Single‐strand conformational polymorphism‐polymerase chain reaction (SSCP‐PCR) and cycle‐sequencing analysis were used to screen FGFR2 mutations in 30 patients with prostate cancer; corresponding blood samples were analysed from 11 of the patients. The human prostate cell lines, LNCaP, PC3, DU145, PNT1A and PNT1B were also examined. In addition, 10 foci of invasive cancer from three patients who underwent radical prostatectomy were also assessed. Results Positive controls containing FGFR2 mutations (Crouzon disease and Pfieffer syndrome) were confirmed by SSCP‐PCR and sequencing. Analysis of all prostate tumour samples and prostate‐derived cell lines revealed no polymorphisms or mutations in the IIIa, IIIb, IIIc and TMD regions of FGFR2. Conclusion
FGFR2 mutations in the‐FGF binding domain and the TMD are not frequent events in human prostate cancer.
A comparison of fluid absorption during transurethral resection and transurethral vaporization for benign prostatic hyperplasia
Authors: Çetinkaya M. , Öztürk B. , Akdemir Ö. , Özden C. , Aki F. T. 
Published: March 2003

Objectives To compare the absorption of irrigant fluid during transurethral vaporization of the prostate (TUVP) and transurethral resection of the prostate (TURP). Patients and methods Thirty patients with clinical benign prostatic hyperplasia were randomly assigned to undergo TURP or TUVP; 1.5% glycine + 1% ethanol solution was used as the irrigating solution. The volume of irrigant absorbed during surgery was estimated from the ethanol concentration in the patient's expired breath, sampled every 10 min. Results In both groups, the estimated absorbed fluid volume increased with the duration of surgery (P < 0.05). At the end of surgery, the mean (median, range) fluid absorption during TUVP was 672 (606, 0–1400) mL and during TURP was 1347 (975, 453–2965) mL; the difference was statistically significant (P < 0.05). Conclusion Although TURP has a greater associated risk of fluid absorption than TUVP there may still be severe fluid absorption with the latter. Even though TUVP is potentially less harmful than TURP in poor‐risk patients, ethanol monitoring is beneficial for increasing patient safety.
The correction of penile curvature with the Essed–Schröder technique: a long‐term follow‐up assessing functional aspects and quality of life
Authors: Friedrich M.G. , Evans D. , Noldus J. , Huland H. 
Published: March 2003

Objectives To investigate, in a retrospective analysis using a detailed questionnaire, the long‐term functional results in and quality of life (QoL) of patients after undergoing the Essed–Schröder procedure, a standard technique for correcting penile curvature. Patients and methods From 1994 to 1999, 40 patients (median age 24 years) had their penile curvature corrected using a modified Essed–Schröder technique. Assessments by the investigators and a self‐completed questionnaire were used to evaluate the functional and cosmetic aspects of the procedure, and QoL issues. Results Complete follow‐up data were available in 31 of the 40 (78%) patients (19 with congenital curvature and 12 with Peyronie's disease). The median follow‐up was 22 months. The degree of penile angulation before surgery was estimated as < 45° in five patients, 45–90° in 22 and > 90° in four. In 21 patients (68%) sexual intercourse was uncomfortable or impossible; 26 (84%) reported an impaired QoL because of the penile curvature. After surgery the cosmetic and functional result was good or sufficient in 25 patients (81%); all 25 were able to have sexual intercourse with no problems. Penile shortening (> 2 cm) was reported by six patients. A significant improvement in QoL was reported by 15 patients (48%), but of the 12 patients with Peyronie's disease before surgery, six reported impaired rigidity and two recurrence of their penile curvature afterward. Whereas only seven of 12 patients with Peyronie's disease reported good functional results, 18 of the 19 with congenital curvature reported good or excellent results after surgery. Conclusion The Essed–Schröder method is a simple operation which provides good functional and cosmetic results. Patients with congenital curvature of the penis have better results than those with Peyronie's disease.
Re‐operative hypospadias repair using the Snodgrass incised plate urethroplasty
Authors: Shanberg A.M. , Sanderson K. , Duel B. 
Published: March 2003

Objective To retrospectively assess the results of tubularized incised plate (Snodgrass) urethroplasty in a series of re‐operative hypospadias repairs in children.Patients and methods The study comprised a follow‐up (from 1996 until 2000) of 13 patients (mean age 7.5 years, range 13 months to 27 years) who had at least one previous hypospadias repair and who then underwent a reconstruction using the Snodgrass repair. In all cases the urethroplasty was covered with an additional layer of subcutaneous tissue. The original location, associated complications and results were recorded. In some cases, the long‐term follow up was conducted by telephone.Results Associated complications before the Snodgrass repair included urethral stricture in two, fistula in three and persistent chordee in one patient. The mean (range) follow‐up was 22 (9–34) months. The cosmetic results were excellent, with two complications (one patient with a glans dehiscence and a urethrocutaneous fistula, and a second with meatal stenosis). The remaining patients required no further procedures and were voiding normally at the last follow‐up.Conclusion Excellent cosmetic and functional results can be obtained using the Snodgrass incised plate urethroplasty for re‐operative hypospadias repair. Only one patient in this series had an initial operation in which the urethral plate was previously incised. Therefore, caution should be used when considering an incised plate urethroplasty in these patients.
Scintigraphic screening for renal damage in siblings of children with symptomatic primary vesico‐ureteric reflux
Authors: Bonnin F. , Lottmann H. , Sauty L. , Garel C. , Archambaud F. , Baudouin V. , El Ghoneimi A. , Loirat C. , Bok B.D. , Aigrain Y. 
Published: March 2003

Objective To define prospectively the incidence of renal parenchymal lesions in the siblings of patients treated at one institution for primary vesico‐ureteric reflux (VUR).Patients and methods From January 1997 to October 1998, a prospective study including renal scintigraphy (using dimercaptosuccinic acid, DMSA) and a radionuclide cystogram was proposed systematically to the asymptomatic siblings of children treated for primary VUR. The radionuclide cystograms were interpreted as showing the presence or absence of VUR and the DMSA scan as symmetrical or asymmetrical differential function, with or with no renal defect.Results Fifty‐five families gave informed consent, of whom 46 completed the study (eight refused secondarily and one was omitted by exclusion criteria), representing 46 symptomatic patients and 65 siblings. There were 17 siblings with VUR (26%) including two of 13 infants and 15 of 52 children aged > 18 months. One radionuclide cystogram failed. Of the 17 refluxing siblings, four had a history of symptomatic urinary tract infection; 62 of the 65 siblings had a DMSA scan, of which 56 were normal and six (10%) showed abnormalities (five asymmetrical differential function and one parenchymal defect). Only one of these six patients had VUR at the time of the evaluation and only one had a small kidney detected by ultrasonography on one side (and no VUR). There were no adverse effects associated with screening.Conclusion This study confirms a significant overall incidence of VUR (26%) in the asymptomatic siblings of patients treated for primary VUR. From the results of the DMSA scan (only one sibling had a parenchymal defect), the systematic screening of asymptomatic siblings does not appear to be beneficial.
Are urologists prepared for latex‐allergic patients?
Authors: Sidwell R.U. , Green J.S.A. , Basarab T. 
Published: March 2003

Objective To determine how prepared operating departments are to manage latex‐allergic patients, and particularly urologists, because the highest incidence of latex allergy occurs in patients with spina bifida who undergo frequent urological procedures. Methods A standard questionnaire about the provision of latex‐free equipment within operating theatres was completed by the 72 hospitals surveyed (33 district general, 27 teaching, six children's and six private hospitals). Results Anaesthetic latex‐free equipment was available in five of the children's hospitals, 56% of the teaching hospitals, 45% of the district general hospitals and two of the private hospitals. A latex‐free catheter only was provided in two of the children's hospitals, 30% of the teaching hospitals and 12% of the district general hospitals. In addition, one of the children's hospitals and one of the private hospitals had a comprehensive range of urological latex‐free equipment available. Conclusion This survey shows that many hospitals are inadequately prepared to manage latex‐allergic patients, because they lack anaesthetic and urological latex‐free equipment.
Cost‐effectiveness analysis of treatments for phimosis: a comparison of surgical and medicinal approaches and their economic effect
Authors: Berdeu D. , Sauze L. , Ha‐Vinh P. , Blum‐Boisgard C. 
Published: March 2003

ObjectiveTo compare the cost‐effectiveness of surgery and topical steroids as treatments for phimosis (defined as a clinically verifiable, pathological, cicatricial stenosis of the prepuce) and to evaluate the financial basis of these treatments.MethodsData on treatment using topical steroids was obtained from published reports and those for circumcision from claims by private hospitals for children < 13 years old registered at the health insurance department of our facility. The estimate of the French national financial cost of the treatments for 1998 was calculated from public and private institutional information.ResultsTreatment with topical steroids for 4–8 weeks was successful in ≈ 85% of patients (mean age 5 years) and had no side‐effects; the remaining 15% were treated by circumcision. Topical steroid therapy costs (in French francs) F 360 per patient. For those primarily treated by circumcision (81 boys, mean age 4.3 years) and diagnosed as having phimosis, the cost was F 3330 per patient in the private sector. The total number of circumcisions performed in France, regardless of sector (public or private) for 1998 was estimated to be 51 080, which represents an annual cost of F 195.7 million.ConclusionAs topical pharmacological treatment avoids the disadvantages, trauma and potential complications of penile surgery, including anaesthesia‐related risks, the use of topical steroids as a primary treatment appears to be justified in boys with clinically verifiable phimosis. This treatment could reduce costs by 75%, which represents a potential annual saving of ≈ F 150 million.
Complications of retroperitoneoscopic surgery at one centre
Authors: Kumar M. , Kumar R. , Hemal A.K. , Gupta N.P. 
Published: March 2003

Objective To evaluate the complications of retroperitoneoscopic urological surgery at one centre and to analyse their causes and means of prevention. Patients and methods The procedural details and complications were analysed retrospectively in 316 patients (aged 4–88 years) who underwent retroperitoneoscopic urological surgery between March 1994 and January 2000 at our centre. Nephrectomies and nephroureterectomies for benign and malignant diseases were the most common procedures. Other indications included urolithiasis, adrenal diseases, pelvi‐ureteric junction obstruction, chyluria, retrocaval ureter and malignant retroperitoneal lymph node enlargement. The specimens were retrieved intact by enlarging the port sites. Results The mean (range) operative duration was 104.9 (30–400) min, the blood loss 130.86 (25–1200) mL and the hospital stay 3.2 (1–10) days; 3.5% of the patients had a major complication, including seven vascular injuries, five of which required immediate conversion to open surgery. Four patients (1.2%) had other major complications including colonic injury, retroperitoneal collections and incisional hernia. There were 50 minor complications (15.8%) of which peritoneal tears (17) were the commonest. Port‐site infections and subcutaneous emphysema contributed 2.2% each. Conclusions As the stages of retroperitoneoscopic surgery become standardized and the outcome predictable, it is rapidly becoming accepted as an important method of treatment. The complications are few and predominantly minor. Increasing experience leads to a decrease in the complication rates. Individual surgeons can identify the common complications in their practice, ascertain the possible causes and devise methods of prevention.
An epidemiological study of nocturnal enuresis in Taiwanese children
Authors: Chang P. , Chen W.J. , Tsai W.‐Y. , Chiu Y.‐N. 
Published: March 2003

Objective To estimate the prevalence of primary nocturnal enuresis (PNE) in Taiwanese children, and to examine factors associated with PNE and its severity. Subjects and methods In all, 1683 questionnaires were sent to parents of schoolchildren aged 6–11 years randomly selected from three primary schools in Taipei City, Taiwan. The questionnaire was designed to collect information about the prevalence of and factors associated with PNE. Results Of the questionnaires distributed, 1176 (70%) were completed. PNE was reported in 92 (8%) of the children; nine (10%) of these children were wet >3 nights per week. Factors associated with PNE included male gender, deep sleep, divorced parents or separated family and a positive family history of enuresis. Of these factors, only those children with deep sleep were more likely to have > 3 wet nights per week. Conclusion The prevalence of and factors associated with PNE in Taiwan are similar to those reported in Western countries, but the percentage of children with severe enuresis is lower than in Sweden, France and Turkey. Deep sleepers are more likely to have severe enuresis.
The Dutch cohort of sildenafil users: baseline characteristics
Authors: Souverein P.C. , Egberts A.C.G. , Sturkenboom M.C.J.M. , Meuleman E.J.H. , Leufkens H.G.M. , Urquhart J. 
Published: March 2003

Objective To identify a Dutch cohort of sildenafil users and describe their baseline characteristics. Patients and methods Each pharmacy in The Netherlands (n = 1571) was asked to identify prospectively the first 20 sildenafil prescriptions in their pharmacy over 1 year, and to complete and return a registration form. The collected data included patient characteristics, the details of the sildenafil prescription (date, prescriber, number of prescriptions, dosing), and the use of co‐medication by the patient in the year preceding the sildenafil prescription. Results Data were collected from 4460 sildenafil prescriptions during the year under study, relating to 3477 individual patients. Most of the cohort had cardiovascular morbidity or diabetes. Sildenafil seems to have been used by a new, previously untreated population of patients with erectile dysfunction. In addition, 69 men were identified who could have been using nitrates and sildenafil concomitantly. Conclusion A cohort of patients using sildenafil was identified and characterized; they appeared to be representative of sildenafil users in The Netherlands. This cohort will be followed prospectively to evaluate the medical status (particularly cardiovascular) of the patients with time.
Histopathological mapping of open testicular biopsies in patients with unobstructive azoospermia
Authors: Altay B. , Hekimgil M. , Çikili N. , Turna B. , Soydan S. 
Published: March 2003

Objective To evaluate, in patients with unobstructive azoospermia, the heterogeneity of spermatogenesis within the testes and thus whether there is any region of advanced spermatogenesis. Patients and methods Seventy infertile men (mean age 34 years, sd 5.01) with no varicoceles or testicular atrophy had bilateral open testicular biopsies taken from six different sites. For each biopsy specimen the number of seminiferous tubules and of tubules with sperm maturation were counted (by light microscopy at × 400). The ratio of tubules with active spermatogenesis to the total number was calculated for each biopsy sample. Results The mean (sd) right and left testicular volumes were 19.82 (7.8) and 18.84 (7.89) mL, respectively; the patients' follicle‐stimulating hormone level was 8.34 (1.17) IU/mL. On sextant biopsy spermatozoa were detected in 42 of the 70 patients (60%). The mean (sd) ratio of tubules with spermatozoa was 5.23 (0.8)% for the right and 5.37 (0.76)% for the left testes. There was no statistically significant difference in the ratio of seminiferous tubules positive for spermatozoa at the different biopsy sites in either the right or left testis. Spermatozoa were identified in only one to three biopsy sites in almost half of those with maturation arrest; this ratio increased to 74% in patients diagnosed as having Sertoli‐cell‐only syndrome with focal spermatogenesis. Conclusion There is no region of the testis that is rich or advanced in spermatogenesis in patients with unobstructive azoospermia. Without multiple testicular biopsy it is possible to miss advanced spermatogenesis in some unobstructed patients. The sextant testis biopsy is a reliable method for detecting the presence and exact location of seminiferous tubules with spermatozoa in patients with unobstructive azoospermia.
How widespread are the symptoms of an overactive bladder and how are they managed? A population‐based prevalence study
Authors: Milsom I. , Abrams P. , Cardozo L. , Roberts R.G. , Thüroff J. , Wein A.J. 
Published: March 2003

Objective To determine the prevalence of chronic and debilitating symptoms of the overactive bladder, defined here as the presence of chronic frequency, urgency and urge incontinence (either alone or in any combination), and presumed to be caused by involuntary detrusor contractions. Subjects and methods Data were collected using a population‐based survey (conducted by telephone or direct interview) of men and women aged  40 years, selected from the general population in France, Germany, Italy, Spain, Sweden and the United Kingdom, using a random stratified approach. The main outcome measures were: prevalence of urinary frequency (> 8 micturitions/24 h), urgency and urge incontinence; the proportion of participants who had sought medical advice for symptoms of an overactive bladder; and current or previous therapy received for these symptoms. Results In all, 16 776 interviews were conducted in the six European countries. The overall prevalence of overactive bladder symptoms in individuals aged  40 years was 16.6%. Frequency (85%) was the most commonly reported symptom, followed by urgency (54%) and urge incontinence (36%). The prevalence of overactive bladder symptoms increased with advancing age. Overall, 60% of respondents with symptoms had consulted a doctor but only 27% were currently receiving treatment. Conclusion Symptoms of an overactive bladder, of which frequency and urgency are as bothersome as urge incontinence, are highly prevalent in the general population. However, only a few affected individuals currently receive treatment. Taken together, such findings indicate that there is considerable scope for improvement in terms of how physicians diagnose and treat this condition.
Human papillomaviruses 6/11, 16/18 and 31/33/51 are not associated with squamous cell carcinoma of the urinary bladder
Authors: Westenend P.J. , Stoop J.A. , Hendriks J.G.M. 
Published: March 2003

Objective To assess high‐risk human papillomavirus (HPV), mainly HPV type 16, 18, 31 and 33 (an important aetiological factor in squamous cell carcinoma, SCC, of the anogenital region) in SCC of the urinary bladder. Material and methods Sixteen SCC from the urinary bladder were evaluated using non‐isotopic in situ hybridization with a sensitive detection system for the presence of high‐risk HPV 16/18, or 31/33/51, and for HPV6/11, a low‐risk type commonly found in condylomata. Previously published studies were also reviewed and assessed. Results No high‐risk HPV was found in any of the SCC of the bladder evaluated. Previous reports identified nine HPV‐positive SCC of a total of 105, including the present series. In four of these positive cases, HPV types were found that are considered a high risk in anogenital carcinomas. Conclusion From the present and previous results, we conclude that HPV has no major role in the pathogenesis of SCC of the urinary bladder.