摘要:

Summary—The critical intravesical pressure range for extravascular absorption of irrigating fluid (EVA) during transurethral resection of the prostate (TURP) is determined by the pressure in the perivesical tissue. This means that the transmural bladder pressure (detrusor pressure), calculated by deducting perivesical pressure from intravesical pressure during cystometry, is the pressure gradient behind EVA. The transmural pressure in 6 patients undergoing TURP has been studied both before and during epidural anaesthesia, using both conventional medium‐fast fill cystometry and “free‐flow” cystometry through the resectoscope. Epidural block does not influence the transmural pressure response on filling the bladder and neither does the type of infusion. A positive transmural pressure, and thereby a pressure gradient for EVA, exists already during the very early phase of bladder filling. Incomplete perforation of the prostatic capsule and clotting, as well as the accumulation of irrigating fluid in the perivesical tissue, probably moderate the rate of a

ISSN:0007-1331    

DOI:10.1111/j.1464-410X.1990.tb14658.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY

摘要:

Summary—A new slow release formulation of buserelin given as a 3‐monthly depot injection has been evaluated in 4 patients with advanced prostatic cancer previously maintained on shorter acting depots. Treatment was maintained for a mean period of 21 months. Steady state urinary buserelin concentrations were reached by the beginning of the third treatment week and maintained until the end of the third treatment month. Serum testosterone remained suppressed in the castrate range for the duration of the study. Seven previously untreated patients were entered into treatment. Serum testosterone was suppressed into the castrate range between the seventh and fourteenth days after implantation. This preparation offers an advantage for the patient and clinician over existing methods of GnRH analogue administration and will now enter further clinical tr

ISSN:0007-1331    

DOI:10.1111/j.1464-410X.1990.tb14659.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY

摘要:

Summary—The relationships between histological prognostic indicators and their relative significance in prognosis were studied in 139 patients who underwent radical prostatectomy. The estimated progression rates at 5 and 8 years were 14 and 52% respectively for patients with high grade tumours, 25 and 50% for those with capsular penetration, 31 and 58% for patients with seminal vesicle invasion and 23 and 55% for those with lymph node metastases. Each of the 4 parameters yielded an approximately equal increased risk of disease progression at 5 and 8 years. The occurrence of 2 or more risk factors in the same patient did not result in a statistically increased risk of progression at 5 and 8 years. The effect of capsular involvement on progression was directly related to the extent of invasion. The progression rate at 8 years was 3% for patients with mild involvement, 19% for those with extensive invasion and 50% for those with capsular penetratio

ISSN:0007-1331    

DOI:10.1111/j.1464-410X.1990.tb14660.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY

摘要:

Summary—Seven patients with complete rupture of the membranous urethra secondary to trauma were treated by internal optical urethrotomy (OU). All underwent initial suprapubic catheter drainage. The diagnosis of complete urethral rupture was confirmed by ascending and descending urethrograms and subsequent urethroscopy. OU was performed 3 weeks to 8 years following injury. Although all patients required further OUs for recurrent strictures, all can pass urine satisfactorily. Two patients have slight stress incontinence. This technique is a viable alternative to more conventional procedures for this conditio

ISSN:0007-1331    

DOI:10.1111/j.1464-410X.1990.tb14661.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY

摘要:

Summary—The surface morphologies of different generic types of Foley catheter have been investigated using scanning electron microscopy (SEM). The characteristic features of each material are illustrated and it is shown that distinct differences exist between the inner and outer surfaces of latex‐based catheters; these differences are attributed to the methods of manufacture. The possible relations between morphology and performancein situare discus

ISSN:0007-1331    

DOI:10.1111/j.1464-410X.1990.tb14662.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY

摘要:

Summary—In a period from January 1978 to January 1989, 114 patients with seminoma have been managed, primarily in studies aimed at examining alteratives to radiotherapy. In a pilot study of single agent platinum in 27 previously untreated patients with metastatic seminoma, 82% remain progression‐free and 89% alive and disease‐free at 5 years compared with 81% progression‐free and 88% alive and disease‐free in a selected group of 16 previously untreated patients who received platinum‐based combination treatment. Results from a pilot study of surveillance in 26 patients with stage 1 seminoma showed that 27% developed evidence of further disease (5 relapses, 2 second tumours) by 3 years, with all relapse patients salvaged by subsequent treatment. Because of the slow pace of relapse compared with malignant teratoma, with relapses occurring after 2 years, a pilot study was initiated to evaluate the effect of 2 courses of adjuvant carboplatin. The results to date in 25 patients suggest that with the use of modern antiemetics this regimen is as well tolerated as prophylactic radiotherapy. With a median follow‐up of 16 months there has been 1 relapse subsequently salvaged by combination chemotherapy. A radomised trial is now justified to assess the quality of life and late toxicity of this approach compared with prophylactic

ISSN:0007-1331    

DOI:10.1111/j.1464-410X.1990.tb14663.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY

摘要:

Summary—Prostaglandin E1(PG E1) was used for diagnostic and therapeutic purposes in 149 men with erectile dysfunction over a period of 20 months (February 1987‐October 1988). The intracavernous application of PG E1in varying doses resulted in an erection sufficient for sexual intercourse in 79% of cases. In order to differentiate between vascular and non‐vascular impotence, 5 pg PG Elwere found to be a sufficiently high and safe dose for the first intracavernous injection. Local discomfort, ranging from mild to severe pain after injection, was recorded in 40% of patients. A significant difference in severe side effects was found between arterial, venous and non‐vasculogenic impotence, the highest incidence of local pain occurring in non‐vasculogenic patients. The most striking result was the occurrence of 4 cases of priapism, all in the non‐vascular group, 1 of these occurring after the injection of only

ISSN:0007-1331    

DOI:10.1111/j.1464-410X.1990.tb14664.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY

ISSN:0007-1331    

DOI:10.1111/j.1464-410X.1990.tb14665.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY

摘要:

Summary—Fifty‐six infants with prenatally diagnosed hydronephrosis are reported. In all instances the diagnosis was confirmed postnatal and at renography 45 were obstructed; 38 obstructed kidneys (84%) and all of the non‐obstructed kidneys had a differential function exceeding 40% of total function.Latterly we have come to recommend early pyeloplasty only if differential function of a renographically obstructed kidney is less than 40%; 6 early pyeloplasties were performed for this reason; 28 infants (30 renal units) were managed non‐operatively and 18 of these (19 renal units) were reassessed renographically. In 11 the obstruction persists. Sonography demonstrated improving hydronephrosis in 8 kidneys with resolution in 5 and no change in 6. Of the other 10 infants (11 renal units), the hydronephrosis has improved in 4, resolved in 1 and remains unchanged in 6.Our experience suggests that neonatal and early pyeloplasty can be restricted to a modest number of infants in whom there is impaired renal function. In cases with normal function the natural history appears essentially benign and does not justify routine pyel

ISSN:0007-1331    

DOI:10.1111/j.1464-410X.1990.tb14666.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY

摘要:

Summary—Buried penis is a congenital abnormality in which the phallus is concealed within the subcutaneous tissue. The corporal bodies and glans have developed normally. A deficiency of penile shaft skin in association with abnormal mobility of the skin gives rise to the phenotypic appearance. The skin defect may be related to an abnormal attachment of dartos muscle during embryogenesis. Correction of this condition requires separation of these abnormal muscular attachments and provision of skin coverage of the penile shaft. It is imperative not to circumcise the patient as this will worsen the skin deficiency. We describe a novel technique for correcting buried penis performed on 12 patients at the Great Ormond Street Hospital for Sick Children. A satisfactory cosmetic result was obtained in all patient

ISSN:0007-1331    

DOI:10.1111/j.1464-410X.1990.tb14667.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY