摘要:

Summary—Fifty‐five patients with chronic urinary retention and incipient or actual renal failure were studied. In the majority of patients renal function improved after bladder decompression, irrespective of whether or not a diuresis occurred. Excessive loss of salt and water was rarely a matter of concern and most patients did not require intravenous fluid replacement. Several lost weight and experienced a fall in blood pressure during the period of diuresis without adverse effect upon renal functional recovery. A profound fall in blood pressure occurred in only three patients, all of whom required long‐term sodium supplementation. It is concluded that the problem of salt and water loss after bladder decompression in patients with renal failure is exaggerated and difficult to predict. Over‐enthusiastic replacement of fluid in strict accordance with output could readily lead to fluid overload and prolongation of the diuretic period. Therefore fluid replacement should be determined by the clinical condition of the patient and measurement of improving renal function with less emphasis on urine output and its electrolyte

ISSN:0007-1331    

DOI:10.1111/j.1464-410X.1985.tb08973.x

出版商:Blackwell Publishing Ltd    

年代:1985

数据来源: WILEY

摘要:

Summary—In 22 of 40 patients with unilateral hydronephrosis the pressure flow study was compared with the outcome of surgery. Seventeen of the 22 patients had impaired function before surgery as judged from the 2‐min uptake on the renogram. The pressure flow study as a measure of pre‐operative obstruction showed no relation to the functional outcome of surgery. Patients with obstructed pressure flow studies as well as those without signs of obstruction either remained stable or improved after surgery.It was concluded that pressure flow studies are of no value in predicting the outcome of surgery for hydroneph

ISSN:0007-1331    

DOI:10.1111/j.1464-410X.1985.tb08974.x

出版商:Blackwell Publishing Ltd    

年代:1985

数据来源: WILEY

摘要:

Summary—The appearance of fixed dehydrated non‐neoplastic human urothelium viewed by conventional scanning electron microscopy (CSEM) is different from that of frozen hydrated human urothelium viewed by low temperature scanning electron microscopy (LTSEM). In the fixed dehydrated material the surface is formed by well defined, polygonal, domed superficial urothelial cells which have prominent surface microridges. In places intermediate urothelial cells are visible and they have surface microvilli. In the frozen hydrated material viewed by LTSEM most of the surface is smooth. This is formed in part by a glutaraldehyde soluble extracellular secretion which may be a mucin barrier to bacteria. We believe that the rest of the smooth surface is formed by superficial urothelial cells which are not well defined and which lack microridges. There are islands of rounded cells lacking microvilli which are probably intermediate urothelial cells as they correspond in appearance with the intermediate urothelial cells seen in freeze fractured material.It seems likely that fixation and dehydration will cause some change in surface configuration and in theory the frozen hydrated material should more closely resemble the natural state. We believe that LTSEM will be of value in investigating normal and diseased urothel

ISSN:0007-1331    

DOI:10.1111/j.1464-410X.1985.tb08975.x

出版商:Blackwell Publishing Ltd    

年代:1985

数据来源: WILEY

摘要:

Summary—In a study of 75 isolated human detrusor muscle strips, spontaneous contractions and an associated sustained rise in basal tension were observed in 43 (57%). Vasoactive intestinal polypeptide (VIP) caused significant reductions in the frequency and amplitude of spontaneous contractions and a fall in basal tension. The results suggest that VIP may have a role as an inhibitor of spontaneous activity in the human detruso

ISSN:0007-1331    

DOI:10.1111/j.1464-410X.1985.tb08976.x

出版商:Blackwell Publishing Ltd    

年代:1985

数据来源: WILEY

摘要:

Summary—Thirty‐seven cases of female chronic retention are reviewed. Only 13 patients had neurological disease. The problems encountered in diagnosis and management are presen

ISSN:0007-1331    

DOI:10.1111/j.1464-410X.1985.tb08977.x

出版商:Blackwell Publishing Ltd    

年代:1985

数据来源: WILEY

摘要:

Summary—Sixty‐one patients with lower urinary tract neuropathy were treated surgically, either to achieve continence or to prevent or arrest renal deterioration, or both. Most were myelodysplastics and all but two were ambulatory. Three techniques were employed, depending on the detrusor/sphincter behaviour and the sex of the patient: enterocystoplasty alone, with or without selective sphincterotomy and/or intermittent self‐catheterisation; total sphincter ablation and an artificial sphincter; or, most commonly, enterocystoplasty combined with sphincter ablation and an artificial sphincter. Continence was achieved in 58 patients, though nocturnal enuresis was sometimes a problem; renal deterioration was arrested in 13 of 14 patients and renal function remained stable in all of the other pat

ISSN:0007-1331    

DOI:10.1111/j.1464-410X.1985.tb08978.x

出版商:Blackwell Publishing Ltd    

年代:1985

数据来源: WILEY

摘要:

Summary—The indirect immunoperoxidase test to detect urothelial cell surface blood group antigens was performed in an attempt to assess the loss of these antigens as a prognostic predictor. In our technique A, B and O(H) blood group specific monoclonal antibodies were used. It was possible to perform the test satisfactorily on histological material from 55 cases which were superficial on presentation; 15 subsequently became invasive. The loss of surface antigens correlated well with histological grade—44.4% of G1, 87.2% of G2 and 94.1% of G3 tumours were antigen‐negative.The blood group phenotype of 114 patients was studied. In the group that subsequently became invasive, 14 of 26 (54%) were of blood group A phenotype compared with 37 of 88 (42%) in the non‐invasive category.Acetylation studies were performed on 47 cases. In the group that subsequently became invasive, 5 of 10 (50%) had the slow phenotype of the enzyme N‐acetyltransferase compared with 13 of 37 (35%) in the group that remained su

ISSN:0007-1331    

DOI:10.1111/j.1464-410X.1985.tb08979.x

出版商:Blackwell Publishing Ltd    

年代:1985

数据来源: WILEY

摘要:

Summary—Twenty‐five patients with early transitional cell carcinoma of the bladder (Tis Ta T1) received intravesical instillations of 40 mg mitomycin C in 40 ml water weekly for 7 weeks. The overall response rate was 70% (complete response 40%). In patients with Ta tumours the response rate was 86%. Minor toxic side effects occurred in four patients and only one patient was unable to complete the course of treatment because of side effe

ISSN:0007-1331    

DOI:10.1111/j.1464-410X.1985.tb08980.x

出版商:Blackwell Publishing Ltd    

年代:1985

数据来源: WILEY

摘要:

Summary—Fifty‐three consecutive, unselected patients with invasive bladder cancer, Stage T2 to T3, treated by radical radiotherapy have been reviewed. Cystectomy was reserved for patients with significant worsening of disease during treatment, histologically confirmed persistent or recurrent invasive tumour after treatment, or patients with intolerable symptoms due to radiation cystitis. In 64% of our patients a favourable tumour response to radiotherapy was seen, while a further 31% showed disease progression either during or on completion of radiotherapy. Cystectomy was performed on 22% of patients, mainly for radiation cystitis, and was not associated with a significant operative mortality rate. The crude 5‐year survival rate was 42%. We conclude that radical radiotherapy is as effective as other forms of treatment for invasive bladder cancer, but that there remains a need to identify those bladder tumours destined to respond poorly to radiotherapy at an earlier

ISSN:0007-1331    

DOI:10.1111/j.1464-410X.1985.tb08981.x

出版商:Blackwell Publishing Ltd    

年代:1985

数据来源: WILEY

摘要:

Summary—In patients with chronic abacterial prostatitis, a double‐blind trial of 3 months of treatment with minocycline 100 mg twice daily compared with diazepam 5 mg twice daily was undertaken.The percentage fall in polymorphonuclear leucocyte counts in the expressed prostatic secretions was much more marked after treatment with minocycline than with diazepam. Over a follow‐up period of at least 12 months, further treatment was necessary in more patients originally treated with diazepam than with minocy

ISSN:0007-1331    

DOI:10.1111/j.1464-410X.1985.tb08982.x

出版商:Blackwell Publishing Ltd    

年代:1985

数据来源: WILEY