Cancer therapies usually depend on cross-sectional imaging for the assessment of treatment response. This study was designed to evaluate the ability of MRI to predict zones of necrosis following the use of high-intensity focused ultrasound (HIFU) to treat liver metastases. Patients with liver metastases, who had been scheduled for elective surgical resection of their tumours, were recruited to this non-randomized Phase II study. In each case, a proportion of an index liver tumour target was ablated. The response to HIFU was assessed after 12 days using contrast-enhanced MRI and compared directly with histological analysis at the time of surgery. Eight patients were treated, of whom six were subsequently assessed with both MRI and histology. There were no major complications. MRI predicted complete ablation in three cases. In each case, histological analysis confirmed complete ablation. In one case, the region of ablation observed on MRI appeared smaller than predicted at the time of HIFU, but histology revealed complete ablation of the target region. The predominant characteristic of HIFU-ablated tissue was coagulative necrosis but heat fixation was evident in some areas. Heat-fixed cells appeared normal under haematoxylin and eosin staining, indicating that this is unreliable as an indicator of HIFU-induced cell death. This study demonstrates that HIFU is capable of achieving selective ablation of pre-defined regions of liver tumour targets, and that MRI evidence of complete ablation of the target region can be taken to infer histological success.

Chronic post-vasectomy scrotal pain (CPVSP) is a poorly quantified clinical problem. Data in this area has been based on retrospective cohort studies, with variable lengths of follow up and compliance. This has resulted in quoted figures of CPVSP varying between 2 & 52% depending upon the definition. We have undertaken the first prospective assessment of CPTP to assess the extent of testicular pain in men before and after vasectomy. Our objective is to produce accurate data to allow better characterisation of men considering this procedure, and to improve informed consent with regard to outcomes.

BJU InternationalVolume 96, Issue 4 p. 475-476 Scrotal ultrasonography in the urology clinic Rowland O. Illing, Corresponding Author Rowland O. Illing Urology, Churchill Hospital, Oxford UKe-mail: [email protected]Search for more papers by this authorDavid W. Cranston, David W. Cranston Urology, Churchill Hospital, Oxford UKSearch for more papers by this author Rowland O. Illing, Corresponding Author Rowland O. Illing Urology, Churchill Hospital, Oxford UKe-mail: [email protected]Search for more papers by this authorDavid W. Cranston, David W. Cranston Urology, Churchill Hospital, Oxford UKSearch for more papers by this author First published: 11 August 2005 https://doi.org/10.1111/j.1464-410X.2005.05668.xCitations: 2Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL REFERENCES 1 Radiology BotFoC. Ultrasound Training Recommendations for Medical and Surgical Specialities. London: The Royal College of Radiologists; 2 November, 2004 2 Dambro TJSR, Barbara CA. The scrotum. In CMWS Rumack, JW Charboneau eds, Diagnostic Ultrasound. 2nd edn. St. Louis, Mo: Mosby, 1998: 791– 821 3 Dogra VS, Gottlieb RH, Oka M, Rubens DJ. Sonography of the scrotum. Radiology 2003; 227: 18– 36 4 Vesey SG, Lumb GN, O'Boyle PJ. An evaluation of urologist-operated ultrasound and its use in the urological out-patient clinic. Br J Urol 1988; 61: 74– 6 5 Older RA, Omary RA, Watson LR. The impact of sonography on the diagnosis of scrotal disorders. J Urol 1997; 158: 479– 80 6 Nuttall MC, Van Der Meulen J, McIntosh G, Gillatt D, Emberton M. Threshold volumes for urological cancer surgery: a survey of UK urologists. BJU Int 2004; 94: 1010– 3 Citing Literature Volume96, Issue4September 2005Pages 475-476 ReferencesRelatedInformation

High-intensity focused ultrasound (HIFU) provides a potential noninvasive alternative to conventional therapies. We report our preliminary experience from clinical trials designed to evaluate the safety and feasibility of a novel, extracorporeal HIFU device for the treatment of liver and kidney tumours in a Western population. The extracorporeal, ultrasound-guided Model-JC Tumor Therapy System (HAIFU™ Technology Company, China) has been used to treat 30 patients according to four trial protocols. Patients with hepatic or renal tumours underwent a single therapeutic HIFU session under general anaesthesia. Magnetic resonance imaging 12 days after treatment provided assessment of response. The patients were subdivided into those followed up with further imaging alone or those undergoing surgical resection of their tumours, which enabled both radiological and histological assessment. HIFU exposure resulted in discrete zones of ablation in 25 of 27 evaluable patients (93%). Ablation of liver tumours was achieved more consistently than for kidney tumours (100 vs 67%, assessed radiologically). The adverse event profile was favourable when compared to more invasive techniques. HIFU treatment of liver and kidney tumours in a Western population is both safe and feasible. These findings have significant implications for future noninvasive image-guided tumour ablation.

You have accessJournal of UrologyPodium, Tuesday, May 24, 2005, 3:30 - 5:30 pm1 Apr 20051400: Early Clinical Experience Using High-Intensity Focused Ultrasound for the Treatment of Renal Tumours James E. Kennedy, Rowland O. Illing, Feng Wu, Gail R. ter Haar, Rachel R. Phillips, Andrew S. Protheroe, and David W. Cranston James E. KennedyJames E. Kennedy More articles by this author , Rowland O. IllingRowland O. Illing More articles by this author , Feng WuFeng Wu More articles by this author , Gail R. ter HaarGail R. ter Haar More articles by this author , Rachel R. PhillipsRachel R. Phillips More articles by this author , Andrew S. ProtheroeAndrew S. Protheroe More articles by this author , and David W. CranstonDavid W. Cranston More articles by this author View All Author Informationhttps://doi.org/10.1016/S0022-5347(18)35534-4AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail "1400: Early Clinical Experience Using High-Intensity Focused Ultrasound for the Treatment of Renal Tumours." The Journal of Urology, 173(4S), pp. 379–380 © 2016 by American Urological AssociationFiguresReferencesRelatedDetails Volume 173Issue 4SApril 2005Page: 379-380 Advertisement Copyright & Permissions© 2016 by American Urological AssociationMetricsAuthor Information James E. Kennedy More articles by this author Rowland O. Illing More articles by this author Feng Wu More articles by this author Gail R. ter Haar More articles by this author Rachel R. Phillips More articles by this author Andrew S. Protheroe More articles by this author David W. Cranston More articles by this author Expand All Advertisement PDF downloadLoading ...

BJU InternationalVolume 92, Issue 5 p. 510-515 Renal transplantation into the abnormal lower urinary tract M.E. Sullivan, M.E. Sullivan Department of Urology, Churchill Hospital, Oxford, &Search for more papers by this authorJ.M. Reynard, J.M. Reynard Department of Urology, Churchill Hospital, Oxford, & The National Spinal Injuries Centre, Stoke Mandeville Hospital, Aylesbury, Bucks, UKSearch for more papers by this authorD.W. Cranston, D.W. Cranston Department of Urology, Churchill Hospital, Oxford, &Search for more papers by this author M.E. Sullivan, M.E. Sullivan Department of Urology, Churchill Hospital, Oxford, &Search for more papers by this authorJ.M. Reynard, J.M. Reynard Department of Urology, Churchill Hospital, Oxford, & The National Spinal Injuries Centre, Stoke Mandeville Hospital, Aylesbury, Bucks, UKSearch for more papers by this authorD.W. Cranston, D.W. Cranston Department of Urology, Churchill Hospital, Oxford, &Search for more papers by this author First published: 21 August 2003 https://doi.org/10.1046/j.1464-410X.2003.04377.xCitations: 17 M.E. Sullivan, Churchill Hospital, Old Road, Oxford OX3 7LJ, UK. e-mail: •• Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL REFERENCES 1 Kelly WD, Merkel FK, Markland C. Ileal urinary diversion in conjunction with renal homotransplantations. Lancet 1966; 1: 222– 6 2 Tunner WS, Whitsell JC, Rubin AL et al. Renal transplantation in children with corrected abnormalities of the lower urinary tract. J Urol 1971; 106: 133– 9 3 Hatch DA. Kidney transplantation in patients with an abnormal lower urinary tract. Urol Clin North Am 1994; 21: 311– 20 4 Nguyen DH, Reinberg Y, Gonzalez R, Fryd D, Najarian JS. Outcome of renal transplantation after urinary diversion and enterocystoplasty: a retrospective controlled study. J Urol 1990; 144: 1349– 51 5 Rudge CJ. Transplantation and the abnormal bladder. In PJ Morris ed. Kidney Transplantation. 5th edn. Philadelphia: WB Saunders, 2001: 173– 83 6 Errando C, Batista JE, Caparros J, Vicente J, Arano P. Urodynamic evaluation and management prior to renal transplantation. Eur Urol 2000; 38: 415– 8 7 Kogan SJ, Levitt SB. Bladder evaluation in paediatric patients before undiversion in previously diverted urinary tracts. J Urol 1976; 118: 443– 6 8 Cerilli J, Anderson GW, Evans WE, Smith JP. Renal transplantation in patients with urinary tract abnormalities. Surgery 1976; 79: 248– 52 9 Tanagho E. Congenitally obstructed bladders: fate after prolonged defunctionalisation. J Urol 1974; 111: 102– 9 10 Firlit CF. Use of defunctionalised bladders in paediatric renal transplantation. J Urol 1976; 116: 634– 7 11 MacGregor P, Novick AC, Cunningham R et al. Renal transplantation in end-stage renal disease patients with existing urinary diversion. J Urol 1986; 135: 686– 8 12 Serrano DP, Flechner SM, Modlin CS, Wyner LM, Novick AC. Transplantation into the long-term defunctionalised bladder. J Urol 1996; 156: 885– 8 13 McGuire EJ, Woodside JR, Borden RA et al. Prognostic value of urodynamic testing in myelodysplastic patients. J Urol 1981; 126: 205– 9 14 Churchill BM, Sheldon CA, McLorie GA et al. Factors influencing patient and graft survival in 300 cadaveric paediatric renal transplants. J Urol 1988; 140: 1129– 33 15 Houle AM, Gilmour RF, Churchill BM, Gaumond M, Bissonnette B. What volume can a child normally store in the bladder at a safe pressure? J Urol 1993; 149: 561– 4 16 Gill IS, Hayes JM, Hodge EE, Novick AC. Clean intermittent catheterisation and urinary diversion in the management of renal transplant recipients with lower urinary tract dysfunction. J Urol 1992; 148: 1397– 400 17 Confer DJ, Banowsky LH. The urological evaluation and management of renal transplant donors and recipients. J Urol 1980; 124: 305– 10 18 Reinberg Y, Bumgardner GL, Aliabadi H. Urological aspects of renal transplantation. J Urol 1990; 143: 1087– 92 19 Najarian JS, Matas AJ. The present and future of kidney transplantation. Trans Proc 1991; 23: 2075– 82 20 US Renal Data System. USRDS 1989 renal data report. Bethesda, MD: National Institute of Diabetes and Digestive and Kidney Diseases, 1989 21 Glazier DB, Whang MIS, Geffner SR et al. Evaluation of voiding cystourethrography prior to renal transplantation. Transplantation 1996; 62: 1762– 5 22 Marshall FF, Smolev JK, Spees EK et al. The urological evaluation and management of patients with congenital lower urinary tract anomalies prior to renal transplantation. J Urol 1982; 127: 1078– 81 23 Thomalla JV, Mitchell ME, Leapman RS. Renal transplantation in a patient with an artificial urinary sphincter device. J Urol 1988; 139: 573– 4 24 Gelet A, Sanseverino R, Salas M et al. The AS800 urinary sphincter in renal transplantation. Br J Urol 1990; 66: 549– 50 25 Griffin PJ, Stephenson TP, Brough S, Salaman JR. Transplanting patients with abnormal lower urinary tracts. Transpl Int 1994; 7: 288– 91 26 Zaragoza MR, Ritchey ML, Bloom DA, McGuire EJ. Enterocystoplasty in renal transplantation candidates. Urodynamic evaluations and outcome. J Urol 1993; 150: 1463– 6 27 McInerny PD, Picramenos D, Koffman CG, Mundy AR. Is cystoplasty a safe alternative to urinary diversion in patients requiring renal transplantation? Eur Urol 1995; 27: 117– 20 28 Gruessner RW, Tzardis PJ, Matas AJ et al. Ileal and colon conduits in renal transplantation. Clin Transplant 1990; 4: 125– 8 29 Mitchell ME, Burns MW. Urinary undiversion and augmentation cystoplasty. In PP Kelalis, LR King, AB Belman eds. Clinical Paediatric Urology, 3rd edn. Philadelphia: WB Saunders, 1992: 904– 9 30 Malone MJ, Khauli RB, Lowell J. Use of small and large bowel in renal transplantation. Urol Clin North Am 1997; 24: 837– 43 31 Cairns HS, Leaker B, Woodhouse CRJ, Rudge CJ, Neild GH. Renal transplantation into abnormal lower urinary tract. Lancet 1991; 338: 1376– 9 32 Coosemans W, Baert L, Kuypers D et al. Renal transplantation onto abnormal urinary tract: Ileal conduit urinary diversion. Trans Proc 2001; 33: 2493– 4 33 Streem SB. Endourological management of urological complications following renal transplantation. Semin Urol 1994; 12: 123– 33 34 Cecka JM. The UNOS renal transplant registry. Clin Transpl 2001: 1– 18 35 McDonald MW, Zincke H, Engen DE, Sterioff S. Adaptation of existing cutaneous ureterostomy for urinary drainage after renal transplantation. J Urol 1985; 133: 1026– 8 36 Purohit RS, Bretan PN. Successful long-term outcome using existing native cutaneous ureterostomy for renal transplant drainage. J Urol 2000; 163: 446– 9 37 Prieto M, Sierra M, De Francisco ALM et al. Long-term outcome in renal transplantation with terminal cutaneous ureterostomy. Br J Urol 1993; 72: 844– 7 38 Mansson W, Willen R. Mucosal morphology and histochemistry of continent cecal reservoir for urine. J Urol 1988; 139: 1199– 201 39 Colombo T, Ziguener R, Zitta S, Petritsch PH, Hubmer G. Orthotopic neobladder in a woman after kidney transplantation. J Urol 1997; 158: 2236– 7 Citing Literature Volume92, Issue5September 2003Pages 510-515 ReferencesRelatedInformation

OBJECTIVE:To determine the incidence of urological complications of renal transplantation at one institution, and relate this to donor and recipient factors.PATIENTS AND METHODS:A consecutive series of 1535 renal transplants were audited, and a database of donor and recipient characteristics created for risk-factor analysis. An unstented Leadbetter-Politano anastomosis was the preferred method of ureteric reimplantation.RESULTS:There were 45 urinary leaks, 54 primary ureteric obstructions, nine cases of ureteric calculi, three bladder stones and 19 cases of bladder outlet obstruction at some time after transplantation. The overall incidence of urological complications was 9.2%, with that for urinary leak or primary ureteric obstruction being 6.5%. One graft was lost because of complications, and there were three deaths associated directly or indirectly with urological complications. There was no association with recipient age, cadaveric vs living-donor transplants, or cold ischaemic times before organ reimplantation, although the donor age was slightly higher in cases of urinary leak. There was no association with kidneys imported via the UK national organ-sharing scheme vs the use of local kidneys. The management of these complications is discussed.CONCLUSION:The incidence of urological complications in this series has remained essentially unchanged for 20 years. The causes of these complications and techniques for their prevention are discussed.

Objectives To assess the accuracy of a hospital coding database at a busy tertiary referral urological unit.Methods Prospectively collected departmental coding data for all urological patients attending the Churchill Hospital, Oxford between 1 May 1999 and 30 April 2000 were compared with the coding data entered by hospital coding clerks on the Oxford Radcliffe NHS Trust database.Results There were significant discrepancies between the number of patients on the hospital and the departmental database (639 vs 1109). There were gross procedural coding errors in 74 cases.Conclusion Hospital-coded data in this study were incomplete and inaccurate. This has important implications when considering the validity of hospital-trust databases when used as a source for medical research, clinical audit and as a representation of a consultants' clinical workload.

Objective To evaluate the natural history of a group of patients who underwent contact laser prostatectomy or transurethral resection of the prostate (TURP). Patients and methods Patients were followed up at 5 years after enrolling in a prospective double‐blind randomized controlled trial of TURP vs contact laser prostatectomy. Results Of the initial trial patients, 11.5% had died (seven in the laser and 10 in the TURP arm) and eight (5.4%) were too incapacitated by coexistent medical disease to respond to the questionnaires. Thirty‐eight patients were not available for follow‐up, despite numerous invitations. Thirteen of the laser patients (18%) and 11 of the TURP patients (14.5%) had undergone re‐operation. Two patients from each arm had received α‐blockers for worsening symptoms. Conclusions Five years after prostatic surgery, a significant number of patients were dead or disabled by coexistent medical disease. The re‐operation rate after TURP and contact laser prostatectomy were similar.

Vascular endothelial growth factor (VEGF) is an important factor mediating tumour angiogenesis. VEGF mRNA is differentially expressed in bladder cancer with high expression in superficial tumours (stage pT a and pT 1 ) contrasting with low expression in muscle invasive tumours (stage ≥ pT 2 ). To investigate mechanisms regulating VEGF expression in bladder cancer, VEGF mRNA and protein were measured in normal bladder ( n = 12) and primary bladder cancers ( n = 57). VEGF protein levels correlated with mRNA expression in normal bladder ( r = 0.68, P = 0.02) and bladder cancer ( r = 0.46, P = 0.0007). Whilst VEGF mRNA expression was threefold higher in superficial compared to muscle invasive bladder cancers ( P = 0.0001) there was no difference in VEGF protein ( P = 0.81). Accordingly, the median protein:mRNA ratios increased more than 15-fold with increasing tumour stage ( P < 0.0001) suggesting translational regulation. Expression of the eukaryotic initiation factor-4E (eIF-4E), a factor implicated in the translational regulation of VEGF, was greater in tumours than normal bladder ( P < 0.0001) and correlated with VEGF protein:mRNA ratios ( n = 43, r = 0.54, P = 0.0004) pointing to its role in the regulation of VEGF. In superficial tumours ( n = 37) high expression of eIF-4E was associated with a poor prognosis and reduced stage progression-free survival ( P = 0.04, Cox proportional hazards model). The study demonstrates that eIF-4E may be involved in translational regulation of VEGF in bladder cancer and might have a role as a prognostic factor in bladder cancer. © 2000 Cancer Research Campaign

No AccessJournal of UrologyCLINICAL UROLOGY: Case Reports1 Dec 1999DIAPHRAGMATIC HERNIA ASSOCIATED WITH ADULT POLYCYSTIC KIDNEY DISEASE D.M. Little, E. Streeter, F.V. Gleeson, O. Dyar, J.M. Preston, and D.W. Cranston D.M. LittleD.M. Little More articles by this author , E. StreeterE. Streeter More articles by this author , F.V. GleesonF.V. Gleeson More articles by this author , O. DyarO. Dyar More articles by this author , J.M. PrestonJ.M. Preston More articles by this author , and D.W. CranstonD.W. Cranston More articles by this author View All Author Informationhttps://doi.org/10.1016/S0022-5347(05)68106-2AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail "DIAPHRAGMATIC HERNIA ASSOCIATED WITH ADULT POLYCYSTIC KIDNEY DISEASE." The Journal of Urology, 162(6), pp. 2082–2083 References 1 : Rupture of the right hemi-diaphragm following blunt trauma: the use of ultrasound in diagnosis. Clin. Rad.1990; 42: 97. Crossref, Medline, Google Scholar 2 : Polycystic kidneys and peritoneopericardial diaphragmatic hernia in the cat: a case report. J. Small Animal Pract.1976; 17: 479. Crossref, Medline, Google Scholar From the Department of Transplantation and Urology, Oxford Transplant Centre, Churchill Hospital, Oxford, United Kingdom© 1999 by American Urological Association, Inc.FiguresReferencesRelatedDetailsCited by Zarrouk M, Mahjoub S, Belhadj S, Belgasmi R and Haltiti R (2010) Diagnostic exceptionnel d’une masse thoracique gauche : le rein intrathoraciqueRevue de Pneumologie Clinique, 10.1016/j.pneumo.2009.10.006, VOL. 66, NO. 3, (214-216), Online publication date: 1-Jun-2010. Volume 162Issue 6December 1999Page: 2082-2083 Advertisement Copyright & Permissions© 1999 by American Urological Association, Inc.Keywordskidney, polycysticherniaMetricsAuthor Information D.M. Little More articles by this author E. Streeter More articles by this author F.V. Gleeson More articles by this author O. Dyar More articles by this author J.M. Preston More articles by this author D.W. Cranston More articles by this author Expand All Advertisement PDF downloadLoading ...

The nature of the procedures and patients in urological day surgery may lead to high admission rates. A retrospective audit was performed over 8 years (1988 to 1996) to determine admission rates in a urological day surgical unit and examine reasons for and methods of decreasing admissions. The overall admission rate was 9.3%. Higher rates were associated with cystoscopic procedures, with 46% of admissions after bladder tumour cystosurveillance and a further 18% after urethroscopic surgery for urethral strictures. There was a surgical indication for admission in 72% of cases, with an anaesthetic indication in 17%. The study demonstrates that admission rates accompanying urological day surgery are higher than the 3% proposed by The Royal College of Surgeons of England. Achieving a rate of 3% may require restrictive patient selection that will deprive some patients the benefits associated with urological day surgical care.

OBJECTIVE To examine the effects of contact laser vaporization prostatectomy and transurethral resection of the prostate (TURP) on sexual function and to examine their association with treatment satisfaction. METHODS Data on sexual function were collected pre-operatively and 3 months after contact laser vaporization prostatectomy or TURP. The sexual outcome was examined in relation to satisfaction with treatment and quality of life. RESULTS A wide variation in sexual function was seen at baseline with overall 45% of the patients being impotent during the previous year and 49% claiming to not always have erections when stimulated 1 month prior to surgery. At 3 months postoperatively, 4% of the laser and 3% of the TURP patients who were previously potent were now impotent. There were no statistically significant associations between preoperative or postoperative (3 months) sexual function and either age, preoperative catheterization, or prostate volume. CONCLUSION The impotence rate 1 month prior to surgery is higher than in previous reports, and the impotence rate after contact laser prostatectomy in this sample size is similar to that seen following TURP.