| 1. |
- Andersson, Lennart, et al.
(författare)
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Chairmen's summary
- 2008
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Ingår i: Scandinavian Journal of Urology and Nephrology, Supplementum. - : Informa UK Limited. - 0300-8886 .- 1651-2537 .- 0036-5599 .- 1651-2065. ; :218, s. 7-11
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Tidskriftsartikel (refereegranskat)
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| 2. |
- Montironi, Rodolfo, et al.
(författare)
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Bladder cancer : pathogenesis.
- 2008
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Ingår i: Scandinavian Journal of Urology and Nephrology, Supplementum. - : Informa UK Limited. - 0300-8886 .- 1651-2537 .- 0036-5599 .- 1651-2065. ; :218, s. 93-4
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Tidskriftsartikel (refereegranskat)
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| 3. |
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| 4. |
- Andersson, Karl-Erik
(författare)
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Overactive bladder--pharmacological aspects.
- 2002
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Ingår i: Scandinavian Journal of Urology and Nephrology, Supplementum. - : Informa UK Limited. - 0300-8886 .- 0036-5599 .- 1651-2065. ; Suppl 210:Supp 210, s. 72-81
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Tidskriftsartikel (refereegranskat)abstract
- The micturition reflex can be initiated by contraction or distension of detrusor smooth muscle cells, or by signals from the urothelium. It has been shown that bladder distension causes release of ATP from the urothelium and that ATP can activate P2X(3) receptors on suburothelial afferent nerve terminals to evoke a neural discharge. However, most probably the activation of afferent fibres during bladder filling involves not only ATP, but a cascade of inhibitory and stimulatory transmitters/mediators. These mechanisms may be targets for future drugs. Both in the normal and functionally disturbed bladder, muscarinic receptor stimulation produces the main part of detrusor contraction, but evidence is accumulating that in disease states, such as neurogenic bladders, outflow obstruction, idiopathic detrusor instability, interstitial cystitis, and also in the ageing bladder, a non-cholinergic activation via purinergic receptors may occur. If this component of activation is responsible not only for part of the bladder contractions, but also for the symptoms of the overactive bladder, it should be considered an important target for therapeutic interventions. Drugs blocking different P2X receptor subtypes, or counteracting bladder contraction via other mechanisms. e.g. beta(3)-adrenoceptor stimulation, may be developed for treatment of the overactive bladder.
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| 5. |
- Bostwick, DG, et al.
(författare)
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Epidemiology and statistical methods in prediction of patient outcome.
- 2005
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Ingår i: Scand J Urol Nephrol Suppl. - : Informa UK Limited. ; 39:216, s. 94-110
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Tidskriftsartikel (refereegranskat)abstract
- Substantial gaps exist in the data of the assessment of risk and prognosis that limit our understanding of the complex mechanisms that contribute to the greatest cancer epidemic, prostate cancer, of our time. This report was prepared by an international multidisciplinary committee of the World Health Organization to address contemporary issues of epidemiology and statistical methods in prostate cancer, including a summary of current risk assessment methods and prognostic factors. Emphasis was placed on the relative merits of each of the statistical methods available. We concluded that: An international committee should be created to guide the assessment and validation of molecular biomarkers. The goal is to achieve more precise identification of those who would benefit from treatment. Prostate cancer is a predictable disease despite its biologic heterogeneity. However, the accuracy of predicting it must be improved. We expect that more precise statistical methods will supplant the current staging system. The simplicity and intuitive ease of using the current staging system must be balanced against the serious compromise in accuracy for the individual patient. The most useful new statistical approaches will integrate molecular biomarkers with existing prognostic factors to predict conditional life expectancy (i.e. the expected remaining years of a patient's life) and take into account all-cause mortality.
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| 6. |
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| 7. |
- Dillner, J, et al.
(författare)
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Etiology of squamous cell carcinoma of the penis
- 2000
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Ingår i: Scandinavian journal of urology and nephrology. Supplementum. - : Informa UK Limited. - 0300-8886 .- 0036-5599 .- 1651-2065. ; 34:205, s. 189-193
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Tidskriftsartikel (refereegranskat)
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| 8. |
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| 9. |
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| 10. |
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| 11. |
- Hall, P
(författare)
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Radiation-associated urinary bladder cancer
- 2008
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Ingår i: Scandinavian journal of urology and nephrology. Supplementum. - : Informa UK Limited. - 0300-8886 .- 0036-5599 .- 1651-2065. ; 42:218, s. 85-88
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Tidskriftsartikel (refereegranskat)
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| 12. |
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| 13. |
- Nilsson, S, et al.
(författare)
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Chemotherapy-induced bladder cancer
- 2008
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Ingår i: Scandinavian journal of urology and nephrology. Supplementum. - : Informa UK Limited. - 0300-8886 .- 0036-5599 .- 1651-2065. ; 42:218, s. 89-92
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Tidskriftsartikel (refereegranskat)
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| 14. |
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| 15. |
- Sillén, Ulla, 1946
(författare)
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Bladder function in infants.
- 2004
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Ingår i: Scandinavian journal of urology and nephrology. Supplementum. - : Informa UK Limited. - 0300-8886 .- 0036-5599 .- 1651-2065. ; :215, s. 69-74
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Tidskriftsartikel (refereegranskat)abstract
- The purpose with the present review was to describe what could be considered as normal urodynamic findings in neonates and infants. During the first months of life, urodynamics were characterised by small bladder capacity and high voiding pressure levels, the latter especially marked in male infants. Also dyscoordination at voiding was a common finding. However, detrusor overactivity (unstable contractions) during filling was uncommon in infants. Towards the end of infancy, findings became more in accordance with what is seen in older children. Concluding these findings concerning urodynamic pattern in early infancy high voiding pressure levels must be looked upon as normal and the same is true for intermittent increase in activity in the pelvic floor during voiding. However, instability during filling is rarely seen.
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| 16. |
- Sillén, Ulla, 1946, et al.
(författare)
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Bladder function in preterm and full-term infants--free voidings during four-hour voiding observation.
- 2004
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Ingår i: Scandinavian journal of urology and nephrology. Supplementum. - : Informa UK Limited. - 0300-8886 .- 0036-5599 .- 1651-2065. ; :215, s. 63-8
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Tidskriftsartikel (refereegranskat)abstract
- The purpose with the present review was to characterise bladder function in healthy preterm and full-term infants from findings in studies using the four-hour voiding observation. Characteristics of the free voiding pattern were very similar in preterm and full-term infants. The frequency of voidings was once an hour, bladder volume inducing voiding varied, infants often woke up before voiding and the bladder was not completely emptied at every voiding. Furthermore, interrupted voidings interpreted as a detrusor-sphincter dyscoordination, were seen and were clearly an immature phenomenon since the frequency was high in the preterm infants and then decreased. Concluding these findings the voiding pattern seems to be immature early in life and there is distinct evidence for a connection to the CNS already in the preterm infant.
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| 17. |
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| 18. |
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| 19. |
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| 20. |
- Abd-el-Gawad, G, et al.
(författare)
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Evaluation of Kock urinary reservoir function in children and adolescents at 3-10 years' follow-up.
- 1999
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Ingår i: Scandinavian journal of urology and nephrology. - : Informa UK Limited. - 0036-5599 .- 1651-2065. ; 33:3, s. 149-55
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this study was to evaluate Kock reservoir function in children and adolescents operated for congenital urinary incontinence and to determine the complication rate. Reservoir function was investigated in 13 children (age range 10.8-16 years) and 7 adolescents (age range 16-18 years) through enterocystometry, enterocystoscopy and patient history. Patients were followed up for 3-10 years. The follow-up was reported as early (3 months-2 years) and late (2-10 years) postoperative periods. At early follow-up reservoir capacity was high in four patients and normal in the remaining patients. A low reservoir pressure was accompanied by high capacity and compliance. On enterocystometry first sensation for emptying was experienced in 82% of patients at early follow-up and 92% at late follow-up. Reservoir contractions were recorded in 60% of patients at early follow-up and 65% at late follow-up. The contractions were recorded at an average reservoir capacity of 270 ml at early follow-up and 340 ml at late follow-up. The complication rate was high in the child group compared with that in adolescents. Of 13 patients with at least one reservoir complication 10 were from the child group. Nipple dysfunction (angled nipple, prolapsed or stenosed stoma) occurred in 35% of patients, stones in 40% and bleeding during catheterization in 15%. Revision was performed in 38% of the child group and 15% of the adolescents. Reservoir perforation was observed in two patients at 6 and 9 years postoperatively. At late follow-up continence was excellent in 17 of 19 patients and good in 2. We conclude that the Kock reservoir is a good modality for urinary diversion, but the complication incidence is high in the child group (<16 years). Stability of the reservoir in terms of volume and low internal pressures was achieved one year after operation, except in the patients with infrequent reservoir emptying. A time-related increase in the reservoir sensitivity and contractility was reported on enterocystometry. Nipple dysfunction is common during the first two years after surgery, particularly in the child group. Stones may form 3-4 years after surgery. Satisfactory continence was achieved in all patients, although a revisional operation was necessary in some patients in order to obtain permanent continence.
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| 21. |
- Abrahamsson, Kate, 1959, et al.
(författare)
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Reference interval for serum creatinine in children and adolescents with myelomeningocele.
- 2009
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Ingår i: Scandinavian journal of urology and nephrology. - : Informa UK Limited. - 0036-5599 .- 1651-2065. ; 43:3, s. 233-5
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: In children and adolescents with myelomeningocele (MMC), the relation between muscle mass and body composition varies considerably, making it difficult to evaluate the relevance of renal function assessments done with serum (s)-creatinine. Therefore, a reference interval for enzymic s-creatinine in individuals with MMC was constructed. MATERIAL AND METHODS: Patients with MMC aged 1.5-18 years who consistently had chromium-51-labelled edetic acid clearance within normal limits (88-132 ml/min/1.73 m(2)) were selected for the study. Included were 52 girls and 71 boys with a total of 471 s-creatinine determinations. Children with normal body composition were used as controls. RESULTS: The mean s-creatinine concentration at the age of 1.5 years was 22 micromol/l in girls and 21 micromol/l in boys and increased to 38 micromol/l in girls and 58 micromol/l in boys at the age of 18 years. There was no difference between the genders until the age of 12. From the age of 3 years, there was a significantly lower median s-creatinine concentration in the MMC children compared with a healthy age-matched population. The median concentration of the MMC children was equivalent to the 2.5 percentile of the control group. CONCLUSION: From the age of 3 years, the reference interval for children and adolescents with MMC showed a lower median concentration for enzymic s-creatinine and a greater interindividual variation compared with the healthy age-matched population.
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| 22. |
- Adolfsson, Jan, et al.
(författare)
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Clinical characteristics and primary treatment of prostate cancer in Sweden between 1996 and 2005 : Data from the national prostate cancer register in Sweden
- 2007
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Ingår i: Scandinavian Journal of Urology and Nephrology. - Stockholm : Taylor & Francis. - 0036-5599 .- 1651-2065. ; 41:6, s. 456-477
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Tidskriftsartikel (refereegranskat)abstract
- Objective. The incidence of prostate cancer is rising rapidly in Sweden and there is a need to better understand the pattern of diagnosis, tumor characteristics and treatment. Material and methods. Between 1996 and 2005, all new cases of adenocarcinoma of the prostate gland were intended to be registered in the National Prostate Cancer Register (NPCR). This register contains information on diagnosing unit, date of diagnosis, cause of diagnosis, tumor grade, tumor stage according to the TNM classification in force, serum prostate-specific antigen (PSA) levels at diagnosis and primary treatment given within the first 6 months after diagnosis. Results. In total, 72 028 patients were registered, comprising >97% of all pertinent incident cases of prostate cancer in the Swedish Cancer Register (SCR). During the study period there was a considerable decrease in median age at the time of diagnosis, a stage migration towards smaller tumors, a decrease in median serum PSA values at diagnosis, a decrease in the age-standardized incidence rate of men diagnosed with distant metastases or with a PSA level of >100 ng/ml at diagnosis and an increase in the proportion of tumors with Gleason score ≤6. Relatively large geographical differences in the median age at diagnosis and the age-standardized incidence of cases with category T1c tumors were observed. Treatment with curative intent increased dramatically and treatment patterns varied according to geographical region. In men with localized tumors and a PSA level of <20 ng/ml at diagnosis, expectant treatment was more commonly used in those aged ≥75 years than in those aged <75 years. Also, the pattern of endocrine treatment varied in different parts of Sweden. Conclusions. All changes in the register seen over time are consistent with increased diagnostic activity, especially PSA testing, resulting in an increased number of cases with early disease, predominantly tumors in category T1c. The patterns of diagnosis and treatment of prostate cancer vary considerably in different parts of Sweden. The NPCR continues to be an important source for research, epidemiological surveillance of the incidence, diagnosis and treatment of prostate cancer
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| 23. |
- Adolfsson, Jan, et al.
(författare)
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Clinical characteristics and primary treatment of prostate cancer in Sweden between 1996 and 2005
- 2007
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Ingår i: Scandinavian Journal of Urology and Nephrology. - : Informa UK Limited. - 0036-5599 .- 1651-2065. ; 41:6, s. 456-477
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: The incidence of prostate cancer is rising rapidly in Sweden and there is a need to better understand the pattern of diagnosis, tumor characteristics and treatment. MATERIAL AND METHODS: Between 1996 and 2005, all new cases of adenocarcinoma of the prostate gland were intended to be registered in the National Prostate Cancer Register (NPCR). This register contains information on diagnosing unit, date of diagnosis, cause of diagnosis, tumor grade, tumor stage according to the TNM classification in force, serum prostate-specific antigen (PSA) levels at diagnosis and primary treatment given within the first 6 months after diagnosis. RESULTS: In total, 72,028 patients were registered, comprising >97% of all pertinent incident cases of prostate cancer in the Swedish Cancer Register (SCR). During the study period there was a considerable decrease in median age at the time of diagnosis, a stage migration towards smaller tumors, a decrease in median serum PSA values at diagnosis, a decrease in the age-standardized incidence rate of men diagnosed with distant metastases or with a PSA level of > 100 ng/ml at diagnosis and an increase in the proportion of tumors with Gleason score <6. Relatively large geographical differences in the median age at diagnosis and the age-standardized incidence of cases with category T1c tumors were observed. Treatment with curative intent increased dramatically and treatment patterns varied according to geographical region. In men with localized tumors and a PSA level of <20 ng/ml at diagnosis, expectant treatment was more commonly used in those aged > or =75 years than in those aged <75 years. Also, the pattern of endocrine treatment varied in different parts of Sweden. CONCLUSIONS: All changes in the register seen over time are consistent with increased diagnostic activity, especially PSA testing, resulting in an increased number of cases with early disease, predominantly tumors in category T1c. The patterns of diagnosis and treatment of prostate cancer vary considerably in different parts of Sweden. The NPCR continues to be an important source for research, epidemiological surveillance of the incidence, diagnosis and treatment of prostate cancer.
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| 24. |
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| 25. |
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| 26. |
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| 27. |
- Alhadad, Alaa, et al.
(författare)
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Incidence of nephrogenic systemic fibrosis at a large university hospital in Sweden.
- 2012
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Ingår i: Scandinavian Journal of Urology and Nephrology. - : Informa UK Limited. - 1651-2065 .- 0036-5599. ; 46, s. 48-53
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Tidskriftsartikel (refereegranskat)abstract
- Objective. Nephrogenic systemic fibrosis (NSF) is a rare condition that may follow administration of gadolinium-based contrast media (Gd-CM) in patients with renal insufficiency. This study was initiated to determine the incidence of NSF at Skåne University Hospital, Malmö, in Sweden. Material and methods. During the period January 2001 to December 2008 10 650 patients underwent magnetic resonance imaging (MRI) examinations. The re-expressed four-variable Modification of Diet in Renal Disease (MDRD) equation was used to calculate the estimated glomerular filtration rate (eGFR). The 272 patients with an eGFR <30 ml/min/1.73 m2 who were given Gd-CM were selected for final analysis. A diagnosis of NSF or other dermatological diagnoses in the 272 patients was searched for in the database of the Departments of Dermatology and Pathology. Results. The 272 patients, of whom 26 patients were on dialysis, had undergone 406 MRI examinations with Gd-CM. Mean follow-up time was 3.9 (±2.7 SD) years. Assuming a mean body weight of 70 kg, the overall median dose of the 406 examinations with Gd-CM was 0.14 mmol/kg body weight (0.06, 0.34; 2.5-97.5 percentiles). In this retrospective study of patients with eGFR <30 ml/min/1.73 m(2), none developed NSF (the upper 95% confidence limit for zero cases of NSF in the 272 patients was 2.3%). Conclusion. Although it is premature to claim that Gd-CM using the regimen employed in this institution is safe to use in all patients with eGFR <30 ml/min/1.73 m(2), the results.indicate that development of NSF is extremely uncommon.
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| 28. |
- Almroth, Gabriel, et al.
(författare)
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Long-term treatment results and the immunoglobulin G subclass distribution patterns of proteinase-3-antineutrophil cytoplasm antibody (ANCA) and myeloperoxidase-ANCA in ANCA-associated vasculitis
- 2009
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Ingår i: Scandinavian Journal of Urology and Nephrology. - : Informa UK Limited. - 0036-5599 .- 1651-2065. ; 43:2, s. 160-170
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Tidskriftsartikel (refereegranskat)abstract
- Objective: Small vessel vasculitis associated with antibodies to neutrophil cytoplasm antigens has been denominated antineutrophil cytoplasm antibody (ANCA)-associated vasculitis (AAV).Material and methods: Ninety-eight patients with various forms of AAV with renal involvement were studied retrospectively with regard to treatment, side-effects and outcome. The immunoglobulin G (IgG) subclass distribution patterns in serum were determined in 51 patients with nephelometry and those of anti-proteinase-3 (PR3) and anti-myeloperoxidase (MPO) in 44 patients by enzyme-linked immunosorbent assay.Results: Fifty-nine patients with a mean age of 63 years were given treatment with intermittent intravenous regimens of cyclophosphamide and continuous corticosteroids, whereas 39 patients with a mean age of 58 years were given continuous oral treatment. Malignancy, mainly due to skin tumours, was more common in AAV than in the general population. The total IgG subclass distribution pattern was asymmetric. The response to PR3 was of IgG1, IgG3 and IgG4 isotypes, while IgG1 and IgG3 predominated in the response to MPO.Conclusion: The aberrant IgG subclass distribution pattern detected in the autoantibodies may be of importance in the pathogenesis of AAV.
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| 29. |
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| 30. |
- Andersson, Gunnel, 1958-, et al.
(författare)
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Urinary incontinence prevalence, impact on daily living and desire for treatmentt : a population-based study
- 2004
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Ingår i: Scandinavian journal of urology and nephrology. - : Taylor & Francis. - 0036-5599 .- 1651-2065. ; 38:2, s. 125-130
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE:To investigate the prevalence of urinary incontinence in a representative population in Sweden, and to assess to what extent the condition affects daily life and to what degree those afflicted desire treatment.MATERIAL AND METHODS:In a population-based study, a postal questionnaire comprising 12 questions on urinary incontinence was sent to a representative sample of 15 360 randomly selected residents (aged 18-79 years) of Orebro County, Sweden. This was a supplement to a comprehensive survey of public health and general living conditions.RESULTS:The response rate was 64.5%. The prevalence of urinary incontinence was 19% when defined as "any leakage" and 7% when defined as "at least once a week". Women were more afflicted than men, and the proportion of people with urinary incontinence increased markedly with increasing age. Most considered their problems to be minor, having little impact on daily life, which was reflected by the fact that only 18% of those with urinary incontinence desired treatment. About 17% of those with urinary incontinence reported severe problems that interfered with daily life. Of respondents with severe problems, 42% did not want treatment.CONCLUSION:According to this population-based study, urinary incontinence is not a major problem for most people in the community. Although a considerable proportion of the population report urinary incontinence, the majority experience minor problems and only 18% desire treatment. For a limited group of people, urinary incontinence is a severe problem. It is important that healthcare resources are optimized to identify and meet the needs of those who are most afflicted.
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| 31. |
- Andersson, Gunnel, 1958-, et al.
(författare)
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Urinary incontinence - why refraining from treatment? : a population based study
- 2005
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Ingår i: Scandinavian Journal of Urology and Nephrology. - London : Taylor & Francis. - 0036-5599 .- 1651-2065. ; 39:4, s. 301-307
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To investigate why persons with urinary incontinence (UI) refrain from seeking care and treatment.MATERIAL AND METHODS: A population-based study was undertaken in which a public health survey and a specific UI questionnaire were sent to 15 360 randomly selected residents (age 18-79 years) of Orebro County, Sweden. For all persons reporting UI, the expressed wish for treatment or no treatment was analyzed in relation to relevant variables from both inquiry forms using binary logistic regression analysis.RESULTS: The response rate was 64.5%. UI was reported by 2194 persons, 1724 of whom comprised the study population. A statistically significant association was found between the degree of UI and a desire for treatment. Persons who did not experience daily leakage and those who did not perceive the leakage as troublesome or having an affect on their daily life mostly stated that they did not desire treatment. Socioeconomic or other health-related factors were not associated with desiring or not desiring treatment for UI.CONCLUSIONS: Our results show that it is the perceived severity of UI that determines whether afflicted persons desire treatment or not. Other factors, relating to seeking healthcare in general, were not found to be of importance. Interventions to identify those in need of treatment for UI should primarily be directed towards those with severe symptoms.
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| 32. |
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| 33. |
- Andersson, Karl-Erik
(författare)
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Detrusor contraction - Focus on muscarinic receptors
- 2004
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Ingår i: Scandinavian Journal of Urology and Nephrology. - : Informa UK Limited. - 0036-5599 .- 1651-2065. ; 38:Suppl 215, s. 54-57
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Forskningsöversikt (refereegranskat)abstract
- Stimulation of muscarinic receptors is a main mechanism for contractile activation of the detrusor from both animals and humans. Muscarinic receptors are coupled to G-proteins, but the signal transduction systems may vary. In general, M-1 , M-3 and M-5 receptors are considered to couple preferentially to G(q/11) , activating phosphoinositide hydrolysis, in turn leading to mobilization of intracellular calcium through inositol trisphosphate generation. M-2 and M-4 receptors couple to pertussis toxin-sensitive G(i/o) , resulting in inhibition of adenylyl cyclase activity. However, in the detrusor smooth muscle, other signalling pathways may be involved. Recent investigations revealed that a main pathway for muscarinic receptor activation of the detrusor may be calcium influx via L-type calcium channels, and increased sensitivity to calcium of the contractile machinery via inhibition of myosin light chain phosphatase through activation of Rho-kinase. The importance of these findings for treatment of voiding dysfunction remains to be established.
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| 34. |
- Andersson, Swen-Olof, et al.
(författare)
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Managing localized prostate cancer by radical prostatectomy or watchful waiting: Cost analysis of a randomized trial (SPCG-4)
- 2011
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Ingår i: SCANDINAVIAN JOURNAL OF UROLOGY AND NEPHROLOGY. - : Informa Healthcare. - 0036-5599 .- 1651-2065. ; 45:3, s. 177-183
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Tidskriftsartikel (refereegranskat)abstract
- Objective. The cost of radical prostatectomy (RP) compared to watchful waiting (WW) has never been estimated in a randomized trial. The goal of this study was to estimate long-term total costs per patient associated with RP and WW arising from inpatient and outpatient hospital care. Material and methods. This investigation used the Scandinavian Prostate Cancer Group Study Number 4 (SPCG-4) trial, comparing RP to WW, and included data from 212 participants living in two counties in Sweden from 1989 to 1999 (105 randomized to WW and 107 to RP). All costs were included from randomization date until death or end of follow-up in July 2007. Resource use arising from inpatient and outpatient hospital costs was measured in physical units and multiplied by a unit cost to come up with a total cost per patient. Results. During a median follow-up of 12 years, the overall cost in the RP group was 34% higher (p andlt; 0.01) than in the WW group, corresponding to euroa,not sign6123 in Sweden. The difference was driven almost exclusively by the cost of the surgical procedure. The cost difference between RP and WW was two times higher among men with low (2--6) than among those with high (7--10) Gleason score. Conclusion. In this economic evaluation of RP versus WW of localized prostate cancer in a randomized study, RP was associated with 34% higher costs. This difference, attributed exclusively to the cost of the RP procedure, was not overcome during extended follow-up.
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| 35. |
- Andersson, Staffan, et al.
(författare)
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Viscoelastic properties of the normal human bladder
- 1989
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Ingår i: Scandinavian Journal of Urology and Nephrology. - : Informa UK Limited. - 0036-5599 .- 1651-2065. ; 23:2, s. 115-120
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Tidskriftsartikel (refereegranskat)abstract
- Continuous and stepwise cystometry were performed through suprapubic catheters in 12 healthy young subjects in order to assess passive viscoelastic variables of the normal human bladder during the collection phase. Elastic contants increased non-linearly with bladder distension. Relative elastic modulus and relaxation time of the bladder wall increased or tended to increase with bladder distension and infusion rate. There was considerable interindividual variation in all variables suggesting that discrimination between normal and abnormal bladder wall viscoelasticity may be difficult in routine clinical practice.
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| 36. |
- Andius, Patrik, 1963, et al.
(författare)
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Prognostic factors in patients with carcinoma in situ treated with intravesical bacille Calmette-Guérin.
- 2004
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Ingår i: Scand J Urol Nephrol. - : Informa UK Limited. ; 38:4, s. 285-290
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Tidskriftsartikel (refereegranskat)abstract
- Abstract Objective: To report prognostic factors and follow-up data for an unselected group of patients with carcinoma in situ (CIS) of the urinary bladder treated with bacille Calmette-Guérin (BCG). Material and Methods: The clinical records of patients with CIS treated with BCG were reviewed. All 173 patients treated between 1986 and 1997 in four hospitals in two Swedish cities were included. The median follow-up period was 72 months (range 6-154 months). The impact of 18 variables on the times to recurrence and progression was studied using multivariate Cox proportional hazard regression and Kaplan-Meier analyses. Results: No pre-treatment variables, including type of CIS and T1G3 tumour, had prognostic value in terms of time to progression. The result of the first cystoscopy had a very strong prognostic importance: 44% of patients with a positive first cystoscopy progressed in stage, 59% were BCG failures and 35% died from urothelial cancer. The corresponding values for patients with a negative first cystoscopy were 11%, 18% and 8%. Fourteen patients (8%) were diagnosed with an upper urinary tract tumour but no variable had prognostic significance. The diagnoses of the upper urinary tract tumours were evenly distributed during follow-up. Conclusions: We were not able to predict which patients would respond favourably to BCG. Cystectomy should be strongly considered even after a positive first cystoscopy. The accumulated incidence of patients with bladder CIS and a subsequent upper urinary tract tumour is rather high but it is questionable whether the prognosis will improve if routine follow-up urographies are performed.
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| 37. |
- Annuk, Margus, et al.
(författare)
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Urinary calculi and jejunoileal bypass operation : A long-term follow-up
- 1998
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Ingår i: Scandinavian Journal of Urology and Nephrology. - 0036-5599 .- 1651-2065. ; 32:3, s. 177-180
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Tidskriftsartikel (refereegranskat)abstract
- Medical records of 56 patients who had undergone jejunoileal bypass (JIB) surgery because of morbid obesity were reviewed. The follow-up time varied from 3 to 25 years (average 16 years). Twenty-two of the 56 patients (39.3%) were found to have renal calculi. The interval between the operation and the occurrence or knowledge of the first stone formation ranged from some months to 19 years. The mean weight loss at 5 years was 36.5 kg. Renal function investigations showed no evidence that the jejunoileal bypass operation alters the renal function. The urinary excretion of oxalate was high: 1.112 mumol/24 h (normal range: 55-400 mumol/24 h), and citrate excretion was low: 1.48 mmol/24 h (normal range: 2-5 mmol/24 h). There was no difference in these respects between stone formers and non-stone formers.
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| 38. |
- Arner, Anders, et al.
(författare)
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Intracellular calcium in hypertrophic smooth muscle from rat urinary bladder
- 2007
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Ingår i: Scandinavian Journal of Urology and Nephrology. - : Informa UK Limited. - 0036-5599 .- 1651-2065. ; 41:4, s. 270-277
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Tidskriftsartikel (refereegranskat)abstract
- Objective. To explore whether infravesical outlet obstruction is associated with alterations in calcium activation of detrusor smooth muscle. Material and methods. Outlet obstruction was created by partial ligature of the urethra in female rats. Western blotting was performed using an antibody against the cytoplasmatic region of the alpha(1c) subunit of the L- type Ca2(+) channel. Intracellular calcium was measured using Fura-2 in detrusors that had been obstructed for 10 days and activated by high K+ concentrations at different extracellular Ca2(+) concentrations. The rate of force development after rapid opening of L- type Ca2(+) channels was measured in contractions initiated by flash photolysis of nifedipine in Ca2(+) containing depolarizing solution. Results. Bladder weight increased from 6293 to 254943 mg after 10 days of obstruction. Expression of the alpha(1c) subunit increased after 3 days and continued to increase until it was about fourfold greater after 10 days; however, it had not increased further at 6 weeks. This change was reversible after removal of obstruction. Activation with K+ produced a stable force at different extracellular Ca2(+) concentrations, with no difference in response between controls and rats that had been obstructed for 10 days. Intracellular Ca2(+) concentrations were lower in the obstructed group, showing that the calcium sensitivity of the contraction force had increased. The delay between the opening of L- type channels and the onset of contraction was longer in obstructed detrusors. Conclusions. Growth of detrusor muscle following obstruction is accompanied by attenuated calcium transients following activation, despite upregulation of L- type Ca2(+) channels. The Ca2(+) sensitivity of contraction was increased in obstructed detrusors. We suggest that the decreased surface: volume ratio in hypertrophic smooth muscle cells is partly involved in the lowered Ca2(+) transients. The increases in L- type calcium channels and in calcium sensitivity may be compensatory mechanisms.
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| 39. |
- Aus, G, et al.
(författare)
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Free-to-total prostate-specific antigen ratio as a predictor of non-organ-confined prostate cancer (stage pT3)
- 2003
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Ingår i: Scandinavian Journal of Urology and Nephrology. - : Informa UK Limited. - 0036-5599 .- 1651-2065. ; 37:6, s. 466-470
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To evaluate whether the free-to-total prostate-specific antigen (F/T-PSA) ratio can be used to differentiate between stage pT2 and pT3 prostate cancer. Material and Methods: A total of 176 consecutive patients from the Goteborg Screening Study (median T-PSA 4.2 ng/ml) who underwent radical prostatectomy (without neoadjuvant hormonal therapy) were included in the study. The pT stage was correlated with classical risk factors such as T-PSA and Gleason sum and the impact of the F/T-PSA ratio was evaluated. Results: A total of 42/176 patients (23.9%) had stage pT3 prostate cancer. Patients with an F/T-PSA ratio in the lowest quartile (<10.7%) had extracapsular tumor growth in 46.5% of cases, compared to 16.7% for those with an F/T-PSA ratio >10.7% ( p = 0.0002). Patients with high-risk features (T-PSA >10 ng/ml or Gleason sum greater than or equal to7) had a high risk (54-60%) for stage pT3 prostate cancer. In low-risk patients, the subgroup with an F/T-PSA ratio <10.7% had a risk of 37.0%, compared to only 13.3% for those with a ratio of >10.7% (p = 0.0092). Conclusions: In patients with low-risk early-stage prostate cancer, the F/T-PSA ratio provides statistically significant, independent and clinically relevant preoperative information about the risk of extracapsular tumor growth.
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| 40. |
- Aus, Gunnar, 1958, et al.
(författare)
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Prostate biopsy and anaesthesia: an overview.
- 2005
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Ingår i: Scand J urol Nephrol. - : Informa UK Limited. ; 39:2, s. 124-129
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Forskningsöversikt (refereegranskat)abstract
- Objective. To evaluate the efficacy of different methods for decreasing pain and discomfort in men undergoing transrectal ultrasound-guided prostate biopsies and to propose a clinical standard useful for pain relief. Material and methods. A MEDLINE search using the search terms "anaesthesia" and "prostate biopsy" was performed in November 2004. The search yielded 198 papers, 45 of which were found to relate to the subject and were in the English language. Results. Intravenously administered sedoanalgesia seems to be effective but is cumbersome to handle in everyday practice. In one study, i.v. tramadol has been shown to be effective, and the same goes for diclofenac 100 mg given as a suppository 1 h prior to the biopsy. Inhaled nitrous oxide (Entonox®) works well but is not widely available. A rectally administered gel containing local anaesthetic seems to have very limited efficacy. Periprostatic injection of a local anaesthetic was used in most studies, nearly all of which showed that it was effective in comparison with placebo or rectal gel. A minimum of 10 cm3 seems to be necessary for optimal effect. Conclusion. At the present time, perirectal injection of a local anaesthetic is the preferred method of pain relief in conjunction with transrectal prostate biopsies.
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| 41. |
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| 42. |
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| 43. |
- Berggren de Verdier, P. J., et al.
(författare)
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Prognostic significance of homozygous deletions and multiple duplications at the CDKN2A (p16INK4a)/ARF (p14ARF) locus in urinary bladder cancer
- 2006
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Ingår i: Scand J Urol Nephrol. - : Informa UK Limited. - 0036-5599 .- 1651-2065. ; 40:5, s. 363-9
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: The 9p21 locus is a major target in the pathogenesis of human urinary bladder cancer. This locus harbours the CDKN2A/ARF tumour suppressor gene, which encodes two cell-cycle regulatory proteins: p16INK4a and p14ARF. We studied how homozygous deletions and multiple duplications at this locus affect prognosis and survival in patients with bladder cancer. MATERIAL AND METHODS: Real-time quantitative polymerase chain reaction (QPCR), based on simultaneous amplification of ARF and a reference gene, glyceraldehyde-3-phosphate dehydrogenase, was used to measure homozygous deletions and multiple duplications in a population-based material consisting of 478 patients with urinary bladder cancer. Results from real-time QPCR were compared with clinico-pathological parameters and survival curves were generated using the Kaplan-Meier method. RESULTS: Real-time QPCR analysis showed 71 (15%) homozygous deletions and 8 (2%) multiple duplications. We were unable to find any association between either stage or grade and urinary neoplasms with homozygous deletions. However, although there were only a limited number of patients with multiple duplications, 7/8 of them had highly malignant tumours (G2b-G4 or > or = T1; p = 0.02). CONCLUSIONS: Urinary bladder cancers constitute a spectrum of neoplasms with varying clinical manifestations. We were unable to establish a prognostic relevance for patients with tumours harbouring homozygous deletions at the CDKN2A/ARF locus. However, our data did indicate that patients with multiple duplications at the CDKN2A/ARF locus had poor survival. This suggests that multiple duplications, in combination with other genetic changes, have cooperative effects which have a negative outcome on urinary bladder cancer prognosis.
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| 44. |
- Berglund, Anna-Lena, 1942-, et al.
(författare)
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Some Sexological Characteristics of Stress Incontinent Women
- 1996
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Ingår i: Scandinavian Journal of Urology and Nephrology. - : Informa Healthcare. - 0036-5599 .- 1651-2065. ; 30:3, s. 207-212
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Tidskriftsartikel (refereegranskat)abstract
- Forty-four women with stress urinary incontinence (SUI) were interviewed in order to investigate sexual activities, sexual function and satisfaction one month before and one year after either one of two possible surgical interventions. The findings were related to sexual response cycle, size of urinary leakage, duration of incontinence and depression. There was no significant difference in sexual activity before and after surgery. One or two sexual dysfunctions within the desire, excitement, orgasmic and resolution phases were reported by the majority both before and after intervention independently of surgical method. Neither the magnitude of the leakage nor the duration of SUI influenced the sexual experiences significantly while continence after surgery promoted sexual desire. The discrepances between the prevalence of sexual dysfunctions and the relatively high level of sexual satisfaction as well as the non-influencing parameters indicate the complexity of human sexuality.
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| 45. |
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| 46. |
- Berrum-Svennung, Ingela, 1963, et al.
(författare)
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Costs of radical cystectomy.
- 2005
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Ingår i: Scand J Urol Nephrol. - : Informa UK Limited. ; 39:1, s. 36-41
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Tidskriftsartikel (refereegranskat)abstract
- Objective . The total costs of radical cystectomy comprise a significant part of the total costs of bladder cancer treatment. The aims of this study were to determine the costs of cystectomy, with and without complications, and to investigate related prognostic factors. Material and methods . The clinical records and relevant economic files of 70 consecutive patients operated on between 1994 and 1998 were studied. Uni- and multivariate analyses were performed on 22 variables of possible prognostic significance to high total costs. Results . The total (median) costs for 53 uncomplicated and 17 complicated cystectomies were 181 096 and 290 625 SEK, respectively. The preoperative variables (patient characteristics) had no or minimal prognostic significance for high total costs. High peri-operative blood loss was the most important factor associated with high total hospital costs for radical cystectomy. Conclusions . Total costs may be very high for a cystectomy with complications. Peri-operative blood loss was the most important factor associated with high total hospital costs for radical cystectomy due to bladder cancer. If the amount of bleeding can be influenced then substantial reductions in the total costs of cystectomy would seem possible.
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| 47. |
- Berrum-Svennung, Ingela, 1963, et al.
(författare)
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Routine postoperative urography after cystectomy and urinary diversion is not necessary.
- 2005
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Ingår i: Scand J Urol Nephrol. - : Informa UK Limited. ; 39:3, s. 211-213
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Tidskriftsartikel (refereegranskat)abstract
- Objective It is routine procedure to obtain a urogram or retrograde stentogram 1-2 weeks after urinary diversion. The purpose of this is to diagnose silent urinary leakage and obstruction of the anastomosis. We registered the frequency of significant findings at routine postoperative urography in patients with bladder cancer treated with radical cystectomy and urinary diversion. Material and methods We identified a total of 200 consecutive patients who were treated with radical cystectomy and urinary diversion between 1994 and 2002. Eight patients were never evaluated radiologically and another 14 were examined earlier than planned due to symptoms or signs from the urinary tract and abdomen. The remaining 178 patients underwent a routine radiological examination. The methods of deviation in these patients were Bricker conduit (n=119), continent abdominal reservoir (n=24) and orthotopic bladder reconstruction (n=35). A total of 170 patients underwent urography, seven underwent bilateral retrograde pyelographies and one was examined by means of antegrade pyelography. Results Not a single significant finding was identified with urography in 170 patients. Minimal leakage was identified at retrograde pyelography in one patient with a Bricker conduit, which resulted in treatment for 2 weeks with a pyelostomy catheter. Conclusion Routine postoperative urography is not necessary in patients who have a normal postoperative course after cystectomy and urinary diversion.
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| 48. |
- Bill-Axelson, Anna, et al.
(författare)
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Experiences of randomization : Interviews with patients and clinicians in the SPCG-IV trial
- 2008
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Ingår i: Scandinavian Journal of Urology and Nephrology. - : Informa UK Limited. - 0036-5599 .- 1651-2065. ; 42:4, s. 358-363
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Tidskriftsartikel (refereegranskat)abstract
- Objective. Recruitment of both patients and clinicians to randomized trials is difficult. Low participation carries the risk of terminating studies early and making them invalid owing to insufficient statistical power. This study investigated patients' and clinicians' experiences of randomization with the aim of facilitating trial participation in the future. Material and methods. This was a qualitative study using content analysis. Patients offered to participate in a randomized trial and randomizing clinicians were interviewed. Five participants, four non-participants and five randomizing clinicians were interviewed, 2-8 years from randomization. Results. Clinicians used strategies in interaction with the patients to facilitate decision making. Patients' attitudes differed and experiences of relatives or friends were often stated as reasons for treatment preferences. Patients described that letting chance decide treatment was a difficult barrier to overcome for randomization. The clinicians used a number of different strategies perceived to make randomization more acceptable to their patients. The clinicians' own motivation for randomizing patients for trials depended on the medical relevance of the study question and the clinicians' major obstacle was to maintain equipoise over time. Regular meetings with the study group helped to maintain equipoise and motivation. Conclusions. To establish a good platform for randomization the clinician needs to know about the patient's treatment preferences and the patient's attitude concerning the role of the clinician to facilitate decision making. The strategies used by the clinicians were perceived as helpful and could be tested in an intervention study.
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| 49. |
- Björk, Jonas, et al.
(författare)
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Validation of the Lund-Malmö, Chronic Kidney Disease Epidemiology (CKD-EPI) and Modification of Diet in Renal Disease (MDRD) equations to estimate glomerular filtration rate in a large Swedish clinical population.
- 2012
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Ingår i: Scandinavian Journal of Urology and Nephrology. - : Informa UK Limited. - 1651-2065 .- 0036-5599. ; 46:3, s. 212-222
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Tidskriftsartikel (refereegranskat)abstract
- Abstract Objective. The aim of this study was to validate externally the Swedish Lund-Malmö revised creatinine-based glomerular filtration rate (GFR) equations (LM Revised) in a Swedish cohort in comparison with the North American Modification of Diet in Renal Disease (MDRD) and Chronic Kidney Disease Epidemiology (CKD-EPI) equations. Material and methods. The study included 1397 examinations [median age 61 years, median body mass index (BMI) 26 kg/m(2)] in 996 patients referred for iohexol clearance (median 44 ml/min/1.73 m(2)). Bias, precision [interquartile range (IQR)], accuracy expressed as percentage of estimates ± 10% (P (10)) and ± 30% (P (30)) of measured GFR, and classification ability for five GFR stages (<15, 15-29, 30-59, 60-89 and ≥90 ml/min/1.73 m(2)) were compared. Results. Overall, all three equations performed satisfactorily: LM Revised, MDRD, CKD-EPI showed, respectively, a median bias of -5.8%, -2.2% and 1.7%, IQR 11.9, 12.3 and 11.7 ml/min/1.73 m(2), P (10) 35%, 34% and 38%, P (30) 84%, 79% and 79% and correctly classified GFR stages 68%, 65% and 69%. LM Revised was at least as accurate in terms of P (30) as the other equations at GFR intervals <90, while CKD-EPI was the only unbiased and the most accurate equation at ≥90 ml/min/1.73 m(2). LM Revised was more stable in terms of bias and accuracy across age and BMI groups than MDRD and CKD-EPI. Both MDRD and CKD-EPI overestimated measured GFR among elderly patients and in the small group of underweight men. Conclusion. The ideal all-purpose GFR prediction equation does not exist. LM Revised should be preferred in patients with suspected or known renal insufficiency, while CKD-EPI is most useful in settings where patients with no a priori suspicion of renal impairment are evaluated. Differences in creatinine measurements between laboratories may limit the generalizability of the present validation.
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| 50. |
- Björkström, Gun, et al.
(författare)
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Electro-acupuncture in the treatment of children with monosymptomatic nocturnal enuresis.
- 2000
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Ingår i: Scandinavian journal of urology and nephrology. - 0036-5599 .- 1651-2065. ; 34:1, s. 21-6
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: The aim of this study was to investigate the effects of a long series of electro-acupuncture (EAP) sessions on bedwetting symptoms. MATERIAL AND METHODS: Twenty-five children (age range 7-16 years) with monosymptomatic nocturnal enuresis and treated earlier without success were included in the study. The median number of wet nights per week was 4.7 before treatment. Bedwetting, voided volume, sleep and nocturia were evaluated 3 weeks, 3 months and 6 months after 20 sessions of EAP lasting 8 weeks. RESULTS: All the children, with the exception of one, tolerated EAP treatment well. At the three follow-up sessions it was found that the number of dry nights had increased gradually from a median of 2.3 in the pre-test to 3.0, 4.3 and 5.0 per week, respectively. Compared to pre-treatment findings there were more dry nights in 65% of the children (p < 0.001) and 5 out of 23 children were responders (> 90% reduction of the numbers of wet nights) at the 6 months' follow-up. According to the parents, the sleep arousal threshold had decreased in about 50% of the children.
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