liu.seSearch for publications in DiVA
Change search
Refine search result
1 - 33 of 33
CiteExportLink to result list
Permanent link
Cite
Citation style
  • apa
  • harvard1
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • oxford
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf
Rows per page
  • 5
  • 10
  • 20
  • 50
  • 100
  • 250
Sort
  • Standard (Relevance)
  • Author A-Ö
  • Author Ö-A
  • Title A-Ö
  • Title Ö-A
  • Publication type A-Ö
  • Publication type Ö-A
  • Issued (Oldest first)
  • Issued (Newest first)
  • Created (Oldest first)
  • Created (Newest first)
  • Last updated (Oldest first)
  • Last updated (Newest first)
  • Disputation date (earliest first)
  • Disputation date (latest first)
  • Standard (Relevance)
  • Author A-Ö
  • Author Ö-A
  • Title A-Ö
  • Title Ö-A
  • Publication type A-Ö
  • Publication type Ö-A
  • Issued (Oldest first)
  • Issued (Newest first)
  • Created (Oldest first)
  • Created (Newest first)
  • Last updated (Oldest first)
  • Last updated (Newest first)
  • Disputation date (earliest first)
  • Disputation date (latest first)
Select
The maximal number of hits you can export is 250. When you want to export more records please use the Create feeds function.
  • 1.
    Aizawa, Naoki
    et al.
    University of Tokyo, Japan.
    Gandaglia, Giorgio
    IRCCS, Italy; Lund University, Sweden.
    Hedlund, Petter
    Linköping University, Department of Medical and Health Sciences, Division of Drug Research. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center for Diagnostics, Department of Clinical Pharmacology.
    Fujimura, Tetsuya
    University of Tokyo, Japan.
    Fukuhara, Hiroshi
    University of Tokyo, Japan.
    Montorsi, Francesco
    IRCCS, Italy.
    Homma, Yukio
    University of Tokyo, Japan.
    Igawa, Yasuhiko
    University of Tokyo, Japan.
    URB937, a peripherally restricted inhibitor for fatty acid amide hydrolase, reduces prostaglandin E-2-induced bladder overactivity and hyperactivity of bladder mechano-afferent nerve fibres in rats2016In: BJU International, ISSN 1464-4096, E-ISSN 1464-410X, Vol. 117, no 5, p. 821-828Article in journal (Refereed)
    Abstract [en]

    Objective To determine if inhibition of the endocannabinoid-degrading enzyme fatty acid amide hydrolase (FAAH) can counteract the changes in urodynamic variables and bladder afferent activities induced by intravesical prostaglandin E-2 (PGE(2)) instillation in rats. Materials and methods In female Sprague-Dawley rats we studied the effects of URB937, a peripherally restricted FAAH inhibitor, on single-unit afferent activity (SAA) during PGE(2)-induced bladder overactivity (BO). SAA measurements were made in urethane-anaesthetised rats and Ad-and C-fibres were identified by electrical stimulation of the pelvic nerve and by bladder distention. Cystometry (CMG) in conscious animals and during SAA measurements was performed during intravesical instillation of PGE(2) (50 or 100 mu M) after intravenous administration of URB937 (0.1 and 1 mg/kg) or vehicle. In separate experiments, the comparative expressions of FAAH and cannabinoid receptors, CB1 and CB2, in microsurgically removed L6 dorsal root ganglion (DRG) were studied by immunofluorescence. Results During CMG, 1 mg/kg URB937, but not vehicle or 0.1 mg/kg URB937, counteracted the PGE(2)-induced changes in urodynamic variables. PGE(2) increased the SAAs of C-fibres, but not Ad-fibres. URB937 (1 mg/kg) depressed Ad-fibre SAA and abolished the facilitated C-fibre SAA induced by PGE(2). The DRG nerve cells showed strong staining for FAAH, CB1 and CB2, with a mean (SEM) of 77 (2)% and 87 (3)% of FAAH-positive nerve cell bodies co-expressing CB1 or CB2 immunofluorescence, respectively. Conclusion The present results show that URB937, a peripherally restricted FAAH inhibitor, reduces BO and C-fibre hyperactivity in the rat bladder provoked by PGE(2), suggesting an important role of the peripheral endocannabinoid system in BO and hypersensitivity.

  • 2.
    Aljabery, Firas
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Division of Surgery, Orthopedics and Oncology. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center for Surgery, Orthopaedics and Cancer Treatment, Department of Urology in Östergötland.
    Shabo, Ivan
    Linköping University, Department of Clinical and Experimental Medicine, Division of Clinical Sciences. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center for Surgery, Orthopaedics and Cancer Treatment, Department of Surgery in Linköping. Endocrine and Sarcoma Surgery Unit, Department of Molecular Medicine and Surgery, Karolinska Institute, Stockholm, Sweden; Department of Breast and Endocrine Surgery, Karolinska University Hospital, Solna Stockholm, Sweden .
    Olsson, Hans
    Linköping University, Department of Clinical and Experimental Medicine, Division of Neuro and Inflammation Science. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center for Diagnostics, Clinical pathology.
    Gimm, Oliver
    Linköping University, Department of Clinical and Experimental Medicine, Division of Surgery, Orthopedics and Oncology. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center for Surgery, Orthopaedics and Cancer Treatment, Department of Surgery in Linköping.
    Jahnson, Staffan
    Region Östergötland, Center for Surgery, Orthopaedics and Cancer Treatment, Department of Urology in Östergötland. Linköping University, Faculty of Medicine and Health Sciences. Linköping University, Department of Clinical and Experimental Medicine, Division of Surgery, Orthopedics and Oncology.
    Radio-guided sentinel lymph node detection and lymph node mapping in invasive urinary bladder cancer: a prospective clinical study.2017In: BJU International, ISSN 1464-4096, E-ISSN 1464-410X, Vol. 120, no 3, p. 329-336Article in journal (Refereed)
    Abstract [en]

    OBJECTIVES: To investigate the possibility of detecting sentinel lymph nodes (SNs) in patients with urinary bladder cancer (BCa) intra-operatively and whether the histopathological status of the identified SNs reflected that of the lymphatic field.

    PATIENTS AND METHODS: We studied 103 patients with BCa pathological stage T1-T4 who were treated with cystectomy and pelvic lymph node (LN) dissection during 2005-2011 at the Department of Urology, Linköping University Hospital. Radioactive tracer Nanocoll 70 MBq and blue dye were injected into the bladder wall around the primary tumour before surgery. SNs were detected ex vivo during the operation with a handheld Geiger probe (Gamma Detection System; Neoprobe Corp., Dublin, OH, USA). All LNs were formalin-fixed, sectioned three times, mounted on slides and stained with haematoxylin and eosin. An experienced uropathologist evaluated the slides.

    RESULTS: The mean age of the patients was 69 years, and 80 (77%) were male. Pathological staging was T1-12 (12%), T2-20 (19%), T3-48 (47%) and T4-23 (22%). A mean (range) number of 31 (7-68) nodes per patient were examined, totalling 3 253 nodes. LN metastases were found in 41 patients (40%). SNs were detected in 83 of the 103 patients (80%). Sensitivity and specificity for detecting metastatic disease by SN biopsy (SNB) varied between LN stations, with average values of 67% and 90%, respectively. LN metastatic density (LNMD) had a significant prognostic impact; a value of ≥8% was significantly related to shorter survival. Lymphovascular invasion (LVI) occurred in 65% of patients (n = 67) and was significantly associated with shorter cancer-specific survival (P < 0.001).

    CONCLUSION: We conclude that SNB is not a reliable technique for peri-operative localization of LN metastases during cystectomy for BCa; however, LNMD has a significant prognostic value in BCa and may be useful in the clinical context and in BCa oncological and surgical research. LVI was also found to be a prognostic factor.

  • 3.
    Benigni, F
    et al.
    BioXell SpA.
    Baroni, E
    BioXell SpA.
    Zecevic, M
    BioXell SpA.
    Zvara, P
    BioXell SpA.
    Streng, T
    Lund University.
    Hedlund, Petter
    Lund University.
    Colli, E
    BioXell SpA.
    DAmbrosio, D
    BioXell SpA.
    Andersson, KE
    Lund University.
    Oral treatment with a vitamin D3 analogue (BXL628) has anti-inflammatory effects in rodent model of interstitial cystitis2006In: BJU International, ISSN 1464-4096, E-ISSN 1464-410X, Vol. 97, no 3, p. 617-624Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: To investigate the effects of a vitamin D3 analogue (BXL628) in a model of chronic cystitis, as calcitriol analogues might be an interesting new therapeutic option for interstitial cystitis, for although the cause of the disease remains unclear, the increase in mast cells in the mucosa and detrusor muscle are significant.

    MATERIALS AND METHODS: We devised a mouse model of allergen-induced allergic cystitis that is associated with the up-regulation of genes for interleukin-13, FcepsilonRIalpha and mast cells-derived proteases, a massive inflammatory reaction in the bladder tissue, and augmented levels of mast cell-derived protease 1 (MMCP1) detected in mouse sera.

    RESULTS: Oral administration of BXL628 significantly reduced the expression of interleukin-13, FcepsilonRIalpha and MMCP1 in the bladder. Furthermore, histological analysis showed a decrease in oedema and leukocyte infiltration in the bladder wall. BXL628 treatment reduced serum MMCP1 levels, indicating an effect on mast cell degranulation in vivo.

    CONCLUSIONS: Vitamin D3 analogues may successfully be used as anti-inflammatory agents in allergen-mediated inflammatory reactions. Moreover, the modulatory effect shown on mast cell activation by the BXL628 analogue strongly supports its potential therapeutic use in a possibly mast cell-dependent disease such as human interstitial cystitis.

  • 4.
    Bivalacqua, Trinity J.
    et al.
    Brady Urological Institute, and Division of Cardiology, Department of Medicine Johns Hopkins Hospital.
    Kendirci, Muammer
    Department of Urology, Tulane University School of Medicine, New Orleans.
    Champion, Hunter C
    Brady Urological Institute, and Division of Cardiology, Department of Medicine Johns Hopkins Hospital.
    Hellstrom, Wayne J G
    Department of Urology, Tulane University School of Medicine, New Orleans.
    Andersson, Karl-Erik
    Department of Clinical Pharmacology, Lund University Hospital, Lund.
    Hedlund, Petter
    Lund University Hospital.
    Dysregulation of cGMP-dependent protein kinase 1 (PKG-1) impairs erectile function in diabetic rats: influence of in vivo gene therapy of PKG1alpha.2007In: BJU International, ISSN 1464-4096, E-ISSN 1464-410X, Vol. 99, no 6, p. 1488-1494Article in journal (Refereed)
    Abstract [en]

    OBJECTIVES: To investigate the expression of cGMP-dependent protein kinase 1 (PKG1)alpha and PKG1beta in the corpus cavernosum, and to evaluate the effect of adenoviral gene transfer of PKG1alpha to the erectile compartment on erectile function in a rat model of diabetes.

    MATERIALS AND METHODS: Diabetic (DM; induced by streptozotocin) male Sprague Dawley rats were transfected with adenoviruses (AdCMVbetagal or AdCMVPKG1alpha, in 10 rats each) 2 months after the induction of DM. Intracavernosal pressure (ICP) during stimulation of the cavernosal nerve (CN) was assessed, and compared with mean arterial pressure (MAP). Erectile tissue was harvested for Western blot analysis, immunohistochemistry and total PKG activity. Ten age-matched rats without DM served as the control.

    RESULTS: Compared to controls, AdCMVbetagal-transfected DM rats had significantly lower peak ICP responses, ICP/MAP ratios, and filling rates during CN stimulation. In DM rats transfected with AdCMVPKG1alpha, peak ICP, ICP/MAP ratios and filling rates were significantly better than in DM rats transfected with the reporter gene. As assessed by Western blot and immunohistochemistry, expression of PKG1alpha and PKG1beta was lower in corporal tissue from DM AdCMVbetagal-transfected rats than in controls. PKG1alpha expression was improved after AdCMVPKG1alpha gene therapy. Total PKG activity was lower in DM rat corporal tissue than in controls, and PKG1alpha gene transfer significantly improved DM corporal PKG activity to a value greater than in the control.

    CONCLUSION: PKG1alpha and PKG1beta activities are reduced in the erectile tissue of the diabetic rat, and gene transfer of PKG1alpha to the penis restored PKG activity and erectile function in vivo in diabetic rats. Gene therapy procedures targeting PKG1alpha might be an interesting future therapeutic approach to overcome diabetic erectile dysfunction resistant to oral pharmacotherapy.

  • 5.
    Brehmer, M
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Neuroscience and Locomotion, Pathology. Östergötlands Läns Landsting, Centre for Laboratory Medicine, Department of Clinical Pathology and Clinical Genetics.
    Svensson, Irene
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Neuroscience and Locomotion, Pathology. Östergötlands Läns Landsting, Centre for Laboratory Medicine, Department of Clinical Pathology and Clinical Genetics.
    Heat-induced apoptosis in human prostatic stromal cells2000In: BJU International, ISSN 1464-4096, E-ISSN 1464-410X, Vol. 85, no 4, p. 535-541Article in journal (Refereed)
    Abstract [en]

    Objective. To determine whether heat, used in transurethral microwave thermotherapy (TUMT) for benign prostatic hyperplasia and which causes necrotic lesions within the adenoma, induces apoptosis in benign human prostatic stromal cells. Materials and methods. Prostatic stromal cells were cultured from benign human prostatic tissue. The origin of the cells was identified by immunohistochemical staining and transmission electron microscopy. Cell cultures were exposed to moderate hyperthermia (47░C) for 1 h and any apoptosis detected by light microscopy, transmission electron microscopy and the measurement of induced caspase-3-like activity. Results. The cultures contained a mixed population of smooth muscle cells and myofibroblasts. Twenty-four hours after heat exposure, 76% of the cells were apoptotic and the caspase activity had increased, whereas only 14% of the cells were necrotic. Conclusion. Moderate hyperthermia induces apoptosis in cultured human prostatic stromal cells.

  • 6.
    Castiglione, Fabio
    et al.
    Univ Leuven, Belgium; Univ Coll London Hosp, England; IRCCS Osped San Raffaele, Italy.
    Hedlund, Petter
    Linköping University, Department of Medical and Health Sciences, Division of Drug Research. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center for Diagnostics, Department of Clinical Pharmacology. Lund Univ, Sweden.
    Weyne, Emmanuel
    Univ Leuven, Belgium.
    Hakim, Lukman
    Univ Leuven, Belgium; Airlangga Univ, Indonesia.
    Montorsi, Francesco
    IRCCS Osped San Raffaele, Italy.
    Salonia, Andrea
    IRCCS Osped San Raffaele, Italy.
    Bivalacqua, Trinity J.
    Johns Hopkins Med Inst, MD 21205 USA.
    De Ridder, Dirk
    Univ Leuven, Belgium.
    Milenkovic, Uros
    Univ Leuven, Belgium.
    Ralph, David
    Univ Coll London Hosp, England.
    Garaffa, Giulio
    Univ Coll London Hosp, England.
    Muneer, Asif
    Univ Coll London Hosp, England.
    Joniau, Steven
    Univ Leuven, Belgium.
    Albersen, Maarten
    Univ Leuven, Belgium.
    Intratunical injection of stromal vascular fraction prevents fibrosis in a rat model of Peyronies disease2019In: BJU International, ISSN 1464-4096, E-ISSN 1464-410X, Vol. 124, no 2, p. 342-348Article in journal (Refereed)
    Abstract [en]

    Objective To investigate whether local injection of autologous adipose stromal vascular fraction (SVF) can prevent the development of fibrosis and elastosis in the tunica albuginea (TA) using a rat model of the acute phase of Peyronies disease (PD). Methods A total of 24 male 12-week-old Sprague-Dawley rats were divided into three equal groups: sham; PD without treatment (transforming growth factor-beta [TGF -beta]); and PD treated with SVF 1 day after disease induction. Sham rats received two injections of vehicle into the TA 1 day apart. TGF -beta rats received TGF- beta 1 injection and injection of vehicle 1 day later. SVF rats received TGF-beta 1 injection, followed by SVF 1 day later. One month after treatment, all rats underwent measurement of intracavernosal pressure and mean arterial pressure during electrostimulation of the cavernous nerve. The rats were then killed and penises were harvested for histology and Western blot analysis. Results Erectile function was moderately reduced in the TGF-beta group and was significantly improved after SVF treatment (P amp;lt; 0.05). PD rats developed areas of fibrosis with a significant upregulation of collagen III, collagen I and elastin protein expression. These fibrotic changes were prevented when treated with SVF. Conclusions Local injection of SVF may represent treatment for the acute phase of PD.

  • 7.
    Ebbinge, Maria
    et al.
    Karolinska Inst, Sweden; Karolinska Univ Hosp, Sweden.
    Berglund, Anders
    EpiStat, Sweden.
    Varenhorst, Eberhard
    Linköping University, Department of Clinical and Experimental Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center for Surgery, Orthopaedics and Cancer Treatment, Department of Urology in Östergötland.
    Hedlund, Per Olov
    Karolinska Inst, Sweden.
    Sandblom, Gabriel
    Soder Sjukhuset, Sweden.
    Clinical and prognostic significance of changes in haemoglobin concentration during 1 year of androgen-deprivation therapy for hormone-naive bone-metastatic prostate cancer2018In: BJU International, ISSN 1464-4096, E-ISSN 1464-410X, Vol. 122, no 4, p. 583-591Article in journal (Refereed)
    Abstract [en]

    Objective To estimate the strength of change in haemoglobin (Hb) concentrations during 1 year of androgen-deprivation therapy (ADT) as a predictor of survival in hormone-naive patients with bone-metastatic (Stage M1b) prostate cancer. Patients and Methods The patients included in this study were taken from the randomised trial (number 5) carried out by the Scandinavian Prostate Cancer Group (SPCG), comparing parenteral oestrogen with total androgen blockade (TAB) in hormone-naive M1b prostate cancer. We identified 597 men where Hb measurements were made at enrolment, as well as at 3, 6 and 12 months of ADT. The time-dependent impact of Hb concentration changes on overall survival (OS) was analysed using multivariate Cox proportional hazards analysis. The 10-year OS according to increase/decrease in Hb concentration for the three treatment periods was demonstrated using Kaplan-Meier curves. Results Multivariate analysis of changes in Hb concentration between baseline and 3 months showed better survival in patients with a decrease in Hb concentration (hazard ratio [HR] 1.42, 95% confidence interval [CI] 1.11-1.80) compared to those with an increase, whilst there was no difference in survival associated with a change in Hb concentration between 3 and 6 months (HR 0.93, 95% CI 0.76-1.12). Contrary to the first 3 months, poorer survival was seen in patients with a decrease in Hb concentration between 6 and 12 months (HR 0.76, 95% CI 0.62-0.92) compared to those with an increase. Conclusions In a large cohort of Scandinavian men with hormone-nave M1b prostate cancer, an increase in Hb concentration between baseline and 3 months of ADT was associated with significantly poorer survival, whereas an increase between 6 and 12 months was associated with better survival. These findings provide new information about patterns of change in Hb concentrations during 12 months of ADT for M1b prostate cancer, and survival. Clinicians should be aware of the prognostic value of Hb concentration changes during ADT in M1b prostate cancer.

  • 8.
    Fagerström, Tim
    et al.
    Karolinska Institutet, Södersjukhuset, Stockholm, Sweden.
    Nyman, Claes R.
    Karolinska Institutet, Södersjukhuset, Stockholm, Sweden.
    Hahn, Robert G.
    Clinical Research Centre, Södertälje Hospital, Sweden.
    Bipolar transurethral resection of the prostate causes less bleeding than the monopolar technique: a single-centre randomized trial of 202 patients2010In: BJU International, ISSN 1464-4096, E-ISSN 1464-410X, Vol. 105, no 11, p. 1560-1564Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: To compare bipolar with the conventional monopolar transurethral resection of the prostate (TURP) for blood loss and speed of resection.

    PATIENTS AND METHODS: In all, 202 consecutive patients from the hospital waiting list were randomized to undergo TURP using either a bipolar system (Surgmaster TURis, Olympus, Tokyo, Japan) or a monopolar system (24 F, Storz, Tübingen, Germany). The blood loss during and after surgery was measured using a photometer. Other variables compared included indices of resection speed and transfusion rate.

    RESULTS: There were no statistically significant differences in operative duration, resection weight, resection speed or radicality of resection. However, the median blood loss was 235 mL for the bipolar and 350 mL for monopolar TURP (P < 0.001). The decrease in blood haemoglobin concentration during the day of surgery was smaller in the bipolar group (5.5% vs 9.6%P < 0.001). Fewer patients were transfused with erythrocytes (4% vs 11%, P < 0.01), which can be explained by the much lower 75th percentile for blood loss in the bipolar group (at 472 vs 855 mL, respectively).

    CONCLUSIONS: Bipolar TURP using the TURis system was performed with the same speed as monopolar TURP but caused 34% less bleeding, the difference being greatest (81%) for the largest blood losses. Bipolar TURP also required fewer erythrocyte transfusions than the conventional monopolar technique.

  • 9.
    Gardmark, T.
    et al.
    Gårdmark, T., Department of Urology, Surgical Sciences, Uppsala, Sweden.
    Jahnson, Staffan
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Clinical and Experimental Medicine, Surgery . Östergötlands Läns Landsting, Centre of Surgery and Oncology, Department of Urology in Östergötland.
    Wahlquist, R.
    Department of Urology, Surgical Sciences, Oslo, Norway.
    Wijkstrom, H.
    Wijkström, H., Department of Urology, Surgical Sciences, Stockholm, Sweden.
    Malmstrom, P.-U.
    Malmström, P.-U., Department of Urology, Surgical Sciences, Uppsala, Sweden.
    Analysis of progression and survival after 10 years of a randomized prospective study comparing mitomycin-C and bacillus Calmette-Guérin in patients with high-risk bladder cancer2007In: BJU International, ISSN 1464-4096, E-ISSN 1464-410X, Vol. 99, no 4, p. 817-820Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: To report the 10-year follow-up of a study randomizing between instillations of bacillus Calmette-Guérin (BCG) and mitomycin-C (MMC) for treating high-risk and not muscle-invasive urinary bladder cancer to assess progression, the need for more aggressive treatment and survival (cancer-specific and overall), as many of the published studies comparing different treatments for disease that is not muscle-invasive have a short follow-up. PATIENTS AND METHODS: Between 1987 and 1992, 261 patients were included, they had frequently recurring Ta/T1G1-G2, T1G3 or primary Tis-dysplasia. The patients were randomized to treatment with either 40 mg of MMC or 120 mg of BCG (Danish strain 1331) given weekly for 6 weeks, then monthly up to a year and finally every third month for a further year. The 250 evaluable patients were followed using hospital files and national registers on causes of death. RESULTS: The median follow-up for survivors was 123 months. The disease progressed in 58 (23%) of the patients, 34 in the MMC group and 24 in the BCG group (P = 0.26). Of the 140 patients who died, 68 were in the BCG and 72 in the MMC group (log-rank P = 0.98), most (95, 68%) died from other causes. CONCLUSION: Based on the follow-up of the present patients it cannot be concluded that the drugs originally administered, MMC or BCG, differed in their effect on progression, need for subsequent treatment or survival. © 2007 The Authors.

  • 10.
    Gladh, Gunilla
    et al.
    Linköping University, Department of Molecular and Clinical Medicine, Pediatrics. Linköping University, Faculty of Health Sciences.
    Mattsson, Sven
    Linköping University, Department of Molecular and Clinical Medicine, Pediatrics. Linköping University, Faculty of Health Sciences.
    Lindström, Sivert
    Linköping University, Department of Biomedicine and Surgery. Linköping University, Faculty of Health Sciences.
    Anogenital electrical stimulation as treatment of urge incontinence in children2001In: BJU International, ISSN 1464-4096, E-ISSN 1464-410X, Vol. 87, no 4, p. 366-371Article in journal (Refereed)
    Abstract [en]

    Objectives To evaluate retrospectively the result of anogenital afferent stimulation (AGAS) in neurological healthy children with therapy-resistant urge incontinence.

    Patients and method The study included 48 children (24 girls and 24 boys, 5–14 years old) with a diagnosis of bladder instability verified by cystometry in all. Anogenital afferent stimulations were applied using a battery-powered dual constant-current stimulator. The children were stimulated continuously at 10 Hz for 20 min once or twice daily and if required the children and/or the parents continued to apply the treatment at home. For home stimulation a single (anal) channel stimulator was used. The patients were instructed to stimulate for 20 min at maximum intensity two to three times a week until the effects were optimal. The outcome was evaluated retrospectively by comparing voiding/incontinence diaries obtained before and at the follow-up 6–12 months after the end of treatment.

    Results AGAS was applied at the clinic for a median (range) of 9 (4–20) times. Thirty-one children continued with home stimulation for another 25 (5–96) sessions. At the follow-up, 18 children were cured and another seven improved, with a leakage score of less than half that before treatment. The treatment was well tolerated by most children.

    Conclusions Anogenital afferent stimulation is an effective, potentially curative treatment in children with severe urge incontinence. Home stimulation is a well accepted adjuvant to treatment at the clinic and improves the outcome.

  • 11.
    Gudjonsson, Sigurdur
    et al.
    Skåne University Hospital, Sweden .
    Blackberg, Mats
    Helsingborg County Hospital, Sweden .
    Chebil, Gunilla
    Helsingborg County Hospital, Sweden .
    Jahnson, Staffan
    Linköping University, Department of Clinical and Experimental Medicine, Division of Clinical Sciences. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Center for Surgery, Orthopaedics and Cancer Treatment, Department of Urology in Östergötland.
    Olsson, Hans
    Lund University, Sweden .
    Bendahl, Par-Ola
    Linköping University, Department of Clinical and Experimental Medicine, Experimental Pathology. Linköping University, Faculty of Health Sciences.
    Mansson, Wiking
    Skåne University Hospital, Sweden .
    Liedberg, Fredrik
    Skåne University Hospital, Sweden Vaxjo County Hospital, Sweden .
    The value of bladder mapping and prostatic urethra biopsies for detection of carcinoma in situ (CIS)2012In: BJU International, ISSN 1464-4096, E-ISSN 1464-410X, Vol. 110, no 2B, p. E41-E45Article in journal (Refereed)
    Abstract [en]

    OBJECTIVES To assess the value of bladder mapping and prostatic urethra biopsies for detection of urothelial carcinoma in situ (CIS). CIS of the urinary bladder is a flat high-grade lesion of the mucosa associated with a significant risk of progression to muscle-invasive disease. CIS is difficult to identify on cystoscopy, and definite diagnosis requires histopathology. Traditionally, if CIS is suspected, multiple cold-cup biopsies are taken from the bladder mucosa, and resection biopsies are obtained from the prostatic urethra in males. This approach is often called bladder mapping (BMAP). The accuracy of BMAP as a diagnostic tool is not known. PATIENTS AND METHODS Male patients with bladder cancer scheduled for cystectomy underwent cold-cup bladder biopsies (sidewalls, posterior wall, dome, trigone), and resection biopsies were taken from the prostatic urethra. After cystectomy, the surgical specimen was investigated in a standardised manner and subsequently compared with the BMAP biopsies for the presence of CIS. RESULTS The histopathology reports of 162 patients were analysed. CIS was detected in 46% of the cystoprostatectomy specimens, and multiple (greater than= 2) CIS lesions were found in 30%. BMAP (cold-cup bladder biopsies + resection biopsies from the prostatic urethra) provided sensitivity of 51% for any CIS, and 55% for multiple CIS lesions. The cold-cup biopsies for CIS in the bladder mucosa showed sensitivity and specificity of 46% and 89%, respectively. CONCLUSION Traditional cold-cup biopsies are unreliable for detecting CIS in bladder mucosa and negative findings must be interpreted with caution.

  • 12.
    Hahn, Robert G.
    et al.
    South Hospital, Stockholm, Sweden.
    Fagerström, Tim
    South Hospital, Stockholm, Sweden.
    Tammela, Teuvo L. J.
    Tampere University Hospital, Finland.
    Van Vierssen Trip, Oncko
    Ziekenhuis Gelderse Vallei, Ede, the Netherlands.
    Beisland, Hans Olav
    Sorlandet Hospital, Arendal, Norway.
    Duggan, Annette
    GlaxoSmithKline, Greenford, UK.
    Morrill, Betsy
    GlaxoSmithKline, Research Triangle Park, North Carolina, USA.
    Blood loss and postoperative complications associated with transurethral resection of the prostate after pretreatment with dutasteride2007In: BJU International, ISSN 1464-4096, E-ISSN 1464-410X, Vol. 99, no 3, p. 587-594Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: To determine whether pretreatment with dutasteride, a dual 5alpha-reductase inhibitor (5ARI), reduces surgical blood loss or postoperative complications in patients with benign prostatic hyperplasia (BPH) who undergo transurethral resection of the prostate (TURP).

    PATIENTS AND METHODS: This double-blind, randomized, placebo-controlled, multicentre study comprised 214 patients with BPH. Placebo was compared with dutasteride 0.5 mg/day 2 weeks before and after TURP, or 4 weeks before and 2 weeks after TURP. Surgical blood loss was measured using a haemoglobin photometer (HemoCue AB, Angelholm, Sweden) and postoperative adverse events were recorded. Microvessel density (MVD) was calculated by immunostaining and light microscopy of the prostatic chips.

    RESULTS: Although dutasteride reduced serum dihydrotestosterone (DHT) by 86-89% in 2-4 weeks, and intraprostatic DHT was approximately 10 times lower than in the placebo group, the (adjusted) mean haemoglobin (Hb) loss during surgery was 2.15-2.55 g Hb/g resectate with no significant difference in blood loss between the groups either during or after TURP. Clot retention occurred in 6-11% and urinary incontinence in 14-15% of patients during the 14 weeks after TURP, with no difference between the groups. The MVD at TURP was also similar for all groups.

    CONCLUSION: There were no significant reductions in blood loss during or after TURP or complications afterward with dutasteride compared with placebo, despite significant suppression of intraprostatic DHT. Blood loss and transfusion rates in the placebo group were lower than those previously reported in studies where there was a beneficial effect of a 5ARI, relative to placebo, on bleeding during TURP.

  • 13.
    Hennenberg, Martin
    et al.
    Department of Urology, University of Munich, Munich, Germany.
    Strittmatter, Frank
    Department of Urology, University of Munich, Munich, Germany.
    Walther, Sebastian
    Department of Urology, University of Munich, Munich, Germany.
    Hedlund, Petter
    Urological Research Institute, University of San Raffaele, Milan, Italy.
    Andersson, Karl-Erik
    Wake Forest Institute for Regenerative Medicine, Wake Forst University School of Medicine, Winston-Salem, NC, USA.
    Stief, Christian G
    Department of Urology, University of Munich, Munich, Germany.
    Schlenker, Boris
    Department of Urology, University of Munich, Munich, Germany.
    Gratzke, Christian
    Department of Urology, University of Munich, Munich, Germany.
    α1-adrenoceptor activation induces phosphorylation of β2-adrenoceptors in human prostate tissue2011In: BJU International, ISSN 1464-4096, E-ISSN 1464-410X, Vol. 108, no 6, p. 922-928Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE:

    • To test whether β1-adrenoceptor activation leads to phosphorylation of the β2-adrenoceptor in human prostate tissue.

    PATIENTS AND METHODS:

    • Prostate tissue from patients undergoing radical prostatectomy was stimulated in vitro with the α1-adrenergic agonist phenylephrine (10 µM).

    • α2-adrenoceptor phosphorylation at serines 345/346 was studied using Western blot analysis with a phospho-specific antibody.

    • The role of second messenger kinases was assessed by studying the effects of the protein kinase C (PKC) inhibitor Ro 31-8425 and the protein kinase A (PKA) inhibitor H89 on phenylephrine-induced phosphorylation.

    • The expression of G protein-coupled receptor kinases (GRKs) 2/3 was analysed using quantitative reverse-transcriptase-polymerase chain reaction (RT-PCR), Western blot analysis and immunohistochemistry.

    RESULTS:

    • Stimulation of prostate tissue with phenylephrine resulted in phosphorylation of the β2-adrenoceptor (5, 10 and 20 min after stimulation).

    • This α1-adrenoceptor-induced phosphorylation of β2-adrenoceptors was resistant to inhibition of PKC and PKA.

    • Changes in phosphorylation levels were not attributable to changes in receptor levels, as these remained constant during stimulation.

    • RT-PCR and Western blot analysis showed expression of GRK2/3 in human prostate tissues.

    • Immunohistochemical staining showed that GRK2/3 expression in human prostate tissue is located to stromal and smooth muscle cells.

    CONCLUSIONS:

    • Activation of α1-adrenoceptors causes phosphorylation of β2-adrenoceptors in the human prostate. This may enhance α1-adrenergic contraction and is possibly mediated by GRK2, which is expressed in prostate smooth muscle.

    • Mutual regulation between different adrenergic receptors might be involved in the therapeutic effects of α1-blockers in patients with benign prostate hyperplasia.

  • 14. Henningsohn, L
    et al.
    Wijkström, H
    Pedersen, J
    Ahlstrand, Christer
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Biomedicine and Surgery, Urology. Östergötlands Läns Landsting, Centre of Surgery and Oncology, Department of Urology in Östergötland.
    Aus, G
    Bergmark, K
    Onelöv, E
    Steineck, G
    Time after surgery, symptoms and well-being in survivors of urinary bladder cancer2003In: BJU International, ISSN 1464-4096, E-ISSN 1464-410X, Vol. 91, no 4, p. 325-330Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: To evaluate how an increasing burden of symptoms influences well-being, anxiety and depression at different intervals after a radical cystectomy with urostomy for bladder cancer, as this therapy can induce long-term distressful symptoms. PATIENTS AND METHODS: Patients with bladder cancer undergoing radical cystectomy in Stockholm between 1969 and 1995 were matched with 434 controls from the normal population, all 404 patients operated on between 1985 and 1995 at three other hospitals in Sweden were invited to enter the study. The final analysis included 306 patients and 310 controls, all assessed for symptoms and well-being. RESULTS: A low or moderate level of well-being was reported by 35% of the patients having none or one of the symptoms studied, by 39% with two symptoms, by 45% with three symptoms and by 66% of those with four or more symptoms. The values, irrespective of symptom burden, were 45% after 2-5 years of follow-up, 58% after 6-10 years and 38% at > 10 years after surgery. The total symptom burden also influenced the risk of anxiety and depression. Symptom prevalence remained largely unaffected by the duration of follow-up, except for defecation urgency. CONCLUSIONS: The number of long-term symptoms after radical surgery with a urostomy for urinary bladder cancer affects the risk of anxiety, depression and low or moderate well-being.

  • 15.
    Jahnson, Staffan
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Division of Surgery, Orthopedics and Oncology. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center for Surgery, Orthopaedics and Cancer Treatment, Department of Urology in Östergötland.
    Rosell, Johan
    Linköping University, Department of Clinical and Experimental Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center for Business support and Development, Regional Cancer Center.
    Aljabery, Firas
    Linköping University, Department of Clinical and Experimental Medicine. Linköping University, Faculty of Science & Engineering. Region Östergötland, Center for Surgery, Orthopaedics and Cancer Treatment, Department of Urology in Östergötland.
    Modulation of the inflammatory response after sclerotherapy for hydrocoele/spermatocoele2019In: BJU International, ISSN 1464-4096, E-ISSN 1464-410X, Vol. 123, no 5A, p. E63-E68Article in journal (Refereed)
    Abstract [en]

    Objective

    To investigate the modulation of the inflammatory response after sclerotherapy for hydrocoele/spermatocoele.

    Patients and Methods

    All patients with hydrocoele or spermatocoele presenting at the Department of Urology, University Hospital, Linköping, Sweden, from 2006 to 2012, were included in this prospective observational study of sclerotherapy for hydrocoele/spermatocoele using polidocanol as a sclerosing agent and adjuvant antibiotic and anti‐inflammatory medication (AAAM) for modulation of the inflammatory response. Patients were clinically evaluated within 24–48 h after a complication or adverse event possibly related to sclerotherapy. Evaluation of cure was scheduled after 3 months and re‐treatment, if necessary was carried out in the same manner as the first treatment. Groups of patients were compared using the chi‐squared test and logistic regression analysis.

    Results

    From a total of 191 patients, AAAM was given to 126, of whom 5% had subclinical epididymitis/swelling (SES) compared to 26% of the patients without AAAM (P < 0.001). No other complication was observed. The rate of cure for the whole group of patients was 93% after one or two treatments and significantly higher in the group with AAAM than in the group without AAAM (96% vs 88%, P = 0.03).

    Conclusions

    Modulation of the inflammatory response after sclerotherapy resulted in a lower incidence of SES and an increased cure rate.

  • 16.
    Klaff, Rami
    et al.
    Linköping University, Department of Clinical and Experimental Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center for Surgery, Orthopaedics and Cancer Treatment, Department of Urology in Östergötland.
    Berglund, Anders
    Eksatravagen 72, Uppsala, Sweden.
    Varenhorst, Eberhard
    Linköping University, Department of Clinical and Experimental Medicine, Urology. Linköping University, Faculty of Health Sciences. Region Östergötland, Center for Surgery, Orthopaedics and Cancer Treatment, Department of Urology in Östergötland.
    Olov Hedlund, Per
    Karolinska Institute Solna, Sweden.
    Nler, Morten J.
    Aalborg University Hospital, Denmark.
    Sandblom, Gabriel
    Karolinska Hospital Huddinge, Sweden.
    Clinical characteristics and quality-of-life in patients surviving a decade of prostate cancer with bone metastases2016In: BJU International, ISSN 1464-4096, E-ISSN 1464-410X, Vol. 117, no 6, p. 904-913Article in journal (Refereed)
    Abstract [en]

    Objective To describe characteristics and quality-of-life (QoL), and to define factors associated with long-term survival in a subgroup of patients with prostate cancer with M1b disease. Patients and Methods The study was based on 915 patients from a prospective randomised multicentre trial (No. 5) by the Scandinavian Prostate Cancer Group, comparing parenteral oestrogen with total androgen blockade. Long-term survival was defined as patients having an overall survival of &gt;= 10 years, and logistic regression models were constructed to identity clinical predictors of survival. QoL during follow-up was assessed using the European Organisation for Research and Treatment of Cancer Quality-of-Life Questionnaire - C30 version 1 (EORTC-C30) ratings. Results In all, 40 (4.4%) of the 915 men survived for &gt;10 years. Factors significantly associated with increased likelihood of surviving for &gt;10 years in the univariate analyses were: absence of cancer-related pain; Eastern Cooperative Oncology Group (ECOG) performance status of &lt;2; negligible analgesic consumption; T-category of 1-2; prostate-specific antigen (PSA) level of &lt;231 mu g/L; and a Soloway score of 1. In the multivariate analyses, ECOG performance status of &lt;2, PSA level of &lt;231 mu g/L, and Soloway score of 1, were all independent predictors of long-term survival. All subscales of the EORTC-C30 were higher in this group than for patients with short survival, but slowly declined over the decade. Conclusion A subgroup of patients with prostate cancer with M1b disease and certain characteristics showed a positive long-term response to androgen-deprivation therapy with an acceptable QoL over a decade or more. Independent predictors of long-term survival were identified as ECOG performance status of &lt;2, limited extent of bone metastases (Soloway score of 1), and a PSA level of &lt;231 mu g/L at the time of enrolment.

  • 17. Kobelt, G
    et al.
    Spångberg, Anders
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Biomedicine and Surgery, Division of surgery. Östergötlands Läns Landsting, Centre of Surgery and Oncology, Department of Urology in Östergötland.
    Mattiasson, A
    The cost of feedback microwave thermotherapy compared with transurethral resection of the prostate for treating benign prostatic hyperplasia2004In: BJU International, ISSN 1464-4096, E-ISSN 1464-410X, Vol. 93, no 4, p. 543-548Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: To compare the efficacy of a new microwave thermotherapy for treating benign prostatic hyperplasia (BPH), the ProstaLund Feedback Treatment (PLFT®, ProstaLund Operations AB, Lund, Sweden) and transurethral resection of the prostate (TURP) in a clinical trial to their effectiveness in clinical practice over 1 year, to estimate their cost over 1 year, and to evaluate the cost of re-interventions over a longer period (2-3 years). PATIENTS AND METHODS: In a large randomized international 1-year clinical trial PLFT was as effective as TURP in improving symptoms of BPH and urinary flow. Because PLFT is an outpatient procedure it was less costly than TURP. However, the cost-effectiveness of the new procedure depends on its long-term effectiveness in clinical practice. All 146 patients in the randomized clinical trial were included in the present analysis. The outcome was based on the International Prostate Symptom Score (IPSS) and the bother score, and costs were estimated from treatment-related adverse events and hospitalisation. To validate the estimates based on the clinical trial 1-year data on effectiveness and complete resource use in clinical practice were collected in a retrospective observational study from hospital charts and patient questionnaires of 88 patients who had undergone either TURP or PLFT. To assess the number of re-interventions after TURP after the first year information was obtained from hospital and surgical procedure data in the Swedish inpatient registry. The 3-year data for a total of 52 010 patients who had an index hospitalization for TURP between 1990 and 1995 were available for the analysis. The estimate of long-term consequences of PLFT was based on complication and re-intervention data for 87 patients who had undergone PLFT between 1997 and 1999. RESULTS: The mean 1-year costs in the clinical trial were estimated at €1763 for PLFT and €3209 for TURP. When all treatment-related resource use in clinical practice for 88 patients was included the costs were estimated at €1924 and €3264 for PLFT and TURP, respectively. The IPSS and bother scores were not significantly different between the groups in both datasets. Using the registry data the cost of TURP including re-interventions (TURP and bladder neck incisions) was estimated at €3159 over 2 years and €3185 over 3 years, the respective costs for PLFT were €2121 and at €2151. CONCLUSIONS: In the 1-year clinical trial PLFT was as effective but less costly than TURP, but long-term data are still lacking. However, the preliminary analysis over 3 years indicates that the average cost of the procedure remains lower than the total cost of TURP for the same period.

  • 18.
    Ladjevardi, Sam
    et al.
    University of Uppsala Hospital, Sweden .
    Berglund, Anders
    University of Uppsala Hospital, Sweden .
    Varenhorst, Eberhard
    Linköping University, Department of Clinical and Experimental Medicine, Urology. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Centre for Surgery, Orthopaedics and Cancer Treatment, Department of Urology in Östergötland.
    Bratt, Ola
    Lund University, Sweden .
    Widmark, Anders
    Umeå University Hospital, Sweden .
    Sandblom, Gabriel
    Karolinska Institute, Sweden .
    Treatment with curative intent and survival in men with high-risk prostate cancer. A population-based study of 11 380 men with serum PSA level 20-100 ng/mL2013In: BJU International, ISSN 1464-4096, E-ISSN 1464-410X, Vol. 111, no 3, p. 381-388Article in journal (Refereed)
    Abstract [en]

    Objective less thanbrgreater than less thanbrgreater thanTo investigate the influence of curative treatment on cause-specific mortality in men diagnosed with prostate cancer (PCa) with serum prostate-specific antigen (PSA) levels between 20 and 100 ng/mL. less thanbrgreater than less thanbrgreater thanMaterials and Methods less thanbrgreater than less thanbrgreater thanPatients with PCa (T1-4, N0/N1/NX, M0/MX), PSA 20-100 ng/mL and age andlt;= 75 years were identified in the National Prostate Cancer Register of Sweden. less thanbrgreater than less thanbrgreater thanData on co-morbidity diagnoses were obtained from the National Patient Register and cause of death from the Cause of Death Register. less thanbrgreater than less thanbrgreater thanFollowing adjustment for age at diagnosis, co-morbidity burden, Gleason score, T-category, PSA level and cause-specific mortality in relation to treatment were estimated using Cox regression analysis. less thanbrgreater than less thanbrgreater thanResult less thanbrgreater than less thanbrgreater thanA total of 11 380 men were diagnosed with PCa between 1996 and 2008 and fulfilled the inclusion criteria. less thanbrgreater than less thanbrgreater thanThe cumulative 10-year PCa-specific mortality was 36% for patients receiving only palliative treatment and 13% for those treated with curative intent. less thanbrgreater than less thanbrgreater thanFor the 8462 (74%) patients with PSA levels from 20 to 50 ng/mL at diagnosis, the hazard ratio for death from PCa was 0.23 (95% confidence interval 0.19-0.27) for those treated with curative intent compared with those given palliative treatment after adjusting for age, co-morbidity, T category, PSA level and Gleason score. The corresponding hazard ratio was 0.22 (95% confidence interval 0.17-0.30) for patients with PSA levels from 51 to 100 ng/mL. less thanbrgreater than less thanbrgreater thanConclusion less thanbrgreater than less thanbrgreater thanTreatment with curative intent for men with high-risk PCa was associated with reduced cause-specific mortality and should be considered even when serum PSA exceeds 20 ng/mL. Keywords prostate cancer, prostate-specific antigen, high-risk tumours, curative treatment, palliative treatment, population-based study

  • 19.
    Lagou, M
    et al.
    University of Newcastle upon Tyne.
    De Vente, J
    Maastricht University.
    Kirkwood, TB
    University of Newcastle upon Tyne.
    Hedlund, Petter
    Lund University Hospital.
    Andersson, KE
    Lund University Hospital.
    Gillespie, JI
    University of Newcastle upon Tyne.
    Drake, MJ
    Bristol Urological Institute.
    Location of interstitial cells and neurotransmitters in the mouse bladder2006In: BJU International, ISSN 1464-4096, E-ISSN 1464-410X, Vol. 97, no 6, p. 1332-1337Article in journal (Refereed)
    Abstract [en]

    INTRODUCTION: To investigate whether interstitial cells (ICs) are present in the adult mouse bladder, and what transmitters characterize adjacent nerve fibres, as ICs in human and guinea-pig bladder lie close to nerve fibres but transmitters present in these nerves have not yet been reported.

    MATERIALS AND METHODS: Sections of the bladder wall from 12 adult male mice (six each, aged 3-4 or 18-24 months) were incubated in carboxygenated Krebs' solution containing isobutyl-methyl-xanthene (1 mm), followed by the nitric oxide (NO) donor diethylamino-NONOate; control tissues remained in Krebs' solution. Samples were fixed in 4% paraformaldehyde and processed for immunofluorescence histochemistry for cGMP, neuronal NO synthase (nNOS), vesicular acetylcholine transferase (VAChT), calcitonin gene-related polypeptide (CGRP) and protein gene product (PGP) 9.5. ICs were identified as non-neuronal cells of appropriate morphology manifesting an increase in cGMP after exposure to the NO donor.

    RESULTS: ICs were apparent in the outer muscle, but not the inner muscle or suburothelial region. nNOS- and CGRP-immunoreactive fibres were close to and alongside IC processes. In contrast, nerve fibres containing VAChT were only occasionally found close to ICs and rarely running alongside them. ICs showed no immunoreactivity to c-kit. There was no overt difference in IC cell distribution between young and aged adult specimens. Older mice showed patchy denervation of the detrusor, but ICs were not specifically affected.

    CONCLUSIONS: ICs are confined to the outer part of the bladder wall in the mouse and may receive peptidergic and nitrergic innervation, which might serve to modulate their putative functional role. Alterations in the overall IC population do not appear to underlie ageing-related changes in lower urinary tract function.

  • 20.
    Li, Longkun
    et al.
    Urologic Center, Southwest Hospital, Third Military Medical University.
    Jiang, Chonghe
    Medical College, Hunan Normal University, Changsha, Hunan Province, China.
    Song, Bo
    Urologic Center, Southwest Hospital, Third Military Medical University.
    Yan, Junan
    Urologic Center, Southwest Hospital, Third Military Medical University.
    Pan, Jinhong
    Urologic Center, Southwest Hospital, Third Military Medical University.
    Altered expression of calcium-activated K and Cl channels in detrusor overactivity of rats with partial bladder outflow obstruction2008In: BJU International, ISSN 1464-4096, E-ISSN 1464-410X, ISSN 1464-4096, Vol. 101, no 12, p. 1588-1594Article in journal (Refereed)
    Abstract [en]

    To evaluate the activity of large- and small-conductance calcium-activated potassium channels (BKCa, SKCa) and calcium-activated chloride channels (ClCa) in detrusor overactivity (DO) cells after partial bladder outlet obstruction (PBOO) in rats.

    MATERIALS AND METHODS

    Thirteen female Wistar rats with DO caused by PBOO were studied simultaneously with eight sham-operated rats. The expression of KCa and ClCa channels was assessed by reverse transcription-polymerase chain reaction, and the function of the two groups compared.

    RESULTS

    In the DO cells the expression of BKCa, SKCa2 and SKCa3 was lower, and that of ClCa channels higher, than in the control group cells. Using confocal laser scanning microscopic analysis, the function of BKCa and SKCa channels was suppressed, and that of ClCa channels was enhanced in DO group cells. KCa and ClCa effectors altered the cell membrane potentials more significantly in the DO cells than in the control cells, indicating a decrease in KCa and an increase in ClCa in DO group in either iso- or hypo-osmolar medium. Moreover, the change in BKCa, SKCa and ClCa channel activators in DO cells showed a more excitable state in hypo-osmolar medium than in iso-osmolar medium.

    CONCLUSION

    In DO myocytes after PBOO, the expression and function of KCa channels were decreased, and those of ClCa channels increased. These changes all provoke greater cell excitability, and could partly account for the DO.

  • 21.
    Liedberg, Fredrik
    et al.
    Skane Univ Hosp, Sweden; Lund Univ, Sweden.
    Hagberg, Oskar
    Reg Canc Ctr South, Sweden.
    Aljabery, Firas
    Region Östergötland, Center for Surgery, Orthopaedics and Cancer Treatment, Department of Urology in Östergötland.
    Gardmark, Truls
    Karolinska Inst, Sweden.
    Hosseini, Abolfazl
    Karolinska Univ Hosp, Sweden.
    Jahnson, Staffan
    Linköping University, Department of Clinical and Experimental Medicine, Division of Surgery, Orthopedics and Oncology. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center for Surgery, Orthopaedics and Cancer Treatment, Department of Urology in Östergötland.
    Jancke, Georg
    Skane Univ Hosp, Sweden; Lund Univ, Sweden.
    Jerlstrom, Tomas
    Orebro Univ, Sweden.
    Malmstrom, Per-Uno
    Uppsala Univ, Sweden.
    Sherif, Amir
    Umea Univ, Sweden.
    Strock, Viveka
    Sahlgrens Univ Hosp, Sweden; Univ Gothenburg, Sweden.
    Haggstrom, Christel
    Uppsala Univ, Sweden; Umea Univ, Sweden.
    Holmberg, Lars
    Uppsala Univ, Sweden; Kings Coll London, England.
    Period-specific mean annual hospital volume of radical cystectomy is associated with outcome and perioperative quality of care: a nationwide population-based study2019In: BJU International, ISSN 1464-4096, E-ISSN 1464-410X, Vol. 124, no 3, p. 449-456Article in journal (Refereed)
    Abstract [en]

    Objective To investigate the association between hospital volume and overall survival (OS), cancer-specific survival (CSS), and quality of care of patients with bladder cancer who undergo radical cystectomy (RC), defined as the use of extended lymphadenectomy (eLND), continent reconstruction, neoadjuvant chemotherapy (NAC), and treatment delay of We used the Bladder Cancer Data Base Sweden (BladderBaSe) to study survival and indicators of perioperative quality of care in all 3172 patients who underwent RC for primary invasive bladder cancer stage T1-T3 in Sweden between 1997 and 2014. The period-specific mean annual hospital volume (PSMAV) during the 3 years preceding surgery was applied as an exposure and analysed using univariate and multivariate mixed models, adjusting for tumour and nodal stage, age, gender, comorbidity, educational level, and NAC. PSMAV was either categorised in tertiles, dichotomised (at amp;gt;= 25 RCs annually), or used as a continuous variable for every increase of 10 RCs annually. Results PSMAV in the highest tertile (amp;gt;= 25 RCs annually) was associated with improved OS (hazard ratio [HR] 0.87, 95% confidence interval [CI] 0.75-1.0), whereas the corresponding HR for CSS was 0.87 (95% CI 0.73-1.04). With PSMAV as a continuous variable, OS was improved for every increase of 10 RCs annually (HR 0.95, 95% CI 0.90-0.99). Moreover, higher PSMAV was associated with increased use of eLND, continent reconstruction and NAC, but also more frequently with a treatment delay of amp;gt;3 months after diagnosis. Conclusions The current study supports centralisation of RC for bladder cancer, but also underpins the need for monitoring treatment delays associated with referral.

  • 22. Nyman, Claes R
    et al.
    Andersen, Jesper T
    Lodding, Per
    Sandin, Thorsten
    Varenhorst, Eberhard
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Biomedicine and Surgery, Division of surgery. Östergötlands Läns Landsting, Centre of Surgery and Oncology, Department of Urology in Östergötland.
    The patient's choice of androgen-deprivation therapy in locally advanced prostate cancer: Bicalutamide, a gonadotrophin-releasing hormone analogue or orchidectomy2005In: BJU International, ISSN 1464-4096, E-ISSN 1464-410X, Vol. 96, no 7, p. 1014-1018Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: To investigate patient preference for three established androgen-deprivation therapies for locally advanced prostate cancer, the patient's capacity to decide his therapy, the reasons for selecting a certain mode of therapy, and patient satisfaction with the chosen therapy 3 months after initiation. PATIENTS AND METHODS: In all, 150 patients (mean age 75 years, range 57-89) with previously untreated locally advanced prostate cancer from 13 hospitals were consecutively given the chance to choose between the antiandrogenic oral drug bicalutamide, a gonadotrophin-releasing hormone analogue (GnRH) by injection, or surgical orchidectomy. After discussing the nature of their disease the patients took home written information about prostate cancer and the three different treatment options. After 1 week they were assessed using a questionnaire for biographical data, their attitude towards the different treatment alternatives and their choice of therapy. Three months later the patients completed a questionnaire about the treatment they had undergone. RESULTS: Sixty-three patients (42%) chose bicalutamide, 51 (34%) the GnRH analogue and 36 (24%) orchidectomy, 87% of those choosing bicalutamide, 84% GnRH and 94% orchidectomy, respectively, were sure about their choice but 12%, 17% and 3% of the patients, respectively, had some difficulty in deciding. The most important reasons for the therapy chosen were avoidance of injections and surgery, and a lower risk of impotence (bicalutamide), negative attitude to surgery and tablets (GnRH), and avoidance of injections and tablets (orchidectomy). Almost all patients (98%, 98% and 97%, respectively) were satisfied with their choice after 3 months of treatment. CONCLUSION: There are three equally effective forms of androgen deprivation for locally advanced prostate cancer without known metastases. There are major differences among these treatments in the mode of application and the likelihood and impact of side-effects. When patients are fully informed and play an active role in the treatment decision they are satisfied with their decision 3 months later. © 2005 BJU International.

  • 23.
    Sakano, S
    et al.
    Karolinska Institutet.
    Kumar, R
    Karolinska Institutet.
    Larsson, Per C M
    Karolinska Institutet.
    Onelov, E
    Karolinska Institutet.
    Adolfsson, J
    Karolinska Hospital.
    Steinbeck, G
    Karolinska Institutet.
    Hemminki, K
    Karolinska Institutet.
    A single-nucleotide polymorphism in the XPG gene, and tumour stage, grade, and clinical course in patients with nonmuscle-invasive neoplasms of the urinary bladder2006In: BJU International, ISSN 1464-4096, E-ISSN 1464-410X, Vol. 97, no 4, p. 847-851Article in journal (Refereed)
    Abstract [en]

    To evaluate whether the single nucleotide polymorphism (SNP), Asp1104His (G3507C), in the XPG gene affects malignant phenotypes of nonmuscle-invasive urinary bladder neoplasms (NIBN), by investigating associations between the SNP and clinicopathological variables in patients with NIBN.

    PATIENTS AND METHODS

    The 233 patients constituted newly diagnosed cases of primary NIBN in the Stockholm area. The Asp1104His polymorphism in the XPG gene was genotyped using a polymerase chain reaction-restriction fragment length polymorphism technique.

    RESULTS

    The GC + CC genotypes were more frequent in stage pT1 tumours at initial diagnosis than pTa (odds ratio 1.9, 95% confidence interval 1.0–3.5, P = 0.048). The difference was larger in the young group (4.6, 1.9–11.8, P = 0.001). In the young group, the GC + CC genotypes were significantly more frequent in high-grade than in low-grade tumours (3.1, 1.5–6.8, P = 0.004) whereas in the older group the genotypes were less frequent in high-grade tumours (0.3, 0.1–0.7, P = 0.007). The XPG genotypes were not associated with tumour recurrence, stage progression or survival.

    CONCLUSION

    These results suggest that the SNP in the XPG gene might be related to tumour invasiveness in NIBN.

  • 24.
    Sandblom, Gabriel
    et al.
    Dept of Surgery Uppsala Akademiska sjukhus.
    Varenhorst, Eberhard
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Biomedicine and Surgery, Division of surgery. Östergötlands Läns Landsting, Centre of Surgery and Oncology, Department of Urology in Östergötland.
    Broadening the criteria for avoiding staging one scans in prostate cancer: A retrospective study of patients at the Royal Marsden Hospital2004In: BJU International, ISSN 1464-4096, E-ISSN 1464-410X, Vol. 93, p. 889-890Article in journal (Refereed)
  • 25.
    Sjostrom, Malin
    et al.
    Umeå University, Sweden.
    Umefjord, Goran
    Umeå University, Sweden.
    Stenlund, Hans
    Umeå University, Sweden.
    Carlbring, Per
    Stockholm University, Sweden.
    Andersson, Gerhard
    Linköping University, Department of Behavioural Sciences and Learning, Psychology. Linköping University, Faculty of Arts and Sciences. Karolinska Institute, Sweden.
    Samuelsson, Eva
    Umeå University, Sweden.
    Internet-based treatment of stress urinary incontinence: 1-and 2-year results of a randomized controlled trial with a focus on pelvic floor muscle training2015In: BJU International, ISSN 1464-4096, E-ISSN 1464-410X, Vol. 116, no 6, p. 955-964Article in journal (Refereed)
    Abstract [en]

    Objectives To evaluate the long-term effects of two non-face-to-face treatment programmes for stress urinary incontinence (SUI) based on pelvic floor muscle training (PFMT). Subjects and Methods The present study was a randomized controlled trial with online recruitment of 250 community-dwelling women aged 18-70 years with SUI greater than= one time/week. Diagnosis was based on validated self-assessed questionnaires, 2-day bladder diary and telephone interview with a urotherapist. Consecutive computer-generated block randomization was carried out with allocation by an independent administrator to 3 months of treatment with either an internet-based treatment programme (n = 124) or a programme sent by post (n = 126). Both interventions focused mainly on PFMT. The internet group received continuous e-mail support from a urotherapist, whereas the postal group trained on their own. Follow-up was performed after 1 and 2 years via self-assessed postal questionnaires. The primary outcomes were symptom severity (International Consultation on Incontinence Questionnaire Short Form [ICIQ-UI SF]) and condition-specific quality of life (ICIQ-Lower Urinary Tract Symptoms Quality of Life [ICIQ-LUTSqol]). Secondary outcomes were the Patient Global Impression of Improvement, health-specific quality of life (EQ-visual analogue scale [EQ-VAS]), use of incontinence aids, and satisfaction with treatment. There was no face-to-face contact with the participants at any time. Analysis was based on intention-to-treat. Results We lost 32.4% (81/250) of participants to follow-up after 1 year and 38.0% (95/250) after 2 years. With both interventions, we observed highly significant (P less than 0.001) improvements withlarge effect sizes (greater than0.8) for symptoms and condition-specific quality of life (QoL) after 1 and 2 years, respectively. No significant differences were found between the groups. The mean (SD) changes in symptom score were 3.7 (3.3) for the internet group and 3.2 (3.4) for the postal group (P = 0.47) after 1 year, and 3.6 (3.5) for the internet group and 3.4 (3.3) for the postal group (P = 0.79) after 2 years. The mean changes (SD) in condition-specific QoL were 5.5 (6.5) for the internet group and 4.7 the for postal group (6.5) (P = 0.55) after 1 year, and 6.4 (6.0) for the internet group and 4.8 (7.6) for the postal group (P= 0.28) after 2 years. The proportions of participants perceiving they were much or very much improved were similar in both intervention groups after 1 year (internet, 31.9% [28/88]; postal, 33.8% [27/80], P = 0.82), but after 2 years significantly more participants in the internet group reported this degree of improvement (39.2% [29/74] vs 23.8% [19/80], P = 0.03). Health-specific QoL improved significantly in the internet group after 2 years (mean change in EQ-VAS, 3.8 [11.4], P= 0.005). We found no other significant improvements in this measure. At 1 year after treatment, 69.8% (60/86) of participants in the internet group and 60.5% (46/76) of participants in the postal group reported that they were still satisfied with the treatment result. After 2 years, the proportions were 64.9% (48/74) and 58.2% (46/79), respectively. Conclusion Non-face-to-face treatment of SUI with PFIVIT provides significant and clinically relevant improvements in symptoms and condition-specific QoL at 1 and 2 years after treatment.

  • 26.
    Sjostrom, Malin
    et al.
    Umeå University, Sweden .
    Umefjord, Goran
    Umeå University, Sweden .
    Stenlund, Hans
    Umeå University, Sweden .
    Carlbring, Per
    Stockholm University, Sweden .
    Andersson, Gerhard
    Linköping University, Department of Behavioural Sciences and Learning, Psychology. Linköping University, Faculty of Arts and Sciences.
    Samuelsson, Eva
    Umeå University, Sweden .
    Internet-based treatment of stress urinary incontinence: a randomised controlled study with focus on pelvic floor muscle training2013In: BJU International, ISSN 1464-4096, E-ISSN 1464-410X, Vol. 112, no 3, p. 362-372Article in journal (Refereed)
    Abstract [en]

    Objective less thanbrgreater than less thanbrgreater thanTo compare two treatment programmes for stress urinary incontinence (SUI) without face-to-face contact: one Internet-based and one sent by post. less thanbrgreater than less thanbrgreater thanPatients and Methods less thanbrgreater than less thanbrgreater thanRandomised, controlled trial conducted in Sweden 2009-2011. Computer-generated block-randomisation, allocation by independent administrator. No blinding. less thanbrgreater than less thanbrgreater thanThe study included 250 community-dwelling women aged 18-70 years, with SUI andgt;= 1 time/week. Consecutive online recruitment. less thanbrgreater than less thanbrgreater thanThe women had 3 months of either; (i) An Internet-based treatment programme (124 women), including e-mail support and cognitive behavioural therapy assignments or (ii) A treatment programme sent by post (126). Both programmes focused mainly on pelvic floor muscle training. less thanbrgreater than less thanbrgreater thanPrimary outcomes: symptom-score (International Consultation on Incontinence Questionnaire Short Form, ICIQ-UI SF) and condition-specific quality of life (ICIQ-Lower Urinary Tract Symptoms Quality of Life, ICIQ-LUTSQoL). Secondary outcomes: (i) Patient Global Impression of Improvement, (ii) Incontinence aids, (iii) Patient satisfaction, (iv) Health-specific QoL (EQ5D-Visual Analogue Scale), and (v) Incontinence episode frequency. Follow-up after 4 months via self-assessed postal questionnaires. less thanbrgreater than less thanbrgreater thanResults less thanbrgreater than less thanbrgreater thanIn all, 12% (30 women) were lost to follow-up. Intention-to-treat analysis showed highly significant improvements (P andlt; 0.001) with large effect sizes (andgt;0.8) with both interventions, but there were no significant differences between groups in primary outcomes. The mean (SD) changes in symptom-score were: Internet 3.4 (3.4), Postal 2.9 (3.1) (P = 0.27). The mean (SD) changes in condition-specific QoL were: Internet 4.8 (6.1), Postal 4.6 (6.7) (P = 0.52). less thanbrgreater than less thanbrgreater thanCompared with the postal-group, more participants in the Internet-group perceived they were much or very much improved (40.9% (43/105) vs 26.5% (30/113), P = 0.01), reported reduced usage of incontinence aids (59.5% (47/79) vs 41.4% (34/82), P = 0.02) and were satisfied with the treatment programme (84.8% (89/105) vs 62.9% (71/113), P andlt; 0.001). less thanbrgreater than less thanbrgreater thanHealth-specific QoL improved in the Internet-group (mean change 3.7 (10.9), P = 0.001), but not in the postal-group (1.9 (13.0), P = 0.13). less thanbrgreater than less thanbrgreater thanOverall, 69.8% (120/172) of participants reported complete lack of leakage or reduced number of leakage episodes by andgt;50%. less thanbrgreater than less thanbrgreater thanConclusions less thanbrgreater than less thanbrgreater thanConcerning primary outcomes, treatment effects were similar between groups whereas for secondary outcomes the Internet-based treatment was more effective. less thanbrgreater than less thanbrgreater thanInternet-based treatment for SUI is a new, promising treatment alternative.

  • 27.
    Spetz, Anna-Clara
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Molecular and Clinical Medicine, Obstetrics and gynecology. Östergötlands Läns Landsting, Centre of Surgery and Oncology, Department of Surgery in Östergötland.
    Hammar, Mats
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Molecular and Clinical Medicine, Obstetrics and gynecology. Östergötlands Läns Landsting, Centre of Surgery and Oncology, Department of Surgery in Östergötland.
    Pettersson, W
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Biomedicine and Surgery, Urology. Östergötlands Läns Landsting, Centre of Surgery and Oncology, Department of Urology in Östergötland.
    Varenhorst, Eberhard
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Biomedicine and Surgery, Urology. Östergötlands Läns Landsting, Centre of Surgery and Oncology, Department of Urology in Östergötland.
    Hot flushes and prostate cancer: pathogenesis and treatment2002In: BJU International, ISSN 1464-4096, E-ISSN 1464-410X, Vol. 90, p. 476-476Article in journal (Refereed)
  • 28.
    Streng, T
    et al.
    Lund University Hospital.
    Hedlund, Petter
    Lund University Hospital.
    Talo, A
    University of Turku.
    Andersson, KE
    Lund University Hospital.
    Gillespie, JI
    University of Newcastle.
    Phasic non-micturition contractions in the bladder of the anaesthetized and awake rat2006In: BJU International, ISSN 1464-4096, E-ISSN 1464-410X, Vol. 97, no 5, p. 1094-1101Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: To characterize the contractile activity that occurs in the bladder during the filling phase of the micturition cycle (non-micturition contractions, NMCs), which generate transient rises in intravesical pressure not associated with urine flow.

    MATERIALS AND METHODS: The experiments were conducted using anaesthetized (chloral hydrate) and un-anaesthetized rats. In un-anaesthetized rats bladder contractile activity was measured using an intravesical cannula implanted under full surgical anaesthesia 3 days previously. In the anaesthetized rats the bladder was exteriorized and a cannula inserted through the dome. In these experiments electrical activity within the detrusor was also measured with a suction electrode on the bladder surface. For each rat, the experimental protocol involved filling the bladder at a constant rate (10 mL/h) to evoke micturition cycles, or infusion of a fixed volume and recording made under effective isovolumetric conditions.

    RESULTS: In both anaesthetized and un-anaesthetized rats there were transient rises in bladder pressure (0.5-3 cmH2O). In the anaesthetized rats the amplitude of the transients increased throughout the filling phase, with little change in frequency. The phasic NMCs generating these pressure transients were accompanied by electrical changes in the detrusor. In the middle phase of bladder filling the slow pressure changes were accompanied by slow waves of electrical activity which changed in the pressure cycles immediately before micturition to high-frequency low-amplitude signals. In the un-anaesthetized rats there was a period immediately after voiding where there was no activity. As filling proceeded, low-amplitude low-frequency NMCs appeared that gradually increased in frequency and amplitude during the filling phase. However, the frequency of the transients decreased immediately before micturition despite an increase in amplitude. Similar responses were seen during isovolumetric recording.

    CONCLUSION: The present results show the presence of NMCs in the rat bladder, identify volume-dependent changes in the pattern of this activity during the micturition cycle, and show that NMCs are accompanied by electrical changes in the detrusor. The physiological significance of NMCs is not known but it might be linked to the generation of afferent discharge from mechanoreceptors in the wall, so contributing to sensations related to bladder volume.

  • 29.
    Streng, Tomi
    et al.
    Turku University, Finland .
    Andersson, Karl-Erik
    Wake Forest University, Winston Salem, NC, USA .
    Hedlund, Petter
    Linköping University, Department of Medical and Health Sciences, Division of Drug Research. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Center for Diagnostics, Department of Clinical Pharmacology. San Raffaele University, Milan, Italy.
    Gratzke, Christian
    Munich University Hospital, Germany.
    Baroni, Enrico
    BioXell, Milano, Italy.
    D’Ambrosio, Daniele
    BioXell, Milano, Italy.
    Benigni, Fabio
    San Raffaele University, Milan, Italy.
    Effects on bladder function of combining elocalcitol and tolterodine in rats with outflow obstruction2012In: BJU International, ISSN 1464-4096, E-ISSN 1464-410X, Vol. 110, no 2b, p. E125-E131Article in journal (Refereed)
    Abstract [en]

    It has previously been shown that elocalcitol might protect bladder contractile function in experimental models and that elocalcitol has beneficial effects in patients with LUTS. In humans, elocalcitol was demonstrated with a very good safety profile but only exhibited limited efficacy on LUTS in patients with BPH and overactive bladder (OAB). Recent reports show that therapies with antimuscarinics, when combined with other drugs in clinical use, might perform better than a monotherapy in managing LUTS. It is not known how a combination of elocalcitol and an antimuscarinic performs on bladder dysfunction. The present study suggests that concomitant use of secosteroids and antimuscarinics has additive beneficial effects on obstruction-related functional changes in an experimental model. If confirmed also in a clinical setting, this could allow for individual dose adjustments to improve efficacy in obstruction-related LUTS, and possibly reduce unwanted adverse activities by antimuscarinic therapy.

    OBJECTIVE:

    To evaluate the effects of tolterodine on urodynamics in elocalcitol- or vehicle-treated rats with partial urethral obstruction (PUO).

    MATERIALS AND METHODS:

    After ethical approval, 20 female Sprague-Dawley rats were subjected to PUO and treated (gavage) for 14 days (once daily) with elocalcitol (75 µg/kg) or vehicle. Cystometries were performed on day 15 in awake rats before and after i.v. administration of tolterodine (1, 10 and 100 µg/kg).

    RESULTS:

    No differences in bladder weights or body/bladder weight ratios were noted between groups. Tolterodine dose-dependently increased micturition intervals and volumes and bladder capacity in both elocalcitol- (n = 11) and vehicle-treated rats (n = 9). In elocalcitol-treated rats, flow pressure (FP) was dose-dependently reduced (12-20%) by tolterodine, whereas no effect on FP was noted in vehicle-treated animals (P < 0.05). Flow compliance (FC) was increased by tolterodine by 21-54% in vehicle-treated rats, and by 47-131% (P < 0.05 vs vehicle) in elocalcitol-treated animals. Maximal tension vs bladder weight was improved in elocalcitol-treated rats in comparison to vehicle (P < 0.05). The area under the curve (AUC) was reduced by tolterodine with 11-16% in vehicle-treated rats and 26-30% in elocalcitol -treated rats (P < 0.05).

    CONCLUSIONS:

    Elocalcitol-treatment improved the effects of tolterodine on bladder compliance at the start of flow. The effects of tolterodine on AUC suggest that elocalcitol exerts additional beneficial actions on PUO-induced functional changes during the filling phase of micturition. The reduction of FP and increase in FC by elocalcitol and tolterodine could have translational value and, if valid in humans, support combined therapy in benign prostatic obstruction (BPO)-related lower urinary tract symptoms (LUTS).

  • 30.
    Thulin, Helena
    et al.
    Karolinska Institute.
    Kreicbergs, Ulrika
    Karolinska Institute.
    Onelov, Erik
    Karolinska Institute.
    Ahlstrand, Christer
    Linköping University, Department of Clinical and Experimental Medicine, Urology. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Centre for Surgery, Orthopaedics and Cancer Treatment, Department of Urology in Östergötland.
    Carringer, Malcolm
    Orebro University Hospital .
    Holmang, Sten
    Sahlgrens University Hospital.
    Ljungberg, Borje
    Norrlands University Hospital.
    Malmstrom, Per-Uno
    Uppsala University.
    Robinsson, David
    Ryhov County Hospital.
    Wijkstrom, Hans
    Karolinska University.
    Wiklund, N. Peter
    Karolinska Institute.
    Steineck, Gunnar
    Karolinska Institute.
    Henningsohn, Lars
    Karolinska Institute.
    Defecation disturbances after cystectomy for urinary bladder cancer2011In: BJU International, ISSN 1464-4096, E-ISSN 1464-410X, Vol. 108, no 2, p. 196-203Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE To describe and compare long-term defecation disturbances in patients who had undergone a cystectomy due to urinary bladder cancer with non-continent urostomies, continent reservoirs and orthotopic neobladder urinary diversions. PATIENTS AND METHODS During their follow-up we attempted to contact all men and women aged 30-80 years who had undergone cystectomy and urinary diversion at seven Swedish hospitals. During a qualitative phase we identified defecation disturbances as a distressful symptom and included this item in a study-specific questionnaire together with freehand comments. The patients completed the questionnaire at home. Outcome variables were dichotomized and the results are presented as relative risks with 95% confidence interval. RESULTS The questionnaire was returned from 452 (92%) of 491 identified patients. Up to 30% reported problems with the physiological emptying process of stool (bowel movement, sensory rectal function, awareness of need for defecation, motoric rectal and anal function, straining ability). A sense of decreased straining capacity was reported by 20% of the men and women with non-continent urostomy and 14% and 8% of those with continent reservoirs and orthotopic neobladders, respectively. CONCLUSIONS Of the cystectomized individuals 30% reported problems with the physiological emptying process of stool (bowel movement, sensory rectal function, awareness of need for defecation, motoric rectal and anal function, straining ability). Those wanting to improve the situation for bladder cancer survivors may consider communicating before surgery the possibility of stool-emptying problems, and asking about them after surgery.

  • 31.
    Vande Walle, Johan GJ
    et al.
    Dept Pediatric Nephrology, University of Gent, .
    Mattsson, Sven
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Molecular and Clinical Medicine, Pediatrics. Östergötlands Läns Landsting, Centre of Paediatrics and Gynecology and Obstetrics, Department of Paediatrics in Linköping.
    Schurmans, Thierry
    Dept of Pediatric Nephrology, Brussels, Belgium.
    Hoebeke, Piet
    Dept of Pediatrics Urology, University of Gent .
    Deboe, Veerle
    Dept of Urology van de Vrije Universiteit, Brussels.
    Norgaard, Jens Peter
    Ferring Pharmaceuticals A/S Copenhagen, Denmark. .
    A new fast-melting oral formulation of desmopressin: A pharmacodynamic study in children with primary nocturnal enuresis2006In: BJU International, ISSN 1464-4096, E-ISSN 1464-410X, Vol. 97, no 3, p. 603-609Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: To determine the pharmacodynamic properties of a new oral lyophilisate formulation of desmopressin (in single doses of 30, 60, 120, 240, 360 or 480 μg) in children with known primary nocturnal enuresis (PNE) and thus identify those dosages that could provide a duration of action corresponding to a typical length of night-time sleep in children with PNE, additional objectives were to determine the safety and tolerability of desmopressin in this population. PATIENTS AND METHODS: Children with PNE (mean three or more wet nights/week), aged 6-12 years, were randomized into a double-blind, placebo-controlled study. An overhydration technique was used before dosing to suppress endogenous vasopressin production and thereby ensure that any antidiuresis could be attributed to treatment. Dosing with desmopressin or placebo occurred when urinary production was >0.13 mL/min/kg. Urinary volume, osmolality and duration of urinary-concentrating action (above three threshold levels: 125, 200 and 400 mOsm/kg) were determined as endpoints. RESULTS: All 72 participants receiving desmopressin had a pharmacodynamic response to the drug, while there was no change in urinary output in the 12 placebo-treated patients. There was a clear relationship between desmopressin dose and duration of action and osmolality during action, although the three highest-dose groups had similar results. The mean duration of action of desmopressin at the lowest osmolality threshold level was 3.6-10.6 h, according to dose, for the highest threshold, the values were 1.3-8.6 h. CONCLUSION: Desmopressin, as the oral lyophilisate, causes a marked decrease in urinary output in hydrated children with PNE. A small dose range (120-240 μg) is likely to control diuresis for a period corresponding to a night's sleep (7-11 h) in most children with PNE. However, some patients might require a higher dose to obtain antidiuresis for the complete night. © 2006 BJU International.

  • 32.
    Waldkirch, Eginhard
    et al.
    Hannover Medical School.
    Ucker, Stefan
    Hannover Medical School.
    Schultheiss, Dirk
    von Baldersche Stiftung, Giessen.
    Geismar, Ulrike
    Private Practice of Dermatology, Hannover.
    Bruns, Carola
    Hannover Medical School.
    Scheller, Friedemann
    Hannover Medical School.
    Jonas, Udo
    Hannover Medical School.
    Becker, Armin J.
    Ludwig-Maximilians-University, Academic Hospital Grosshadern, Munich.
    Stief, Christian G.
    Ludwig-Maximilians-University, Academic Hospital Grosshadern, Munich.
    Hedlund, Petter
    Linköping University, Department of Medical and Health Sciences, Clinical Pharmacology. Linköping University, Faculty of Health Sciences.
    Non-genomic effects of androgens on isolated human vascular and nonvascular penile erectile tissue2008In: BJU International, ISSN 1464-4096, E-ISSN 1464-410X, Vol. 101, no 1, p. 71-75Article in journal (Refereed)
    Abstract [en]

    OBJECTIVES: To evaluate non-genomic effects of testosterone and dihydrotestosterone (DHT) on isolated human cavernosal arteries (HCA) and corpus cavernosum (HCC) using organ-bath studies and radio-immunoassays (RIA), as non-genomic effects of androgens are reported for vascular smooth musculature and there is evidence that the relaxant response involves a modulation of cyclic nucleotide tissue levels.

    MATERIALS AND METHODS: The relaxation induced by the cumulative addition of testosterone and DHT (0.01-10 microm) was studied using circular segments of HCA and strip preparations of HCC. To evaluate the effects of testosterone and DHT on tissue levels of cAMP and cGMP, specimens were exposed to increasing concentrations of the hormones. Forskolin and sodium nitroprusside (SNP) served as reference compounds.

    RESULTS: Testosterone and DHT dose-dependently reversed the noradrenaline-induced tension of vascular segments and HCC strips. At the maximum concentration, testosterone and DHT reduced the mean (sd) tension to 79.8 (4.43)% and 83.9 (10.94)%, respectively. SNP and forskolin significantly stimulated the production of cGMP and cAMP. No effects of testosterone and DHT on cGMP and cAMP levels were detected.

    CONCLUSION: Rapid androgen-induced relaxation of HCA and HCC occurs via non-genomic mechanisms. In penile erectile tissue, non-genomic relaxant effects of testosterone and DHT are not mediated via modulation of cyclic nucleotide tissue levels. Additional studies are required to establish if non-genomic relaxant effects are important in ensuring a basal level of perfusion to maintain overall penile function.

  • 33.
    Werkstrom, Viktoria
    et al.
    Lund University Hospital.
    Svensson, Anna
    Lund University Hospital.
    Andersson, Karl-Erik
    Lund University Hospital.
    Hedlund, Petter
    Lund University Hospital.
    Phosphodiesterase 5 in the female pig and human urethra: morphological and functional aspects2006In: BJU International, ISSN 1464-4096, E-ISSN 1464-410X, Vol. 98, no 2, p. 414-423Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: To characterize the distribution of phosphodiesterase 5 (PDE-5), cGMP and cGMP-dependent protein kinase I (PKG1), and to evaluate the effect of pharmacological inhibition of PDE-5 in isolated preparations of pig and human urethra, as the nitric oxide (NO)/cGMP pathway generates the main inhibitory signals to reduce resistance in the bladder outlet and urethra during emptying of the bladder.

    MATERIALS AND METHODS: After obtaining ethics committee approval, urethral specimens were obtained from three female patients during cystectomy, and from young female pigs. The specimens were prepared for immunohistochemical investigations and for functional studies in organ baths. Effects of sildenafil, vardenafil and tadalafil (1 nm to 30 microm) were studied in l-noradrenaline (1 microm)-activated or spontaneously contracted preparations, and on relaxations induced by electrical-field stimulation (EFS). Levels of cGMP were determined by radioimmunoassay.

    RESULTS: After stimulation with the NO donor, DETA NONO-ate (1 mm), there was greater cGMP-immunoreactivity (IR) in urethral and vascular smooth muscles. There was a wide distribution of cGMP- and vimentin-positive interstitial cells between pig urethral smooth muscle bundles. There was also cGMP-IR within NO-synthase-IR endothelium. There was PDE-5 IR within the urethral and vascular smooth muscle cells, but also in vascular endothelial cells that expressed cGMP-IR. In pig and human sections, there was strong PKG1-IR in alpha-actin-IR urethral smooth muscle cells that also contained IR for cGMP. Sildenafil, vardenafil and tadalafil caused mean (sem) concentration-dependent relaxations of the pig urethra which, at 30 microm, were 80 (3)% (11 samples), 81 (5)% (12 samples) and 64 (4)% (10 samples) of the spontaneous tone. The relaxation of L-noradrenaline-contracted female human urethra was 100% in response to 10 microm sildenafil, and 85 (15)% and 47 (13)% for 30 microm of vardenafil and tadalafil, respectively (three samples). Vardenafil or sildenafil (30 microm) doubled cGMP levels in pig specimens. There were no effects on cGMP levels with tadalafil. EFS (1-32 Hz) caused l-NG-nitroarginine-sensitive relaxations of pig urethral muscle that were increased in amplitude and duration by PDE-5 inhibition. At 0.1 microm, sildenafil, vardenafil or tadalafil significantly prolonged the mean (sem) duration of the relaxation at 4 Hz by 55 (19)%, 45 (14)% and 51 (12)%, respectively.

    CONCLUSIONS: PDE-5-, cGMP- and PKG1-IR is widely distributed in human and pig urethral tissues. Nerve-induced relaxations of urethral preparations were enhanced at low concentrations of sildenafil, vardenafil and tadalafil, whereas there were direct smooth muscle-relaxant actions of the PDE-5 inhibitors at high concentrations. Inhibition of PDE-5 might be an interesting option to facilitate cGMP-mediated relaxation of the outflow region.

1 - 33 of 33
CiteExportLink to result list
Permanent link
Cite
Citation style
  • apa
  • harvard1
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • oxford
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf