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Biomedical subjects

G J Fellows

Publications and source records attributed to G J Fellows.

At least 19 recordsLinked to original sources
PubMed1994

Marker tumour response to Evans and Pasteur bacille Calmette-Guérin in multiple recurrent pTa/pT1 bladder tumours: report from the Medical Research Council Subgroup on Superficial Bladder Cancer (Urological Cancer Working Party).

OBJECTIVE: To compare the efficacy of Evans bacille Calmette-Guérin (BCG) and Pasteur BCG in eradicating marker bladder tumours and to compare the toxicity of the two strains. PATIENTS AND METHODS: Ninety-nine patients with multiple recurrent pTa or pT1 bladder tumours were allocated at random to six instillations at weekly intervals of either Evans BCG or Pasteur BCG. All tumours were resected except one marker tumour. At cystoscopy 3 months after randomization all tumours including the marker tumour, if still present, were resected. RESULTS: The incidence of adverse events was similar in the two groups but numbers were small and only large differences would have been detected. No statistically significant difference in efficacy regarding the response of the marker tumour or the appearance of other tumours at 3 months was noted in the two groups. There was no evidence of stage progression of the marker tumours. CONCLUSIONS: In multiple recurrent pTa or pT1 bladder tumours clearing the bladder of all except one marker tumour provides a safe and convenient way of measuring the response to intravesical therapy. No significant difference in efficacy or toxicity was detected between Evans BCG and Pasteur BCG.

Administration, Intravesical↗
PubMed1992

Treatment of advanced localised prostatic cancer by orchiectomy, radiotherapy, or combined treatment. A Medical Research Council Study. Urological Cancer Working Party--Subgroup on Prostatic Cancer.

A total of 277 patients with apparently localised prostatic cancer (T2-T4 NXMO) were allocated at random to receive radiotherapy alone (88), orchiectomy alone (90) and combined therapy (99) between 1980 and 1985. The main outcome measures were survival, time to appearance of metastases and treatment of local disease progression by further transurethral resection. Orchiectomy, whether alone or with radiotherapy, produced a significant delay in detection of metastases when compared with radiotherapy alone. There were no statistically significant differences between the 3 treatment groups in local disease control or in overall survival.

Combined Modality Therapy↗
PubMed1991

Flexible cystoscopy compared with ultrasound in the detection of recurrent bladder tumours.

A combination of transrectal and transabdominal ultrasound was compared with flexible cystoscopy as a means of detecting recurrent bladder tumours. The study group comprised 50 patients who had previously had rigid cystoscopy. They underwent combination ultrasound in the out-patient department 1 week before flexible cystoscopy. Combination ultrasound identified 25 patients with recurrent tumours and flexible cystoscopy identified 26. Thirty-four patients (68%) preferred ultrasound, 10 (20%) preferred flexible cystoscopy, 3 (6%) preferred general anaesthesia and rigid cystoscopy and 3 (6%) had no preference. The main objection to ultrasound was the use of the transrectal probe.

Aged↗
PubMed1990

External-beam radiation for carcinoma of the prostate.

Over 14 years 111 patients with prostatic cancer underwent attempted curative radiotherapy; full data was obtained on 105 patients. The 5-year actuarial survival rate was 62%, with 54 patients still alive at the time of review. The toxicity rate was 94%, and serious late complications occurred in 4%. 40% of the patients developed symptomatic recurrence, and only 4% of the patients had local recurrence.

Aged↗
PubMed1990

The role of abdominal and transrectal ultrasound and cytology in the detection of recurrent bladder tumours.

Transrectal and transabdominal ultrasound combined with cytology were compared with conventional cystoscopy as a mean of detecting recurrences of bladder tumours. One hundred and twenty-five patients underwent combination ultrasound in the outpatient department 1 week before cystoscopy. Combination ultrasound identified 90% of recurrent tumours and tumour identification with the results of ultrasound and cytology combined was 93%. The false positive rate was 2%. The ultrasonographer would have referred 97% of patients with recurrent tumour for cystoscopy. Combination ultrasound and cytology may be a satisfactory alternative to check cystoscopy in certain categories of bladder tumours.

Adult↗
PubMed1990

Double J stents in the treatment of gynaecological injury to the ureter.

Ureteric injury is a recognized complication of hysterectomy and may present with obstruction or fistula. Between 1987 and 1989 in Oxford nine patients with 10 injured ureters underwent attempted retrograde placement of double J stents. Three patients had successful outcomes and one patient with bilateral ureteric obstruction required reimplantation of the right ureter after successful stenting of the left ureter. One patient required removal of a stent due to irritation but her fistula eventually closed. In three patients placement was unsuccessful and in one patient injury to the bladder base prevented the ureteric orifices from being seen and hence stenting was not possible. Thus five of these 10 injured ureters were managed successfully with double J stents. We advocate the initial use of double J stents in gynaecological ureteric injury. This approach is simple and may cure the fistula. If it is unsuccessful, subsequent reimplantation is not hindered.

Female↗
PubMed1989

Detection of recurrent bladder tumours by transrectal and abdominal ultrasound compared with cystoscopy.

Transrectal and transabdominal ultrasound was used to detect the recurrence of bladder tumours and compared with conventional cystoscopy. Forty patients with a previous history of bladder tumour were examined by these methods; 50% had a recurrence. Transabdominal and transrectal ultrasound together identified 95% of recurrences; 1 tumour (diameter 1 mm) was missed. The false positive rate was 5% and these areas, identified wrongly by ultrasound as tumour, were shown to be scars on cystoscopy. Combination ultrasound may be used as an alternative to check cystoscopy in certain categories of bladder tumour.

Abdomen↗
PubMed1989

Dynamic ultrasonography for voiding dysfunction.

Transrectal or transvaginal ultrasonography provides a convenient and acceptable way of imaging the lower urinary tract in action. It has a number of advantages over x-ray cystourethrography but also some limitations. It can help to delineate voiding dysfunctions, particularly in neuropathic disorders and female urinary incontinence.

Female↗
PubMed1987

A study of the pathogenesis, urodynamic assessment and outcome of detrusor instability associated with bladder outflow obstruction.

One hundred patients awaiting surgery for bladder outflow obstruction were studied prospectively. All patients completed a symptom score and had urodynamic studies pre-operatively. These results were not known to the urologist and did not therefore influence the course of surgery. There was a good positive correlation between both the severity and the duration of irritative symptoms and the presence of detrusor instability. Eighty per cent of patients were significantly improved 3 months post-operatively. Patients with detrusor instability or low compliance were four times more likely to have an unsatisfactory outcome than those with stable bladders. The outcome could have been predicted in half of the unsuccessful patients on the basis of their pre-operative symptom score and urodynamic studies. Whilst a full urodynamic evaluation is usually unnecessary, all patients should have a flow rate estimation and those with a high urgency symptom score and an unexpectedly high flow rate require full urodynamic assessment. These patients should be considered for alternative treatment or warned pre-operatively of the likely outcome.

Aged↗
PubMed1987

Transrectal ultrasonography compared with voiding cystourethrography after spinal cord injury.

Transrectal ultrasonography was compared with voiding cystourethrography (VCU) in 27 patients after spinal cord injury. Both techniques gave clear images of the bladder and posterior urethra. Ureteric reflux, intraprostatic reflux and anterior urethral diverticula were seen only on VCU. Ultrasonography showed soft tissue detail and muscle contraction not seen on VCU. Other advantages of ultrasonography included the lack of radiation hazard, allowing prolonged observation; no contrast medium was required and this eliminated the need for catheterisation.

Humans↗
PubMed1986

Treatment of multiple superficial transitional cell carcinoma of the bladder with intravesical yttrium-90.

Thirty-eight patients with extensive multiple superficial transitional cell carcinoma of the bladder which could not be controlled endoscopically were treated with intravesical yttrium-90. Nineteen are alive at between 1 and 9 years. Short-term control of the disease was achieved in most patients. In those followed up for at least 3 years, 48% remained alive and well and 36% avoided cystectomy or other major treatment.

Adult↗
PubMed1983

A comparison of fine-bore suprapubic and an intermittent urethral catheterisation regime after spinal cord injury.

A prospective trial, comparing fine-bore suprapubic catheterisation and intermittent urethral catheterisation as methods of bladder drainage in the acute stage following spinal cord injury, was conducted. The results showed no important difference in either method of bladder management. Fine-bore suprapubic catheterisation is particularly suitable for young female patients, who find repeated urethral catheterisation distasteful; in other patients it is an acceptable alternative to intermittent urethral catheterisation, particularly where economic considerations are paramount.

Adolescent↗
PubMed1983

The accuracy of a hand-held real time ultrasound scanner for estimating bladder volume.

In a prospective study using a portable real time ultrasound scanner, 82 estimations of the bladder volume were made in male patients with neurogenic bladder and these were compared in each case with the measured volume of urine obtained by catheterisation performed immediately after estimation. A further 25 estimations/measurements were made in patients in whom the bladder volume was less than 150 ml. Both studies showed that the scanner offered a reproducible and safe alternative to catheterisation for estimating bladder volumes. The accuracy is sufficient for most clinical purposes.

Humans↗