Scientific basis of urology

531 Pages·1999·0.45 MB·English

by  Anthony R. Mundy

Scientific Basis
of Urology

Scientific Basis
of Urology
Edited by
Anthony R. Mundy
Professor of Urology, Institute of Urology and Nephrology,
London, UK
John M. Fitzpatrick
Professor of Surgery, Surgical Professorial Unit,
University College Dublin, Ireland
David E. Neal
Professor of Surgery, Department of Surgery, School of Surgical and Reproductive Sciences,
University of Newcastle upon Tyne, UK
Nicholas J. R. George
Consultant Urologist, Withington Hospital, Manchester, UK
I S IS
MEDICAL
M E D IA
© 1999 by Isis Medical Media Ltd.
59 St. Aldates
Oxford OX1 1ST, UK
First published 1999
All rights reserved. No part of this publication
may be reproduced, stored in a retrieval system,
or transmitted in any form or by any means, electronic,
mechanical, photocopying, recording or otherwise
without the prior permission of the copyright owner.
The Authors have asserted their right under the
Copyright, Designs and Patents Act, 1988,
to be identified as the Authors of this work.
British Library Cataloguing in Publication Data.
A catalogue record for this title is available from
the British Library.
ISBN 1 899066 21 7
Mundy, A. R. (Anthony)
Scientific Basis of Urology
Anthony R. Mundy, John M. Fitzpatrick, David E. Neal and Nicholas J. R. George (eds)
Always refer to the manufacturer's Prescribing
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Contents
List of contributors vii
Preface ix
1. An introduction to cell biology 1
A. R. Mundy
2. The cell and cell division 29
D. E. Neal
3. The nature of renal function 53
G. B. Haycock
4. Structure and function of the upper urinary tract in health and disease 91
J. M. Fitzpatrick and P. G. Horgan
5. Upper urinary tract obstruction 113
L. S. Young, N. J. Hegarty and J. M. Fitzpatrick
6. Interactive obstructive uropathy: observations and conclusions
from studies on humans 125
N. J. R. George
7. Urinary tract infection 143
N. J. R. George
8. The scientific basis of calcium oxalate stone formation 175
R. L. Ryall
9. Acute renal failure 193
G. H. Neild
10. Chronic renal failure 205
G. H. Neild
11. Structure and function of the lower urinary tract 217
A. R. Mundy
12. Male sexual function 243
J. P. Pryor
13. The prostate and benign prostatic hyperplasia 257
M. Emberton and A. R. Mundy
14. Energy sources in urology 277
Τ. H. Lynch and J. M. Fitzpatrick
vi Contents
15. Urological instrumentation 295
J. P. Blandy
16. Cancer, tumour suppressor genes and oncogenes 301
D. E. Neal
17. The molecular genetics of renal cell carcinoma 319
S. C. Clifford and E. R. Maher
18. Transitional cell carcinoma of the bladder 343
T. R. L. Griffiths and D. E. Neal
19. Prostate cancer 355
F. C. Hamdy, Μ. I. Johnson and C. N. Robson
20. Testis cancer 375
M. C. Parkinson and S. J. Harland
21. Principles of radiotherapy 395
G. M. Duchesne
22. Embryology 407
D. F. M. Thomas
23. Intersex 421
M. O. Savage and C. Sultan
24. Immunology 439
A. C. Cunningham and J. A. Kirby
25. Tissue transfer in urology 453
S. N. Venn and A. R. Mundy
26. Screening 465
N. J. R. George
27. The design, construction and interpretation of clinical trials 483
J. A. Morris
28. Evidence-based medicine for urologists 493
M. Emberton
Index 505
List of contributors
John P. Blandy Surgery, The Medical School, University of Newcastle,
Emeritus Professor of Urology, University of London at Newcastle-upon-Tyne NE2 4HH, UK
the Royal London Hospital; Consulting Surgeon to St.
Stephen J. Harland
Peter's Hospital, London, UK
Senior Lecturer in Medical Oncology, Institute of
Steven C. Clifford Urology and Nephrology, University College London,
Department of Pathology, University of Cambridge, UK
Tennis Court Road, Cambridge CB2 1QP, UK and
George B. Haycock
Division of Medical and Molecular Genetics,
Professor of Paediatrics, Department of Paediatrics,
Department of Paediatrics and Child Health, University
Guy's Hospital, St. Thomas Street, London SE1 9RT,
of Birmingham Medical School, Edgbaston,
UK
Birmingham B15 2TT, UK
Nicholas J. Hegarty
Anne C. Cunningham
Surgical Professorial Unit, University College Dublin,
Senior Lecturer in Immunology, School of Health
47 Eccles Street, Dublin 7, Ireland
Sciences, University of Sunderland, Wharncliffe Street,
Sunderland SR2 3SD, UK
Paul G. Horgan
Gillian M. Duchesne Lecturer in Surgery, University College Dublin,
Associate Professor, Radiation Oncology, Peter 47 Eccles Street, Dublin 7, Ireland
MacCallum Cancer Institute, Locked Bag 1, A'Beckett
Mark I. Johnson
Street, Melbourne, Victoria 8006, Australia
Department of Surgery, School of Surgical Sciences,
Mark Emberton The Medical School, University of Newcastle,
Senior Lecturer in Oncological Urology and Honorary Newcastle-upon-Tyne NE2 4HH, UK
Consultant Urologist, Institute of Urology and
John A. Kirby
Nephrology, 48 Riding House Street, London W1N 7PN,
Senior Lecturer in Transplant Immunology,
UK
Department of Surgery, The Medical School,
John M. Fitzpatrick University of Newcastle, Newcastle-upon-Tyne
Professor of Surgery, University College Dublin, NE2 4HH, UK
Surgical Professorial Unit, 47 Eccles Street, Dublin 7,
T. R. Leyshon Griffiths
Ireland
Department of Surgery, School of Surgical Sciences,
Nicholas J. R. George The Medical School, University of Νewcastle,
Senior Lecturer/Consultant Urologist, University Newcastle-upon-Tyne NE2 4HH, UK
Hospital of South Manchester, Withington Hospital,
Thomas H. Lynch
West Didsbury, Manchester M20 2LR, UK
Senior Registrar in Urology, Mater Misericordiae
Freddie C. Hamdy Hospital and University College Dublin,
Senior Lecturer in Urological Surgery, Department of 47 Eccles Street, Dublin, Ireland
vi ii Scientific Basis of Urology
Eamonn R. Maher Craig N. Robson
Department of Pathology, University of Cambridge, Lecturer in Urological Sciences, Department of Surgery,
Tennis Court Road, Cambridge CB2 1QP, UK and School of Surgical Sciences, The Medical School,
Division of Medical and Molecular Genetics, University of Newcastle, Newcastle-upon-Tyne NE2
Department of Paediatrics and Child Health, University 4HH, UK
of Birmingham Medical School, Edgbaston, Birmingham
Rosemary L. Ryall
B15 2TT, UK
Professor of Urological Research and Chief Medical
Julie A. Morris Scientist, Department of Surgery, Flinders Medical
Senior Medical Statistician, Department of Medical Centre, Bedford Park, SA 5042, Australia
Statistics, University Hospital of South Manchester,
Martin O. Savage
Withington Hospital, Nell Lane, Manchester M20 8LR,
Professor of Paediatric Endocrinology, St. Bartholomew's
UK
Hospital, West Smithfield, London EC1A 7BE, UK
Anthony R. Mundy
C. Sultan
Professor of Urology, Institute of Urology and
Professor of Paediatric Endocrinology,
Nephrology, 48 Riding House Street, London W1P 7PN,
Endocrinologie/Gynécologie Pédiatrique, Service de
UK
Pediatric lHôpital A. de Villeneuve, 34259 Montpellier,
David E. Neal France
Department of Surgery, School of Surgical Sciences, The
David Ε Μ. Thomas
Medical School, University of Newcastle, Newcastle-
Consultant Paediatric Urologist, Department of
upon-Tyne NE2 4HH, UK
Paediatric Surgery, Clinical Sciences Building, St. James's
Guy H. Neild University Hospital and General Infirmary, Leeds
Professor of Nephrology, Institute of Urology and LS9 7TF, UK
Nephrology, Middlesex Hospital, Mortimer Street,
Suzanne N. Venn
London W1N 8 A A, UK
Institute of Urology and Nephrology, 48 Riding House
M. Constance Parkinson Street, London W1N 7PN, UK
Consultant Histopathologist, University College London
Leonie S. Young
Hospitals Trust and Institute of Urology U.C.L.,
Surgical Professorial Unit, University College Dublin,
Rockefeller Building, University Street, London WC1E
47 Eccles Street, Dublin 7, Ireland
6JJ, UK
John P. Pryor
Consultant Uroandrologist, The Lister Hospital, Chelsea
Bridge Road, London SW1 8RH, UK and Reader,
Institute of Urology and Nephrology, Middlesex
Hospital, University College London, UK
Preface
For even the most junior urological trainee learning of the chapters in this book do not match closely with
the basic medical sciences is all but a distant memory. the titles of the lectures on the course. This is because
Since then the sciences have changed as knowledge has we have tried to make the scientific material more
advanced and whole new disciplines have developed. clinically relevant with a wider audience in mind. In
The focus of a urological trainee is, in any case, fun- this way we hope to make this book interesting to all
damentally different from a student just beginning his practising urologists, although we should stress that
or her medical education who must have a grounding although many of the chapters address specific disease
in order to be equipped to comprehend the whole conditions the authors cover only the scientific
field of medicine and surgery in the ensuing few years aspects. Details of diagnosis and treatment will have
of undergraduate medical training. So, even discount- to be sought elsewhere. Equally, this book does not
ing all that a trainee urologist has forgotten, there is a aim to be comprehensive. We have tried to keep it to
great deal of new knowledge to acquire and a specifi- a size that a reader, with an average attention span,
cally urological perspective from which to view that might expect to read in its entirety rather than let the
knowledge. book expand to a size that would confine it to a dusty
Five years ago the Editors were asked to organise shelf. Indeed some of the more basic 'basic sciences'
an annual course on 'The Scientific Basis of Urology'. have been skated over to a degree that the purist might
The aim was to address basic science in urology from find objectionable. We have aimed the text, however,
just this perspective and to take account of the recent at the specifically urological audience who, we think,
changes in the scope and format of medical and surgi- wants to be able to understand these particular topics
cal undergraduate and postgraduate examinations, as a without necessarily acquiring any great depth of
result of which the student and subsequently the knowledge. Hence, also, the use of recommended
trainee is no longer expected to have such a detailed reading lists in such chapters rather than the more tra-
knowledge of these subjects as used to be expected. ditional list of references.
This annual course is sponsored by the British The Editors have all learnt a great deal from the
Association of Urological Surgeons and the British exercise of preparing the annual courses and now
Journal of Urology and is regarded nowadays as manda- from the preparation of this book. For those who
tory for all urological trainees during the first two have attended the courses and have nagged us (inces-
years of training. It is evidence of how highly we santly) for the book during its preparation - here it is,
regard the importance of a grounding in basic science and thank you for giving us the opportunity to benefit
for training in clinical urology. from the whole teaching process as well.
This book arose from the course, although some of
the authors have not taught on the course, some of A. R. Mundy
the course teachers are not authors here, and the titles London, 22nd December, 1998