The ScienTific Mundy Fitzpatrick Neal BaSiS of Urology George The Third ediTion T ScienTific About the editors h e Anthony R. Mundy, MS, FRCP, FRCS Professor of Urology, Institute of Urology and Nephrology, University College S Hospital, London, UK c BaSiS of John M. Fitzpatrick, MCh, FRCSI, FRC(Urol), FRCSGlas, FRCS i Professor of Surgery, Surgical Professorial Unit, University College Dublin, Ireland e David E. Neal, FMed Sci, MS, FRCS n Urology Professor of Surgery, Department of Surgery, School of Surgical and Reproductive T Science, University of Cambridge, UK i f Nicholas J. R. George, MD, FRCS Consultant Urologist, Withington Hospital, and Senior Lecturer, Department of i c Urology, University Hospitals of South Manchester, UK B Third ediTion About the book a Each area, function, illness and treatment of the urinary tract – along with specific S discussions of the relevant anatomy and physiology – is included here in clearly i written text, illustrated with diagrams and color clinical photographs as relevant. S This third edition has been revised throughout, with entirely new material on genetic alterations in cancer, on hypogonadism, and on minimally invasive o Edited by technologies, amongst others. Urologists and andrologists in training and in practice will benefit from this clear summary of the scientific underpinnings to their subject. f Praise for previous editions U Anthony R. Mundy I would strongly recommend that all students, residents, and faculty r interested in the basic science of urology add this text to their collection o John M. Fitzpatrick and congratulate the editors and authors on this great work. l Urology o David E. Neal g y Nicholas J. R. George Third ediTion Telephone House, 69-77 Paul Street, London EC2A 4LQ, UK 52 Vanderbilt Avenue, New York, NY 10017, USA www.informahealthcare.com [Shaji][D:/informa_Publishing/Mundy_2400042/z_production/z_3B2_3D_files/978-1-8418-4679-8_CH0000_O.3d] [26/5/010/12:22:45][1–10] The Scientific Basis of Urology Third Edition Edited by Anthony R. Mundy, MS, FRCP, FRCS Professor of Urology, Institute of Urology and Nephrology, University College Hospital, London, UK John M. Fitzpatrick, MCh, FRCSI, FRC(Urol), FRCSGlas, FRCS Professor of Surgery, Surgical Professorial Unit, University College Dublin, Ireland David E. Neal, FMed Sci, MS, FRCS Professor of Surgery, Department of Surgery, School of Surgical and Reproductive Science, University of Cambridge, UK Nicholas J. R. George, MD, FRCS Consultant Urologist, Withington Hospital, and Senior Lecturer, Department of Urology, University Hospitals of South Manchester, UK [gajendra][D:/informa_Publishing/Mundy_2400042/z_production/z_3B2_3D_files/978-1-8418-4679- 8_CH0000_O.3d][2/6/010/21:14:2][1–10] Firstpublishedin1999byIsisMedicalMedia,Ltd,Oxford,UK Thiseditionpublishedin2010byInformaHealthcare,TelephoneHouse,69-77PaulStreet,LondonEC2A4LQ,UK. SimultaneouslypublishedintheUSAbyInformaHealthcare,52VanderbiltAvenue,7thfloor,NewYork,NY10017,USA. #2010InformaUKLtd,exceptasotherwiseindicated. NoclaimtooriginalU.S.Governmentworks. Reprintedmaterialisquotedwithpermission.Althougheveryefforthasbeenmadetoensurethatallownersofcopyrightmaterial have been acknowledged in this publication, we would be glad to acknowledge in subsequent reprints or editions any omissions broughttoourattention. 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Any information or guidance contained in this book is intended for use solely by medical professionals strictly as a supplement to the medical professional’s own judgement, knowledge of the patient’s medical history, relevant manufacturer’s instructionsandtheappropriatebestpracticeguidelines.Becauseoftherapidadvancesinmedicalscience,anyinformationoradvice ondosages,procedures,ordiagnosesshouldbeindependentlyverified.Thisbookdoesnotindicatewhetheraparticulartreatmentis appropriateorsuitableforaparticularindividual.Ultimatelyitisthesoleresponsibilityofthemedicalprofessionaltomakehisorher own professional judgements, so as appropriately to advise and treat patients. Save for death or personal injury caused by the publisher’snegligenceandtothefullestextentotherwisepermittedbylaw,neitherthepublishernoranypersonengagedoremployed bythepublishershallberesponsibleorliableforanyloss,injuryordamagecausedtoanypersonorpropertyarisinginanywayfrom theuseofthisbook. ACIPrecordforthisbookisavailablefromtheBritishLibrary. ISBN-13:978-1-84184-679-8 Ordersmaybesentto:InformaHealthcare,SheepenPlace,Colchester,EssexCO33LP,UK Telephone:+44(0)2070175540 Email:[email protected] Website:http://informahealthcarebooks.com/ Forcorporatesalespleasecontact:[email protected] Forforeignrightspleasecontact:[email protected] Forreprintpermissionspleasecontact:[email protected] TypesetbyMPSLimited,AMacmillanCompany PrintedandboundintheUnitedKingdom [Shaji][D:/informa_Publishing/Mundy_2400042/z_production/z_3B2_3D_files/978-1-8418-4679-8_CH0000_O.3d] [26/5/010/12:22:45][1–10] Preface It is 10 years since the first edition, and 5 years since the second edition of this book. We are pleased that there is demand for a third edition. Once again, we have included some new chapters, but more importantly, the whole book has beenrevisedtoreflectachangingunderstandingofthescientificbasisofurology over the last few years. When the editors—senior gentlemen all!—completed their training in urology and became consultants, there was a tacit assumption that our knowledge base would last us through for the rest of our careers. Now, instead of reckoning on a 25-year life expectancy for our knowledge base, it is probablynearer2.5years.Oneconsiderablebenefitfromeditingthisbookisthat the fourof us havemanaged to keep upto date,and we hope that other readers will benefit in the same way. We all believe that a sound scientific basis is essential for a good clinical practice and therefore hope that this book will be of interest to all urologists. Tony Mundy [Shaji][D:/informa_Publishing/Mundy_2400042/z_production/z_3B2_3D_files/978-1-8418-4679-8_CH0000_O.3d] [26/5/010/12:22:45][1–10] [vijay][D:/informa_Publishing/Mundy_2400042/z_production/z_3B2_3D_files/978-1-8418-4679-8_CH0000_O.3d][9/ 6/010/12:30:54][1–10] Contents Preface....iii Contributors....vii 1. Introduction to Cell Biology................................................. 1 Haley L. Bennett and Hing Leung 2. The Cell and Cell Division................................................. 11 David E. Neal 3. Inflammation................................................................. 34 Neville Woolf 4. Immunology.................................................................. 42 Anne C. Cunningham, Graeme O’Boyle, and John A. Kirby 5. The Nature of Renal Function.............................................. 57 George B. Haycock 6. Principles of Radiological Imaging of the Urinary Tract................. 83 Uday Patel and Miles Walkden 7. Upper Urinary Tract Obstruction.......................................... 103 Neil G. Docherty and John M. Fitzpatrick 8. Interactive Obstructive Uropathy: Observations and Conclusions from Studies on Humans .................................................. 113 Nicholas J. R. George 9. Urinary Tract Infection..................................................... 130 Nicholas J. R. George 10. The Scientific Basis of Urinary Stone Formation ........................ 162 William G. Robertson 11. Pathophysiology and Management of Shock............................. 182 Iain M. J. Mackenzie 12. Acute Renal Failure ........................................................ 203 Rona Smith and John R. Bradley 13. Chronic Renal Failure...................................................... 210 Sanjay Ojha and John R. Bradley 14. Structure and Function of the Lower Urinary Tract ..................... 221 Anthony R. Mundy 15. Physiological Properties of the Lower Urinary Tract .................... 244 Christopher H. Fry 16. Scientific Basis of Urodynamics........................................... 266 Michael Craggs and Sarah Knight 17. Scientific Basis of Male Hypogonadism.................................. 279 Thang S. Han and Pierre-Marc G. Bouloux [Shaji][D:/informa_Publishing/Mundy_2400042/z_production/z_3B2_3D_files/978-1-8418-4679-8_CH0000_O.3d] [28/5/010/11:21:15][1–10] vi Contents 18. Male Sexual Function ...................................................... 300 Giulio Garaffa, Suks Minhas, and David J. Ralph 19. The Prostate and Benign Prostatic Hyperplasia.......................... 316 Mark Feneley, Anthony R. Mundy, and Mark Emberton 20. Genetic and Biological Alterations in Cancer............................ 335 Vincent J. Gnanapragasam 21. General Biology of Cancer and Metastasis............................... 343 David E. Neal 22. Tumor Suppressor Genes and Oncogenes................................ 351 David E. Neal 23. The Molecular Genetics and Pathology of Renal Cell Carcinoma...... 360 Maxine G. B. Tran, Tim O’Brien, and Patrick H. Maxwell 24. Transitional Cell Carcinoma of the Bladder.............................. 374 T. R. Leyshon Griffiths and Nick Mayer 25. Prostate Cancer.............................................................. 386 Freddie C. Hamdy and Craig N. Robson 26. Testis Cancer................................................................ 403 Danish Mazhar and Michael Williams 27. Radiotherapy: Scientific Principles and Practical Application in Urogical Malignancies .................................................. 415 Angela Swampillai, Rachel Lewis, Mary McCormack, and Heather Payne 28. Principles of Systemic Cancer Therapy................................... 428 Christina Thirlwell, John Bridgewater, and Judith Cave 29. Embryology ................................................................. 438 David F. M. Thomas 30. Urological and Biochemical Aspects of Transplantation Biology....... 454 David Talbot and Naeem Soomro 31. Tissue Transfer in Urology ................................................ 462 Daniela E. Andrich and Anthony R. Mundy 32. Energy Sources in Urology................................................. 474 Andy Symes and Ken M. Anson 33. Instrumentation in Urology................................................ 492 Rashmi Singh and Ken M. Anson 34. Minimally Invasive Technologies in the Treatment of Renal and Prostate Cancer ........................................................ 506 Hashim U. Ahmed, Caroline Moore, Manit Arya, and Mark Emberton 35. Stratified Risk Assessment for Urological Surgery...................... 523 Thiru Gunendran, Nicholas A. Wisely, and Nicholas J. R. George 36. Screening in Urology....................................................... 542 Nicholas J. R. George 37. Evidence-Based Medicine.................................................. 560 Kieran J. O’Flynn Index....575 [Shaji][D:/informa_Publishing/Mundy_2400042/z_production/z_3B2_3D_files/978-1-8418-4679-8_CH0000_O.3d] [26/5/010/12:22:45][1–10] Contributors Hashim U. Ahmed Department of Urology, Division of Surgical and Interventional Sciences, University College London, London, U.K. Daniela E. Andrich Institute of Urology and Nephrology, University College Hospital, London, U.K. Ken M. Anson Department of Urology, St. George’s Hospital, London, U.K. Manit Arya Department of Urology, Division of Surgical and Interventional Sciences, University College London, London, U.K. Haley L. Bennett Beatson Institute for Cancer Research, Glasgow, U.K. Pierre-Marc G. Bouloux Department of Endocrinology, Royal Free and University College Hospital Medical School, Royal Free Hospital, London, U.K. John R. Bradley Cambridge University Hospitals NHS Foundation Trust, Cambridge, U.K. John Bridgewater University College London Cancer Institute, University College London Medical School, London, U.K. Judith Cave Southampton General Hospital, Southampton, U.K. Michael Craggs London Spinal Cord Injuries Centre, Royal National Orthopaedic Hospital, Stanmore, U.K. Anne C. Cunningham Faculty of Applied Sciences, University of Sunderland, Sunderland, U.K. Neil G. Docherty The Conway Institute, University College Dublin, Ireland MarkEmberton DepartmentofUrology,DivisionofSurgicalandInterventional Sciences, University College London, London, U.K. Mark Feneley Institute of Urology and Nephrology, University College Hospital, London, U.K. John M. Fitzpatrick Mater Misericordiae Hospital and University College Dublin, Ireland Christopher H. Fry Postgraduate Medical School, University of Surrey, Guildford, U.K. Giulio Garaffa Department of Urology, University College London Hospitals, London, U.K. NicholasJ.R.George DepartmentofUrology,WithingtonHospital,University Hospitals of South Manchester, Manchester, U.K. Vincent J. Gnanapragasam Uro-oncology Group, Department of Oncology, Hutchinson MRC Research Centre, University of Cambridge, Cambridge, U.K. T. R. Leyshon Griffiths Urology Group, Department of Cancer Studies and Molecular Medicine, University of Leicester, Leicester, U.K. [Shaji][D:/informa_Publishing/Mundy_2400042/z_production/z_3B2_3D_files/978-1-8418-4679-8_CH0000_O.3d] [26/5/010/12:22:45][1–10] viii Contributors Thiru Gunendran Department of Urology, University Hospital of South Manchester, Manchester, U.K. Freddie C. Hamdy Nuffield Department of Surgery, University of Oxford, Oxford, U.K. Thang S. Han Department of Endocrinology, Royal Free and University Col- lege Hospital Medical School, Royal Free Hospital, London, U.K. George B. Haycock Academic Department of Paediatrics, Guy’s Hospital, London, U.K. John A. Kirby Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne, U.K. SarahKnight LondonSpinalCordInjuriesCentre,RoyalNationalOrthopaedic Hospital, Stanmore, U.K. Hing Leung Beatson Institute for Cancer Research, Glasgow, U.K. Rachel Lewis Department of Oncology, University College Hospitals, London, U.K. Iain M. J. Mackenzie Departmentof Anaesthesia andCriticalCare,University Hospital Birmingham NHS Foundation Trust, Edgbaston, Birmingham, U.K. Patrick H. Maxwell Division of Medicine, University College Hospital, London, U.K. Nick Mayer University Hospitals of Leicester, Leicester, U.K. Danish Mazhar Department of Medical Oncology, Addenbrooke’s Hospital, Cambridge, U.K. Mary McCormack Department of Oncology, University College Hospitals, London, U.K. Suks Minhas Department of Urology, University College London Hospitals, London, U.K. Caroline Moore Department of Urology, Division of Surgical and Interventional Sciences, University College London, London, U.K. Anthony R. Mundy Institute of Urology and Nephrology, University College Hospital, London, U.K. David E. Neal Department of Oncology, University of Cambridge, Addenbrooke’s Hospital, Cambridge, U.K. Graeme O’Boyle Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne, U.K. TimO’Brien DepartmentofUrology,Guy’sandStThomas’Hospital,London, U.K. Kieran J. O’Flynn Department of Urology, Salford Royal Foundation Trust, Salford, Manchester, U.K. Sanjay Ojha Cambridge University Hospitals NHS Foundation Trust, Cambridge, U.K. Uday Patel St George’s Hospital and Medical School, London, U.K. Heather Payne Department of Oncology, University College Hospitals, London, U.K. [Shaji][D:/informa_Publishing/Mundy_2400042/z_production/z_3B2_3D_files/978-1-8418-4679-8_CH0000_O.3d] [26/5/010/12:22:45][1–10] Contributors ix David J. Ralph Department of Urology, University College London Hospitals, London, U.K. William G. Robertson Physiology Department, Royal Free and University College Medical School, London, U.K. Craig N. Robson Northern Institute for Cancer Research, The Medical School, University of Newcastle, Newcastle, U.K. Rashmi Singh Department of Urology, Kingston and St. George’s Hospital, London, U.K. Rona Smith Cambridge University Hospitals NHS Foundation Trust, Cambridge, U.K. Naeem Soomro Department of Urology, Freeman Hospital, Newcastle upon Tyne, U.K. Angela Swampillai Department of Oncology, University College Hospitals, London, U.K. Andy Symes Department of Urology, St George’s Hospital, London, U.K. David Talbot Department of Hepatobiliary and Transplant Surgery, Freeman Hospital, Newcastle upon Tyne, U.K. Christina Thirlwell University College London Cancer Institute, University College London Medical School, London, U.K. David F. M. Thomas Department of Paediatric Urology, St James’s University Hospital, Leeds, U.K. Maxine G. B. Tran Department of Urology, Addenbrooke’s Hospital, Cambridge, U.K. Miles Walkden University College Hospital, London, U.K. Michael Williams Department of Clinical Oncology, Addenbrooke’s Hospital, Cambridge, U.K. Nicholas A. Wisely Department of Anaesthesia, University Hospital of South Manchester, Manchester, U.K. Neville Woolf Medical School Administration, University College London, London, U.K.