In a retrospective study of 408 patients with Peyronie's disease 8 (1.9%) patients gave a positive family history for the condition. Sixty-three (15.4%) patients had a Dupuytren's contracture and trauma was considered to be an aetiological factor in 88 (21.5%) patients. One hundred and twenty-two (29.9%) patients had evidence of atherosclerosis and this is thought to be a factor in the pathogenesis of the disease. Peyronie's disease is not a single disease entity and is associated with many aetiological factors.

In a review of 1057 consecutive prostatectomies of which 95% were performed transurethrally, carcinoma was present in 11.8%. There were 10 deaths within a month of operation (0.9%), 9 of these patients having been exceptionally old and unfit. The rate of complications and the end results appear to justify using transurethral resection as the method of choice for prostatectomy whenever it is feasible.

Abstract. We propose a compositional specification theory for reasoning about components that interact by synchronisation of input and output (I/O) actions, in which the specification of a component constrains the temporal ordering of interactions with the environment. Such a theory is motivated by the need to support composability of components, in addition to modelling environmental assumptions, and reasoning about run-time behaviour. Models can be specified operationally by means of I/O labelled transition systems augmented by an inconsistency predicate on states, or in a purely declarative manner by means of traces.We introduce a refinement preorder that supports safe-substitutivity of components. Our specification theory includes the operations of parallel composition for composing components at run-time, logical conjunction for independent development, and quotient for incremental development. We prove congruence properties of the operations and show correspondence between the operational and declarative frameworks.

This study concerns 2043 male partners of infertile marriages who underwent testicular biopsy in the 28 years from 1955 to 1982. In a review of the pathological material carcinoma in situ (CIS) was diagnosed in 8 men (0.39%). Six of these men were later found to have invasive germ cell tumours; one has remained tumour-free and one is lost to follow-up. The implication of these findings in relation to the selection of patients for biopsy and the treatment of CIS when diagnosed is discussed.

We formulate a compositional specification theory for interface automata, where a component model specifies the allowed sequences of input and output interactions with the environment. A trace-based linear-time refinement is provided, which is the weakest preorder preserving substitutivity of components, and is weaker than the classical alternating simulation defined on interface automata. Since our refinement allows a component to be refined by refusing to produce any output, we also define a refinement relation that guarantees safety and progress. The theory includes the operations of parallel composition to support the structural composition of components, logical conjunction and disjunction for independent development, hiding to support abstraction of interfaces, and quotient for incremental synthesis of components. Our component formulation highlights the algebraic properties of the specification theory for both refinement preorders, and is shown to be fully abstract with respect to observation of communication mismatches. Examples of independent and incremental component development are provided.

The introduction of optical urethrotomy by Sachse has reduced the need for urethroplasty: 261 urethroplasties were performed between 1964 and 1983, of which 87 were performed in one stage on patients who would today have undergone urethrotomy as the procedure of first choice. The results in this group are compared with those in 151 patients treated between 1978 and 1983 by 265 internal optical urethrotomies. At 5 years 50% of those treated by urethrotomy needed no further treatment, compared with 83% of those treated by urethroplasty. Nevertheless, the ease and safety of urethrotomy makes it the procedure of first choice, and urethoroplasty should be reserved either for cases where urethrotomy is unsuitable or where it has been tried on several occasions without success.

The dynamic component of bladder outflow obstruction due to benign prostatic hyperplasia (BPH) has been shown to be modified by alpha 1 adrenergic receptors. Terazosin is an alpha 1 receptor-blocking agent with a long half-life permitting once-daily dosing. This drug was administered in a multicentre, randomised, placebo-controlled trial involving patients with symptomatic bladder outflow obstruction. Of 132 patients recruited for the study, 86 were randomised to receive placebo or terazosin, 81 completed the study, and 80 were considered eligible for efficacy analysis. All terazosin treatment groups showed dramatic improvement in obstructive symptoms when compared with the placebo group, but these differences were not statistically significant because of the small numbers of patients in each group. There were improvements in peak urinary flow rates, mean urinary flow rates, and residual urine volumes for the placebo and terazosin groups, but there were no statistically significant differences in the changes between the groups. Terazosin was well tolerated by patients in this study and may provide symptomatic relief in patients with BPH.

The Stamey vesical neck suspension has a good early success rate but the results in the longer term are not acceptable. This operation should not be used as a first-line treatment for stress incontinence and should be reserved for specific patient subgroups.