An increase in serum glycine was associated with TUR syndrome; there were large variations in the amounts of glycine absorbed, reaching levels many times the upper limit of normal. In other studies, glycine was reportedly toxic, and that the levels recorded were many times the upper limit of normal may have both immediate and long-term effects.

Transurethral prostate resection has an effect on the myocardium perioperatively. Glycine absorption causes echocardiogram changes and it is associated with increased troponin I. Increasing patient age and blood loss are associated with myocardial insult. The risk of increased blood loss was accumulative with each unit lost. Unrecognized blood loss or glycine absorption may explain the increase in morbidity and mortality previously reported in patients who undergo transurethral prostate resection.

Objective  To evaluate the specificity and sensitivity of the Bard bladder tumour antigen (BTA) (Bard Inc, Covington, USA) test. Patients and methods  The performance of the BTA test was assessed prospectively in 98 patients (30 women and 68 men, mean age 64 years, median 67, sd 14.8) undergoing cystoscopy for various indications. The urine of the patients was assessed using the BTA test, cytology, culture and a dipstick test for haematuria, and the results compared with those from cystoscopy as the ‘standard’. Results  The overall specificity for the BTA test was 79% and the sensitivity 37%. The sensitivity was higher than for urine cytology (33%) but less than for the dipstick test (59%). The specificity was less than for cytology (100%) but higher than for the dipstick test (66%). Conclusion  The BTA test is a rapid, non‐invasive qualitative test identifying degradation products of the basement membrane of the transitional cell epithelium. It represents an advance in the search for a ‘tumour marker’ for carcinoma of the bladder. The specificity is acceptable but the sensitivity relatively low, which limits its value in everyday practice. Further research and development are needed to improve sensitivity.

Interstitial cystitis (IC) is characterised by recurrent inflammation and destruction of bladder tissue without obvious cause. To determine whether this self-perpetuating disease is the result of an autoimmune disorder, we studied 26 patients with IC of mean duration 5 years and compared the results with those of a control group of similar age and sex with other urological complaints. We performed a standard autoimmune profile and looked for specific antibodies to normal human bladder in the serum, using an indirect immunofluorescence technique. Deep bladder biopsies were examined by conventional histology and cryostat sections were studied with peroxidase-conjugated anti-human antibodies in a search for immunoglobulin deposition within the bladder. Seventeen of 26 patients with IC (65%) and 5 of 14 controls (36%) demonstrated non-organ-specific antibodies; 40% of those with IC had anti-nuclear antibodies; 18 IC patients (75%) and 4 of 10 controls (40%) had anti-bladder antibodies present in the serum, but 5 healthy volunteers showed no such antibody activity. There was no statistically significant difference between the two groups for either type of antibody (Fisher's exact test). Only 5 of 17 patients with IC (29%) showed immunoglobulin deposition in the bladder epithelium, a similar proportion to controls (38%); 4 of these 5 had circulating anti-bladder antibodies present in the serum. Although IC patients demonstrated a non-specific increase in antibody formation, this was not significantly different from a similar group of other urological patients. The lack of specificity makes this immunological response more likely to be a secondary phenomenon associated with inflammatory damage to the bladder rather than the primary cause of the disease.