Scandinavian journal of urology
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Randomized Controlled Trial
Less painful ESWL with ultrasound-guided quadratus lumborum block: a prospective randomized controlled study.
Objectives: Extracorporeal shock wave lithotripsy (ESWL) has been widely used for the treatment of urinary tract stones and is usually administered as an outpatient procedure, although the vast majority of patients do not tolerate it without sedoanalgesia. The quadratus lumborum block (QLB) is a newly-defined technique for abdominal surgery. The aim of this study was to evaluate the analgesic efficacy of ultrasound-guided QLB in ESWL. ⋯ The fragmentation success rate was significantly higher in Group QLB than in Group C (19/20 vs 14/20, respectively, p = 0.046). Patient satisfaction was also higher in Group QLB (p = 0.011). Conclusions: This study shows that QLB provided adequate analgesia for ESWL and that it reduced extra opioid consumption significantly compared to the control group.
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Randomized Controlled Trial
The effect of preoperative nefopam treatment on postoperative catheter-related bladder discomfort in patients undergoing transurethral bladder tumor resection: a randomized double-blind study.
Catheter-related bladder discomfort (C.R.B.D.) is a risk factor for emergence agitation and delirium in postoperative phase. It may be resistant to conventional analgesic therapy such as opioids. This study evaluated the role of preoperative treatment using intravenous 20 mg nefopam in reducing the incidence and severity of C.R.B.D. during the first postoperative 24 h after urinary catheterization when compared with placebo. ⋯ The preoperative administration of single-dose intravenous nefopam reduced the incidence and severity of C.R.B.D. in the early postoperative period in patients undergoing T.U.R.-B. under spinal anesthesia.
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Randomized Controlled Trial
Eighteen-year follow-up of the Göteborg Randomized Population-based Prostate Cancer Screening Trial: effect of sociodemographic variables on participation, prostate cancer incidence and mortality.
This study examined whether previously reported results, indicating that prostate-specific antigen (PSA) screening can reduce prostate cancer (PC) mortality regardless of sociodemographic inequality, could be corroborated in an 18 year follow-up. ⋯ These data corroborate previous findings that systematic PSA screening reduces PC mortality and suggest that systematic screening may reduce sociodemographic inequality in PC mortality.
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Randomized Controlled Trial Comparative Study
Seventeen-year follow-up of the prospective randomized Nordic CIS study: BCG monotherapy versus alternating therapy with mitomycin C and BCG in patients with carcinoma in situ of the urinary bladder.
The aim of this study was to compare the long-term efficacy of BCG monotherapy to alternating therapy of mitomycin C (MMC) and BCG in patients with carcinoma in situ (CIS). ⋯ BCG monotherapy including monthly maintenance was effective and better than the alternating therapy. The risk of dying from bladder carcinoma after progression was high.
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Randomized Controlled Trial
Efficacy of a multiprofessional rehabilitation programme in radical cystectomy pathways: a prospective randomized controlled trial.
Radical cystectomy with lymph-node dissection is a complex procedure and often followed by high postoperative morbidity and physical impairments leading to prolonged length of stay (LOS). Fast-track principles are standard procedure in radical cystectomy. Additional preoperative and postoperative physical exercises and enhanced mobilization may reduce LOS and early complications. ⋯ There was no reduction in LOS due to the preoperative and postoperative rehabilitation programme, although enhanced mobilization was achieved. The optimized minimal surgical procedure may have affected the ability to reduce LOS further with available techniques and procedures. Alternative parameters for recovery may offer more precise and relevant information.