International urology and nephrology
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Comparative Study
Percutaneous nephrostomy for ureteric obstruction due to advanced pelvic malignancy: have we got the balance right?
The optimal management of patients with ureteric obstruction in advanced pelvic malignancy is unclear. Effective judgment is required to decide which patients would benefit most from decompression of the urinary tract. The objective of our study was to assess survival and complication rates post-percutaneous nephrostomy (PCN) in patients with ureteric obstruction due to advanced pelvic malignancy. ⋯ Although effective in improving renal function, PCN is a procedure not without associated morbidity and does not always prolong survival. Therefore, the decision to decompress an obstructed kidney with advanced pelvic malignancy should not be taken lightly. We recommend that such cases be discussed in a multidisciplinary setting, and a decision is taken only after a full informed discussion involving patients and their relatives.
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Randomized Controlled Trial
Intracutaneous sterile water injection versus oral paracetamol for renal colic during pregnancy: a randomized controlled trial.
The aim of this study was to assess the analgesic efficacy of intracutaneous sterile water injection compared with oral paracetamol in pregnant women with acute renal colic caused by urolithiasis. ⋯ Intracutaneous injection of sterile water is an efficacious treatment for renal colic caused by urolithiasis in pregnant women. It was significantly superior to oral administration of paracetamol.
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Multicenter Study
Severe acute hypophosphatemia during renal replacement therapy adversely affects outcome of critically ill patients with acute kidney injury.
Hypophosphatemia during renal replacement therapy (RRT) is common in critically ill patients with acute kidney injury (AKI). The clinical consequences of RRT-induced phosphate depletion are not well defined in this patient population, and there is no evidence that intravenous sodium phosphate supplementation (PS) prevents the clinical sequelae of acute hypophosphatemia. The purpose of this retrospective analysis of the Acute Renal Support Registry of the University of Munich was to examine the association between severe hypophosphatemia and severity of and recovery from AKI. ⋯ This multicenter study indicates for the first time that hypophosphatemia during IHD adversely affects short- and long-term outcome of critically-ill patients with AKI. The clinical consequences of the acute hypophosphatemic syndrome may be prevented by PS.
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To compare the grade 3 genitourinary toxicity and oncological outcome for localized prostate cancer between high-dose-rate (HDR) brachytherapy and external beam radiation therapy (EBRT) alone in patients with previously undergone Transurethral resection of the prostate (TURP). ⋯ In patients with prostate cancer who have previously undergone TURP, we observed that HDR brachytherapy was able to control prostate cancer with fewer GU morbidities and oncological outcomes that were similar to those associated with traditional EBRT alone. Moreover, HDR brachytherapy led to a decrease in major GU toxicity and also preserved the sphincter function more than that in TURP patients who underwent EBRT alone.