Urology
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Randomized Controlled Trial Comparative Study
A prospective randomized study comparing shock wave lithotripsy and semirigid ureteroscopy for the management of proximal ureteral calculi.
To conduct a prospective randomized study comparing both techniques for the management of solitary radio-opaque upper ureteral stones < 2 cm in diameter. The ideal treatment for upper ureteral stones > 1 cm size remains to be determined with shock wave lithotripsy (SWL) and ureteroscopy (URS) being acceptable options. ⋯ URS with intracorporeal lithotripsy is an acceptable treatment modality for all proximal ureteral calculi, particularly stones > 1 cm. SWL should remain the first-line therapy for proximal ureteral calculi < or = 1 cm because of the less invasive nature and lower anesthesia (i.v. sedation).
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To determine the incidence of sepsis following transrectal ultrasound (TRUS)-guided prostate biopsy at our center. ⋯ Prophylactic ciprofloxacin is still a useful option for the prevention of urosepsis after TRUS biopsy, as the incidence is relatively low. For the patient who develops urosepsis after TRUS biopsy, ciprofloxacin resistance needs to be suspected and the treatment regime should be tailored to the resistance profiles of the local region, the patient's medical history, and the culture and sensitivity reports.
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To report our initial experience with laparoendoscopic single-site (LESS) surgery in 100 patients in urology. ⋯ The LESS surgery is technically feasible for a variety of ablative and reconstructive applications in urology. With proper patient selection, conversion and complications rates are low. Improvement in instrumentation and technology is likely to expand the role of LESS in minimally invasive urology.
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Angiomyolipoma is a benign renal tumor that tends to grow with time and can be associated with complications, such as hemorrhage and pain, requiring active intervention. Nephron-sparing surgery for sporadic renal angiomyolipomas offers preservation of renal function and is associated with acceptable complication and recurrence rates. Preoperative embolization of the large tumors is recommended to avoid excess blood loss during surgery. We report a case of giant renal angiomyolipoma treated with preoperative embolization, followed by partial nephrectomy without complications.