Urology
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Randomized Controlled Trial
Diclofenac suppository administration in conjunction with lidocaine gel during transrectal ultrasound-guided prostate biopsy: prospective, randomized, placebo-controlled study.
To evaluate the additional analgesic efficacy of the rectal administration of diclofenac suppository compared with placebo in patients undergoing transrectal ultrasound-guided prostate biopsy. ⋯ Intrarectal diclofenac suppository administration is a simple, safe, and effective procedure to reduce pain and improve patients' tolerance of transrectal ultrasound-guided prostate biopsy. We recommend intrarectal diclofenac suppository administration, together with intrarectally administered lidocaine gel, in men undergoing transrectal ultrasound-guided prostate biopsy.
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Randomized Controlled Trial Clinical Trial
Efficacy of continuous local anesthetic infusion for postoperative pain after radical retropubic prostatectomy.
To determine whether a subfascial continuous infusion of local anesthetic in patients undergoing radical retropubic prostatectomy would result in a reduction in postoperative opioid requirements and an improvement in pain scores. ⋯ Continuous subfascial infusion of local anesthetic did not result in a postoperative reduction in opioid requirements or an improvement in pain scores in patients undergoing radical retropubic prostatectomy.
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Transitional cell carcinoma (TCC) of the bladder in children is a rare occurrence. Cyclophosphamide is a known risk factor for the development of TCC. ⋯ The role of radiotherapy in the development of secondary malignancies of the bladder remains controversial. We report a case of childhood TCC in a patient in remission from Hodgkin's lymphoma previously treated with non-cyclophosphamide chemotherapy and low-dose nodal radiotherapy.
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To evaluate, in a pilot study, the tumor control outcomes of our approach and define the pretreatment characteristics that predict a response to therapy. Patients with advanced clinically localized prostate cancer have a high likelihood of prostate-specific antigen (PSA) failure 3 to 5 years after initial treatment. We adopted trimodality therapy (neoadjuvant and adjuvant androgen ablation, external beam radiotherapy [RT], and a brachytherapy boost) to augment biochemical disease-free survival in this patient population. ⋯ Trimodality RT offers excellent tumor control in patients with poor prognosis who often relapse early. Longer follow-up will be important to determine whether these results are durable over time.
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To determine whether prostate-specific antigen (PSA) velocity (PSAV), used as a selection criterion for salvage radiotherapy (RT) after radical prostatectomy (RP), predicts the likelihood of response to RT in men with biochemical relapse. ⋯ In the present study, PSAV accurately predicted the likelihood of response to salvage RT in men with biochemical relapse after RP. No other pathologic parameters predicted the likelihood of response to RT. Using PSAV as a sole selection criterion for salvage RT after RP may allow improvement in the historically low rates of durable response.