Urology
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Comparative Study
Prostate-specific antigen change in the European Randomized Study of Screening for Prostate Cancer, section Rotterdam.
To determine the prostate-specific antigen (PSA) velocity, PSA slope, and PSA doubling time (PSADT) in men with positive biopsies, negative biopsies, and no biopsy indications 4 years after an initial screening; and to use this information to improve the test characteristics in the early detection of prostate cancer and provide normal values for these parameters in screened men with and without evidence of prostate cancer. ⋯ The mean values of PSA velocity, PSA slope, and PSADT in a rescreened population differed significantly between men with and without prostate cancer. However, in predicting the biopsy outcome, the PSA dynamics were of limited value.
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Clinical Trial
Effect of testosterone supplementation on sexual function in hypogonadal men with erectile dysfunction.
To evaluate the impact of normalization of testosterone levels in men with documented hypogonadism and erectile dysfunction on erectile function and sexual satisfaction. Although the data support the role of testosterone in the preservation of libido and nocturnal erectile function, the evidence supporting the use of testosterone supplementation in hypogonadal men with erectile dysfunction is weak. ⋯ In men with documented hypogonadism and erectile dysfunction, normalization of serum testosterone levels was associated with only short-term improvement in erectile function and sexual satisfaction. The use of testosterone supplementation in this population for the treatment of erectile dysfunction is questionable.
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To review our technique and experience with laparoscopic radical nephrectomy (LRN) in the obese patient population. Obesity has been considered a potential risk factor for poor outcomes in a variety of surgical procedures and has been considered a relative contraindication to laparoscopy. Since 1996, with increased experience and technical modifications, obesity has not been considered a contraindication for laparoscopy at our institution. ⋯ With minor technical modifications, LRN can be safely performed in obese patients. Proper trocar site selection and greater insufflation pressures were critical for success. The differences in the intraoperative and postoperative course of LRN in obese and nonobese patients were not statistically significant. Obesity should not be considered a contraindication to laparoscopic nephrectomy.
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Comparative Study
Analysis of biochemical bone markers as prognostic factors for survival in patients with hormone-resistant prostate cancer and bone metastases.
To investigate the prognostic value of some conventional bone markers and a number of other factors in terms of the survival of patients with hormone-resistant prostate cancer and bone metastases treated with chemotherapy. ⋯ The results of this study suggest that bone-alkaline phosphatase, type I collagen propeptide, the carboxyterminal telopeptide of type I collagen, and the urinary calcium/creatinine ratio are not prognostic of survival in patients with hormone-resistant prostate cancer and bone metastases treated with chemotherapy.
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To describe and demonstrate the use and benefit of robotic-assisted laparoscopic sacrocolpopexy in the treatment of posthysterectomy vaginal vault prolapse. ⋯ A total of 5 women have undergone this procedure, 3 with concomitant pubovaginal sling placement. All 5 women were discharged after 24 hours. No complications from the sacrocolpopexy were reported; however, 1 patient experienced transient vaginal bleeding related to the pubovaginal portion of the case. No recurrent anterior, posterior, or apical prolapse has occurred at mean of 4 months of follow-up. Using a robotic system for laparoscopic sacrocolpopexy facilitated precise intracorporeal suture placement so that the procedure could be done in a fashion similar to that of the open method. Robotic-assisted laparoscopic sacrocolpopexy may provide the same long-term durability of open sacrocolpopexy with the benefit of a minimally invasive approach.