The Journal of urology
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The Journal of urology · Sep 2005
Randomized Controlled Trial Clinical TrialClonidine increases duration of bupivacaine caudal analgesia for ureteroneocystostomy: a double-blind prospective trial.
We evaluated whether clonidine, when added to bupivacaine, would significantly prolong caudal analgesia and decrease opioid requirements in children undergoing ureteroneocystostomy. ⋯ The addition of clonidine to bupivacaine significantly increases the duration of caudal analgesia and decreases postoperative morphine requirements in children undergoing ureteroneocystostomy.
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The Journal of urology · Sep 2005
Comparative StudyA new model using number of needles and androgen deprivation to predict chronic urinary toxicity for high or low dose rate prostate brachytherapy.
Prostate brachytherapy is an established treatment modality in early stage prostate cancer. We retrospectively reviewed our experience with low dose rate (LDR) and high dose rate (HDR) brachytherapy as a single treatment modality for early prostate cancer with emphasis on chronic toxicity. ⋯ HDR and LDR chronic urinary toxicity grade 2 or greater rates were equivalent. However, grade 1 was lower for HDR. The impotence rate was decrease by half with HDR. Neoadjuvant hormonal therapy and 14 or greater needles were significantly associated with increased chronic urinary toxicity on multivariate analysis.
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The Journal of urology · Sep 2005
Randomized Controlled Trial Comparative Study Clinical TrialA double-blind, placebo controlled comparison of the morphine sparing effect of oral rofecoxib and diclofenac for acute renal colic.
We compared the morphine sparing effect of a single dose of 50 mg oral rofecoxib, 3, 8-hourly doses of 50 mg diclofenac and placebo for acute renal colic. ⋯ No clinically relevant morphine sparing effect was seen in patients with renal colic treated with 50 mg oral diclofenac every 8 hours or a single dose of 50 mg rofecoxib as a representative of the specific inhibitors of cyclooxygenase-2.
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The Journal of urology · Sep 2005
Comparative Study Clinical TrialRobotic assisted laparoscopic radical prostatectomy versus retropubic radical prostatectomy: a prospective assessment of postoperative pain.
Laparoscopic prostatectomy, whether or not coupled with robotic assistance, is often considered less invasive than open radical retropubic prostatectomy (RRP). Minimal postoperative pain has been reported following robot assisted laparoscopic prostatectomy (RALP) but there have been few comparative studies with RRP. We compared perioperative narcotic use and patient reported pain in a prospective patient series. ⋯ Perioperative narcotic use and patient reported pain are low regardless of the surgical approach used for radical prostatectomy. RALP did not provide a clinically meaningful decrease in pain compared with RRP, primarily because of the low pain scores reported in each group. Outcomes other than pain will ultimately determine the role of laparoscopic radical prostatectomy and RALP.