The Journal of urology
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The Journal of urology · Oct 2006
Randomized Controlled TrialCombination of oral tramadol, acetaminophen and 1% lidocaine induced periprostatic nerve block for pain control during transrectal ultrasound guided biopsy of the prostate: a prospective, randomized, controlled trial.
Prostate biopsy for diagnosing cancer can be painful. Tramadol is a centrally acting analgesic used to treat many pain disorders. We determined whether administering oral tramadol and acetaminophen combined with 1% lidocaine induced periprostatic nerve block would significantly decrease the pain experienced by patients during standard 10-core transrectal ultrasound guided needle biopsy of the prostate. ⋯ Administering 75 mg tramadol/650 mg acetaminophen orally with periprostatic 1% lidocaine before transrectal ultrasound guided prostate biopsy is a safe, easy and effective method of controlling pain during the biopsy procedure.
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The Journal of urology · Oct 2006
Randomized Controlled TrialLaparoscopic decision making: impact of preoperative reading and laparoscopic experience.
A competent laparoscopic surgeon requires good technical skills and good surgical judgment. The assessment of technical skills using bench models and simulators has been well studied. However, there has been a paucity of studies examining the cognitive aspects of surgery. We developed a novel tool to assess the procedural knowledge and higher level decision making required for successful laparoscopic nephrectomy. We assessed the effect of laparoscopic experience and the effect of self-preparation or preoperative reading on surgical decision making abilities using a novel assessment tool and methodology. ⋯ Overall preoperative reading did not improve the surgical decision making rating scale. Novice procedural knowledge benefited from preoperative reading but not surgical judgment. The surgical decision making rating scale appears promising and it may have future implications for assessing surgical competency.
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The Journal of urology · Oct 2006
Central obesity is an independent predictor of erectile dysfunction in older men.
There is a growing body of evidence in the literature correlating erectile dysfunction to obesity. We investigated the correlation of different anthropometric indexes of central obesity to erectile dysfunction. ⋯ This study suggests that central obesity, assessed by several anthropometric indicators, is associated to the presence of erectile dysfunction in men older than 60 years. Sagittal abdominal diameter, sagittal abdominal diameter-height index, maximum abdominal circumference, waist circumference and waist-hip index were useful indicators to predict the presence of erectile dysfunction.
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The Journal of urology · Oct 2006
Association between the dihydrotestosterone level in the prostate and prostate cancer aggressiveness using the Gleason score.
To our knowledge the association between dihydrotestosterone in the prostate and prostate cancer aggressiveness has not yet been elucidated. We analyzed dihydrotestosterone levels in the prostate and Gleason score in patients diagnosed with clinically localized prostate cancer. ⋯ Patients with Gleason score 7 to 10 prostate cancer have low dihydrotestosterone in the prostate, although there were no significant differences between patients with Gleason score 7 to 10 vs 6 or less prostate cancer with respect to serum androgens. Low dihydrotestosterone in cases of aggressive prostate cancer is probably sufficient to activate androgen receptor expression and propagate tumor growth.