The Journal of urology
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The Journal of urology · Jun 2007
An assessment of quality of life following radical prostatectomy, high dose external beam radiation therapy and brachytherapy iodine implantation as monotherapies for localized prostate cancer.
Monotherapy with radical prostatectomy, high dose external beam radiotherapy or a (125)I implant is reported to produce equivalent outcomes. We assessed the health related quality of life associated with these 3 treatment approaches. ⋯ Of patients with prostate cancer treated with a monotherapy approach we noted better urinary continence in those who underwent radiation based therapies, and better bowel function and less urinary irritation in those who underwent surgery. Sexual function was impaired across all monotherapies but higher scores were seen in men who selected brachytherapy.
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The Journal of urology · Jun 2007
Bilateral caudal epidural neuromodulation for refractory urinary retention: a salvage procedure.
Sacral neuromodulation with InterStim is approved for idiopathic urinary retention with a success rate of approximately 69%. To our knowledge currently no alternatives exist for patients in whom S3 neuromodulation fails. We report a new technique and our experience with bilateral caudal epidural neuromodulation in patients in urinary retention in whom unilateral or bilateral S3 InterStim failed. ⋯ To our knowledge this is the first report of the use of bilateral caudal epidural neuromodulation for refractory urinary retention. This therapy can be successful in patients in whom prior InterStim therapy failed.
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The Journal of urology · Jun 2007
Selective, concurrent bilateral nephrectomies at renal transplantation for autosomal dominant polycystic kidney disease.
An algorithm was developed for performing bilateral nephrectomies for specific indications before or at renal transplantation in patients with autosomal dominant polycystic kidney disease. Outcomes for the living donor arm of the algorithm are reported. ⋯ Selective bilateral nephrectomies at living donor renal transplantation results in decreased total length of stay without compromising patient or graft outcomes and it allows preemptive renal transplantation. Concurrent nephrectomy is safe and it further validates the algorithm for selective, concurrent bilateral nephrectomies for patients with autosomal dominant polycystic kidney disease who undergo living donor renal transplantation.
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The Journal of urology · Jun 2007
Randomized Controlled TrialReduction of renal stone risk by potassium-magnesium citrate during 5 weeks of bed rest.
Exposure to the microgravity environment of space increases the risk of kidney stone formation, particularly for calcium oxalate and uric acid stones. This study was performed to evaluate the efficacy of potassium alkali as potassium-magnesium citrate in reducing renal stone risk and bone turnover. ⋯ Provision of alkali as potassium-magnesium citrate is an effective countermeasure for the increased risk of renal stone disease associated with immobilization. Despite an increase in urine calcium concentration, the relative saturation of calcium oxalate decreased due to citrate chelation of calcium and the concentration of undissociated uric acid decreased due to the significant increase in urine pH.
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The Journal of urology · Jun 2007
Randomized Controlled TrialEfficacy of botulinum toxin-A for treating idiopathic detrusor overactivity: results from a single center, randomized, double-blind, placebo controlled trial.
We evaluated the use of botulinum toxin-A in treating patients with idiopathic detrusor overactivity refractory to anticholinergics. ⋯ Botulinum toxin-A at 200 U is safe and effective for idiopathic detrusor overactivity and the beneficial effects persist for at least 24 weeks.