The Journal of urology
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The Journal of urology · Jul 2007
Randomized Controlled TrialNitrous oxide inhalation to improve patient acceptance and reduce procedure related pain of flexible cystoscopy for men younger than 55 years.
Flexible cystoscopy in men younger than 55 years is painful despite the current best standard anesthesia (20 ml 2% lidocaine gel 15 minutes before endoscopy). The anesthetic value of lidocaine gel is debated and led us to seek an alternative. Nitrous oxide is a well established analgesic and anxiolytic agent, and it significantly reduces pain associated with transrectal ultrasound guided prostate biopsy. We studied its use in flexible cystoscopy in men younger than 55 years. ⋯ Nitrous oxide inhalation significantly reduces cystoscopy related pain without significant complications. We propose that Entonox should be the anesthetic agent of choice for men younger than 55 years.
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The Journal of urology · Jul 2007
Effect of prostate volume on tumor grade in patients undergoing radical prostatectomy in the era of extended prostatic biopsies.
We investigated the influence of prostate volume on biopsy and prostatectomy Gleason score, the incidence of upgrading and total tumor volume. ⋯ In the era of extended prostatic biopsies patients with a large prostate volume have a significantly higher incidence of well differentiated tumor at prostatectomy and a lower likelihood of tumor upgrading.
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The Journal of urology · Jul 2007
Randomized Controlled TrialAuricular acupressure as a treatment for anxiety before extracorporeal shock wave lithotripsy in the elderly.
Auricular acupuncture at the relaxation point has been shown to be effective treatment for anxiety. We hypothesized that auricular acupressure may decrease anxiety in elderly individuals who are transported by ambulance before receiving ESWL. ⋯ Elderly patients who received auricular acupressure at specific relaxation points while being transported to the hospital were less anxious, anticipated less pain and were more optimistic about the outcome of treatment that they will receive than the sham treated group. These data prove that this is an effective treatment for anxiety that improves the patient overall perception of ESWL.
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The Journal of urology · Jul 2007
Randomized Controlled TrialAnesthesia for laparoscopic donor nephrectomy: is nitrous oxide contraindicated?
We performed this study to test the hypothesis that nitrous oxide produces clinically significant bowel distention during laparoscopic abdominal surgery. ⋯ The use of N2O anesthetic causes bowel distention in 50% of abdominal laparoscopic donor nephrectomy operations. The distention was severe enough to interfere with the progress of surgery in 25% of cases and the use of N2O had to be discontinued.
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The Journal of urology · Jul 2007
Randomized Controlled TrialDoes the intrarectal instillation of lidocaine gel before periprostatic neurovascular bundle block during transrectal ultrasound guided prostate biopsies improve analgesic efficacy? A prospective, randomized trial.
We assessed the analgesic effect of additional intrarectal lidocaine gel instillation during transrectal ultrasound guided prostate biopsy and identified the procedural steps that benefit from lidocaine gel instillation. ⋯ Intrarectal lidocaine gel instillation before periprostatic neurovascular bundle block produces a significant additional analgesic effect during biopsy. The procedure is simple, safe and rapid, and it should be considered in all patients undergoing transrectal ultrasound guided prostate biopsy.