The Journal of urology
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The Journal of urology · Aug 2007
Urethral instability and sacral nerve stimulation-a better parameter to predict efficacy?
Urodynamic parameters that predict the outcome of sacral nerve stimulation are difficult to define. We studied the predictive value of urethral instability and other urodynamic parameters on the efficacy of sacral nerve stimulation. ⋯ In this study urethral instability appeared to be a valuable urodynamic parameter for predicting the outcome of sacral nerve stimulation.
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The Journal of urology · Aug 2007
Randomized Controlled Trial Comparative StudyEffect of intraprostatic local anesthesia during transrectal ultrasound guided prostate biopsy: comparison of 3 methods in a randomized, double-blind, placebo controlled trial.
We evaluated the effect of intracapsular anesthesia and periprostatic nerve block during transrectal ultrasound guided prostate biopsy. ⋯ A combination of intracapsular anesthesia and periprostatic nerve block is an effective and useful technique that is well tolerated by the patient. It decreases the level of pain and discomfort associated with the prostatic biopsy procedure.
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The Journal of urology · Aug 2007
Randomized Controlled TrialEarly initiation of aspirin after prostate and transurethral bladder surgeries is not associated with increased incidence of postoperative bleeding: a prospective, randomized trial.
Lower urinary tract operations are being increasingly performed in elderly patients, in whom aspirin intake is common for preventing cardiovascular disease. We determined the safety of early aspirin re-initiation after lower urinary tract surgeries. ⋯ Early aspirin initiation after lower urinary tract surgeries does not appear to carry an increased risk of postoperative bleeding. Thus, it may be considered in patients at high risk for cardiovascular morbidity.
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The Journal of urology · Aug 2007
Comparative StudySurgical outcomes for men undergoing laparoscopic radical prostatectomy after transurethral resection of the prostate.
We reviewed outcomes for men with a history of transurethral prostate resection who underwent laparoscopic radical prostatectomy for prostate cancer. ⋯ We report that patients with a history of transurethral prostate resection who undergo laparoscopic radical prostatectomy have worse outcomes with respect to operative time, length of stay, positive margin rate and overall complication rate. This subset of patients should be made aware of these potential risks before undergoing laparoscopic radical prostatectomy.
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The Journal of urology · Aug 2007
Radical prostatectomy for clinically localized, high risk prostate cancer: critical analysis of risk assessment methods.
Standardized criteria are lacking to define high risk, clinically localized prostate cancer before definitive treatment. Reliance on simple risk stratification schemes to define high risk cancers has led many physicians and patients toward therapeutic nihilism, inappropriately selecting androgen deprivation instead of definitive local therapy. Of patients undergoing radical prostatectomy we identified those at high risk based on 8 previously described definitions. We examined pathological characteristics and prostate specific antigen outcomes. ⋯ Patients diagnosed with high risk cancer by currently available definitions do not have a uniformly poor prognosis after radical prostatectomy. Many cancers classified clinically as high risk are actually confined to the prostate pathologically. The risk of extraprostatic disease and prostate specific antigen relapse varies greatly depending on the definition used.