The Journal of urology
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The Journal of urology · Sep 2007
Renal injury mechanisms of motor vehicle collisions: analysis of the crash injury research and engineering network data set.
Injury prevention requires efficient diagnosis and management, and knowledge of collision kinematics may allow first responders to triage victims earlier based on crash scene assessment. We identified possible collision patterns and vehicle interior components that may have a role in kidney injury following motor vehicle collision. ⋯ Renal injury in frontal and side impact collisions appears to occur after direct impact from objects in the vehicle compartment. For frontal crashes occupant acceleration into the seat belt or steering wheel seems to result in renal injuries. Side impact injuries occur when the vehicle side panel intrudes into the compartment, striking the occupant. Further collision evaluation in larger data sets is required to substantiate our findings.
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The Journal of urology · Sep 2007
Factors influencing the outcome of mid urethral sling procedures for female urinary incontinence.
We evaluated the outcome at least 6 months after the tension-free vaginal tape or transobturator tape procedure in women with urinary incontinence, and identified factors predicting persistent stress urinary incontinence. ⋯ The cure rates in women with urinary incontinence are not similar after tension-free vaginal tape and transobturator tape procedures. Our findings suggest that characteristics including the type of procedure, comorbid diseases, mixed urinary incontinence and severe grade cystocele should be considered high risk factors for persistent stress urinary incontinence in these patients.
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The Journal of urology · Sep 2007
Randomized Controlled TrialSubcutaneous bupivacaine infiltration and postoperative pain perception after percutaneous nephrolithotomy.
Recent studies have shown a significant decrease in patient reported pain scores when the nephrostomy tube size is decreased from 22 to 10Fr. We hypothesize that patient reported pain and narcotic use could be further decreased for patients with post-percutaneous nephrolithotomy nephrostomy tubes if the incision is infiltrated with a local anesthetic. ⋯ In this preliminary pilot study no significant differences in patient reported pain scores were observed. However, a trend toward decreased postoperative narcotic use was seen in patients receiving subcutaneous Marcaine administration around the nephrostomy tube tract. Further studies are warranted to define additional measures to reduce discomfort in those requiring nephrostomy tube drainage following percutaneous nephrolithotomy.
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The Journal of urology · Sep 2007
Comparative StudyProspective evaluation of short-term impact and recovery of health related quality of life in men undergoing robotic assisted laparoscopic radical prostatectomy versus open radical prostatectomy.
In the last few years there have been increasing claims that robotic assisted laparoscopic radical prostatectomy decreases short-term morbidity in patients undergoing surgical treatment for prostate cancer. However, there is surprisingly little objective evidence to support this point, which is often used to market the procedure to patients. To address this issue we prospectively evaluated patients undergoing open and robotic assisted laparoscopic radical prostatectomy at baseline and weekly through the postoperative period using a validated questionnaire. ⋯ This study helps prospectively define short-term health related quality of life in patients undergoing robotic assisted laparoscopic vs open radical prostatectomy. Higher physical scores were seen in the robotic assisted laparoscopic group than the open group beginning postoperative week 1 and continuing weekly throughout the 6-week study period. Physical Component Score scores returned to baseline sooner in the robotic assisted laparoscopic group than in the open group.
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The Journal of urology · Sep 2007
Incidence and risk factors of stomal complications in patients undergoing cystectomy with ileal conduit urinary diversion for bladder cancer.
In this study we examined the incidence and associated factors of stomal complications in patients undergoing radical cystectomy with ileal conduit urinary diversion for bladder cancer. In addition, we evaluated the treatment and outcomes of surgical procedures in patients in whom stoma related complications developed. ⋯ Stomal complications associated with ileal conduit urinary diversion are not uncommon and occur in almost 15% of patients, with the most common problem being parastomal hernia. Evaluation of possible risk factors demonstrates that obesity may be a contributing factor in the development of stomal complications, particularly in the elderly. Furthermore, our experience suggests that subsequent repairs of parastomal hernias are only moderately successful.