The Journal of urology
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The Journal of urology · Oct 2008
Superficial genitourinary abscesses in children: emergence of methicillin resistant Staphylococcus aureus.
The prevalence of methicillin resistant Staphylococcus aureus is increasing. However, little is known about methicillin resistant S. aureus in the genitourinary tract, particularly in children. We assessed the incidence of pediatric genitourinary methicillin resistant S. aureus superficial abscess requiring surgical intervention. ⋯ Methicillin resistant S. aureus has become the predominant organism causing pediatric superficial genitourinary abscesses at our institution, accounting for three-quarters of all surgically managed infections in the last 2 years. Methicillin resistant S. aureus was more common at the groin and genitalia. One debridement was generally curative, and patient morbidity was low with aggressive treatment.
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The Journal of urology · Oct 2008
Comparative StudyImmunomagnetic quantification of circulating tumor cells as a prognostic factor of androgen deprivation responsiveness in patients with hormone naive metastatic prostate cancer.
We determined whether circulating tumor cells predict prostate specific antigen failure in patients with metastatic prostate cancer before endocrine therapy and compared their prognostic ability with other clinical factors. ⋯ In this study the presence of 5 or more circulating tumor cells in 7.5 ml blood was associated with androgen deprivation responsiveness in patients with metastatic prostate cancer before endocrine therapy.
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The Journal of urology · Oct 2008
Risk factors for recurrent ureteropelvic junction obstruction after open pyeloplasty in a large pediatric cohort.
Recurrent ureteropelvic junction obstruction after open pyeloplasty is a serious complication for which treatment remains challenging. We identified risk factors for persistent obstruction. ⋯ In this series lack of retrograde pyelography and dorsal lumbotomy were independently associated with a higher risk of recurrent ureteropelvic junction obstruction. While retrograde pyelography or a flank approach could not be directly shown to prevent recurrent ureteropelvic junction obstruction, electing to perform retrograde pyelography may be a proxy for better perioperative planning, including the choice of incision, and it may ultimately increase the chances of successful pyeloplasty.
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The Journal of urology · Oct 2008
Randomized Controlled Trial Multicenter Study Comparative StudyThe relevance of urodynamic studies for Urge syndrome and dysfunctional voiding: a multicenter controlled trial in children.
The objective of this study was to compare prospectively, in urge syndrome and dysfunctional voiding, clinical patterns with urodynamic patterns, to assess changes in urodynamic patterns after treatment, and to correlate urodynamic patterns and parameters with treatment outcome. ⋯ Neither detrusor overactivity nor increased pelvic floor activity during voiding correlated with treatment outcome. Standard treatment could be the first choice in urge syndrome as well as in dysfunctional voiding, reserving urodynamic studies for patients in whom this first approach fails.
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The Journal of urology · Oct 2008
Comparative StudyIntermittent torsion of the spermatic cord portends an increased risk of acute testicular infarction.
Intermittent torsion of the spermatic cord is an episode of acute torsion of the spermatic cord that resolves spontaneously. We compared the outcomes in boys with intermittent spermatic cord torsion treated electively with testicular fixation with those in boys with a history of recurrent scrotal pain who required emergent operation for acute spermatic cord torsion without spontaneous resolution. ⋯ When diagnosed accurately, intermittent spermatic cord torsion can be treated with elective testicular fixation with an excellent outcome. Misdiagnosis may create a cohort of boys with intermittent spermatic cord torsion who are at risk for acute unresolved torsion and potential testicular loss. Urologists should be proactive in recommending elective scrotal exploration when intermittent spermatic cord torsion is a likely diagnosis.