The Journal of urology
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The Journal of urology · Jul 2008
Surgical salvage of renal cell carcinoma recurrence after thermal ablative therapy.
Thermal ablative therapies, including cryoablation and radio frequency ablation, have become viable options for the management of small renal tumors. However, initial data have suggested higher local recurrence rates for ablation compared to partial nephrectomy. We evaluated options for salvage of ipsilateral tumor recurrence after previous ablation. ⋯ Primary thermal ablation for small renal masses may preclude or complicate subsequent surgical salvage. Cryoablation in particular can lead to extensive perinephric fibrosis which can complicate attempts at salvage. Appropriate patient selection for thermal ablation remains of paramount importance.
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The Journal of urology · Jul 2008
Multicenter StudyMorbidity, mortality and early outcome of transurethral resection of the prostate: a prospective multicenter evaluation of 10,654 patients.
Transurethral resection of the prostate has for decades been the standard surgical therapy for lower urinary tract symptoms secondary to benign prostatic hyperplasia, the most common benign neoplasm in men. To generate a contemporary reference for evolving medical and minimally invasive therapies we analyzed complications and immediate outcomes of transurethral prostate resection in a statewide multicenter study. ⋯ In a large scale evaluation comprising 44 mostly nonacademic urological departments in Bavaria, unique real-world data for transurethral prostate resection were prospectively generated. This most contemporary information should be of use to potential patients and facilitate subsumption of emerging surgical and nonsurgical benign prostatic hyperplasia treatment options.
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The Journal of urology · Jul 2008
Topical anesthesia with EMLA does not decrease pain during vasectomy.
Previous studies show conflicting results of the ability of EMLA (eutectic mixture of local anesthetics) to decrease pain during vasectomy. We examined the effectiveness of EMLA cream to decrease pain in patients undergoing bilateral percutaneous no-scalpel vasectomy. ⋯ Topical anesthesia with EMLA did not significantly decrease the pain associated with percutaneous vasectomy.
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The Journal of urology · Jul 2008
Urology resident training with an unexpected patient death scenario: experiential learning with high fidelity simulation.
Communicating unexpected news of a patient death is rarely encountered in urology. We evaluated resident performance during an unexpected patient death scenario involving high fidelity simulation. We also studied simulation as a tool to teach and assess nontechnical skills in urology. ⋯ Evaluation of urology resident performance was possible during an unexpected patient death scenario. Upon completion of the scenario perceived competency of the simulation task was increased. High fidelity simulation was found to be an effective method for teaching and assessing the acquisition of nontechnical skills. All residents agreed that the simulation was useful and should be included in urological training.
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The Journal of urology · Jul 2008
Penetrating external genital trauma: a 30-year single institution experience.
We examine the characteristics, outcomes and incidence of penetrating external genital trauma at our level I trauma center. ⋯ Conservative débridement of penetrating injuries to the external genitalia should be stressed to maximize tissue preservation. Testicular salvage rates are significantly higher in gunshot wound injuries (75%) compared to stab wounds/lacerations injuries (23%) (p <0.001). A select group of patients with penile and scrotal injuries (ie those with injuries superficial to Buck's or dartos fascia) may undergo nonsurgical treatment of the penetrating external genital injury with minimal morbidity.