The Journal of urology
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The Journal of urology · Sep 2010
Comparative StudyOpening ambulatory surgery centers and stone surgery rates in health care markets.
Ambulatory surgery centers deliver surgical care more efficiently than hospitals but may increase overall procedure use and adversely affect competing hospitals. Motivated by these concerns we evaluated how opening of an ambulatory surgery center impacts stone surgery use in a health care market and assessed the effect of its opening on the patient mix at nearby hospitals. ⋯ While opening of an ambulatory surgery center did not appear to have an overly detrimental effect on competing hospitals, it led to a significant increase in the population based rate of stone surgery in the hospital service area. Possible explanations are the role of physician financial incentives and unmet surgical demand.
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The Journal of urology · Sep 2010
Urological malpractice: analysis of indemnity and claim data from 1985 to 2007.
The possibility of a medical malpractice lawsuit is present in the practice of modern day medicine. A basic knowledge of trends, monetary values and types of claims involved in urological litigation is beneficial to the practicing surgeon. ⋯ Urology tends to be at or below average compared to other medical specialties in regard to total claims, total monies paid and average monies paid during the last 23 years. From 1997 to 2007 the average indemnity paid increased by 23%. Improper performance, diagnostic errors and failure to monitor cases resulted in the most lawsuits. In those groups malignancy of the prostate, testis and kidney appeared consistently. Continued analysis and education on medical litigation in urology can aid in increased awareness and possibly improved care for patients in the future.
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The Journal of urology · Sep 2010
Randomized Controlled TrialLong-term effect of early postoperative pelvic floor biofeedback on continence in men undergoing radical prostatectomy: a prospective, randomized, controlled trial.
The impact of pelvic floor muscle training on the recovery of urinary continence after radical prostatectomy is still controversial. We tested the effectiveness of biofeedback-pelvic floor muscle training in improving urinary incontinence in the 12 months following radical prostatectomy. ⋯ Early biofeedback-pelvic floor muscle training not only hastens the recovery of urinary continence after radical prostatectomy but allows for significant improvements in the severity of incontinence, voiding symptoms and pelvic floor muscle strength 12 months postoperatively.
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The Journal of urology · Sep 2010
Gating of sensory information differs in patients with interstitial cystitis/painful bladder syndrome.
Altered sensory processing in interstitial cystitis/painful bladder syndrome cases may result from a deficiency of the central nervous system to adequately filter incoming visceral afferent information. We used prepulse inhibition as an operational measure of sensorimotor gating to examine early pre-attentive stages of information processing in females with interstitial cystitis/painful bladder syndrome and healthy controls. ⋯ Compared to healthy controls, female patients with interstitial cystitis/painful bladder syndrome had decreased ability to adequately filter incoming information and perform appropriate sensorimotor gating. These results suggest that a possible mechanism for altered interoceptive information processing in interstitial cystitis/painful bladder syndrome cases may be a general deficit in filtering mechanisms due to altered pre-attentive processing.