The Journal of urology
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The Journal of urology · Jul 2008
Randomized Controlled TrialCombined periprostatic and intraprostatic local anesthesia for prostate biopsy: a double-blind, placebo controlled, randomized trial.
Transrectal ultrasonography guided prostate biopsy is the principle procedure in the histological diagnosis of prostate cancer. Recently a trend toward increasing the number of cores has been popularized. This practice further increases the need for a proper anesthetic application. However, there is no consensus on a standard local anesthetic strategy, while groups at most institutions currently prefer periprostatic anesthesia. We prospectively evaluated the contribution of intraprostatic anesthesia for transrectal prostate biopsies even when the sampling number was doubled to 12 cores. ⋯ The current study suggested that adding intraprostatic local anesthesia provides a significantly efficient strategy during transrectal ultrasound prostate biopsy, even in cases of 12-core sampling. Subsequent trials are needed to establish a standard analgesia policy for prostate biopsy.
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The Journal of urology · Feb 2008
Randomized Controlled Trial Multicenter StudyThe effects of dutasteride, tamsulosin and combination therapy on lower urinary tract symptoms in men with benign prostatic hyperplasia and prostatic enlargement: 2-year results from the CombAT study.
We investigated whether combination therapy with dutasteride and tamsulosin is more effective than either monotherapy alone for improving symptoms and long-term outcomes in men with moderate to severe lower urinary tract symptoms and prostatic enlargement (30 cc or greater). We report preplanned 2-year analyses. ⋯ In men with moderate to severe lower urinary tract symptoms and prostate enlargement (30 cc or greater) combination therapy provides a significantly greater degree of benefit than tamsulosin or dutasteride monotherapy.
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The Journal of urology · Feb 2008
Randomized Controlled Trial Multicenter StudyAntibiotic prophylaxis for the prevention of recurrent urinary tract infection in children with low grade vesicoureteral reflux: results from a prospective randomized study.
Antibiotic prophylaxis is given to children at risk for urinary tract infection. However, evidence concerning its effectiveness in grade I to III vesicoureteral reflux is lacking. The objective of this study was to determine whether antibiotic prophylaxis reduces the incidence of urinary tract infection in young children with low grade vesicoureteral reflux. ⋯ These data suggest that antibiotic prophylaxis does not reduce the overall incidence of urinary tract infection in children with low grade vesicoureteral reflux. However, such a strategy may prevent further urinary tract infection in boys with grade III reflux.
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The Journal of urology · Dec 2007
Randomized Controlled TrialDorsal onlay buccal mucosa versus penile skin flap urethroplasty for anterior urethral strictures: results from a randomized prospective trial.
Reconstructive techniques for anterior urethral strictures have not been subjected to a randomized comparison. In a randomized controlled study we compared outcomes of buccal mucosa dorsal onlay vs skin flap dorsal onlay urethroplasty in patients with complex anterior urethral strictures. ⋯ On intermediate followup dorsal onlay penile skin flap and buccal mucosa urethroplasty provide similar success rates. Compared to buccal mucosa, penile flap procedures are technically complex, associated with higher morbidity and less preferred by patients.
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The Journal of urology · Nov 2007
Randomized Controlled Trial Multicenter StudyResults of sacral neuromodulation therapy for urinary voiding dysfunction: outcomes of a prospective, worldwide clinical study.
This 5-year, prospective, multicenter trial evaluated the long-term safety and efficacy of sacral neuromodulation in patients with refractory urge incontinence, urgency frequency and retention. ⋯ This long-term study demonstrates that InterStim therapy is safe and effective for restoring voiding in appropriately selected cases refractory to other forms of treatment.