The Journal of urology
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The Journal of urology · Jun 2013
Randomized Controlled Trial Multicenter StudyOnabotulinumtoxinA for the treatment of patients with overactive bladder and urinary incontinence: results of a phase 3, randomized, placebo controlled trial.
Overactive bladder affects 12% to 17% of the general population and almost a third experience urinary incontinence, which may severely impact health related quality of life. Oral anticholinergics are the mainstay of pharmacological treatment but they are limited by inadequate efficacy or side effects, leading to a high discontinuation rate. We report the results of the first large (557 patients), phase 3, placebo controlled trial of onabotulinumtoxinA in patients with overactive bladder and urinary incontinence inadequately managed with anticholinergics. ⋯ OnabotulinumtoxinA 100 U showed significant, clinically relevant improvement in all overactive bladder symptoms and health related quality of life in patients inadequately treated with anticholinergics and was well tolerated.
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The Journal of urology · Jun 2013
Randomized Controlled TrialPercutaneous tibial nerve stimulation for the long-term treatment of overactive bladder: 3-year results of the STEP study.
We report the long-term efficacy and safety of percutaneous tibial nerve stimulation with the Urgent® PC Neuromodulation System for overactive bladder after 3 years of therapy. ⋯ Most STEP participants with an initial positive response to 12 weekly percutaneous tibial nerve stimulation treatments safely sustained overactive bladder symptom improvement to 3 years with an average of 1 treatment per month.
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The Journal of urology · May 2013
Randomized Controlled TrialTranexamic acid reduces blood loss during percutaneous nephrolithotomy: a prospective randomized controlled study.
Bleeding is a significant morbidity associated with percutaneous nephrolithotomy. This study was conducted to evaluate the safety and efficacy of the antifibrinolytic agent tranexamic acid in reducing blood loss in patients undergoing percutaneous nephrolithotomy. ⋯ The use of tranexamic acid in percutaneous nephrolithotomy is safe, and is associated with reduced blood loss and a lower complication rate.
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The Journal of urology · Feb 2013
Randomized Controlled TrialPerioperative outcomes and oncologic efficacy from a pilot prospective randomized clinical trial of open versus robotic assisted radical cystectomy.
Robotic assisted laparoscopic radical cystectomy for bladder cancer has been reported with potential for improvement in perioperative morbidity compared to the open approach. However, most studies are retrospective with significant selection bias. ⋯ Our study validates the concept of randomizing patients with bladder cancer undergoing radical cystectomy to an open or robotic approach. Our results suggest no significant differences in surrogates of oncologic efficacy. Robotic assisted laparoscopic radical cystectomy demonstrates potential benefits of decreased estimated blood loss and decreased hospital stay compared to open radical cystectomy. Our results need to be validated in a larger multicenter prospective randomized clinical trial.
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The Journal of urology · Jan 2013
Randomized Controlled Trial Multicenter Study Comparative StudyRandomized multicenter feasibility trial of myofascial physical therapy for the treatment of urological chronic pelvic pain syndromes.
We determined the feasibility of conducting a randomized clinical trial designed to compare 2 methods of manual therapy (myofascial physical therapy and global therapeutic massage) in patients with urological chronic pelvic pain syndromes. ⋯ We judged the feasibility of conducting a full-scale trial of physical therapy methods and the preliminary findings of a beneficial effect of myofascial physical therapy warrants further study.