The Journal of urology
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The Journal of urology · Dec 2012
Practice GuidelineDiagnosis and treatment of overactive bladder (non-neurogenic) in adults: AUA/SUFU guideline.
The purpose of this guideline is to provide a clinical framework for the diagnosis and treatment of non-neurogenic overactive bladder (OAB). ⋯ The evidence-based statements are provided for diagnosis and overall management of OAB, as well as for the various treatments. Diagnosis and treatment methodologies can be expected to change as the evidence base grows and as new treatment strategies become obtainable.
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The Journal of urology · Nov 2012
Multicenter StudyThe impact of neuropathic pain in the chronic pelvic pain population.
Patients with chronic pelvic pain disorders often present with neuropathic features. We examined a cohort of patients with a primary complaint of chronic pelvic pain for the presence of neuropathic pain symptoms. ⋯ A large proportion of patients with chronic pelvic pain present with neuropathic features and report decreased quality of life compared with the general population. Those with neuropathic symptoms have significantly lower quality of life than those without such symptoms. Clinicians can identify patients to use targeted therapies and use a multidisciplinary approach to care.
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The Journal of urology · Oct 2012
Contributing factors for cancellations of outpatient pediatric urology procedures: single center experience.
Surgery cancellations in the pediatric population are often due to preventable causes and can lead to decreased operating room efficiency. We hypothesized that clinical and demographic patient factors are associated with preventable cancellations of scheduled outpatient pediatric urology procedures at our institution. ⋯ While the most common cause of surgical cancellation is patient illness, a significant number of cancellations are preventable. These findings suggest that future targeted hospital interventions, including improved evaluation of insurance status and preoperative parental education regarding preoperative requirements, may improve operating room use.
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The Journal of urology · Oct 2012
Comparative analysis of detorsion alone versus detorsion and tunica albuginea decompression (fasciotomy) with tunica vaginalis flap coverage in the surgical management of prolonged testicular ischemia.
Recent data suggest that testicular torsion may include an element of the compartment syndrome that improves with decompression. In 2009 we instituted tunica albuginea incision with tunica vaginalis flap coverage as an alternative in cases in which the torsed testis continued to appear ischemic after detorsion. ⋯ This preliminary experience suggests that tunica albuginea incision with tunica vaginalis flap coverage is a promising option for the management of clinically marginal torsed testes, enhancing salvageability after prolonged ischemia. We recommend considering this maneuver before performing orchiectomy in selected cases of testicular torsion.
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The Journal of urology · Oct 2012
Long-term impact of laparoscopic cyst decortication on renal function, hypertension and pain control in patients with autosomal dominant polycystic kidney disease.
Cyst proliferation in patients with autosomal dominant polycystic kidney disease is associated with renal failure, hypertension and pain. We examined the long-term impact of laparoscopic cyst decortication on renal function, hypertension and pain control in patients with adult dominant polycystic kidney disease presenting with refractory pain. ⋯ Durable pain relief but not hypertension control was seen at 10-year followup. Preoperative estimated glomerular filtration rate is a strong predictor of post-laparoscopic cyst decortication progression to end stage renal disease. A cautious approach with laparoscopic cyst decortication should be taken in patients with poor preoperative renal function.