BJU international
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Randomized Controlled Trial Clinical Trial
Does pericapsular lignocaine reduce pain during transrectal ultrasonography-guided biopsy of the prostate?
To evaluate whether injection with pericapsular lignocaine before transrectal ultrasonography (TRUS)-guided biopsy reduces the perceived pain of prostatic biopsy. ⋯ Pericapsular injection with 1% lignocaine significantly reduces the perceived pain of TRUS-guided prostatic biopsy.
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To re-survey (after 1 year) men identified in 1999 as having perineal and/or ejaculatory pain/discomfort severe enough to suggest a clinical diagnosis of chronic prostatitis (using the National Institutes of Health-Chronic Prostatitis Symptom Index, NIH-CPSI), and to compare them with an age-matched population of men who had no prostatitis-like symptoms in the initial survey, to determine the effect of time on specific symptoms associated with the diagnosis of chronic prostatitis. ⋯ About a third of men reporting prostatitis-like symptoms in the general population had resolution of their symptoms (usually those with a shorter duration and less severe symptoms) 1 year later. The severity of symptoms of men with persistent chronic prostatitis remained relatively unchanged over the year.
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To determine the long-term efficacy and complications of sacral nerve stimulation as an alternative therapy for functional unobstructive urinary retention, often considered to be psychogenic and effectively treated by clean intermittent catheterization, but for which pelvic floor dysfunction has been recognized as a possible cause. ⋯ Sacral nerve stimulation is an effective and durable new approach to functional urinary retention, with few associated complications. Test stimulation provides a valuable tool for selecting patients.
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To examine, in young pigs, changes in baseline pelvic pressure and diuresis in the contralateral kidney during conditions of increasing pelvic pressure and perfusion with isotonic saline in the ipsilateral renal pelvis; the role of a reno-renal nervous mechanism was examined by denervating the kidneys, and the effect of bladder filling on these variables assessed. ⋯ These results indicate that a reno-renal reflex mechanism has no apparent role in young pigs during pressure-perfusion measurements with an empty or full bladder.
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Contemporary medicine is characterized by sophisticated specialization of the individual physician. The specialist in urological surgery may undertake one of the most important and primary medical tasks, the mitigation and therapy of pain. This review aims to provide an overview of the concepts of pain therapy in urology. ⋯ Neuropathic pain is probably the most difficult to manage and requires consultation with a pain-management specialist. In the case of neuropathic pain, treatment only with opioids is of limited efficacy and combination with co-analgesics is necessary. In addition, invasive analgesic therapies should sometimes be considered.