Der Urologe. Ausg. A
-
This article reviews aspects of postoperative and chronic pain management in urology patients. Continuous epidural techniques are recommended for extensive retroperitoneal und transperitoneal surgery due to its excellent analgesia and facilitation of enhanced recovery. In patients without regional analgesia techniques, intravenous or oral non-opioid analgesics should be combined with titration of fast acting opioids on an as-needed basis. ⋯ Additional pain relief approaches, such as radiation as well as psychosocial and spiritual needs of these patients have to be considered. In long-term treatment of non-cancer pain, effective use of opioids is not evidence-based. These patients often benefit from multimodal, interdisciplinary pain management comprising psychological and educational approaches as well as activating physiotherapy.
-
Patients with stone disease usually present to the urologist with acute colic pain. For the right choice of therapy the diagnosis needs to be confirmed using one of many imaging methods, including ultrasonography, abdominal radiography, intravenous urography, non-contrast-enhanced computed tomography (CT), CT and magnetic resonance imaging (MRI) urography and dual-energy CT. ⋯ Compared to the others dual-energy CT allows distinction between different stone compositions with high accuracy and can affect the choice of therapy. This article on imaging and diagnosis of urolithiasis discusses the different imaging methods and highlights dual-energy CT and its distinctive features.
-
Der Urologe. Ausg. A · Apr 2013
[Confidence intervals and p-values in urology: interpretation and misinterpretation].
Confidence intervals and p-values are widely used in the urological literature to describe and interpret outcomes. However, several readers, authors and reviewers are unfamiliar with the true interpretation of these values. P-values determine statistical significance of data. ⋯ An independent but complementary interpretation of both values is important in studies with and without statistical significance. Based on a clinical case scenario this article discusses the interpretation as well as common pitfalls in interpretation of p-values and confidence intervals. An accurate assessment of these statistical cornerstones is fundamental for a correct interpretation of the urological literature and thus important aspects of evidence-based urology.