European urology
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To compare morbidity in two groups of patients who underwent retropubic or laparoscopic radical prostatectomy in the same period. ⋯ The results of our non-randomized study show that up to now laparoscopic radical prostatectomy does not provide significant advantages in terms of peri-operative morbidity compared with the traditional retropubic approach.
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Randomized Controlled Trial Comparative Study Clinical Trial
Prospective study comparing two methods of anaesthesia for prostate biopsies: apex periprostatic nerve block versus intrarectal lidocaine gel: review of the literature.
Studies have demonstrated the need for pain control during multiple transrectal prostate biopsies. Due to encountered published results on periprostatic nerve block, we prospectively evaluated the efficacy and safety of periprostatic local anaesthesia at the apex in comparison to intrarectal lidocaine gel. ⋯ Periprostatic nerve block at the apex is superior to intrarectal lidocaine gel for controlling pain during transrectal prostate biopsy, with no increased complications. This technique should be recommended for those patients without anal or rectal inflammatory diseases.
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Review
Rational selection of a control arm for randomised trials in metastatic renal cell carcinoma.
Immunotherapy, and only immunotherapy, has reproducible, albeit limited efficacy in metastatic renal cell cancer (MRCC). Further improvement is warranted and progress will have to be investigated in randomised clinical trials, because the variable natural history of this disease precludes firm conclusions outside the context of controlled clinical studies. Currently, there is no general accepted standard arm to compare for those randomised clinical protocols. This needs to be established, which is the goal of this project. ⋯ An appealing safety profile, the applicability in an outpatient regimen, the possibility of less stringent selection criteria, and the proven life prolonging effect will make adjuvant monotherapy, in particular IFN-alpha monotherapy, after a tumournephrectomy currently the control-arm of choice in randomised trials for MRCC.
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Randomized Controlled Trial Clinical Trial
Alternating mitomycin C and BCG instillations versus BCG alone in treatment of carcinoma in situ of the urinary bladder: a nordic study.
To evaluate whether, in patients with carcinoma in situ (CIS) of the urinary bladder, alternating instillation therapy with mitomycin C (MMC) and bacillus Calmette-Guerin (BCG) was more effective and less toxic than conventional BCG monotherapy. ⋯ One-year BCG monotherapy was more effective than the alternating therapy for reducing recurrence and compared well with the best regimens reported from substantially smaller series. The alternating therapy was better tolerated.
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We wanted to determine if there was a difference in outcome for those patients with Fournier's disease who underwent numerous debridements as opposed to only one initial debridement. ⋯ Fournier's gangrene is a disease process with a wide variability in presentation. The FSI does give some indication about the likelihood of survival based on variables which can be recorded upon presentation. It also provides an efficient way to characterize the acuity of presentation and compare patients. While the repeated nature of debridements may be considered the accepted standard of care in these patients, this was not found to be predictive of outcome.