European urology
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Randomized Controlled Trial Clinical Trial
Effect of irrigating fluid on perioperative temperature regulation during transurethral prostatectomy.
Hypothermia in the immediate postoperative period is associated with postoperative instability, prolonged recovery and increased risk of myocardial ischemia in the subsequent 24 h. This study examined the effect of irrigating-fluid temperature during transurethral resection of the prostate on perioperative temperature regulation. A randomized prospective study was conducted on twenty-eight consecutive patients undergoing transurethral resections of the prostate. ⋯ The decrease from pre- to postoperative temperature was greater with cold (0.95 +/- 0.47 degrees C) than with warm (0.42 +/- 0.64 degrees C) irrigant (p = 0.01). The type of anesthesia (spinal versus general) and method of fluid warming (incubator versus level-one) did not have a significant effect on the perioperative temperature drop. Regression analysis demonstrated that the time of resection, amount of prostate resected, volume of irrigant fluid, and volume of intravenous fluid administered were not independent predictors of intraoperative temperature change.
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Clinical Trial
Respiratory effects of CO2 pneumoperitoneum during transperitoneal laparoscopic urological surgery.
To evaluate the effects of CO2 pneumoperitoneum on respiratory function during urological laparoscopic surgery with exposure of the retroperitoneal space in the lateral decubitus position. ⋯ The respiratory effects of CO2 pneumoperitoneum are more pronounced during laparoscopic urological surgery with opening of the retroperitoneum. It is possible that exposure of the retroperitoneal space increased CO2 absorption during insufflation.
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To evaluate changes in the management of major blunt renal trauma since the introduction of computerized tomographic diagnosis and follow-up. ⋯ In most patients with major blunt renal lacerations, a conservative approach is safe. Most extravasation spontaneously resolves and minimally invasive techniques will deal with nearly all complications. In our experience, open surgery usually results in nephrectomy.
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Prostatic abscess is a rare but severe disease. Conventional therapy is transurethral resection of the prostatic abscess. ⋯ TRUS is a simple, rapid, easily accessible, and accurate method for diagnosis, therapy and follow-up of a prostatic abscess. TRUS-guided perineal drainage of a prostatic abscess is an effective, minimal-invasive and cost-effective treatment without adverse side effects.
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Bone metastases that develop in patients with advanced prostate cancer often cause deep, unremitting pain. Palliative options for the control of this pain include analgesic support, cytotoxic chemotherapy and external-beam radiotherapy. In addition to external irradiation, interest in intravenously injected radioisotopes that are preferentially localized to bone has been mounting. ⋯ In the large, randomized Trans Canada study in which Metastron or placebo was given to patients as an adjunct to local field irradiation, those patients treated with Metastron had a significantly reduced intake of analgesics. Furthermore, progression of pain, as measured either by sites of new pain or by the requirement for further palliative radiotherapy, demonstrated statistically significant differences in favour of Metastron. There is thus increasing evidence of a useful role for Metastron in the treatment of prostate cancer metastatic to bone.