Journal of endourology
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Journal of endourology · Jun 2001
Clinical TrialPatient-controlled analgesia during SWL treatments.
To identify the factors that influence analgesic consumption during SWL on the Dornier Lithotripter U/50. ⋯ Intravenous administration of a combination of alfentanil and propofol via a PCA device is an elegant, reliable, and safe method of analgesosedation for SWL. Patient satisfaction is high, and side effects are uncommon. Faster turnover of patients is possible.
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Journal of endourology · Apr 2001
Randomized Controlled Trial Comparative Study Clinical TrialRandomized study of transurethral resection of the prostate and combined transurethral resection and vaporization of the prostate as a therapeutic alternative in men with benign prostatic hyperplasia.
In recent years, various minimally invasive alternatives to transurethral resection have become available for treatment of benign prostatic hyperplasia (BPH). Transurethral electrovaporization has become popular, with reported improvements in subjective and objectives measures, but a high rate of postoperative irritative symptoms and lack of tissue for histologic examination are the two most commonly reported disadvantages of this procedure. To decrease the postoperative irritative symptoms while minimizing intraoperative and postoperative bleeding and also to obtain tissue samples, we have combined the techniques of vaporization, which was termed "vapor-cut." The aim of this randomized study was to compare the efficacy and safety of vapor-cut with those of the gold standard, transurethral resection. ⋯ From our preliminary experience, vapor-cut seems to give results comparable to those of TURP. Because there is almost no bleeding during vapor-cut, the procedure is performed under excellent visibility, which permits more rapid and effective resection.
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Journal of endourology · Mar 2001
Randomized Controlled Trial Clinical TrialProspective double-blind study of effect of ketorolac administration after laparoscopic urologic surgery.
To decrease postoperative dependence on narcotics for analgesia, we have evaluated ketorolac as an adjunct to perioperative pain control in patients undergoing laparoscopic urologic surgery. ⋯ Ketorolac decreases the subjective perception of pain after laparoscopic urologic surgery. It is suggested that ketorolac administration decreases the amount of narcotic usage as well. Time to resumption of oral intake and length of hospital stay were not influenced by use of ketorolac.
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Journal of endourology · Mar 2001
Laparoscopic repair of incisional and parastomal hernias after major genitourinary or abdominal surgery.
Abdominal wall or parastomal hernias following major genitourinary or abdominal surgery are a significant surgical problem. Open surgical repair is difficult because of adhesion formation and poor definition of the hernia fascial edges. Laparoscopic intervention has allowed effective correction of these abdominal wall hernias. ⋯ Laparoscopic repair of abdominal wall incisional or parastomal hernias provides an excellent anatomic correction of such defects. Adhesions are lysed under magnified laparoscopic vision, and the true limits of the fascial defects are clearly identified. The DualMesh is easy to work with and has yielded excellent results. A comparison with open repair with respect to perioperative factors and long-term success is currently under way.
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At our department, adults presenting with hydronephrosis secondary to short intrinsic stenoses of the ureteropelvic junction (UPJ) or ventrally crossing vessels are treated with laparoscopic nondismembered pyeloplasty. We herein present our long-term results. ⋯ At our department, laparoscopic nondismembered pyeloplasty is the preferred method for the management of UPJ obstruction, while dismembered pyeloplasty is performed in rare cases only.