Urology
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Gunshot wounds (GSW) affecting the genitourinary (GU) system in civilians are uncommon. This study describes the incidence, anatomic distribution, demographics, associated injuries, management, and outcomes after civilian GU GSW. ⋯ GU injury occurred in 10.5% of 2941 civilian GSW patients. Associated injuries were very common, with many cases involving multiple organs. Most injuries (90%) were managed surgically. Mortality is usually the result of associated nongenitourinary injuries. A high index of suspicion for injuries affecting other organs is necessary in managing GU GSW trauma patients.
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Comparative Study
Microparticulate ice slurry for renal hypothermia: laparoscopic partial nephrectomy in a porcine model.
Previously, we described the feasibility of renal hypothermia using microparticulate ice slurry during laparoscopy. In the present study, we compared surface cooling with the ice slurry versus near-frozen saline or warm ischemia (WI) during laparoscopic partial nephrectomy (LPN) in a porcine model. ⋯ Ice slurry provides superior renal cooling compared with near-frozen saline during LPN without associated core hypothermia.
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To present a simple technique for the repair of a ruptured testis after blunt trauma when extruded but viable testicular tissue prevents closure of the testicular capsule during surgical exploration. Preservation of viable testicular tissue is important because the risk of impaired fertility and hormone function is minimized. ⋯ This technique avoids the loss of extruded but viable testicular tissue and may reduce the risk of impaired fertility and hormone function, without compromising the goals of scrotal exploration.
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Delay in treatment of testis cancer (TC) has a proven negative impact on disease stage, treatment outcome, and mortality. Poor public awareness of the disease and lack of testis self-examination (TSE) may account for late presentation. The aim of this study was to examine the knowledge of TC and performance of TSE in a group of men over 2 time periods 20 years apart. ⋯ Increased testicular cancer knowledge combined with TSE may have a role in improving detection of significant testicular pathology.
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To report the first series of laparoendoscopic single-site surgery for radical cystectomy and bilateral pelvic lymph node dissection. The development of laparoendoscopic single-site surgery and its application to urothelial malignancy has not been previously evaluated. ⋯ Laparoendoscopic single-site surgery for radical cystectomy and bilateral pelvic lymph node dissection is feasible and safe for select patients. Adequate lymph node dissection was possible through a single multichannel port. The long-term oncologic evaluation of these patients awaits; however, the preliminary outcomes have been promising.