Urology
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Randomized Controlled Trial Comparative Study
Retrograde intrarenal surgery vs extracorporeal shock wave lithotripsy for intermediate size inferior pole calculi: a prospective assessment of objective and subjective outcomes.
To assess objective and subjective outcomes of retrograde intrarenal surgery (RIRS) and extracorporeal shock wave lithotripsy (SWL) for the treatment of intermediate size (1-2 cm) inferior calyceal (IC) stones in a prospective randomized fashion. ⋯ For the treatment of intermediate size IC calculi, RIRS is superior to SWL in terms of objective and subjective outcomes.
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Review Meta Analysis Comparative Study
Primary realignment vs suprapubic cystostomy for the management of pelvic fracture-associated urethral injuries: a systematic review and meta-analysis.
To compare primary urethral realignment (PR) with suprapubic cystostomy (SPC) for the management of pelvic fracture-associated posterior urethral injuries with regards to rates of stricture, erectile dysfunction, and urinary incontinence. ⋯ PR appears to reduce the incidence of stricture formation after pelvic fracture-associated posterior urethral injuries as compared with SPC.
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To evaluate the credentials of urologists choosing to testify as expert witnesses. As health care reform has become an increasingly important topic in national debate, medical malpractice and related issues have come to the forefront of topics for discussion by the medical community. Physicians are often recruited to testify as expert witnesses in malpractice cases. Defining what constitutes an expert in this setting has been an area of controversy. ⋯ Urologists testifying for plaintiffs and defendants both had over 30 years of experience on average, with those in the latter having slightly less experience. Defendant witnesses, however, had greater scholarly impact and were more likely to practice in an academic setting. Organizations such as the American Urological Association may wish to re-evaluate guidelines on expert witness testimony, particularly regarding those who testify frequently.
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To examine variation in the open market cost of a radical prostatectomy (RP) procedure in the US hospitals for an uninsured patient, as many proposals for health care reform highlight the importance of individuals actively participating in selecting care. However, reports suggest that obtaining procedure prices remains challenging and highly variable. ⋯ There is wide variation in pricing for RP, with higher rates found in academic centers. Wide variation in facility costs were observed, and nearly all were unable to provide surgeon and/or anesthesia fees. Currently, it appears to be unacceptably difficult for men with prostate cancer without insurance to obtain prices for an RP procedure.