Urology
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Comparative Study
Active surveillance of very-low-risk prostate cancer in the setting of active treatment of benign prostatic hyperplasia with 5α-reductase inhibitors.
To review the efficacy of treating benign prostatic hyperplasia and very-low-risk prostate cancer (PCa) in patients receiving active surveillance and 5α-reductase inhibitor (5-ARI; finasteride or dutasteride) treatment. ⋯ Active surveillance of very-low-risk PCa in the setting of 5-ARI therapy for benign prostatic hyperplasia appears to be a safe therapeutic option, because most (57 of 82; 70%) patients maintained very-low-risk PCa or had negative follow-up biopsies during a 3-year follow-up period. Complementary to the Prostate Cancer Prevention Trial, our results indicate that 5-ARI therapy increases prostate-specific antigen sensitivity and can aid the clinician in appropriately targeting biopsies.
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We report the first case of acute gastric dilatation after simple extraperitoneal nephrectomy for benign disease.
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Comparative Study
Holmium laser enucleation of the prostate for persistent lower urinary tract symptoms after prior benign prostatic hyperplasia surgery.
To evaluate comparative safety and outcomes in patients undergoing holmium laser enucleation of the prostate (HoLEP) with and without previous transurethral prostate surgery. ⋯ HoLEP is safe and effective at relieving persistent LUTS after failed previous BPH surgery. Outcomes similar to those of a primary HoLEP procedure can be expected.
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To identify the causative pathogens and evaluate the antibiotic sensitivity, resistance patterns, and virulence in a contemporary series of patients with Fournier's gangrene. ⋯ Fournier's gangrene remains a community-acquired polymicrobial infection, with anaerobic bacteria as the most common causative pathogens. Candida and methicillin-resistant S aureus are emerging causative pathogens, but methicillin-resistant S aureus remains sensitive to clindamycin and trimethoprim/sulfamethoxazole. Although resistance was demonstrated by some causative pathogens, together, the currently recommended broad-spectrum antibiotics adequately covered all pathogens. Coverage with agents such as fluconazole, vancomycin, or piperacillin-tazobactam is indicated in patients at risk of fungal or hospital-acquired organisms.
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To examine the outcomes in patients with and without a comorbid neurologic diagnosis (ND) or neurogenic bladder dysfunction after a staged neuromodulation procedure for refractory bladder symptoms. ⋯ Patients with neurogenic bladder dysfunction experience benefits after neuromodulation similar to the benefits experienced by those without coexisting neurologic conditions.