Urology
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To evaluate the efficacy and postoperative morbidity of a mini-incision vasectomy reversal (MIVR) using no-scalpel vasectomy principles compared with traditional incisional approaches to vasectomy reversal (VR). ⋯ The results of our study have shown that MIVR does not compromise patency outcomes or semen parameters compared with more traditional approaches to VR and results in less pain during the early period of recovery after surgery and quicker functional recovery.
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Urologists are integrally involved in the management of acute kidney injury (AKI), which is common after renal surgery or secondary to postrenal (obstructive) etiologies. The measurement of serum creatinine is a suboptimal indicator of AKI because it lags behind acute changes in renal function. Recent advances indicate that serum/urine biomarkers will prove useful for early detection of AKI, analogous to the use of cardiac enzymes for acute myocardial infarction. These serum/urine markers may guide future therapy, facilitate research efforts to reduce the severity of AKI, such as after partial nephrectomy, and allow for more accurate prognostication for patients with AKI.
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Pneumoscrotum, the accumulation of air inside the scrotum, is a rare complication associated with blunt chest trauma. We report a case of severe subcutaneous emphysema, pneumothorax, pneumomediastinum, pneumopericardium, and pneumoscrotum after blunt chest trauma in a 44-year-old man. ⋯ Primary repair of the tracheal injury was performed, and he was weaned successfully from the ventilator by day 5. He was discharged on day 7.
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To examine whether it would be safe to use adult criteria for imaging in pediatric blunt renal trauma and hematuria. ⋯ The yield of abdominal CT in pediatric renal trauma is low in patients presenting with microhematuria. Our data suggest that it may be possible that adult criteria for renal imaging are sufficient for children with abdominal blunt trauma and microhematuria. Adopting such strategy will result in substantial reduction in exposure to radiation, supposedly without increasing the patient's risk.
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The impact of patient positioning can be profound. Urological surgeons must often exercise strategic positioning in order to access retroperitoneal and pelvic organs. ⋯ The purpose of the following review is to summarize the current literature on positioning-related concerns as they pertain to the practicing urologist. To our knowledge, this is the first such review of its kind in the urological literature.