Urology
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To report on a series of patients with Peyronie's disease (PD) who experienced a penile fracture, examining the history, presentation, and management. Additionally, we describe an unreported surgical technique implementing combined fracture repair and tunica plication. PD is an acquired inflammatory condition of the penis that can cause fibrotic, nonexpansile thickening of the tunica albuginea, resulting in a focal bend or narrowing on erection. ⋯ Patients with PD who have a penile fracture are candidates for combined fracture repair and tunica plication at the same setting.
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Men with metastatic hormone-refractory prostate cancer (HRPC) form a heterogeneous population with a wide range of symptoms and variable survival. Patient selection is critical in determining which patients will receive the most benefit from aggressive chemotherapy. The prostate-specific antigen (PSA) doubling time (PSADT) has been shown to be a surrogate for survival in earlier stages of prostate cancer, but its utility as a predictor in HRPC is unknown. ⋯ PSADT serves as an independent prognostic marker for survival in patients with metastatic HRPC. Men with a PSADT of 70 days or less had a significantly shorter survival time compared with men with a PSADT of more than 70 days. Inclusion of PSADT with other clinical data could help clinicians select men at high risk of early mortality who may most benefit from aggressive treatment regimens, such as docetaxel-based regimens.
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To evaluate the use of Avagard compared with a hand-brush scrub preparation by the urologist in preparation for inpatient and outpatient pediatric urologic operations. Avagard (chlorhexidine gluconate 1% solution and ethyl alcohol 61% wt/wt) is a waterless, brushless, and scrubless hand antiseptic indicated as a replacement for traditional preoperative brush hand scrubbing. ⋯ To our knowledge, this is the first study demonstrating that Avagard is a fast, effective, easy to apply, and safe surgical hand preparation for pediatric urologic surgery. Its use is cost effective, as well as time efficient, in relation to the traditional surgical scrub.
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Randomized Controlled Trial Comparative Study
Efficacy compared between caudal block and periprostatic local anesthesia for transrectal ultrasound-guided prostate needle biopsy.
To investigate the clinical efficacy of a caudal block compared with periprostatic local anesthesia for transrectal ultrasound-guided multicore prostate needle biopsy. ⋯ The results of our study have shown that the caudal block provides less effective anesthesia than periprostatic local anesthesia with the same dose of lidocaine for prostate biopsy. We have concluded that local anesthesia is a safe, simple, and rapid method of pain relief during prostate biopsy.
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To evaluate the potential association between sexual motivation and patterns of erectile dysfunction (ED) therapy among a large cohort of localized prostate cancer treatment survivors. ⋯ Many men who are bothered by posttreatment ED reported never having tried medications or devices to improve their erections. The lack of ED therapy was more prevalent among patients with erectile concerns after brachytherapy or 3D-CRT than after radical prostatectomy, suggesting possible opportunities for improving sexual HRQOL among long-term survivors.