Urology
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Uncertainty exists regarding optimal prostate cancer screening parameters for high-risk populations. The purpose of this study is to report the use of percent free prostate-specific antigen (PSA) as an indication for biopsy in men at increased risk for developing prostate cancer who have a normal digital rectal examination (DRE) and total PSA level between 2 and 4 ng/mL. ⋯ In this unique population of men at high risk for prostate cancer, a percent free PSA of less than 27% was found to be useful for detecting early-stage but clinically significant cancers in men with a total PSA value between 2 and 4 ng/mL and normal DRE findings.
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Case Reports
Allergy to chlorhexidine gluconate in urethral gel: report of four cases and review of the literature.
Chlorhexidine is a bis-biguanide molecule widely used in many preparations as a disinfectant and an antiseptic. We describe four confirmed cases of allergy to chlorhexidine gluconate in urethral gel and review the existing published reports. Pertinent issues in the treatment and investigation of these patients are discussed.
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To describe a technique for facilitating the urethrovesical anastomosis at the time of laparoscopic radical prostatectomy. ⋯ We describe a simple, watertight, running laparoscopic suture technique for accomplishing the urethrovesical anastomosis during laparoscopic radical prostatectomy.
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Randomized Controlled Trial Comparative Study Clinical Trial
Periprostatic administration of local anesthesia during transrectal ultrasound-guided biopsy of the prostate: a randomized, double-blind, placebo-controlled study.
To evaluate the effect of periprostatic infiltration with local anesthesia on the level of discomfort associated with transrectal ultrasound-guided needle biopsy of the prostate. Transrectal ultrasound-guided needle biopsy of the prostate is the standard procedure to diagnose prostate cancer. ⋯ Periprostatic injection of lidocaine represents a simple and safe procedure that significantly reduces discomfort during probe manipulation and biopsy. We recommend this procedure in men undergoing transrectal ultrasound-guided prostate biopsy.
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Inguinal and testicular pain are challenging problems for which no reliable, standardized treatment exists. We report 3 patients with groin pain or orchialgia who were treated with pulsed radiofrequency of the nerves innervating these areas. ⋯ The techniques and settings used for the nerve blocks and radiofrequency procedures are explained in detail, along with a brief synopsis of the rationale for using it. Randomized, placebo-controlled studies are needed to better assess the efficacy of this procedure and identify eligible candidates.