The Journal of urology
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The Journal of urology · Jan 1998
Randomized Controlled Trial Clinical TrialBupivacaine infiltration into the neurovascular bundle of the prostatic nerve does not improve postoperative pain or recovery following transvesical prostatectomy.
We assessed the effect of intraoperative bupivacaine infiltration into the neurovascular bundle of the prostatic nerve on postoperative pain and patient outcome. ⋯ Following transvesical prostatectomy, prostatic nerve blockade has no beneficial effects on postoperative pain or patient outcome.
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The Journal of urology · Jan 1998
Diagnosing the combination of renal dysgenesis, Gartner's duct cyst and ipsilateral müllerian duct obstruction.
We describe the differential points in the diagnosis of the combination of renal dysgenesis, Gartner's duct cyst and ipsilateral müllerian duct obstruction. Various imaging studies and urological procedures were performed. We report our experience in detecting these anomalies in 10 girls and review the literature. ⋯ When cystic dilatation of the pelvis, especially a ureterocele-like cyst without ureteral dilatation, is found in girls with ipsilateral renal dysgenesis, the possibility of a Gartner's duct cyst should be considered. For early detection and treatment of unilateral obstruction of duplicated müllerian ducts pelvic sonography should be performed at puberty, especially just after menarche, in girls with renal dysgenesis and ipsilateral Gartner's duct cyst.
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The Journal of urology · Jan 1998
Case ReportsThe use of 2 ipsilateral ureteral stents for relief of ureteral obstruction from extrinsic compression.
We present our early experience with the novel approach of placing 2 parallel stents simultaneously in extrinsically obstructed ureters in which single stents had failed. The increased stiffness of 2 stents reduces kinking and luminal compression, and the potential space between the stents likely preserves flow around as well as through them. ⋯ Placement of 2 ipsilateral parallel ureteral stents simultaneously is an easy technique. It may obviate percutaneous nephrostomy tube placement in patients in whom drainage with a single stent failed, especially in cases of extrinsic ureteral compression.
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The Journal of urology · Jan 1998
Constant elevation in renal pelvic pressure induces an increase in urinary N-acetyl-beta-D-glucosaminidase in a nonobstructive porcine model.
To clarify the physiological significance of renal pelvic pressure elevations encountered in the evaluation of hydronephrotic kidney we examined the effects of different levels of renal pelvic pressure on the induction of renal injury. ⋯ Excessively high collecting system pressure induced renal cellular injury, as reflected by an increase in urinary N-acetyl-beta-D-glucosaminidase levels. While renal pelvic pressure up to 10 cm. water appeared to be innocuous, renal cellular injury was evident within as little as 1 hour at renal pelvic pressures 20 cm. water or greater. The degree of N-acetyl-beta-D-glucosaminidase in the urine also correlated with a decrease in renal arterial blood flow.