The Journal of urology
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The Journal of urology · Jan 2002
Randomized Controlled Trial Comparative Study Clinical TrialTamsulosin for treating lower urinary tract symptoms compatible with benign prostatic obstruction: a systematic review of efficacy and adverse effects.
We systematically reviewed the effectiveness and adverse effects of tamsulosin for lower urinary tract symptoms compatible with benign prostatic obstruction. ⋯ Tamsulosin improves lower urinary tract symptoms and flow. Its effectiveness was similar to that of other alpha-antagonists, increasing slightly at higher doses. Adverse effects were generally mild but the incidence, including treatment withdrawals, increased substantially at higher doses.
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The Journal of urology · Jan 2002
Preoperative serum prostate specific antigen levels between 2 and 22 ng./ml. correlate poorly with post-radical prostatectomy cancer morphology: prostate specific antigen cure rates appear constant between 2 and 9 ng./ml.
Serum prostate specific antigen (PSA) is widely used as a guide to initiate prostatic biopsies and to follow men older than 50 years old with and without prostate cancer. However, benign prostatic hyperplasia (BPH) is a common cause of serum PSA values between 2 and 10 ng./ml. A better understanding of the relationships among serum PSA, prostate cancer and BPH is important. ⋯ Preoperative serum PSA has a clinically useless relationship with cancer volume and grade in radical prostatectomy specimens, and a limited relationship with PSA cure rates at preoperative serum PSA levels of 2 to 9 ng./ml. Trend summaries for prostate weight on broken line regression showed that below 9 ng./ml. BPH is a strong contender for the cause of PSA elevation, constituting the primary cause of the over diagnosis of prostate cancer.
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The Journal of urology · Jan 2002
Pain and morbidity of an extensive prostate 10-biopsy protocol: a prospective study in 289 patients.
Some studies imply that increasing the number of prostate biopsy cores may improve the cancer detection rate. We performed a prospective study to evaluate pain and morbidity after an extensive transrectal ultrasound guided 10-core biopsy protocol. ⋯ Although minor complications are common, the extensive 10-core prostate biopsy protocol is associated with few major complications. The occurrence and intensity of pain and discomfort are in the range reported after the standard 6-core biopsy protocol.
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Acquired infundibular stenosis can develop after percutaneous nephrolithotomy. We review our experience with infundibular stenosis after this procedure. ⋯ Infundibular stenosis is a rare complication of percutaneous nephrolithotomy. In this series it was associated with prolonged operative time, a large stone burden requiring multiple removal procedures and extended postoperative nephrostomy tube drainage. In most cases stenosis developed at previous access sites within 1 year of initial percutaneous nephrolithotomy. Mild and moderate cases may be treated with observation and endoscopic dilation, respectively, while severe cases may result in renal impairment.
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The Journal of urology · Jan 2002
Causes of increased hospital stay after radical cystectomy in a clinical pathway setting.
Our institution targets postoperative days 6 to 8 for discharge home after radical cystectomy. We examined this population to determine the causes of increased hospital stay and risk factors that may predict prolonged hospitalization. ⋯ Our cystectomy clinical care pathway targets a hospital discharge date that is safely achieved in the majority of patients. Postoperative ileus is the most common cause of prolonged hospitalization. Age, gender, American Society of Anesthesiologists score, urinary diversion type and pathological stage did not correlate with increased hospital stay.