The Journal of urology
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The Journal of urology · Nov 2003
Perineal repair of pelvic fracture urethral distraction defects: experience in 120 patients during the last 10 years.
We report the long-term success of a 1-stage perineal anastomotic repair in patients with pelvic fracture urethral distraction defects. ⋯ The overall success of our progressive 1-stage perineal anastomotic repair of pelvic fracture urethral distraction defect continues to be excellent with the majority of failures occurring in prepubescent boys and secondary repairs.
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The Journal of urology · Nov 2003
Randomized Controlled Trial Comparative Study Clinical TrialNitrous oxide vs periprostatic nerve block with 1% lidocaine during transrectal ultrasound guided biopsy of the prostate: a prospective, randomized, controlled trial.
We compared the efficacy of Entonox (BOC Gases, Manchester, United Kingdom), a mixture of 50% nitrous oxide and oxygen, with periprostatic infiltration of 1% lidocaine to provide analgesia during transrectal ultrasound (TRUS) guided biopsy of the prostate. ⋯ Inhalation of Entonox or periprostatic infiltration with 1% lidocaine can be used for analgesia during TRUS guided biopsy of the prostate since each provides significant and similar pain relief.
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The Journal of urology · Nov 2003
Fear of cancer recurrence in patients undergoing definitive treatment for prostate cancer: results from CaPSURE.
Contemporary cancer treatments have resulted in patients living longer but with the risk of disease recurrence. Studies suggest that fear of recurrence is a significant burden. We described fear of cancer recurrence in patients with prostate cancer undergoing treatment with radical prostatectomy (RP), radiation (XRT) or brachytherapy (BT). ⋯ Fear of prostate cancer recurrence imposes a substantial burden in patients before and after treatment. Understanding the fear of cancer recurrence associated with different treatments can help physicians better counsel patients and promote psychological well-being.
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The Journal of urology · Nov 2003
New sacral neuromodulation lead for percutaneous implantation using local anesthesia: description and first experience.
In functional urology today chronic stimulation of the sacral nerves has become one of the most accepted methods of stimulation treatment. Many studies have described the advantage of test stimulation prior to implanting the definitive system to enable effective patient selection. We studied a method aimed at improving lead anchoring by developing a self-blocking electrode with a simple placement procedure, in the process creating a 2-stage approach to full percutaneous implantation that allows a long screening period during the first temporary stimulation stage. ⋯ Our results show that the new tined anchoring system is a reliable way to allow truly minimally invasive placement of the chronic lead.
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The Journal of urology · Nov 2003
ReviewThe nonsteroidal effects of diethylstilbestrol: the rationale for androgen deprivation therapy without estrogen deprivation in the treatment of prostate cancer.
During the last 2 decades there has been an increase in the number of men with prostate cancer placed on luteinizing hormone releasing hormone (LH-RH) agonist therapy. In addition, the duration of individual therapy has extended from what was once only a few months to, in many cases, several years. As a result there has been an increase in the incidence of side effects, including osteoporosis, decreased cognitive abilities, vascular stiffness and fatigue. We explored the use of estrogen in the form of diethylstilbestrol (DES) as an alternative treatment for men with prostate cancer, and introduce the concept of androgen deprivation without estrogen deprivation. In doing so we hope to elucidate some of the nonhormonal nonsteroidal effects of DES. Furthermore, we hope to define the mechanisms by which DES can be useful when LH-RH agonist therapy or orchiectomy has failed. ⋯ The efficacy of 1 mg DES extends well beyond its androgen suppressive effects. Androgen deprivation without estrogen deprivation is a concept that deserves further attention in the urological community.