The Journal of urology
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The Journal of urology · Dec 2003
Management of trauma to the male external genitalia: the usefulness of American Association for the Surgery of Trauma organ injury scales.
Injury to the male external genitalia is rare and, therefore, there are little data in the literature regarding the options for nonoperative management and outcome. To assist in defining the indications for nonoperative management the usefulness of the American Association for the Surgery of Trauma (AAST) organ injury scales for these injuries was examined. ⋯ The AAST grading for male external genital trauma readily characterizes patients with high grade injuries that require operative management as well as select patients in whom injury can be safely managed nonoperatively.
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The Journal of urology · Dec 2003
Neurophysiological evidence may predict the outcome of sacral neuromodulation.
Chronic stimulation of the sacral nerves has now become one of the most accepted stimulation therapies for functional lower urinary tract symptoms refractory to conservative treatment. Despite the existence of a large amount of literature on sacral neuromodulation (SNM) showing a fairly high percent of significant improvement in clinical outcome there are few experimental studies of SNM stimulus parameters and/or neurophysiological monitoring. We evaluated the specific action of SNM on the primary sensory cortical area. Somatosensory evoked potentials (SEPs) of the pudendal and posterior tibial nerves were evaluated in patients implanted with a monolateral permanent quadripolar electrode. ⋯ Our study confirms previous observations that SNM acts by the afferent pathway at the cortical site level and it sheds light on so-called idiopathic lower urinary tract symptoms. A modification of SEPs induced by SNM seems to be a prognostic factor of clinical outcomes. The action of SNM on the afferent pathway from the sacral area to the somatosensory cortex is specific and neurophysiological evaluation via pudendal SEPs provides evidence to this effect.
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The Journal of urology · Dec 2003
Randomized Controlled Trial Clinical TrialThe optimum doses of and injection locations for periprostatic nerve blockade for transrectal ultrasound guided biopsy of the prostate: a prospective, randomized, placebo controlled study.
We evaluated the efficiency of various amounts of local anesthesia and various numbers of injection sites to determine the most effective pain control with the least number of injections and the amount of injected medium in patients who underwent transrectal ultrasound guided prostate biopsy. ⋯ Our placebo controlled, prospective, randomized study indicated that 10 cc local anesthetic injections supply significantly better pain control than lower doses for periprostatic nerve blockade during prostate biopsy. Although bilateral basal plus apical 10 cc lidocaine injections resulted in the lowest mean pain score, there was no statistically significant difference from 10 cc bilateral basal injections.
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The Journal of urology · Dec 2003
Randomized Controlled Trial Clinical TrialEfficacy of tamsulosin in the medical management of juxtavesical ureteral stones.
We evaluated the efficacy of the alpha1-adrenergic antagonist tamsulosin for conservative expulsive therapy in patients with ureteral colic due to juxtavesical stones. ⋯ Tamsulosin used as a spasmolytic drug during renal colic due to juxtavesical calculi increased the stone expulsion rate and decreased expulsion time, the need for hospitalization and endoscopic procedures, and provided particularly good control of colic pain.