The Journal of urology
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The Journal of urology · May 2010
Development, validation and testing of an epidemiological case definition of interstitial cystitis/painful bladder syndrome.
No standard case definition exists for interstitial cystitis/painful bladder syndrome for patient screening or epidemiological studies. As part of the RAND Interstitial Cystitis Epidemiology study, we developed a case definition for interstitial cystitis/painful bladder syndrome with known sensitivity and specificity. We compared this definition with others used in interstitial cystitis/painful bladder syndrome epidemiological studies. ⋯ No single case definition of interstitial cystitis/painful bladder syndrome provides high sensitivity and high specificity to identify the condition. For prevalence studies of interstitial cystitis/painful bladder syndrome the best approach may be to use 2 definitions that would yield a prevalence range. The RAND Interstitial Cystitis Epidemiology interstitial cystitis/painful bladder syndrome case definitions, developed through structured consensus and validation, can be used for this purpose.
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The Journal of urology · May 2010
Minimizing pain during vasectomy: the mini-needle anesthetic technique.
We describe pain scores for a modified anesthesia technique for no-scalpel vasectomy using a 1-inch 30 gauge mini-needle. ⋯ The mini-needle technique provides excellent anesthesia for no-scalpel vasectomy. It compares favorably to the standard vasal block and other anesthetic alternatives with the additional benefit of minimal equipment and less anesthesia.
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The Journal of urology · May 2010
Randomized Controlled Trial Multicenter StudyEffect of amitriptyline on symptoms in treatment naïve patients with interstitial cystitis/painful bladder syndrome.
Amitriptyline is frequently used to treat patients with interstitial cystitis/painful bladder syndrome. The evidence to support this practice is derived mainly from a small, single site clinical trial and case reports. ⋯ When all randomized subjects were considered, amitriptyline plus an education and behavioral modification program did not significantly improve symptoms in treatment naïve patients with interstitial cystitis/painful bladder syndrome. However, amitriptyline may be beneficial in persons who can achieve a daily dose of 50 mg or greater, although this subgroup comparison was not specified in advance.
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The Journal of urology · May 2010
Randomized Controlled Trial Multicenter Study Comparative StudyTolerability of 5 mg solifenacin once daily versus 5 mg oxybutynin immediate release 3 times daily: results of the VECTOR trial.
Although antimuscarinic treatment is indicated for overactive bladder, many patients discontinue it because of dry mouth. Of available antimuscarinics oxybutynin is associated with the highest dry mouth rate. We compared the safety and tolerability of 5 mg solifenacin vs 15 mg oxybutynin immediate release. ⋯ Significantly fewer patients on 5 mg solifenacin once daily reported dry mouth vs those receiving 5 mg oxybutynin immediate release 3 times daily. Significantly fewer patients on solifenacin reported moderate/severe dry mouth. Significantly fewer patients on solifenacin withdrew from study due to dry mouth and there were significantly fewer overall adverse events. Solifenacin and oxybutynin immediate release were efficacious in decreasing efficacy end points, and improved Patient Perception of Bladder Condition scale and Overactive Bladder Questionnaire results from baseline to treatment end.
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The Journal of urology · May 2010
ReviewReporting of harm in randomized controlled trials published in the urological literature.
Evidence-based decision making seeks to balance potential benefits and harms (adverse effects) of health care interventions for an individual patient. We determined the prevalence and completeness of harm reporting in randomized controlled trials in the urological literature. ⋯ Randomized controlled trials published in the urological literature contain significant deficiencies in adverse event reporting. These findings suggest the need for reporting standards for harm in urological journals. Improvements in adverse event reporting would permit a more balanced assessment of interventions and would enhance evidence-based urological practice.