The Journal of urology
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The Journal of urology · Jul 2010
Multicenter StudyDevelopment and external validation of a nomogram predicting disease specific survival after nephrectomy for papillary renal cell carcinoma.
We developed and externally validated a prognostic nomogram specifically for papillary renal cell carcinoma. ⋯ We developed a highly accurate tool specifically for papillary renal cell carcinoma using basic clinical and pathological information to predict disease specific survival. This tool should be helpful to identify papillary renal cell carcinoma with aggressive clinical behavior and may contribute to the ability to individualize postoperative surveillance and therapy.
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The Journal of urology · Jul 2010
Randomized Controlled TrialScribes in an ambulatory urology practice: patient and physician satisfaction.
The increasing use of electronic medical records during the clinical encounter brings not only benefits but also barriers that may affect the doctor-patient relationship and increase the work burden of the physician. We evaluated whether the use of an electronic medical record scribe in an academic urology program would ameliorate these problems. ⋯ Electronic medical record scribes in a urology practice may be a practical solution to provide documentation while maintaining or improving the doctor-patient relationship because they increase physician satisfaction and do not detract from patient satisfaction.
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The Journal of urology · Jul 2010
Bladder management after spinal cord injury in the United States 1972 to 2005.
Studies have shown that bladder management with an indwelling catheter for patients with spinal cord injury is associated with more urological complications such as stones, urinary infection, urethral strictures and bladder cancer. However, little is known about actual bladder management for these patients in clinical practice. ⋯ With time bladder management with clean intermittent catheterization has increased in popularity. However, only 20% of patients initially on clean intermittent catheterization remained on this form of bladder management. More research on the safety of each of these methods needs to be performed to provide better guidance to aid with this decision.
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The Journal of urology · Jul 2010
Prostate cancer death of men treated with initial active surveillance: clinical and biochemical characteristics.
Active surveillance for favorable risk prostate cancer is an approach that may reduce the risk of overtreatment of clinically insignificant prostate cancer. In fact, some patients with favorable risk disease at diagnosis harbor more aggressive disease and may be at risk for prostate cancer mortality despite close monitoring. This is a detailed report of 5 of 453 patients on surveillance who died of prostate cancer. ⋯ The low prostate cancer mortality in our surveillance cohort provides support for an active surveillance approach to favorable risk prostate cancer. Only 1 of the 5 patients presented with favorable disease and experienced a theoretically preventable death. The absence of preventable deaths suggests that the basic approach is sound. Two patients had a trigger for intervention but did not receive it. This reinforces the importance of close monitoring and of definitive treatment for those in whom disease is reclassified as higher risk over time.
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The Journal of urology · Jul 2010
Construction and evaluation of an anatomically correct multi-image modality compatible phantom for prostate cancer focal ablation.
Focal therapy using lasers is emerging as an alternative strategy for prostate cancer treatment. However, to our knowledge no anatomically correct models are available to test imaging and ablation techniques. Animal models present ethical, anatomical and cost challenges. We designed and validated an inexpensive but anatomically correct prostate phantom incorporating tumor, rectum and urethra that can be used for simulated and experimental magnetic resonance guided focal intervention. Our secondary aim was to asses the phantom using other imaging modalities. ⋯ The phantom is a useful tool to test different aspects of thermal focal ablation for prostate cancer using multiple imaging modalities, particularly magnetic resonance. It is inexpensive and easily constructed, and may be considered a valuable model to train on and teach focal therapy.