The Journal of urology
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The Journal of urology · Apr 2012
Comparative StudyPopulation based comparative effectiveness of transurethral resection of the prostate and laser therapy for benign prostatic hyperplasia.
As the American population ages, benign prostatic hyperplasia and its associated lower urinary tract symptoms have become increasingly important causes of chronic morbidity. We assessed the comparative effectiveness of 2 common forms of surgical therapy, transurethral prostate resection and laser therapy, for benign prostatic hyperplasia. ⋯ Laser procedures and transurethral prostate resection provide effective management of benign prostatic hyperplasia/lower urinary tract symptoms. Laser procedures are associated with less need for hospitalization than transurethral prostate resection but appear to involve a trade-off in long-term efficacy.
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The Journal of urology · Apr 2012
Comparative StudyUse, costs and comparative effectiveness of robotic assisted, laparoscopic and open urological surgery.
Although robotic assisted laparoscopic surgery has been aggressively marketed and rapidly adopted, there are few comparative effectiveness studies that support its purported advantages compared to open and laparoscopic surgery. We used a population based approach to assess use, costs and outcomes of robotic assisted laparoscopic surgery vs laparoscopic surgery and open surgery for common robotic assisted urological procedures. ⋯ While robotic assisted and laparoscopic surgery are associated with fewer deaths, complications, transfusions and shorter length of hospital stay compared to open surgery, robotic assisted laparoscopic surgery is more costly than laparoscopic and open surgery. Additional studies are needed to better delineate the comparative and cost-effectiveness of robotic assisted laparoscopic surgery relative to laparoscopic surgery and open surgery.
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The Journal of urology · Apr 2012
High fidelity simulation based team training in urology: a preliminary interdisciplinary study of technical and nontechnical skills in laparoscopic complications management.
Simulation based team training provides an opportunity to develop interdisciplinary communication skills and address potential medical errors in a high fidelity, low stakes environment. We evaluated the implementation of a novel simulation based team training scenario and assessed the technical and nontechnical performance of urology and anesthesiology residents. ⋯ Residents rated the simulation based team training scenario as useful for interdisciplinary communication skill training. Urology resident training level correlated with technical performance but not with nontechnical performance. Urology residents consistently overestimated their nontechnical performance.
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Chronic pelvic pain syndrome accounts for 90% of all chronic prostatitis but it has an unknown pathogenesis. We sought to understand the role of mast cells and nerve growth factor in chronic pelvic pain. ⋯ Results suggest that mast cells are important mediators of chronic pelvic pain in experimental autoimmune prostatitis cases. They may be potential targets for therapeutic intervention in men with chronic prostatitis/chronic pelvic pain syndrome.