The Journal of urology
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The Journal of urology · Jan 2013
Comparative StudyHospitalization trends after prostate and bladder surgery: implications of potential payment reforms.
Hospital stays have decreased for patients undergoing surgery for urological cancer. However, there are concerns that patients are being discharged from the hospital prematurely. We examined associations between hospital stay and short-term outcomes for a low risk procedure (prostatectomy) and high risk procedure (cystectomy). ⋯ Reductions in hospital stay were more dramatic for patients who underwent prostatectomy and were associated with stable short-term outcomes. Conversely, smaller reductions in hospitalization for patients undergoing cystectomy were met with substantial increases in the use of post-acute care. Going forward, close surveillance of how imminent policy reforms affect patterns and quality of care will be necessary.
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The Journal of urology · Jan 2013
Herpes simplex virus vector mediated gene therapy of tumor necrosis factor-α blockade for bladder overactivity and nociception in rats.
We examined the effects of tumor necrosis factor-α blockade on bladder overactivity and nociception using replication defective HSV vectors expressing tumor necrosis factor-α soluble receptor. ⋯ HSV vector mediated tumor necrosis factor-α blockade gene therapy in the bladder and bladder afferent pathways decreases the bladder pain and overactivity induced by nociceptive bladder stimuli.
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The Journal of urology · Jan 2013
Comparative StudyCost of neuromodulation therapies for overactive bladder: percutaneous tibial nerve stimulation versus sacral nerve stimulation.
Conservative therapy and antimuscarinic agents are first line therapies for overactive bladder. Patients refractory to treatment are candidates for neuromodulation therapy. We estimated the costs and cost-effectiveness of percutaneous tibial nerve stimulation and sacral nerve stimulation. ⋯ Percutaneous tibial nerve stimulation and sacral nerve stimulation are safe, effective neuromodulation therapies for overactive bladder. In this economic model percutaneous tibial nerve stimulation had substantially lower cost. An additional 1% of patients would remain on therapy at 2 years if sacral nerve stimulation were used rather than percutaneous tibial nerve stimulation but the average cost per additional patient would be more than $500,000.