The Journal of urology
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The Journal of urology · Jul 2013
Randomized Controlled Trial Comparative StudyRoutine flexible nephroscopy for percutaneous nephrolithotomy for renal stones with low density: a prospective, randomized study.
We evaluated the usefulness of routine flexible nephroscopy during percutaneous nephrolithotomy. ⋯ Routine flexible nephroscopy during percutaneous nephrolithotomy was associated with a higher stone-free rate, fewer interventions and less bleeding, especially in patients with low HU density stones.
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The Journal of urology · Jul 2013
Comparative StudyComparative performance of comorbidity indices for estimating perioperative and 5-year all cause mortality following radical cystectomy for bladder cancer.
Radical cystectomy continues to be associated with a nonnegligible risk of perioperative death and all cause mortality in the years after surgery remains relatively high. We investigated the comparative ability of various comorbidity indices to predict perioperative and 5-year all cause mortality after radical cystectomy. ⋯ Comorbidity status is predictive of perioperative death and 5-year all cause mortality after radical cystectomy and, therefore, should be incorporated into patient counseling and risk stratification models. Further prospective studies are warranted to overcome the retrospective limitations in determining the relative prognostic value of various comorbidity indices.
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The Journal of urology · Jul 2013
Comparative StudyEffect of practice integration between urologists and radiation oncologists on prostate cancer treatment patterns.
National attention has focused on whether urology-radiation oncology practice integration, known as integrated prostate cancer centers, contributes to the use of intensity modulated radiation therapy, a common and expensive prostate cancer treatment. ⋯ Coincident with the conversion of a urology group practice to an integrated prostate cancer center, we observed an increase in intensity modulated radiation therapy and a decrease in androgen deprivation therapy in patients seen by integrated prostate cancer center physicians and those seen in the surrounding health care market that were not observed in the remainder of the state.
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The Journal of urology · Jul 2013
Comparative StudyUrine neutrophil gelatinase-associated lipocalin as a marker of acute kidney injury after kidney surgery.
We evaluated urine NGAL as a marker of acute kidney injury in patients undergoing partial nephrectomy. We sought to identify the preoperative clinical features and surgical factors during partial nephrectomy that are associated with renal injury, as measured by increased urine NGAL vs controls. ⋯ Urine NGAL does not appear to be a useful marker for detecting renal injury in healthy patients treated with partial nephrectomy. However, patients with poorer preoperative renal function have higher baseline urine levels and appear more susceptible to acute kidney injury, as detected by urine levels and Acute Kidney Injury Network criteria, than those with a normal estimated glomerular filtration rate.
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The Journal of urology · Jul 2013
Comparative StudyTunica albuginea decompression fails to alter the injury of prolonged arterial occlusion during testicular torsion.
The correlation between intratesticular pressure during torsion/detorsion and subsequent testicular function and viability has been reported in several recent studies. We assessed the impact of tunica albuginea incision with tunica vaginalis flap coverage on intratesticular pressure and future histopathological parameters in a rat testicular torsion model. ⋯ Tunica albuginea decompression with tunica vaginalis flap coverage is an effective technique for decreasing intratesticular pressure in torsed testes. However, this technique failed to alter the injury of prolonged arterial occlusion in testicular torsion.