The Journal of urology
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The Journal of urology · Dec 2014
A high throughput, minimally invasive, ultrasound guided model for the study of catheter associated urinary tract infections and device encrustation in mice.
Catheter associated urinary tract infections are one of the most common health care associated infections. The condition is frequently complicated by encrustation, which blocks the catheter lumen. Preclinical research is limited by the lack of relevant high throughput and cost-effective animal models. Current models are restricted to female mice, associated with major transurethral loss of catheter materials during micturition, highly invasive and complex. We present an ultrasound guided, minimally invasive model that enables catheter associated urinary tract infection and catheter encrustation studies in each mouse gender. ⋯ Our minimally invasive, reproducible percutaneous technique is suitable for studying catheter associated urinary tract infection in each gender. Infecting urine with P. mirabilis generates a preclinical model of catheter encrustation within 3 days. The progression of encrustation can be monitored in vivo by ultrasound, making this image based model suitable for assessing novel antibacterial and anti-encrustation therapies.
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The Journal of urology · Dec 2014
Following the needles: an anatomical study to evaluate the postoperative safety and symptoms of patients receiving a transobturator male sling implant.
Implanting a transobturator male sling is a valid option to manage urinary incontinence after prostatectomy. We evaluated the trajectory of Argus T™ needles blindly introduced into the retropubic space to determine the safety and etiology of postoperative symptoms that can arise from this implant. ⋯ The needle sling implant preserves the obturator neurovascular bundle and obviates the potential for postoperative pelvic hematoma. The anatomical trajectory of the needles used for this implant account for the groin and perineal pain side effects. Based on similarities between the Argus T and other types of outside-in transobturator male slings the results of the current study could be extrapolated to the latter slings.
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The Journal of urology · Dec 2014
Identification of threshold prostate specific antigen levels to optimize the detection of clinically significant prostate cancer by magnetic resonance imaging/ultrasound fusion guided biopsy.
Prostate specific antigen sensitivity increases with lower threshold values but with a corresponding decrease in specificity. Magnetic resonance imaging/ultrasound targeted biopsy detects prostate cancer more efficiently and of higher grade than standard 12-core transrectal ultrasound biopsy but the optimal population for its use is not well defined. We evaluated the performance of magnetic resonance imaging/ultrasound targeted biopsy vs 12-core biopsy across a prostate specific antigen continuum. ⋯ Prostate cancer upgrading with targeted biopsy increases with an increasing prostate specific antigen cutoff. Above a prostate specific antigen threshold of 5.2 ng/ml most upgrading to clinically significant disease was achieved by targeted biopsy. In our population this corresponded to potentially sparing biopsy in 36% of patients who underwent multiparametric magnetic resonance imaging. Below this value 12-core biopsy detected more clinically insignificant cancer. Thus, the diagnostic usefulness of targeted biopsy is optimized in patients with prostate specific antigen 5.2 ng/ml or greater.
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The Journal of urology · Dec 2014
Comment LetterRe: Ultrasound guided transversus abdominis plane vs surgeon administered intraoperative regional field infiltration with bupivacaine for early postoperative pain control in children undergoing open pyeloplasty: A. J. Lorenzo, J. Lynch, C. Matava, H. El-Beheiry and J. Hayes. J Urol 2014; 192: 207-213.