The Journal of urology
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The Journal of urology · Jan 2015
Randomized Controlled TrialSuperior functional outcome after radical cystectomy and orthotopic bladder substitution with restrictive intraoperative fluid management: a followup study of a randomized clinical trial.
Continuous intraoperative norepinephrine infusion combined with restrictive deferred hydration improves surgical field visibility, and significantly decreases intraoperative blood loss and postoperative complications in patients undergoing radical cystectomy and urinary diversion. We determined whether the intraoperative fluid regimen would affect functional results (continence and erectile function) 1 year after orthotopic ileal bladder substitution. ⋯ Patients who undergo radical cystectomy and orthotopic bladder substitution with continuous norepinephrine infusion and restrictive hydration during surgery have significantly better daytime continence and erectile function 1 year postoperatively.
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The Journal of urology · Jan 2015
Comparative StudyComparative analysis of transperineal template saturation prostate biopsy versus magnetic resonance imaging targeted biopsy with magnetic resonance imaging-ultrasound fusion guidance.
Multiparametric magnetic resonance imaging and magnetic resonance imaging targeted biopsy may improve the detection of clinically significant prostate cancer. However, standardized prospective evaluation is limited. ⋯ Compared to systematic, transperineal biopsy as a reference test, magnetic resonance imaging targeted biopsy alone detected as many Gleason score 7 or greater tumors while simultaneously mitigating the detection of lower grade disease. The gold standard for cancer detection in primary biopsy is a combination of systematic and targeted cores.
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The Journal of urology · Jan 2015
Increased brain gray matter in the primary somatosensory cortex is associated with increased pain and mood disturbance in patients with interstitial cystitis/painful bladder syndrome.
Interstitial cystitis is a highly prevalent pain condition estimated to affect 3% to 6% of women in the United States. Emerging data suggest there are central neurobiological components to the etiology of this disease. We report the first brain structural imaging findings from the MAPP network with data on more than 300 participants. ⋯ These data support the notion that changes in somatosensory gray matter may have an important role in pain sensitivity as well as affective and sensory aspects of interstitial cystitis. Further studies are needed to confirm the generalizability of these findings to other pain conditions.
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The Journal of urology · Jan 2015
Sunitinib, pazopanib or sorafenib for the treatment of patients with late relapsing metastatic renal cell carcinoma.
Late recurrence of renal cell carcinoma is not a rare event. In this retrospective study we investigate the clinicopathological features and the outcome of patients treated with sorafenib, sunitinib and pazopanib for late relapsing renal cell carcinoma. ⋯ Patients with late relapsing renal cell carcinoma seem to present a characteristic pattern of metastatic spread without showing significant differences in terms of progression-free survival among sorafenib, sunitinib and pazopanib.
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The Journal of urology · Jan 2015
Clinical and psychological parameters associated with pain pattern phenotypes in women with interstitial cystitis/bladder pain syndrome.
It was recently suggested that 2 distinct clinical phenotypes can be described in patients with urological chronic pelvic pain syndrome, including pelvic pain only and pelvic pain beyond. We examined data on patients with interstitial cystitis/bladder pain syndrome, including body pain location mapping, and associated medical and psychosocial phenotyping to validate these body pain maps in a cohort of female patients with interstitial cystitis/bladder pain syndrome undergoing tertiary care. ⋯ Two distinct pain location phenotypes, including pelvic pain only and pelvic pain beyond, were identified by our independent analysis of patients with interstitial cystitis/bladder pain syndrome. Assessing clinical phenotypes based on pain patterns has significant ramifications in our improved understanding of the etiology and treatment of female patients diagnosed with interstitial cystitis/bladder pain syndrome.