The Journal of urology
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The Journal of urology · Oct 2003
Hemodynamic and respiratory effect of pediatric urological laparoscopic surgery: a retrospective study.
We investigate the impact of extraperitoneal and intraperitoneal CO2 insufflation on cardiopulmonary variables in children undergoing laparoscopic surgery. ⋯ Our study documented significant hemodynamic and respiratory changes during pediatric laparoscopic surgeries. A similar effect on the respiratory parameters was observed in both groups. Although there were no apparent complications associated with either approach, further prospective studies are warranted to confirm the effect of laparoscopic urological surgery on cardiopulmonary function in children.
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The Journal of urology · Oct 2003
Evaluation of age and comorbidity as risk factors after laparoscopic urological surgery.
Few reports in the urological literature have focused on the growing population of elderly (65 years or older) patients. Coexistent medical conditions, which are more prevalent in elderly individuals, can confound results of outcome studies in this population. This single center, retrospective study was done to determine whether age and comorbidity are predictors of outcome in patients undergoing laparoscopic renal and adrenal surgery. ⋯ Laparoscopic renal and adrenal surgery in patients 65 years or older is well tolerated. Age 65 years or older is predictive of a significantly increased hospital stay of approximately 1 day after major renal and adrenal laparoscopic surgery and it does not appear to increase independently the risk of intraoperative, postoperative or late operative complications.
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The Journal of urology · Oct 2003
How to investigate neurovesical dysfunction in children with anorectal malformations.
Neurovesical dysfunction (NVD) is common in children with anorectal malformation (ARM). NVD is mainly related to tethered cord or iatrogenic injury but how to investigate it is still debated. We evaluate the usefulness of routine magnetic resonance imaging (MRI) and urodynamics (UDS) for ARM. ⋯ Because tethered cord occurs in children without sacral anomalies as well as in those with low ARM, we recommend evaluation of all patients using MRI. When MRI is positive UDS should be performed. We agree with a previous suggestion to evaluate all males with rectourethral fistula and females with cloaca malformations. Finally we recommend a noninvasive evaluation for all other children and UDS when neurogenic dysfunction is suspected.
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The Journal of urology · Oct 2003
Randomized Controlled Trial Clinical TrialDuloxetine versus placebo for the treatment of North American women with stress urinary incontinence.
Duloxetine, a selective serotonin and norepinephrine reuptake inhibitor, increases rhabdosphincter contractility via the stimulation of pudendal motor neuron alpha-1 adrenergic and 5-hydroxytryptamine-2 receptors. In this first phase 3 study we assessed the efficacy and safety of duloxetine in women with stress urinary incontinence (SUI). ⋯ These phase 3 data are consistent with phase 2 data and they provide further evidence for the safety and efficacy of duloxetine as a pharmacological agent for the treatment of women with SUI.
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The Journal of urology · Oct 2003
Tandem cuff artificial urinary sphincter as a salvage procedure following failed primary sphincter placement for the treatment of post-prostatectomy incontinence.
Management of post-artificial urinary sphincter (AUS) urethral atrophy can be difficult for the treating physician, yielding unsatisfactory results for the patient. As with many incontinence procedures, initial results are generally encouraging. We determined the durability and success of tandem cuff placement for urethral atrophy following AUS placement. ⋯ Placement of tandem urethral cuff as a salvage procedure for recurrent stress urinary incontinence provides marked sustained improvement in leakage and overall high patient satisfaction in the difficult setting of urethral atrophy.