The Journal of urology
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The Journal of urology · May 1993
Laparoscopic surgical training: effectiveness and impact on urological surgical practice patterns.
Urological interest in laparoscopic surgical techniques has dramatically increased during the last several years. However, the extent to which these methods are being used and the impact of training courses on clinical use are unclear. We assessed urologist practice patterns subsequent to a formal training course in urological laparoscopic surgery. ⋯ Of those who responded 88% believed that their future use of laparoscopy would increase. This survey suggests that subsequent to training, laparoscopic techniques are being rapidly and safely used by urologists. However, in the current state of development the impact of laparoscopic surgery on global urological practice patterns appears to be small.
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The Journal of urology · May 1993
Incidence and management of autonomic dysreflexia and other intraoperative problems encountered in spinal cord injury patients undergoing extracorporeal shock wave lithotripsy without anesthesia on a second generation lithotriptor.
Spinal cord injury patients are at increased risk for urolithiasis and many will require treatment, most commonly with extracorporeal shock wave lithotripsy. New, second generation lithotripsy devices allow treatment without tub immersion, and without general or regional anesthesia for most patients. Spinal cord injury patients, with loss of sensation below the level of injury, would seem to be ideal candidates for such treatment. ⋯ Other problems included uncontrolled skeletal muscle spasms elicited by shock waves, which proved to be troublesome in maintaining patient position and stone localization. Muscle spasms were decreased with benzodiazepines. Care was also observed in spinal cord injury patients to pad all pressure points on the hard, dry treatment surfaces associated with second generation lithotriptors and, thus, prevent skin breakdown.
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The Journal of urology · May 1993
Case ReportsDelayed rupture of type I posterior urethral injury: case report.
Type I posterior urethral injuries are a frequently noted but infrequently reported entity in the setting of pelvic fracture. Almost all of these injuries will do well with Foley catheter drainage. However, the urethral integrity as established by admission retrograde urethrography is not an unalterable state and serious septic sequelae may be noted if the evolving injury is unrecognized. We report a case of delayed rupture of a type I posterior urethral injury causing infection of the pelvic hematoma and subsequent sepsis.
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The Journal of urology · Apr 1993
Case ReportsSevere chemical cystitis from the transurethral intravesical insertion of a vaginal contraceptive suppository: a report of 3 cases and proposed method of management.
We report on 3 patients who sustained severe chemical cystitis from the inadvertent insertion of a nonoxynol-9 containing vaginal contraceptive suppository into the bladder. A suggested treatment schedule is presented and the toxicity of nonoxynol-9 is discussed.
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The Journal of urology · Mar 1993
Patterns of irrigating fluid absorption during transurethral resection of the prostate as indicated by ethanol.
The absorption of irrigating fluid was measured by the ethanol method every 10 minutes during the course of 700 transurethral prostatic resections. The total blood loss was also measured using a photometer method. We found that ethanol determination is a convenient method of monitoring irrigating fluid absorption in daily practice. ⋯ Once absorption had started, there was an 87% probability that it would continue through the next 10 minutes with the exception of the last 10 minutes of surgery, when there was a 67% probability. A sudden decrease in arterial pressure coincided with the onset of fluid absorption 3.7 times more often than expected by chance. The absorption was no different in the 114 patients with a cancerous histology, compared to those with benign prostatic hyperplasia.