The Journal of urology
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The Journal of urology · Aug 1990
Randomized Controlled Trial Clinical TrialCaudal epidural anesthesia reduces blood loss during hypospadias repair.
We studied 24 boys who were randomized to receive caudal epidural anesthesia with 0.33 ml.kg.-1 0.25% bupivacaine either before (group A) or after (group B) Mathieu repair of distal hypospadias. The 2 groups did not differ in regard to age or weight, and all boys received a standardized anesthetic with halothane and nitrous oxide in oxygen. Intraoperative blood loss was measured with sponge weights and microcalibrated suction canisters. ⋯ Operating time was reduced in group A (92 plus or minus 13 minutes versus 103 plus or minus 14 minutes, p less than 0.05). There was no apparent difference in postoperative pain relief between the 2 groups. We conclude that caudal epidural anesthesia can reduce blood loss and improve surgical conditions during hypospadias repair.
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The Journal of urology · Jul 1990
Strategies for asymptomatic microscopic hematuria: a prospective study of 1,034 patients.
To establish strategies for treatment of asymptomatic microscopic hematuria we conducted a prospective study of 1,034 patients with this disease. The patients were examined by cystoscopy, urine cytology, abdominal ultrasound and excretory urography. ⋯ Of the 246 patients with insignificant lesions and 563 with unexplained asymptomatic microscopic hematuria followup was done in 421 at 6-month intervals for more than 1 year. A diagnosis became clear within 3 years in 22 patients, including 3 cases of bladder carcinoma and 1 of prostatic carcinoma.
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The Journal of urology · May 1990
Case ReportsBowel injury as a result of penetrating scrotal trauma: review of associated injuries.
We report a case of bowel injury as a result of an isolated gunshot wound to the scrotum. Our experience with penetrating scrotal trauma reveals a high rate of associated injuries, the most common being trauma to the soft tissue of the thigh. Our case emphasizes the importance of a thorough preoperative and operative evaluation of patients with penetrating scrotal trauma.
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The Journal of urology · Apr 1990
Treatment of post-orchiectomy hot flashes with transdermal administration of clonidine.
The occurrence of hot flashes in men after bilateral orchiectomy for prostatic carcinoma can be bothersome and difficult to treat. Transdermal clonidine was administered to 7 patients with such symptoms. ⋯ No significant side effects were encountered. We suggest that transdermal clonidine (0.1 mg.) administered weekly can safely control undesirable hot flashes in men after bilateral orchiectomy.
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The Journal of urology · Mar 1990
Delay in diagnosis and survival in testicular cancer: impact of effective therapy and changes during 18 years.
In an effort to determine the impact of a delayed diagnosis in testicular cancer the records of 148 patients with a known interval of delay were reviewed. The over-all mean symptomatic interval of this population was 21.1 weeks and did not change significantly during an 18-year review period. ⋯ Further analysis of the nonseminoma patients revealed that delay strongly affected survival (p equals 0.001) in the pre-cisplatin era (1970 to 1978) but it was less pronounced (p equals 0.262) in the cisplatin era (1979 to 1987). Despite an attenuation of the effect of delay in the current era of effective chemotherapy, deaths still occur due to delay in diagnosis and programs to lessen delay, such as testicular self-examination, and patient and physician education, are strongly encouraged.