The Journal of urology
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The Journal of urology · Nov 2013
Randomized Controlled TrialPerioperative celecoxib decreases opioid use in patients undergoing testicular surgery: a randomized, double-blind, placebo controlled trial.
We evaluated the effect of daily perioperative celecoxib on patient reported pain control and opioid use after testicular surgery. ⋯ Twice daily celecoxib use started preoperatively significantly decreased patient reported postoperative pain and opioid use, especially in the early postoperative period. A short course of celecoxib is well tolerated and may be effective as part of multimodal postoperative analgesia in patients who undergo testicular surgery for sperm retrieval.
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The Journal of urology · Nov 2013
Comparative StudyComparison of creatinine based and kidney volume based methods of estimating glomerular filtration rates in potential living kidney donors.
Accurate assessment of kidney function is critical to evaluate living kidney donors. Direct glomerular filtration rate measurement using isotopes is currently the gold standard but it is complex and costly. We evaluated the performance of surrogate markers of the glomerular filtration rate in living kidney donors by comparing direct measurement of the rate to the creatinine based equation estimated rate, the kidney volume based estimated rate using a newly developed equation and creatinine clearance. ⋯ To estimate the glomerular filtration rate in healthy individuals a volume based model correlated better than the MDRD equation, which is the best performing creatinine based equation used to estimate the rate. By providing a more robust estimation of the glomerular filtration rate in healthy potential kidney donors, the volume based model adds value to routine preoperative computerized tomography above that of anatomical evaluation.
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The Journal of urology · Nov 2013
Use of surveillance imaging following treatment of small renal masses.
With the increasing incidence of small renal masses, there is greater use of ablation, nephron sparing surgery and surveillance compared to radical nephrectomy. However, patterns of care in the use of posttreatment imaging remain uncharacterized. The purpose of this study is to determine the rate of posttreatment imaging after various treatments for small renal mass. ⋯ Subjects undergoing nephron sparing surgery undergo more posttreatment imaging compared to open radical nephrectomy. Although possibly associated with lower morbidity, thermal ablation is associated with significantly greater use of imaging compared to other small renal mass treatments. This may increase costs and radiation exposure, although further study is needed for confirmation.
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The Journal of urology · Nov 2013
Population based study of use and determinants of active surveillance and watchful waiting for low and intermediate risk prostate cancer.
Prior studies have reported the underuse of deferred treatment (ie active surveillance or watchful waiting) for low risk prostate cancer in the United States. We examined contemporary trends in active surveillance and watchful waiting in the nationwide Swedish prostate cancer registry. We also examined factors associated with selection of deferred management, which might provide insight into the rational diffusion of this important management strategy. ⋯ Deferred treatment for low and intermediate risk prostate cancer was frequently used in Sweden. Dissociating diagnosis from treatment in men with a low risk of progression can decrease the rate of overtreatment.