The Journal of urology
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The Journal of urology · Sep 2013
Comparative StudyMedical expulsive therapy versus early endoscopic stone removal for acute renal colic: an instrumental variable analysis.
The use of medical expulsive therapy to hasten stone passage potentially decreases expenditures around episodes of renal colic. However, these efficiency gains may be mitigated if patients treated with medical expulsive therapy have frequent health care encounters due to pain while waiting for the stones to pass. ⋯ Findings on medical expulsive therapy are mixed, with lower 6-week payments but more frequent repeat emergency department visits. These data inform patients who are candidates for medical expulsive therapy or endoscopic stone removal when making decisions about their care.
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The Journal of urology · Sep 2013
Men with low preoperative sexual function may benefit from nerve sparing radical prostatectomy.
We determined the effect of nerve sparing radical prostatectomy on sexual and urinary function in men at various levels of pretreatment sexual function. ⋯ Nerve sparing radical prostatectomy results in better sexual function outcomes than no nerve sparing in most men except those with little baseline function. Urinary function was positively impacted in all men. Men who are suitable candidates for nerve preservation may benefit from nerve sparing surgery. Poorer baseline sexual function should not exclude these men from such surgery.
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The Journal of urology · Sep 2013
Review Meta Analysis Comparative StudyLaparoscopic pyelolithotomy compared to percutaneous nephrolithotomy as surgical management for large renal pelvic calculi: a meta-analysis.
We assessed the effectiveness and safety of laparoscopic pyelolithotomy and percutaneous nephrolithotomy as surgical management for solitary renal pelvic calculi larger than 2 cm. ⋯ Current evidence suggests that laparoscopic pyelolithotomy and percutaneous nephrolithotomy are effective and safe for large renal pelvic calculi but laparoscopic pyelolithotomy seems to be more advantageous. However, given the inherent limitations of the included studies, results must be further confirmed in high quality randomized, controlled trials.
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The Journal of urology · Sep 2013
Functional status and postoperative morbidity in older women with prolapse.
We determined the relationship of preoperative functional status to postoperative morbidity after pelvic organ prolapse surgery in women older than 60 years. ⋯ As defined by ASA class, preoperative functional status is significantly associated with postoperative length of stay and complications. Preoperative functional status is useful for predicting postoperative outcomes in older women who undergo pelvic organ prolapse surgery.
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The Journal of urology · Sep 2013
Comparative StudyThe impact of running versus interrupted anastomosis on ureterointestinal stricture rate after radical cystectomy.
Benign ureterointestinal anastomotic stricture is not uncommon after radical cystectomy and urinary diversion. We studied the impact of the running vs the interrupted technique on the ureterointestinal anastomotic stricture rate. ⋯ A running anastomosis and postoperative urinary tract infection may be associated with ureterointestinal anastomotic stricture. Larger series with multiple surgeons are needed to confirm these findings.