The Journal of urology
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The Journal of urology · Jun 2013
Comparative StudyClinical implementation of quality of life instruments and prediction tools for localized prostate cancer: results from a national survey of radiation oncologists and urologists.
Although clinical guidelines recommend assessing quality of life, cancer aggressiveness and life expectancy for making localized prostate cancer treatment decisions, it is unknown whether instruments that objectively measure such outcomes have disseminated into clinical practice. In this context we determined whether quality of life and prediction instruments for prostate cancer have been adopted by radiation oncologists and urologists in the United States. ⋯ Although prostate cancer nomograms have been implemented into clinical practice to some degree, the use of quality of life and life expectancy tools has been more limited. Increased attention to implementing validated instruments into clinical practice may facilitate shared decision making for patients with prostate cancer.
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The Journal of urology · Jun 2013
How painful is adult circumcision? A prospective, observational cohort study.
Men are particularly concerned about pain after circumcision. Concerns about pain can be a reason to refuse surgery. We assessed the severity of postoperative pain and investigated factors that may influence postoperative pain. ⋯ Pain is mild to moderate after circumcision in adults under general anesthesia with an intraoperative penile block. Severe pain is rare and mostly related to complications. Younger patients generally have more discomfort.
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The Journal of urology · May 2013
Randomized Controlled TrialTranexamic acid reduces blood loss during percutaneous nephrolithotomy: a prospective randomized controlled study.
Bleeding is a significant morbidity associated with percutaneous nephrolithotomy. This study was conducted to evaluate the safety and efficacy of the antifibrinolytic agent tranexamic acid in reducing blood loss in patients undergoing percutaneous nephrolithotomy. ⋯ The use of tranexamic acid in percutaneous nephrolithotomy is safe, and is associated with reduced blood loss and a lower complication rate.
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The Journal of urology · May 2013
High grade renal injuries: application of Parkland Hospital predictors of intervention for renal hemorrhage.
Investigators from Parkland Hospital proposed substratification of the AAST (American Association for the Surgery of Trauma) grading scale based on 3 risk factors, including active vascular extravasation, a medial laceration and a perinephric hematoma of greater than 3.5 cm. We hypothesized that these characteristics would also be associated with intervention for renal hemorrhage in our large trauma series. ⋯ Vascular extravasation, a perinephric hematoma greater than 3.5 cm and the number of risk factors (0 to 3) were associated with intervention for renal hemorrhage. Our findings are similar to those at Parkland Hospital. These imaging features may serve as useful prognostic indicators for renal trauma.
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The Journal of urology · May 2013
Detection of normal intratesticular perfusion using color coded duplex sonography obviates need for scrotal exploration in patients with suspected testicular torsion.
Although color coded duplex sonography is useful for visualizing testicular perfusion in patients with clinical suspicion of testicular torsion, fear of overlooking the condition itself remains. Thus, routine scrotal exploration in every patient with acute scrotal pain is common at many centers. We assessed the efficacy of color coded duplex sonography in predicting the need for scrotal exploration in patients with clinical suspicion of testicular torsion. ⋯ Our data provide evidence that routine surgical exploration is no longer justified in patients with clinical suspicion of testicular torsion if color coded duplex sonography has revealed normal intratesticular perfusion.