The Journal of urology
-
The Journal of urology · Aug 2012
Population based study of long-term rates of surgery for urinary incontinence after radical prostatectomy for prostate cancer.
Urinary incontinence can be a significant complication of radical prostatectomy. It can be treated with post-prostatectomy surgical procedures. The long-term rate of patients who undergo these surgeries, including artificial urinary sphincter or urethral sling insertion, is not well described. We examined the long-term rate of post-prostatectomy incontinence surgery and factors influencing it. ⋯ Of patients who undergo radical prostatectomy 5% are expected to be treated with surgery for urinary incontinence during a 15-year period. Increasing patient age, radiation treatment and low surgeon volume are associated with significantly higher risk.
-
The Journal of urology · Aug 2012
Trends in regionalization of adrenalectomy to higher volume surgical centers.
Although centralization of surgical procedures to high volume centers has been described previously, patterns of care for adrenal surgery are largely unknown. We determined the extent of regionalization of care for adrenal surgery and the extent to which this centralization has evolved with time. ⋯ These data reveal the increasing centralization of adrenalectomy to very high volume hospitals since 1996 with improved clinical outcomes. Inequities in access to care to higher volume centers appear to exist and require further investigation.
-
The Journal of urology · Jul 2012
Comparative StudyNonoperative management of penetrating kidney injuries: a prospective audit.
The role of nonoperative management for penetrating kidney injuries is unknown. Therefore, we review the management and outcome of penetrating kidney injuries at a center with a high incidence of penetrating trauma. ⋯ Penetrating trauma is associated with a high nephrectomy rate (24.3%). However, a high nonoperative success rate (100%) is achievable with minimal morbidity (9%).
-
The Journal of urology · Jul 2012
Comparative StudyOutcomes of endoscopic realignment of pelvic fracture associated urethral injuries at a level 1 trauma center.
We examined the success of early endoscopic realignment of pelvic fracture associated urethral injury after blunt pelvic trauma. ⋯ Early endoscopic realignment after blunt pelvic fracture associated urethral injury results in high rates of symptomatic urethral stricture requiring further operative treatment. Close followup after initial catheter removal is warranted, as the mean time to failure after early endoscopic realignment was 79 days in our cohort.