The Journal of urology
-
The Journal of urology · Nov 2009
Comparative StudyDifferences in initial benign prostatic hyperplasia management between primary care physicians and urologists.
The introduction of efficacious pharmacotherapies has effectively transformed benign prostatic hyperplasia into a chronic disease that requires ongoing medical care. With this transformation primary care physicians have become more involved in the management of benign prostatic hyperplasia. The impact of the increasing role of the primary care physician on the use of benign prostatic hyperplasia related health services remains unknown. ⋯ On average, urologists had a higher intensity practice style for benign prostatic hyperplasia than primary care physicians. Further studies are needed to determine how these practice style differences relate to patient clinical outcomes.
-
The Journal of urology · Nov 2009
A prospective study of risk factors for nephrolithiasis after Roux-en-Y gastric bypass surgery.
Roux-en-Y gastric bypass surgery has become an increasingly common form of weight management. Early retrospective reviews have suggested that new onset nephrolithiasis develops in some patients after undergoing Roux-en-Y gastric bypass. We present a prospective longitudinal study to assess risk factors for nephrolithiasis after Roux-en-Y gastric bypass. ⋯ Our prospective study demonstrated multiple factors that increase the relative risk of nephrolithiasis after Roux-en-Y gastric bypass. These changes may make stone formation after Roux-en-Y gastric bypass increasingly likely and pose an ongoing challenge in the realm of urology.
-
The Journal of urology · Oct 2009
Do oral antimuscarinic drugs carry an increased risk of acute urinary retention?
We determined whether men treated with oral antimuscarinics are at increased risk for acute urinary retention. ⋯ Men prescribed antimuscarinics, particularly for a urogenital condition, should be closely monitored during the first 30 days of treatment for signs or symptoms of urinary retention.
-
The Journal of urology · Oct 2009
Multicenter StudyLocation, extent and number of positive surgical margins do not improve accuracy of predicting prostate cancer recurrence after radical prostatectomy.
Positive surgical margins increase the risk of biochemical recurrence after radical prostatectomy by 2 to 4-fold. The risk of biochemical recurrence may be influenced by the anatomical location and extent of positive surgical margins. In a multicenter study we analyzed the predictive usefulness of several subclassifications of positive surgical margins. ⋯ The number and extent of positive surgical margin significantly influence the risk of biochemical recurrence after radical prostatectomy. However, the empirical prognostic usefulness of subclassifications of positive surgical margins is limited.
-
The Journal of urology · Oct 2009
Randomized Controlled Trial Comparative StudyContinuous epidural versus nonepidural analgesia for post-pyeloplasty pain in children.
We compared the effectiveness of post-pyeloplasty epidural and nonepidural analgesia in children. ⋯ Nonepidural analgesia is as effective as continuous epidural analgesia to control post-pyeloplasty pain in children. A noninvasive analgesic regimen is recommended when there is a relative contraindication to line insertion, a less experienced anesthetist is available or parents prefer it.