The Journal of urology
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The Journal of urology · Sep 2009
Diagnosis and surgical management of colovesical fistulas due to sigmoid diverticulitis.
Diverticular disease of the colon is the most frequent cause of colovesical fistulas. In this study we evaluated the accuracy of different diagnostic procedures for the detection of colovesical fistula and the clinical outcome in a series of 49 patients who underwent surgery for colovesical fistula due to sigmoid diverticulitis. ⋯ In our series the poppy seed test had the highest sensitivity to detect colovesical fistulas. However, abdominopelvic computerized tomography, colonoscopy and cystoscopy are essential diagnostic procedures because the presence of colon or bladder cancer as an underlying cause of colovesical fistula will determine further therapy.
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The Journal of urology · Sep 2009
Comparative StudyPreliminary study of virtual reality and model simulation for learning laparoscopic suturing skills.
Repetitive practice of laparoscopic suturing and knot tying can facilitate surgeon proficiency in performing this reconstructive technique. We compared a silicone model and pelvic trainer to a virtual reality simulator in the learning of laparoscopic suturing and knot tying by laparoscopically naïve medical students, and evaluated the subsequent performance of porcine laparoscopic cystorrhaphy. ⋯ There is no significant difference between the pelvic trainer and virtual reality trained medical students in proficiency to perform laparoscopic cystorrhaphy in a pig model, although both groups require considerably more training before performing this procedure clinically. The pelvic trainer training may be more user-friendly for the novice surgeon to begin learning these challenging laparoscopic skills.
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The Journal of urology · Aug 2009
Randomized Controlled TrialIntraprostatic local anesthesia with periprostatic nerve block for transrectal ultrasound guided prostate biopsy.
Prostate biopsy is an invasive procedure that may be painful and require some form of anesthesia. We compared the pain control results of periprostatic nerve block alone vs periprostatic nerve block with intraprostatic anesthesia as local anesthesia for prostate biopsy. ⋯ Combining periprostatic nerve block and intraprostatic local anesthesia provided significantly better pain control than periprostatic nerve block alone. The combination may be of maximum benefit in patients with a smaller prostate volume or younger patients.
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The Journal of urology · Aug 2009
Randomized Controlled Trial Multicenter Study Comparative StudyRandomized multicenter feasibility trial of myofascial physical therapy for the treatment of urological chronic pelvic pain syndromes.
We determined the feasibility of conducting a randomized clinical trial designed to compare 2 methods of manual therapy (myofascial physical therapy and global therapeutic massage) in patients with urological chronic pelvic pain syndromes. ⋯ We judged the feasibility of conducting a full-scale trial of physical therapy methods and the preliminary findings of a beneficial effect of myofascial physical therapy warrants further study.
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The Journal of urology · Aug 2009
Comparative StudyLocally recurrent prostate cancer after initial radiation therapy: a comparison of salvage radical prostatectomy versus cryotherapy.
We compared the treatment outcomes of salvage radical prostatectomy and salvage cryotherapy for patients with locally recurrent prostate cancer after initial radiation therapy. ⋯ Young, healthy patients with recurrent prostate cancer after radiation therapy should consider salvage radical prostatectomy as it offers superior biochemical disease-free survival and may potentially offer the best chance of cure.