Can J Urol
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Comparative Study
Post-vasectomy semen analysis compliance with use of a home-based test.
INTRODUCTION Although the importance of post-vasectomy semen analysis (PVSA) is well known, compliance with this test has historically been low. We sought to compare compliance with PVSA when using a home-based testing kit with traditional office based microscopy, and to estimate the impact of compliance differences on the risk of undetected vasectomy failure.
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Adrenal-renal fusion is an anomaly misclassified as a renal tumor due to the absence of pathognomonic radiographic features. Herein, we report a case of a 61-year-old male who underwent a right radical nephrectomy for a presumed renal malignancy. ⋯ To our knowledge, this is the first description of a pheochromocytoma originating from an adrenal-renal fusion. The clinical presentation did not raise a high index of suspicion for the ultimate diagnosis rendered.
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Robotic surgical procedures have become more common in female pelvic reconstruction. Purported benefits of robotic assisted pelvic floor reconstruction (RAPFR) procedures include shorter hospital stay, faster recovery, lower blood loss, and decreased postoperative pain. Following RAPFR procedures, the current accepted practice is discharge after a one-night hospitalization. We assessed whether same day discharge (SDD) affects the short term safety of and patient satisfaction with robotic assisted pelvic floor reconstructive procedures, relative to those who remain hospitalized overnight. ⋯ In this pilot study, same day discharge after RAPFR procedures appears to be safe and feasible. RAPFR procedures were well-tolerated, with no difference in ED or non-urology office visits occurring during the early post-operative period in our series, regardless of length of stay. Patient satisfaction was equivalent between groups and universally high.
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Comparative Study
Outcomes of renal salvage for penetrating renal trauma: a single institution experience.
Conservative management of penetrating renal trauma is emerging, with data originating from centers with variable level of trauma care. This study reviews the outcomes of renal salvage after penetrating trauma at a level I trauma center. ⋯ CT grade of injury predicts nephrectomy after penetrating renal trauma. Conservative management is a feasible option in penetrating renal trauma even with a higher grade of injury.
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Comparative Study
The comparative effectiveness of quadratus lumborum blocks and paravertebral blocks in radical cystectomy patients.
Multimodal analgesia is an effective way to control pain and limit opioid use after surgery. The quadratus lumborum block and paravertebral block are two regional anesthesia techniques that leverage multimodal analgesia to improve postoperative pain control. We sought to compare the efficacy of these blocks for pain management following radical cystectomy. ⋯ There were no differences in opioid consumption among patients receiving bilateral single shot quadratus lumborum blocks and bilateral continuous paravertebral blocks after radical cystectomy. These data suggest that the quadratus lumborum block is a viable alternative for delivering multimodal analgesia in cystectomy patients.