Prog Urol
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Chronic pelvic and perineal pain can be related to a nerve lesion caused by direct or indirect trauma or by an entrapment syndrome, which must then be demonstrated by a test block. The purpose of this article is to review the techniques and modalities of somatic nerve block in the management of chronic pelvic and perineal pain. ⋯ Somatic nerve blocks are an integral part of the management of chronic pelvic and perineal pain and are predominantly performed under CT guidance in order to be as selective as possible. Once the diagnosis and the level of the nerve lesion have been defined, more specific therapeutic procedures can then be proposed.
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Randomized Controlled Trial
[Effect of wound infiltration of ropivacaine in postoperative pain after extraperitoneal laparoscopic radical prostatectomy].
Evaluation of the efficiency of wound infiltration of ropivacaine in postoperative pain after extraperitoneal laparoscopic radical prostatectomy. ⋯ Ropivacaine in wound infiltration did not decrease significantly the postoperative pain and must not be used systematically.
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The use of immediate postoperative and salvage radiotherapy in high-risk patients after radical prostatectomy for prostate cancer remains controversial. Immediate postoperative radiotherapy improves biochemical and clinical progression-free survival in randomised trials. ⋯ The adjunction of androgen deprivation therapy to immediate postoperative or salvage radiotherapy is only supported by retrospective data. The results of the ongoing, prospective, randomized trials will hopefully enable accurate comparison of immediate postoperative radiotherapy with salvage radiotherapy and assessment of the value of androgen deprivation therapy.
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Randomized Controlled Trial Multicenter Study
[Results and participation factors to the European Randomized study of Screening for Prostate Cancer (ERSPC) with Prostate Specific Antigen: French departments of Tarn and Hérault].
Mass screening modalities remained controversial and made necessary large studies. The European Randomized study of Screening for Prostate cancer (ERSPC) was initiated in 1994. Eight countries including France are participating. ⋯ Participation rate at first round was modest. Profile of men who participated compared to men who did not were different. The control group was probably contaminated by PSA testing outside study protocol. Consequences at ERSPC level of this low participation rate on final analysis remain to be determined.
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To determine whether quantitative dynamic contrast-enhanced MRI improves the performance of T2W-MRI for the localisation of non-palpable prostate cancer (PCa) and for the estimation of tumor volume. ⋯ Quantitative dynamic MRI is more accurate than T2W imaging for tumor localisation of non-palpable cancer greater than 0,2 cm(3), but the difference is only significant for the PZ. Above this volume, correlation between tumor volume measured on dynamic MRI and that on the specimen is poor.