British journal of urology
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To compare retrospectively the efficacy of radical perineal and retropubic prostatectomy in patients with T1, T2 cancer of the prostate. ⋯ When nodal status has been assessed by lymph node dissection (open or endosurgical), radical perineal prostatectomy is a reasonable, minimally invasive alternative to radical retropubic prostatectomy provided that impotence and a slower return to full continence are accepted.
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To survey patient attitudes and assess the extent of patient morbidity in the first 24 h following walk-in, walk-out day case genito-scrotal surgery with sedation reversal. ⋯ Walk-in, walk-out day case surgery as described is a well-tolerated technique with a low morbidity and towards which patients have a positive attitude.
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Randomized Controlled Trial Clinical Trial
Choosing the correct pain relief for extracorporeal lithotripsy.
To determine the best choice of analgesic for patients undergoing lithotripsy, and to attempt to identify factors which might predict which patients are most likely to find the procedure painful. ⋯ This study shows that modern lithotripsy, in addition to being safe and effective, can be performed as an out-patient procedure using simple non-opiate analgesics. The need for stronger analgesia and/or sedation should be tailored to the needs of the individual patient, although it remains difficult to predict which patients will require such measures.
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To assess the results from ultrasound-monitored extracorporeal shock wave lithotripsy (ESWL) for ureteric stones, to compare the results with other treatment modalities and to evaluate experiential audit-evoked gains. ⋯ The choice of treatment for patients with ureteric stones is critical but will vary depending on the individual's circumstances, the availability of equipment, costs and time required to perform the procedure. The results obtained using ESWL for ureteric stones improved considerably over the course of the study as a result of experience and refinement of the technique. Stones located in more difficult systems such as in kidneys with a thin cortex and those located above the ischial spine were no longer subjected to ESWL. Audit of the results obtained following treatment allows identification of problem areas, alerts physicians to alternative methods of treatment and gives an objective quantification of experience, assisting rational decision making with consequent improved success.
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To review the records of patients with suspected urinary tract trauma to determine whether eliminating imaging studies would have missed any significant injuries. ⋯ Radiographic evaluation of the urinary tract is recommended for all patients with penetrating trauma and any degree of haematuria, but only for patients with blunt trauma if associated with gross haematuria, microscopic haematuria and hypotension, or microscopic haematuria and significant associated injuries.