BJU international
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Randomized Controlled Trial Multicenter Study Comparative Study Clinical Trial
A comparison of the effect of 1.5% glycine and 5% glucose irrigants on plasma serum physiology and the incidence of transurethral resection syndrome during prostate resection.
To examine changes in the pathophysiology and frequency of the transurethral resection (TUR) syndrome with two irrigation fluids, as variable amounts of irrigation fluid are absorbed during TUR of the prostate (TURP), and although polar solutes are required to prevent an effect on diathermy, the solutes may have effects when absorbed. ⋯ An increase in serum glycine was associated with TUR syndrome; there were large variations in the amounts of glycine absorbed, reaching levels many times the upper limit of normal. In other studies, glycine was reportedly toxic, and that the levels recorded were many times the upper limit of normal may have both immediate and long-term effects.
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Anaesthesia for urological surgery poses particular challenges for the anaesthetist related to the patient population and procedure type. The aim of this article is to cover the general principles of anaesthesia, with dedicated sections relevant to practising urological surgeons. ⋯ Significant proportions of urological surgical patients have some degree of renal failure and this may be related to the surgery required. Anaesthetic care of patients with chronic renal impairment and transplant surgery will be covered in a future review.
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Comparative Study
Outcome from percutaneous nephrolithotomy in patients with spinal cord injury, using a single-stage dilator for access.
To present our experience of percutaneous nephrolithotomy (PCNL) for treating urolithiasis in patients with spinal cord injury (SCI) using a single-stage dilator for percutaneous access. ⋯ PCNL has a high success rate and acceptable complication rate compared to extracorporeal shock-wave lithotripsy, and remains a valid first-line treatment option for kidney stones in patients with SCI.
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Randomized Controlled Trial Multicenter Study Comparative Study Clinical Trial
A prospective randomized trial comparing transurethral prostatic resection and clean intermittent self-catheterization in men with chronic urinary retention.
To determine whether a preliminary period of clean intermittent self-catheterization (CISC) before transurethral resection of the prostate (TURP) improves bladder contractility and surgical outcome in men with chronic urinary retention (CUR), and whether pressure-flow studies (PFS) before TURP predict the outcome. ⋯ The present results emphasize the usefulness of CISC in ensuring the recovery of bladder function in men with CUR. Measuring the voiding pressure before TURP can predict the surgical outcome. Both CISC and immediate TURP are effective for relieving LUTS and result in a better quality of life. A preliminary period of CISC before TURP for men with CUR and low voiding pressure may be valuable. The presence of upper tract dilatation is associated with high end-void and end-fill bladder pressures, and such men have a good outcome from surgery.
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Comparative Study
Radical prostatectomy versus high-dose rate brachytherapy for prostate cancer: effects on health-related quality of life.
To examine the effects of different treatments on the health-related quality of life (HRQoL) of men with localized prostate cancer. ⋯ In terms of HRQoL, RP and HDR-BT did not differ, but HDR-BT resulted in better urinary and sexual function than RP. When planning treatment, QoL concerns, including mental health issues associated with prostate cancer, need to be addressed with the patients, as do the potential side-effects.