BJU international
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Randomized Controlled Trial Comparative Study
Differences among patients undergoing perineal or retropubic radical prostatectomy in pain and perioperative variables: a prospective study.
To compare pain in the first 24 h, the perioperative variables and the histopathological results among patients who had perineal (PRP) and retropubic radical prostatectomy (RRP), in a randomized trial. ⋯ Patients who had RRP with general anaesthesia had a greater intensity of pain and higher morphine intake than the other groups. Men who had PRP had significantly less bleeding and shorter hospital stay than those having RRP.
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To evaluate the overall survival (OS) and disease-specific survival (DSS) in men receiving primary androgen-deprivation therapy (PADT) or salvage medical ADT (SADT) for prostate cancer. ⋯ PADT and SADT prolong survival in men with prostate cancer. HRPC portends a poor DSS. Age at diagnosis and ADT induction, PSA level before ADT, and disease stage predict both OS and DSS in this population. However, most men died from causes unrelated to prostate cancer, thus questioning the true value of ADT in prolonging patient survival.
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To evaluate the effect of preoperative risk factors on perioperative outcomes up to 3 months after robot-assisted radical cystectomy (RARC), as RC continues to be associated with a high rate of morbidity and mortality. ⋯ RARC appears to be well tolerated, independent of comorbid risk factors such as age, BMI, RCRI and ASA score.
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To validate a model to stratify patients with obstructive nephropathy due to malignant ureteric obstruction, associated with a poor prognosis, into different prognostic groups, as a recent report identified low serum albumin, degree of hydronephrosis and number of events related to metastatic disease as prognostic indicators before palliative decompression. ⋯ Consistent with a previous report we showed that a low serum albumin level and events related to metastatic disease were indicative of a poor prognosis. We also found that a low serum sodium level might be associated with a worse prognosis. We externally validated a model for stratifying patients into different prognostic groups. Palliative decompression is associated with significant morbidity.
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To assess our experience with salvage permanent perineal radioactive-seed implantation (SPPI) as a possible therapeutic option for recurrent prostate adenocarcinoma, as salvage therapies for recurrences after definitive external beam radiotherapy (EBRT) for localized adenocarcinoma of the prostate are associated with significant morbidity and biochemical failure. ⋯ With a short-term follow-up SPPI appears to provide excellent prostate cancer control with an acceptable rate of complications for patients with local recurrence of prostate cancer after EBRT. An extended follow-up is necessary to determine the long-term durability and safety of SPPI.