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There is little data available on the effects of energy-based surgical devices (ESD) on tissues other than arteries and veins. As such, we quantified the lateral thermal damage associated with contemporary ESD: the Harmonic ACE, a prototype bipolar device known as the Gyrus Trisector, the Harmonic LCS-C5, and the LigaSure V.We divided 24 domestic pigs into 4 groups, 1 group for each ESD tested. Segments...
To evaluate the safety and reliability of the Hem-o-lok clips for the control of the renal artery during laparoscopic nephrectomies.Our multi-institutional working group compiled a retrospective review of all laparoscopic nephrectomies (radical nephrectomy, simple nephrectomy, nephroureterectomy, and donor nephrectomy) performed by surgeons in our group. For each procedure, we used Hem-o-lok clips...
Recent studies have suggested that obesity is associated with lower serum prostate-specific antigen levels, perhaps influencing the recommendation for prostate biopsy and potentially explaining part of the observed poorer prognosis among obese men. African-American men have the greatest rates of prostate cancer and are more likely to die of the disease, making early detection a priority in this group...
Laparoscopic assisted nephroureterectomy is a well established technique for managing the upper urinary tract urothelial cancer. However, management of the distal ureter remains a controversial issue. We describe a modified method of cystoscopic loop ligation and detachment of the distal ureter.We performed transperitoneal laparoscopic assisted nephroureterectomy in 13 patients. The lower end of the...
To provide a characterization of a cohort of women with interstitial cystitis/painful bladder syndrome (IC/PBS) by describing their historical and clinical characteristics. This was reported with the National Institutes of Health chronic prostatitis cohort, but a literature review did not reveal a similar study for women with IC/PBS.A total of 87 women with IC/PBS were referred to the Beaumont Women’s...
To evaluate hereditary behavior of varicocele through comparison of prevalence of disease in first-degree relatives of patients with known varicocele and normal healthy kidney donation volunteers.Sixty-two patients with known varicocele who admitted for surgery in Razi Hospital between September 2005 and October 2006 were enrolled in the study. The patients were asked to refer for examination healthy...
We describe a 55-year-old woman with a urethral recurrence of transitional cell carcinoma of her bladder 4 years after she underwent radical cystectomy with negative margins and no evidence of invasion of the bladder neck, anterior vaginal wall, or proximal urethra. This was the first urethral recurrence in an appropriately selected female patient at our institution. This report emphasizes the need...
To investigate the influence of androgen deprivation therapy (ADT) in men with nonmetastatic prostate cancer.We conducted a 2-year controlled, prospective study. Twenty-three men on 6 months or longer of ADT (chronic), 12 men on less than 6 months of ADT (acute), and 13 men not on ADT (healthy controls or prostate cancer patients not on ADT) were studied. We used validated, objective tests for physical...
The role of the anterolateral abdominal wall muscles (AAWM) during vesical filling and evacuation has not been sufficiently addressed in the literature. We investigated the hypothesis that the AAWM exhibit increased electromyographic (EMG) activity on vesical distension and contraction that presumably assists in vesical evacuation.The effect of vesical balloon distension on vescial (VP) and vesical...
Endoscopic subureteral injection for the management of vesicoureteral reflux has become a well-established first-line minimally invasive treatment strategy. One potential pitfall is the creation of ureteral obstruction. No predictors are available to determine which patients will develop this rare, but real, complication.A retrospective evaluation of 2 girls, aged 3 and 4 years, with grade 4 and 3...
To determine the incidence of dissemination and port site metastases in patients undergoing laparoscopic surgery for urologic cancer.From June 1992 to August 2005, 459 laparoscopic procedures were performed, 304 of which were for cancer. These included 162 radical prostatectomies, 67 radical nephrectomies, 20 partial nephrectomies, 45 nephroureterectomies, 5 retroperitoneal lymph node dissections...
The aim of this study was to determine the acute urodynamic effects of posterior tibial nerve stimulation (PTNS) in patients with neurogenic detrusor overactivity (NDO) caused by multiple sclerosis (MS).A total of 29 patients of whom there were 12 (41.3%) men and 17 (58.6%) women with NDO, mean age 46.5 ± 8.5 years (range 29 to 55 years) enrolled in the study. Mean duration of MS was 8.80 ± 3.6 years;...
We present the results of our series of 65 consecutive laparoscopic pyeloplasties, which include some unexpected late failures.We retrospectively reviewed the perioperative course of 65 consecutive patients who underwent transperitoneal laparoscopic pyeloplasty from August 1996 through July 2005 at our institution.Of the obstructions, 47 and 18 were primary and secondary, respectively. Laparoscopic...
To define a novel technique in the diagnosis of partial and complete ejaculatory duct obstruction (EDO).Twenty men with suspected EDO were initially evaluated by transrectal ultrasound (TRUS). Subsequently, all patients underwent TRUS-guided seminal vesicle (SV) scintigraphy. Technetium Tc 99m sulphur colloid solution was injected into each SV under TRUS guidance and patients were immediately evaluated...
To measure urinary epidermal growth factor (EGF) and interleukin-6 (IL-6) levels in painful bladder syndrome/interstitial cystitis (PBS/IC) patients randomized to either cyclosporine A (CyA) or pentosan polysulfate sodium (PPS) treatment for 6 months and compare the results with treatment response.Urine samples from PBS/IC patients were collected before (n = 37) and after treatment (n = 34). The concentration...
Waiting for prostate-specific antigen (PSA) results may create anxiety for patients. Recently developed “rapid” PSA assays have become available, which achieve laboratory sensitivity and specificity. The manufacturers claim these assays will help to reduce anxiety associated with PSA testing. The aim of this study was to test the hypothesis that rapid received PSA results reduce patient anxiety.One...
Fibromuscular dysplasia is the most common cause of renovascular hypertension in young patients. It primarily involves the renal and carotid arteries, and it is less common in the coronary, iliac, and visceral arteries. Digital subtraction angiography is still the best investigation to determine the location, extent, and complications of renal artery involvement. However, currently, other imaging...
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