Re: Transrectal ultrasound appearance of prostatic granulomas secondary to bacillus Calmette-Guerin instillation.
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Adjuvants, Immunologic↗
Biomedical subjects
K C Shandera
Publications and source records attributed to K C Shandera.
Efficacy of one dose fluoroquinolone before prostate biopsy.
OBJECTIVES: To demonstrate the efficacy of a simple preparation for prostate biopsy (PBX) and to determine its potential cost savings. METHODS: One hundred fifty consecutive PBXs were performed using a Fleet enema and a single oral dose (300 mg) of ofloxacin as the pre-PBX preparation. RESULTS: Of the 150 PBXs we performed, only 1 (0.67%) patient developed a urinary tract infection. CONCLUSIONS: A simple and inexpensive pre-PBX preparation proved to be successful in preventing infectious complications and is presented as a potential model for inclusion in clinical pathways for diagnosing adenocarcinoma of the prostate.
Anti-Infective Agents↗
Variability in patient preparation for prostate biopsy among American urologists.
OBJECTIVES: To assess the variability in patient preparation for prostate biopsy (PBX) among practicing American urologists. METHODS: A survey was sent to 900 practicing American urologists randomly selected by the American Urological Association computer files. The survey asked about their pre-PBX protocol. RESULTS: Approximately 63% (568 of 900) of the surveys were returned and showed considerable differences in pre-PBX protocol among those urologists. The pre-PBX regimen included prophylactic antibiotics in 98.6% and a cleansing rectal enema in 81%. Eleven different antibiotics were used, with 20 different doses and 23 different timing-duration regimens. CONCLUSIONS: The pre-PBX preparation is not standardized among American urologists.
Antibiotic Prophylaxis↗
Diagnosis and management of female urinary incontinence.
Urinary incontinence affects an estimated 13 million Americans of which 85% are women. It is an embarrassing and lifestyle limiting condition for which effective treatment is available. Health care providers should be alert to the signs and symptoms of UI and pursue its etiology. Those patients who fail medical therapy, in whom the etiology for the incontinence is unclear, or those patients with concomitant cystocele, enterocele, or rectocele, should be referred to an incontinence specialist.
Adolescent↗
Minimally invasive management of the calcified ureteral stent.
The double "J" ureter stent has become one of the most basic and valuable tools in urology, but it can cause complications. Stent encrustation is one of its most difficult complications to manage. An evaluation and treatment algorithm that stratifies the treatment based upon the function of the stented kidney and the presence or absence of concomitant ureteral obstruction is presented. Minimally invasive surgery using ESWL and cystolitholapaxy is recommended as the first line of treatment of the extensively encrusted ureteral stent when the kidney has greater than 10% function.
Adult↗
The necessity of voiding cystourethrogram in the pretransplant urologic evaluation.
OBJECTIVES: To determine the efficacy of limited use of voiding cystourethrogram (VCUG) in the evaluation of patients for renal transplantation. METHODS: A retrospective review of 439 patients who underwent renal transplantation between October 1983 and May 1995; however, since September 1993 we used VCUG selectively in the pretransplant evaluation. RESULTS: Since September 1993, only 51% of our renal transplant patients had a VCUG as part of their pretransplant evaluation . Only one urologic complication has occurred in a 68-year-old man with a history of glomerulonephritis. He had an episode of acute urinary retention, which was treated successfully with a temporary suprapubic tube followed by medical therapy. CONCLUSIONS: Our preliminary results reveal no adverse outcomes associated with the selective use of VCUG in the pretransplant evaluation, and indicate that this study is of little value in the routine evaluation of these patients.
Aged↗
Delayed development of mid-ileal conduit stenosis: the importance of life-long urologic follow-up.
Mid-ileal conduit stenosis is an unusual yet morbid complication following ileal conduit urinary diversion. We report the cases of four patients who developed mid-ileal stenosis at an average interval of 19.5 years after urinary diversion, with the longest interval being 25 years. This series emphasizes the importance of life-long follow-up of patients who have had urinary-intestinal diversion.
Adolescent↗
Intraperitoneal urinary extravasation associated with infected urachal cyst.
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Aged↗
Urologic prostheses.
Urologic prosthetics have become increasingly complex and include an assortment of urinary catheters, penile prostheses, artificial urinary sphincters, and testicular prostheses. The majority of urologic prosthetics are constructed of silicone because it is relatively inert, easily sterilized, maintains its strength, and has not been linked to malignancy. Nevertheless, silicone causes some local tissue reaction and deteriorates with time; thus, it is not the ideal prosthetic material. This article provides the clinician with an overview of the most common of these prostheses, their function, and a guide for the management of associated acute urologic complaints.
Emergencies↗
Cystic fibrosis--an otolaryngologic perspective.
Cystic fibrosis (CF) is the most common lethal genetic disorder in white patients. The protean manifestations of the disease result from exocrine gland dysfunction and include chronically debilitating pulmonary and pancreatic compromise and clinically inconsequential (although diagnostically extremely important) sweat electrolyte abnormalities. The subject of this article is the otolaryngologic manifestations of the disease, based on a retrospective analysis of 450 cases. Nasal polyposis and sinusitis occurred in 10% and 11% of patients, respectively, and polypectomy was, after laparotomy, the most common surgical procedure these children underwent. The extent of intranasal surgery for polyposis was found to be inversely proportional to the recurrence rate. A simple polypectomy was relatively ineffective treatment; when performed in conjunction with a Caldwell-Luc and either an intranasal or extranasal ethmoidectomy, the recurrence rate was less than 13%. Otologic problems, found in 8% of patients, included chronic otitis media (2.5%) and acute otitis media (5.5%). Only five patients required pressure-equalizing tubes. Recent genetic advances of immense importance are also described. Although the basic gene defect has yet to be elucidated, by use of a technique known as restriction-fragment-linked polymorphism, the gene associated with CF has been found in the middle of the long arm of chromosome 7. By following gene markers closely associated with this gene, it is possible to do carrier tests within affected families and, if certain criteria are met, perform prenatal diagnosis. Eventual isolation and characterization of the gene will follow, hopefully making prevention possible and treatment more effective.
Adolescent↗