PAIN
Opiods vs. non-opioids makes no different in chronic back pain.(1) Perioperative gabapentin in RCT showed a 24% increase in the rate of opioid cessation after surgery (HR, 1.24; 95% CI, 1.00-1.54; P = .05). No significant differences were noted in the number of adverse events as well as the rate of medication discontinuation due to sedation or dizziness (placebo, 42 of 202 [20.8%]; gabapentin, 52 of 208 [25.0%]). (8) An excellent review of chronic scrotal pain was published in 2019. (18) PDE-5i in non ED patients have been shown to decrease chronic prostatitis/chronic pelvic pain syndrome in one study. (9)
PEYRONIE's
Nonabsorbable sutures during Peyronie's disease repair has low levels of nodularity and bother at suture site. (3) There are multiple grafts used for Peyronies. Criteria for grafting include >60degree curve or hourglass, >20% shortening estimated after surgeyr, absence of ED, extensively calcified plaques, patient preference. If patient had ED, should not undergo incision/excision due to risk of post-operative ED. Autologous dermis, tunica vaginalis, dura mater, fascia, saphenous vein, tunica albuginea, buccal mucosa, porcine intestinal submucosa, pericardium, TachoSil, synthetic materials are all reviewed in this article. (12)
BPH
One study showed allopurinol use is associated with lowered risk of BPH medication, diagnosis and surgery. A possible explanation could be antioxidative effects of urate-lowering allopurinol. decreased risk for all three BPH endpoints: BPH medication (HR 0.81; 95% CI 0.75–0.88), BPH diagnosis (HR 0.78; 95% CI 0.71–0.86) and BPH-related surgery (HR 0.67; 95% CI 0.58–0.76) after multivariable adjustment. The risk association did not change by cumulative use. The risk decrease disappeared after 1–2 years lag time. Only BMI modified the risk association; the risk decrease was observed only among men with BMI above the median (27.3 kg/m2); p for interaction <0.05 for each endpoint. (2)
OTHER RANDOM STUDIES
NSAIDS use can reduce symptoms of UTI's allowing resolution with less antibiotic usage, however with increased complications from UTI. (4,5) NSAIDs appear to make no difference in survival of mRCC (10).
Women who ride bicycle have higher rate of UTI's but better sexual function. (6) Another study showed males have no difference sexual or urinary functions that swimmers or runners, but increase in urethral stricture. (11)
Average cost of California OR time is $36 to $37 per minute; $20 to $21 of this amount is direct cost, with $13 to $14 attributable to wages and benefits and $2.50 to $3.50 attributable to surgical supplies(7)
INCISION INFECTIONS
Application of NPWT on closed laparotomy wounds in general and colorectal surgery is associated with reduced SSI rates but similar rates of seroma and wound dehiscence compared with conventional nonpressure dressings. A meta-analysis found wound vacs on closed laparotomy wounds in general and colorectal surgery is associated with reduced SSI rates but similar rates of seroma and wound dehiscence compared with conventional nonpressure dressings. However, there was a very high rate of SSI. (15) One study of nearly 1700 people found no difference on surgical site infection if hair was clipped or not. (17)
One study showed using alternative medicine for cancer treatment had worse 5yr survival (55% vs. 78%) and a 2.2x increased risk of death .(16)
INTERSTITIAL CYSTITIS
Epstein Barr Virus is a may play a role in interstitial cystitis. (13) PDE-5i in non ED patients have been shown to decrease chronic prostatitis/chronic pelvic pain syndrome in one study. (9)
HIT
One study showed the odds ratio of HIT was 23x in patietns with in-hospital infections. (14)
Opiods vs. non-opioids makes no different in chronic back pain.(1) Perioperative gabapentin in RCT showed a 24% increase in the rate of opioid cessation after surgery (HR, 1.24; 95% CI, 1.00-1.54; P = .05). No significant differences were noted in the number of adverse events as well as the rate of medication discontinuation due to sedation or dizziness (placebo, 42 of 202 [20.8%]; gabapentin, 52 of 208 [25.0%]). (8) An excellent review of chronic scrotal pain was published in 2019. (18) PDE-5i in non ED patients have been shown to decrease chronic prostatitis/chronic pelvic pain syndrome in one study. (9)
PEYRONIE's
Nonabsorbable sutures during Peyronie's disease repair has low levels of nodularity and bother at suture site. (3) There are multiple grafts used for Peyronies. Criteria for grafting include >60degree curve or hourglass, >20% shortening estimated after surgeyr, absence of ED, extensively calcified plaques, patient preference. If patient had ED, should not undergo incision/excision due to risk of post-operative ED. Autologous dermis, tunica vaginalis, dura mater, fascia, saphenous vein, tunica albuginea, buccal mucosa, porcine intestinal submucosa, pericardium, TachoSil, synthetic materials are all reviewed in this article. (12)
BPH
One study showed allopurinol use is associated with lowered risk of BPH medication, diagnosis and surgery. A possible explanation could be antioxidative effects of urate-lowering allopurinol. decreased risk for all three BPH endpoints: BPH medication (HR 0.81; 95% CI 0.75–0.88), BPH diagnosis (HR 0.78; 95% CI 0.71–0.86) and BPH-related surgery (HR 0.67; 95% CI 0.58–0.76) after multivariable adjustment. The risk association did not change by cumulative use. The risk decrease disappeared after 1–2 years lag time. Only BMI modified the risk association; the risk decrease was observed only among men with BMI above the median (27.3 kg/m2); p for interaction <0.05 for each endpoint. (2)
OTHER RANDOM STUDIES
NSAIDS use can reduce symptoms of UTI's allowing resolution with less antibiotic usage, however with increased complications from UTI. (4,5) NSAIDs appear to make no difference in survival of mRCC (10).
Women who ride bicycle have higher rate of UTI's but better sexual function. (6) Another study showed males have no difference sexual or urinary functions that swimmers or runners, but increase in urethral stricture. (11)
Average cost of California OR time is $36 to $37 per minute; $20 to $21 of this amount is direct cost, with $13 to $14 attributable to wages and benefits and $2.50 to $3.50 attributable to surgical supplies(7)
INCISION INFECTIONS
Application of NPWT on closed laparotomy wounds in general and colorectal surgery is associated with reduced SSI rates but similar rates of seroma and wound dehiscence compared with conventional nonpressure dressings. A meta-analysis found wound vacs on closed laparotomy wounds in general and colorectal surgery is associated with reduced SSI rates but similar rates of seroma and wound dehiscence compared with conventional nonpressure dressings. However, there was a very high rate of SSI. (15) One study of nearly 1700 people found no difference on surgical site infection if hair was clipped or not. (17)
One study showed using alternative medicine for cancer treatment had worse 5yr survival (55% vs. 78%) and a 2.2x increased risk of death .(16)
INTERSTITIAL CYSTITIS
Epstein Barr Virus is a may play a role in interstitial cystitis. (13) PDE-5i in non ED patients have been shown to decrease chronic prostatitis/chronic pelvic pain syndrome in one study. (9)
HIT
One study showed the odds ratio of HIT was 23x in patietns with in-hospital infections. (14)
- Krebs, Erin E., et al. "Effect of Opioid vs Nonopioid Medications on Pain-Related Function in Patients With Chronic Back Pain or Hip or Knee Osteoarthritis Pain: The SPACE Randomized Clinical Trial." JAMA 319.9 (2018): 872-882.
- Kukko, Ville, et al. "Allopurinol and risk of benign prostatic hyperplasia in a Finnish population-based cohort." Prostate cancer and prostatic diseases (2017): 1.
- Papagiannopoulos, D., et al. "Surgical outcomes from limiting the use of nonabsorbable suture in tunica albuginea plication for Peyronie’s disease." International journal of impotence research 29.6 (2017): 258.
- Kronenberg, Andreas, et al. "Symptomatic treatment of uncomplicated lower urinary tract infections in the ambulatory setting: randomised, double blind trial." bmj 359 (2017): j4784.
- Gágyor, Ildikó, et al. "Ibuprofen versus fosfomycin for uncomplicated urinary tract infection in women: randomised controlled trial." bmj 351 (2015): h6544.
- Gaither, Thomas W., et al. "Cycling and Female Sexual and Urinary Function: Results From a Large, Multinational, Cross-Sectional Study." The journal of sexual medicine (2018).
- Childers, Christopher P., and Melinda Maggard-Gibbons. "Understanding Costs of Care in the Operating Room." JAMA surgery (2018): e176233-e176233.
- Hah, Jennifer, et al. "Effect of Perioperative Gabapentin on Postoperative Pain Resolution and Opioid Cessation in a Mixed Surgical Cohort: A Randomized Clinical Trial." JAMA surgery (2017).
- Park, H. J., et al. "Efficacy of tadalafil for treating chronic prostatitis/chronic pelvic pain syndrome in patients without erectile dysfunction." European Urology Supplements 16.3 (2017): e453.
- Hamieh, Lana, et al. "Impact of Aspirin and Non-Aspirin Nonsteroidal Anti-Inflammatory Drugs on Outcomes in Patients with Metastatic Renal Cell Carcinoma." Kidney Cancer 2.1 (2018): 37-46.
- Awad, Mohannad A., et al. "Cycling, and male sexual and urinary function: results from a large, multinational, cross-sectional study." The Journal of urology 199.3 (2018): 798-804.
- Garcia‐Gomez, B., et al. "Grafts for Peyronie's disease: a comprehensive review." Andrology 6.1 (2018): 117-126.
- Jhang, Jia-Fong, et al. "Epstein-Barr Virus Presence as a Potential Etiology of Persistent Bladder Inflammation in Human Interstitial Cystitis/Bladder Pain Syndrome." The Journal of urology (2018).
- Grigorian, Areg, et al. "Association of Heparin-Induced Thrombocytopenia With Bacterial Infection in Trauma Patients." JAMA surgery (2018).
- Sahebally, Shaheel Mohammad, et al. "Negative Pressure Wound Therapy for Closed Laparotomy Incisions in General and Colorectal Surgery: A Systematic Review and Meta-analysis." JAMA surgery (2018): e183467-e183467.
- Johnson, S. B., et al. “Use of Alternative Medicine for Cancer and Its Impact on Survival.” International Journal of Radiation Oncology Biology Physics, vol. 99, no. 2, 2017.
- Kowalski, Todd J., et al. “Impact of Hair Removal on Surgical Site Infection Rates: A Prospective Randomized Noninferiority Trial.” Journal of The American College of Surgeons, vol. 223, no. 5, 2016, pp. 704–711.
- Ziegelmann, Matthew J., M. Ryan Farrell, and Laurence A. Levine. "Evaluation and Management of Chronic Scrotal Content Pain—A Common Yet Poorly Understood Condition." Reviews in urology 21.2-3 (2019): 74.