Jocelyn M. Rieder

Differences in Left and Right Laparoscopic Adrenalectomy

Although no difference was found in complications or conversion rates for either right or left laparoscopic adrenalectomy, the authors report that lower blood loss and decreased operative time were noted with laparoscopic right adrenalectomy.

A Preliminary Report on Combined Penoscrotal and Perineal Approach for Placement of Penile Prosthesis with Corporal Fibrosis

Purpose. This paper aims at describing the combined penoscrotal and perineal approach for placement of penile prosthesis in cases of severe corporal fibrosis and scarring. Materials and methods. Three patients with extensive corporal fibrosis underwent penile prosthesis placement via combined penoscrotal and perineal approach from 1997 to 2006. Follow-up ranged from 15 to 129 months. Results. All patients underwent successful implantation of semirigid penile prosthesis. There were no short- or long-term complications. Conclusions. Results on combined penoscrotal and perineal approach to penile prosthetic surgery in this preliminary series of patients suggest that it is a safe technique and increases the chance of successful outcome in the surgical management of severe corporal fibrosis.

IL-6 Does Not Predict Current Urolithiasis in Stone Formers

INTRODUCTION Interleukin-6 (IL-6), an inflammatory marker, has previously been found to be elevated in the urine of patients with urolithiasis. Oxalate and other stone precursors have been shown to increase IL-6 production in proximal tubular epithelial cells in vitro. We examined whether urinary IL-6 could be used as a screening test to determine current urolithiasis in individuals who are known to form urinary stones. METHODS Thirty-five adult patients with current urolithiasis demonstrated on imaging were enrolled in the study. Exclusion criteria included disease known to elevate IL-6. Each patient provided a pre-treatment urine specimen and one month after proven to be stone-free an additional urine specimen was obtained. The urinary IL-6/creatinine ratio was determined for both specimens and compared. RESULTS Ten patients provided both specimens. The mean pre-operative urinary IL-6/creatinine ratio before the procedure was 1.63 pg/mL. The mean post procedure urinary IL-6/creatinine ratio after the patient was confirmed to be stone-free was 1.81 pg/mL. These were not significantly different (p=0.38). Preoperative urinary IL-6/creatinine ratio did not correlate to stone size (r=0.15) and no correlation was seen between time from treatment and stone free IL-6/creatinine ratio (r=0.48). CONCLUSION Urinary IL-6 is not a good screening test for current urolithiasis in stone-forming individuals. It is elevated whether the stone is present or not.

COMPLIANCE WITH OVERACTIVE BLADDER MEDICATIONS IN A MANAGED HEALTHCARE ORGANIZATION

399 COMPLIANCE WITH OVERACTIVE BLADDER MEDICATIONS IN A MANAGED HEALTHCARE ORGANIZATION Jocelyn Rieder*, Viet Tran, Karen Stern, Ashok Chopra, Sherif Aboseif. Los Angeles, CA. INTRODUCTION AND OBJECTIVE: Currently the main treatment of overactive bladder is anticholinergic medications. This treatment is limited by patients’ willingness to continue taking the medications. The purpose of this study is to evaluate the level of compliance with anticholinergic medication prescribed to treat overactive bladder disease in a managed healthcare population. METHODS: During a 12 month period in 2005 and 2006, 10,321 patients were newly prescribed an anticholiergic medication in the Southern California Kaiser Permanente Region. Medications included Tolteridine (Detrol), Tolteridine Extended Release (Detrol LA), Oxybutynin Immediate Release (IR), Oxybutynin Extended Release (ER), and Oxybutynin Patch (Oxytrol). Patients were followed for one year after