Raman M. Unnikrishnan

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OBJECTIVE To compare survival in patients with clinical T1b renal tumors that are pathologically upstaged, or high-grade tumors, treated by either partial nephrectomy (PN) or radical nephrectomy (RN). The American Urological Association Guidelines recently advocated increasing use of PN in all patients with cT1 renal masses, but urologists are often(More)
OBJECTIVE To investigate whether there is benefit with a longer acting oral fluoroquinolone, we compared the rate of infection after transrectal ultrasound-guided prostate biopsy between 2 prophylactic antibiotic regimens: ciprofloxacin vs levofloxacin, each combined with an aminoglycoside (AG). METHODS A retrospective review was performed of all(More)
Acute urinary tract disorders often manifest as flank pain and are a common complaint of patients who present to the emergency department. The pain is often a vague, poorly localized sensation that may have a variety of causes. Laboratory and clinical findings, such as hematuria, are neither sensitive nor specific for determining the cause of the flank(More)
Benign prostatic hyperplasia (BPH) is a common cause of lower urinary tract symptoms in aging men, worsening their quality of life. Primary care physicians are uniquely positioned to screen for BPH, conduct a timely diagnostic workup, and if indicated, initiate medical therapy. A number of safe and effective medical treatments are available to alleviate(More)
OBJECTIVES To evaluate the potential impact of the experience of the first assistant on the positive surgical margin rate (PSMR) after laparoscopic radical prostatectomy (LRP). The impact of training surgical residents and fellows on patient outcomes is difficult to quantify. METHODS A single-institution prospective database of 303 patients who underwent(More)
OBJECTIVE While the success of microvascular reconstruction is well established, even in the setting of prior radiotherapy, the outcomes in the setting of prior chemoradiation are less well documented. We present our experience with microvascular reconstruction in a unique cohort of patients previously treated with concomitant hyperfractionated radiation(More)
A 61-year-old woman was admitted for the management of a prepubic abscess. The patient had a history of an anterior vaginal wall sling 18 years previously, with an autologous fascial sling 1 year later for recurrent stress incontinence. Eight months before presentation, she was referred to another urologist for urge incontinence and an incidental bladder(More)
Spontaneous perforation of the esophagus is an uncommon event; when it does occur, it usually affects the thoracic esophagus. We present a rare and fatal case of spontaneous perforation of the cervical esophagus in a 68-year-old woman. We believe this rupture was related to a proximal outlet obstruction secondary to cricopharyngeal muscle dysfunction.