Urology
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Increasingly, radiation therapists are using neoadjuvant and/or adjuvant androgen deprivation therapy (ADT) in higher-risk patients who are receiving radiation therapy with curative intent. Studies supporting this combination therapy have shown a benefit in patients with locally advanced disease based on the relatively short follow-up time to report, to date. The differing study designs, patient selection criteria, and regimens used in these studies are reviewed and compared, along with the reported outcomes. Trials currently underway will examine the efficacy of ADT (4 to 6 months in duration) in patients with clinically localized prostate cancer with >/=1 high-risk features.
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Randomized Controlled Trial Clinical Trial
Effects of irrigation fluid temperature on core body temperature during transurethral resection of the prostate.
To determine the effect irrigation fluid temperature has on core body temperature changes in patients undergoing transurethral resection of the prostate (TURP). ⋯ The results of our study suggest that irrigation fluid temperature is not a factor responsible for altering the core body temperature in patients undergoing TURP.
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Randomized Controlled Trial Comparative Study Clinical Trial
Comparison of the efficacy and safety of finasteride in older versus younger men with benign prostatic hyperplasia.
To compare the efficacy and safety of finasteride 5 mg in older (65 years old or older) versus younger (45 to younger than 65 years old) men with benign prostatic hyperplasia (BPH). ⋯ The present analysis from PLESS demonstrates that in both older (65 years old or older) and younger men with symptomatic BPH and enlarged prostates, finasteride is highly effective in improving symptoms and reducing prostate volume in many men and in reducing the risk of acute urinary retention and BPH-related surgery. In addition, the safety profile of finasteride in both older and younger men is similar and no drug interactions of clinical importance were observed.
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Testicular torsion is an active area of medical malpractice litigation because of the diagnostic uncertainty, delays in diagnosis and treatment, diagnostic errors, and resultant testicular loss. We reviewed this topic to determine the nature of patient claims and their clinical and legal outcomes. ⋯ Testicular torsion litigation most often focuses on the urologist. Claims are more common in older patients and those with atypical complaints. Settlement is the most common outcome, with a fairly standard indemnity payment rewarded. The initial treating physician must have a high index of suspicion for the diagnosis and refer promptly. In lieu of a definitive radiologic study, or when the diagnosis is in question, the urologist should strongly consider exploration and should perform contralateral exploration when torsion is found.