Urology
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To evaluate short-term and long-term variability between prostate-specific antigen (PSA) measurements to determine the most appropriate PSA sampling interval and rate of PSA change (PSA velocity) to distinguish between men with and without prostate cancer. ⋯ PSA velocity is inversely related to the interval between PSA measurements. A PSA velocity more than 0.75 ng/mL per year is useful in distinguishing between men with and without prostate cancer when: (1) velocity is based on three consecutive measurements; and (2) PSA is sampled long-term (2 years) but not short-term (3 to 6 months).
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Clinical Trial
Accuracy of the initial history and physical examination to establish the etiology of erectile dysfunction.
Because of its implications for possible therapy, the ability to establish a diagnosis of erectile dysfunction (ED) solely on the basis of history and physical examination has been a matter of controversy. The determination of the etiology of ED based on history and physical examination is evaluated in this present study. ⋯ A multifaceted comprehensive approach is required to evaluate fully and to diagnose ED.
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Comparative Study
Radiation therapy for T1 and T2 prostate cancer: prostate-specific antigen and disease outcome.
To evaluate disease outcome using serum prostate-specific antigen (PSA) as an outcome measure in patients with T1 or T2 prostate cancer treated with radiation therapy in the PSA era. ⋯ Radiation therapy is an acceptable modality for treating T1 or T2 disease and produces results comparable to those following radical prostatectomy when patients are stratified according to their pretreatment PSA value. The rapid PSA doubling times observed in patients with relapsing disease are more consistent with a "selective" rather than an "aggravation" mechanism.
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To review a contemporary series of rectal injuries occurring during radical perineal prostatectomy. ⋯ Rectal injury occurs with significantly greater frequency with radical perineal prostatectomy than with the retropubic approach. However, if the rectum is adequately prepared, the injury promptly recognized and repaired, and postoperative care appropriate, the great majority of cases will not lead to attendant morbidity.
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Comparative Study
Management of small unilateral renal cell carcinomas: radical versus nephron-sparing surgery.
There is controversy concerning the management of small unilateral renal cell carcinomas. The present study was undertaken to evaluate the relative efficacy of radical nephrectomy versus nephron-sparing surgery in such patients. ⋯ Radical nephrectomy and nephron-sparing surgery each provide safe and effective curative treatment for patients with a single, small, unilateral localized RCC. The long-term renal functional advantage of nephron-sparing surgery in this setting is not established.