Urologic oncology
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Randomized Controlled Trial
Multiparametric magnetic resonance imaging vs. standard care in men being evaluated for prostate cancer: a randomized study.
To assess whether the proportion of men with clinically significant prostate cancer (PCa) is higher among men randomized to multiparametric magnetic resonance imaging (mp-MRI)/biopsy vs. those randomized to transrectal ultrasound (TRUS)-guided biopsy. ⋯ The proportion of men with clinically significant PCa is higher among those randomized to mp-MRI/biopsy vs. those randomized to TRUS-guided biopsy; moreover, mp-MRI is a very reliable tool to identify patients to schedule in active surveillance.
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Randomized Controlled Trial Multicenter Study
The Personal Patient Profile-Prostate decision support for men with localized prostate cancer: a multi-center randomized trial.
The purpose of this trial was to compare usual patient education plus the Internet-based Personal Patient Profile-Prostate, vs. usual education alone, on conflict associated with decision making, plus explore time-to-treatment, and treatment choice. ⋯ The Personal Patient Profile-Prostate is the first intervention to significantly reduce decisional conflict in a multi-center trial of American men with newly diagnosed localized CaP. Our findings support efficacy of P3P for addressing decision uncertainty and facilitating patient selection of a CaP treatment that is consistent with the patient values and preferences.
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Randomized Controlled Trial Multicenter Study Comparative Study
A prospective randomized multicenter study of Turkish Society of Urooncology comparing two different mechanical bowel preparation methods for radical cystectomy.
To investigate the outcomes and complication rates of urinary diversion using mechanical bowel preparation (BP) with 3 day conventional and limited BP method through a standard perioperative care plan. ⋯ Regarding all endpoints, including septic and nonseptic complications, current clinical research offers no evidence to show any advantage of 3-day BP over limited BP.
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Randomized Controlled Trial Comparative Study
Noninfiltrative anesthesia for transrectal prostate biopsy: a randomized prospective study comparing lidocaine-prilocaine cream and lidocaine-ketorolac gel.
Periprostatic nerve block (PPNB) is the standard anesthesia for ultrasound (US) guided transrectal prostate biopsy (TPB), but periprostatic infiltration itself constitutes a major, though often neglected, source of discomfort even in patients receiving perianal-intrarectal lidocaine-prilocaine (PILP) cream before PPNB. Noninfiltrative anesthesia therefore represents an attractive alternative to periprostatic infiltration. With this in mind, we aimed to determine the efficacy and safety of perianal-intrarectal (PI) lidocaine gel, lidocaine-ketorolac gel, and lidocaine-prilocaine cream in relieving pain during TPB. ⋯ Lidocaine-prilocaine cream was most effective on probe-related pain, whereas lidocaine-ketorolac gel was most effective on sampling-related pain. These noninfiltrative anesthetics were safe, easy to administer, and well accepted by patients; the possibility to combine them to further improve pain control during TPB deserves further well-designed studies.
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Randomized Controlled Trial Multicenter Study
Screening for prostate cancer (PC)--an update on recent findings of the European Randomized Study of Screening for Prostate Cancer (ERSPC).
Introduction for screening for prostate cancer as a healthcare policy is desirable provided its effectiveness can be shown in terms of decreasing prostate cancer mortality at an acceptable price in terms of quality of life and costs. The European Randomized Study of Screening for Prostate Cancer (ERSPC) was initiated in 1993 and should in 2008 have the power to produce the required information. The structure and status of ERSPC. ⋯ The application of this nomogram to screen detected cases allows the the advice "active observation" to about 30% of such patients. ERSPC is set to show or exclude at least a 25% reduction in prostate cancer mortality through screening. Many pending problems still have to be resolved prior to the introduction of populations based screening as a worldwide healthcare policy.