The Journal of urology
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The Journal of urology · May 2010
Multicenter StudyProgression of lower urinary tract symptoms in older men: a community based study.
Lower urinary tract symptom progression in community dwelling older men is not well described. ⋯ Up to 29% of community dwelling older men with no or mild lower urinary tract symptoms will have clinically significant lower urinary tract symptoms within 2 years. These data help elucidate the natural history of lower urinary tract symptoms in the community and provide useful data to design clinical trials of lower urinary tract symptom prevention.
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The Journal of urology · May 2010
Prostate cancer screening in men 75 years old or older: an assessment of self-reported health status and life expectancy.
Opinions vary regarding the appropriate age at which to stop prostate specific antigen screening. Some groups recommend screening men with a greater than 10-year life expectancy while the United States Preventive Services Task Force recommends against screening men 75 years old or older. In this study we evaluated the influence of health status and life expectancy on prostate specific antigen screening in older men in the United States before the 2008 United States Preventive Services Task Force guidelines. ⋯ Before the United States Preventive Services Task Force recommendation, health status and life expectancy were used to select older men for prostate specific antigen screening. However, many men expected to live less than 5 years were screened. A strict age cutoff of 75 years reduces over screening but also prohibits screening in healthy older men with a long life expectancy who may benefit from screening.
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The Journal of urology · May 2010
The inadequacy of urinary dipstick and microscopy as surrogate markers of urinary tract infection in urological outpatients with lower urinary tract symptoms without acute frequency and dysuria.
Diagnosing urinary infection in patients with chronic lower urinary tract symptoms without dysuria is a critical step. In this study we scrutinize the sensitivity and specificity of dipstick urinalysis and microscopic pyuria (10 or more white blood cells per microl) to identify infection in such patients. ⋯ Despite official guidelines and widespread use these tests cannot be considered appropriate for diagnosing urinary tract infection in patients with lower urinary tract symptoms, and should be abandoned in this context.
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The Journal of urology · May 2010
Development and validation of the Bladder Cancer Index: a comprehensive, disease specific measure of health related quality of life in patients with localized bladder cancer.
We developed and validated a reliable, responsive multidimensional instrument to measure disease specific health related quality of life in bladder cancer survivors treated with local cancer therapy. ⋯ The Bladder Cancer Index is a robust, multidimensional measure of bladder cancer specific health related quality of life and to our knowledge is the first available validated instrument to assess health outcomes across a range of local treatments commonly used for bladder cancer.
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The Journal of urology · May 2010
Medical malpractice claims risk in urology: an empirical analysis of patient complaint data.
Patient complaints are associated with physician risk management experience, including medical malpractice claims risk, and small proportions of physicians account for disproportionate shares of claims. We investigated whether patient complaint experience differs among urologists, and whether urological subspecialists generate distinct quantities and types of complaints. ⋯ Unsolicited patient complaints were nonrandomly distributed among urologists and urological subspecialties. Monitoring patient complaints may allow for early identification of and intervention with high risk urologists before malpractice claims accumulate.