Can J Urol
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The 2003 American Urological Association (AUA) guideline on management of benign prostatic hyperplasia (BPH) was released at the AUA annual meeting in Chicago, April 2003 and the diagnosis and treatment recommendations were published later in 2003. It is likely that the 2003 AUA guideline on the management of BPH will have a profound effect on clinical urologic practice in the USA, but its influence on Canadian urological practice will be different because of our socialized medical system, manpower issues, availability of expensive technology and our unique Canadian perspective. ⋯ We conclude that the 2003 AUA guideline for the management of BPH is an important document that should be studied, evaluated and understood by Canadian urologists. Although our perspective is clearly different than our US colleagues, it is likely that the guideline will influence the management of BPH in Canada.
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Comparative Study
Clinical results of combined epidural and general anesthesia procedure in radical prostatectomy management.
Improvement of radical prostatectomy surgical technique remains an objective for urological practice. The aim of this study was to evaluate the potential benefit of intra and postoperative epidural versus general anesthesia alone. ⋯ Our study suggests that improved results can be obtained when epidural anesthesia is associated with general anesthesia in radical retropubic prostatectomy intra and postoperative management, with a significant reduction in morbidity.
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Review Meta Analysis
A systematic review of randomized trials in localized prostate cancer.
Most treatment studies of localized prostate cancer are observational in nature. The recent publication of a large randomized trial of radical prostatectomy (RP) versus watchful waiting (WW) has focused increased attention on the treatment of localized prostate cancer. We reviewed all published randomized trials that compared different primary treatment modalities for localized prostate cancer. ⋯ There is high-quality evidence from one randomized trial in favor of surgery over watchful waiting with palliative intent for non-high grade localized prostate cancer. However, most tumors in this study were clinically diagnosed rather than screen-detected. Further randomized trials examining the treatment of screen-detected, localized prostate cancer are needed; several are currently underway.
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Comparative Study
An oncology perspective on the benefits and cost of combined androgen blockade in advanced prostate cancer.
To provide context in oncology for the significance of the benefits and cost of combined androgen blockade (CAB) in the treatment of advanced prostate cancer. ⋯ The advantages offered by CAB (including the cost per month of survival benefit and minimal associated clinical toxicities) are comparable to the reported advantages of new treatments for other common cancers such as NSCLC, colorectal cancer, and breast cancer.
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Comparative Study
Laparoscopic versus open adrenalectomy for surgical adrenal disease.
To compare the intraoperative and postoperative outcomes of laparoscopic versus open adrenalectomy for surgical adrenal disease. ⋯ In our experience, prior ipsilateral adrenal surgery greatly increases the risk of open conversion. This study is consistent with the findings of a number of previously reported studies, supporting the emergence of laparoscopic adrenalectomy as the standard of care for surgical management of benign adrenal disease.