Archivio italiano di urologia, andrologia : organo ufficiale [di] Società italiana di ecografia urologica e nefrologica / Associazione ricerche in urologia
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Arch Ital Urol Androl · Apr 1998
ReviewSome remarks on the epidemiology of acute urinary retention.
Acute urinary retention is an unpleasant, painful experience which requires immediate medical, and frequently surgical intervention. Population studies reveal that acute urinary retention is a common event: a 60 year-old man who survives a further 20 years has a 23 per cent probability of experiencing an acute episode of urinary retention. About half of acute retention episodes appear to be linked to general anaesthesia and a further large population due to the natural history of benign prostatic hyperplasia. ⋯ Since finasteride acts in a positive manner on the major risk factors (finasteride use increases peak urinary flow rate, reduces symptom scores in moderately symptomatic men and reduces prostate volume), this result is not too surprising. It remains to be determined what the risk factors for anaesthesia-induced acute retention are and how they can be altered. Nevertheless, the improvement of our knowledge of the epidemiology of acute urinary retention in the past 12 months is impressive.
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Since February 1993 six patients with bladder diverticula have undergone resection of the diverticular neck and fulguration of the diverticular mucosa at the time of transurethral resection of the prostate in 5 cases and urethral dilation in one case. The mean dimension of the diverticular was 5.2 cm. ⋯ Our paper demonstrates the effectiveness of this technique in the treatment of bladder diverticular. In our opinion endoscopic fulguration represents a valid alternative to open surgery for the treatment of small bladder diverticular.
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Meta-analysis is a procedure to systematically research and collect published and (ideally) unpublished randomized clinical trials (RCTs) of treatments and quantitatively summarise their results, in order to obtain an objective assessment of efficacy. Collaboration between statisticians and clinical experts in the field of pathology addressed by the treatment is needed for performing reliable meta-analyses. "Typical" meta-analysis can be refined as "cumulative" meta-analysis, where the pooled assessment of treatment effect is repeated every time a new trial is added to a set of trials, and by meta-analysis "on individual patient data", i.e. using information on each patient included in every trial. ⋯ Meta-analysis is suggested as the most convenient and reliable source of data for practising EBM. EBM is taking advantage from the Cochrane Collaboration, an international network of experts performing, updating and disseminating meta-analyses of important treatments, according to a common model and established procedures.
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Arch Ital Urol Androl · Dec 1996
Clinical Trial Controlled Clinical Trial[Role of expectant therapy in prostatic carcinoma of low grade and staging].
Low stage and grade prostate cancer can be treated by radical prostatectomy, radiotherapy and expectant therapy. Preoperative evaluation with biopsy is in many cases unreliable to pathological stage and grade. ⋯ Grading was confirmed by radical prostatectomy specimen in 62.5%. The role of expectant therapy is then discussed.
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Arch Ital Urol Androl · Dec 1996
[Preoperative staging of prostatic carcinoma: evaluation of the role of transrectal echography].
Radical Retropubic Prostatectomy (RRP) is the choice treatment for localized prostate cancer. Transrectal ultrasonography (TRUS) was used to predict local tumor extension in ninety-one patients prior RRP. In these patients 41% showed histologic evidence of extracapsular spread. These data suggest that ultrasonography is associated with considerable staging errors when used to evaluate men with clinically localized prostate cancer.