Urology | Page 2 of 27 | Links Medicus Content Curation & Alerts in Medicine

Systematic review & meta-analysis drawing on 2 decades of epidemiologic literature and including data from over 3 million patients shows no significant association between use of 5-alpha reductase inhibitor use and mortality from prostate cancer. https://t.co/3l9jT1l2P9 #PCSM

— JAMA Oncology (@JAMAOnc) April 21, 2023

ASCO Guideline Update | Initial management of noncastrate advanced, recurrent, or metastatic prostate cancer

18 Apr, 2023 | 12:54h | UTC

Initial Management of Noncastrate Advanced, Recurrent, or Metastatic Prostate Cancer: ASCO Guideline Update – Journal of Clinical Oncology

RCT | MRI–guided vs CT–guided stereotactic body radiotherapy for prostate cancer

18 Apr, 2023 | 12:52h | UTC

Magnetic Resonance Imaging–Guided vs Computed Tomography–Guided Stereotactic Body Radiotherapy for Prostate Cancer: The MIRAGE Randomized Clinical Trial – JAMA Oncology

News Release: MRI-guided radiotherapy produces fewer side effects and better quality of life for patients with localized prostate cancer – University of California – Los Angeles Health Sciences

RCT | Doxycycline postexposure prophylaxis effective in preventing gonorrhea, chlamydia, and syphilis in MSM

12 Apr, 2023 | 13:30h | UTC

Summary: In this open-label, randomized study involving 501 men who have sex with men (MSM) and transgender women, researchers investigated the effectiveness of postexposure doxycycline in preventing bacterial sexually transmitted infections (STIs), specifically gonorrhea, chlamydia, and syphilis. Participants with a previous STI in the past year, either taking preexposure prophylaxis (PrEP) against HIV or living with HIV, were randomly assigned to receive 200 mg of doxycycline within 72 hours after condomless sex or standard care without doxycycline. STI testing was performed quarterly, with the primary end point being the incidence of at least one STI per follow-up quarter.

Results demonstrated a significant reduction in STI incidence in both the PrEP and persons living with HIV cohorts who received doxycycline. Overall, the combined incidence of these three STIs was lower by two thirds with doxycycline postexposure prophylaxis compared to standard care. The study also reported five grade 3 adverse events but no serious adverse events attributed to doxycycline. This finding supports the use of doxycycline postexposure prophylaxis among MSM with recent bacterial STIs.

Article: Postexposure Doxycycline to Prevent Bacterial Sexually Transmitted Infections – New England Journal of Medicine (link to abstract – $ for full-text)

Commentary: Doxycycline after sex found to reduce STI incidence in gay men, transgender women – CIDRAP

Commentary on Twitter

In an open-label, randomized study involving men who have sex with men, doxycycline use after high-risk sexual exposure reduced the incidence of sexually transmitted infections (chlamydia, gonorrhea, and syphilis). https://t.co/tYOj8FLEy2 pic.twitter.com/bzNyvwzYS7

— NEJM (@NEJM) April 5, 2023

RCT | Effects of focal vs. extended irreversible electroporation ablation of localized prostate cancer

12 Apr, 2023 | 13:05h | UTC

Effect of Focal vs Extended Irreversible Electroporation for the Ablation of Localized Low- or Intermediate-Risk Prostate Cancer on Early Oncological Control: A Randomized Clinical Trial – JAMA Surgery (link to abstract – $ for full-text)

Commentary: Focal vs Extended Irreversible Electroporation in Ablation of Localized Low- or Intermediate-Risk Prostate Cancer – The ASCO Post

Commentary on Twitter

Irreversible electroporation (IRE) can provide promising oncological control as a focal therapy for patients with localized low-intermediate risk prostate cancer patients. https://t.co/lmYnYpSRmY

— JAMA Surgery (@JAMASurgery) February 1, 2023

Phase 2 RCT | Addition of metastasis-directed therapy to intermittent hormone therapy for oligometastatic prostate cancer

10 Apr, 2023 | 13:41h | UTC

Addition of Metastasis-Directed Therapy to Intermittent Hormone Therapy for Oligometastatic Prostate Cancer: The EXTEND Phase 2 Randomized Clinical Trial – JAMA Oncology (free for a limited period)

Commentary on Twitter

Randomized trial of intermittent hormone therapy +/- radiation to oligometastatic sites of #prostatecancer shows significantly improved PFS & assoc time off hormone therapy & w/normal testosterone from combination. https://t.co/ZnmkQuqHZm #RadOnc #PCSM #GUCSM

— JAMA Oncology (@JAMAOnc) April 6, 2023

Review | Urinary incontinence and pelvic organ prolapse in women

10 Apr, 2023 | 13:27h | UTC

Urinary Incontinence and Pelvic Organ Prolapse in Women: Prevention and Treatment – Deutsches Ärzteblatt International

ESMO Guideline | Updated treatment recommendations for prostate cancer

6 Apr, 2023 | 13:18h | UTC

Updated treatment recommendations for prostate cancer from the ESMO Clinical Practice Guideline considering treatment intensification and use of novel systemic agents – Annals of Oncology

Guideline | Muscle-invasive and metastatic bladder cancer

6 Apr, 2023 | 13:19h | UTC

Muscle-invasive and Metastatic Bladder Cancer – European Association of Urology (see PDF)

Consensus Paper | Treatment of sexual dysfunction after surgery for prostate cancer

22 Mar, 2023 | 13:34h | UTC

Consensus of Experts on the Treatment of Sexual Dysfunction after Surgery for Prostate Cancer in Taiwan – Journal of Clinical Medicine

RCT | Patient-reported outcomes 12 years after different treatments for localized prostate cancer

15 Mar, 2023 | 15:24h | UTC

Summary: The article reports on a study that evaluated patient-reported outcomes of 1,643 participants in the ProtecT trial over a period of 7 to 12 years to assess the long-term functional and quality-of-life impacts of prostatectomy, radiotherapy with neoadjuvant androgen deprivation, and active monitoring for localized prostate cancer detected by PSA screening.

The study found that generic quality-of-life scores were similar among the randomized groups over 7 to 12 years. However, although the prostatectomy group had a lower incidence of nocturia, they showed a higher incidence of urinary incontinence and sexual dysfunction compared to the radiotherapy and active monitoring groups. The radiotherapy group had a higher incidence of fecal leakage compared to the other groups.

The study provides evidence that helps patients and their clinicians assess the trade-offs between treatment harms and benefits and make better-informed treatment decisions.

Article: Patient-Reported Outcomes 12 Years after Localized Prostate Cancer Treatment – NEJM Evidence

Original Study: RCT | Localized prostate cancer treatment options have similar 15-year survival outcomes

Consensus Statement | Best current practice and research priorities in active surveillance for prostate cancer

15 Mar, 2023 | 15:11h | UTC

Best Current Practice and Research Priorities in Active Surveillance for Prostate Cancer—A Report of a Movember International Consensus Meeting – European Urology Oncology

Review | Approach to the patient with adrenal hemorrhage

15 Mar, 2023 | 15:03h | UTC

Approach to the Patient With Adrenal Hemorrhage – The Journal of Clinical Endocrinology & Metabolism

Press release | New technique reduces postoperative complications in prostate cancer surgery

14 Mar, 2023 | 13:33h | UTC

Press release: New technique reduces postoperative complications in prostate cancer surgery – European Association of Urology

RCT | Cannabidiol oil not effective for post-ureteroscopy pain control

10 Mar, 2023 | 14:34h | UTC

Summary: The study evaluated the effect of cannabidiol oil on pain control and opioid usage in patients undergoing ureteroscopy with stent placement for urinary stone disease. Ninety patients were randomized 1:1 to receive either placebo or 20mg of cannabidiol oil daily for 3 days postoperatively.

Results showed no difference between CBD oil and placebo in reducing pain scores, opioid usage, or stent-related symptoms. The study suggests that despite the availability of numerous analgesic agents, stent symptoms continue to be bothersome for most patients, and further research is needed to find effective non-opioid alternatives for pain management in this setting.

Article: Effect of Cannabidiol Oil on Post-ureteroscopy Pain for Urinary Calculi: A Randomized, Double-blind, Placebo-controlled Trial – The Journal of Urology (free for a limited period)

Consensus Paper | Management of patients with advanced prostate cancer

7 Mar, 2023 | 13:02h | UTC

Management of patients with advanced prostate cancer. Metastatic and/or castration resistant prostate cancer: Report of the Advanced Prostate Cancer Consensus Conference (APCCC) 2022 – European Journal of Cancer

RCT | Hydrochlorothiazide is not effective for the prevention of kidney-stone recurrence

6 Mar, 2023 | 14:26h | UTC

Summary:

This study aimed to assess the effectiveness of hydrochlorothiazide, a thiazide diuretic, in preventing the recurrence of calcium-containing kidney stones. The trial randomly assigned 416 patients with recurrent kidney stones to receive hydrochlorothiazide at a dose of 12.5 mg, 25 mg, or 50 mg once daily, or a placebo once daily, and followed them for a median of 2.9 years.

The results showed that the incidence of kidney stone recurrence did not differ significantly between the hydrochlorothiazide and placebo groups, regardless of the dose. Furthermore, patients who received hydrochlorothiazide were more likely to experience side effects such as hypokalemia, gout, new-onset diabetes mellitus, skin allergy, and a plasma creatinine level exceeding 150% of the baseline level.

Therefore, the effectiveness of hydrochlorothiazide in preventing kidney stone recurrence may be limited, and the common practice of prescribing it for these patients should be reevaluated.

Article: Hydrochlorothiazide and Prevention of Kidney-Stone Recurrence – New England Journal of Medicine (link to abstract – $ for full-text)

Video Summary: Hydrochlorothiazide and Kidney-Stone Recurrence | NEJM

Commentary: Hydrochlorothiazide and Prevention of Kidney Stones – NEJM Resident 360

Guideline | Diagnosis, management, and follow-up of the incidentally discovered adrenal mass

6 Mar, 2023 | 14:16h | UTC

Canadian Urological Association guideline: Diagnosis, management, and follow up of the incidentally discovered adrenal mass – Canadian Medical Association Journal

Perspective | Gender dysphoria in young people is rising — and so is professional disagreement

28 Feb, 2023 | 13:55h | UTC

Gender dysphoria in young people is rising—and so is professional disagreement – The BMJ

News Release: Gender dysphoria is rising—and so is professional disagreement – BMJ Newsroom

Commentary on Twitter

More children and adolescents are identifying as transgender and are being offered medical treatment, especially in the US—but some providers and European authorities are urging caution because of a lack of strong evidence. @writingblock reports https://t.co/24aDMo7rb0

— The BMJ (@bmj_latest) February 26, 2023

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