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564 results found

Onabotulinum toxin A (BTX) not helpful for chronic scrotal pain

It is refreshing to read a report on negative outcomes as it reinforces the honesty that is often lacking with the well-known publication bias in medical publications. It is also not common to come across surgical randomised controlled trials (RCTs)...

Reviewing the evidence for TNS in neurogenic lower urinary tract dysfunction

Tibial nerve stimulation (TNS) is a recognised minimally invasive treatment option for bladder overactivity and non-neurogenic lower urinary tract dysfunction. In this systematic review, the role TNS can play in the management of neurogenic lower urinary tract dysfunction is evaluated...

Focal therapy trials

Men with localised prostate cancer have traditionally required whole gland treatment involving radical prostatectomy or radical radiation treatment, independent of disease location and size. Increasing evidence supports the use of active treatment only in those men diagnosed with prostate cancer...

SUSPEND suspended MET

This review is on the recent groundbreaking evidence on medical expulsive therapy (MET). MET using alpha adrenergic blockers (like tamsulosin) are in regular clinical practice. Even though it is an off label prescription, it is well accepted and practised world...

Prostatic artery embolisation versus sham

Randomised trials with use of sham is uncommon in the surgical literature, which makes this paper more interesting. Many different treatments are available for treating lower urinary tract symptoms / benign prostatic hyperplasia (LUTS / BPH). Prostatic artery embolisation (PAE)...

Low dose PDE5I in IC

This is a randomised, double-blind, placebo-controlled trial to evaluate the efficacy of daily low-dose sildenafil (25mg) for the treatment of non-ulcer interstitial cystitis (IC) in women. Forty-eight women with clinical diagnosis of IC, from three centres, were equally randomised to...

Has laparoscopic radical prostatectomy had its day?

Over recent years there has been a massive uptake in robotic surgery particularly for robot-assisted prostatectomy. The drive for this has been patient and physician led with little in the way of prospective randomised trials showing benefits over established operative...

Can transcutaneous peroneal nerve stimulation treat OAB?

The peroneal nerve follows sacral, pudendal, and tibial nerves as a target for overactive bladder (OAB) treatment. This multicentre prospective randomised RCT compared a transcutaneous electrical neuromodulation system (eTNM) at-home treatment once daily for 30 minutes to solifenacin 5mg once...

MRI screening for prostate cancer: a step towards a ‘prostagram’

The UK National Screening Committee has been calling for further research into alternative screening tests for prostate cancer. The committee decided against prostate cancer screening using prostate specific antigen (PSA) testing on the basis that “PSA is still a poor...

Abiraterone plus prednisone in metastatic, castration-sensitive prostate cancer

Abiraterone acetate, the prodrug of abiraterone, blocks endogenous androgen synthesis by inhibiting cytochrome p-450c17, a critical enzyme in androgen biosynthesis. Its active D4A metabolite also has anti-tumour effects through possibly multiple mechanisms. 3-5% of men diagnosed with prostate cancer in...

Clinical trials 1

Clinical Trials 2 is available here. Case 1 1. What are the levels of clinical evidence based on the 2009 definitions from the ‘Oxford CEBM’? 2. What is the null hypothesis? 3. What are type 1 and type 2 errors?...

Trials offering cytoreductive surgery for men with de novo synchronous metastatic prostate cancer

Life expectancy in men diagnosed with de novo synchronous metastatic hormone-sensitive prostate cancer (mHSPC) has risen to a median of 4.8 years with upfront systemic agents (such as docetaxel) in addition to standard androgen deprivation therapy (ADT) [1-3]. Within this...