Testosterone replacement therapy for the primary care physician.

Testosterone replacement therapy (TRT) can have significant beneficial effects in the appropriate hypogonadal male patient. Testosterone deficiency is common in primary care practice and recognition of the signs and symptoms of this abnormality will allow physicians to choose appropriate interventions. The symptoms of clinical hypogonadism include muscle weakness, fatigue, mood changes and a reduced libido.

Levofloxacin for chronic prostatitis/chronic pelvic pain syndrome in men: a randomized placebo-controlled multicenter trial.

Objectives: To perform a Canadian multicenter randomized placebo-controlled trial to evaluate the safety and efficacy of 6 weeks of levofloxacin therapy compared with placebo in chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS). Uncontrolled studies have supported the use of antibiotics in CP/CPPS.

Methods: Men with a National Institutes of Health (NIH) diagnosis of CP/CPPS (specifically, no infection localized to the prostate) were randomized to levofloxacin (500 mg/day) or placebo for 6 weeks in 11 Canadian centers.

Counterpoint: urologists should take an active role in the diagnosis and treatment of hypogonadism in the aging male.

The recent interest in the potential applications of new testosterone preparations has stimulated industry and physicians to develop indications for their use. Despite little scientific evidence to support the widespread application of testosterone in aging men, a clinical symptom complex called Partial Androgen Deficiency in the Aging Male (PADAM) has been described. Many of these symptoms can be successfully treated without testosterone administration.

Canadian experience with high intensity focused ultrasound for the treatment of BPH.

INTRODUCTION: High Intensity Focused Ultrasound (HIFU) ablates benign prostatic tissue in a minimally invasive manner with low morbidity. The safety and effectiveness of treating of benign prostatic hypertrophy (BPH) with HIFU using 3 different protocols are reported. METHODS: Forty six male patients with a mean age of 65 (range 47-84) were treated using the Sonablate HIFU device (Focus Surgery, Indianapolis IN) with 3 different protocols at 3 centres (LDS n=20, PJP n=12, RWC n=14).