Effects of 100 and 300 units of onabotulinum toxin A on lower urinary tract symptoms of benign prostatic hyperplasia: a phase II randomized clinical trial.

Purpose: We conducted a 2-stage, multicenter, double-blind, randomized phase II clinical trial of 100 and 300 unit doses of onabotulinum toxin A to treat the lower urinary tract symptoms of benign prostatic hyperplasia.

Materials And Methods: Men 50 years old or older with clinically diagnosed benign prostatic hyperplasia, American Urological Association symptom index 8 or greater, maximum urinary flow rate less than 15 ml per second, voided volume 125 ml or greater, and post-void residual 350 ml or less were randomized to prostatic transrectal injection of 100 or 300 units of onabotulinum toxin A. The primary outcome was at least 30% improvement from baseline to 3 months in American Urological Association symptom index and/or maximum urinary flow rate and safety.

Update on AUA guideline on the management of benign prostatic hyperplasia.

Purpose: To revise the 2003 version of the American Urological Association's (AUA) Guideline on the management of benign prostatic hyperplasia (BPH).

Materials And Methods: From MEDLINE® searches of English language publications (January 1999 through February 2008) using relevant MeSH terms, articles concerning the management of the index patient, a male ≥45 years of age who is consulting a healthcare provider for lower urinary tract symptoms (LUTS) were identified. Qualitative analysis of the evidence was performed.

Benign prostate hyperplasia: a review of the year's progress from bench to clinic.

Purpose Of Review: Therapeutic tools for classic benign prostate hyperplasia (BPH) have focused on the dynamic component of obstruction and/or elimination of the static component via surgical or pharmaceutical therapies. Unfortunately, an exact cause for this disease process has not been identified, but additional insight has been achieved. This article presents an update of the BPH literature with a special focus on basic science or translational studies concerned with the cause of clinically significant BPH with lower urinary tract symptoms (LUTS).

Minimally invasive therapy of lower urinary tract symptoms.

The establishment of guidelines, pharmacologic therapies, improved understanding of lower urinary tract symptoms (LUTS) versus benign prostate hyperplasia (BPH), respect for patient-centered goals, and improved discrimination of the patient with occult prostate cancer have empowered change in the management of LUTS. These developments have allowed urologists to recognize the limitations of transurethral prostatectomy as the gold standard and search for "ideal therapies" to provide treatments with an improved relief of symptoms, decreased complication rate and cost, to correct BPH-associated morbidities and prevent future morbidities. Prognostic parameters and their ability to predict progression may be important in the future of LUTS management and selection of therapy.

Use of consumer health vocabularies in online physician directory to improve physician search.

There is a language gap between health care providers and consumers, which is a substantial barrier to access health information for consumers. Unlike doctors who tend to use formal medical terms to describe health-related concepts, consumers use more simple words or "everyday language" to express those concepts. We compared the health care emphasis terms entered by providers on the HealthLink online physician directory with the search terms entered by consumers in the year of 2006 to sort out the different ways between professional and lay expressions to describe health-related concepts.

Management of ileostomy trauma produced by a dog bite in a patient with thoracic paraplegia.

Urologic trauma produced by dog bites is uncommon. Several previous single reports and small case series have described the treatment of dog bite-induced injuries to the external genitalia. In this report, we describe our treatment of a patient with thoracic paraplegia and an ileal conduit who had extensive trauma to his ileostomy as a result of a bite by the family dog.

Prostatitis: the cost of disease and therapies to patients and society.

Prostatitis is an elusive clinical phenomenon that has become a synonymous term to describe a plethora of lower urinary tract symptoms in men including urinary problems, sexual dysfunction, and pelvic pain. Although symptom presentation has been standardized, an accurate, consistent clinical diagnosis continues to be elusive at best. As a result, recurrence is common, quality of life is compromised, and the patients and society feel the cost of this disease.

Changes in medicare reimbursement: impact on therapy for benign prostatic hyperplasia.

Medicare spending accounts for 17% of all health spending and therefore exerts a significant influence on health care spending policies. Medicare policies such as Diagnostic Related Groups and the Resource Based Relative Value System have resulted in profound changes in health care delivery in the United States. These resource-allocation methods are one of the major sources of controversies between managers, doctors, politicians, and social scientists.