Abstract:
UNLABELLED:What's known on the subject? and What does the study add? For the past 30 years Serenoa repens has become a widely used phytotherapy in the USA and in Europe, mostly because of positive comparisons to α-blockers and 5α-reductase inhibitors. During the last 4 years we have seen two very high quality trials comparing Serenoa repens to placebo and up to 72 weeks' duration. These trials found Serenoa repens no better than placebo, even (in one trial) at escalating doses. OBJECTIVE:• To estimate the effectiveness and harms of Serenoa repens monotherapy in the treatment of lower urinary tract symptoms (LUTS) consistent with benign prostatic hyperplasia (BPH). MATERIALS AND METHODS:• We searched MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials (CENTRAL), and other sources through to January 2012 to identify randomised trials. • Trials were eligible if they randomised men with symptomatic BPH to receive Serenoa repens extract monotherapy for at least 4 weeks in comparison with placebo, and assessed clinical outcomes and urodynamic measurements. • Our primary outcome was improvement in LUTS, based on change in urological symptom-scale scores. RESULTS:• In all, 17 randomised controlled trials (N= 2008) assessing Serenoa repens monotherapy (typically 320 mg/day) vs placebo met inclusion criteria, although only five reported American Urological Association Symptom Index (AUASI) or International Prostate Symptom Scores (IPSS). Trial lengths ranged from 4 to 72 weeks. The mean age of all enrolees was 64.3 years and most participants were of White race. The mean baseline total score was 14 points, indicating moderately severe symptoms. In all, 16 trials were double blinded and adequate treatment allocation concealment was reported in six trials. • In a meta-analysis of three high quality long-to-moderate term trials (n= 661), Serenoa repens therapy was no better than placebo in reducing LUTS based on the AUASI/IPSS (weighted mean difference [WMD]-0.16 points, 95% confidence interval [CI]-1.45 to 1.14) or maximum urinary flow rate (Q(max) ; WMD 0.40 mL/s, 95% CI -0.30 to 1.09). Based on mostly short-term studies, Q(max) measured at study endpoint were also not significantly different between treatment groups (WMD 1.15 mL/s, 95% CI -0.23 to 2.53) with evidence of substantial heterogeneity (I(2) 58%). • One long-term dose escalation trial (72 weeks) found double and triple doses of Serenoa repens extract did not improve AUASI compared with placebo and the proportions of clinical responders (≥ 3 point decrease in the AUASI) were nearly identical (43% vs 44% for Serenoa repens and placebo, respectively) with a corresponding risk ratio of 0.96 (95% CI 0.76-1.22). • Long-term, Serenoa repens therapy was no better than placebo in improving nocturia in one high-quality study (P= 0.19). Pooled analysis of nine short-term Permixon® trials showed a reduction in the frequency of nocturia (WMD -0.79 times/night, 95% CI-1.28 to -0.29), although there was evidence of heterogeneity (I(2) 76%) • Adverse events of Serenoa repens extracts were few and mild, and incidences were not statistically significantly different vs placebo. Study withdrawals occurred in ≈ 10% and did not differ between Serenoa repens and placebo. CONCLUSIONS:• Serenoa repens therapy does not improve LUTS or Q(max ) compared with placebo in men with BPH, even at double and triple the usual dose. • Adverse events were generally mild and comparable to placebo.
journal_name
BJU Intjournal_title
BJU internationalauthors
MacDonald R,Tacklind JW,Rutks I,Wilt TJdoi
10.1111/j.1464-410X.2012.11172.xsubject
Has Abstractpub_date
2012-06-01 00:00:00pages
1756-61issue
12eissn
1464-4096issn
1464-410Xjournal_volume
109pub_type
杂志文章,评审abstract:OBJECTIVE:To determine the metabolic characteristics of elderly patients with recurrent calcium oxalate stones. PATIENTS AND METHODS:Metabolic abnormalities were investigated in 88 patients with recurrent calcium oxalate stones, including 70 aged <60 years and 18 aged >/=60 years. The frequency of each metabolic abnor...
journal_title:BJU international
pub_type: 杂志文章
doi:10.1046/j.1464-410x.1999.00057.x
更新日期:1999-06-01 00:00:00
abstract:UNLABELLED:Study Type - Therapy (case series). LEVEL OF EVIDENCE:4. What's known on the subject? and What does the study add? The indications and timing of native nephrectomy in patients with autosomal dominant polycystic kidney disease (ADPKD) is controversial, especially for those undergoing renal transplantation. P...
journal_title:BJU international
pub_type: 杂志文章
doi:10.1111/j.1464-410X.2010.09938.x
更新日期:2011-08-01 00:00:00
abstract:OBJECTIVE:To assess the results of transperitoneal laparoscopic pelvic lymphadenectomy as a separate staging procedure in patients with early prostate cancer. PATIENTS AND METHODS:The results were reviewed from the first 27 patients with prostate cancer admitted for laparoscopic lymphadenectomy between January 1994 an...
journal_title:BJU international
pub_type: 杂志文章
doi:10.1046/j.1464-410x.1999.00931.x
更新日期:1999-02-01 00:00:00
abstract:OBJECTIVE:To report the overall success rate of a laparoscopic orchidopexy (LO) series over 5 years including over 100 procedures. PATIENTS AND METHODS:The records were reviewed of children who underwent laparoscopic procedures for an impalpable testis at our institutions. The laparoscopic procedures included the stan...
journal_title:BJU international
pub_type: 杂志文章,多中心研究
doi:10.1046/j.1464-410x.2001.00100.x
更新日期:2001-04-01 00:00:00
abstract:OBJECTIVE:To determine the acceptability and patient satisfaction of transrectal biopsy undertaken with the patient under sedation. Patients and methods A retrospective questionnaire was sent to 100 patients who had undergone transrectal biopsy between January and August 1998. Levels of patient acceptability and satisf...
journal_title:BJU international
pub_type: 杂志文章
doi:10.1046/j.1464-410x.2001.02221.x
更新日期:2001-06-01 00:00:00
abstract:BACKGROUND:Pelvi-ureteric junction (PUJ) obstruction is characterized by a functionally significant impairment of urinary transport caused by intrinsic or extrinsic obstruction in the area where the ureter joins the renal pelvis. The majority of cases are congenital in origin; however, acquired conditions at the level ...
journal_title:BJU international
pub_type: 杂志文章,评审
doi:10.1111/j.1464-410X.2009.08682.x
更新日期:2009-12-01 00:00:00
abstract:OBJECTIVE:To examine the effect of short-course androgen-suppression therapy (AST) before brachytherapy on all-cause mortality (ACM) rates, stratified by the presence or absence of a history of myocardial infarction (MI) or stroke. AST is used to reduce prostate size to enable men with favourable-risk prostate cancer t...
journal_title:BJU international
pub_type: 杂志文章,多中心研究
doi:10.1111/j.1464-410X.2010.09273.x
更新日期:2010-10-01 00:00:00
abstract:OBJECTIVES:To evaluate if the obesity paradox, wherein obesity portends worse overall prognosis for a disease but improved outcomes for patients receiving immunotherapy, exists for patients receiving bacillus Calmette-Guérin (BCG) in a contemporary cohort. PATIENTS AND METHODS:We performed an Institutional Review Boar...
journal_title:BJU international
pub_type: 杂志文章
doi:10.1111/bju.15296
更新日期:2020-11-14 00:00:00
abstract:OBJECTIVE:To evaluate the relevance of ureterocele ectopia and associated reflux on the outcome of duplex system ureteroceles (DSU) after neonatal transurethral incision (TUI). PATIENTS AND METHODS:The study included 41 neonates with a diagnosis of DSU; the ureterocele was ectopic in 24 (58%). Before TUI, vesico-urete...
journal_title:BJU international
pub_type: 杂志文章
doi:10.1111/j.1464-410X.2004.04861.x
更新日期:2004-06-01 00:00:00
abstract:OBJECTIVE:To examine the urinary cytological changes caused by flexible cystoscopy and provide clinical guidelines for a reliable time interval for urinary cytological examination after flexible cystoscopy. PATIENTS AND METHODS:Forty-eight patients attending for flexible cystoscopy were recruited into the study. Each ...
journal_title:BJU international
pub_type: 杂志文章
doi:10.1111/j.1464-410X.2004.04998.x
更新日期:2004-09-01 00:00:00
abstract:OBJECTIVE:To compare the efficacy of sustained-release (SR) bupropion to placebo in treating hypoactive sexual desire disorder (HSDD) in ovulating women. PATIENTS AND METHODS:After a 1-week, placebo lead-in phase, 232 treatment-seeking women with regular menstrual cycles were randomly assigned to bupropion SR 150 mg/d...
journal_title:BJU international
pub_type: 杂志文章,随机对照试验
doi:10.1111/j.1464-410X.2010.09208.x
更新日期:2010-09-01 00:00:00
abstract:OBJECTIVE:To demonstrate an ergonomic fourth arm technique to oversew the dorsal vascular complex (DVC) during robot-assisted laparoscopic prostatectomy (RALP). PATIENTS AND METHODS:Balloon of a Foley catheter inflated in the bulbar urethra. Fourth arm cranial traction via suture in the tip of the catheter. DVC overse...
journal_title:BJU international
pub_type: 杂志文章
doi:10.1111/j.1464-410X.2012.11716.x
更新日期:2013-01-01 00:00:00
abstract:OBJECTIVES:To explore the spontaneous regeneration, over a long period, of the seriously injured sympathetic pathway controlling the prostate. MATERIALS AND METHODS:The hypogastric nerve (HGN), which is part of the sympathetic pathway from the spinal cord to the prostate, was partly removed over half of its length on ...
journal_title:BJU international
pub_type: 杂志文章
doi:10.1046/j.1464-410x.2003.04222.x
更新日期:2003-06-01 00:00:00
abstract:OBJECTIVE:• To employ decision curve analysis to determine the impact of nuclear matrix protein 22 (NMP22) on clinical decision making in the detection of bladder cancer using data from a prospective trial. PATIENTS AND METHODS:• The study included 1303 patients at risk for bladder cancer who underwent cystoscopy, uri...
journal_title:BJU international
pub_type: 杂志文章,多中心研究
doi:10.1111/j.1464-410X.2011.010419.x
更新日期:2012-03-01 00:00:00
abstract::The introduction of prostate-specific antigen (PSA) has revolutionized the detection and management of patients with prostate cancer. Despite this there has always been a concern among clinicians about the usefulness of total PSA levels as a marker for prostate cancer. We discuss the use of calculated variables and mo...
journal_title:BJU international
pub_type: 杂志文章,评审
doi:10.1111/j.1464-410X.2007.07283.x
更新日期:2008-03-01 00:00:00
abstract:OBJECTIVES:To assess the cost, quality of life (QoL) and cost-effectiveness of a single-incision mini-sling (SIMS; Ajust(®) , C. R. Bard Inc., New Providence, NJ, USA) compared with a standard mid-urethral sling (SMUS; TVT-O™, Ethicon Inc., Somerville, NJ, USA) in the surgical management of female stress urinary incont...
journal_title:BJU international
pub_type: 杂志文章,随机对照试验
doi:10.1111/bju.12388
更新日期:2013-12-01 00:00:00
abstract:OBJECTIVES:To use the Fragility Index to evaluate the robustness of statistically significant findings from urological randomised controlled trials (RCTs). MATERIALS AND METHODS:The 'Fragility Index' is defined as the minimum number of patients in one arm of a trial whose status would have to change from 'event' to 'n...
journal_title:BJU international
pub_type: 杂志文章
doi:10.1111/bju.14210
更新日期:2018-07-01 00:00:00
abstract:OBJECTIVES:To assess the safety and feasibility of early single-dose mitomycin C (MMC) bladder instillation after robot-assisted radical nephroureterectomy (RARNU) at a tertiary kidney cancer centre. RARNU with bladder cuff excision and subsequent MMC bladder instillation to reduce recurrence risk is the 'gold standard...
journal_title:BJU international
pub_type: 杂志文章
doi:10.1111/bju.15162
更新日期:2020-12-01 00:00:00
abstract:UNLABELLED:What's known on the subject? and what does the study add?: Variations in the type of urinary diversion exist for patients undergoing radical cystectomy. Although its use has been increasing from 2001 to 2008, patients who are older, female, and primary insured by Medicaid are less likely to receive continent...
journal_title:BJU international
pub_type: 杂志文章
doi:10.1111/j.1464-410X.2012.11508.x
更新日期:2013-08-01 00:00:00
abstract:OBJECTIVE:To explore patients' quality of life (QoL) during neoadjuvant hormone therapy (HT) using data from the Medical Research Council RT01 trial of standard- (64 Gy/32-fraction) and high- (74 Gy/37-fraction) dose radiotherapy (RT, both given conformally). PATIENTS AND METHODS:Of the 843 patients randomized to the ...
journal_title:BJU international
pub_type: 杂志文章,随机对照试验
doi:10.1111/j.1464-410X.2006.06560.x
更新日期:2007-02-01 00:00:00
abstract:OBJECTIVE:To evaluate the accuracy of various prostate tumour volume (TV) estimation methods. To determine the most appropriate estimation method for current clinical practice. PATIENTS AND METHODS:Radical prostatectomy (RP) specimens from multiple institutions were analysed by a single uro-pathologist between Septemb...
journal_title:BJU international
pub_type: 杂志文章
doi:10.1111/bju.12458
更新日期:2014-03-01 00:00:00
abstract:OBJECTIVE:To examine a large, single-surgeon series of patients with prostate cancer who underwent retropubic radical prostatectomy (RRP) for men with postoperative bladder neck contractures (BNCs). PATIENTS AND METHODS:From 1983 to 2007, 4132 men underwent RRP for prostate cancer by one surgeon. All patients had BN r...
journal_title:BJU international
pub_type: 杂志文章
doi:10.1111/j.1464-410X.2009.08700.x
更新日期:2009-12-01 00:00:00
abstract:OBJECTIVES:To compare the serum levels of insulin-like growth factor-1 (IGF-1) in patients with prostate cancer and in control patients with no malignancy, and to evaluate any possible influence of testicular androgen withdrawal on the level of IGF-1 in patients with prostate cancer. PATIENTS AND METHODS:IGF-1 was mea...
journal_title:BJU international
pub_type: 杂志文章
doi:10.1046/j.1464-410x.2000.00350.x
更新日期:2000-01-01 00:00:00
abstract:OBJECTIVE:To evaluate the variability of subjective tutor performance improvement (Pi) assessment and to compare it with a novel measurement algorithm: the Pi score. MATERIALS AND METHODS:The Pi-score algorithm considers time measurement and number of errors from two different repetitions (first and fifth) of the same...
journal_title:BJU international
pub_type: 杂志文章
doi:10.1111/bju.14621
更新日期:2019-04-01 00:00:00
abstract::OBJECTIVE • To evaluate a novel technique to lower positive surgical margin rates while preserving as much of the neurovascular bundles as possible during nerve-sparing robotic prostatectomy. MATERIALS AND METHODS • In situ intraoperative frozen section (IFS) was performed during robotic-assisted laparoscopic prostate...
journal_title:BJU international
pub_type: 杂志文章
doi:10.1111/j.1464-410X.2010.09595.x
更新日期:2011-03-01 00:00:00
abstract:OBJECTIVE:To evaluate whether assessing the anatomical characteristics of renal masses increases the accuracy of prediction of tumour pathology in small renal masses (SRMs). PATIENTS AND METHODS:We retrospectively reviewed 1129 consecutive patients who underwent extirpative surgeries for a clinical T1 renal mass, for ...
journal_title:BJU international
pub_type: 杂志文章
doi:10.1111/bju.12446
更新日期:2014-05-01 00:00:00
abstract:OBJECTIVE:To evaluate the long-term safety and effectiveness of inside-out transobturator tape (tension-free vaginal tape-obturator, TVT-O) for the treatment of stress urinary incontinence (SUI). PATIENTS AND METHODS:Between August 2004 and August 2006, 87 consecutive patients with SUI who underwent TVT-O were enrolle...
journal_title:BJU international
pub_type: 杂志文章
doi:10.1111/bju.14555
更新日期:2019-05-01 00:00:00
abstract:OBJECTIVE:To determine whether conformity to standard recommendations of retroperitoneal lymph node dissection (RPLND) after chemotherapy for testicular and primary retroperitoneal nonseminomatous germ cell tumours (NSGCT) and completeness of surgical excision have an effect on oncological outcome. PATIENTS AND METHOD...
journal_title:BJU international
pub_type: 杂志文章
doi:10.1111/j.1464-410X.2009.09175.x
更新日期:2010-09-01 00:00:00
abstract::OBJECTIVE To investigate the incidence of new-onset diabetes mellitus (NODM) and of worsening glycaemic control in established DM after starting androgen-deprivation therapy (ADT) for prostate cancer, as ADT is associated with altered body composition, potentially influencing insulin sensitivity. PATIENTS AND METHODS ...
journal_title:BJU international
pub_type: 杂志文章
doi:10.1111/j.1464-410X.2007.07184.x
更新日期:2007-11-01 00:00:00
abstract:UNLABELLED:Study Type--Therapy (cohort) Level of Evidence 2a. What's known on the subject? and What does the study add? Patient-reported quality of life (QoL) in prostate cancer is recognized as an important outcome, and has been shown in multiple studies to capture the incidence and timing of patient symptoms more acc...
journal_title:BJU international
pub_type: 杂志文章
doi:10.1111/j.1464-410X.2012.11117.x
更新日期:2012-12-01 00:00:00