Evidence-based consensus recommendations to improve the quality of life in prostate cancer treatment.

INTRODUCTION: Prostate cancer (PC) is one of the tumours with the highest incidence in recent years. PC therapies have several adverse effects. A panel consensus recommendation has been made to prevent or ameliorate complications in PC treatment to improve quality of life. MATERIAL AND METHODS: Fifteen specialists have met to analyse the different toxicities associated with PC treatment. Each medical specialist performed a National Library of Medicine PubMed search citations searching about these secondary effects and his specialty from 1999 to 2009 to propose measures for their prevention/amelioration. RESULTS: Surgery is associated with incontinence and impotence. Radiotherapy can produce acute, late urological and gastrointestinal toxicity. Brachytherapy can produce acute urinary retention. Chemotherapy is associated with haematotoxicity, peripheral neuropathy and diarrhoea, and hormone therapy can produce osteoporosis, metabolic syndrome, cognitive and muscular alterations, cardiotoxicity, etc. CONCLUSIONS: Improvement in surgical techniques and technology (IMRT/IGRT) can prevent surgical and radiotherapeutic toxicity, respectively. Brachytherapy toxicity can be prevented with precise techniques to preserve the urethra. Chemotherapy toxicity can be prevented with personalized schedules of treatment and close follow-up of iatrogenia and hormone therapy toxicity can be prevented with close follow-up of possible secondary effects.

[Living donor kidney transplantation: a surgical procedure]. / Trasplante renal de donante vivo: implante renal y sus variantes.

OBJECTIVES: The objective of this paper is to review the various surgical techniques for living donor kidney transplantation. METHODS: We perform a bibliographic review adding our experience in living kidney transplantation. RESULTS: We present various techniques indicating which one is the most appropriate for each case. CONCLUSIONS: We should promote living door kidney transplantation if we want to increase the number of transplants performed. It is a complex transplant because the graft lacks of vascular patches; there are various surgical techniques that we can choose depending on the case.

Comparison of the efficacy and safety of 90 mg versus 20 mg fluoxetine in the treatment of premature ejaculation.

PURPOSE: We compare the efficacy and side effects of 90 mg fluoxetine once weekly versus 20 mg fluoxetine as single oral therapy for patients complaining of premature ejaculation without evident organic causes. MATERIALS AND METHODS: The study comprised 80 patients with a mean age of 36 years with premature ejaculation who presented to the urology clinic of 3 hospitals in Barcelona. Pretreatment evaluation included history and physical examination, International Index of Erectile Function (IIEF), Meares-Stamey test and ejaculatory latency time evaluation. The patients were randomized into treatment groups receiving 1 capsule of 90 mg fluoxetine a week (group 1) and 1 capsule of 20 mg fluoxetine a day (group 2) for 3 months. The 4-month followup included: ejaculatory latency time measurement, IIEF and partner sexual satisfaction. RESULTS: Mean pretreatment ejaculatory latency times for groups 1 and 2 were 0.48 minute (range 0 to 2.10) and 0.50 minute (0 to 2.04), respectively. After 3 months of treatment of weekly and daily administration of fluoxetine mean ejaculatory latency time was 3.57 and 3.37 minutes, respectively (p >0.01). Partner sexual satisfaction and IIEF rate were greater with 90 mg fluoxetine but no statistical difference was found. Nausea, insomnia and headache were reported side effects but no significant difference was noted between 90 and 20 mg fluoxetine. CONCLUSIONS: In men with premature ejaculation 90 mg fluoxetine weekly may be regarded as an effective and safe treatment.