Clinical Pearls in Men's Health

    June 2010 in “ Mayo Clinic Proceedings ”
    Thomas J. Beckman, Scott C. Litin
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    TLDR The conclusion is that individualized treatment and proper medication use are crucial in men's health, with specific recommendations for ED, BPH, and prostate cancer management.
    The document "Clinical Pearls in Men's Health" from 2010 highlights several cases to emphasize the importance of proper medication use and individualized treatment in men's health issues. It discusses the correct administration of sildenafil for erectile dysfunction (ED), the interaction between tamsulosin for benign prostatic hyperplasia (BPH) and cataract surgery, the link between mood disorders and ED, and the limited effectiveness of finasteride for hair regrowth in men with mild BPH symptoms. Additionally, it addresses concerns about finasteride and prostate cancer, noting that despite the Prostate Cancer Prevention Trial's findings, finasteride is still used for BPH treatment, with a recommendation to monitor and adjust PSA levels. A study involving 6,729 men showed a 22.8% reduction in prostate cancer incidence with dutasteride. Watchful waiting is advised for mild BPH symptoms, and weight loss is recommended for ED treatment in obese men. The document also advises against yearly PSA screening for prostate cancer in men over 75 years old, as it does not reduce mortality. The best treatments for the cases presented are exercise stress testing and weight loss for ED, and discontinuing PSA screening for prostate cancer in older men.
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