OKDrs.com

1. Patients with kidney stones
Did you know that forcing fluids during an episode of renal colic can make the pain worse?

2. Night-time Urination
Did you know that frequent urination at night may not be always due to an enlarged prostate? It could be a result of fluids accumulating in the legs during daytime. The volume of liquids will, once the patient is laying down, go to his kidneys, then to the bladder, and fill it up so that the patient has to void several times.

3. Inability to Void
If a patient is unable to void, he should stop drinking, because this will make things worse. The concept of putting more fluid in the bladder to push it through is obsolete and actually counterproductive.

There are three concerns in prostate surgery for cancer:
1. Impotence
2. Incontinence
3. Positive surgical margins
    When the specimen is sent to the lab, the pathologist will study the borders and will know if some cancerous tissue was left behind or not.
    So far, the literature is not very clear on all three issues.
    It is well known that patients with moderate grade cancers will do well, no matter what the treatment is, for at least five years. The difference in outcome for these patients is really between five and fifteen years.

03/08/2010
PSA
       A well-known society has just come out with yet another suggestion about PSA. Basically, they are suggesting that PSA should not be done in most cases. They also very carefully craft their words, saying that the physician should make sure the patient understands what are the implications of this decision.
       Their main point is that there may be some unnecessary procedures, like ultrasound and biopsy, that may end up in complications or diagnosing a very early and non-aggressive cancer that may not need treatment at all.
       I think everybody agrees that an 80-year-old man may not need a PSA. This is pure science; however, occasionally one may discover a patient with very aggressive cancer when it's too late. Malpractice lawyers may have a different view about that. I also wonder if this is a national trend, like the story on mammograms before, to cut down on the cost of health care by a unilateral, strictly financial consideration.