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Kidney Stones: Treatment and Prevention - American Family Physician

Apr 15, 2019 - Kidney stones are a common disorder, with an annual incidence of eight cases per 1,000 adults. During an episode of renal colic, the first priority is to rule out conditions requiring immediate referral to an emergency department, then to alleviate pain, preferably with a nonsteroidal ...

American Family Physician : Article

https://www.aafp.org/afp/2019/0415/p490.html

Testosterone Therapy: Review of Clinical Applications - American Family Physician

Oct 1, 2017 - Testosterone therapy is increasingly common in the United States, and many of these prescriptions are written by primary care physicians. There is conflicting evidence on the benefit of male testosterone therapy for age-related declines in testosterone. Physicians should not measure ...

American Family Physician : Article

https://www.aafp.org/afp/2017/1001/p441.html

Newborn Circumcision Techniques - American Family Physician Restricted content. Login required.

Jun 1, 2020 - Newborn male circumcision is a common elective surgical procedure for the removal of foreskin covering the glans penis. The American Academy of Pediatrics, the American College of Obstetricians and Gynecologists, the Centers for Disease Control and Prevention, and the American Academy ...

American Family Physician : Article

https://www.aafp.org/afp/2020/0601/p680.html

Diagnosis and Treatment of Acute Uncomplicated Cystitis - American Family Physician

Oct 1, 2011 - Urinary tract infections are the most common bacterial infections in women. Most urinary tract infections are acute uncomplicated cystitis. Identifiers of acute uncomplicated cystitis are frequency and dysuria in an immunocompetent woman of childbearing age who has no comorbidities or ...

American Family Physician : Article

https://www.aafp.org/afp/2011/1001/p771.html

Localized Prostate Cancer: Treatment Options - American Family Physician

Jun 15, 2018 - In the United States, prostate cancer will be diagnosed in one out of seven men in his lifetime. Most cases are localized, and only one in 39 men will die from the disease. Prostate cancer is most often detected using serum prostate-specific antigen testing. The National Comprehensive ...

American Family Physician : Article

https://www.aafp.org/afp/2018/0615/p798.html

Treatment and Prevention of Kidney Stones: An Update - American Family Physician

Dec 1, 2011 - Kidney stones are associated with chronic kidney disease. Preventing recurrence is largely specific to the type of stone (e.g., calcium oxalate, calcium phosphate, cystine, struvite [magnesium ammonium phosphate]), and uric acid stones); however, even when the stone cannot be retrieved,...

American Family Physician : Article

https://www.aafp.org/afp/2011/1201/p1234.html

Primary Care of the Prostate Cancer Survivor - American Family Physician

May 1, 2016 - This summary of the American Cancer Society Prostate Cancer Survivorship Care Guidelines targets primary care physicians who coordinate care of prostate cancer survivors with subspecialists. Prostate cancer survivors should undergo prostate-specific antigen screening every six to 12 ...

American Family Physician : Article

https://www.aafp.org/afp/2016/0501/p764.html

Clinical Management of Urinary Incontinence in Women - American Family Physician

May 1, 2013 - Most cases of urinary incontinence in women fall under one of three major subtypes: urge, stress, or mixed. A stepped-care approach that advances from least invasive (behavioral modification) to more invasive (surgery) interventions is recommended. Bladder retraining and pelvic floor ...

American Family Physician : Article

https://www.aafp.org/afp/2013/0501/p634.html

Common Questions About Vasectomy - American Family Physician

Dec 1, 2013 - Vasectomy offers a safe, effective, and permanent method of male contraception, with an overall failure rate of less than 1% in pooled studies. Men older than 30 years in a stable, committed relationship appear to be the best candidates for vasectomy. The no-scalpel technique reduces ...

American Family Physician : Article

https://www.aafp.org/afp/2013/1201/p757.html

Evaluation and Treatment of Hematospermia - American Family Physician

Dec 15, 2009 - Hematospermia can be a distressing symptom for patients, but most cases are effectively managed by a primary care physician. Although the condition is usually benign, significant underlying pathology must be excluded by history, physical examination, laboratory evaluation, and, in ...

American Family Physician : Article

https://www.aafp.org/afp/2009/1215/p1421.html

Management of Erectile Dysfunction - American Family Physician

Feb 1, 2010 - Erectile dysfunction (ED) is the most common sexual problem in men. The incidence increases with age and affects up to one third of men throughout their lives. It causes a substantial negative impact on intimate relationships, quality of life, and self-esteem. History and physical ...

American Family Physician : Article

https://www.aafp.org/afp/2010/0201/p305.html

Treatment Options for Localized Prostate Cancer - American Family Physician

Aug 15, 2011 - In the United States, more than 90 percent of prostate cancers are detected by serum prostate-specific antigen testing. Most patients are found to have localized prostate cancer, and most of these patients undergo surgery or radiotherapy. However, many patients have low-risk cancer and ...

American Family Physician : Article

https://www.aafp.org/afp/2011/0815/p413.html

Pelvic Floor Muscle Training vs. Control for Urinary Incontinence in Women - Cochrane ... Restricted content. Login required.

Apr 1, 2020 - Use of pelvic floor muscle training to treat women with all subtypes of urinary incontinence results in improvement or cure vs. no treatment (number needed to treat [NNT] = 2.5; 95% CI, 1.4 to 5.4). Treatment with pelvic floor muscle training also results in one fewer episode of leakage...

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2020/0401/p393.html

No Benefit, Longer Hospital Stay with Treatment of Asymptomatic Bacteriuria - POEMs - ... Restricted content. Login required.

Feb 15, 2020 - Inappropriate treatment of asymptomatic bacteriuria is common in hospitalized patients. Older patients, those with dementia or acutely altered mental status, and those with abnormal urinalysis results are more likely to be treated with antibiotics.

American Family Physician : POEMs

https://www.aafp.org/afp/2020/0215/p248.html

Alpha Blockers for Nephrolithiasis - FPIN's Clinical Inquiries - American Family Physician Restricted content. Login required.

Dec 1, 2019 - The alpha blocker tamsulosin (Flomax) can be used to improve clearance of stones larger than 5 mm, shorten expulsion times, and reduce hospitalization.

American Family Physician : FPIN's Clinical Inquiries

https://www.aafp.org/afp/2019/1201/p710.html

Pelvic Floor Muscle Training for Treatment of Urinary Incontinence in Women - Medicine ... Restricted content. Login required.

Dec 1, 2019 - Urinary incontinence is common in adult women, leading to health complications such as rash and urinary tract infections. This review discusses pelvic floor muscle training for the treatment of urinary incontinence in women.

American Family Physician : Medicine by the Numbers

https://www.aafp.org/afp/2019/1201/od1.html

Alternative Interventions for Chronic Prostatitis/Chronic Pelvic Pain Syndrome in Men -...

Jun 1, 2019 - In men with chronic pelvic pain and urinary dysfunction who have not responded to standard medical management, extracorporeal shock wave therapy reduces symptoms and increases quality of life. Acupuncture may also provide benefit to some patients.

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2019/0601/p677.html

Treatment of Prostatitis - American Family Physician

May 15, 2000 - The term prostatitis is applied to a series of disorders, ranging from acute bacterial infection to chronic pain syndromes, in which the prostate gland is inflamed. Patients present with a variety of symptoms, including urinary obstruction, fever, myalgias, decreased libido or ...

American Family Physician : Article

https://www.aafp.org/afp/2000/0515/p3015.html

Five-Day Nitrofurantoin Superior to Single-Dose Fosfomycin for Women with Uncomplicated...

Oct 15, 2018 - A five-day course of nitrofurantoin is significantly more likely than single-dose fosfomycin to achieve both clinical and microbiologic resolution of uncomplicated lower UTI in otherwise healthy adult women.

American Family Physician : POEMs

https://www.aafp.org/afp/2018/1015/od4.html

Paraphimosis: Current Treatment Options - American Family Physician

Dec 15, 2000 - Paraphimosis is a urologic emergency, occurring in uncircumcised males, in which the foreskin becomes trapped behind the corona and forms a tight band of constricting tissue. Often iatrogenically induced, paraphimosis can be prevented by returning the prepuce to cover the glans ...

American Family Physician : Article

https://www.aafp.org/afp/2000/1215/p2623.html

OnabotulinumtoxinA Injections for Urge Incontinence - FPIN's Help Desk Answers - ...

Feb 1, 2018 - Detrusor muscle injections of onabotulinumtoxinA can be used to decrease the number of episodes of urinary incontinence in women for whom treatment with anticholinergic agents has been ineffective.

American Family Physician : FPIN's Help Desk Answers

https://www.aafp.org/afp/2018/0201/od3.html

Testosterone Treatments: Why, When, and How? - American Family Physician

May 1, 2006 - Testosterone treatment is controversial for men and even more so for women. Although long-term outcome data are not available, prescriptions for testosterone are becoming more common. Testosterone is used primarily to treat symptoms of sexual dysfunction in men and women and hot flashes...

American Family Physician : Article

https://www.aafp.org/afp/2006/0501/p1591.html

Treating Aging with Testosterone - Editorials - American Family Physician

Oct 1, 2017 - Most patients on testosterone are being treated for normal symptoms of aging. Given that the diagnostics are questionable and the benefits are unconvincing, the risks of testosterone, some of which may be life-threatening, are not worth taking.

American Family Physician : Editorials

https://www.aafp.org/afp/2017/1001/p428.html

Citrate Salts for Preventing and Treating Calcium-Containing Kidney Stones in Adults - ...

May 1, 2017 - Citrate supplementation reduces stone size to less than 5 mm and prevents new stone formation when compared with placebo or no intervention. Citrate therapy also stabilizes existing stones and decreases the need for retreatment. These benefits come at the expense of upper ...

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2017/0501/p552.html

Newer Agents for the Management of Overactive Bladder - American Family Physician

Dec 15, 2006 - The anticholinergics tolterodine and oxybutynin are well established in the management of overactive bladder. However, their activity at muscarinic receptors distant from the target site (i.e., bladder) produces anticholinergic side effects leading to poor tolerability. In 2004, ...

American Family Physician : Article

https://www.aafp.org/afp/2006/1215/p2061.html

Active Surveillance for Localized Prostate Cancer: No Increased Mortality, but Higher ...

Feb 1, 2017 - This landmark study compared active surveillance with radical prostatectomy or radiation therapy for patients with T1c or T2 prostate cancer. The benefits of active surveillance include avoiding radical therapy in one-half of the patients, with no effect on disease-specific survival or ...

American Family Physician : POEMs

https://www.aafp.org/afp/2017/0201/p196.html

Tamsulosin Beneficial for Passage of 5- to 10-mm Distal Ureteral Stones - POEMs - ...

Jan 15, 2017 - Tamsulosin promotes stone passage of distal ureteral stones that are 5 to 10 mm in size. You would need to treat five such patients to get one stone passage. Smaller stones tend to pass on their own at a rate of 86% in this study.

American Family Physician : POEMs

https://www.aafp.org/afp/2017/0115/p123a.html

Low-Dose Morphine Less Effective Than Diclofenac or Acetaminophen for Renal Colic - ...

Oct 15, 2016 - This is a good example of how a well-done study can lead to erroneous conclusions. The comparator most likely to be effective here—titrated morphine—was used at a low dose and found to be less effective than intramuscular diclofenac or intravenous paracetamol (acetaminophen).

American Family Physician : POEMs

https://www.aafp.org/afp/2016/1015/p665.html

Medical Management of Common Urinary Calculi - American Family Physician

Jul 1, 2006 - Nephrolithiasis is a common condition affecting nearly 5 percent of U.S. men and women during their lifetimes. Recurrent calculi can be prevented in most patients by the use of a simplified evaluation, reasonable dietary and fluid recommendations, and directed pharmacologic ...

American Family Physician : Article

https://www.aafp.org/afp/2006/0701/p86.html

Vasectomy: An Update - American Family Physician

Dec 15, 2006 - Vasectomy remains an important option for contraception. Research findings have clarified many questions regarding patient selection, optimal technique, postsurgical follow-up, and risk of long-term complications. Men who receive vasectomies tend to be non-Hispanic whites, well ...

American Family Physician : Article

https://www.aafp.org/afp/2006/1215/p2069.html

Tamsulosin Effective as Expulsion Therapy for 5- to 10-mm Distal Ureteric Stones - ...

May 1, 2016 - Tamsulosin promotes stone passage of ureteric stones that are 5 to 10 mm. Five patients would need to be treated with tamsulosin to cause the expulsion of one such stone. Stones smaller than 5 mm have a high rate of spontaneous passage without any intervention.

American Family Physician : POEMs

https://www.aafp.org/afp/2016/0501/p788a.html

Selecting Medications for the Treatment of Urinary Incontinence - American Family ...

Jan 15, 2005 - In response to the growing population of older patients with incontinence, pharmaceutical companies are developing new drugs to treat the condition. Before prescribing medications for incontinence, however, physicians should determine the nature and cause of the patient's incontinence. ...

American Family Physician : Article

https://www.aafp.org/afp/2005/0115/p315.html

Alpha Blockers to Speed Ureteral Stone Passage - Cochrane for Clinicians - American ...

Feb 1, 2015 - Compared with patients receiving standard therapy (e.g., fluids, analgesics), placebo, or calcium channel blockers, patients receiving alpha blockers had about three fewer days to ureteral stone expulsion and were less likely to be hospitalized. Adverse effects of alpha blocker therapy ...

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2015/0201/p164.html

Medications for Treatment of Interstitial Cystitis - FPIN's Clinical Inquiries - ...

Jan 15, 2015 - There are no long-term clinically effective oral medications. Pentosan (Elmiron) can improve overall symptom scores for interstitial cystitis over three to six months, but it does not improve scores for any of three individual symptoms (dysuria, urgency, frequency) compared with placebo.

American Family Physician : FPIN's Clinical Inquiries

https://www.aafp.org/afp/2015/0115/p116.html

Desmopressin Effective for Treating Nocturia in Adults - POEMs - American Family Physician

Dec 1, 2014 - Desmopressin is a safe and effective treatment to offer adults with clinically significant nocturia. The initial starting dose should be 50 to 100 mcg, with lower dosing for the advanced older patient. All patients should be monitored for hyponatremia.

American Family Physician : POEMs

https://www.aafp.org/afp/2014/1201/p796a.html

Treatment Options for Prostate Cancer: Evaluating the Evidence - American Family Physician

May 15, 2005 - Controversy surrounds the management options for localized prostate cancer-conservative management, prostatectomy, and radiation. Choosing among these options is difficult because of long-term side effects that include sexual, urinary, and bowel dysfunction. Some recent studies suggest ...

American Family Physician : Article

https://www.aafp.org/afp/2005/0515/p1915.html

Saw Palmetto for Prostate Disorders - American Family Physician

Mar 15, 2003 - Saw palmetto is an herbal product used in the treatment of symptoms related to benign prostatic hyperplasia. The active component is found in the fruit of the American dwarf palm tree. Studies have demonstrated the effectiveness of saw palmetto in reducing symptoms associated with ...

American Family Physician : Article

https://www.aafp.org/afp/2003/0315/p1281.html

Testosterone Therapy in Men Associated with an Increase in the Risk of Nonfatal MI - ...

Jun 1, 2014 - Filling a prescription for testosterone therapy is associated with an increased likelihood of experiencing an MI, especially in older men and those with a history of cardiovascular disease.

American Family Physician : POEMs

https://www.aafp.org/afp/2014/0601/p907.html

Preventing Recurrent Nephrolithiasis in Adults - Implementing AHRQ Effective Health ...

Mar 15, 2014 - What are the potential benefits and adverse effects associated with dietary and pharmacologic interventions to prevent recurrence of kidney stones in adults 18 years and older?

American Family Physician : Implementing AHRQ Effective Health Care Reviews

https://www.aafp.org/afp/2014/0315/p461.html

Are Cranberry Products Effective for the Prevention of Urinary Tract Infections? - ...

Dec 1, 2013 - Cranberry products are not effective and should not be recommended for the prevention of UTIs.

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2013/1201/p745.html

Peyronie's Disease: Current Management - American Family Physician

Aug 1, 1999 - Peyronie's disease is an acquired inflammatory condition of the penis associated with penile curvature and,in some cases, pain. It primarily affects men between 45 and 60 years of age, although an age range of 18 to 80 years has been reported. If left untreated, Peyronie's disease may ...

American Family Physician : Article

https://www.aafp.org/afp/1999/0801/p549.html

Pioglitazone Exposure Increases Bladder Cancer Risk - POEMs - American Family Physician

Jan 15, 2014 - This review of all available data found a significantly increased risk of bladder cancer among adults with type 2 diabetes treated with pioglitazone. Pioglitazone also significantly increases the risk of heart failure, and there is minimal, if any, patient-oriented evidence of benefit ...

American Family Physician : POEMs

https://www.aafp.org/afp/2014/0115/p136.html

Finasteride Prevents Low-Grade Prostate Cancers, but Does Not Reduce Mortality - POEMs ...

Dec 1, 2013 - Although finasteride prevents low-grade prostate tumors, it does not affect overall survival or survival after prostate cancer diagnosis. Although high-grade cancers were more common among men taking finasteride, up to 18 years of follow-up failed to show increased mortality in this group.

American Family Physician : POEMs

https://www.aafp.org/afp/2013/1201/p744.html

Optimal Antibiotic Regimen for Treating Lower UTI in Children - Cochrane for Clinicians...

Nov 1, 2013 - For the afebrile child with a UTI, a short course (three to seven days) of antibiotics is as effective at preventing the recurrence of symptomatic UTI as a long course (seven to 10 days). There is no clear evidence of superiority for any one antibiotic regimen.

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2013/1101/p577.html

Sexual, Urinary, and Bowel Dysfunction Common After Treatment for Localized Prostate ...

Nov 1, 2013 - Patients undergoing surgery had worse urinary and sexual outcomes, whereas those undergoing external beam radiation therapy (EBRT) had worse bowel symptoms. Watchful waiting (active surveillance) was not the subject of this study, but given the problems associated with therapy, active ...

American Family Physician : POEMs

https://www.aafp.org/afp/2013/1101/p609.html

Treatments for Urinary Incontinence in Women - Implementing AHRQ Effective Health Care ...

May 15, 2013 - What are the effectiveness, benefits, and adverse effects of options for diagnosis and treatment of urinary incontinence (UI) that are available in primary care?

American Family Physician : Implementing AHRQ Effective Health Care Reviews

https://www.aafp.org/afp/2013/0515/p726.html

Kidney Stones - Clinical Evidence Handbook - American Family Physician

Mar 15, 2013 - What are the effects of interventions for the removal of asymptomatic renal or ureteric stones? What are the effects of interventions for the management of acute renal colic?

American Family Physician : Clinical Evidence Handbook

https://www.aafp.org/afp/2013/0315/p441.html

Benign Prostatic Hyperplasia and Male Lower Urinary Tract Symptoms - Clinical Evidence ...

Aug 15, 2012 - What are the effects of medical, herbal, and surgical treatments in men with BPH?

American Family Physician : Clinical Evidence Handbook

https://www.aafp.org/afp/2012/0815/p359.html

Urinary Tract Infections in Children: Why They Occur and How to Prevent Them - American...

May 15, 1998 - Urinary tract infections (UTIs) usually occur as a consequence of colonization of the periurethral area by a virulent organism that subsequently gains access to the bladder. During the first few months of life, uncircumcised male infants are at increased risk for UTIs, but thereafter ...

American Family Physician : Article

https://www.aafp.org/afp/1998/0515/p2440.html

Managing Benign Prostatic Hyperplasia - American Family Physician

Jul 1, 2002 - Medical and surgical options for the treatment of benign prostatic hyperplasia have expanded in recent years. Saw palmetto, the most widely used complementary medication, is less effective than standard medical therapy but has fewer side effects. Although non-selective alpha blockers ...

American Family Physician : Article

https://www.aafp.org/afp/2002/0701/p77.html

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