Immediate treatment with 150 mg. bicalutamide daily, either alone or as adjuvant to treatment of curative intent, significantly reduces the risk of disease progression in patients with localized or locally advanced prostate cancer. This benefit must be balanced with the morbidity associated with long-term hormonal therapy. Followup is ongoing to determine potential survival benefits of this treatment approach.

198 (3.8% comprising 4.7% of the males and 2.9% of the females) out of 5220 surgical patients developed total urinary retention postoperatively. The frequency of this condition increased with age and was highest after thoracotomies and endoprosthetic surgery of the hip joints. Voiding history was abnormal in 80% of the patients affected. Subclinical obstructive bladder dysfunction, over-distension of the bladder during the operation and in the recovery room after the operation, sympathomimetic and anticholinergic medication during or after anaesthesia, and an inability to stand or sit after surgery were common causes of retention. Premedication, type of anaesthesia, nature of the liquids given and postoperative analgetics seemed not to affect the incidence of retention. Postoperative urinary retention is an underestimated and mostly avoidable complication. Every patient should be asked for a urinary history before an elective operation. Infravesical obstruction should be relieved before any other elective surgical procedures are undertaken. In cases of emergency surgery prophylactic catheterization to prevent postoperative retention is recommended for patients with obstructive symptoms.

Objective To study the lifetime occurrence of prostatitis in Finnish men and their exposure to the disease. Subjects and methods A population-based cross-sectional survey was conducted in the two most northerly provinces of Finland (Oulu and Lapland). Altogether, 2500 male residents aged 20±59 years were chosen at random to complete a questionnaire on prostatitis. The data were collected between June 1996 and October 1997. Replies were received from 1832 men, giving a response rate of 75%. Results The overall lifetime prevalence of prostatitis was 14.2%. The risk of having or having had prostatitis increased with age, being 1.7 times greater in men aged 40±49 years than in those aged 20±39 years, and 3.1 times greater in those aged 50±59 years. The overall incidence was 37.8/10 000 person years. More than a quarter of the 261 men who had or had had prostatitis symptoms (27%) suffered from them at least once a year, while 16% suffered from persistent symptoms; 63% of the men with prostatitis had their worst symptoms during the winter (November-March). Neither education nor profession had much in¯uence on the occurrence of prostatitis, but divorced and single men had a lower risk than married men. Most patients felt they had not received enough information about the disease at their ®rst visit to a general practitioner. Conclusions The results of this survey showed that the occurrence of prostatitis symptoms in men living in northern Finland is higher than that reported in other parts of the world. This could be partly caused by the cold climate.

Article abstract-Background: Recent observations have indicated that reproductive endocrine disorders are common among women taking valproate (VPA) for epilepsy, but it is not known whether respective abnormalities develop in men taking VPA for epilepsy. Carbamazepine (CBZ) may induce endocrine disorders in men with epilepsy, but the endocrine effects of oxcarbazepine (OXC) are not known. Methods: Reproductive endocrine function was evaluated in 90 men taking VPA (n ϭ 21), CBZ (n ϭ 40), or OXC (n ϭ 29) as monotherapy for epilepsy and in 25 healthy control men. Results: Twelve men (57%) taking VPA had increased serum androgen levels. The mean serum level of androstenedione was high in patients taking VPA. Serum levels of dehydroepiandrosterone sulfate were low, and serum concentrations of sex hormonebinding globulin (SHBG) were high in men taking CBZ. The endocrine effects of OXC seemed to be dose-dependent, because serum hormone levels were normal in patients with low OXC doses (Ͻ900 mg/day), but serum concentrations of testosterone, gonadotropins, and SHBG were high in patients with a daily OXC dose Ն900 mg. Conclusions: VPA increases serum androgen concentrations in men with epilepsy. The endocrine effects of CBZ and OXC were different, because CBZ appears to decrease the bioactivity of androgens, whereas OXC does not. NEUROLOGY 2001;56:31-36 Reproductive endocrine disorders and sexual dysfunction have frequently been attributed to epilepsy itself, but antiepileptic drugs (AED) also have various effects on endocrine function.1-7 Valproate (VPA) has been implicated to have only minor effects on the hormonal system in men with epilepsy.3,4 However, there is growing evidence that VPA therapy induces endocrine disorders in women with epilepsy, which are characterized by hyperandrogenism and hyperinsulinemia that are related to obesity. 5,6 Carbamazepine (CBZ) is one of the most widely used first-line AED. The use of CBZ is associated with a progressive increase in circulating levels of sex hormone-binding globulin (SHBG) and, consequently, in a decreased proportion of free, bioactive testosterone, which may result in sexual dysfunction in some men with epilepsy after long-term CBZ treatment.8 CBZ-related endocrine changes have been attributed to the induction of the hepatic P450-enzyme system by the drug. 9,10Oxcarbazepine (OXC), a keto-derivative of CBZ, is a new AED that closely resembles CBZ in structure.11 However, it has a different metabolic pathway in the liver; instead of by oxidation, it is mainly metabolized by reduction, and does not appear to induce the oxidative P450-enzyme system to the same extent as CBZ.12 Previous studies have shown that the CBZ-induced changes in endocrine and metabolic function equilibrate after CBZ is replaced with OXC.13,14 Thus, OXC has been suggested to be a safe AED with regard to endocrine and metabolic effects. However, there is evidence that OXC may also induce liver enzymes when prescribed at higher doses. 15 Endocrine effects of OXC have not been previously assessed...