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Jack Barkin

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Clinical Professor, Dept of Surgery -University of Toronto. Urologic and Robotic Surgeon since 1982. P.I. in over 250 clinical trials. Multiple peer reviewed publications. Previous Chief of Staff- Humber River Hospital. Medical director: Can-am HIFU. Developed the first Blue Light Cystoscopy of any Hospital in Canada. Executive Editor of the Canadian Journal of Urology. History of helping to develop, research, market and launch new drugs and technology in Canada and around the world.

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Papers by Jack Barkin

Corrigendum to: “The Influence of Baseline Parameters on Changes in IPSS with Dutasteride, Tamsulosin, and Combination Therapy: Two-Year Data from the Combination of Avodart® and Tamsulosin (CombAT) Study” [Eur Urol Suppl 2008;7:171 (Abstract no. 403)]

by Ramiro Castro, Venancio Chantada Abal, and Jack Barkin

European Urology, 2009

The user has requested enhancement of the downloaded file.

Three year results of the prostatic urethral L.I.F.T. study

by Prem Rashid and Jack Barkin

The Canadian journal of urology, 2015

To report the three year results of a multi-center, randomized, patient and outcome assessor blin... more To report the three year results of a multi-center, randomized, patient and outcome assessor blinded trial of the Prostatic Urethral Lift (PUL) in men with bothersome lower urinary tract symptoms (LUTS) due to benign prostatic hyperplasia (BPH). At 19 centers in North America and Australia, 206 subjects = 50 years old with International Prostate Symptom Score (IPSS) ≥ 13, peak flow rate (Qmax) ≤ 12 mL/s, and prostate volume between 30 cc-80 cc were randomized 2:1 to the PUL procedure or sham control. PUL involved placing permanent UroLift implants into the lateral lobes of the prostate to enlarge the urethral lumen. After randomized comparison at 3 months, PUL patients were followed to 3 years. LUTS severity (IPSS), quality of life, Qmax, sexual function, and adverse events were assessed throughout follow up. The therapeutic effect of PUL regarding IPSS was 88% greater than sham at 3 months. Average improvements from baseline through 3 years were significant for total IPSS (41.1%), ...

Faculty of 1000 evaluation for The effect of dutasteride on the detection of prostate cancer: a set of meta-analyses

F1000 - Post-publication peer review of the biomedical literature, 2013

Faculty of 1000 evaluation for NMP-22, urinary cytology, and cystoscopy: a 1 year comparison study

F1000 - Post-publication peer review of the biomedical literature, 2012

Faculty of 1000 evaluation for The role of pelvic lymphadenectomy in non-muscle invasive bladder cancer

F1000 - Post-publication peer review of the biomedical literature, 2014

Optimizing subcutaneous injection of the gonadotropin-releasing hormone receptor antagonist degarelix

The Canadian journal of urology, 2016

The gonadotropin-releasing hormone (GnRH) receptor antagonist degarelix has several unique charac... more The gonadotropin-releasing hormone (GnRH) receptor antagonist degarelix has several unique characteristics compared to luteinizing hormone-releasing hormone (LHRH) analogs used in the management of prostate cancer. Notable differences of GnRH receptor antagonists include no flare reaction, and a more rapid suppression of testosterone, luteinizing hormone (LH), follicle stimulating hormone (FSH) and prostate-specific antigen (PSA) compared to LHRH analogs. Despite emerging evidence supporting the use of GnRH receptor antagonists over the more widely used LHRH analogs in the management of prostate cancer, physicians may be reluctant to prescribe degarelix. They may be concerned about patient complaints about injection-site reactions (ISRs). The subcutaneous injection of degarelix has been associated with a higher rate of ISRs compared with the intramuscular injections of LHRH analogs. This "How I Do It" article describes techniques and strategies that have been developed by ...

$Research paper thumbnail of Alpha blocker monotherapy versus combination therapy with antimuscarinics in men with persistent LUTS refractory to alpha-adrenergic treatment: patterns of persistence$

Alpha blocker monotherapy versus combination therapy with antimuscarinics in men with persistent LUTS refractory to alpha-adrenergic treatment: patterns of persistence

The Canadian journal of urology, 2015

Patients with lower urinary tract symptoms (LUTS) associated with benign prostatic hyperplasia (B... more Patients with lower urinary tract symptoms (LUTS) associated with benign prostatic hyperplasia (BPH) often present with voiding and storage symptoms, which may require combination therapy with an alpha blocker and an antimuscarinic (AM). This study compared treatment persistence in LUTS/BPH patients on alpha blocker monotherapy with those using combination alpha blocker and AM therapy (AB/AM). Retrospective analysis of anonymized patient longitudinal prescription reimbursement claims data. All patients who had claims for any of four alpha blocker medications and six AM agents during an index period from April 1, 2011 to March 31, 2012 were included. For the combination therapy group, the effect of adherence with the AM medication on persistence to the alpha blocker was examined. Patients on AB/AM combination therapy remained on alpha blockers for longer than those on alpha blocker monotherapy (p = 0.04); 92.4% were persistent at 3 months versus 89.0%, and at 1 year 50.8% were persis...

Improvements in Patient-Reported Quality of Life With Dutasteride, Tamsulosin and the Combination: 2-YEAR Results From the Combination of Avodart and Tamsulosin (Combat) Trial

European Urology Supplements, 2008

In the pre-planned 2-year analysis of the ongoing CombAT study, dutasteride and either monotherap... more

Androgens and sexual function: a placebo-controlled, randomized, double-blind study of testosterone vs . dehydroepiandrosterone in men with sexual dysfunction and androgen deficiency

The Aging Male the Official Journal of the International Society For the Study of the Aging Male, Nov 1, 2009

Supplemental administration of androgens has been advocated for men with sexual dysfunction (SD) ... more Supplemental administration of androgens has been advocated for men with sexual dysfunction (SD) and hypoandrogenism. The preponderance of evidence indicates that most delivery forms of testosterone (T) are effective but the role of dehydroepiandrosterone (DHEA) is controversial. A placebo-controlled, randomized trial of oral androgen (T versus DHEA) supplementation was carried out to determine their efficacy. Eighty-six men with SD and decreased levels of serum T and/or DHEA, participated in a study receiving oral T undecanoate (OTU) (n = 29) 80 mg twice daily, DHEA (n = 28) 50 mg twice daily, or placebo (n = 29). Outcomes included evaluation of sexual performance by the International Index of Erectile Function (IIEF), the Androgen Deficiency in the Aging Male (ADAM), Aging Male Symtom Scale (AMS), and Global Assessment Questionnaire (GAQ) questionnaires. Biochemical evaluations included measurement of T and DHEA, prolactin, gonadotropins, and PSA. Seventy-nine men completed the study. There were no significant differences in outcomes as assessed by four different instruments: the ADAM, IIEF, AMS, and GAQ in regard to sexual interest or erectile function. Biochemically, a significant increase in serum DHEA between baseline and final visit was documented in the group receiving DHEA. The levels of T, on the other hand, increased insignificantly between entry and final visit in the T cohort. No biochemical changes were observed in the placebo group. Levels of PSA remained stable in all three groups. This study did not suggest a clinical benefit of OTU or DHEA supplementation in men with hypoandrogenism and SD. The recommended dose of OTU may have been inadequate or poorly absorbed. Increased doses or an alternative T delivery form may result in a different response.

HIFU: Definitely ready for prime time

Canadian Urological Association Journal Journal De L Association Des Urologues Du Canada, Dec 1, 2011

POD-06.02: The effects of dutasteride, tamsulosin, and combination therapy on lower urinary tract symptoms and Qmax in men with BPH and prostatic enlargement: Two-year results from the Combination of Avodart ® and Tamsulosin (CombAT) study

Urology, 2007

The ongoing CombAT study is investigating whether combination therapy with dutasteride and tamsul... more The ongoing CombAT study is investigating whether combination therapy with dutasteride and tamsulosin is more effective than either monotherapy alone for improvement of symptoms and long-term clinical outcomes of AUR and BPH-related prostatic surgery in a population of men aged Ն50 years with moderate-to-severe BPH symptoms and prostatic enlargement. This abstract reports pre-planned 2-year analyses of IPSS and Qmax findings.

Systematic overview of the evidence for brachytherapy in clinically localized prostate cancer

990 Clinical Outcomes After Combination Therapy With Dutasteride and Tamsulosin in Men With Benign Prostatic Hyperplasia (BPH) by Baseline Characteristics: 4 Year Results From the Randomized, Double-Blind, Combat Trial

European Urology Supplements, 2010

Office based non-oncology urology trials

The Canadian Journal of Urology

Testosterone replacement therapy for the primary care physician

The Canadian Journal of Urology

A new update: Urology best practices for the primary care physician (PCP)

The Canadian Journal of Urology

Improvements in Patient-Reported Quality of Life With Dutasteride, Tamsulosin and the Combination: 2YEAR Results From the Combat Trial

In the pre-planned 2-year analysis of the ongoing CombAT study, dutasteride and either monotherap... more

Is open urologic surgery a lost skill in this era of minimally invasive urologic malady management?

The Canadian Journal of Urology

Office based urology trials

The Canadian Journal of Urology

Benign prostatic hyperplasia and lower urinary tract symptoms: evidence and approaches for best case management

The Canadian Journal of Urology

Significant lower urinary tract symptoms (LUTS) are very common in men over age 50. It is appropr... more Significant lower urinary tract symptoms (LUTS) are very common in men over age 50. It is appropriate for the primary care physician to perform the work up to confirm that benign prostatic hyperplasia (BPH) is causing the LUTS. If the physician determines that the patient has moderate symptoms (an International Prostate Symptom Score [IPSS] ≥ 8), moderate 'bother' (≥ 3 on the IPSS "bothersome index" question), and an enlarged (> 30 cc) prostate, then the most effective treatment is combination therapy with an alpha blocker and 5-alpha reductase inhibitor (5-ARI) at the time of confirmed BPH diagnosis. This combination will provide the most dramatic, early symptom response, the most sustained symptom response, and the most durable, reliable prevention of long term sequelae (acute urinary retention or the need for surgery), if the patient is compliant with taking the combination therapy.

Corrigendum to: “The Influence of Baseline Parameters on Changes in IPSS with Dutasteride, Tamsulosin, and Combination Therapy: Two-Year Data from the Combination of Avodart® and Tamsulosin (CombAT) Study” [Eur Urol Suppl 2008;7:171 (Abstract no. 403)]

by Ramiro Castro, Venancio Chantada Abal, and Jack Barkin

European Urology, 2009

The user has requested enhancement of the downloaded file.

Three year results of the prostatic urethral L.I.F.T. study

by Prem Rashid and Jack Barkin

The Canadian journal of urology, 2015

To report the three year results of a multi-center, randomized, patient and outcome assessor blin... more To report the three year results of a multi-center, randomized, patient and outcome assessor blinded trial of the Prostatic Urethral Lift (PUL) in men with bothersome lower urinary tract symptoms (LUTS) due to benign prostatic hyperplasia (BPH). At 19 centers in North America and Australia, 206 subjects = 50 years old with International Prostate Symptom Score (IPSS) ≥ 13, peak flow rate (Qmax) ≤ 12 mL/s, and prostate volume between 30 cc-80 cc were randomized 2:1 to the PUL procedure or sham control. PUL involved placing permanent UroLift implants into the lateral lobes of the prostate to enlarge the urethral lumen. After randomized comparison at 3 months, PUL patients were followed to 3 years. LUTS severity (IPSS), quality of life, Qmax, sexual function, and adverse events were assessed throughout follow up. The therapeutic effect of PUL regarding IPSS was 88% greater than sham at 3 months. Average improvements from baseline through 3 years were significant for total IPSS (41.1%), ...

Faculty of 1000 evaluation for The effect of dutasteride on the detection of prostate cancer: a set of meta-analyses

F1000 - Post-publication peer review of the biomedical literature, 2013

Faculty of 1000 evaluation for NMP-22, urinary cytology, and cystoscopy: a 1 year comparison study

F1000 - Post-publication peer review of the biomedical literature, 2012

Faculty of 1000 evaluation for The role of pelvic lymphadenectomy in non-muscle invasive bladder cancer

F1000 - Post-publication peer review of the biomedical literature, 2014

Optimizing subcutaneous injection of the gonadotropin-releasing hormone receptor antagonist degarelix

The Canadian journal of urology, 2016

The gonadotropin-releasing hormone (GnRH) receptor antagonist degarelix has several unique charac... more The gonadotropin-releasing hormone (GnRH) receptor antagonist degarelix has several unique characteristics compared to luteinizing hormone-releasing hormone (LHRH) analogs used in the management of prostate cancer. Notable differences of GnRH receptor antagonists include no flare reaction, and a more rapid suppression of testosterone, luteinizing hormone (LH), follicle stimulating hormone (FSH) and prostate-specific antigen (PSA) compared to LHRH analogs. Despite emerging evidence supporting the use of GnRH receptor antagonists over the more widely used LHRH analogs in the management of prostate cancer, physicians may be reluctant to prescribe degarelix. They may be concerned about patient complaints about injection-site reactions (ISRs). The subcutaneous injection of degarelix has been associated with a higher rate of ISRs compared with the intramuscular injections of LHRH analogs. This "How I Do It" article describes techniques and strategies that have been developed by ...

$Research paper thumbnail of Alpha blocker monotherapy versus combination therapy with antimuscarinics in men with persistent LUTS refractory to alpha-adrenergic treatment: patterns of persistence$

Alpha blocker monotherapy versus combination therapy with antimuscarinics in men with persistent LUTS refractory to alpha-adrenergic treatment: patterns of persistence

The Canadian journal of urology, 2015

Patients with lower urinary tract symptoms (LUTS) associated with benign prostatic hyperplasia (B... more Patients with lower urinary tract symptoms (LUTS) associated with benign prostatic hyperplasia (BPH) often present with voiding and storage symptoms, which may require combination therapy with an alpha blocker and an antimuscarinic (AM). This study compared treatment persistence in LUTS/BPH patients on alpha blocker monotherapy with those using combination alpha blocker and AM therapy (AB/AM). Retrospective analysis of anonymized patient longitudinal prescription reimbursement claims data. All patients who had claims for any of four alpha blocker medications and six AM agents during an index period from April 1, 2011 to March 31, 2012 were included. For the combination therapy group, the effect of adherence with the AM medication on persistence to the alpha blocker was examined. Patients on AB/AM combination therapy remained on alpha blockers for longer than those on alpha blocker monotherapy (p = 0.04); 92.4% were persistent at 3 months versus 89.0%, and at 1 year 50.8% were persis...

Improvements in Patient-Reported Quality of Life With Dutasteride, Tamsulosin and the Combination: 2-YEAR Results From the Combination of Avodart and Tamsulosin (Combat) Trial

European Urology Supplements, 2008

In the pre-planned 2-year analysis of the ongoing CombAT study, dutasteride and either monotherap... more

Androgens and sexual function: a placebo-controlled, randomized, double-blind study of testosterone vs . dehydroepiandrosterone in men with sexual dysfunction and androgen deficiency

The Aging Male the Official Journal of the International Society For the Study of the Aging Male, Nov 1, 2009

Supplemental administration of androgens has been advocated for men with sexual dysfunction (SD) ... more Supplemental administration of androgens has been advocated for men with sexual dysfunction (SD) and hypoandrogenism. The preponderance of evidence indicates that most delivery forms of testosterone (T) are effective but the role of dehydroepiandrosterone (DHEA) is controversial. A placebo-controlled, randomized trial of oral androgen (T versus DHEA) supplementation was carried out to determine their efficacy. Eighty-six men with SD and decreased levels of serum T and/or DHEA, participated in a study receiving oral T undecanoate (OTU) (n = 29) 80 mg twice daily, DHEA (n = 28) 50 mg twice daily, or placebo (n = 29). Outcomes included evaluation of sexual performance by the International Index of Erectile Function (IIEF), the Androgen Deficiency in the Aging Male (ADAM), Aging Male Symtom Scale (AMS), and Global Assessment Questionnaire (GAQ) questionnaires. Biochemical evaluations included measurement of T and DHEA, prolactin, gonadotropins, and PSA. Seventy-nine men completed the study. There were no significant differences in outcomes as assessed by four different instruments: the ADAM, IIEF, AMS, and GAQ in regard to sexual interest or erectile function. Biochemically, a significant increase in serum DHEA between baseline and final visit was documented in the group receiving DHEA. The levels of T, on the other hand, increased insignificantly between entry and final visit in the T cohort. No biochemical changes were observed in the placebo group. Levels of PSA remained stable in all three groups. This study did not suggest a clinical benefit of OTU or DHEA supplementation in men with hypoandrogenism and SD. The recommended dose of OTU may have been inadequate or poorly absorbed. Increased doses or an alternative T delivery form may result in a different response.

HIFU: Definitely ready for prime time

Canadian Urological Association Journal Journal De L Association Des Urologues Du Canada, Dec 1, 2011

POD-06.02: The effects of dutasteride, tamsulosin, and combination therapy on lower urinary tract symptoms and Qmax in men with BPH and prostatic enlargement: Two-year results from the Combination of Avodart ® and Tamsulosin (CombAT) study

Urology, 2007

The ongoing CombAT study is investigating whether combination therapy with dutasteride and tamsul... more The ongoing CombAT study is investigating whether combination therapy with dutasteride and tamsulosin is more effective than either monotherapy alone for improvement of symptoms and long-term clinical outcomes of AUR and BPH-related prostatic surgery in a population of men aged Ն50 years with moderate-to-severe BPH symptoms and prostatic enlargement. This abstract reports pre-planned 2-year analyses of IPSS and Qmax findings.

Systematic overview of the evidence for brachytherapy in clinically localized prostate cancer

990 Clinical Outcomes After Combination Therapy With Dutasteride and Tamsulosin in Men With Benign Prostatic Hyperplasia (BPH) by Baseline Characteristics: 4 Year Results From the Randomized, Double-Blind, Combat Trial

European Urology Supplements, 2010

Office based non-oncology urology trials

The Canadian Journal of Urology

Testosterone replacement therapy for the primary care physician

The Canadian Journal of Urology

A new update: Urology best practices for the primary care physician (PCP)

The Canadian Journal of Urology

Improvements in Patient-Reported Quality of Life With Dutasteride, Tamsulosin and the Combination: 2YEAR Results From the Combat Trial

In the pre-planned 2-year analysis of the ongoing CombAT study, dutasteride and either monotherap... more

Is open urologic surgery a lost skill in this era of minimally invasive urologic malady management?

The Canadian Journal of Urology

Office based urology trials

The Canadian Journal of Urology

Benign prostatic hyperplasia and lower urinary tract symptoms: evidence and approaches for best case management

The Canadian Journal of Urology

Significant lower urinary tract symptoms (LUTS) are very common in men over age 50. It is appropr... more Significant lower urinary tract symptoms (LUTS) are very common in men over age 50. It is appropriate for the primary care physician to perform the work up to confirm that benign prostatic hyperplasia (BPH) is causing the LUTS. If the physician determines that the patient has moderate symptoms (an International Prostate Symptom Score [IPSS] ≥ 8), moderate 'bother' (≥ 3 on the IPSS "bothersome index" question), and an enlarged (> 30 cc) prostate, then the most effective treatment is combination therapy with an alpha blocker and 5-alpha reductase inhibitor (5-ARI) at the time of confirmed BPH diagnosis. This combination will provide the most dramatic, early symptom response, the most sustained symptom response, and the most durable, reliable prevention of long term sequelae (acute urinary retention or the need for surgery), if the patient is compliant with taking the combination therapy.