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The clinical significance of this finding is that for men with favorable-risk prostate cancer and a history of congestive heart failure or myocardial infarction who require neoadjuvant HT solely to eliminate pubic arch interference, alternative strategies such as active surveillance or treatment with external beam radiation therapy or prostatectomy should be considered.
Contraindications may include an earlier transurethral resection of the prostate, poor general health, obesity, bowel disease, previous abdominal surgery, pubic arch interference, and urinary retention (2).