Female Urology

San Antonio--The adverse side effects of hormone therapy in prostate cancer patients may be more severe and manifest sooner than many might believe, according to two separate studies presented here at the 2005 AUA annual meeting.

We know the PSA test is not perfect. Nevertheless, we must move forward and continue to raise awareness about prostate cancer.

Screening for detrusor activity in women who are undergoing surgery for pure or predominant stress incontinence is not an efficient practice, according to findings from a large study presented here on Thursday.

Factors such as body mass index, smoking, and the use of hormone replacement therapy affect whether women will develop various forms of incontinence in later life, according to results of a longitudinal study from Germany presented here yesterday.

Procedures using tension-free vaginal tape (TVT, Gynecare/Ethicon, Somerville, NJ) or trans-obturator tape (TOT, Mentor Corp., Santa Barbara, CA) appear to equally treat the incontinence associated with stress urinary incontinence. TOT, however, may leave patients more comfortable because it is associated with a lower risk of urgency symptoms, Italian researchers say.

San Antonio--Application of laparoscopic surgical techniques continues to expand in urology. As experience with laparoscopy grows, the efficiency and results improve. Several noteworthy presentations related to laparoscopic surgery at the 2005 AUA meeting caught the attention of Stephen Y. Nakada, MD, chairman of urology at the University of Wisconsin, Madison.

One by one, drug-resistant microbes have weakened or destroyed the efficacy of established antimicrobials. The appearance of a strain of urinary tract infection-associated Escherichia coli that is resistant to ciprofloxacin (Cipro, Proquin) is not necessarily a surprise, but it is a significant concern, according to Anthony J. Schaeffer, MD, chairman of the department of urology, Northwestern School of Medicine, Chicago.

Advances in the field of male infertility continue to provide insight into the factors and processes that make fertility possible. Ultimately, the advances lead to techniques that extend the possibility of fertility to an ever-increasing population of patients.

Women receiving four weekly bladder-specific acupuncture treatments experienced significant improvements in bladder capacity, urgency, frequency, and quality of life compared with women receiving placebo treatments in a study appearing in Obstetrics & Gynecology (2005; 106:138-43).

The most important factor in predicting a successful prostatectomy appears to be the overall experience of the surgeon, not the frequency of using a specific approach.

Novartis and the FDA have revised the prescribing information of zoledronic acid (Zometa) to include the occurrence of osteonecrosis of the jaw.

This year, you have a unique opportunity to improve your income by providing more services in the office.

Atlanta--Children treated with endoscopic intervention for vesicoureteral reflux continue to demonstrate cures that approach those of open surgery and have a high resolution rate after initial failure. In addition, incidence of febrile and non-febrile urinary tract infection after treatment is lower than after surgery, according to data presented here at the State-of-the-Art Symposium on Pediatric UTI, Reflux, Antibiotic Resistance, and Endoscopy.

San Antonio--A relatively new inherited syndrome known as hereditary leiomyomatosis and renal cell cancer (HLRCC) has a more aggressive clinical course than other hereditary renal cancer syndromes, and expectant management of even small HLRCC tumors is not recommended, according to a study presented at the AUA annual meeting here.

A bill that would amend the Public Health Service Act to require the Secretary of Health and Human Services to conduct and support research that utilizes human embryonic stem cells was passed in the House on Tuesday, and members of the Senate have urged Senate Majority Leader Bill Frist (R-TN) to allow the Senate to vote on the bill, without amendments, immediately.

Sperm cryopreservation does not adversely affect hyaluronan binding, an apparently critical step in fertilization, and may even modestly enhance the process, according to a study of 36 specimens conducted by Stanford University investigators. They reported yesterday that cryopreservation increased overall hyaluronan binding rates by a mean of 9% (p=.002).

Midpoint results of a 5-year multi-center IDE study comparing a new cooled transurethral microwave thermotherapy device against the conventional 60-minute Targis treatment (both from Urologix, Minneapolis) were announced here on Wednesday, and the data appear promising.

Men who experience painful recurrent varicoceles after undergoing conservative treatment and failed surgical repair are best served by microsurgical varicocelectomy, according to Canadian researchers.Of 11 men who had failed standard varicocelectomy and experienced pain before and after surgery, 10 experienced a favorable response following microsurgical repair, according to investigators."In my mind, microsurgical varicocelectomy is the gold standard, and non-microsurgical repair is sub-standard," said lead author Armand Zini, MD, associate professor of urology at McGill University, Montreal. "However, few urologists are able to perform this procedure, since they have not been trained properly."

The adverse side effects of hormone therapy in prostate cancer patients may be more severe and may manifest sooner than many believe, according to two separate studies discussed here yesterday.

Measurement of two cytokines in expressed prostatic secretions (EPS) might provide diagnostic guidance for patients with chronic prostatitis/chronic pelvic pain syndrome (CPPS), according to a study presented at the AUA annual meeting.

Kingston, Ontario--An interstitial cystitis (IC) drug has shown modest benefit in men with chronic pelvic pain syndrome (CPPS). Although the study doesn't open new therapeutic doors, it does raise interesting questions about how similar IC and CPPS may be or whether some men are being misdiagnosed.

Urologists treating patients with advanced prostate cancer should anticipate a number of advances this year and next. They will also need to anticipate some of the challenges these advances will create, according to Paul F. Schellhammer, MD, program director of the Virginia Prostate Center and professor of urology at Eastern Virginia Medical School, Norfolk.

It often takes years before medical advances make their way from the laboratory bench to the physician's office. Such is not the case in andrology. In many instances, the cutting edge will be of clinical relevance very soon for urologists who treat male infertility, according to Craig S. Niederberger, chief of andrology at the University of Illinois, Chicago.

More effective treatment will come as interstitial cystitis becomes better defined and research makes inroads on the epidemiology and etiology of this enigmatic and difficult-to-treat condition.

Tamoxifen (Nolvadex) reduces the frequency of gynecomastia and breast pain in prostate cancer patients taking bicalutamide (Casodex), according to a study in Lancet Oncology (2005; 6:295-300).

Human epidermal growth factor receptor 2 (HER-2), associated with breast cancer, is a key culprit in prostate cancer recurrence, say researchers from the University of North Carolina at Chapel Hill.

Cryosurgery appears to be a promising primary treatment for prostate cancer, even in men with high-risk features, according to results of a 4-year study published in Cancer (2005; 103:1625-30).

The National Academies recommended research guidelines for human embryonic stem cells.

Tamoxifen (Nolvadex) reduces the frequency of gynecomastia and breast pain in prostate cancer patients taking bicalutamide (Casodex), according to a study in Lancet Oncology (2005; 6:295-300).

Istanbul, Turkey--Chronic prostatitis appears to be significantly associated with psychological disorders, such as depression, anxiety, and panic, according to the results of a German study. The study also found that pelvic pain symptoms are far less prevalent than expected (3.2%), while the mean age of afflicted men was significantly higher than noted in previous trials (60.6 years).