Female Urology

Los Angeles-After a follow-up of almost 2 years, 70% of patients withstress urinary incontinence reported no repeat SUI after surgery with syntheticpolypropylene sling material, according to UCLA researchers.

Treatment with a transdermal testosterone patch significantly increased sexual desire and sexual activity in women with hypoactive sexual desire disorder (HSDD) resulting from the surgical removal of both ovaries, a recent study showed.

An oral bisphosphonate may slow the development of symptomatic bone metastases and reduce the risk of death from this disease, new data show.

Chemoprevention is the use of natural or synthetic agents to avert the induction of, or to inhibit, delay, or suppress the progression of cancers or other diseases. Carcinogenesis is a process that occurs over a period of months to years and is under the influence of a range of genetic and environmental factors.

Although antibiotics are commonly used to treat symptoms of chronic pelvicpain syndrome, this approach is beneficial in a relatively small subsetof patients, and urologists must consider alternative treatment modalities,including physical therapy. In this exclusive Urology Times interview, JeannettePotts, MD, discusses current research and her own views on the diagnosisand treatment of chronic prostatitis. Dr. Potts is a member of the staffat the Cleveland Clinic Glickman Urological Institute. The interview wasconducted by Philip M. Hanno, MD, of the department of urology, Universityof Pennsylvania, Philadelphia.

Prostate cancer is the most prevalent non-cutaneous cancer diagnosed in men today, still accounting for a significant amount of morbidity and mortality in spite of increased screening efforts and advances in treatment.

Chicago-The selective endothelin receptor antagonist atrasentan significantly attenuates changes in biochemical markers of bone metabolism and disease progression in a group of patients with advanced hormone-refractory prostate cancer that had progressed on placebo, according to the results of a randomized clinical trial.

Presented by Allen D. Seftel, MD, Case Western Reserve University, Cleveland

Presented by Larry Lipshultz, MD, Baylor College of Medicine, Houston.

Presented by Richard Grady, MD, University of Washington, Seattle.

Presented by Donald A. Elmajian, MD, Lousiiana State University, Shreveport

Urologic laparoscopy has assumed an important role as an alternative to open surgery. Advancement in techniques and equipment result in continuous expansion of the indications for urologic laparoscopy.

Chicago-Two alpha blockers appear to have modest efficacy in treatingchronic prostatitis/chronic pelvic pain syndrome, according to separatestudies presented here at the AUA annual meeting.

Chicago-The etiology of male factor infertility remains one ofthe larger mysteries confronting urologists. A study from Baylor Collegeof Medicine suggests that the origins of the problem might lie with thetestes and may not involve either inflammation or oxidative radicals, assome have suggested.

Chicago-Radical prostatectomy patients taking sildenafil postoperativelywere seven times more likely to report a return to spontaneous erectionsthan those taking placebo in a multi-institutional, double-blind study presentedhere yesterday.

Chicago-Women who undergo cesarean section without a trial of labor appearto be significantly less likely to experience stress urinary incontinencethan those who deliver vaginally or underwent a CS for obstructed labor,according to a study from Israel.

Chicago-Six weeks of antimicrobial therapy with levofloxacin (Levaquin)appears to improve symptoms of chronic prostatitis/chronic pelvic pain syndromein men, although the benefits are not sustained, according to a Canadianstudy presented yesterday.

Chicago-Two alpha-blockers appear to have modest efficacy in treatingchronic prostatitis/chronic pelvic pain syndrome, according to separatestudies presented here.

Auxilium Pharmaceuticals, Inc., introduces Testim testosterone topicalgel to supplement low levels of testosterone in men with hypogonadism. Duringclinical trials, patients reported a 59% increase in sexual activity anda 78% increase in days with a spontaneous erection over a 90-day period,according to the company. Initial analysis of long-term data suggests thatthe gel also improves bone mineral density.

Nearly one in 10 men who walk into the outpatient office of a urologist leave with a coded diagnosis of prostatitis. Urologists have described the traditional approach to the diagnosis and management of the chronic prostatitis syndromes as one of the most frustrating areas of urologic practice.

Seattle-A retrospective review of patients with secondary azoospermia has uncovered an alarming tumor rate and a high sperm recovery rate, reiterating the importance of urologic evaluation in this population.

House approves national liability insurance bill; CMS outlines changesin Medicare

Seattle-Microsurgical vasectomy reversal has higher success rates whenperformed for couples with the same female partner, underscoring the importanceof counseling patients when considering reconstructive surgery.

Societies can help with Medicare matters and with private insurance companies

Seattle-Use of some over-the-counter herbal supplements may be adverselyaffecting male fertility. In an ironic twist, those supplements touted ashelping with infertility appear to be among those doing harm.

One does not have to go far on the Internet to find solicitations encouragingcouples whose infertility derives from a wide variety of causes to undergointracytoplasmic sperm injection with aspirated testicular sperm. Many ofthese advertisements hint that ICSI with aspirated sperm is an easy, "one-stop"method of conceiving a child, leading urologists to be rightly concernedthat, without adequate evaluation of the male half of the equation, thepatient's medical interests are inadequately served.

Copenhagen, Denmark-An oral antidiuretic approved for the treatment ofnocturnal enuresis also appears to be effective for treating nocturia inadult men and women, according to phase III clinical trial results reportedby the multinational Nocturia Study Group.

Boston-Children with myelomeningocele and undescended testis face greaterrisk of infertility than patients with undescended testis alone, accordingto research presented at the American Academy of Pediatrics Section on Urologyannual meeting here. In a related study, researchers found that patientswith defective second step germ cell maturation due to cryptorchidism havea poor fertility prognosis.

Nephron-sparing surgery (NSS) was initially developed as a mechanism to preserve renal function in patients at risk of requiring dialysis in the face of total nephrectomy. Indications included tumors in patients with a solitary kidney, multifocal disease, or chronic renal insufficiency.

Scranton, PA-Calling the medical liability insurance crisis a"national problem that needs a national solution," President Bushrenewed his support for federal reform that would include a cap on non-economicdamages awarded to injured patients. Meanwhile, urologists and other physiciansthroughout Pennsylvania, the site of Bush's speech, canceled plans to shuttertheir practices after the governor revealed short-term measures aimed atalleviating the crisis.