Female Urology

Presented by John N. Krieger, MD, University of Washington School ofMedicine, Seattle.

Presented by Ricardo Gonzalez, MD, University of Miami Schoolof Medicine.

Presented by John Trachtenberg, MD, University of Toronto.

The incidence of hydronephrosis diagnosed in the neonatal period has increased dramatically with the routine use of ultrasound in obstetrical care. Prior to the mid-1980s, most children with obstructive uropathy secondary to ureteropelvic junction obstruction or ureterovesical junction obstruction were diagnosed after urinary tract infections had occurred or an abdominal mass was noted.

Orlando, FL-A new analysis of data from the National Cancer Institute'snationwide Prostate, Lung, Colorectal and Ovarian (PLCO) cancer screeningtrial suggests that annual PSA screening may not be necessary for many men.

San Francisco-Prostate cancer bone metastases appear to react favorablyto treatment with a new bisphosphonate and the tyrosine-kinase inhibitorsPKI-166 and STI-571, according to studies presented at the American Associationfor Cancer Research annual meeting here.

Characterized by symptoms of urinary frequency, urgency, and urge urinary incontinence, overactive bladder (OAB) is a condition that results from a deficiency in the bladder's ability to store urine and in the onset of involuntary bladder muscle contractions that promote urgency and possibly urine loss.

Group presses for $420 million at NIH and $100 million at Defense Departmentin 2003Washington - The case for bolstering funding for prostate cancerresearch is being pressed on Capitol Hill by a 6-year-old coalition of organizationsand individuals who are determined to end the disease that has accountedfor 15% of all male cancer deaths over the last decade.

New Products as presented in the April 1, 2002 issue of Urology Times

San Francisco - Researchers have successfully induced hypospadias in mice, an accomplishment that observers say provides more compelling evidence in support of the endocrine disruptor hypothesis as an explanation for the increase in hypospadias observed over the past 30 years.

San Francisco-Factors that may help to predict future infertilityin cryptorchid boys-enabling clinicians to intervene earlier-have emergedfrom two long-term studies of cryptorchidism and fertility presented atthe American Academy of Pediatrics Section on Urology annual meeting.

Varicocele was first recognized by Lawrence Dubin, MD, and Richard D.Amelar, MD, as the male reproductive anatomic anomaly most amenable to surgicalcorrection. Varicocelectomy has long since played an important role in theurologist's toolbox. Yet with the emergence of intracytoplasmic sperm injection, a variantof in vitro fertilization in which a single sperm is injected into an ovum,some have questioned the utility of all forms of reproductive therapy otherthan assisted reproductive technologies (ARTs). Among many papers presentedat the American Society for Reproductive Medicine annual meeting-and reportedin this issue of Urology Times-several supported the continued role forvaricocelectomy.

The advent of intracytoplasmic sperm injection (ICSI) in 1993 and subsequent successful fertilization and pregnancy using testicular sperm in conjunction with ICSI

Orlando, FL-Is assisted reproduction technology (ART) a better way to deal with varicocele-related infertility, or is surgical repair the better choice? Given the high pregnancy success of ART, the optimal management of infertility secondary to varicocele is unclear," said Paul J. Turek, MD, associate professor of urology, University of California, San Francisco.

Jena, Germany-Botulinum toxin has shown promise as a potential therapy for chronic pelvic pain and lower urinary tract dysfunction. In a German study, injection of botulinum toxin type A into the urethral sphincter muscle led to improvement in muscle tone, pain, and urodynamic parameters in patients enrolled.

Orlando, FL-Infertile men are at increased risk for testicular cancer compared with the general population. That is the disturbing conclusion reached by researchers at the New York Weill-Cornell Medical Center, following a study of 4,470 men over a 13-year period.

Chicago-A mixed serotonin and noradrenaline reuptake inhibitor appears to reduce the symptoms associated with stress urinary incontinence (SUI) and improve the quality of life in patients receiving it, according to findings from a phase II clinical trial presented at the American Urogynecologic Society 22nd annual scientific meeting here. While the agent, duloxetine, is still investigational, observers say the prospects for a pharmacologic approach to stress incontinence are promising.

New York-Recently published data could better help diagnose and select treatments for infertile couples, targeting treatments likely to work and perhaps sparing some patients invasive, high-cost treatments less likely to prove effective.

Cleveland-Although skeletal fractures attributed to androgen suppressionare present in a small percentage of men on the therapy, the incidence maybe as high as five times that of the normal population, according to VincentS. Ricchiuti, MD, chief resident, department of urology, Case Western Reserve-UniversityHospitals, Cleveland.

Toronto-Not unlike many of the patients seen in urology practices, a significant percentage of young infertile men take alternative therapies, some of which may adversely affect their fertility. But many of these men may be hesitant to share this information with you.

Boston-Perhaps offering a measure of reassurance to prostatitis patientsand their urologists, data from a prospective study suggest that the symptomsof chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) typicallyimprove or remain stable over time. During a 1-year follow-up of a cohort receiving "usual care"for their symptoms, half the patients had symptom improvement, and morethan one-third reported their symptoms unchanged. Symptoms deterioratedin about 14% of patients.

New York-The young, otherwise healthy men urologists see for an infertility evaluation may be hiding a condition more commonly observed in older men and women. Researchers from the Cornell Institute of Reproductive Medicine in New York report that three-fourths of men with nonobstructive azoospermia, a severe form of male infertility, are at risk for significant bone loss.

Baltimore-For the first time, urologists and gynecologists have the basis for a unified approach to the management of male infertility in a series of four practice policies jointly produced by AUA and the American Society for Reproductive Medicine.

Washington-MDLinx now offers www.urologylinx.com, a web site featuring news about general urology and urologic subspecialties. The site's subspecialties include adrenal glands, erectile dysfunction, infertility, kidney, pediatric urology, penis, prostate, stones, testis/scrotum, ureter, urethra, urinary bladder, uroradiology, voiding dysfunction, basic science/genetics, economics of medicine, and popular press.

Many prostate cancer researchers were delighted last fall by two significant developments. First, Myriad Genetics, a Salt Lake City-based biopharmaceutical company, announced on October 4 that its research team had cloned a prostate cancer susceptibility gene (HPC2), also known as ELAC2. That same month, an independent research team at the University of Pennsylvania published its findings that the variant allele (copy) of the gene was found to be more common in men with prostate cancer than in healthy matched controls.