Neurophysiologic tests for CP/CPPS show promiseMarch 1st 2006
Baltimore?Someday, you may be using neurophysiologic testing for follow-up and possibly even diagnosis of chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) before you turn to the four-glass or modified test. That's because, increasingly, CP/CPPS is being recognized not as a disorder of the prostate, but as a neurologic disorder?a chronic pain syndrome that may begin in the viscera, but becomes a nervous system disorder as pain is centralized.
BMI linked with changes that may affect fertilityFebruary 1st 2006
Montreal--Men with a body mass index indicative of being overweight or obese may exhibit changes in endocrine levels—notably lower testosterone levels—that could contribute to infertility, new research shows. It is possible, therefore, that fertility problems could be ameliorated with weight loss in some men.
Smoking affects sperm's ability to fertilizeFebruary 1st 2006
Montreal--In case your patients need another reason to quit, recent research indicates that smoking tobacco reduces the ability of sperm to fertilize an egg. There appears to be a dose-response relationship, with heavy smokers at greater risk for more severe impairment of sperm, according to a study presented at the American Society for Reproductive Medicine annual meeting here. It remains to be seen whether quitting smoking or even cutting down will lead to improvements in sperm functions that support fertilization.
Nonobstructive azoospermia is tied to genetic defectFebruary 1st 2006
Montreal--Idiopathic, primary nonobstructive azoospermia (NOA) is linked to a genetic defect known as a dysfunctional DNA mismatch repair pathway that also places these men at increased risk for cancer and other medical illnesses. Given that the problem is genetic in origin, the consequences of this defect may be of significance for both patients and their offspring, researchers say. Both concerns require close monitoring by physicians.
Anti-estrogen may benefit some men with idiopathic HHFebruary 1st 2006
Montreal--The anti-estrogen agent clomiphene citrate (Clomid, Milophene, Serophene) may provide an easier, less expensive treatment for infertility among some men with hypogonadotropic hypo-gonadism [HH], according to a small retrospective study. The agent may be worth trying before the more expensive and difficult-to-administer gonadotropins are employed.
Vasectomy reversal: Data point to choice of techniqueFebruary 1st 2006
Montreal--As the controversy over whether to perform vasovasostomy or vasoepididymostomy for vasectomy reversal rages, two small studies have provided some new insight into when to choose one surgical technique over the other. One study demonstrates that expert surgeons can provide better results with vasoepididymostomy among patients with vasospermia, defined as no sperm in the vasal fluid, regardless of the condition of the vasal fluid. The second study suggests that the presence of sperm parts in the vasal fluid signals that vasovasostomy might be the better option.
Despite drawbacks, TESE-derived sperm is superiorFebruary 1st 2006
Montreal--Although testicular sperm extraction (TESE) may provide somewhat better pregnancy rates than the use of ejaculated sperm for intracytoplasmic sperm injection for men with low sperm counts, a higher-than-average proportion of abnormal sperm, or almost no sperm in the ejaculate, TESE does have important disadvantages. It is up to patients and their physicians to choose the appropriate procedure, based on individual circumstances and clinical features, researchers say.
Inhibin B: A better infertility marker than FSH or LH?February 1st 2006
Montreal--The level of inhibin B may be a better marker of male infertility than both the typically used follicle stimulating hormone (FSH) and luteinizing hormone (LH), according to new research. These findings have yet to be confirmed in a large, prospective trial, however.
Gender identity and assignment issues spark debateFebruary 1st 2006
Washington--For children with ambiguous genitalia at birth, surgical techniques have improved vastly, but deciding when and whether to do surgery hasn't gotten easier. That was apparent from the lively and sometimes contentious panel and audience discussion here at the American Academy of Pediatrics Section on Urology annual meeting.
Testis biopsy: Integral to workup of infertile menFebruary 1st 2006
Montreal--Spermatogenesis markers that can be easily obtained from a noninvasive testis biopsy may predict which patients will respond to surgical varicocele repair. Testis biopsy, therefore, should be part of the regular workup for male infertility patients, suggest the authors of the 2005 Society for Male Reproduction and Urology Prize paper presented here at the American Society for Reproductive Medicine annual meeting.
Congress urges FDA crackdown on epidemic of counterfeit drugsDecember 1st 2005
Washington--Counterfeit prescription drugs pose a "potentially serious health threat" in the United States, one that can result in serious or deadly consequences for patients because of unscrupulous acts of profiteers who take advantage of a lack of uniform regulation and enforcement.
Vaginal delivery may cause levator ani traumaDecember 1st 2005
Montreal--Vaginal delivery may cause significant pelvic floor trauma in as many as one-third of first-time deliveries. This trauma appears, upon ultrasound, to primarily affect the levator ani muscle, according to new research from Australia.
Lifestyle, not childbirth method, affects continenceDecember 1st 2005
Montreal--Women who are choosing to have a Caesarean section instead of a vaginal delivery to avoid incontinence later in life should opt for vaginal delivery and should focus on their lifestyle choices, which can influence the likelihood that they will develop incontinence, according to research presented here at the International Continence Society annual meeting.
Study yields reference values for urodynamic studiesDecember 1st 2005
Montreal--Findings from a large cohort study presented at the International Continence Society annual meeting here have led to reference values for clinicians conducting preoperative urodynamic studies in women with stress urinary incontinence.
TOT, TVT results similar: TOT may manage urgency betterDecember 1st 2005
Montreal--Procedures using tension-free vaginal tape (TVT, Gynecare/Ethicon, Somerville, NJ) or the recently introduced trans-obturator tape (TOT, Mentor Corp., Santa Barbara, CA) appear to provide equal outcomes in the treatment of stress urinary incontinence. However, TOT may leave a subset of patients more comfortable because it is associated with a lower risk of urgency symptoms, according to a prospective, multicenter, randomized Italian study presented at the International Continence Society here.
Two EPS proteins are diagnostic markers for CPPSNovember 1st 2005
Chicago--A study of cytokines in expressed prostatic secretions (EPS) has identified two potential candidates as diagnostic markers for inflammatory and noninflammatory forms of chronic prostatitis/chronic pelvic pain syndrome (CPPS), according to researchers from Northwestern University Medical Center in Chicago.
CPPS data document its impact, but more work is neededNovember 1st 2005
Paris--Most cases of chronic pelvic pain syndrome (CPPS) are spontaneous with unknown causes, and more studies are needed on all aspects of the condition, said Anthony Schaeffer, MD, who chaired the Committee on Prostatitis and Chronic Pelvic Pain at the International Consultation on New Developments in Prostate Cancer and Prostate Diseases here.
New treatments escalate war on metastatic prostate cancerNovember 1st 2005
Paris--An expert committee charged with examining coming trends in new therapeutic targets and treatments for metastatic prostate cancer painted a positive picture of the future, with chemotherapy, vaccines, and gene therapy all potentially playing a role. But the committee also recognized a milestone advancement of the recent past.
Minnetonka, MN--The Halo kidney stone basket from Sacred Heart Medical, Inc. features improved basket symmetry and stability to ensure complete capture and retrieval of small stones and fragments, as well as a 1.5F diameter sheath to permit simultaneous use of laser fiber for intracorporeal lithotripsy without compromising irrigation or visibility.
Microsurgical varicocelectomy improves sperm integrityOctober 1st 2005
Montreal--The first report of improved sperm DNA integrity after specific surgical therapy was presented at the AUA annual meeting in San Antonio. Although the cohort was small and the statistical significance slim, the study's authors say the data support the beneficial effect of varicocelectomy on human spermatogenesis.