Men's Health

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The opportunities for physicians in men’s health are tremendous. As with most career moves, blindly entering a field is ill advised. Rather, I recommend that the thoughtful young urologist carefully consider the following steps and pointers.

A novel treatment for the targeted removal of prostate tissue may soon be coming to a hospital near you. According to the results of a phase II study presented at the AUA annual meeting in New Orleans, Aquablation, a minimally invasive water ablation therapy, demonstrated efficient and precise resection of prostate tissue in patients with BPH.

The prostatic urethral lift (PUL [UroLift, NeoTract, Inc.]) yields successful 3-year durability and superior rate of improvement of BPH symptoms compared to transurethral resection of the prostate, according to separate studies presented at the AUA annual meeting in New Orleans.

The association between testosterone replacement therapy (TRT) and thrombotic risk in elderly men remains controversial. While the FDA has mandated that all approved testosterone products include warnings about a possible increase in cardiovascular, stroke, and venous blood clot risk, at least one study presented at the AUA annual meeting in New Orleans found no link between TRT and cardiovascular events.

The management of BPH has had an interesting roller coaster ride over the past 25 years with new medicines, minimally invasive surgical therapies, and a host of novel surgical technologies, including lasers and bipolar electrosurgery.

After accounting for the risk of reclassification, carefully monitored men with favorable-risk prostate cancer who enroll in active surveillance and undergo delayed surgery are no more likely to demonstrate adverse features associated with 15-year prostate cancer-specific mortality than their counterparts who elect immediate curative treatment, say researchers from the Johns Hopkins University Brady Urological Institute, Baltimore.

After a median of 2 years in an active surveillance cohort being followed with multiparametric-magnetic resonance imaging and MRI-transrectal ultrasound fusion-guided biopsy (“targeted biopsy”), rates of biopsy-proven pathologic progression are similar among men with low-risk and intermediate-risk disease, say researchers from the National Institutes of Health.

Among men who are potent and have low-risk prostate cancer, focal cryotherapy appears to deliver similar oncologic control but with much better recovery of erectile function than a whole-gland approach, according to an analysis using data from the Cryo On-Line Data Registry.

The cost of radiation therapy for prostate cancer in the United States varies substantially, and most of the variation is accounted for by factors that are not related to the patient or tumor, according to the results of a study published online in Journal of Oncology Practice (Aug. 11, 2015).

Middle-aged and older men undergoing testosterone replacement therapy aren’t at increased risk of venous thromboembolism (VTE), the results of a large comparative case-control analysis published online in Mayo Clinic Proceedings (July 15, 2015) suggest.