Men's Health

Continuing its participation in the Choosing Wisely campaign, the AUA has added five new recommendations about tests and treatments that physicians and patients should question.

“We strongly believe that PSA-based prostate cancer screening should be made available, especially to men 70 years and older to decrease the morbidity and mortality of prostate cancer,” write Navin Shah, MD, and Vladimir Ioffe, MD.

“Abiraterone should change the treatment paradigm for patients with newly diagnosed metastatic prostate cancer and largely displaces chemotherapy from the current paradigm,” said Sumanta Kumar Pal, MD.

Administering bone supportive therapy within 1 month prior to starting radium Ra 223 dichloride (Xofigo) may increase the likelihood of achieving pain palliation with the radionuclide therapy and reduce the chance of pain flare, according to the findings of a retrospective study.

Findings of a meta-analysis show that phosphodiesterase type 5 inhibitor use is associated with a statistically significant increased risk of melanoma, but they do not support a causal relationship.

Urologist Henry Rosevear, MD, reviews his personal highlights from AUA 2017, along with a few bumps in the road.

Although theory and preliminary clinical data indicated that intraoperative regional hypothermia could improve the return to potency and continence after robot-assisted radical prostatectomy, the intervention did not have any significant benefits when put to the more rigorous test of a randomized controlled trial.

The use of robot-assisted simple prostatectomy is increasing for the management of BPH in the United States. Patients were nearly seven times more likely to undergo RASP in 2011-2015 compared to 2003-2006, after adjusting for confounders.

Analyses of data from 5 years of prospective follow-up in the pivotal trial supporting regulatory approval of the prostatic urethral lift ([PUL] UroLift System, NeoTract) show that the minimally invasive procedure remains safe and provides rapid and durable benefits for men with symptomatic BPH.

"For low-grade disease, it’s certainly worth a try because nothing is really lost. For high-grade disease, I don’t know that it’s appropriate-we don’t have the data," says one urologist.

"The nurse practitioner, nurse, and other ancillary providers who make up the urology team are an essential and valuable asset in the consideration of adding oral androgen receptor inhibitors into the office setting," writes Gwendolyn Hooper, PhD, APRN.

More than 96% of urologists surveyed said that incorporating abiraterone acetate (ZYTIGA) treatment into practice for patients with metastatic castrate-resistant prostate cancer is easy or manageable after overcoming initial barriers, according to new research presented at the Genitourinary Cancers Symposium in Orlando, FL.

Findings of a retrospective study including 1,000 men with follow-up ranging to 8 years demonstrate the long-term safety and efficacy of prostatic artery embolization for relieving lower urinary tract symptoms secondary to BPH, researchers reported at the Society of Interventional Radiology annual scientific meeting in Washington.

While close to 90% of men diagnosed with prostate cancer between 1998 and 2012 had stage 1 and stage 2 disease, more than 90% underwent surgery or radiation to treat the cancer, according to a study presented at the Genitourinary Cancers Symposium in Orlando, FL.

“From our results, the Decipher test helps reassure low-risk patients that observation may be warranted or confirm that high-risk patients need additional treatment,” says study author John L. Gore, MD, MSHS.

"As a urologic community, we should promote the use of AS for favorable-risk disease to reduce the downstream harms of screening while preserving the benefits of early detection for life-threatening cases," writes Stacy Loeb, MD, MSc.

“We believe that aggressive loco-regional resection may be worth considering in well-selected patients as a part of a multimodal approach in the management of men with node-positive prostate cancer,” says study author Bimal Bhindi, MD.

Urologists’ adherence to value-based care pathways for BPH surgery is extremely low and only modestly improved when given individualized feedback on patient outcomes, costs, and practice patterns relative to peers, say UCLA researchers.

Cryopreservation is far more cost-effective than post-treatment surgical sperm extraction and assisted reproductive technology for men with testis cancer who desire fertility preservation, new data show.

Men who use the Internet as their primary source for prostate cancer treatment decision-making are more likely to regret those decisions a year after treatment than those whose primary sources of information are radiation oncologists or urologists.

Findings of an ecologic study indicate that direct-to-consumer advertising for testosterone therapy influenced men to seek treatment and was accompanied by increased testosterone prescribing, including initiation in men without clear indications for use.

Use of 5α-reductase inhibitors for the treatment of BPH appears to be associated with increased risks of self-harm and depression, according to a population-based, retrospective, matched cohort study of men in Canada.

Participants in an outreach event for prostate cancer screening preferred education about prostate cancer prior to undergoing screening, and thought the use of an informed decision-making model was beneficial, researchers reported at the Genitourinary Cancers Symposium in Orlando, FL.