Sexual Dysfunction

Prospective, long-term follow-up in a large cohort of hypogonadal men treated with testosterone replacement therapy (TRT) provides no evidence that TRT increases the risk for prostate cancer.

Symptomatic hypogonadal men treated with clomiphene citrate (Clomid) or testosterone gels report similar satisfaction levels as age-matched men treated with testosterone injections, despite having significantly lower serum total testosterone levels, according to the findings of a recent retrospective study from Baylor College of Medicine, Houston.

Testosterone replacement therapy has been much debated in recent months, in light of two studies linking the treatment to increased risk of all-cause mortality, myocardial infarction, and stroke, prompting an FDA investigation into TRT’s safety and widespread criticism from members of the urologic community. In this article, Ajay Nehra, MD, discusses those studies, evolving attitudes toward “low T,” and the importance of individualizing treatment.

Men are being too easily enticed lately into ill-advised use of testosterone supplementation. Even men with only minimal, vague complaints are promised a hormonal fountain of youth and ageless virility. Many potential candidates seem to be under the misconception that “T” replacement will boost or energize their natural testicular production. In fact, exogenous testosterone suppresses testicular function.

Landon Trost, MD, presents the take home messages on sexual function/dysfunction from the AUA annual meeting in Orlando, FL, including studies of clostridium collagenase histolyticum (CCH [XIAFLEX]).

Richard K. Lee, MD, MBA, presents the take home messages on BPH/LUTS from the AUA annual meeting in Orlando, FL.

K.C. Balaji, MD, presents the take home messages on basic science research from the AUA annual meeting in Orlando, FL.

Tobias S. Köhler, MD, MPH, presents the take home messages on infertility/andrology from the AUA annual meeting in Orlando, FL.

I consider urology to be a very unique field, one that I am lucky to be part of. Recently, though, I have begun to wonder whether the medical community (not necessarily the urology community) has been too quick to embrace the widespread use of testosterone replacement therapy.

New urology products and services from Symtelligence Medical Informatics, LABORIE, Metamark Genetics, the MediSafe Project, and Olympus

A recent large study has found no increased risk of heart attack in men undergoing testosterone replacement therapy.

Testosterone replacement therapy is in the news again, for reasons both good and bad.

New products and services from TERUMO Medical Corp., TOLMAR Pharmaceuticals, Spry Publishing, and Beckman Coulter Diagnostics.

The FDA has approved a new testosterone gel formulation, marking the agency’s second approval of a testosterone replacement therapy in the course of a week.

The FDA has approved a nasal gel for men with hypogonadism and has granted clearance to a treatment for urinary incontinence in men. Separately, two drug makers are approaching the agency about regulatory approval for an over-the-counter version of a phosphodiesterase-type-5 inhibitor.

Drugs in the pipeline from Astellas Pharma, Medivation, TesoRx, Strategic Science and Technologies, Cubist Pharmaceuticals, and SCA.

The recently concluded AUA annual meeting in Orlando may not go down as one of the most memorable annual meetings in recent years. Nevertheless, it was noteworthy for some interesting news and lively debate on hot-button topics: the safety of certain urologic products, namely, testosterone and transvaginal mesh; new tests for prostate cancer; infection prevention and treatment; and use of an advanced prostate cancer agent in the pre-chemotherapy setting.

Testosterone replacement therapy may be considered for treatment of hypogonadism in carefully selected men who have undergone radical prostatectomy for low- to intermediate-risk prostate cancer, according to researchers from New York University Medical Center, New York.

Lumenis Ltd. has announced the U.S. launch of the Lumenis Pulse 120H Holmium laser platform for a range of urologic applications.

Other cases discussed in this edition of "Malpractice Consult" include cecum perforated during prostatectomy, injections fail to improve Peyronie's disease, and dementia diagnosis blamed on urologic procedure.

New products and services from Lumenis, ITelagen, Mission Pharmacal, PatientPoint, and HealthTronics IT Solutions.

Intralesional injection of collagenase clostridium histolyticum (CCH [XIAFLEX]) improves the physical and psychological aspects of Peyronie’s disease in men regardless of erectile dysfunction severity and whether they have a history of prior treatment or prostatectomy, according to a recent study.

Our traditional thinking about sex steroids is being challenged.

The safety of testosterone replacement therapy has been the subject of two recently published studies, which were followed by a January 2014 FDA announcement that the agency is investigating the risk of stroke, heart attack, and death in men taking TRT. Additional data on the safety of TRT, including its use in men following radical prostatectomy, will be presented at the AUA meeting, said John J. Mulcahy, MD, PhD.

A number of studies at the 2014 AUA annual meeting will indicate that male infertility is a harbinger of other diseases, specifically suggesting “linkage to all-cause mortality, psychiatric disorders, morbidity, and offspring birth defect risk,” said James M. Hotaling, MD, assistant professor of surgery in the division of urology at the University of Utah, Salt Lake City.

Drugs and devices in the pipeline from Astellas Pharma, Medivation, Repros Therapeutics, Metamark Genetics, Argos Therapeutics, S1 Biopharma, Ipsen, Sprout Pharmaceuticals, Antigen Express, Generex Biotechnology, Veloxis Pharmaceuticals, and Absorption Pharmaceuticals.

New products and services from Accuray, Cook Medical, OPKO Health, Intuitive Surgical, Skipta, Mauna Kea Technologies, and the National Comprehensive Cancer Network.

This list of U.S.-based National Institutes of Health trials is derived from the NIH’s database and includes phase I-IV hypogonadism and BPH trials that are currently recruiting participants.

Among men undergoing radiation therapy for prostate cancer, daily use of the phosphodiesterase type-5 inhibitor tadalafil (Cialis), compared with placebo, did not prevent loss of erectile function, a recently published study found.

This guide features products and services from manufacturers that are exhibiting at the AUA annual meeting in Orlando. Exhibit hall booth numbers have been included so that you can search for product demonstrations and exhibits that are of particular interest to you.