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This article describes a risk-stratified approach based on a three-zone anatomic layout to the periprostatic neural architecture and a modified athermal robotic technique for better continence and potency outcomes without compromising surgical margin rates.

The value and timing of chemotherapy in patients undergoing cystectomy for clinically localized bladder cancer has long been controversial. There are myriad reasons supporting both neoadjuvant and adjuvant chemotherapies.

Urologist Andrew C. Novick, MD, chairman of the Cleveland Clinic Glickman Urological and Kidney Institute, died Oct. 18 from complications of lymphoma. He was 60.

An algorithm based on near-infrared spectroscopy (NIRS) is able to correctly identify more than 85% of men classified as obstructed, using catheter urodynamics, according to study findings published in the Canadian Journal of Urology (2008; 1515:4241-8).

A profound gap exists in the understanding of physicians about the literacy levels of their patients related to the efficacy of written screening tools, including the International Prostate Symptom Score, researchers from Emory University School of Medicine, Atlanta, reported.

Use of 5-alpha-reductase inhibitors is not associated with increased risk of hip fracture, according to a study published in JAMA (2008; 300:1660-4).

Older and younger patients with renal cancer derive similar benefit from sorafenib (Nexavar) therapy and tolerate the drug equally well, according to a study from the United Kingdom.

Watson Pharmaceuticals has received FDA approval to market silodosin (Rapaflo), an alpha-blocker for the treatment of BPH signs and symptoms.

Elevated serum follicle-stimulating hormone does not predict a lower sperm retrieval rate for men with nonobstructive azoospermia undergoing microdissection tes­ticular sperm extraction, and should not be considered a contraindication for this fertility procedure.

Tubeless percutaneous nephrolithotomy can be performed safely and effectively without preoperative selection, and it appears to be associated with fewer postoperative intracorporeal changes than standard percutaneous nephrolithotomy.

A gel formulation of oxybutynin for overactive bladder is nearing commercial availability, with the potential for a significant improvement in cosmesis and skin-related side effects.

In the search for novel biomarkers for prostate cancer diagnosis, a urinary assay for prostate cancer gene 3 (PCA3) has emerged as a promising modality.

Evaluating the efficacy of radiofrequency ablation of renal cortical tumors requires a degree of patience because histologic changes and cell death in and near lesions targeted by the treatment may continue to evolve for a year or even longer.

A diagnostic assay based on computer chip technology could allow clinicians-and perhaps patients-to identify urinary tract pathogens in 45 minutes or less and it might also determine antibiotic susceptibility.

Incorporating image guidance into robotic surgery significantly enhanced tumor resection in a series of mock procedures involving surgical phantoms

Minneapolis-Coloplast's Titan inflatable penile prosthetic implant is designed for use in men who have erectile dysfunction as a consequence of nerve damage after prostatectomy and who do not respond to oral ED therapy. The implanted device now features a low-profile pump with inflate/deflate touch pads that move at the patient's control to emulate the look and performance of a natural erection. The One-Touch Release pump is designed to make it easier for patients to learn to operate the device.

An adjustable urethral prosthesis significantly improved urinary symptoms, urine leakage, and quality of life in women with stress urinary incontinence who had failed to improve after prior therapy.

Complications after laparoscopic radical prostatectomy demonstrates the effect of a learning curve and the benefits of improved surgical technique, but shows little difference in overall morbidity when compared with those of anatomic radical retropubic prostatectomy .

In overactive bladder, percutaneous tibial nerve stimulation performs just as well as well as the most frequently prescribed drug.

Tensioning is a challenge in transvaginal tape procedures for stress urinary incontinence.

Two investigational BPH therapies are yielding positive efficacy results in men with the condition, according to studies presented at recent AUA section meetings.

Counting the copies of a specific gene in cells gathered from a urine sample may provide a simple, noninvasive way to detect bladder cancer, according to researchers at The University of Texas M.D. Anderson Cancer Center in Houston.

Among men with nonmetatastic prostate cancer receiving androgen deprivation therapy, once-weekly alendronate (Fosamax) improves bone density and decreases turnover, according to data published in the Journal of Clinical Oncology (2008; 26:4426-34).

Researchers at Fox Chase Cancer Center in Philadelphia have developed a prediction tool that uses a prostate cancer patient's clinical information to estimate the benefit of adding androgen deprivation therapy of various durations to radiation therapy.

A panel of experts convened by AUA has determined that primary cryosurgery is an option for men who have clinically organ-confined prostate cancer of any grade with negative metatastic evaluation. Clinicians using cryosurgery are advised to review this best practice statement, which will be published in the Journal of Urology.

Delayed hemorrhage occurs in less than 2% of the patients following laparoscopic nephrectomy, but that's too few patients to identify any preoperative or perioperative factors that might increase the risks of delayed hemorrhage.

While concerns have been raised about a relationship between shock wave lithotripsy and diabetes or hypertension, data are still lacking.

Stephen Y. Nakada, MD, interviews Jihad Kaouk, MD, about the nuances of single-port surgery technique, patient selection, the learning curve, technical modifications, and outcomes.