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Pediatric urologists have confirmed that environmental pollutants can impair male sexual development and fertility and that reinnervation of the bladder after spinal cord injury may be within reach.

Studies that looked at botulinum-A toxin for overactive bladder, studies of the transobturator male sling, and an investigation of stem cell injections for stress urinary incontinence all show promise, but all raise important clinical questions.

Bacillus Calmette-Guerin remains the treatment of choice for bladder cancer in the United States, but more than half of patients with nonmuscle-invasive bladder cancers will eventually fail BCG. Several promising alternative treatments are under development, but radical cystectomy remains the optimal choice for patients who fail BCG.

The bisphosphonate zoledronic acid (Zometa) offers significant benefit in lowering the skeletal-related events rate in patients with bony metastatic bladder cancer, according to results of a prospective, randomized, placebo-controlled study.

Blockage by the selective inhibitor abiraterone acetate of cytochrome P (CYP) 17 is safe and has significant antitumor activity in castration-resistant prostate cancer, according to a phase I study from the Royal Marsden NHS Foundation Trust, Sutton, Surrey, United Kingdom. The data confirm that castration-resistant prostate cancer commonly remains dependent on ligand-activated androgen receptor signaling, study authors say.

Men age 75 years and older should not be screened for prostate cancer, and younger men should discuss the benefits and harms of the PSA test with their clinicians before being tested, according to a new recommendation from the U.S. Preventive Services Task Force published in the Annals of Internal Medicine (2008; 149:185-91).

A minimally invasive treatment for varicoceles can significantly improve a couple’s chances of achieving pregnancy, according to a study published in Radiology (2008; 248:540-9). The study, conducted at the University of Bonn in Germany, also found that the level of sperm motility prior to treatment is a key predictor of success.

A phase I trial shows that an adenovirus/ PSA vaccine is safe and can induce anti-PSA antibody and T cell responses in a significant number of men with stage D2 or D3 prostate cancer, researchers from the University of Iowa, Iowa City, reported

Outside of the United States, technology for HIFU is available from two companies. HIFU is being used as primary treatment for men with small prostates and low-stage, low-volume disease, particularly in those who are not good candidates for conventional treatments because of their age or comorbidities. It is also being used as salvage treatment after failure of radiation therapy.

In this exclusive article, Urology Times Editorial Consultant Philip M. Hanno, MD, professor of urology at the University of Pennsylvania, asks FDA Commissioner Andrew C. von Eschenbach, MD, about his role at FDA, his priorities and goals, and issues facing the agency and the U.S. health care system.

Urologists continue to face a controversial, challenging question: Which course of treatment is best for low- to intermediate-risk prostate cancer? In recent years, 90% of newly diagnosed prostate cancer patients have this level of disease, so the question is increasingly relevant to clinical practice.

Leading European urologists have reviewed the findings from the Prostate Cancer Prevention Trial (PCPT) and have reached consensus supporting the use of finasteride (Proscar) as a chemopreventive agent for the disease. A similar consensus statement in the United States appears to be coming soon.

Research continues to progress in developing promising new oncologic markers for diagnosing prostate cancer. Ultimately, researchers hope to address the challenge of identifying a biomarker that can help physicians differentiate indolent from aggressive prostate cancer to avoid overtreatment of the disease.

New data confirm that excellent clinical outcomes can be achieved when men with node-positive prostate cancer are treated with a multimodal approach combining radical prostatectomy, pelvic lymph node dissection, and adjuvant hormonal treatment, investigators reported.

Salvage cryotherapy for locally recurrent prostate cancer following primary radiotherapy is curative in approximately one-third of men after 10 years of follow-up, according to results from a retrospective chart review investigating long-term treatment outcomes.