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Studies in urinary tract infections provided the foundation for rapid diagnosis of common urinary tract infection pathogens and opened windows into the mechanisms underlying chronic prostatitis and interstitial cystitis, two diseases characterized by their resistance to treatment.

Long-term results from Southwest Oncology Group trial S8949 confirm the original study finding that performing palliative debulking surgery prior to starting systemic therapy with interferon alfa-2b confers a survival benefit in patients with advanced renal cell carcinoma.

Results of a phase three study evaluating second-line chemotherapy with gemcitabine/paclitaxel for metastatic bladder cancer failed to answer its primary question of whether maintenance treatment is superior to a temporary six-cycle regimen because maintenance treatment was usually not possible. However specific subgroups of patients who may be more likely to benefit from this combination regimen after failing first-line chemotherapy.

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.