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FDA Commissioner Andrew C. von Eschenbach, MD, recently received the American Association for Cancer Research Distinguished Service Award for exemplary leadership as director of the National Cancer Institute during a time of flourishing scientific and technological advances with gradually diminishing resources.

The Cleveland Clinic has announced the creation of a new institute combining the hospital's urology and nephrology programs. Andrew C. Novick, MD, will serve as chairman of the newly formed Glickman Urological and Kidney Institute.

FDA Commissioner Andrew C. von Eschenbach, MD, recently received the American Association for Cancer Research Distinguished Service Award for exemplary leadership as director of the National Cancer Institute during a time of flourishing scientific and technological advances with gradually diminishing resources.

Men who have survived for at least 1 year after being diagnosed with testicular cancer have a slightly higher risk of dying from non-cancer causes-including infections, digestive diseases, and circulatory diseases-than the general population does, a study published in the Journal of the National Cancer Institute (2007; 99:533-44) suggests. Men treated with chemotherapy in 1975 or later may be at particularly high risk.

Abuse history, other major trauma, and post-traumatic stress disorder are reported commonly in women with chronic pelvic pain, suggesting the importance of screening for post-traumatic stress disorder in these women, according to researchers at the University of North Carolina at Chapel Hill.

The stress hormone epinephrine causes changes in prostate cancer cells that may make them resistant to cell death, scientists at Wake Forest University School of Medicine, Winston-Salem, NC, report.

In prostate cancer patients receiving a gonadotropin-releasing hormone agonist, a single treatment with the bisphosphonate zoledronic acid (Zometa) significantly increases bone mineral density, according to researchers at Massachusetts General Hospital and Dana-Farber Cancer Institute, Boston.

PSA doubling time appears to be a reliable tool to distinguish which patients have prolonged innocuous PSA levels after therapy from those who are at great risk for disease recurrence and death from prostate cancer, according to researchers from the Mayo Clinic in Rochester, MN.

Excerpts from Q&A sessions that followed the coding sessions at the Urology Congress

Advances in nephron-sparing procedures have given them clear advantages over radical nephrectomy for most small renal masses, according to Stephen E. Strup, MD, an associate professor of urology at the University of Kentucky.

Most penile implant surgeries produce a positive outcome. Even problem cases can have a successful outcome with careful planning.

Synthetic materials work much better than biological ones for surgical treatment of stress urinary incontinence, in the experience of Shlomo Raz, MD, professor of urology at the University of California, Los Angeles.

In an era when reimbursement for medical services is flat to declining, there is one sure-fire way to increase revenue: Better coding.

I commonly hear, "Doc, there's nothing wrong, but will Viagra make it better?"

Infection panelist Anthony J. Schaeffer, MD, of the Feinberg School of Medicine, Northwestern University, Chicago, said it is important to draw a distinction between the syndrome of prostatitis and inflammation in the literal sense.

"It depends on the circumstances of your practice," advised Robert G. Uzzo, MD, of the Fox Chase Cancer Center, Philadelphia, and moderator of the urothelial and renal cell carcinoma session. "At our cancer center, we co-manage the patients. I'm not afraid to start a patient on a drug, and I'm not afraid to see or operate on patients taking the drug."

The therapeutic revolution that began in 1997 when the first phosphodiesterase type-5 inhibitor was approved for erectile dysfunction is poised to expand. ED is just the first, most obvious use for PDE-5 inhibitors, said Culley Carson, MD, of the University of North Carolina, Chapel Hill.

Phosphodiesterase type-5 inhibitors are the first step in the treatment of erectile dysfunction. But about 30% of men fail to respond to PDE-5 inhibitors, noted Andrew McCullough, MD. Another 20% suffer significant side effects.

The launch of two targeted therapies in the past 15 months dramatically changed the landscape for renal cell carcinoma, improving the prospects for patients with this deadliest of urologic cancers. The advances in medical treatment for metastatic RCC are not over, however, as two additional targeted therapies have shown great promise in clinical trials and may soon earn FDA approval.

Fears that testosterone replacement therapy may induce or promote prostate cancer are overblown, according to one leading urologist. The reality is that TRT can be a safe and effective treatment for hypogonadal men.

Medical therapy has a long history as a first-line treatment for men with lower urinary tract symptoms, and recent data have brought into focus which drugs work best for which men, according to Claus G. Roehrborn, MD, of the University of Texas Southwestern Medical Center in Dallas. Combination therapy-not necessarily the combination that urologists are most familiar with-also plays an important role.

With seven approved drugs for overactive bladder already on the market, the potential for new treatments might seem to be limited. The reality is that OAB treatment is still not optimal.

What advice do you have for managing adults with complaints of nocturia?

What are your criteria for triggering intervention in prostate cancer patients undergoing surveillance?

What have we learned from the work of Dean Ornish, MD about the effect of diet on prostate cancer prevention?

Urologists currently have several minimally invasive surgical therapies (MIST) for the treatment of BPH, but each has advantages and disadvantages that must be considered before initiating treatment. Newer MIST modalities tend to fall somewhere between the old standby of transurethral resection of the prostate and medical therapy, according to presenter Kevin T. McVary, MD, of the Feinberg School of Medicine, Northwestern University, Chicago.

Antimuscarinic agents are the primary pharmacologic therapies for overactive bladder, and their ranks continue to grow. The agents in this class-oxybutynin (Ditropan), tolterodine (Detrol), trospium (Sanctura), solifenacin (Vesicare), and darifenacin (Enablex)-are similar in efficacy and side effects, but not identical.