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Early research on the use of gene transfer to treat erectile dysfunction shows promising results and suggests the potential for using the technology to treat overactive bladder and other conditions, according to researchers from North Carolina and New York.

Cleveland-Intraprostatic injection of mepivacaine epinephrine through a specialized catheter reduces the need for analgesia, as well as treatment time and energy consumption in patients undergoing high-energy transurethral microwave thermotherapy (TUMT) for BPH, researchers reported here.

Chicago-Although chemotherapy reigns supreme as the most effective systemic therapy to treat advanced prostate cancer, it is being contested with the rapid emergence and development of novel agents that are showing great promise in targeting pathways of cancer without causing damage to normal cells. However, it doesn't appear that chemotherapy will be relegated to the history books any time soon. Even if targeted therapies prove to be all they promise they may be, chemotherapy may still be essential.

Chicago-With the evolving definition of advanced prostate cancer that now includes a number of clinical states not previously defined, treatment has also evolved into a multimodal approach. This mandates close cooperation among urologists and medical and radiation oncologists to ensure optimal patient care, according to leading oncologists.

Chicago-One of the most difficult issues in the management of prostate cancer is identifying which men with indolent disease are at increased risk of progressing to more advanced disease. Reliance on traditional clinical prognostic factors, including PSA, has provided some guidance on treatment, but all too often, men with indolent disease are over-treated based on an incomplete knowledge of disease risk.

Cleveland-Although their data show otherwise, a group of researchers at the University of Rochester (NY) Medical Center have faith that using a cautery-free approach with Weck clips to preserve the neurovascular bundle during robot-assisted prostatectomy is a better choice than bipolar cautery.

Cleveland-Preoperative transrectal ultrasound biopsies are not always reliable tools for predicting positive surgical margins and tumor location in nerve-sparing robotic radical prostatectomies. However, this unreliability may be partly due to the biopsy results coming from outside labs and pathologists versus in-house evaluations.

Cleveland-Intraprostatic injection of mepivacaine epinephrine through a specialized catheter reduces the need for analgesia, as well as treatment time and energy consumption in patients undergoing high-energy transurethral microwave thermotherapy (TUMT) for BPH, researchers reported here.

Beginning in 1998, consensus conferences concerning the grading of urothelial cancer addressed removal of the word "carcinoma" from low-grade papillary tumors with little or no malignant potential. The subsequent change in terminology has been controversial, however, and many pathologists as well as most urologists continue to use the traditional three-grade classification system.

National Report-With another year of Medicare payment cuts looming in 2007, declining reimbursement is no surprise as the number one current concern among practicing urologists, according to an exclusive survey from Urology Times and its sister publication, Contemporary Urology. Changes in reimbursement are followed closely by malpractice, office overhead, pay for performance, and increasing regulations as the top five issues that urologists are extremely or very concerned about, the first State of the Specialty survey found.

Ankara, Turkey-Elevated PSA levels and the presence of urinary tract infection are the symptomatic parameters that are most predictive of acute urine retention in men with BPH, according to a group of Turkish researchers. Their data also suggest that plasmakinetic resection of the prostate may provide 1-year outcomes similar to those of open prostatectomy in BPH patients who do not have retention.

Men with overactive bladder and lower urinary tract symptoms who receive combination therapy are more likely to report improvement in symptoms than those who receive only one medication, according to results of a study recently reported in JAMA (2006; 296:2319-28).

Three new staff members have joined the Cleveland Clinic Glickman Urological Institute: Jeffrey Palmer, MD, is the director of minimally invasive surgery, pediatric urology; Courtenay K. Moore, MD, is a specialist in female urology; and Edmund Sabanegh, MD, is head of the section of male infertility.

Vardenafil (Levitra) appears to be effective at first dose, with continued success in treating erectile dysfunction in men with associated medical conditions, including hypertension, diabetes, and dyslipidemia, the authors of a Canadian study report.

Treatment with anti-thymocyte globulin (rabbit [Thymoglobulin]) results in a significantly reduced risk of acute rejection and acute rejection requiring antibody therapy and a similar risk of delayed graft function, graft loss, and death in kidney transplant patients compared with patients receiving induction therapy with basiliximab (Simulect), according to a study published this month in the New England Journal of Medicine (2006; 355:1967-77).

Topiramate (Topamax), a drug commonly prescribed to treat seizures and migraines, can increase the propensity for calcium phosphate kidney stones, according to a study by researchers at the University of Texas Southwestern Medical Center in Dallas.

Men with overactive bladder and lower urinary tract symptoms who receive combination therapy are more likely to report improvement in symptoms than those who receive only one medication, according to results of a study recently reported in JAMA (2006; 296:2319-28).

PSA velocity is an accurate gauge of prostate tumor aggression and danger, even when PSA levels are so low as to not warrant a biopsy, according to researchers at the Brady Urological Institute, Johns Hopkins University School of Medicine, Baltimore.