Atlanta-Five new compounds-none an antimuscarinic and all in different classes-are showing potential for overactive bladder. They may also have applications in BPH, chronic prostatitis/chronic pelvic pain syndrome, and painful bladder syndrome/interstitial cystitis (PBS/IC).
Is routine screening for bladder cancer on the horizon? Is it cost-effective? Is it practical?
In men with BPH, drugs indicated for other urologic conditions may play a role in the treatment of their lower urinary tract symptoms, suggest data from a number of studies presented at the 2006 AUA annual meeting. These studies were among those on BPH and LUTS highlighted by Claus G. Roehrborn, MD, professor and chairman of the department of urology at the University of Texas Southwestern Medical Center, Dallas.
The take-home messages on infection/inflammation at the AUA annual meeting covered a spectrum of urological conditions, including stone disease, urinary tract infection, urethritis, and interstitial cystitis. Results from both clinical studies and laboratory research have potential implications for urologists in their evaluation and management of patients with these disorders, said Anthony J. Schaeffer, MD, Herman L. Kretschmer professor and chairman, department of urology, Feinberg School of Medicine, Northwestern University, Chicago.
Urologists attending this year's AUA annual meeting found that erectile dysfunction raises the risk of stroke and heart disease, testosterone is safe in older men, phosphodiesterase type-5 inhibitors do not appear to induce an ocular disorder known as nonarteritic anterior ischemic optic neuropathy (NAION), and aggressive antiseptic washout reduces penile prostheses infections.
From the genetic basis of male reproductive dysfunction to the psychology of those who suffer from it, men who experience infertility issues continue to benefit from research into all facets of the condition.
As lifestyle choices influence the incidence of stone disease, shockwave lithotripsy appears to be losing ground as a treatment option for patients with stones of certain compositions and stones located in hard-to-reach places.
Studies of laparoscopic nephrectomy presented at the AUA annual meeting suggest that the minimally invasive procedure has come of age and produces outcomes that rival open surgery under a variety of circumstances.
Atlanta-Diet does make a difference in symptoms in patients with interstitial cystitis. Most IC patients and the urologists who specialize in treating them are aware that certain foods, beverages, and supplements exacerbate IC symptoms, and a few ease them. Evidence for this has been sketchy and anecdotal, and a study presented at the 2004 AUA annual meeting cast doubt on that common wisdom by demonstrating that instillation of solutions from pH 5 to 7.5 had no effect on symptoms.
Worcester, MA-An off-the-shelf test for an already-identified biomarker may emerge as a quick, simple, and affordable screen for aggressive renal cell carcinoma. Clinicians may soon be able to identify their highest-risk kidney cancer patients and begin aggressive treatment earlier in the course of their disease.
Houston-Obesity has emerged as a potent predictor of whether localized prostate cancer will recur or progress.
Atlanta-The idea that abuse plays a role in pelvic pain syndromes in women has been a controversial one. Now, another study is adding to that debate.
Seattle-The prognosis for patients with advanced hormone-refractory prostate cancer is improving. That is the ultimate result from the latest trial of sipuleucel-T (Provenge), published last month (J Clin Oncol 2006; 24:3089-94). The novel immunotherapy agent showed a statistically significant survival advantage and a solid safety profile. Consequently, the manufacturer plans to submit trial data later this year as the basis for a biologics license application to the FDA.
New data on outcomes of surgery, radiotherapy, and watchful waiting, along with studies of minimally invasive surgical approaches provided the core for the AUA meeting take-home messages on management of localized prostate cancer. Findings of research on outcomes of different disease management options are important in providing longer-term follow-up that generally corroborates results of previous studies, said Richard D. Williams, MD, Rubin H. Flocks professor and chairman, department of urology, University of Iowa, Iowa City.
An intravesical formulation of the chemotherapy agent docetaxel (Taxotere) appears to be safe for further investigation in patients with superficial bladder cancer that has recurred following standard therapies, according to findings from a phase I trial published in the Journal of Clinical Oncology (2006; 24:3075-80).
A three-question, noninvasive test appears to accurately classify stress and urge incontinence, according to a study in the Annals of Internal Medicine (2006; 144:715-23).
Mayo Clinic researchers say they have identified a molecule known as B7-H4 that blocks the immune system, thereby helping renal cell carcinoma grow and metastasize.
The FDA has granted approval to two devices indicated for the treatment of overactive bladder.
Heat sensitivity may make testicular cancer, and possibly other malignancies, more susceptible to standard treatments and die off more readily, according to a commentary in last week's JAMA (2006; 296:445-8).
If a protein known as BAD is inhibited, then prostate cancer cells survive, a finding that may lead to more effective drug treatments for the disease. Researchers from Wake Forest University Baptist Medical Center, Winston-Salem, NC, recently reported their findings about the BAD protein in the Journal of Biological Chemistry (2006; 281:20891-901).
When it comes to the business side of medicine, managers and physicians are irritated by the flow of paper in their office and the major investment of time and money required to manage it. So much for the paperless office!
Atlanta-Patients with metastatic hormone-refractory prostate cancer who were treated with triple therapy using docetaxel (Taxotere), thalidomide (Thalomid), and estramustine phosphate sodium (Emcyt) demonstrated a 90% response rate, defined as a decline in PSA levels of at least 50%, reported researchers from the National Cancer Institute, Bethesda, MD.
Washington-Changes are coming in the way the Centers for Medicare and Medicaid Services calculates physician payments for Medicare services. The agency is putting the finishing touches on a new plan that would provide higher physician payments for cognitive services, while making corresponding reductions in practice expense payments.
Malvern, PA and Woodstock, GA-The new LithoGold spark gap shockwave lilthotripsy unit from Siemens Medical Solutions, USA, and Shockwave Technical Service, a division of Tissue Regeneration Technologies, LLC, is built into the housing of the Siemens Modularis system, ensuring compatibility with Siemens' C-arms and the Modularis table. The unit incorporates the STS SmartTrode intelligent electrode, which automatically adjusts to the specified energy level. FDA 510(k) review is pending.
AEterna Zentaris Inc. said it will file an investigational new drug application with the FDA for permission to proceed to phase III clinical trials of cetrorelix, a luteinizing hormone-releasing hormone antagonist product candidate for the treatment of BPH. The decision follows FDA review of safety and efficacy data from an extensive phase II program of the drug.
Atlanta-An approach to transvaginal total pelvic reconstruction that uses a single piece of polypropylene mesh with four-point fixation is proving to be safe and efficacious during long-term follow-up, according to an outcomes analysis undertaken by urologists at North Shore-Long Island Jewish Medical Center, New Hyde Park, NY.
Atlanta-A study of patients receiving a double-cuff artificial urinary sphincter (AUS) shows encouraging short-term outcomes, but a second, longer-term study comparing single-cuff and double-cuff AUS indicates comparable outcomes but a greater complication rate with the double-cuff version.
Atlanta-The transobturator approach for sling placement may result in decreased pad use and overall patient satisfaction in men with stress urinary incontinence, according to the preliminary findings of a small study presented by Peter Rehder, MD, a urologist at the University of Innsbruck, Austria. The data were reported at the AUA annual meeting here.
Atlanta-Sling procedures have long been touted as minimally invasive approaches to stress urinary incontinence, but new data from UCLA suggest that complications resulting from sling surgery may happen far more frequently than is reported in the literature.
Atlanta-A sling procedure for women with stress urinary incontinence known as the distal urethral polypropylene sling (DUPS) procedure results in minimal complications and produces long-lasting results, according to 5-year results presented here at the AUA annual meeting.
