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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.

Mounting evidence suggests that finasteride (Proscar) can prevent the clinical manifestation of prostate cancer. Whether eligible men should receive the drug routinely must be an individualized decision, said Eric Klein, MD, of the Cleveland Clinic Lerner College of Medicine.

Seven genetic risk factors (DNA sequences) that determine prostate cancer risk have been identified by researchers from the University of Southern California in Los Angeles and Harvard Medical School in Boston.

A new, less-invasive treatment for female stress urinary incontinence has garnered clearance from the FDA.

Inflammation may strongly affect metastasis of prostate cancer, according to researchers from the University of California, San Diego. Their findings may result in development of new drugs to block prostate cancer metastasis.

A soy-rich diet offers mixed results on its impact on the risk of prostate cancer, according to a large study from the National Cancer Center in Japan.

Patients with prostate cancer who are being treated with androgen deprivation therapy (ADT) have three times the risk of periodontal disease as do patients who are not taking the therapy, according to a study published recently in the Journal of Urology (2007; 177:921-4).

Weekly oral treatment with the bisphosphonate alendronate (Fosamax) may prevent bone loss and bone turnover resulting from androgen deprivation therapy (ADT) in men with prostate cancer, researchers from the University of Pittsburgh Medical Center report.

Low-dose multidetector CT (MDCT) that uses a modulated tube current system may be as precise as the standard dose in the detection of urinary stone disease, regardless of the patient&'s weight, Belgian researchers report.

The FDA’s Office of Cellular, Tissue and Gene Therapies Advisory Committee has recommended to the FDA that there is substantial evidence of efficacy and safety of sipuleucel-T (Provenge) for patients with asymptomatic, metastatic hormone-refractory prostate cancer.

With 183 drugs tied to painful bladder syndrome/interstitial cystitis and none hitting a home run, what should clinicians do?

New products and services available to urologists.

This article reviews the current state of knowledge of the incidence and pathophysiology of bone loss and skeletal events in patients with prostate cancer who are on ADT.

Among women with stress incontinence and no signs of detrusor overactivity, there exists a significant subgroup with low voided volumes, high incidences of urgency and urge-related leaks, and relatively severe symptoms that can only be identified through careful evaluation.

Dorsal genital nerve stimulation using a minimally invasive, pre-pubic approach appears to reduce the symptoms of overactive bladder and is well tolerated by patients, according to results of a prospective, multicenter feasibility study.

In a study designed to uncover patterns of synthetic mesh use, researchers found that those doctors who are most likely to use mesh are male surgeons, those in private practices, and those who did not undergo fellowship training.

Infertile men with varicoceles demonstrate reductions in Leydig cell count, along with compensatory hypertrophy and signs of oxidative stress.

Vasovasostomy anastomosis that is reinforced by tissue sealants is significantly less time-consuming than standard suture techniques and less likely to leak, and certain glues perform better than others.

Because almost 94% of painful bladder syndrome/interstitial cystitis patients experience pain in some part of their body, pain management is essential.

Exactly what painful bladder syndrome/interstitial cystitis is, how many people have it, what the risk factors are, what its causes are, what its natural history is, and how it differs from other types of voiding dysfunction in men are questions still looking for answers.

The lack of standardization and agreement [about what to call interstitial cystitis] are major impediments to the progress we all hope to see.

Growth factors may play a role in the micro-recanalization that can occur after vasectomy.