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When Stephen Y. Nakada, MD, chairman of the department of urology at the University of Wisconsin, looks to the future, he sees increasing use of robotics, advances in ureteroscope technology that will bring more flexibility and greater clarity to imaging, and the use of computer-driven simulators that will allow both novice and experienced surgeons to learn new skills and hone old ones.

When Howard M. Snyder, MD, was asked to moderate a session on the latest developments in pediatric urology at the American College of Surgeons clinical congress last fall, he didn't have to think twice about the topics he wanted to cover.

More effective treatment will come as interstitial cystitis becomes better defined and research makes inroads on the epidemiology and etiology of this enigmatic and difficult-to-treat condition.

Ongoing research into the pathogenesis of recurrent urinary tract infections is fundamentally changing how scientists view this common problem and may some day alter how clinicians manage it. The research, led by Scott Hultgren, PhD, of the University of Washington in St. Louis, describes a developmental process whereby uropathogenic Escherichia coli invade the superficial epithelial cells of the bladder and contribute to recurrent UTIs.

The use of non-embryonic stem cells and the growing popularity of botulinum toxin are among key trends to watch for in the management of stress incontinence and overactive bladder, respectively, said Shlomo Raz, MD, director of female urology, urodynamics, and reconstructive surgery at UCLA Medical Center.

Linthicum, MD--Leaders of the American Foundation for Urologic Disease (AFUD) and the Executive Committee of AUA have reached an agreement that will bring AFUD under the aegis of AUA. Beginning this month, AFUD will operate under the name of the American Urological Association Foundation (AUAF).

Istanbul, Turkey--Swiss data add to growing evidence that injecting botulinum toxin A (Botox) into the detrusor muscle is a safe and efficient treatment option in patients suffering from overactive bladder, particularly in cases that prove refractory to other more conventional treatment modalities, like anticholinergic agents and physiotherapy.

This special issue takes an up-close look at what’s new, and what’s coming, in key areas of clinical urology. UT’s board members share their expert views on what to expect at this month’s AUA annual meeting and beyond.

Tamoxifen (Nolvadex) reduces the frequency of gynecomastia and breast pain in prostate cancer patients taking bicalutamide (Casodex), according to a study in Lancet Oncology (2005; 6:295-300).

The FDA has authorized a label change for the phosphodiesterase type-5 inhibitor tadalafil (Cialis), removing a contraindication on the use of the drug with alpha-blockers.

The University of Pittsburgh Medical Center Shadyside said it will become the first hospital to institute the Urological Comprehensive Care Program (UCCP), a new model of care to increase patient satisfaction while reducing medical errors.

Human epidermal growth factor receptor 2 (HER-2), associated with breast cancer, is a key culprit in prostate cancer recurrence, say researchers from the University of North Carolina at Chapel Hill.

The use of magnetic resonance spectroscopy to evaluate prostate tumors may help identify the most appropriate treatment, according to a study published in Cancer Research (2005; 65:3030-4).

Cryosurgery appears to be a promising primary treatment for prostate cancer, even in men with high-risk features, according to results of a 4-year study published in Cancer (2005; 103:1625-30).

A particular signature set of inherited characteristics and mutations in mitochondrial DNA (mtDNA) significantly increases the risk of kidney and prostate cancers in men, according to a presentation at the American Association of Cancer Research annual meeting in Anaheim, CA.

Tamoxifen (Nolvadex) reduces the frequency of gynecomastia and breast pain in prostate cancer patients taking bicalutamide (Casodex), according to a study in Lancet Oncology (2005; 6:295-300).

For the third straight year, Urology Times will bring readers E-news Daily Meeting Report--free daily news updates from the upcoming AUA annual meeting in San Antonio, delivered directly to your e-mail box.

No patient has developed urinary retention or elevated post-void residuals following our modified injection technique.

Links to many manufacturers exhibiting at the 2005 American Urological Association meeting in San Antonio. Exhibit Hall booth numbers have been included so that you can find items and exhibits of particular interest to you.

Istanbul, Turkey--Nearly half of men with self-described erectile dysfunction report the occurrence of premature ejaculation either "always" or "frequently," according to data from the Men's Attitudes to Life Events and Sexuality (MALES) study.

Istanbul, Turkey--Chronic prostatitis appears to be significantly associated with psychological disorders, such as depression, anxiety, and panic, according to the results of a German study. The study also found that pelvic pain symptoms are far less prevalent than expected (3.2%), while the mean age of afflicted men was significantly higher than noted in previous trials (60.6 years).

Istanbul, Turkey--Prostate inflammation significantly raises the risk of clinical progression in men with lower urinary tract symptoms and BPH, according to a first-time investigation into the impact of acute and/or chronic inflammation on men with BPH. The most significant impact of acute or chronic inflammation was an increased risk of acute urinary retention, particularly in patients receiving placebo, according to the analysis, based on a subset of patients from the Medical Therapy of Prostatic Symptoms (MTOPS) patient cohort.

Istanbul, Turkey--Transurethral microwave thermotherapy of the prostate offers a 50% improvement in pain in up to two-thirds of patients with chronic prostatitis/chronic pelvic pain syndrome, which is comparable to other treatment modalities, according to researcher Christof Kastner, MD, PhD. The therapy also appears to promise good durability 2 years post-procedure.

Istanbul, Turkey--Biofeedback physical therapy and pelvic floor re-education appear to offer symptomatic improvement in men with chronic pelvic pain syndrome type III, Dutch researchers say. The techniques appear to work by improving relaxation and demonstrating proper use of pelvic floor muscles.

No patient has developed urinary retention or elevated post-void residuals following our modified injection technique.

Orlando, FL--How likely are patients who have undergone radical prostatectomy to present with rising PSA levels and subsequent metastatic progression? Researchers at Memorial Sloan-Kettering Cancer Center employ a computerized tool called a nomogram to find the answer.

Orlando, FL--The management of localized prostate cancer has undergone a significant, dramatic shift in recent years. Both pure and robot-assisted laparoscopic prostatectomy appears to be a viable treatment option that is popular with patients; watchful waiting has declined, despite the stage migration seen in the PSA era; and hormonal therapy has become more widely used in low-risk patients, a source of controversy.

Washington--Both physicians and Medicare beneficiaries are in for a jolt next year, according to government officials who indicated in late March that Medicare will slash physician payments by 4.3% in 2006 and slap beneficiaries with an $11 per month premium increase.

Abundant choices for any budgetFrom Caribbean and Continental to Southwest fare and seafood, restaurants in San Antonio offer an abundance of choices to suit your taste and budget.Below is a list you can refer to during the AUA annual meeting. Urology Times thanks San Antonio urologists Allen Morey, MD, Juan Reyna, MD, Michael Sarosdy, MD, and Ritchie Spence, MD, for commenting on some of their favorite area restaurants.Note that the area code for all restaurants in 210.

Montreal--Phosphodiesterase type-5 inhibitors appear to be effective in treating erectile dysfunction in men who are also receiving pharmacologic treatment for depression. A retrospective study presented here at the Canadian Psychiatric Association annual meeting that looked specifically at tadalafil (Cialis) demonstrated that the drug was effective in improving erections and achieving intercourse in this population.