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In patients with prostate cancer, measures of PSA kinetics are proving to be accurate predictors of outcomes as well as treatment efficacy in those patients who are receiving systemic therapy. This, along with reports about the use of traditional and nontraditional agents for slowing the progression of PSA rise and the effects of androgen deprivation on bone, headed the key take-home messages in advanced prostate cancer presented at this year's AUA annual meeting.

One by one, drug-resistant microbes have weakened or destroyed the efficacy of established antimicrobials. The appearance of a strain of urinary tract infection-associated Escherichia coli that is resistant to ciprofloxacin (Cipro, Proquin) is not necessarily a surprise, but it is a significant concern, according to Anthony J. Schaeffer, MD, chairman of the department of urology, Northwestern School of Medicine, Chicago.

Advances in the field of male infertility continue to provide insight into the factors and processes that make fertility possible. Ultimately, the advances lead to techniques that extend the possibility of fertility to an ever-increasing population of patients.

Across a spectrum of indications, minimally invasive procedures are having a major impact on the practice of pediatric urology, said Howard Snyder, MD, professor of surgery in urology, University of Pennsylvania School of Medicine and Children's Hospital of Philadelphia. This observation was evident in a number of papers presented at the AUA annual meeting.

San Antonio--With new technology that performs large-scale genotyping, researchers are homing in on the genes responsible for interstitial cystitis. It won't be long before they know what those genes are, and a specific drug target or even gene therapy for IC could soon follow.

San Antonio--Youth, usually seen as an asset in clinical situations, confers no advantage in clinical outcomes following radical prostatectomy. In fact, a study from the Mayo Clinic, Rochester, MN, found that high-risk patients younger than age 55 years were more likely to suffer systemic disease progression than older, high-risk patients and that age at treatment offers little to no prognostic value when all other clinical factors are being considered.

The 2005 AUA annual meeting in San Antonio proved to be fertile ground for research on both epidemiologic trends and clinical aspects of benign prostatic hyperplasia and lower urinary tract symptoms—medical therapy, minimally invasive treatments, and phytotherapy. Data from several key studies appeared to clarify the role of various treatment modalities in selected patient populations. Not all the news was positive, however, as one study showed no significant effect with saw palmetto, a commonly used herbal therapy.

Aloe Vesta Protective Barrier Spray from ConvaTec is an occlusive barrier that repels moisture and protects skin from irritants in urine, feces, and exudate.

The evadri Bladder Control System from Hollister, Inc. is an office-based pelvic floor muscle retraining program that includes six to eight sessions of lifestyle adjustment, monitored Kegel exercises, and biofeedback combined with a home-based exercise program for effective bladder control in as few as 6 weeks.

Indevus Pharmaceuticals, Inc., Lexington, MA has licensed exclusive U.S. rights from Schering AG, Germany to market Nebido, a long-acting injectable testosterone preparation for the treatment of male hypogonadism.

The discovery that microscopic evidence of prostate cancer is present in some men with a normal PSA level (

Scientists in the United Kingdom report that a single dose of carboplatin (Paraplatin) after surgery for early testicular cancer is as safe and effective as 2 to 3 weeks of radiotherapy after surgery, with less toxicity, and with durable results.

Circumcision has fallen out of favor in recent years, but an Australian meta-analysis of published data and a French study for the country's National AIDS Research Agency may turn that trend.

An investigational laboratory test known as BPH-A may help identify BPH, researchers reported at a joint meeting of the International Federation of Clinical Chemistry and Laboratory Medicine and American Association for Clinical Chemistry in Orlando, FL.

Three risk factors--PSA doubling time, Gleason score, and time from surgery to biochemical recurrence--can be used to determine whether to treat patients aggressively or carefully following radical prostatectomy for prostate cancer, according to a study published last week in JAMA (2005; 294:433-9).

The U.S. House of Representatives has passed a bill that would limit punitive damages in medical liability lawsuits.

The Centers for Medicare & Medicaid Services has announced the details of a proposed rule that would lower payment rates and revise payment policies under the Medicare Physician Fee Schedule.

Urologists should recommend that their patients with stones maintain a normal intake of calcium.

Barr Laboratories, Inc. has received FDA approval to market a generic version of desmopressin acetate tablets in 0.1- and 0.2-mg strengths. The agent is indicated for the treatment of primary nocturnal enuresis.

Imaging and Urodynamics of the Lower Urinary Tract is a new textbook from publishers Taylor & Francis. The book is a comprehensive reference on lower urinary tract imaging and nonendoscopic assessment, divided into separate sections on the bladder and the urethra.

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San Antonio--Although it may be routine at any number of tertiary care institutions and centers of excellence, the practice of automatically reviewing pathology slides that accompany referred bladder cancer patients nets little gain for either physicians or patients. In an overwhelming majority of instances, the practice does little more than add unnecessary dollars to the cost of treatment, according to a study presented at the 2005 AUA annual meeting here.

Orlando, FL--Radical cystectomy with pelvic lymph node dissection is the mainstay surgical treatment of locally advanced bladder cancer. Despite aggressive surgery, half of patients experience recurrence and die of the disease following cystectomy alone. However, there is evidence that patients receiving optimizing therapy (ie, neoadjuvant chemotherapy before cystectomy, radical cystectomy, and adequate lymph node dissection) have prolonged survival, compared with those treated with cystectomy only.

Orlando, FL--Gemcitabine (Gemzar) administered as an intravesical instillation appears to be well tolerated and to demonstrate modest efficacy in patients with stage Ta, grade I/II urinary bladder cancer, with about one-third of patients achieving a response. However, a twice-weekly dose given for 3 weeks is comparable in efficacy to a once-weekly dose given for 6 weeks, a new study suggests, and a single dose given once is not effective in this patient population.

San Antonio--Ureteroscopy is associated with significantly better outcomes than extracorporeal shock wave lithotripsy (ESWL) for the treatment of proximal ureteral stones, according to the results of a prospective randomized study undertaken by urologists at the University of Innsbruck, Austria. The researchers now recommend the ureteroscopic approach as first-line treatment for proximal stones, they said at the 2005 AUA annual meeting here.

Orlando, FL--An investigational agent that inhibits both Raf kinase and vascular endothelial growth factor receptor significantly prolongs progression-free survival in pa-tients with advanced renal cell carcinoma, according to results of a phase III clinical trial presented at the American Society for Clinical Oncology annual meeting here.

Washington--The federal government is preparing restrictions on the physician-owned specialty hospital industry, an emerging field it says could be a financial boon to physician investors and unfair competition to traditional hospitals and ambulatory surgery centers.

New York--Imaging and Urodynamics of the Lower Urinary Tract is a new textbook from publishers Taylor & Francis. The book is a comprehensive reference on lower urinary tract imaging and nonendoscopic assessment, divided into separate sections on the bladder and the urethra.