Two newer-generation antimuscarinic agents — solifenacin succinate (Vesicare) and tolterodine tartrate extended-release (Detrol LA) — improve symptoms of overactive bladder, but solifenacin appears to provide superior outcomes, partly because it offers a flexible dosing regimen, researchers say.
San Antonio--A combination of physical and psychological therapy for chronic pelvic pain syndrome (CPPS, or chronic nonbacterial prostatitis) can provide relief for many patients who have pain refractory to conventional treatments, according to researchers from Stanford (CA) University.
Q I read the article about "group shared appointments" in the Aug. 1, 2005, issue of Urology Times. Are there specific billing, coding, and documentation issues associated with this type of appointment?
San Antonio--The Meares-Stamey four-glass test is the gold standard for localizing bacteria and assessing inflammation in the lower urinary tract of symptomatic men. The classifications of prostatitis—bacterial, nonbacterial, inflammatory, and noninflammatory—are based on it. But few clinicians actually perform the test.
San Antonio--Robotic-assisted laparoscopic prostatectomy (RALP) is a minimally invasive procedure associated with a shorter operative time than that of conventional laparoscopy, and clinical outcomes comparing favorably to those obtained after open radical prostatectomy performed at major centers, according to a study presented at the AUA annual meeting here. David I. Lee, MD, who gathered the data while in private practice, said his findings suggest that the procedure can be successfully adapted to a community practice setting.
Despite ongoing debate over the reliability of PSA as a marker of disease progression, it remains the primary means of determining prostate cancer recurrence following local therapy as well as the establishment of androgen independence following androgen deprivation therapy (ADT). This article provides an up-to-date review on the role of PSA kinetics—PSA velocity (PSAV), PSA doubling time (PSADT), and time to PSA recurrence—in evaluation and treatment of patients with prostate cancer.
Newark, CA--The FDA has approved for marketing Novasys Medical's Renessa System, a treatment for stress urinary incontinence due to hypermobility in women unresponsive to conservative care who are not candidates for surgical therapy. The 20-minute outpatient treatment involves applying controlled heat to tissue in the lower urinary tract, denaturing collagen at multiple small sites to increase tissue resistance to involuntary leakage during increased intra-abdominal pressure.
San Antonio--PSA can be used to measure prostate size in patients with true BPH, according to a study using information from the Medical Therapy of Prostatic Symptoms (MTOPS) study. Claus G. Roehrborn, MD, and colleagues determined that in men with lower urinary tract symptoms and BPH, more than half of the PSA variability is due to prostate volume.
San Antonio--A rapid increase in PSA level could be indicative of progressive benign prostatic hyperplasia if prostate cancer is ruled out. With the push for testing PSA levels in men at earlier ages, keeping BPH in mind when tracking results over time makes sense.
San Antonio--Five-year follow-up data from the original FDA trial cohort demonstrate that transurethral microwave thermotherapy (TUMT) using the TherMatrx TMx-2000 (American Medical Systems, Minnetonka, MN) provides durable, safe treatment for men with symptomatic BPH. Study findings were presented by David M. Albala, MD, at the AUA annual meeting here.
San Antonio--Minimally invasive transurethral microwave thermotherapy using the ProstaLund Feedback Treatment (PLFT; ProstaLund, Lund, Sweden) system is a safe and effective alternative to surgery in patients with symptomatic BPH and persistent urinary retention, regardless of prostate size, according to Scandinavian investigators. Their conclusion is based on a prospective, randomized, multicenter comparison study of the two approaches presented at the AUA annual meeting here.
San Antonio--A combination of physical and psychological therapy for chronic pelvic pain syndrome (CPPS, or chronic nonbacterial prostatitis) can provide relief for many patients who have pain refractory to conventional treatments, according to researchers from Stanford (CA) University.
San Antonio--A new estimate shows that chronic prostatitis, especially nonbacterial prostatitis, is common in American men, and that most diagnosis and treatment takes place in primary care.
San Antonio--The epidemiologic confusion wrought by the introduction of the PSA test in the 1990s appears to have settled down at the opening of the new century, according to a study of biopsy patterns presented here at the 2005 AUA annual meeting. Biopsy rates that had soared early in the decade have fallen dramatically, and the incidence of prostate cancer has stabilized.
San Antonio--A study presented here at the annual AUA meeting confirmed what many urologists have suspected: The sexual health of men is affected by the severity of their lower urinary tract symptoms. Researchers also found that sexual health declined with age, while African-American patients fared slightly worse than Caucasian patients in terms of sexual function.
Please discuss the trial you presented at this year's AUA annual meeting and its implications for the use of hormonal therapy in early prostate cancer.
Chicago--As the new horse at the track, cryotherapy is struggling to show its stride as a viable, effective treatment option for early prostate cancer.
Chicago--For early-stage prostate cancer, "brachytherapy has emerged as the weapon of choice," said Gregory Merrick, MD, of the Schiffler Cancer Center and Wheeling Jesuit University in West Virginia, in his opening remarks at the Windy City Shoot-Out here.
Orlando, FL--Older men with hormone-refractory prostate cancer (HRPC) have a modest increase in risk of death compared with younger men, but only when age is considered as a continuous variable, a new study suggests. By contrast, when the same re-searchers evaluated risk of mortality in men categorized as less than 65 years and 65 years of age or older, no significant difference was found, according to the study, which was presented at the American Society of Clinical Oncology annual meeting here.
Orlando, FL--Atrasentan (Xinlay), a novel cytostatic agent, provides significant clinical benefit to patients with metastatic hormone-refractory prostate cancer, suggesting that it could be a valuable addition to the limited treatment options available for this patient population.
Orlando, FL--A small clinical trial presented at the American Society of Clinical Oncology annual meeting has demonstrated the feasibility of a vaccine strategy for the treatment of men with prostate cancer who had completed neoadjuvant chemotherapy or hormone therapy at least 6 months prior to enrollment. The multi-institutional phase II study evaluated the role of vaccination in men with rising PSA after local treatment for prostate cancer using a prime/boost approach with vaccinia virus and fowl pox virus expressing PSA.
Orlando, FL--The addition of the nonsteroidal antiandrogen bicalutamide (Casodex) to a luteinizing hormone-releasing hormone agonist (LHRHa) confers significant benefits over LHRH monotherapy as first-line treatment for advanced prostate cancer, according to a study presented by Japanese researchers at the American Society of Clinical Oncology annual meeting here.
Orlando, FL--Treatment with a novel form of immunotherapy known as APC8015 (Provenge) offers a substantial survival advantage in asymptomatic prostate cancer patients with metastatic disease who have failed to respond to hormone treatment, according to findings from a placebo-controlled phase III trial. At 36 months, 34% of the treated patients were alive versus 11% of those on placebo.
San Antonio--The adverse side effects of hormone therapy in prostate cancer patients may be more severe and manifest sooner than many might believe, according to two separate studies presented here at the 2005 AUA annual meeting.
San Antonio—Researchers continue to probe the effects of docetaxel (Taxotere) on prostate cancer in efforts to devise the most efficacious application of the compound. Combining the agent with thalidomide (Thalomid) appears to enhance survival in androgen-independent disease, according to a phase II National Cancer Institute study whose initial data appeared earlier this year.
San Antonio--The foundation for a wider application of docetaxel (Taxotere) in prostate cancer is being laid, but it is far from complete. Two major studies appearing last year allowed the drug to replace mitoxantrone (Novantrone) as a first-line treatment in hormone-resistant metastatic prostate cancer. Data from a continuing phase II study of the agent as adjuvant therapy in radical prostatectomy patients at high risk of recurrence were presented here at the AUA annual meeting. Initial findings have shown that the drug is well tolerated, with reversible side effects.
We know the PSA test is not perfect. Nevertheless, we must move forward and continue to raise awareness about prostate cancer.
Coding for cystourethroscopy
Screening for detrusor activity in women who are undergoing surgery for pure or predominant stress incontinence is not an efficient practice, according to findings from a large study presented here on Thursday.
Pelvic floor muscle training is a safe, noninvasive method to significantly improve the symptoms of stress urinary incontinence. Just 8 weeks of training can provide relief to some patients that lasts for years, Japanese researchers reported on Thursday.