San Antonio--The United States and United Kingdom are two nations united by a common language and also an apparent proclivity for using complementary therapies to treat prostate cancer. A study presented at the AUA annual meeting found that one in four prostate cancer patients in the United Kingdom used complementary medicines. A similar report, published 2 years ago in the Journal of Clinical Oncology (2003; 21:2199-210), found that 23.5% of U.S. patients used complementary medicine.
San Antonio--Thomas Stamey, MD, professor of urology at Stanford (CA) University, more or less threw down the gauntlet last year when he and his colleagues stated in a headline in the Journal of Urology: "The prostate specific antigen era in the U.S. is over for prostate cancer: What happened in the last 20 years?" (J Urol 2004; 172:1297-301).
San Antonio--A study relating prostate size to tumor grade presented here at the AUA annual meeting appears to dispel the concern that finasteride (Proscar) as a prophylaxis for prostate cancer might increase the incidence of higher-grade tumors.
San Antonio--Initial encouraging results of sacral neuromodulation for interstitial cystitis may not hold up in the long term, according to a study from The Cleveland Clinic Foundation presented at the AUA annual meeting. The variable results raise questions about which patients may benefit best from the therapy and what the best techniques may be, but they don't preclude these urologists from offering sacral neuromodulation to these IC patients as a treatment option.
San Antonio--A number of new techniques for management of urinary incontinence and other female urologic problems are affording promising results, according to studies presented at the AUA annual meeting. However, urologists wondering about integrating those approaches into their clinical practices need to be very careful in considering the data, paying special attention to issues of durability and comparisons with existing treatment approaches, said Shlomo Raz, MD, professor of urology at UCLA School of Medicine.
San Antonio--Application of laparoscopic surgical techniques continues to expand in urology. As experience with laparoscopy grows, the efficiency and results improve. Several noteworthy presentations related to laparoscopic surgery at the 2005 AUA meeting caught the attention of Stephen Y. Nakada, MD, chairman of urology at the University of Wisconsin, Madison.
From surgical techniques to genetic manipulation, researchers continue to find new and novel ways to deal with the age-old problem of stone disease. Urologists are now better equipped to deal with the condition than they have ever been, said Glenn M. Preminger, MD, professor of urology and director of the Comprehensive Kidney Stone Center at Duke University Medical Center, Durham, NC.
No single study on the topic of sexual dysfunction leapt from the podium as a breakthrough at this year's AUA annual meeting, but a number of studies offered valuable observations about various aspects of sexual function/dysfunction. Among these were studies showing that the degree of personal involvement in restoring sexual function after radical prostatectomy correlates with the degree of success, said John Mulcahy, MD, PhD, professor of urology, Indiana University Medical Center, Indianapolis. Also, research showed that erectile dysfunction can be associated with metabolic disorders and heart disease, and when prescriptions with level 1 interactions overlap, they are often for sildenafil citrate (Viagra) and nitrates.
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.
The Interstitial Cystitis Association's new video, IC: The Basics, offers up-to-date information on theories, treatments, self-help measures, and research developments in interstitial cystitis.
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.