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Washington--Federal officials, after considering arguments and concerns presented by urologists and others, have decided to continue coverage for nearly 100 procedures performed in ambulatory surgical centers, including three urologic procedures, instead of removing them from the approved list as had been previously proposed.

Sen. Chuck Grassley (R-IA) proposed legislation Tuesday that would end federal funding for "lifestyle" drugs such as sildenafil (Viagra), tadalafil (Cialis), and vardenafil (Levitra) to treat sexual and erectile dysfunction. Coverage would be provided if the drugs are prescribed for a purpose other than sexual performance.

Methylation-specific polymerase chain reaction (M-PCR) is a sensitive, specific, fast, and relatively inexpensive method of diagnosing Klinefelter's syndrome, according to data presented here by Peter N. Schlegel, MD, and colleagues from Cornell University, New York.

Midpoint results of a 5-year multi-center IDE study comparing a new cooled transurethral microwave thermotherapy device against the conventional 60-minute Targis treatment (both from Urologix, Minneapolis) were announced here on Wednesday, and the data appear promising.

Conflicting with results of previous trials, saw palmetto showed no effect on urinary symptoms or objective measures of BPH in a study reported at the AUA annual meeting yesterday.

Findings from a large study of prospectively evaluated men demonstrate that digital rectal exam is an independent predictor of prostate cancer in men undergoing prostate needle biopsy.

A new study examining the expression of the vascular endothelial growth factor (VEGF) family of proteins in kidney cancer has yielded several important findings, including the identification of different expression profiles of VEGF proteins in clear cell and papillary type renal cell carcinoma.

Patients who have other primary cancers have increased risk for renal cancer, the authors of a retrospective study reported yesterday. But while physicians should be alert to the possibility of renal cancer, the risk is not high enough to warrant that all patients in this population should be screened, the authors advise.

An inherited syndrome known as hereditary leiomyomatosis and renal cell cancer (HLRCC) has a more aggressive clinical course than other hereditary renal cancer syndromes, according to a new study. The authors recommend surgical therapy early in the course of treatment of HLRCC patients rather than expectant management.

Men who experience painful recurrent varicoceles after undergoing conservative treatment and failed surgical repair are best served by microsurgical varicocelectomy, according to Canadian researchers.Of 11 men who had failed standard varicocelectomy and experienced pain before and after surgery, 10 experienced a favorable response following microsurgical repair, according to investigators."In my mind, microsurgical varicocelectomy is the gold standard, and non-microsurgical repair is sub-standard," said lead author Armand Zini, MD, associate professor of urology at McGill University, Montreal. "However, few urologists are able to perform this procedure, since they have not been trained properly."

The prevalence of women being discharged for stone disease has increased in recent years, according to research presented here yesterday. The rate of discharges for men with stone disease over the same period increased slightly for renal calculi and decreased in the case of ureteral calculi.

Genetic factors may play a role in the pathophysiology of vaginal prolapse in women younger than 55 years, according to a study presented yesterday.

Botulinum toxin A (Botox) injections show potential for providing a quick, easy, and safe treatment option for men with lower urinary tract symptoms related to BPH, but two small studies presented yesterday provided equivocal results regarding the efficacy of this investigational approach. U.S. researchers tested their 10-minute, ultrasound-guided technique in a two-part study. In the first part, 10 patients were injected with botulinum, 100 units, to assess safety, International Prostate Symptom Score, flow rates, and bother scores. In the second part, 30 patients received 200 units of botulinum in a sham-controlled, double-blind study, and sequential MRIs were taken pretreatment and at 1 and 3 months post-treatment to measure prostate volume.

For most of her life, former Olympic gymnast Mary Lou Retton suffered from severe urgency and frequency related to overactive bladder. It wasn't until she consulted a urologist just over a year ago that Retton, now 37, received relief from her sometimes debilitating symptoms.Retton has gone public with her personal struggle in a campaign backed by Pfizer. She said she hopes her own experience will help others with the condition seek proper care.

A new laparoscopic ultrasound probe recently cleared for market by the FDA is being offered as an option on Endocare, Inc.'s Cryocare CS System.

Findings from two studies presented at the AUA meeting here yesterday provide further evidence that obesity negatively affects prostate and bladder cancer outcomes.

A study estimating the dispensation rate of interacting medications to an outpatient population found that while only 0.05% of patients received co-prescriptions for medications that could potentially cause adverse effects, about half of these were given were for sildenafil citrate (Viagra) and one of two different nitrates.

The adverse side effects of hormone therapy in prostate cancer patients may be more severe and may manifest sooner than many believe, according to two separate studies discussed here yesterday.

Genitofemoral (GF) nerve grafting during radical retropubic prostatectomy can be performed safely with a low risk of postoperative morbidity and shows promising efficacy for returning erectile function after surgery involving wide nerve resection, according to the results of a retrospective study undertaken by urologists from Vanderbilt University, Nashville, TN.

Dapoxetine, the first treatment developed specifically for premature ejaculation, has no significant interaction when taken concurrently with the type-5 phosphodiesterase type-5 inhibitors sildenafil citrate (Viagra) and tadalafil (Cialis), according to results presented here yesterday.

Data from two separate phase II studies show docetaxel (Taxotere) to be an increasingly promising therapy in the more advanced and aggressive forms of prostate cancer.One study of the agent in prostatectomy patients at high risk of recurrence showed that the drug, administered intravenously, was well tolerated with only two (2.6%) of the 77 patients in the trial experiencing grade IV toxicity (hyperglycemia).

Patients with clinical T3 (cT3) disease are often better off having surgery than going directly to a radiation oncologist, according to a new study.The typical cT3 prostate cancer patient's survival rate is about 79% at 15 years for those who undergo radical prostatectomy , about the same rate as it is at 5 years after radiation therapy without surgery, according to senior study investigator Horst Zincke, MD, PhD, urologist and director of uro-oncologic surgery at the Mayo Clinic, Rochester, MN.

It's a 19th century military field hospital at the nucleus of cutting-edge medical therapies, and it's capturing the eyes and minds of AUA attendees. The Civil War Medicine exhibit (Booth 368), sponsored by The William P. Didusch Center for Urologic History of the AUA with support from Lilly ICOS and special contributions from the National Museum of Civil War Medicine, captures the horror and eloquence of military medicine in a remarkable daguerrotype of medical progress from the Civil War to the dawn of the 20th century.

PSA level remains an excellent marker for prostate cancer, and PSA velocity (PSAV) can be used to determine when to perform a biopsy, according to William J. Catalona, MD, professor of urology, Northwestern University Feinberg School of Medicine, Chicago.

Prostate cancer studies that compare contemporary outcomes with historic controls should be viewed with the understanding that Gleason scores quietly have been climbing for the past 10 years. This observation is more than a curiosity because clinicians and others use Gleason scores to stage cancers and establish prognoses, and epidemiologists apply them to end results when trying to determine the effect that procedures and therapies have on outcomes.

Detrusor botulism A (BTX-A) toxin injections may be an effective, safe treatment option in patients experiencing overactive bladder (OAB) refractory to other treatments, according to a Swiss study presented yesterday.

Biopsy rates, which had soared early in the 1990s with the introduction of the PSA assay, have fallen dramatically and the incidence of prostate cancer has stabilized, according to a study from the University of Southern California, Los Angeles.

Findings from a retrospective analysis of men presenting for prostate biopsy because of elevated PSA indicate that an appreciable subset of this population is hypogonadal and suggest those men undergo biopsy at a relatively lower PSA cut-off relative to eugonadal men. Thus, correcting PSA density (PSAD) based on serum testosterone level may improve specificity for cancer detection in men with elevated PSA.