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Nocturia is a bothersome condition brought on by a host of factors in a broad segment of the population, particularly the elderly. It may have a significant impact on quality of life, and the associated sleep deprivation may lead to psychological and physical illness. Management of nocturia can only be pursued once the specific etiology of the condition is defined. This article describes a modern approach to pinpointing the underlying etiology, which in turn leads to appropriate treatment.

Q A pediatric urologist I code for is concerned that we cannot bill/code for both orchiopexy and a hernia repair done during the same operating room session. Do you have any documentation on this matter? When you look up 54640 in CPT 2004, it references, "For inguinal hernia repair performed in conjunction with inguinal orchiopexy, see 49495-49525." In the Medicare Correct Coding Guidelines, I do not see any edits stating not to bill both procedures together.

Since its inception in 1995, the Cancer of the Prostate Urologic Research Endeavor has become one of the world's largest databases on prostate cancer. CaPSURE shows a rapidly evolving picture of how the disease is treated and the typical patient confronting it. In this exclusive Urology Times interview, Peter R. Carroll, MD, CaPSURE's principal investigator, discusses these trends and the forces driving them. The interview was conducted by UT Editorial Consultant Richard D. Williams, MD, professor and chairman of the department of urology, University of Iowa, Iowa City.

New Orleans--Four-year results of a phase III clinical trial suggest that a single dose of the chemotherapeutic agent carboplatin (Paraplatin) is as safe and effective as adjuvant 3-week-long radiation therapy following orchiectomy of seminomatous testis cancer. More surprising was the observation that there were fewer germ cell cancers in the other testis, British oncologists reported at the American Society of Clinical Oncology annual meeting.

Tel Aviv, Israel--Twin pregnancy per se, with no trial of labor, increases the risk of postpartum stress urinary incontinence, according to a prospective study by obstetrician-gynecologists from Tel Aviv University, Israel.

Toronto--Patients who show evidence of rare non-motile sperm after undergoing vasectomy will eventually become azoospermic-marking vasectomy success. However, patient compliance post-vasectomy remains low, despite aggressive pre- and postoperative counseling, University of Toronto researchers report.

Homburg, Germany--A combined approach of chemotherapy and surgical resection is not only feasible, it may be preferable to chemotherapy alone in some patients with advanced urothelial cancer, German researchers report.

Honolulu--A standardized hematuria evaluation that follows recommendations of the AUA Best Practice Guidelines appears to improve survival in patients with transitional cell carcinoma of the bladder, results of a retrospective analysis of a longitudinal database suggest.

A leading consumer advocacy group has filed a complaint with the Federal Trade Commission over what it says is deceptive advertising of a nutritional supplement known as Enzyte, which is designed to improve erectile function.

The majority of testicular tumors identified during the course of an infertility examination would not otherwise have been found at that stage, according to urologists from Tel Aviv University in Israel.

Drinking alcohol may play a role in preventing the two most common urologic cancers, according to two recently published studies funded by the National Cancer Institute.

A leading consumer advocacy group has filed a complaint with the Federal Trade Commission over what it says is deceptive advertising of a nutritional supplement known as Enzyte, which is designed to improve erectile function.

A higher intake of dietary calcium appears to decrease the risk of kidney stone formation in women, according to findings from the Nurses' Health Study II.

Measuring the level of activity of a signaling pathway called Hedgehog may differentiate between localized and metastatic prostate cancer, according to research from Johns Hopkins Medical Institute.

Physicians need to develop a team approach to screen and treat prostate cancer, according to a report released last week by the Prostate Cancer Foundation.

An estimated 2.6 million couples in the United States experience problems with fertility, and numerous factors may be involved in both the male and the female partners. In up to 40% of infertile couples, male factor infertility plays a contributing role. For many years, the evaluation of male infertility has relied on-and been limited to-semen analysis, which measures sperm count and assesses sperm motility and morphology. More recently, new technologies have evolved that measure DNA fragmentation in sperm. Clinical studies have shown that sperm with elevated levels of DNA fragmentation are a strong predictor of reduced male fertility. Many factors-infection, diet, illicit drugs, some prescribed and over-the-counter medications, lack of sleep, stress, high fever, elevated testicular temperature, air pollution, alcohol, cigarette smoking, toxin exposures, advanced age-may result in DNA fragmentation.Now on the market is a dietary supplement called Proxeed?, which has been designed to enhance and support the quality of sperm. This supplement provides ingredients that contribute to the metabolic processes in the cells that manufacture sperm. Clinical data have shown that the ingredients in Proxeed? may potentially optimize sperm motility, speed, count, morphology, and concentration.Recently, Mark Perloe, MD, an endocrinologist and fertility specialist, posed questions to Phillip Werthman, MD, a board certified urologist and fellowship-trained andrologist, on the use of DNA testing of sperm, on the implications of DNA fragmentation, and on the benefits of dietary fertility supplements in optimizing the reproductive health of men. The following is a report of Dr. Werthman’s answers to these questions.

Articles on prostate cancer and colon cancer screening in high-circulation consumer magazines do not offer the necessary information for readers to make an informed decision, according to a recent study in the Journal of General Internal Medicine (2004; 19:843-8).

Howard B. Goldman, MD, has joined the Cleveland Clinic Glickman Urological Institute.

Unimed Pharmaceuticals said it now offers testosterone gel 1% (AndroGel) in a metered-dose pump.

A federal appeals court in Atlanta has confirmed class-action status for a lawsuit alleging that six health insurers had systematically underpaid 900,000 active and retired physicians.

PSA has lost its value as a screening tool for prostate cancer and does nothing more than indicate the size of the prostate gland, according to a study led by Thomas A. Stamey, MD, and published in the October issue of the Journal of Urology (2004; 172:1297-1301).

International Volunteers in Urology (IVU) carried out its second trip to care for children in Mongolia in June.

Prostate Centers of America said its first urologist-owned LLC joint venture using photoselective vaporization of the prostate (PVP) had reached profitability.

Even though men age 56 years and older continue to receive the majority of sildenafil citrate (Viagra) prescriptions, use in men ages 18 to 46 years increased 312% from 1998 to 2002, according to a study in the International Journal of Impotence Research (2004 16:313-8.)

A combined genome-wide linkage analysis of 426 families from four existing hereditary prostate cancer study populations found strong evidence of prostate cancer linkage at chromosome region 17q22, according to a study reported in the Journal of the National Cancer Institute (2004; 96:1240-7).

A new study has been launched to compare long-term benefits and risks of three treatments for BPH-transurethral needle ablation, transurethral microwave thermotherapy, and a combination drug regimen of alfuzosin (Uroxatral) and finasteride (Proscar), the National Institute of Diabetes and Digestive and Kidney Diseases announced.

The addition of a short course of androgen suppression therapy following radiation therapy improves survival in men with localized prostate cancer compared with radiation therapy alone, according to researchers from Brigham and Women's Hospital and the Dana Farber Cancer Institute, Boston.