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Among the important research on male infertility presented at the 2004 AUA annual meeting, a new vasoepididymostomy technique and findings about the impact of long-term varicoceles on pregnancy rates took center stage, said Craig S. Niederberger, MD, chief of andrology at the University of Illinois, Chicago. This research, as well as data questioning the value of two widely used prognostic measures, provided the most significant take-home points for practicing urologists, he said

At the 2004 AUA annual meeting, researchers reported that daily administration of a phosphodiesterase type-5 inhibitor improves chances of recovery from post-prostatectomy erectile dysfunction-good news about a difficult-to-treat patient population. The bad news was a finding that herbal ED treatments purchased over the Internet are often ineffective, potentially dangerous, and occasionally tainted with active, unlabeled PDE-5 inhibitors.

As treatment approaches to urinary incontinence continue to evolve, their safety and efficacy relative to existing techniques, and in particular the durability of their results, remain important issues for determining their ultimate place in clinical practice.

New research on the potential of antibiotic-eluting stents and alpha-blockers that may speed or ease the passage of stones may lead to significant changes in urologic practices, according to Glenn M. Preminger, MD.

Studies reported at the AUA annual meeting have provided some answers to important questions concerning the management of localized prostate cancer, according to Richard D. Williams, MD, professor and Rubin H. Flocks chair, department of urology, University of Iowa, Iowa City. Among the issues addressed were the usefulness of adjuvant radiation therapy, the value of extended lymph node dissection, outcomes achieved with minimally invasive treatment options, and who is best suited to perform robotic-assisted laparoscopic prostatectomy.

Minnetonka, MN-The FDA has cleared for marketing American Medical Systems' 700 Tactile Pump, the latest addition to the AMS 700 line of penile prostheses.

San Francisco--Even though patients with von Hippel-Lindau disease are at risk for renal tumors and eventual metastatic RCC, parenchymal-sparing surgery can be delayed until the largest tumor reaches 3 cm with minimal concern that the patient will develop metastatic renal cell carcinoma, according to updated data from an ongoing National Institutes of Health study.

San Francisco--Just because it looks like interstitial cystitis doesn't mean it is interstitial cystitis. Some irritative voiding symptoms that look like IC may be symptoms of bladder cancer, even in patients who do not have the usual bladder cancer risk factors.

The 2004 AUA annual meeting brought news of the most dramatic advance in the field of interstitial cystitis/painful bladder syndrome over the last 20 years. Researchers reported the complete molecular structure of antiproliferative factor (APF), the peptide produced by bladder epithelial cells only in IC patients.

I believe the evidence is accumulating in favor of earlier [androgen deprivation] therapy to provide a survival benefit.

San Francisco--The discovery of the peptide made only by interstitial cystitis in a patient's bladder epithelium has held out the possibility of a diagnostic test, but it wasn't until University of Maryland researchers recently identified the peptide's exact structure that such a test was feasible. The latest research on antiproliferative factor (APF) not only moves researchers a step closer to a commercial diagnostic test for IC but also to new possibilities for treatment of both IC and bladder cancer and to intriguing questions about a new family of proteins.

Boston--A preoperative rise in serum PSA of >2.0 ng/mL predicts an increased mortality risk in patients with localized prostate cancer undergoing radical prostatectomy and might identify men who require additional therapy, investigators have concluded after reviewing outcomes in more than 1,000 cases.

American Medical Systems Holdings Inc. has completed its acquisition of TherMatrx Inc.

Single-channel and multichannel cystometrograms show similar results, according to a study presented at the International Consultation of Incontinence in Monte Carlo.

Urologist Peter L. Scardino, MD, co-founder of Memorial Hospital in Savannah, GA, passed away July 21 at his home in Savannah.

The U.S. Senate has passed the Patient Safety and Quality Improvement Act of 2004.

Urologists are the 10th most recruited physicians, according to a new survey by Merritt, Hawkins & Associates, a national physician search and consulting firm.

The Centers for Medicare and Medicaid Services proposed an across-the-board 1.5% increase in payment rates for physicians caring for Medicare beneficiaries.

New Orleans--PSA doubling time (PSADT) appears to be a strong predictor of the probability of distant metastasis and prostate cancer-specific survival in men with biochemical relapse after radical prostatectomy, according to Mario A. Eisenberger, MD.

Q What issues do we currently face in training surgeons of the future?

The use of stem cells to treat otherwise incurable or serious human disease remains a political "hot potato." One must remember, however, that the sources of embryonic and adult stem cells are distinctly different. The use of adult stem cells avoids all of the ethical and political criticism associated with the former's fetal etiology. While not totipotential, adult stem cells still have the advantage of prolonged proliferation, self-renewal, generation of more differentiated cells, maintenance of developmental potential, and proliferation in response to injury.

Corrective mobilization may incur such deficits, researchers say

When congential venous leakage via the crura without evidence of leakage in other areas of the penis can be established, the procedure appears to be curative.

San Francisco--The microsurgical approach is an effective method for varicocele repair in adolescents and offers the advantages of lower rates of persistence, recurrence, and hydrocele formation than alternative methods, according to the findings of two independent studies presented at the AUA annual meeting.

San Francisco--Scientific and technical obstacles notwithstanding, stem cell transplantation has considerable potential for treatment of male infertility.

Chronic prostatitis carries a high price-both on the health care system and society in general. Two separate studies demonstrate those costs may be 1.7 times higher than for men without prostatitis and perhaps 1.5 times higher than for another debilitating chronic pain syndrome, rheumatoid arthritis.

Physician groups decry Supreme Court decision limiting patient lawsuits against HMOs

Arlington Heights, IL-Presutti Laboratories has received FDA approval to market tinidazole (Tindamax) for the treatment of trichomoniasis, as well as giardiases, intestinal amebiases, and amebic liver abscess.