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Edinburgh, Scotland-When used by the same operators in a single center, shockwave lithotriptors of different power generators provide comparable results and have similar complication rates in the treatment of renal stones, urologists at a Scottish stone center reported at the AUA annual meeting.

Older men's sperm is more likely to contain disease-causing genetic mutations, suggests an analysis of sperm from men of various ages by scientists from the McKusick-Nathans Institute for Genetic Medicine at Johns Hopkins University, Baltimore.

Texas patients and physicians scored a major victory when voters approved Proposition 12, a constitutional amendment that authorizes the legislature to determine limitations on non-economic damages in medical liability cases. The vote ratifies the state's recently enacted medical liability reforms.

Patients undergoing surgery in ambulatory surgery centers are safer than those who undergo procedures in doctors' offices, although the relative risk of death or injury is low in both types of facilities, a new Florida study indicates.

Progress has been shown in the death rates from prostate cancer and the other three leading cancers-lung, breast, and colorectal. Deaths from prostate cancer have fallen 4.0% during the 5-year period from 1996 to 2000. Bladder cancer decreased by 0.4% over the same period.

A new prognostic model could decrease the number of unneeded prostate biopsies by 24% without sacrificing cancer detection, according to a study to be published in the October 1, 2003, issue of Cancer.

Patients with locally advanced bladder cancer have more than a fighting chance for survival with neoadjuvant chemotherapy, which has been found to provide a longer life in patients compared with the standard treatment of surgery alone, according to an 11-year study published in the New England Journal of Medicine (2003; 349:859-66).

Increasing knowledge of the ways in which we differ from each other genetically has the potential to change the way medicine is practiced in the not too distant future.88 One of the most common forms of human genetic diversity is the single nucleotide polymorphism (SNP), a single base-pair position in genomic DNA at which different sequence alternatives (alleles) exist in normal individuals.

In the developed world, environmental factors-particularly diet-seem to play a prominent role in the development of prostate cancer.27 Research into the molecular pathogenesis of prostate cancer may help us assess why prostate cells are particularly vulnerable to such environmental effects and to determine what somatic genome mutations are involved in the transformation of normal epithelium into intraepithelial neoplasia (PIN) and ultimately to invasive carcinoma (Figure 5).

Chemoprevention is the use of natural or synthetic agents to avert the induction of, or to inhibit, delay, or suppress the progression of cancers or other diseases. Carcinogenesis is a process that occurs over a period of months to years and is under the influence of a range of genetic and environmental factors.

Prostate cancer is the most common nonskin malignancy among men in Europe, North America, and Australia and, after lung cancer, represents the second leading cause of cancer-related death in men in these regions.4 Data from the Surveillance, Epidemiology, and End Results (SEER) program of the National Cancer Institute, which covers approximately 26% of the US population, show the rising incidence of cancer of the prostate (Figure 1).

Introduction

In the field of prostate cancer, one of the key goals of researchers and physicians is to reduce the morbidity and mortality associated with the condition. Strategies to help achieve this goal include screening, surgery, therapy (pharmacological, chemotherapy, and radiotherapy), and prevention.

Urology has always been a fascinating and somewhat hybrid specialty inthe field of medicine. First and foremost, it has been a surgical specialty,requiring many years of intense surgical training to master. Many of ushave been drawn to urology because of the wide assortment of surgical proceduresand the ability to put to use the highest technological advancements inthe course of our work.

Chicago-Real-world clinical practice data provide further evidencethat treatment with a 5-alpha-reductase inhibitor significantly reducesthe risks for progression to acute urinary retention (AUR), catheterization,or surgery in men with BPH, according to a retrospective analysis from theUnited Kingdom.

Chicago-Adjuvant androgen ablation following radiation therapysignificantly reduces the risk of local and distant failure and significantlyimproves overall survival in patients with unfavorable-prognosis prostatecancer, according to 10-year results from a large cooperative group trial.

Although antibiotics are commonly used to treat symptoms of chronic pelvicpain syndrome, this approach is beneficial in a relatively small subsetof patients, and urologists must consider alternative treatment modalities,including physical therapy. In this exclusive Urology Times interview, JeannettePotts, MD, discusses current research and her own views on the diagnosisand treatment of chronic prostatitis. Dr. Potts is a member of the staffat the Cleveland Clinic Glickman Urological Institute. The interview wasconducted by Philip M. Hanno, MD, of the department of urology, Universityof Pennsylvania, Philadelphia.