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    AUA look-back: TRT safety, PCa tests spark news, debate

    The recently concluded AUA annual meeting in Orlando may not go down as one of the most memorable annual meetings in recent years. Nevertheless, it was noteworthy for some interesting news and lively debate on hot-button topics: the safety of certain urologic products, namely, testosterone and transvaginal mesh; new tests for prostate cancer; infection prevention and treatment; and use of an advanced prostate cancer agent in the pre-chemotherapy setting.

    Unlike the meeting’s last three installments, where the focus was squarely on prostate cancer screening and associated guidelines, this event lacked a singular theme or focus. In the words of one urologist I spoke with, the Orlando meeting had little “buzz.” Attendance seemed light, although official attendance figures were not available as of this writing.

    This was my 18th annual meeting as Urology Times’ chief editor. Here are a few of the trends that caught my attention from the scientific sessions, visits with attendees, and social media. This is not meant to be a comprehensive report; for that, watch for our annual “Best of AUA” article on the meeting’s take-home messages, coming soon.

    Safety of testosterone, mesh

    Key stakeholders debated the use of testosterone replacement therapy in men with hypogonadism, which has come under attack since the publication of two studies suggesting an increased risk of cardiovascular events associated with TRT. William Finkle, PhD, an author of one of the studies (PLoS One 2014; 9:e85805), and Adriane Fugh-Berman, MD, a pharmacologist whose research examines pharmaceutical marketing, discussed the evidence of increased cardiovascular risk following TRT. Abraham Morgentaler, MD, took the studies and researchers to task.

    “Morgentaler systematically deconstructed (ie tore to shreds) Finkle and Fugh-Berman's argument. Great lecture on basic stats, ethics,” Christopher Bayne, MD, tweeted during the meeting.

    Not all urologists disagree that TRT is overused. “Is testosterone being abused? Yes. All over the world,” said Ajay Nangia, MD. “This is giving us all a bad name.”

    Like TRT, the safety of transvaginal mesh has also drawn interest from the FDA, not to mention eager trial lawyers. A Cleveland Clinic study found that 61% of women presenting to their center with pelvic organ prolapse or stress incontinence were aware of the FDA safety communication concerning mesh. But two-thirds were unsure if the mesh used for SUI was different from that used for POP, and half incorrectly believed mesh had been recalled. Urologists can play an important role in clarifying these misconceptions.

    Continue to next page for more.


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