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| Combination therapy improves both LUTS and ED
| Combining the alpha-blocker alfuzosin SR (Uroxatral) with the
phosphodiesterase type-5 inhibitor sildenafil citrate (Viagra)
appears to produce a greater therapeutic benefit in men with lower
urinary tract symptoms than either drug alone, researchers said
yesterday. | | | Dr. Flanigan is named new AUA secretary
| | Robert C. Flanigan, MD, was named the new secretary of AUA during
the association's business meeting yesterday. He is professor and
chair of urology at the Loyola University Health System, Maywood,
IL. | | | Botulinum toxin shows sustained, positive effects in BPH
| | Intraprostatic injection of botulinum toxin type A (Botox) is a
safe and effective treatment in patients with symptomatic BPH that
results in improvements in symptoms and quality of life that may
persist for up to 1 year, researchers from Taiwan said. | |
| | Older men and ED drugs: Interest and use are low
| | Despite media images depicting middle-aged and older men embracing
the use of phosphodiesterase type-5 inhibitors to correct erectile
dysfunction, actual interest and usage in this population is
unknown. | | | Study suggests PDE-5 inhibitor improves LUTS in men with BPH
| | Once-a-day tadalafil (Cialis) at dosages ranging from 5 mg to 20 mg
produces measurable benefits in men with BPH and lower urinary
tract symptoms, according to a multicenter study presented here
yesterday. | | | New biomaterial launched for treatment of Peyronie's disease
| | Cook Urological introduced on Tuesday a new biomaterial known as
Surgisis ES for the treatment of Peyronie's disease. Surgisis ES is
a natural biomaterial that provides a graft that is strong, easy to
handle, easy to use, and biocompatible, the company said. It
supports the growth of new fully vascularized host tissue in the
penis. | | | Infertility affects patients mentally as well as physically
| | Two separate studies have found that men and women dealing with
infertility suffer from depression and anxiety at a greater rate
than the general population. | | | Long-term survival impressive for inflatable penile prostheses
| | Long-term survival of inflatable penile prostheses (IPPs) that have
been in use over the past 2 decades is excellent, and the
reliability of those devices appears even more promising for the
enhanced models that have become more recently available, said
Steven K. Wilson, MD. | | | Pudendal nerve stimulation may be alternative to sacral
neuromodulation
| | Stimulation of the pudendal nerve may be an alternative to sacral
neurostimulation (SNS) in the treatment of urinary voiding
dysfunction. Two studies presented yesterday indicate that pudendal
neurostimulation (PNS) is effective in patients who do not respond
to SNS. | |  MORE ARTICLES
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| FDA gives nod to combination treatment for BPH
| | FDA has approved the 5-alpha-reductase inhibitor dutasteride (Avodart) in combination with the alpha-blocker tamsulosin (Flomax) for treatment of symptomatic enlarged prostate. Both drugs had previously been approved individually for treatment of enlarged prostate. | | | Therapy combination superior in high-risk BPH patients
| | The combination of dutasteride (Avodart) and tamsulosin (Flomax) provides significantly greater improvement in International Prostate Symptom Score (IPSS) and patient-reported quality of life than either therapy alone in men with BPH who are at increased risk of progression. | | | Alpha-blocker raises success of trial without catheter
| | A trial without catheter (TWOC) following an average of 3 days of catheterization has become standard practice in men with acute urinary retention (AUR) associated with BPH. Now, the results of a recent study have shown that the administration of an alpha-blocker prior to a TWOC can significantly increase the chances of the success of TWOC. | | | Two-drug combination superior in high-risk BPH patients
| | The combination of dutasteride (Avodart) and tamsulosin (Flomax) provides significantly greater improvement in International Prostate Symptom Score (IPSS) and patient-reported quality of life than either therapy alone in men with BPH who are at increased risk of progression, according to a 2-year analysis of data from the 4-year Combination of Avodart and Tamsulosin (CombAT) trial. | | | TURP, PVP show comparable efficacy in apples-to-apples trial
| | Men facing treatment for BPH can expect similar outcomes after transurethral resection of the prostate (TURP) or photoselective vaporization of the prostate (PVP), according to results of a multicenter head-to-head comparison of the two treatments, presented at the AUA annual meeting. | | | Alpha-blocker raises success of trial without catheter
| | A trial without catheter (TWOC) following an average of 3 days of catheterization has become standard practice in men with acute urinary retention (AUR) associated with BPH. Now the results of a study presented here have shown that the administration of an alpha-blocker prior to a TWOC can significantly increase the chances of TWOC success. | | | New in-office BPH laser treatment is efficient, cost-effective
| | Biolitec has launched the 150-watt Evolve side-firing diode laser unit, which the company says precisely ablates and coagulates prostate tissue, resulting in shorter procedures and recovery times. | | | Use of minimally invasive BPH treatments up significantly
| | Use of minimally invasive surgical treatments (MISTs) for BPH has increased tremendously in the past decade, but urologists should be careful about overusing these newer technologies, given the lack of long-term evidence of their efficacy, researchers from the University of Minnesota said here. | | | TURP: Superior results confirm value in treating BPH
| | A leading BPH researcher has presented data demonstrating the persistent value and utility of a time-tested treatment: monopolar transurethral resection of the prostate. | | | MORE ARTICLES
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| Repeat resection emphasized in new bladder cancer guideline
| | Among the many recommendations within the new AUA guideline for the management of nonmuscle-invasive bladder cancer, arguably one of the most important is the idea of repeating resection for patients with high-grade Ta or T1 disease within a few weeks of the initial resection before making a treatment recommendation. | |
| | Adjuvant chemotherapy after cystectomy may prolong survival
| | A retrospective study of patients seen at the University of Chicago suggests that adjuvant chemotherapy is an essential part of the treatment protocol for lymph node-positive bladder cancer. | | | When is immediate cystectomy necessary in TCC?
| | While immediate cystectomy offers excellent long-term outcomes for patients with high-grade T1 transitional cell carcinoma, genetic biomarkers one day could help urologists select the most appropriate candidates for this surgery. | | | Cancer survivors have low levels of physical activity
| | A new study reveals that many cancer survivors are inactive and obese, which may negatively affect the control of their disease. The findings, which come from a study of cancer survivors in Canada, show that a cancer diagnosis does not appear to prompt significant behavior change and that interventions to increase physical activity and promote better eating habits among cancer survivors are warranted. | | | Pesticide exposure may increase testicular tumor risk
| | Exposure to endocrine-disrupting chemicals, such as persistent organochlorine pesticides, is associated with the risk of both seminomatous and nonseminomatous testicular germ cell tumors, whereas exposure to chlordane compounds and metabolites may be associated with the risk of seminoma, according to a study published in an online issue of the Journal of the National Cancer Institute (April 28). | | | Data dispute en bloc ligation, arteriovenous fistula link during nephrectomy
| | Researchers now have evidence that the risk of arteriovenous fistula formation is low in patients who undergo en bloc ligation. | | | Endoscopy: Safe option in select upper tract transitional cell carcinomas?
| | With continuing advances in endoscopic equipment combined with the increasing dissemination of ureteroscopic skills, upper tract TCC is increasingly being evaluated and treated endoscopically. | | | Laparoscopic nephrectomy: Not just for localized renal cell carcinoma?
| | Intermediate-term oncologic results after laparoscopic radical nephrectomy for locally advanced renal cell carcinoma are similar to those of open nephrectomy. | | | Laparoscopic renal surgery: Ongoing progress, promise
| | Since the initial description of laparoscopic nephrectomy by Clayman and associates in 1991, the technique and the principles of the procedure have evolved logically. | | | MORE ARTICLES
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| IC patients show marked improvement with lidocaine treatment
| | Treatment options are few for interstitial cystitis patients, especially for those with refractory disease. Frustratingly, trial after trial of promising therapies have shown no real improvement compared with placebo. But yesterday, that changed with presentation of the results of a trial of intravesical alkalinized lidocaine. | | | IC/BPS research, therapies push treatment frontier
| | In 2008, urology is focusing on interstitial cystitis/bladder pain syndrome (IC/BPS) in earnest, with important clinical trial results. | | | Studies probe pain, pathogen origins, interactions
| | In chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS), two pivotal clinical trials "are going to have an immediate impact on the way you practice," said Anthony J. Schæffer, MD, professor and chairman of the department of urology at the Northwestern University Feinberg School of Medicine, Chicago. | | | Company halts study of IC drug due to positive results
| | Urigen Pharmaceuticals has announced the early closure of its study of a drug known as URG101 due to positive, statistically significant interim analysis results in both the primary and all secondary endpoints. Top-line results of the interim analysis, which was planned at 50% enrollment, were previously released March 12. | | | Investigational agent improves interstitial cystitis pain
| | An investigational bladder instillation appears to improve daytime pain in patients with painful bladder syndrome/interstitial cystitis in a single dose, according to interim results of a phase II study. | | | Guidelines direct treatment for three types of UTIs
| | Thomas Hooton, MD, discusses the Infectious Diseases Society of America guidelines on three common urologic infections. | | | Does post-neuromodulation APF signal interstitial cystitis treatment success?
| | Interstitial cystitis biomarkers didn't change with long-term neuromodulation in a surprising study. | | | Cyclosporine shows 'dramatic' results in severe interstitial cystitis
| | For the first time in years, patients with interstitial cystitis, especially those with the worst cases, may have an effective new treatment. | | | FDA approves injectable treatment for complicated UTIs
| | The FDA has approved injectable doripenem (Doribax) for the treatment of complicated urinary tract infections, including pyelonephritis. Doripenem has demonstrated activity against a wide range of gram-positive and gram-negative bacteria, including Pseudomonas, that cause these serious infections, research has shown. | | | MORE ARTICLES
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| Survey: Inadequate fertility response for male adolescent cancer patients
| | Pediatric oncologists appear strongly motivated to preserve fertility in male adolescent cancer patients, although there remains a disconnect between their attitudes and practices with respect to referring patients for available services, according to results of the Survey for Preservation of Adolescent REproduction (SPARE) study. | | | Data suggest possible link between male infertility, somatic cancers
| | Results of a study based on data from approximately 43,400 men show risks of developing melanoma and prostate cancer are increased among those with a diagnosis of male factor infertility, reported researchers from the University of California, San Francisco. | | | Research illuminates influences on male fertility
| | Increasingly, genetics is changing the way urologists diagnose and treat problems related to male infertility. As lab findings become clinical realities, andrologists and general urologists alike are finding their daily practices changed by advances in our understanding of the human genome. | | | Sperm morphology can't predict intrauterine insemination pregnancy rate
| | Mounting evidence suggests that the appearance of sperm has little to do with its function. | | | Novel use of technology sparks infertility advances
| | Two groups have taken innovative steps to match technology with important clinical problems: the microscope with NOA and the Whitaker test with EDO. | | | Assays useful for measuring sperm chromatin quality
| | Routine semen analysis does not absolutely predict the quality of sperm chromatin, which may help to explain why it often fails to predict reproductive outcomes in infertile couples. | | | Soy in diet may lower sperm concentration, male fertility
| | Higher intakes of soy foods and soy isoflavones were associated with reduced sperm concentrations in a Harvard study. | | | Novel test diagnoses ejaculatory duct obstruction
| | A novel modification of the Whitaker test using ejaculatory duct manometry shows promise for the diagnosis of ejaculatory duct obstruction. | | | One azoospermic sample enough after vasectomy to confirm future sterility
| | Data from studies on post-vasectomy clearance suggest that a single azoospermic sample submitted 16 weeks following vasectomy is sufficient to establish the success of the procedure and future sterility. | | | MORE ARTICLES
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| Long-term DxHA implants may create diagnostic dilemma
| | Young children who present with calcifications in the ureter on computed tomography scans may not have ureteral stones, but may simply have a history of receiving dextranomer/hyaluronic acid copolymer (Dx/HA [Deflux]) injections for the treatment of vesicoureteral reflux, according to pediatric urologists from Emory University in Atlanta. Their study findings were presented as a word of caution to radiologists and emergency room physicians who may suspect stones in children with abdominal pain and associated imaging findings. | | | Lap procedures increasing in pediatric urology
| | In the office and the operating room, urologists are finding an array of more palatable approaches to managing pediatric cases. | | | Cerebral palsy incontinence likely due to underlying pathology
| | Video urodynamic studies found serious underlying pathology in a majority of cerebral palsy children who had urinary incontinence. | | | Research supports endoscopic surgery to treat VUR
| | Studies of vesicoureteral reflux in children show steady progress in treatment modalities and outcomes. | | | Pediatric refractory urgency, neuropsychiatric disorders linked
| | Children who do not respond to treatment for urgency frequency syndrome may have underlying neuropsychiatric disorders that need treatment before UFS symptoms can be resolved. | | | FDA requests new prescribing information for desmopressin
| | The FDA has requested that manufacturers update the labels and prescribing information for tablet and intranasal formulations of desmopressin (DDAVP, Minirin, Stimate), used to treat pediatric nocturnal enuresis, to include important new information about the risk of severe hyponatremia and seizures. The action follows reports of 61 patients who experienced hyponatremia-related seizures linked to use of the drug, including two who died. | | | Early treatment of UTI in infants may not prevent renal scarring
| | Early and appropriate treatment of urinary tract infection, especially during the first 24 hours after the onset of symptoms, diminishes the likelihood of renal involvement during the acute phase of the infection, but does not prevent scar formation, researchers reported in Pediatrics (2007; 120:e922-e928). | | | | Therapy reduces UTIs in kids with vesicoureteral reflux
| | Hyaluronic acid/dextranomer gel (Deflux) reduced by 62% the incidence of recurrent urinary tract infections in children with vesicoureteral reflux, according to a study published in the Journal of Laparoendoscopic & Advanced Surgical Techniques (2007; 17:353-9). The therapy also eliminated the need for prophylactic antibiotics in 87% of patients. | | | Minimally invasive techniques often appropriate in pediatric urology cases
| | Presentations in pediatric urology at the 2007 AUA annual meeting signaled changes in practice, increasing momentum in current trends, and some surprising findings on hot-button topics. | | | MORE ARTICLES
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| TRT in older men not linked to increased prostate cancer risk
| | The risk of developing prostate cancer among older men who receive testosterone replacement therapy for low testosterone is no greater than it is for similarly aged men not treated with testosterone, according to a study presented at The Endocrine Society’s annual meeting in San Francisco. | | | Radiation treatment benefits men with recurrent prostate cancer
| | Chances of surviving prostate cancer in men whose tumors recur after prostatectomy are threefold higher for those who undergo radiotherapy within 2 years after recurrence, according to new research findings from the Johns Hopkins Medical Institutions in Baltimore. In men whose new tumors grew fastest, prolonged survival chances were greatest, researchers reported last week in JAMA (2008; 299:2760-9). | | | Researchers identify biomarkers targeting prostate cancer recurrence
| | A panel of seven biomarkers can predict with 86% accuracy which prostate cancer patients will experience recurrence and progression of prostate cancer, researchers from the University of Texas Southwestern Medical Center in Dallas reported in Clinical Cancer Research (2008; 14:3785-91). | | | Component in dried tomatoes may prevent prostate cancer
| | The form of tomato product one eats could be the key to unlocking its prostate cancer-fighting potential, researchers from the University of Missouri, Columbia, recently reported in Cancer Research (2008; 68:4384-91). | | | Invasive methods unnecessary for PCa radiation therapy planning
| | Modern 3-D computed tomography is effective for locating the prostatic apex for radiation therapy treatment planning in prostate cancer patients because it eliminates the need for an invasive procedure and related side effects, according to a study in the International Journal of Radiation Oncology Biology Physics (2008; 71:51-7). | | | New analysis: Finasteride does not appear to increase high-grade PCa risk
| | An extensive re-analysis of the drug finasteride (Proscar) shows that it reduced the risk of developing prostate cancer by about 30% compared with the initial finding of a 25% reduction in risk. | |
| | Estrogen helps drive aggressive form of prostate cancer
| | Estrogen-linked signaling helps drive a discrete and aggressive form of prostate cancer caused by a chromosomal translocation, which, in turn, results in the fusion of two genes, researchers report. | | | Data suggest possible link between male infertility, somatic cancers
| | Results of a study based on data from approximately 43,400 men show risks of developing melanoma and prostate cancer are increased among those with a diagnosis of male factor infertility, reported researchers from the University of California, San Francisco. | | | Tumor tracking device cleared for use in post-RP patients
| | FDA has cleared the use of the implantable Beacon electromagnetic transponders with Calypso Medical's Calypso System in external beam radiation therapy for post-prostatectomy patients. Previously, the system (known as "GPS for the Body") was cleared solely for use in patients with an intact prostate. | | | MORE ARTICLES
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| Rehab is key to restoring post-RP erectile dysfunction
| | The return and quality of sexual function is a major concern for men undergoing radical prostatectomy. New research on the etiology of post-prostatectomy erectile dysfunction is shaping new rehabilitation strategies for prostatectomy patients, according to John P. Mulhall, MD, who discusses current and future rehabilitation strategies and his own approach to post-prostatectomy ED in this exclusive interview. | | | Studies show positive results of TRT gel formulations in obese, diabetic men
| | Two testosterone gel formulations are efficacious in obese men and those with diabetes, according to separate studies reported at the Endocrine Society annual meeting in San Francisco. | | | Panel develops definition of premature ejaculation
| | The International Society for Sexual Medicine has developed an evidence-based definition of premature ejaculation that its authors say will aid future diagnosis, treatment, and research. | | | Investigational premature ejaculation therapy improves quality of life in men, partners
| | Dapoxetine, a drug currently under investigation for the treatment of premature ejaculation, provides significant improvement in the sexual function of men and their sexual partners, according to the results of a recent multinational study. | | | Injection therapy salvages 25% of PDE-5 failures
| | About one-quarter of men who fail to respond to phosphodiesterase type-5 (PDE-5) inhibitors for treatment of erectile dysfunction will respond to the drug on rechallenge if they are first exposed to a short-term course of intracavernosal injection (ICI) therapy. | | | Not men only: Premature ejaculation adversely affects female partners
| | Results of a recent study have shown that female partners of men suffering from premature ejaculation (PE) confirm the lack of ejaculatory control of their partners. Significantly lower sexual satisfaction as well as higher ejaculation-related distress and interpersonal difficulties in the relationship were also seen in both male and female participants, compared to relationships in which PE was not an issue. | | | Premature ejaculation: A common problem with a promising future
| | Premature ejaculation (PE) is a common problem estimated to affect between 20% and 40% of men. The distress of this condition is actually felt by both partners. | | | Investigational PE Rx improves QoL in men, partners
| | Dapoxetine, a drug currently under investigation for the treatment of premature ejaculation, provides significant improvement in the sexual function of men and their sexual partners, according to the results of a recent multinational study presented here. | | | Survey results make case for establishing Peyronie's guidelines
| | Results of a survey of Peyronie's disease knowledge and practice patterns among urologists in the United States raise concerns and speak to the need for developing Peyronie's disease guidelines, John P. Mulhall, MD, said at the AUA annual meeting. | | | MORE ARTICLES
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| Modified scope reduces luminal pressure by 40%
| | Use of dead space within a ureteroscope can enhance its performance and reduce intrarenal pressure without compromising the efficiency and structural integrity of the instrument, Joseph V. DiTrolio, MD, of the University of Medicine and Dentistry of New Jersey in Roseland, reported at the AUA annual meeting. | | | Real-world study finds higher risk of second procedure after SWL
| | Patients undergoing shock wave lithotripsy are significantly more likely to undergo a subsequent surgical procedure than are patients undergoing ureteroscopy, according to results of a study designed to investigate real-world practice patterns in surgical therapy for urinary lithiasis. Researchers from Duke University, Durham, NC, reported the finding at the AUA annual meeting yesterday. | | | Second-look nephroscopy for residual fragments: Size matters
| | Second-look flexible nephroscopy after percutaneous nephrolithotomy (PCNL) is cost effective only for residual stone fragments larger than 4 mm, according to findings from a study reported at the AUA meeting yesterday. | | | Improved imaging, tubeless PNL mark stone advances
| | Glenn M. Preminger, MD, professor of urologic surgery and director of the Comprehensive Kidney Stone Center at Duke University Medical Center, Durham, NC, suggests that the next decade might best be spent refining those technologies and determining which patients are likely to derive the greatest benefit from these advances. | |
| | Tubeless percutaneous nephrolithotomy: Viable approach for some renal stones
| | Percutaneous nephrolithotomy (PNL) continues to be an effective minimally invasive approach to the treatment of large-volume renal stone disease. | | | Technical insights, controversy mark shock wave lithotripsy's evolution
| | While understanding of the basic science of shock waves has increased dramatically, questions have also been raised about the potential for serious adverse advents and urologist ownership of lithotriptors. | | | Ambulatory surgical center owners much more likely to operate on stones
| | Urologists who own or who have an interest in ambulatory surgical centers perform more than three times as many stone surgeries as non-owners do. | | | New ureteral stone guidelines reflect treatment changes
| | When AUA announced release of new guidelines for the management of ureteral calculi in mid-November, the document established landmarks. | | | Company sells line of kidney stone diagnostic tests
| | Mission Pharmacal has sold the rights to its line of kidney stone diagnostics to Quest Diagnostics Inc. Products in the diagnostic line include UroRisk Diagnostic Profile, StoneRisk Diagnostic Profile, StoneTrack Diagnostic Monitoring Test, StoneRisk Citrate Test, and StoneRisk Cystine Tests. These tests are designed to help physicians diagnose patients who are symptomatic and, among those who previously had a stone, help in periodic evaluations of a patient’s propensity to form stones. | | | MORE ARTICLES
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