Drug Therapy

Baltimore?What causes chronic pain in chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS)? This could be the wrong question to ask, said Jeffrey S. Mogil, PhD, at the NIDDK-sponsored Chronic Pelvic Pain/Chronic Prostatitis Scientific Workshop. The better question may be: Why do these particular men have chronic pain, whereas others do not?

Prostate cancer is more prevalent than anticipated in patients with a normal DRE and a PSA <4.0 ng/mL.

The use of opiates in chronic nonmalignant pain has its share of proponents and opponents among urologists who specialize in chronic pelvic pain.

New York--The FDA has granted approval of oral sunitinib malate (Sutent), a multi-targeted receptor tyrosine kinase inhibitor, for the treatment of advanced renal cell carcinoma. The approval came after a priority review and was based on results from two phase II clinical trials dem-onstrating impressive drug activity measured by high partial response rates and delay to disease progression. It marks the second FDA approval of a drug for advanced RCC in as many months.

Washington--Over a 5-year study period, researchers have documented a significant increase of extended-spectrum beta-lactamases producing Escherichia coli (ESBL-E coli) isolated from urinary tract infections in both hospital and community settings.

Washington--Results from a small study demonstrate that urinary interleukin-8 (IL-8) can be used as an early diagnostic tool for nosocomial urinary tract infections, Mexican infectious disease specialists said during a presentation at the 45th Interscience Conference on Antimicrobial Agents and Chemotherapy here. IL-8 appears to offer a faster alternative to quantitative cultures, according to the researchers.

Past terminology has held management back, Dr. Baranowski argued. The 'itis' of prostatitis, for example, has encouraged patients to seek anti-inflammatory or long-term antibiotic therapies that often don't help.

The popular herbal therapy saw palmetto appears to be no more effective than placebo for relieving symptoms of BPH, according to a year-long, double-blind study published last week in the New England Journal of Medicine (2006; 354:557-66).

Watson Pharmaceuticals has received FDA approval on its abbreviated new drug application for a generic version of testosterone gel 1% CIII.

The FDA has approved sunitinib (Sutent), a tyrosine kinase inhibitor, for the treatment of advanced renal cell carcinoma.

Montreal--In case your patients need another reason to quit, recent research indicates that smoking tobacco reduces the ability of sperm to fertilize an egg. There appears to be a dose-response relationship, with heavy smokers at greater risk for more severe impairment of sperm, according to a study presented at the American Society for Reproductive Medicine annual meeting here. It remains to be seen whether quitting smoking or even cutting down will lead to improvements in sperm functions that support fertilization.

New York--A multifaceted rehabilitation program designed to improve erectile performance and penile length in men undergoing radical prostatectomy was successful in nearly three-fourths of cases, according to researchers from the M.D. Anderson Cancer Center in Houston.

New York--Avanafil, an investigational, fast-acting phosphodiesterase type-5 inhibitor, has been successful in its first large-scale trial, Joel M. Kaufman, MD, reported at the Sexual Medical Society of North America annual meeting here.

Washington--For children with ambiguous genitalia at birth, surgical techniques have improved vastly, but deciding when and whether to do surgery hasn't gotten easier. That was apparent from the lively and sometimes contentious panel and audience discussion here at the American Academy of Pediatrics Section on Urology annual meeting.

I predict that we will find that MR urography will rapidly develop and eventually come to be the imaging technique of choice in adult and pediatric urology.

Montreal--Spermatogenesis markers that can be easily obtained from a noninvasive testis biopsy may predict which patients will respond to surgical varicocele repair. Testis biopsy, therefore, should be part of the regular workup for male infertility patients, suggest the authors of the 2005 Society for Male Reproduction and Urology Prize paper presented here at the American Society for Reproductive Medicine annual meeting.

Washington--When hydronephrosis is diagnosed antenatally in an infant, is pyeloplasty needed? More often than not, the indication is not clear.

Contrary to previous reports, statins do not appear to reduce the incidence of cancer or cancer deaths, according to a meta-analysis of previous studies (JAMA 2006; 295:74-80). The finding held true for a range of cancers, including prostate cancer.

Trimedyne, Inc., Irvine, CA, has received FDA approval to market its VaporMAX Fiber for use with its Holmium lasers to treat BPH.

A compound found in many fruits and vegetables shows major promise in combating prostate cancer, according to researchers at the University of Wisconsin School of Medicine and Public Health, Madison.

The FDA has approved sorafenib (Nexavar) for the treatment of advanced renal cell carcinoma.

Paris--Adding a form of high-dose calcitriol to docetaxel (Taxotere) offers improved survival over docetaxel alone in men with metastatic androgen-independent prostate cancer, according to results of a multicenter trial presented at the 13th European Cancer Conference (ECCO-13) here. Further, the addition of the calcitriol formulation, known as DN-101, to the chemotherapy agent produced an unanticipated advantage in a reduced number of serious gastrointestinal and thromboembolic adverse events.

Amsterdam, Netherlands--Three-dimensional computed tomography reconstruction of the pelvicalyceal system helps in the planning and execution of percutaneous nephrolithotomy, but the relative value of each reconstruction method is not known.

Paris--Results of a second phase III trial suggest that a still-investigational immunotherapy agent offers a survival benefit in men with asymptomatic metastatic androgen-independent prostate cancer. Survival data from the more recent study support the findings of the first phase III trial of the agent, APC8015, also known as sipuleucel-T (Provenge), researchers reported at the European Cancer Conference here.

New York--Differential diagnosis of erectile dysfunction doesn't appear worth the effort when selecting a drug for treatment: No meaningful difference in the effect of the three available phosphodiesterase type-5 inhibitors was seen among men in a clinical trial, regardless of the cause of their ED, according to Hartmut Porst, MD.

Paris--Adding a form of high-dose calcitriol to docetaxel (Taxotere) offers improved survival over docetaxel alone in men with metastatic androgen-independent prostate cancer, according to results of a multicenter trial presented at the 13th European Cancer Conference (ECCO-13) here. Further, the addition of the calcitriol formulation, known as DN-101, to the chemotherapy agent produced an unanticipated advantage in a reduced number of serious gastrointestinal and thromboembolic adverse events.

Irvine, CA--Rhabdomyolysis following laparoscopic procedures is a rarity, but it does occur and can have severe rehabilitative consequences for patients.

Amsterdam, Netherlands--An increased body mass index has been shown to confound the outcome of numerous surgical treatments. The effect of BMI on cardiovascular disease, insulin resistance, cancer mortality, and blood loss during radical surgery is well documented. Less clear is the effect of BMI on laparoscopic surgery, including laparoscopic radical prostatectomy.

A third interim safety analysis of an ongoing multicenter phase II trial of NX-1207, for the treatment of BPH, has revealed no serious side effects, according to Nymox Pharmaceutical Corp., the drug's manufacturer.

Former New York Knicks basketball star Earl "The Pearl" Monroe is the point man for the "Flomax One-Week Challenge," a national campaign to educate men about BPH.