Drug Therapy

The FDA is investigating a possible connection between PDE-5 inhibitors and a form of blindness known as nonarteritic anterior ischemic optic neuropathy (NAION).

Atlanta--Children treated with endoscopic intervention for vesicoureteral reflux continue to demonstrate cures that approach those of open surgery and have a high resolution rate after initial failure. In addition, incidence of febrile and non-febrile urinary tract infection after treatment is lower than after surgery, according to data presented here at the State-of-the-Art Symposium on Pediatric UTI, Reflux, Antibiotic Resistance, and Endoscopy.

San Antonio--Genitofemoral (GF) nerve grafting during radical retropubic prostatectomy can be performed safely with a low risk of postoperative morbidity and shows promising efficacy for returning erectile function after surgery involving wide nerve resection, according to the results of a retrospective study.

Sen. Chuck Grassley (R-IA) proposed legislation Tuesday that would end federal funding for "lifestyle" drugs such as sildenafil (Viagra), tadalafil (Cialis), and vardenafil (Levitra) to treat sexual and erectile dysfunction. Coverage would be provided if the drugs are prescribed for a purpose other than sexual performance.

Men who experience painful recurrent varicoceles after undergoing conservative treatment and failed surgical repair are best served by microsurgical varicocelectomy, according to Canadian researchers.Of 11 men who had failed standard varicocelectomy and experienced pain before and after surgery, 10 experienced a favorable response following microsurgical repair, according to investigators."In my mind, microsurgical varicocelectomy is the gold standard, and non-microsurgical repair is sub-standard," said lead author Armand Zini, MD, associate professor of urology at McGill University, Montreal. "However, few urologists are able to perform this procedure, since they have not been trained properly."

Botulinum toxin A (Botox) injections show potential for providing a quick, easy, and safe treatment option for men with lower urinary tract symptoms related to BPH, but two small studies presented yesterday provided equivocal results regarding the efficacy of this investigational approach. U.S. researchers tested their 10-minute, ultrasound-guided technique in a two-part study. In the first part, 10 patients were injected with botulinum, 100 units, to assess safety, International Prostate Symptom Score, flow rates, and bother scores. In the second part, 30 patients received 200 units of botulinum in a sham-controlled, double-blind study, and sequential MRIs were taken pretreatment and at 1 and 3 months post-treatment to measure prostate volume.

Amitriptyline has long been used for treating symptoms of interstitial cystitis, but now long-term data confirm its usefulness, even when patients don't fit the strict NIDDK research definition of IC. Key to long-term success is allowing patients to titrate the dose themselves.

A study estimating the dispensation rate of interacting medications to an outpatient population found that while only 0.05% of patients received co-prescriptions for medications that could potentially cause adverse effects, about half of these were given were for sildenafil citrate (Viagra) and one of two different nitrates.

Genitofemoral (GF) nerve grafting during radical retropubic prostatectomy can be performed safely with a low risk of postoperative morbidity and shows promising efficacy for returning erectile function after surgery involving wide nerve resection, according to the results of a retrospective study undertaken by urologists from Vanderbilt University, Nashville, TN.

Dapoxetine, the first treatment developed specifically for premature ejaculation, has no significant interaction when taken concurrently with the type-5 phosphodiesterase type-5 inhibitors sildenafil citrate (Viagra) and tadalafil (Cialis), according to results presented here yesterday.

Depomed, Inc. has received approval from the FDA for a once-daily formulation of ciprofloxacin hydrochloride (Proquin XR) for the treatment of uncomplicated urinary tract infections. It is the first version of ciprofloxacin with nausea and diarrhea listed as "uncommon" adverse events, rather than "common" adverse events, according to the company.

Ongoing research on a variety of fronts has yet to make a revolutionary impact on the management of localized prostate cancer, but changes are likely on the horizon, according to Richard D. Williams, MD.

Ongoing research on a variety of fronts has yet to make a revolutionary impact on the management of localized prostate cancer, but changes are likely on the horizon, according to Richard D. Williams, MD.

Charleston, SC--A two-component synthetic tissue sealant may serve as a viable alternative to current standard suturing techniques used in collecting system repair, according to researchers from Duke University, Durham, NC. Their research used a swine model to compare two FDA-approved sealants and traditional suturing.

Istanbul, Turkey--The phosphodiesterase type-5 inhibitor vardenafil (Levitra) significantly improves sexual pleasure and treatment satisfaction in both men with erectile dysfunction and their partners, according to study results presented at the European Association of Urology annual congress here.

Convincing patients to lose weight and treating them early with standard medical therapies for erectile dysfunction are two ways clinicians can help their patients return to sexual function after radical prostatectomy or radiotherapy for prostate cancer.

Natural compounds, a novel new drug class, and the growing popularity of a minimally invasive laser are poised to make news in the treatment of benign prostate hyperplasia, Claus G. Roehrborn, MD, told Urology Times.

More effective treatment will come as interstitial cystitis becomes better defined and research makes inroads on the epidemiology and etiology of this enigmatic and difficult-to-treat condition.

The use of non-embryonic stem cells and the growing popularity of botulinum toxin are among key trends to watch for in the management of stress incontinence and overactive bladder, respectively, said Shlomo Raz, MD, director of female urology, urodynamics, and reconstructive surgery at UCLA Medical Center.

Istanbul, Turkey--Swiss data add to growing evidence that injecting botulinum toxin A (Botox) into the detrusor muscle is a safe and efficient treatment option in patients suffering from overactive bladder, particularly in cases that prove refractory to other more conventional treatment modalities, like anticholinergic agents and physiotherapy.

The FDA has authorized a label change for the phosphodiesterase type-5 inhibitor tadalafil (Cialis), removing a contraindication on the use of the drug with alpha-blockers.

Human epidermal growth factor receptor 2 (HER-2), associated with breast cancer, is a key culprit in prostate cancer recurrence, say researchers from the University of North Carolina at Chapel Hill.

No patient has developed urinary retention or elevated post-void residuals following our modified injection technique.

Istanbul, Turkey--Prostate inflammation significantly raises the risk of clinical progression in men with lower urinary tract symptoms and BPH, according to a first-time investigation into the impact of acute and/or chronic inflammation on men with BPH. The most significant impact of acute or chronic inflammation was an increased risk of acute urinary retention, particularly in patients receiving placebo, according to the analysis, based on a subset of patients from the Medical Therapy of Prostatic Symptoms (MTOPS) patient cohort.

No patient has developed urinary retention or elevated post-void residuals following our modified injection technique.

Montreal--Phosphodiesterase type-5 inhibitors appear to be effective in treating erectile dysfunction in men who are also receiving pharmacologic treatment for depression. A retrospective study presented here at the Canadian Psychiatric Association annual meeting that looked specifically at tadalafil (Cialis) demonstrated that the drug was effective in improving erections and achieving intercourse in this population.

Anti-inflammatory drugs, either alone or in combination with an alpha-blocker or 5-alpha-reductase inhibitor, may have an important role in treating or possibly even preventing the progression of BPH.

Orlando, FL--Testosterone's effect on the development and progression of BPH and prostate cancer is well known, but a group of University of Tennessee researchers has been focusing on testosterone's less frequently studied "partner in crime"—estrogen.

Hormone therapy increased the incidence of all types of incontinence at 1 year among women who were continent at baseline.

Orlando, FL--A genetically modified vaccine has demonstrated immunogenicity and clinical activity in hormone-refractory prostate cancer patients with metastatic disease, researchers reported in a poster presentation at the 2005 Multidisciplinary Prostate Cancer Symposium.