Drug Therapy

How do you determine if a patient is an appropriate candidate for PVP?

Please explain the importance of BPH in urology practice

This Urology Times supplement was produced by Advanstar Medical Education Services under an unrestricted grant from Laserscope www.laserscope.com. The views and opinions in this supplement are those of the interviewed physicians and do not necessarily reflect the views of the editors, Advanstar Medical Education Services or Laserscope.Copyright 2002 Advanstar Communications Inc. All rights reserved.

Bethesda, MD-Treatment with an intravesical formulation of gemcitabine(Gemzar) in patients with transitional cell carcinoma shows promise, accordingto results from a phase I trial. The findings were presented at the Societyof Urologic Oncology/National Cancer Institute second annual meeting here.

With reports describing continued improvements in the success rates of hypospadias repair using contemporary one-stage techniques, only a minority of pediatric patients requires secondary urethroplasty to address significant complications. In the adult, the reconstructive urologic surgeon may similarly encounter the patient who requires extensive primary or secondary urethral reconstruction for stricture disease.

Rochester, MN-When Mayo Clinic researchers recently reported a link between nonsteroidal anti-inflammatory drugs (NSAIDs) and a reduced incidence of prostate cancer, it simply confirmed what many in the field already suspected.

New Products as presented in the April 1, 2002 issue of Urology Times

San Francisco - Researchers have successfully induced hypospadias in mice, an accomplishment that observers say provides more compelling evidence in support of the endocrine disruptor hypothesis as an explanation for the increase in hypospadias observed over the past 30 years.

Antibiotic resistance is a primary concern to urologists and physiciansas a whole-not to mention a favorite topic of the consumer media. In anarticle in its Jan. 21 issue, Time described the chain of events leadingto resistance-from the poultry farm to the public-in an article headlined,"Playing Chicken With Our Antibiotics."

Chicago-Three large-scale, international surveillance surveyshave demonstrated that, while antimicrobial resistance in urinary tractpathogens is on the rise, the antimicrobial susceptibility of bacterialisolates from urinary tract infections varies from country to country andfrom region to region. The reports were presented at the 41st InterscienceConference on Antimicrobial Agents and Chemotherapy.

Chicago-Virulence factors among strains of Escherichia coli thatcause prostatitis are more prevalent than among strains that cause pyelonephritisor cystitis, according to a study by Spanish researchers presented at theannual Interscience Conference on Antimicrobial Agents and Chemotherapyhere.

Handheld devices offer immediate access to medical history, drug interactions,and more

New Products as presented in the March 1, 2002 issue of Urology Times

Chicago-Physicians appear to be inflating the costs of treating uncomplicatedurinary tract infections in women, and possibly promoting resistance toantibiotics, by ignoring treatment guidelines, a new study suggests.

Because of its occasional dramatic effect in the treatment of androgen-independentprostate cancer, PC-SPES, a mixture of eight Chinese herbs, has awakenedphysician interest in herbal remedies, dietary modifications, vitamins,minerals, and supplements (see related article, page 12). What not so manyyears ago was considered "alternative medicine" has moved steadilyinto the realm of acceptance as indicated by the current terminology, "complementary,or integrated, medicine," and is now beginning to reach the mainstreamof traditional care.

Rome-The prospects for safe and effective therapy for male erectiledysfunction have never looked brighter, according to experts speaking atthe 4th Congress of the European Society for Sexual and Impotence Researchhere. Results from clinical trials of new oral medications are particularlypromising, but research on other, non-oral agents also showed promise inpatients who fail to respond to oral treatment.

New Products as presented in the February 2002 issue of Urology Times.

The advent of intracytoplasmic sperm injection (ICSI) in 1993 and subsequent successful fertilization and pregnancy using testicular sperm in conjunction with ICSI

San Francisco-Despite a settlement by TAP Pharmaceuticals last fall on charges concerning fraudulent pricing and marketing of leuprolide acetate (Lupron)

New Products as presented in the January 2002 issue of Urology Times

Unfortunately, infection associated with placement of a penile prosthesis is infrequent, occurring in about 1% to 3% of cases. In the past, this was a catastrophic occurrence that necessitated the removal of the implant and a later return for replacement, if the patient wished.

Chicago-A mixed serotonin and noradrenaline reuptake inhibitor appears to reduce the symptoms associated with stress urinary incontinence (SUI) and improve the quality of life in patients receiving it, according to findings from a phase II clinical trial presented at the American Urogynecologic Society 22nd annual scientific meeting here. While the agent, duloxetine, is still investigational, observers say the prospects for a pharmacologic approach to stress incontinence are promising.

Washington-While several major health issues that were sidetrackedby the Sept. 11 terrorist attacks are poised for consideration by Congresswhen it returns to action this month, lobbyists for urologists and otherphysician groups were working hard at press time to prevent a reductionin 2002 Medicare fees.

Attention to reimbursement, billing/collection, and accounts receivablewill boost cash flow

Cleveland-Although skeletal fractures attributed to androgen suppressionare present in a small percentage of men on the therapy, the incidence maybe as high as five times that of the normal population, according to VincentS. Ricchiuti, MD, chief resident, department of urology, Case Western Reserve-UniversityHospitals, Cleveland.

Shiga, Japan-The improvement of interstitial cystitis symptoms with a still-investigational oral agent correlates well with a reduction in bladder platelet-derived endothelial cell growth factor/thymidine phosphorylase (PD-ECGF/TP) expression, suggesting the agent's potential for treating symptoms in patients with nonulcerative IC.

Toronto-Not unlike many of the patients seen in urology practices, a significant percentage of young infertile men take alternative therapies, some of which may adversely affect their fertility. But many of these men may be hesitant to share this information with you.

New York-A newer monoclonal antibody is showing a canny ability to target prostate cancer cells in both bony and soft tissue, and its therapeutic potential is now undergoing testing. Neil Bander, MD, and colleagues from New York Presbyterian-Weill Cornell Medical Center developed the antibody, dubbed J591 (licensed by BZL Biologics, Inc., Framingham, MA, and sub-licensed by Millennium Pharmaceuticals, Cambridge, MA).

This is an exciting time to be involved with interstitial cystitis, fromthe clinical aspect of caring for patients, to the search for markers andbetter methods of diagnosis, to the basic research so critical in ultimatelyfinding etiologies and a cure. The articles in this month's Urology Times help to underscore these issues(see page 8). Tomohiro Ueda, MD, PhD, and colleagues have identified a cytokineinhibitor that seems to improve interstitial cystitis symptoms and increasebladder capacity, according to a preliminary trial in patients with non-ulcerativedisease. The potassium chloride test study of Tony Yen-Huang Chen, MD, wouldappear to limit the usefulness of this potentially painful examination asa diagnostic adjunct. The profile that Frederic Liandier, MD, did of 287IC patients serves to confirm that while we have many therapies for thisdisorder, nothing works for everyone and the treatment of IC is as muchart as it is science-perhaps more so.

Uppsala, Sweden-Q-Med has received FDA approval to market Deflux, a treatmentfor vesicoureteral reflux grades II-IV in children.