Drug Therapy

Downers Grove, IL-Vysis, Inc. has received FDA approval to market itsUroVysion assay for monitoring bladder cancer recurrence.

The presentations of Jay Pearson, PhD, and Brett Carver, MD, cited in this issue of Urology Times, provide further experimental and epidemiologic evidence that nonsteroidal anti-inflammatory drugs (NSAIDs) may have some role in the fight against prostate cancer. While these are certainly not the first reports that NSAIDs might beuseful for the prevention or treatment of this malignancy, they continueto identify the remarkable value of these agents for human health and raiseimportant questions as to why so many different types of disease statesare affected by them. Arthritis, benign cardiac conditions, and colon andprostate cancer are diseases of extraordinarily different tissues, etiologies,pathologies, and outcomes. Yet each of these conditions are likely benefitedby NSAID therapy.

Benign prostatic hyperplasia afflicts millions of men throughout the world, with an overall prevalence of histologic BPH at autopsy of 50% by age 60 years and 90% by age 85 years (J Urol 1984; 132:474-9). Surgery, although effective, includes a 1% to 3% incidence of mortality.

Baltimore-Nonsteroidal anti-inflammatory drugs may reduce therisk of prostate cancer, suggests a study completed by Johns Hopkins Hospitalin Baltimore, the National Institute on Aging, and Merck Research Labs.The researchers stress that the findings are suggestive but not definitive.

Dublin, Ireland-A dimethyl sulfoxide (DMSO) "cocktail" significantly improves pain and quality-of-life scores in interstitial cystitis patients, and the regimen may serve as an alternative to other instillation treatments in patients whose principal complaint is pain rather than frequency and urgency, according to researchers from Gartnavel General Hospital, Glasgow, Scotland.

Minneapolis-American Medical Systems has received FDA approval to market the AMS SPARC Sling System for female stress incontinence. The system's suprapubic approach is designed to provide a potentially safer and simpler option for sling placement, according to the company.

Los Angeles-Diagnostic Products Corp., has been granted FDA approval to market four PSA immunoassays for prostate cancer detection: Immulite PSA, Immulite 2000 PSA, Immulite Third Generation PSA, and Immulite 2000 Third Generation PSA. The assays are intended for in vitro diagnostic use with the Immulite and Immulite 2000 immunoassay analyzers.

Paris-Many therapies for urinary incontinence continue to suffer from a lack of definitive data from well-controlled clinical trials, according to a panel of experts convened by a group of international health organizations. Their findings were reported here at the Second International Consultation on Incontinence, which was sponsored by the World Health Organization International and organized by the International Consultation on Urological Diseases and the International Continence Society.

Internet Grateful Med, the United States National Library of Medicine(NLM) Medline search service that we have grown to love and rely on formany years, will almost be fully retired by the time you read this column.All databases searched by Grateful Med have not been updated since December2000.

West St. Paul, MN-Memcath Technologies has received FDA approval for the Memcath Model 201 Introducer Sheath, which is designed to facilitate the introduction of catheters or instruments into the urethra. The company says its base technology provides clean access without passive transportation of any bacterial or urethral substances.

Peyronie's disease resulting in shorter and curved erections occurs more commonly than the 1% to 2% of the population related in textbooks. Patients with the problem may be embarrassed to come forward, or the angulation of the erection-although uncomfortable-may not prohibit intercourse. But with more open discussion of sexuality in all forms of the media, more men are coming forward for treatment of sexual problems. Past medical treatments have been unsuccessful in restoring a straight erection in such patients. Reports of newer treatments such as intralesional verapamil and collagenase have been inconsistent and must stand the test of time.

As laptop computers have become more reliable, less fragile, and less expensive, these machines have gone from being a luxury to an everyday business tool. Many physicians travel frequently and often have projects or correspondence to work on at home and at the office. All of this can be made much more practical with a laptop computer.

San Jose, CA-Laserscope has received FDA approval to market a high-power KTP laser system for photoselective vaporization of the prostate for the treatment of BPH. The product uses an 80-watt KTP/532 laser system and sterile, disposable, fiber-optic delivery devices. During the procedure, a miniature camera attached to an endoscope is inserted through the urethra to the prostate. A laser fiber is threaded through the endoscope to the area to be treated. The laser, which operates at 532 nm, is then used to vaporize excess tissue. The minimally invasive procedure can be performed on an outpatient basis, the company says.

San Francisco-Non-myeloablative allogeneic stem cell transplantation for metastatic renal cell carcinoma appears feasible in a very select, younger, healthier patient population with slow-growing tumors and human leukocyte antigen (HLA)-matched siblings, said Brian I. Rini, MD. He reported results from a University of Chicago Hospital phase II trial at the 37th annual meeting of the American Society of Clinical Oncology here.

Anaheim, CA- Epidemiologists, puzzling over metabolism, diet, food supplements, and genes, may have to look no further than the medicine chest to find one of the factors contributing to the putative rise in kidney stone disease. Three studies presented here at the annual AUA meeting suggest a link between calcium oxalate stones, the bacterium Oxalobacter formigenes, and antibiotics.

San Francisco-Results from a 14-year Southwest Oncology Group trial show for the first time that neoadjuvant chemotherapy plus cystectomy offers improved survival over cystectomy alone in the treatment of patients with locally advanced bladder cancer. This finding challenges the results of seven previous clinical studies.

Many prostate cancer researchers were delighted last fall by two significant developments. First, Myriad Genetics, a Salt Lake City-based biopharmaceutical company, announced on October 4 that its research team had cloned a prostate cancer susceptibility gene (HPC2), also known as ELAC2. That same month, an independent research team at the University of Pennsylvania published its findings that the variant allele (copy) of the gene was found to be more common in men with prostate cancer than in healthy matched controls.

The AUA annual meeting is a remarkable gathering of international thought leaders, practitioners, and industry. As in past years, last month's event in Anaheim provided attendees not only with a measure of urology's scientific progress but also a barometer for many of the issues and concerns facing urologists in the trenches. Here is a very brief look at some of the science and trends that drew applause and raised eyebrows during the scientific sessions, on the exhibit floor, and behind closed doors.

Minneapolis-American Medical Systems has received FDA approval for InhibiZone, an antibiotic surface treatment used on its AMS 700 series penile prostheses. The treatment is impregnated through a patented process into the tissue-contacting surfaces of the prostheses. In laboratory testing, the device elutes the drugs from the surface when exposed to a warm, moist environment, providing antibiotic action both on the surface and in a zone surrounding the treated device, according to the company.

Las Vegas--Urologists are beginning to use a more extensive biopsyregimen when working up men with suspected prostate cancer. Although thisis paying off in increased disease detection, it also has raised questionsabout whether some men are being over-treated for clinically insignificantdisease.