Female Urology

Societies can help with Medicare matters and with private insurance companies

Seattle-Use of some over-the-counter herbal supplements may be adverselyaffecting male fertility. In an ironic twist, those supplements touted ashelping with infertility appear to be among those doing harm.

One does not have to go far on the Internet to find solicitations encouragingcouples whose infertility derives from a wide variety of causes to undergointracytoplasmic sperm injection with aspirated testicular sperm. Many ofthese advertisements hint that ICSI with aspirated sperm is an easy, "one-stop"method of conceiving a child, leading urologists to be rightly concernedthat, without adequate evaluation of the male half of the equation, thepatient's medical interests are inadequately served.

Copenhagen, Denmark-An oral antidiuretic approved for the treatment ofnocturnal enuresis also appears to be effective for treating nocturia inadult men and women, according to phase III clinical trial results reportedby the multinational Nocturia Study Group.

Boston-Children with myelomeningocele and undescended testis face greaterrisk of infertility than patients with undescended testis alone, accordingto research presented at the American Academy of Pediatrics Section on Urologyannual meeting here. In a related study, researchers found that patientswith defective second step germ cell maturation due to cryptorchidism havea poor fertility prognosis.

Nephron-sparing surgery (NSS) was initially developed as a mechanism to preserve renal function in patients at risk of requiring dialysis in the face of total nephrectomy. Indications included tumors in patients with a solitary kidney, multifocal disease, or chronic renal insufficiency.

Scranton, PA-Calling the medical liability insurance crisis a"national problem that needs a national solution," President Bushrenewed his support for federal reform that would include a cap on non-economicdamages awarded to injured patients. Meanwhile, urologists and other physiciansthroughout Pennsylvania, the site of Bush's speech, canceled plans to shuttertheir practices after the governor revealed short-term measures aimed atalleviating the crisis.

Recurrent urinary tract infections are so common in our female patientsthat urologists and other clinicians give little thought to their evaluationand treatment. However, new research findings may lead to some small butimportant changes in our approach to this prevalent urologic problem.

Over-the-counter fertility test receives FDA approval. Vernon Hills, IL-Lake Consumer Products introduces FertilMARQ, an FDA-approved test for male infertility.

San Diego-A new once-daily formulation of ciprofloxacin (Cipro XR) is equivalent to conventional twice-daily dosing for treatment of uncomplicated urinary tract infections, according to results from a large, multicenter randomized trial. The extended-release formulation was granted FDA approval last month.

San Diego-Treatment with nitrofurantoin is superior to an estriol-containing vaginal pessary for prevention of urinary tract infections in postmenopausal women, according to results of an Israeli study.

Philadelphia-The City of Brotherly Love has what many say is theleast friendly climate for physicians when it comes to medical liabilityinsurance. Insurance and reimbursement problems, however, are statewidephenomena in Pennsylvania. In Scranton, located in the northeastern cornerof the state, a seven-urologist group has said it will decide in Januarywhether to close.

Bethesda, MD-A screening technique based on the interplay of blood proteinsmay help clearly differentiate between prostate cancer and benign conditionslike BPH, according to a National Cancer Institute study. The test, whichis still under investigation, showed a specificity of 71% in men with marginallyelevated PSA levels, NCI researchers reported.

New minimally invasive techniques for the surgical treatment of stressincontinence have been based on novel concepts concerning the surgical supportof the mid-urethra and the utilization of artificial graft materials. Inthis exclusive Urology Times interview, David Staskin, MD, discusses theevolution of sling techniques and the pros and cons of using artificialmaterials. Dr. Staskin is director of the Section of Voiding Dysfunction,New York Presbyterian Hospital, and associate professor of urology and obstetricsand gynecology, Weill Medical College, Cornell University. The interviewwas conducted by UT Editorial Consultant Philip M. Hanno, MD, of the departmentof urology, University of Pennsylvania, Philadelphia.

New Products & Services

Q What is the current state of prostate cancer markers?With prostate cancer, we are fortunate in that it has the very best markeror combination of markers for any cancer that I'm aware of, short of skincancer where visual markers are quite good. PSA's performance for predictinglocalized prostate cancer probably exceeds the performance of other cancermarkers, such as CA125 for ovarian cancer, CEA for colon cancer, and someof the genetic markers for breast cancer.

Orlando, FL-Currently established T- and Z- bone mineral density scores may require revision in order to accurately assess changes in men receiving androgen deprivation therapy, suggests an Austrian study presented at the AUA annual meeting.

Orlando, FL-The 5-alpha-reductase inhibitor finasteride (Proscar)is associated with symptom improvement in men with category IIIA chronicpelvic pain syndrome, say leading prostatitis researchers.

Orlando, FL-Treatment with an alpha blocker used commonly in men withBPH is associated with improvement of symptoms in men with moderate to severechronic non-bacterial prostatitis, said Perinchery Narayan, MD.

Newton, MA-Matritech Inc. has received FDA clearance to market the NMP22 BladderChek bladder cancer test for use in conjunction with cystoscopy. The test works like a home pregnancy test and returns results while the patient is in the physician's office, the company says.

Presented by Richard A. Santucci, MD, Wayne State University School of Medicine, Detroit.

Presented by Deborah R. Erickson, MD, Pennsylvania State UniversityCollege of Medicine, Hershey.

Presented by Edward Kim, MD, University of Tennessee School ofMedicine, Knoxville.

Presented by John N. Krieger, MD, University of Washington School ofMedicine, Seattle.

Presented by Ricardo Gonzalez, MD, University of Miami Schoolof Medicine.

Presented by John Trachtenberg, MD, University of Toronto.

The incidence of hydronephrosis diagnosed in the neonatal period has increased dramatically with the routine use of ultrasound in obstetrical care. Prior to the mid-1980s, most children with obstructive uropathy secondary to ureteropelvic junction obstruction or ureterovesical junction obstruction were diagnosed after urinary tract infections had occurred or an abdominal mass was noted.

Orlando, FL-A new analysis of data from the National Cancer Institute'snationwide Prostate, Lung, Colorectal and Ovarian (PLCO) cancer screeningtrial suggests that annual PSA screening may not be necessary for many men.

San Francisco-Prostate cancer bone metastases appear to react favorablyto treatment with a new bisphosphonate and the tyrosine-kinase inhibitorsPKI-166 and STI-571, according to studies presented at the American Associationfor Cancer Research annual meeting here.

Characterized by symptoms of urinary frequency, urgency, and urge urinary incontinence, overactive bladder (OAB) is a condition that results from a deficiency in the bladder's ability to store urine and in the onset of involuntary bladder muscle contractions that promote urgency and possibly urine loss.