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Results of a phase three study evaluating second-line chemotherapy with gemcitabine/paclitaxel for metastatic bladder cancer failed to answer its primary question of whether maintenance treatment is superior to a temporary six-cycle regimen because maintenance treatment was usually not possible. However specific subgroups of patients who may be more likely to benefit from this combination regimen after failing first-line chemotherapy.

AUA take-home messages on management of localized prostate cancer

Pediatric urologists have confirmed that environmental pollutants can impair male sexual development and fertility and that reinnervation of the bladder after spinal cord injury may be within reach.

What role should urologists play in the evaluation and management of couples who have difficulty conceiving?

The growing use of robot-assisted laparoscopic techniques should cause urologists in the community to sit up and take more immediate notice.

Improvements in percutaneous stone removal, concern about radiation exposure from computed tomography imaging, and reassurance about the safety of shock wave lithotripsy highlighted presentations about stone removal.

Studies that looked at botulinum-A toxin for overactive bladder, studies of the transobturator male sling, and an investigation of stem cell injections for stress urinary incontinence all show promise, but all raise important clinical questions.

Combining topical and systemic therapies after surgery for balanitis xerotica obliterans can profoundly affect disease recovery.

Combination therapy using targeted agents is a promising yet elusive target in renal cell carcinoma, but questions about toxicity and benefits versus monotherapy have been raised in other studies.

Bacillus Calmette-Guerin remains the treatment of choice for bladder cancer in the United States, but more than half of patients with nonmuscle-invasive bladder cancers will eventually fail BCG. Several promising alternative treatments are under development, but radical cystectomy remains the optimal choice for patients who fail BCG.

Findings from a study of testicular cancer survivors add to existing evidence that cognitive impairment is a potential long-term risk of cancer chemotherapy.

The bisphosphonate zoledronic acid (Zometa) offers significant benefit in lowering the skeletal-related events rate in patients with bony metastatic bladder cancer, according to results of a prospective, randomized, placebo-controlled study.

Studies in the field of sexual dusfunction suggest urologists don't know as much as they think they do about Peyronie's disease and that incidence of erectile dysfunction has other implications.

This clinical trial shows that alkalinization of lidocaine improves absorption into the bladder and that the therapy decreases interstitial cystitis pain.

Christian O. Twiss, MD, has joined The University of Arizona department of surgery as assistant professor of clinical surgery and director of female urology, pelvic medicine, and pelvic reconstructive surgery.

Marc Goldstein, MD, has been named the Matthew P. Hardy Distinguished Professor of Reproductive Medicine and Urology at Weill Cornell Medical College.

A recent review of the literature has found that hormone deprivation therapy may have subtle adverse effects on cognition in patients receiving the treatment for prostate cancer, researchers will report in an upcoming issue of Cancer.

Blockage by the selective inhibitor abiraterone acetate of cytochrome P (CYP) 17 is safe and has significant antitumor activity in castration-resistant prostate cancer, according to a phase I study from the Royal Marsden NHS Foundation Trust, Sutton, Surrey, United Kingdom. The data confirm that castration-resistant prostate cancer commonly remains dependent on ligand-activated androgen receptor signaling, study authors say.

For the first time, a strategic plan for research into benign prostate disease, based on the latest scientific knowledge, has been published by the National Institute of Diabetes and Digestive and Kidney Diseases.

Men age 75 years and older should not be screened for prostate cancer, and younger men should discuss the benefits and harms of the PSA test with their clinicians before being tested, according to a new recommendation from the U.S. Preventive Services Task Force published in the Annals of Internal Medicine (2008; 149:185-91).

A minimally invasive treatment for varicoceles can significantly improve a couple’s chances of achieving pregnancy, according to a study published in Radiology (2008; 248:540-9). The study, conducted at the University of Bonn in Germany, also found that the level of sperm motility prior to treatment is a key predictor of success.

A phase I trial shows that an adenovirus/ PSA vaccine is safe and can induce anti-PSA antibody and T cell responses in a significant number of men with stage D2 or D3 prostate cancer, researchers from the University of Iowa, Iowa City, reported

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Outside of the United States, technology for HIFU is available from two companies. HIFU is being used as primary treatment for men with small prostates and low-stage, low-volume disease, particularly in those who are not good candidates for conventional treatments because of their age or comorbidities. It is also being used as salvage treatment after failure of radiation therapy.

High-intensity focused ultrasound (HIFU), while still a number of years away from clinical use in the United States, shows promise as a first-line treatment for low-risk prostate cancer, Cary N. Robertson, MD, reported at the International Prostate Cancer Update.

In this exclusive article, Urology Times Editorial Consultant Philip M. Hanno, MD, professor of urology at the University of Pennsylvania, asks FDA Commissioner Andrew C. von Eschenbach, MD, about his role at FDA, his priorities and goals, and issues facing the agency and the U.S. health care system.

Urologists continue to face a controversial, challenging question: Which course of treatment is best for low- to intermediate-risk prostate cancer? In recent years, 90% of newly diagnosed prostate cancer patients have this level of disease, so the question is increasingly relevant to clinical practice.

Leading European urologists have reviewed the findings from the Prostate Cancer Prevention Trial (PCPT) and have reached consensus supporting the use of finasteride (Proscar) as a chemopreventive agent for the disease. A similar consensus statement in the United States appears to be coming soon.

Research continues to progress in developing promising new oncologic markers for diagnosing prostate cancer. Ultimately, researchers hope to address the challenge of identifying a biomarker that can help physicians differentiate indolent from aggressive prostate cancer to avoid overtreatment of the disease.