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San Francisco-AUA's recommendation that PSA screening for prostate cancer be avoided in men with an anticipated life expectancy of less than 10 years appears to be a guideline more honored in the breach, according to a study from the San Francisco VA Medical Center published in JAMA (2006; 296:2336-42).

Las Vegas-The best way to treat premature ejaculation (PE) is through a combination of sex therapy and pharmaceutical management, Michael A. Perelman, PhD, argued at the Sexual Medicine Society of North America fall meeting here.

PSA doubling time is an accepted tool to determine the probability that prostate cancer will or will not be clinically significant following primary treatment. However, the definition and proper use of PSA doubling time in clinical practice has become controversial. In this interview, W. Scott McDougal, MD, discusses where the controversy lies and explains when and how this measurement can (and cannot) be used to guide treatment decisions. Dr. McDougal is chief of the department of urology at Massachusetts General Hospital and professor of urology at Harvard Medical School, Boston. He was interviewed by former Urology Times Editorial Consultant Robert C. Flanigan, MD, who is professor and chairman of the department of urology, Loyola University, Maywood, IL.

Las Vegas-Researchers don't agree on how to measure erectile function and dysfunction, making it difficult to determine the effects of prostate cancer treatment on patients' sex lives, said Johns Hopkins researchers who presented a review of 592 articles at the Sexual Medicine Society of North America fall meeting here.

For clinicians, serious conundrums accompany the 80-year-old patient who arrives in the waiting room with an elevated PSA. This is the man who puts urologists and family practitioners dead center in a damned-if-you-do, damned-if-you-don't situation.

Calling it quits in any relationship is a source of discomfort, but when it's the physician-patient relationship, it must be handled precisely and with caution. You want to avoid angering patients or leaving them without the urologic care they need. By the same token, if you or your patient are disgruntled with the relationship, there may come a point when you need to fire the patient. Here is some advice to help you through it.

Quality improvement, pay for performance, and better patient outcomes have been major themes in health care during the past few years. However, many physicians don't fully understand how to introduce quality programs into their practices. Those who do have programs in place often don't know how to objectively measure quality health care.

La Jolla, CA-EMR Experts, Inc. has released the free, downloadable, 48-page Electronic Medical Records eBook, designed to educate health care organizations about electronic medical records and to teach them how to plan for purchasing an EMR system, including a tutorial for conducting return on investment and cost-benefit analyses studies; selecting the right hardware for the project; and implementing a quality network.

Five-year recurrence and disease-free survival rates for laparoscopic cryoablation are equivalent to those of standard open surgical techniques.

New Orleans-When retrieving sperm from men with nonobstructive azoospermia (NOA) and associated varicocele, go for the testis on the right side. That's the bottom line advice of University of California, San Francisco investigators who evaluated whether side matters in retrieving sperm for ICSI.

New Orleans-Men with high body mass index values have lower serum inhibin B levels, according to a report from Reproductive Biology Associates, Atlanta. The study's authors point out that additional research is needed to determine whether increased BMI affects men's fertility.

New Orleans-While improvements in sperm motility are seen when sperm are incubated in media for extended periods, no guidelines have been established yet for the optimal duration of incubation and culture type. Investigators from the University of Michigan have addressed this issue and have made determinations that may help guide intracytoplasmic sperm injection.

New Orleans-Men who are interested in fatherhood had better eat their fruits and vegetables and add soy to their diet. These dietary recommendations were recently shown to boost sperm quality in an observational study from the University of Rochester, Rochester, NY.

New Orleans-Transrectal ultrasound-guided biopsy of the prostate appears to have an immediate impact on the semen parameters of reproductive-age men, according to findings from a small study from Beth Israel Medical Center, New York. However, these effects were transient in all but one patient.

Las Vegas-In a recent trial, men with erectile dysfunction and their partners reported that they were somewhat satisfied with a new wrap-around prosthetic device used to stiffen the men's penises.

Las Vegas-Middle-aged men with erectile dysfunction may benefit from penile microvascular arterial bypass surgery as much as young men do, Boston University researchers reported at the Sexual Medicine Society of North America fall meeting here.

Las Vegas-An investigational drug that acts on the central nervous system may work as a treatment for female sexual dysfunction (FSD), according to a recent study from New York Presbyterian Hospital/Weill Cornell Medical Center in New York. The drug, bremelanotide, is also being investigated for the treatment of erectile dysfunction in men.

Las Vegas-Most men with erectile dysfunction should be tested for androgen deficiency, according to researchers from the University of Minnesota Medical School, Minneapolis. In their study of men with erectile dysfunction, nearly half had testosterone levels less than 400 ng/dL, but they cautioned that the results did not suggest a cause-effect relationship.

New York-Management of metastatic, clear-cell renal cell carcinoma has been significantly advanced by the development of the oral small-molecule kinase inhibitors sunitinib malate (Sutent) and sorafenib (Nexavar), recent results from two large, international, randomized, double-blind, phase III trials indicate. Both studies appeared in the Jan. 11, 2007 issue of the New England Journal of Medicine (2007; 356:115-24 and 125-34).

Patients should be advised that ED is a good possibility with any form of treatment.

Highlights of an industry-sponsored educational program at the 24th World Congress of Endourology. The 24th World Congress of Endourology was jointly sponsored by The Cleveland Clinic Center for Continuing Education and the Endourological Society and was held on The Cleveland Clinic campus in Ohio, August 17?20, 2006.

HealthTronics, Inc., an Austin, TX-based provider of services and products for the urology community, has entered into a definitive agreement for the purchase of a 35% interest in Keystone Mobile Partners, LP, Willow Grove, PA.

Bostwick Laboratories, which provides pathology and diagnostic laboratory services in the United States and United Kingdom, has opened a new laboratory in Uniondale, NY. Separately, Hillel Kahane, MD, has been appointed medical director of the new facility, the company’s fifth.

The manufacturer of a sexual performance-enhancing supplement has announced a voluntary recall of the product, known as Liviro3. FDA lab analysis found the product contains the erectile dysfunction drug tadalafil, making Liviro3 an unapproved drug.

Circulating tumor cell levels 3 to 5 weeks after the initiation of chemotherapy appear to predict overall survival in patients with metastatic androgen-independent prostate cancer, according to a prospective multicenter trial. Further, overall survival could be predicted at each of the tested time points.

Researchers at Northwestern University’s Feinberg School of Medicine, Chicago, have discovered that men who have had a vasectomy may be at increased risk for developing primary progressive aphasia (PPA), an irreversible neurologic disorder that causes patients to lose the ability to use and comprehend words.

Erectile dysfunction is significantly and independently associated with age, cardiovascular disease, diabetes, and lack of physical activity, suggests a study published in The American Journal of Medicine (2007; 120:151-7). Using data obtained from a computerized self-interview, the authors found that 18.4% of men 20 years of age and older experienced ED, defined as “sometimes able” or “never able” to have and keep an erection.

Obese men are more likely than are normal-weight men to have a prostate cancer screening, and associations among advanced stage, worse outcomes, and obesity may not be explained by disparities in screening, according to a study published in the Journal of Urology (2007; 177:493-8).

GPC Biotech AG has completed its rolling submission of a new drug application to the FDA for its oral formulation of satraplatin for the treatment of patients with androgen-independent prostate cancer who have failed prior chemotherapy.