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Discrepancy may be due to a reporting bias; testis-sparing approach recommended

White River Junction, VT--The often-controversial PSA test has now achieved broad public acceptance as a screening tool, according to a recent study. But only a minority of primary care physicians are following published guidelines for administering the test, according to another, separate study.

Ralph Straffon, MD, a urologist and retired chief of staff at the Cleveland Clinic, died Jan. 22.

A phase II study comparing the onset of action of two oral phosphodiesterase-type 5 inhibitors?TA-1790, an investigational agent and sildenafil citrate (Viagra) showed comparable results, according to VIVUS, Inc., maker of TA-1790.

Up to 40% of men with prostate cancer have a virus in their blood that, until now, has been linked to relatively rare cancers, new research from the University of Pittsburgh shows.

Most men over the age of 40 years attempt to protect themselves against prostate cancer, according to a new survey by researchers at Thomas Jefferson University?s Kimmel Cancer Center in Philadelphia.

Death rates continue to level off for prostate cancer and the two other leading cancer killers in men?lung and colon cancer?according to the American Cancer Society?s report, "Cancer Facts & Figures 2004."

Las Vegas--An in-office bladder cancer test is significantly more sensitive than cytology at detecting the disease in high-risk patients, report community-based urologists from Anchorage, AK. The test also appears to be effective at determining risk of recurrence in patients with known disease, at least in the short term.

Las Vegas--Which material is better for pelvic floor reconstruction: allografts or synthetic mesh? If you ask two of urology's leading pelvic floor surgeons, each will provide a very different answer. Gary Leach, MD, a proponent of allografts, and Shlomo Raz, MD, a proponent of synthetic slings, made their points known in a verbal face-off at the AUA Western Section annual meeting here

Las Vegas--Radical cystectomy has a different risk profile in women than men, a difference that should be addressed during preoperative patient counseling, say investigators at Stanford (CA) Medical Center.

Las Vegas--The development of a robot-assisted method for laparoscopic radical prostatectomy could lessen morbidity, cut recovery times, and shorten the learning curve for urologists who have not been trained in the procedure.

Las Vegas--Obesity in prostate cancer patients is associated withhigher-grade tumors, cancer recurrence, and more aggressive disease, recentstudies have shown. The research has prompted some urologists to suggestusing body mass index (BMI) as a marker for early screening and treatment.Others suggest that further studies should be undertaken to determine ifweight loss may, in fact, lower prostate cancer risk.

Las Vegas--Brachytherapy is a growing treatment choice for menwith low-risk prostate cancer, although it is still selected by less than22% of men with the disease, according to San Francisco researchers. Theuse of androgen ablation has also increased, the researchers found in ananalysis of data from the CaPSURE database.

Urologist Ramsay L. Kuo, MD, has joined the department of urology at Thomas Jefferson University Hospital, Philadelphia, with an appointment as assistant professor of urology, Jefferson Medical College of Thomas Jefferson University.

A group of three leading cancer centers has developed guidelines to determine which prostate cancer patients at risk for relapse should participate in a clinical trial and which compounds are appropriate in these studies.

The National Institute of Diabetes and Digestive and Kidney Diseases has announced a request for applications (RFA) for a study entitled, "Interstitial Cystitis/Painful Bladder Syndrome: Epidemiology" (RFA-DK-04-009).

A sustained-release anticholinergic drug provides appears to be beneficial in the reduction of urge incontinence for patients with either severe or moderate symptoms of overactive bladder, according to results of a study published in the February issue of The Journal of Urology (2004; 171:752-6).

Anthony Atala, MD, a pediatric urologist and internationally recognized leader in tissue engineering, has joined Wake Forest University Baptist Medical Center in Winston-Salem, NC.

There is no causal relationship between testosterone replacement and prostate cancer or heart disease risk, according to a retrospective analysis by researchers at Beth Israel Deaconess Medical Center, published last week in The New England Journal of Medicine (2004; 350:482-92).

The last few years have witnessed an enormous interest in androgen replacement therapy for late-onset hypogonadism-also known as "androgen deficiency in the aging male." As urologists, we frequently deal with sexual dysfunction and are seen as experienced on issues of prostate health.

Montreal--Laparoscopic nephroureterectomy is becoming a widely utilized option in the surgical treatment of upper tract transitional cell carcinoma. As more centers accrue larger series with longer follow-up, assessment of surgical as well as oncologic results is possible and necessary.

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All of us see great clinical cases from time to time and make valuableobservations. Often there is an opportunity to present this material asa poster at scientific meetings. Until recently, the production of a high-qualityscientific poster required the use of an outside graphic arts firm at acost of more than $1,000.

Varicocele is a common clinical finding, present in approximately 15%of adult men. When the patient with a varicocele visits a urologist, itis often due to testicular discomfort or fertility-related concerns. Atthe 2003 meeting of the American Society for Reproductive Medicine, bothof these issues were addressed and are discussed in this issue of UrologyTimes.

San Antonio--Repair of clinically significant varicoceles may resultin nearly a 25% chance of natural conception, even in men who do not demonstratesignificant improvements in their postoperative seminal parameters, accordingto University of Iowa researchers.

San Antonio--Biomaterial wraps are a promising adjunct for vasovasostomy,according to results of an animal study that incorporated a biomaterialmatrix and a sealant into the conventional three-suture anastomosis. Researcherscalled this "polishing the gold standard" because of the highpatency rate of the standard procedure.

Our income tax law, the Internal Revenue Code, turned 90 in 2003. Whatstarted as a 400-page tax bill when Woodrow Wilson signed it into law in1913 now contains more than 55,000 pages. In fact, last year, Congress passedand the president quickly signed into law a $330 billion, 10-year tax cutplan-The Jobs and Growth Tax Relief Reconciliation Act of 2003. That billboth added to the page count and made a significant impact on the tax billsof many physician practices.

Many myths surround the Fair Labor Standards Act (FLSA), which governsovertime pay, but the biggest myth may be that FLSA issues are low-riskdecisions for medical practices.

Washington--Physicians who perform services, or have financial interests,in ambulatory surgery centers (ASC) are facing an uncertain future whenit comes to how much they will be paid for serving Medicare patients.

San Antonio--A retrospective study of men with cancer who elected to cryopreservetheir sperm because of cancer therapy found that 20% of men had alreadyreceived one or more cycles of chemotherapy. The recognized toxic effectsof chemotherapy and radiation on sperm cells make this a questionable practice