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Tel Aviv, Israel--Twin pregnancy per se, with no trial of labor, increases the risk of postpartum stress urinary incontinence, according to a prospective study by obstetrician-gynecologists from Tel Aviv University, Israel.

Toronto--Patients who show evidence of rare non-motile sperm after undergoing vasectomy will eventually become azoospermic-marking vasectomy success. However, patient compliance post-vasectomy remains low, despite aggressive pre- and postoperative counseling, University of Toronto researchers report.

The majority of testicular tumors identified during the course of an infertility examination would not otherwise have been found at that stage, according to urologists from Tel Aviv University in Israel.

San Francisco--As a salvage for locally recurrent prostate cancer after failed radiation, targeted cryoablation of the prostate (TCAP) provides a "significantly better overall quality of life" than salvage radical prostatectomy, said Aaron E. Katz, MD, at the AUA annual meeting.

San Francisco--Once infection has been ruled out as a cause of a man's pelvic pain, chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) is the diagnosis. Although a symptom and problem index is available to help clinicians and researchers follow the patient's progress, there is no objective test that helps clinch a diagnosis, define the extent of disease, or measure its progression or regression.

New Orleans--Data from a randomized clinical trial show that long-term treatment with the bisphosphonate agent zoledronic acid (Zometa) halved the rate of skeletal events in patients with advanced prostate cancer and bone metastases.

Dextranomer/hyaluronic acid has the potential to lower the cost and also the morbidity of repeated voiding cystourethrograms in children.

Among the important research on male infertility presented at the 2004 AUA annual meeting, a new vasoepididymostomy technique and findings about the impact of long-term varicoceles on pregnancy rates took center stage, said Craig S. Niederberger, MD, chief of andrology at the University of Illinois, Chicago. This research, as well as data questioning the value of two widely used prognostic measures, provided the most significant take-home points for practicing urologists, he said

Studies reported at the AUA annual meeting have provided some answers to important questions concerning the management of localized prostate cancer, according to Richard D. Williams, MD, professor and Rubin H. Flocks chair, department of urology, University of Iowa, Iowa City. Among the issues addressed were the usefulness of adjuvant radiation therapy, the value of extended lymph node dissection, outcomes achieved with minimally invasive treatment options, and who is best suited to perform robotic-assisted laparoscopic prostatectomy.

The use of stem cells to treat otherwise incurable or serious human disease remains a political "hot potato." One must remember, however, that the sources of embryonic and adult stem cells are distinctly different. The use of adult stem cells avoids all of the ethical and political criticism associated with the former's fetal etiology. While not totipotential, adult stem cells still have the advantage of prolonged proliferation, self-renewal, generation of more differentiated cells, maintenance of developmental potential, and proliferation in response to injury.

San Francisco--The microsurgical approach is an effective method for varicocele repair in adolescents and offers the advantages of lower rates of persistence, recurrence, and hydrocele formation than alternative methods, according to the findings of two independent studies presented at the AUA annual meeting.

San Francisco--Scientific and technical obstacles notwithstanding, stem cell transplantation has considerable potential for treatment of male infertility.

The goal of endoscopic intervention for vesicoureteral reflux should be the same as it is for open surgery-a 95% to 98% cure rate after one treatment with the option of excluding a postoperative voiding cystogram.

San Francisco--The tricyclic antidepressant amitriptyline (Elavil) is a safe and effective treatment for interstitial cystitis with significant benefits for reducing overall symptoms along with pain and urgency, according to the results of a German study.

Prostate cancer survivors are the second largest group of cancer survivors in the United States, following breast cancer survivors as the largest group, according to a report by the Centers for Disease Control and Prevention and the National Cancer Institute.

San Francisco--A commonly prescribed antibiotic and alpha-blocker appear to be ineffective in the treatment of men with moderate to severe chronic prostatitis/chronic pelvic pain syndrome of long duration. Results of a multicenter study found that both ciprofloxacin and tamsulosin-used primarily in the treatment of urinary tract infections and BPH, respectively-offered no significant benefit in the treatment of chronic prostatitis in patients who were heavily pretreated and had long-standing symptoms.

Sequential monotherapy yields poor results in CPPS

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.

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.

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.

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

Among men undergoing cryotherapy for prostate cancer, 95% showed no biochemical evidence of cancer recurrence at a follow-up of 3.5 years in a small study presented at the Radiological Society of North America annual meeting.

Los Angeles-After a follow-up of almost 2 years, 70% of patients withstress urinary incontinence reported no repeat SUI after surgery with syntheticpolypropylene sling material, according to UCLA researchers.

An oral bisphosphonate may slow the development of symptomatic bone metastases and reduce the risk of death from this disease, new data show.

Chemoprevention is the use of natural or synthetic agents to avert the induction of, or to inhibit, delay, or suppress the progression of cancers or other diseases. Carcinogenesis is a process that occurs over a period of months to years and is under the influence of a range of genetic and environmental factors.

Although antibiotics are commonly used to treat symptoms of chronic pelvicpain syndrome, this approach is beneficial in a relatively small subsetof patients, and urologists must consider alternative treatment modalities,including physical therapy. In this exclusive Urology Times interview, JeannettePotts, MD, discusses current research and her own views on the diagnosisand treatment of chronic prostatitis. Dr. Potts is a member of the staffat the Cleveland Clinic Glickman Urological Institute. The interview wasconducted by Philip M. Hanno, MD, of the department of urology, Universityof Pennsylvania, Philadelphia.

Prostate cancer is the most prevalent non-cutaneous cancer diagnosed in men today, still accounting for a significant amount of morbidity and mortality in spite of increased screening efforts and advances in treatment.

Chicago-The selective endothelin receptor antagonist atrasentan significantly attenuates changes in biochemical markers of bone metabolism and disease progression in a group of patients with advanced hormone-refractory prostate cancer that had progressed on placebo, according to the results of a randomized clinical trial.