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American Urological Association, May 17-22, 2008

American Urological Association Annual Meeting

The American Urological Association's annual meeting took place May 17-22 in Orlando, Fla., and attracted about 15,000 attendees, including 11,000 professionals, from around the world. Highlights included new research showing the pros and cons of radiation therapy for prostate cancer, promising new techniques that may help regenerate bladder and external urinary sphincter tissue, and a new evidence-based definition of premature ejaculation.

Gregory P. Swanson, M.D., of Cancer Care Northwest in Spokane, Wash., presented late-breaking data showing that adjuvant radiation administered soon after radical prostatectomy reduces the long-term risk of biochemical recurrence in men with advanced, localized prostate cancer. Swanson and colleagues randomly assigned 413 men to receive radiation or no radiation after surgery and followed them for a mean of 11.5 years. Despite a higher rate of side effects such as impotence and incontinence, the researchers found that the radiation group had significantly improved disease-free survival and overall survival. On average, they lived almost two years longer than the no-radiation group.

Researchers from Canada, Italy and the United States showed that men who undergo external-beam radiation therapy for localized prostate cancer may have a significantly increased risk of secondary cancers compared to men who undergo radical prostatectomy. When they compared outcomes in 10,333 patients who were treated between 1983 and 2004, they found that the radiation group has a threefold higher rate of cystectomy for bladder cancer, a 1.8-fold higher rate of long cancer resections, and a 1.7-fold higher rate of rectal cancer.

"The increased rate of secondary malignancies after external-beam radiation therapy should be considered in localized prostate cancer treatment decision-making," lead author Naeem Bhojani, M.D., of the University of Montreal in Quebec, Canada, and colleagues conclude.

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Other research -- conducted in 14 large mammals -- demonstrated the feasibility of a technique in which bladder progenitor cells are grown in culture and seeded on a biodegradable bladder-shaped scaffold to form a functional neo-organ that can be transplanted into patients. "This treatment option essentially regenerates the patients' own bladder, reducing the risk of rejection and the need for immunosuppressant drugs," Timothy Bertram, Ph.D., of Tengion, Inc., in Winston-Salem, N.C., said in a statement.

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Similar research -- conducted in Europe -- demonstrated that the transplantation of muscle-derived stem cells can help repair the external urinary sphincter and improve continence. In one study, German researchers implanted cells grown from patients' deltoid-muscle tissue into their damaged sphincters. After a year, four patients had achieved complete continence and 19 others had improved from grade III to grade I incontinence. In a second study, Austrian researchers implanted cells grown from patients' upper arm muscle tissue into the sphincters of 65 men who became incontinent after radical prostatectomy. After treatment, only 28.5 percent of the men still required pads while 43.6 percent only needed them for special occasions, and 27.9 percent did not need them at all.

During a press conference, Ira D. Sharlip, M.D., of the University of California San Francisco, presented the International Society of Sexual Medicine's first evidence-based definition for premature ejaculation: "A male sexual dysfunction characterized by ejaculation which always or nearly always occurs prior to or within about one minute of vaginal penetration; and, inability to delay ejaculation on all or nearly all vaginal penetrations; and, negative personal consequences, such as distress, bother, frustration and/or the avoidance of sexual intimacy."

Sharlip explained in a statement, "For something that has such a profound effect on men young and old, there needs to be a definitive measure to diagnose premature ejaculation. The hope is that more people with these symptoms will understand this is an actual health condition and seek treatment. They no longer need to suffer in silence."

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AUA: Some Elderly Men Can Discontinue PSA Testing

THURSDAY, May 22 (HealthDay News) -- Men aged 75 and older may be able to safely discontinue prostate-specific antigen (PSA) testing if their levels are less than 3 ng/mL, according to research presented at the Annual Scientific Meeting of the American Urological Association in Orlando, Fla.

Abstract #1751
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AUA: Gene Therapy Promising for Erectile Dysfunction

WEDNESDAY, May 21 (HealthDay News) -- For men with erectile dysfunction who don't respond to oral therapy, Maxi-K gene transfer may be a safe and effective alternative, according to two studies presented at the Annual Scientific Meeting of the American Urological Association in Orlando, Fla.

Abstract #1240
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Abstract #1241
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AUA: Firefighters Have Elevated Bladder Cancer Risk

TUESDAY, May 20 (HealthDay News) -- In firefighters, high exposure to smoke and chemicals may increase the risk of bladder cancer, according to research presented at the Annual Scientific Meeting of the American Urological Association in Orlando, Fla.

Abstract #937

AUA: Organic Pollutants Linked to Urologic Anomalies

TUESDAY, May 20 (HealthDay News) -- Sons born to mothers with high serum levels of polychlorinated biphenyls (PCBs) or polybrominated biphenyls (PBBs) are significantly more likely to have congenital urologic anomalies, according to research presented at the Annual Scientific Meeting of the American Urological Association in Orlando, Fla.

Abstract #276
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AUA: Cholesterol Levels Linked to Cancer Recurrence

MONDAY, May 19 (HealthDay News) -- Men who have high levels of low-density lipoprotein cholesterol and increased serum cholesterol have a more than doubled risk of cancer recurrence after undergoing radical prostatectomy, according to research presented at the Annual Scientific Meeting of the American Urological Association in Orlando, Fla.

Abstract #192
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AUA: Vaccine May Be Effective for Advanced Prostate Cancer

MONDAY, May 19 (HealthDay News) -- The new adenovirus/PSA (Ad/PSA) vaccine -- which stimulates the immune system to produce anti-antigens and attack cancer cells -- shows promise for men with metastatic prostate cancer. In addition, baseline prostate-specific antigen (PSA) readings are reliable predictors of prostate cancer and may be especially important for black men with a family history of the disease, according to research presented at the Annual Meeting of the American Urological Association in Orlando, Fla.

Abstract #526
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Physician's Briefing
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