Urology News
Serum testosterone is associated with aggressive prostate cancer in older men: results from the Baltimore Longitudinal Study of Aging
An Article in the British Journal of Urology evaluated the relationship between testosterone levels and the development of high-risk prostate cancer, by prospectively examining serum androgen concentrations in a well-studied cohort, as the role of testosterone in prostate cancer progression is debated. The study comprised 781 men in the Baltimore Longitudinal Study of Aging who had sex steroid measurements before a diagnosis of prostate cancer, or at their last visit for those without cancer. The likelihood of high-risk prostate cancer doubled per unit (0.1) increase in the free testosterone index (FTI) for patients aged >65 years and concluded that higher levels of serum free testosterone are associated with an increased risk of aggressive prostate cancer among older men. These data highlight the importance of prospective trials to insure the safety of testosterone-replacement therapy.
Initial Prostate Specific Antigen 1.5 ng/ml or Greater in Men 50 Years Old or Younger Predicts Higher Prostate Cancer Risk
Screening with PSA has been widely used to detect PCa for 2 decades but it continues to be controversial. The results of 2 large randomized, controlled trials were recently released but due to conflicting results the usefulness of PSA screening for decreasing PCa mortality remains hotly debated. A study out of the Journal of Urology showed a median prostate specific antigen in black and white men was 0.7 ng/ml at age 50 years or less. The prostate cancer rate was not significantly different in the groups with prostate specific antigen less than 0.6 and 0.7 to 1.4 ng/ml in black or white men. Black and white men with initial prostate specific antigen in the 1.5 to 2.4 ng/ml range had a 9.3 and 6.7-fold increase in the age adjusted prostate cancer RR, respectively. At up to 9 years of followup initial prostate specific antigen 1.5 ng/ml or greater was associated with gradually increased detection at followup in black and white men.
Flomax Helps Pass Kidney Stones
A total of 100 patients with stones sized 10 mm or smaller, located in the distal part of the ureter were included. Patients were randomly assigned to 2 equal groups. Group 1 received 0.4 mg tamsulosin once daily and group 2 received placebo. The investigators and the patients were masked to the type of treatment. Patients were followed-up until passage of the stone, or for a maximum of 4 weeks. Apart from 4 patients in the placebo group who were lost to follow-up, all patients complied with the prescribed medications and continued the study. Stone expulsion occurred in 41 of 50 patients (82%) in group 1 and in 28 of 46 patients (61%) in group 2 (P = .02). The chance of stone expulsion was 3 times higher in the tamsulosin group. Urology
.Gastric Banding Doesn't Increase Kidney Stone Disease
Bariatric surgical procedures are being increasingly utilized in the treatment of patients with morbid obesity. Certain malabsorptive bariatric procedures have been associated with an increased risk for kidney stone formation. However, the kidney stone risk of gastric banding, a restrictive bariatric procedure, is unknown. After gastric banding, the diagnosis of an upper urinary tract calculus occurred in 3 subjects (1.49%), as compared with 12 subjects (5.97%) in the comparison cohort (P = .0179). Overall it was shown that Gastric banding is not associated with an increased risk for kidney stone disease or kidney stone surgery in the postoperative period.
Hormonal Therapy Use for Prostate Cancer Increases Mortality in Men With Coronary Artery Disease
JAMA Abstract
Hormonal therapy (HT) when added to radiation therapy (RT) for treating unfavorable-risk prostate cancer leads to an increase in survival except possibly in men with moderate to severe comorbidity. However, it is unknown which comorbid conditions eliminate this survival benefit. This study showed that for men with CAD-induced CHF or MI, after a median follow-up of 5.1 years, neoadjuvant HT use was significantly associated with an increased risk of all-cause mortality (26.3% vs 11.2%, adjusted HR, 1.96; 95% CI, 1.04-3.71; P = .04).
Sound Waves Treat Prostate Cancer With Fewer Side Effects
An Experimental cancer therapy for prostate cancer may be able to treat men without surgery and offer fewer side effects according to the results of a UK study published in the British Journal of Cancer* today (Wednesday).
Botulinum treatment improves quality of life in patients with idiopathic overactive bladder
Injection of botulinum toxin A (Botox) is associated with improvement in patient-reported quality of life in the treatment of idiopathic overactive bladder, the authors of a 36-week, multinational, multicenter study reported at the AUA annual meeting.
Postoperative PSA measures separate prostate cancer and BPH patients
Prostate cancer patients can be distinguished from those with histologic benign prostatic hyperplasia (BPH) using postoperative prostate-specific antigen (PSA) levels and velocity, conclude US researchers.
