oc tober 2013
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Vo l ume 12, is sue Numbe r 10
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www.renalandurologynews.com
Sling Outcomes Unaffected by Age BY JILL STEIN BARCELONA—Older and younger women have similar stress urinary incontinence (SUI) outcomes after primary midurethral sling (MUS) placement, according to study findings reported at the 43rd Annual Meeting of the International Continence Society. The results, however, also show that older patients are less likely to perceive that their incontinence has improved with MUS than their younger counterparts. “We believe these results have clinical relevance as they will enable physicians
in this issue 7 Non-UTI problems common with urethral catheters 10 Ketoconazole found to improve AUR treatment 1 1
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A surgical complication results in a lawsuit PAGE 16
to enhance age-related patient counseling, especially regarding post-intervention expectations,” said David R. Ellington, MD, Fellow/Instructor in the Division of Urogynecology and Pelvic Reconstructive Surgery at the University of Alabama School of Medicine at Birmingham. “Many women worry that they may develop new lower urinary tract symptoms after MUS placement, and our study demonstrated that new-onset UUI and resolution of symptoms of this form of incontinence are similar for both age groups.”
© science source / dna illustrations
Younger, older women have similar success rates
a woman’s age may not matter with midurethral sling surgery.
The researchers reviewed results in 696 women who underwent primary MUS at their institution over a recent four-year period. SUI affects about one third of all women, and the likelihood of devel-
oping the condition increases with age, Dr. Ellington noted. The number of women aged 70 years and older is increasing, and thus it is thought that the number of women who seek continued on page 10
Hypogonadism PSADT Prognosis Flaws ID’d in Men Has An BY ROSEMARY FREI, MSc cal uncertainty of the PSA doubling VANCOUVER—Relying on PSA time leads to a substantial risk of Estrogen Link doubling time (PSADT) from just one patients being misclassified as having Estrogen deficiency explains, at least in part, some of the physiologic changes observed in hypogonadal men, according to a new study. While testosterone deficiency accounts for decreases in lean mass, muscle size, and strength, estrogen deficiency primarily accounts for increases in body fat. Deficiency of both hormones contributes to a decrease in sexual function. “Our findings support changes in the approach to evaluation and management of hypogonadism in men,” investigators concluded in the New England Journal of Medicine (2013;369:1011-1022). continued on page 10
year of active surveillance can result in as many as one in five prostate cancer (PCa) patients being advised to undergo curative treatment that may be unnecessary, new research has revealed. Frederik B. Thomsen, MD, from Rigshospitalet, University of Copenhagen, Denmark, and his colleagues found that using only one year of PSA testing results can lead to 10%20% of patients being misclassified as having a high risk of PCa progression. “Our study shows that the statisti-
cme feature
an aggressive tumor using the currently applied active surveillance criteria,” Dr. Thomsen said after presenting results at the 33rd Congress of the Societé Internationale d’Urologie. “Therefore, PSA doubling time should not be used as a trigger for recommending curative therapy in these patients.” He presented other results demonstrating the unreliability of PSADT earlier in the year at the 28th annual congress of the European Association of Urology. His team performed the analysis continued on page 10
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Dietary Interventions for Treating Progressive CKD Page 20
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