Renal & Urology News June 2013 Issue

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Volume 12, issue Number 6

RP May Prevent LUTS Progression Following surgery, symptom severity declined ­significantly and remained stable over 10 years BY JODY A. CHARNOW SAN DIEGO—Although radical prostatectomy (RP) frequently has negative effects on quality of life because of urinary incontinence and erectile dysfunction, removal of the prostate can prevent progression of lower urinary tract symptoms (LUTS), according to study findings presented at the American Urological Association annual meeting. A prospective study of 1,788 men who underwent RP found that men who had clinically significant LUTS preoperatively experienced a decline

in this issue 4 TRT not associated with increased risk of PCa 6 Silodosin aids in the management 1 of acute urinary retention

17 AUA updates PCa screening guidelines

22 Heparin-free hemodialysis is not safer, a study finds

28 Lithotripsy is effective for lower pole stones

Hemodialysis patients should eat more foods high in zinc like oysters. PAGE 23

in LUTS severity and remained stable over a 10-year interval, researchers reported. Prior studies have shown a progressive increase in LUTS for aging men with an intact prostate. “This is an unrecognized benefit of prostatectomy,” said investigator Vinay Prabhu, a fourth-year medical student at New York University School of Medicine. The study findings provide evidence that the prostate is the most important contributor to LUTS in men, Prabhu said.

Drinking Lots of Water May Cut CKD Risk BY ROSEMARY FREI, MSc MONTREAL—Individuals who drink lots of water may lower their risk of chronic kidney disease (CKD), according to investigators. At the Canadian Society of Nephrology’s 2013 annual meeting, researchers reported on an analysis of data from the 2005-2006 National Health and Nutrition Examination Survey (NHANES) data showing that CKD was 2.5 times less likely to develop in people in the highest tertile of water consumption (more than 4 L/day) compared with those in the lowest tertile (less than 2 L/day). continued on page 16

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Radical Prostatectomy’s LUTS Benefit In a study, prostate cancer patients with clinically significant lower urinary tract symptoms (LUTS) experienced significant improvements in American Urological Association Symptom Index (AUASI) score after radical prostatectomy that remained stable for 10 years. Baseline 10 years after surgery

Source: Prabhu V, et al. Radical prostatectomy (RP) prevents age-dependent progression of lower urinary tract symptoms (LUTS). Data presented at the 2013 American Urological Association annual meeting, San Diego. Abstract 80.

He and his colleagues ascertained subjects’ AUA Symptom Index (AUASI) score prior to surgery and three, six, 12, 24, 48, 60, 84, 96, and 120 months after surgery. The study is the longest reported longitudinal assess-

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ment of LUTS after RP, the researchers noted. The prevalence of clinically significant LUTS declined from 35.5% to 26.9% between baseline and 10 years, Prabhu reported. “This is the opposite continued on page 16

BPH Drug Use Increasing BY JODY A. CHARNOW SAN DIEGO—Physicians in the U.S. increasingly have been prescribing pharmacotherapy to treat lower urinary tract symptoms (LUTS) related to benign prostatic hyperplasia (BPH), according to data from two studies presented at the American Urological Association annual meeting. In an analysis of National Ambulatory Medical Care Survey 1993-2010 data, Christopher P. Filson, MD, and colleagues at the University of Michigan in Ann Arbor found more than 102 million outpatient visits for men with BPH/LUTS. Alpha blockers were the most commonly prescribed

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drug class. The proportion of visits in which physicians prescribed alpha blockers alone rose from 8.3% in 1993 to nearly 20% in 2010, Dr. Filson and his colleagues reported. The use of 5-alpha-reductase inhibitors (5-ARIs) alone increased from 3.2% of visits in 1993 to 7.5% of visits in 2009-2010. The use of anticholinergics alone increased from 1.2% of visits in 19992000 to 5.3% of visits in 2009-2010. In the modern era, the researchers noted, tamsulosin was the most common alpha blocker prescribed, accounting for the majority of alpha blocker prescriptions from 2008-2010. continued on page 16

Earn 1 CME credit in this issue

Managing Bone Loss Associated with ADT Page 31

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Renal & Urology News June 2013 Issue by Haymarket Media - Issuu