The American Urological Association's 104th Annual Scientific Meeting took place April 25 to 30 in Chicago. Attendance at this year's meeting was up slightly from last year, reaching 16,000 total registrants, including urologists, researchers and other health care professionals. Over half of the meeting participants were international attendees. The meeting featured lectures delivered by internationally recognized urology specialists, presented recent results from clinical trials, and discussed research advancements in the diagnosis and treatment of several urological conditions, including prostate, bladder, and other urologic cancers, as well as incontinence, sexual dysfunction and stone disease.
Michelle J. Semins, M.D., of Johns Hopkins Hospital in Baltimore, reported findings of patients from a private insurance database, who had a urinary tract infection (UTI) diagnosis and body mass index (BMI) information available from 2002 to 2006. The prevalence of UTI was found to be significantly increased among obese individuals, particularly so among those with a BMI greater than 50.
In a statement, Semins acknowledged that while diabetes and other medical conditions known to promote UTI were controlled for, "there may be other medical conditions that promote infection that we were not able to control for that may be more prevalent among the obese." Semins also stated a possible association between obesity and UTI that "with the switch from fee for service to pay for performance, doctors and hospitals may not get reimbursed for certain types of hospital-acquired UTI. These programs should think about considering risk factors like obesity to avoid penalizing programs that care for the obese."
Charles R. Vincent, M.D., of the University of Florida in Gainesville, presented a study in which college-aged females who presented with a first episode of a UTI were administered a questionnaire to determine any contributing factors for their infection, including dietary and lifestyle habits. These results were compared with questionnaires from matched females who presented for routine care and had no prior history of a UTI. Vincent observed that UTIs were significantly more common among women who reported increased sexual activity, recent consumption of alcohol-containing beverages, and use of sanitary napkins during menstruation. In contrast, co-existing infections including chlamydia, gonorrhea, and yeast infections did not significantly increase UTI incidence. Vincent also reported that urinary frequency and urgency were the most common presenting symptoms for these young women experiencing a first-time UTI.
According to Vincent, "the most significant risk factor for first-time UTI was increased sexual activity, mainly penile-vaginal intercourse. What we also found was that there was an increased association with alcohol consumption to that with having sexual intercourse." Vincent added that this could possibly suggest an "impaired judgement phenomenon," in which increased alcohol use leads to increased intercourse, thus raising the risk for first-time UTI. "The direct causative nature of this is not explained but that is one way to interpret the data." Vincent summarized, "understanding the risk factors associated with UTI, and modifying their lifestyle accordingly, and also knowing when to present to their doctor, are the important aspects of this study."
Lesley K. Carr, M.D., of the University of Toronto, reported results of an ongoing study of 29 women (mean age of 49.5 years) who experienced stress urinary incontinence which had not responded to standard therapy for at least 12 months. Low-dose and high-dose amounts of autologous muscle-derived cells were administered to 20 and 9 patients, respectively. The majority of participants (86.2 percent) chose to receive a second injection of cells. Approximately three-quarters of the participants (76.5 percent) experienced an overall reduction in stress leaks and urgency symptoms. At three months after the first injection, quality of life was improved in 68 percent of patients, and 61 percent experienced symptom improvement. While no serious adverse events occurred, minor events included pain and bruising at the site of muscled biopsy, pain at the injection site, self-limiting urinary retention, and UTI.
Carr and other study authors disclosed various relationships with Cook Medical, a maker of health care devices.
Roger Dmochowski, M.D., of Vanderbilt Medical Center in Nashville, Tenn., presented the results of a double-blind, multicenter, placebo-controlled trial which demonstrated that the PDE-5 inhibitor drug tadalafil (approved for erectile dysfunction) may also improve symptoms of bladder outlet obstruction. A total of 200 men (age 40 years and older) diagnosed with lower urinary tract symptoms associated with benign prostatic hyperplasia were randomized to receive tadalafil or placebo for up to 12 weeks. Dmochowski reported that while the number of patients experiencing an obstruction increased in the placebo group, this proportion decreased slightly in the group who received tadalafil. Further, patients who received tadalafil were significantly more likely to experience a relative symptom improvement.
Dmochowski and other study authors disclosed relationships with several pharmaceutical companies including Eli Lilly, the maker of tadalafil (Cialis).
Jian Guo Wen, M.D., of Zhengzhou University in China, presented results from two studies which investigated long-term urologic complications among children with a history of consuming melamine-contaminated milk powder. In the first, ultrasound images from 50 children diagnosed with double kidney stones were analyzed. Most of these (85 percent) occurred between 6 to 18 months of age. Renal failure occurred in 11 children; the diameters of the kidney stones in these children were significantly larger than those in children who did not experience renal failure. In the second study, which included 165 children (ages 50 days to 3 years old), the peak incidence of urinary stones was found to occur between 6 to 12 months of age. Wen reported that half of these cases were asymptomatic (50.3 percent), while the other half experienced dysuria (16.9 percent), infantile colic (14.6 percent), decreased or absent urine (10.9 percent), and bloody urine (7.3 percent). The majority (63.5 percent) of stones were 4 to 10 mm in diameter, although 9.9 percent of cases exhibited stones greater than 10 mm.
Other meeting highlights included "Stromal-Epithelial Interactions in Prostatic Development - BPH and Cancer", the John K. Lattimer Award Lecture presented by David Rowley, Ph.D., of the Baylor College of Medicine in Houston, and the John Duckett Memorial Lecture, which was presented by Laurence S. Baskin, M.D., of the University of California in San Francisco, who discussed the possibility of preventing the birth defect hypospadia.
AUA: Nighttime Urination Linked to Death in Elderly
MONDAY, April 27 (HealthDay News) -- Elderly individuals who need to urinate at least twice per night have a higher risk of death, according to a study presented at the annual meeting of the American Urological Association held April 25 to 30 in Chicago.
AUA: Diet 7-Up + Pomegranate Juice = A Urologist Cocktail
MONDAY, April 27 (HealthDay News) -- Diet 7-Up and other diet soft drinks can help prevent kidney stones, and pomegranate juice can slow the increase of prostate-specific antigen (PSA) levels after prostate cancer treatment, according to papers presented at the annual meeting of the American Urological Association held April 25 to 30 in Chicago.
AUA: Diet Supplements May Not Prevent Prostate Cancer
MONDAY, April 27 (HealthDay News) -- Diet supplementation with soy protein, vitamin E and selenium did not prevent the development of prostate cancer in men with a precursor prostate condition, according to research presented at the annual meeting of the American Urological Association held April 25 to 30 in Chicago.
AUA: Panel Addresses Prostate Screening Controversies
MONDAY, April 27 (HealthDay News) -- Some restrictions on prostate-specific antigen (PSA) testing could result in substantial cost savings without compromising patient safety, according to research presented during an expert panel session at the annual meeting of the American Urological Association held April 25 to 30 in Chicago.
AUA: Statins Have Wide Range of Urological Benefits
MONDAY, April 27 (HealthDay News) -- A growing body of evidence suggests that statins are associated with multiple urological benefits in men, according to six studies presented during an expert panel session at the American Urological Association annual meeting held April 25 to 30 in Chicago.
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