AUA Convention Chicago - 2003

Yesterday evening we had a fine evening in the House of Blues, however without much blues, but with much booze and just plain good live music. There was a nice atmosfere and people were all dancing around, driven by an oldfashion lightheadedness and a lowering of the daily threshold. The InterContinental Hotel, residence of your Reporter Team, was built in 1929 as a luxurious gym, even including a mooring point (a sort of small Bagdad minaret) for the airplanes of that time, the Zeppelins. It is a nice change from the concrete skyscraping monsters of today, although those are some 80 floors higher (like Sears Tower with its 102 floors). A real gem is the swimming pool on the 12th floor (amazing that they puuled it off to support all those tons of water!), in which Johnny Weismuller trained to prepare for the Tarzan movies. Your Reporter was there and took a dive!

Niews from the AUA frontline:
The very early morning session started at 5.45 featuring Parsons on Interstitial Cystitis, who highlighted various features of this disease. The incidence is quoted to be 1 in 4.5 women and 1 in 40 man. Symptoms include frequency, urge and pain. The patient group may be called heterogeneous, including vaginitis, urethral syndrome, scrotalgia, ejaculatory pains, chronic prostatitis. There is one unique sign: urologists generally want to stay clear of these patients. On of the key tests is the Potassium sensitivity test, a pain provocation test using bladder instillation of a 40 cc potassium solution (40mEq Potassium in 100 cc H2O). It will yield $140 per instillation in the US. It is found to be positive in 40% of cases. The pathophysiology of this syndrome needs furtherv research and its high incidence is alarming. Today's morning session featured a Point-Counterpoint discussieon between Zvi Fuks and Nelson Stone: external beam radiotherapy vs. brachytherapy for prostate cancer. According to presiding Arthur Porter 'for the occasional patient' - as you know, most US urologists still do not like the idea of radiotherapy for prostate cancer. Fuks started off with a convincing story in favour of RT, explaining that the Intensively Modulated version (IMRT) is able to deliver high dose radiotherapy (upto 88 Gray) to the prostate without the urge that somtimes accompanies brachytherapy (also the IMPB version).
The end results approach a PSA-relapse free percentage of 96 in case of low-risk prostate cancer. Stone's pictures were almost as nice as Fuks', and his story just a bit more convincing: while sparing urethra and rectum better than with IMRT, even higher dosages can be delivered to the prostate (upto 140 Gray), while brachytherapy is not bothered by movements of the prostate. A few seeds may fall out without affecting the delivered does all that much. Apart from that, IMRT may lead to additional bladder cancer in 6 percent of treatments. And, important for a lot of US urologists, there is a code for brachytherapy.
A randomized trial seems necessary and feasible, especially for high-risk prostate cancer.

During the session on medical treatment of BPH, alpha-blockers were shown to increase blood circulation in the prostate and bladder with about 23 percent, thereby lowering pain sensations in the bladder upon KCl bladder instillation, which maybe explains the symtomatic effects of those medications in case of the pelvic pain syndrome (abs 1782, Austria). Doppler ultraosund shows that finasteride lowers blood circulation in the prostate within 1-2 weeks bij 23 percent, most prevalently in the transitionzone (abs 1785, USA, abs 1786, Austria). Possibly, this could enhance visualisation tumor neovascularisation of prostate malignancies using Color Doppler, while it might also create opportunities for TUMT treatment, better results being created through less cooling and therefore higher temperatures.

From the exhibition floor:
Testosterone gel is highlighted by both Auxilium and Solvay, highlighting the increasing number of men in need for adjuvant hormonal therapy.
A novelty is the FoleyGoalie, which firmly connects the penis to the Foley catheter by way of 'chinese fingers', thus preventing the patient from removing his catheter. Only to be used if sufficient penile length. Costs 20 Dollar.
Another novelty is a special non-absorbable clip specially designed for vasectomies. The surgery should then be less painful and shorter. If only the cost of 350 Dollars per two clips could be lowered ...

That's it. While a thundering storm rages above us, using at least one skyscraper as an electric conductor, your Reporter Team agains signs off, a job being done again.

See you again next year. San Francisco seems a nice enough place to go to.

ENGLISH version 26 April 2003 27 April 2003 28 April 2003 29 April 2003 30 April 2003

DUTCH version 26 April 2003 27 April 2003 28 April 2003 29 April 2003 30 April 2003