This double-blind, placebo-controlled, phase II study showed a significant improvement in the NIH CPSI total score from baseline in patients treated with silodosin, 4 mg, versus placebo (−12.1 vs −8.5). The patients in the silodosin, 4 mg, group also experienced marked or moderate improvement in the global subjective assessment in a significantly higher proportion compared with the placebo-treated patients (Table 2). It remains Inhibitors,research,lifescience,medical to be seen

whether Watson Pharmaceuticals will conduct a properly designed and empowered phase III study utilizing silodosin either in a 4-mg or an 8-mg dose for the treatment of CPPS.32 Table 2 Effects of Silodosin in Men With Moderate or Severe Chronic Prostatitis/Chronic Pelvic Pain Syndrome BPH Surgical Therapy and New Technology Thirty-two abstracts

were presented in two sessions on surgical therapy and new technology. Doctors Lee and Lerner from Massachusetts examined the surgical management of BPH by way of a 90-item online survey mailed by the AUA, the Veterans Administration, and the Society for Government Service Urologists to 600 Inhibitors,research,lifescience,medical urologists. The goal was to compare the utilization of 12 surgical techniques. A total of 600 urologists replied with 570 currently performing BPH surgery. The percentages of urologists utilizing the various procedures are: Inhibitors,research,lifescience,medical open prostatectomy (OP) at 78% of respondents; monopolar TURP, 73%; photoselective vaporization (PVP), 58%; button TURP, 24%; bipolar TURP, 20%; holmium laser enucleation of the prostate (HoLEP), 18%; thulium laser ablation of the prostate, 4%; and ABT-263 laparoscopic (LP) and robotic (RP) Inhibitors,research,lifescience,medical simple prostatectomy at 1% and 3%, respectively. When stratified by urologist age, there are no differences in utilization of monopolar TURP or OP, and laser therapies are employed across all age ranges. However, RP is only used by urologists younger than age 50 years. The authors did not observe differences in type of procedures performed in the full-time academic versus nonacademic setting Inhibitors,research,lifescience,medical except for RP and button TURP, which was more often

used in academic settings. Of interest, the frequency of any type of BPH surgery is relatively low, with over half of the respondents doing less than 50 procedures per year: 1 to 24 per year, 23.4%; 25 to 49 per year, 32.1%; 50 to 74 per year, 22.5%; and more than 75 per year, 22.%.90 Three abstracts described isothipendyl endovascular superselective embolization of prostatic arteries as the new method to treat LUTS and BPH less invasively. Kurbatov presented data on 65 patients with moderate to severe symptoms and reported an improvement in the AUA Symptom Score from 21.8 to 7.3 points. Similarly, peak urinary flow rates were significantly improved. Figure 8 demonstrates angiography before and after embolization of the right and the left prostatic artery.91 Figure 8 Angiography before and after embolization of the right and left prostatic artery.