In an article by Nguyen et al published in JAMA (2011) the results of a meta-analysis of 8 studies (4141 men) showed no evidence to link excess cardiovascular death with androgen deprivation therapy used to treat advanced prostate cancer. Observational studies have previously reported an association. The authors did acknowledge that there was still a possibility of excess mortality in a subgroup of men with a history of heart attack or heart failure.

The International Cystitis Network has developed an app for iPhones and iPads that gives patients with overactive bladders the confidence to select foods and drinks that should not aggravate their condition. It contains a list of more than 250 items divided into three categories: bladder friendly foods, foods worth trying cautiously, and foods to avoid. Users will also find highlighted foods and beverages that will be soothing to them during interstitial cystitis flare-ups. There are even recommendations for lower acid wines, pale ale beers and mixed drink mixers. The app can be purchased for 99 cents and downloaded from Apple’s App store.

A recently updated Cochraine review published in BJU Int (2012) concludes that extracts of the fruit of Seronoa repens (otherwise known as the American saw palmetto) does not improve the urinary symptoms associated with benign prostatic enlargement compared to placebo (sham treatment). The reviewers studied 17 randomised controlled published studies to reach this conclusion.

In a large study of men following radical prostatectomy for pT3 prostate cancer published in Eur Urol (2012) Briganti et al investigated whether radiotherapy was best given early (adjuvant) or delayed (salvage) until PSA started to rise (but was still below 0.51). 500 men were observed and 390 treated immediately. At 2 and 5 years there was no difference in PSA relapse (PSA >0.2). They concluded that it was safe to withhold radiotherapy until relapse, rather than treating all patients based on the risk that they may recur. This approach avoided treating 55% of patients that they monitored, thus avoiding the risks of overtreatment, without compromising cancer cure.

In an article by Holmang et al in Eur Urol (2012) the authors looked at bladder tumour recurrence after intravesical BCG treatment. Recurrent tumours were seen even after 10 recurrence free years and the authors therefore conclude that patients should be followed for at least 15 tumour free years, if not indefinitely.

Oral capsules of lactobacillus effectively reduce recurrent urinary tract infections without causing resistance or interfering with normal human bacterial flora. However, in a head to head trial published in Arch Intern Med (2012) comparing lactobacillus to antibiotic (cotrimoxazole) suppression therapy, lactobacillus treatment was not as effective at reducing recurrent urinary tract infection In post menopausal women as the antibiotics.

Women treated with lactobacilli prophylactically for 12 months saw a reduction in the mean number of UTIs from 6.8 to 3.3, whereas those women treated with prophylactic trimethoprim-sulfamethoxazole had a reduction in the number of UTIs from 7.0 to 2.9.

After a price reduction in the drug arbiraterone the National Institute of Clinical Excellence (NICE) has changed its draft guidelines to approve the drugs use in advanced prostate cancer. It is now recommended for use in advancing prostate cancer which is no longer responsive to hormone treatment or the chemotherapy docetaxol.