BJUIBJU INTERNATIONAL NEWS ANDU INFORMATIONroscan RESOURCE FOR THE INTERNATIONAL UROLOGY COMMUNITY By Kevin D. Blanchet Cycling Through the Last Eden Madagascar trip raises money for The Urology Foundation Imagine waking up at 5 am each morning enshrouded in a frosty mist outside. By mid- afternoon, you are sweating buckets, pedaling furiously as the temperature climbs and the humidity sets in. By dusk, jackets, a hot toddy and a warm bed are needed as the night chills down. Now, try doing this for five straight days. Such was the adventure of 22 men and women, including six urologists, who embarked on The Urology Foundation’s (TUF) Cycle Madagascar last Riders looking set for the Tour de France. Left to right: John September. Organised every Fitzpatrick, Krishna Patil, Roger Kirby, Alex Cooke, Roger Plail and year by Roger Kirby of The Peter Rimington. Prostate Centre in London, UK, this time the charity ride nation of Madagascar, located (Jay) Smith, Jr. from Nashville, took participants to the island off the southeastern coast of USA. The group also included Africa in the Indian Ocean. The actor Christian Cooke, costar ride raised £56 000 for TUF. In of Cemetery Junction, and his Must Reads at BJUI.org 2009, Roger took the group to brother Alex, an actors’ agent, Malawi, another African nation EMI Records producer Avery For a limited time, read and download for free December’s best (See the December 2009 issue Duff, prostate cancer survivors, papers as selected by BJUI’s editor and reviewers at www.bjui.org. of UroScan to read about the family members and friends. This issue’s selections are: Malawi trip). “This was a similar Wiley-Blackwell employees Gavin • Successful control of schistosomiasis and the changing trip but in many ways much Sharrock, publisher of BJUI, and epidemiology of bladder cancer in Egypt better”, he says. “Madagascar Chris Graf, editorial director, also • Overall survival in patients with metastatic renal cell carcinoma was a more interesting place rose to the challenge. Possibly initially treated with bevacizumab plus interferon-±2a and with its fascinating flora and the most inspirational member subsequent therapy with TKIs: a retrospective analysis of the fauna. The people were so of the group was Andrew phase III AVOREN trial amazingly welcoming”! Etherington. At age 75, Andrew • Prostate cancer death is unlikely in high-risk patients following Joining Roger were fellow has supported the TUF by quality permanent interstitial brachytherapy urologists John Fitzpatrick, participating in every challenge • Patient-specific risk of a missed cancer following investigation editor-in-chief of BJUI; Krishna Roger has organised. “Andrew for haematuria based on a four year follow up Patil from Surrey, UK; Roger Plail is a bit of a legend”, Roger • The prevalence of chronic constipation and fecal incontinence and Peter Rimington, both from explains, “having participated in among men and women with symptoms of overactive bladder East Sussex, UK; and Joseph 25 marathons as well as climbing t UROSCAN t Mt. Kilimanjaro. ... He is an capital city of Antananarivo, toward the coast. “There were an flood-damaged tarmac and huge inspiration to all of us”. known locally as Tana. By the awful lot of long, uphill stretches undulating bumps”. next afternoon, they were hitting of road”, recalls John. “It was RIDE WAS NO PICNIC the road on their way to the extremely hot. One day we cycled THE CALL OF THE LEMUR As the fourth largest island in royal city of Ambohimanga in the rain. The elements were Other highlights of the trip the world, Madagascar is slightly Rova, with its palace and burial not on our side, making our ride included an overnight stay at larger than France. The vast grounds. A UNESCO world quite difficult”. Joe Kirby, Roger’s Lake Mantasoa in Tana, a visit majority of plants and animals heritage site, it remains a son, agrees, noting that “we to the Andasibe Nature Reserve, found there in its microclimates spiritual pilgrimage centre and cycled in torrential rain in the dinner on Lake Rasoa and a are endemic to the country. home to Tana history. rain forest. The visibility was very guided nature walk through After flying from London to Along the way, the participants poor, and it was very humid”. the zoological park in Ivoloina. Madagascar via Paris, the cyclists had to deal with some difficult Having studied international Krishna Patil often engaged the began their adventure in the riding as they toiled their way economics as part of his group with evening talks on Masters degree, Joe was quite Hinduism and meditation classes. Clinical Trial surprised at the quality of roads One evening in a remote village, in Madagascar. “Road quality is another rider, Georgina Stewart, a good indication of the level managed to put together an TITLE: of government corruption”, he impromptu party for Christian rd AA4500 IN THE TREATMENT OF PEYRONIE’S DISEASE explains. “I cycle a lot in France. Cooke’s 23 birthday. “It was held Even compared to some of at this small wooden building PROTOCOL ID: the roads there, the main road the people had managed to connecting the coast to the construct in the deepest part NCT 01221623 middle of the country was pretty of Madagascar”, says Joe with SUMMARY: good with very few potholes”. admiration. “The locals gave us Not all of the minor roads were music and dancing that night”. This phase 3, double-blind, randomized, placebo-controlled smooth, however. “On the last However, Joe, Christian and the study is evaluating the safety and efficacy of AA4500 for day, we journeyed by bus for two other younger riders couldn’t the treatment of Peyronie’s disease. Participants will be hours on a stretch of road that understand why the streets were stratified into groups depending on their degree of pe- nile curvature and then randomized into treatment or a had taken us only three hours to so deserted. “We didn’t realise placebo group (2:1 ratio). Following each treatment cycle, navigate by bike the day before”, they had a set curfew of 10 the investigator (or designee) will stretch the plaque to recalls Roger Plail. “Such was pm—a leftover from the civil war model it. Once curvature is lowered to less than 15º after the state of the highway with in the country just a year ago.“ one to three treatment cycles, no more treatment will be given. There will be a maximum of four treatment cycles per subject. Participants will continued to be monitored IMportant pApERS for safety and efficacy at various time intervals up to one you may HAvE MISSED JOURNAL year. The primary outcome measures will be the percent improvement from baseline in penile curvature and the WATCH change from baseline in the Peyronie’s disease bother do- • O’Connor OJ, Fitzgerald E main, both at 52 weeks. Once they complete this protocol, and Maher MM. Imaging of subjects receiving placebo may opt to receive open-label hematuria. AJR: Amn J Roentgenol AA4500 as part of another study. 2010; 195: W263-W267 • Mendenhall WM, Nichols RC, Henderson R ELIGIBILITY: and Mendenhall NP. Is radical prostatectomy Subjects will be men age 18 years and older who are in the “gold standard” for localized prostate a stable relationship with a female partner/spouse for at cancer? Am J Clin Oncol 2010; 33: 511-515 least three months before screening. They must be willing • Westerlund A, Steineck G, Bälter K, et al. to have vaginal intercourse with the partner/spouse. Pey- Dietary supplement use patterns in men with ronie’s disease should be present for at least 12 months and be stable at the time of study entry. The penile cur- prostate cancer: the Cancer Prostate Sweden vature must be at last 30º in the dorsal, lateral or dorsal/ Study. Ann Oncol 2010; October 6. [Epub ahead lateral plane at screening. of print] • Cunningham GR and Toma SM. Why is LOCATIONS AND CONTACTS: androgen replacement in males controversial? There are 34 study locations in the US and Australia. For US J Clin Endocrinol Metab 2010; September 29. information, contact Karen Raudibaugh, Auxilium Phar- [Epub ahead of print] maceuticals, (484) 321-5900, ext. 2123, kraudibaugh@ • Soccorso G, Ninan GK, Rajimwale A et al. auxilium.com. For Australian information, contact Ni- Acute scrotum: is scrotal exploration the best gel Jones, Auxilium Pharmaceuticals, (44) 1443-421707, [email protected]. management? Eur J Pediatr Surg 2010; 20: 312-315 UROSCAN going to stop for you”. Roger Plail also found the traffic scary at times. “Vehicles would come towards us two or three abreast. The drivers were bemused that Lycra-clad bike warriors would even dare contest the highway with them”. According to him, the riders often shared the road with trucks and ox-drawn makeshift pallet carts with noisy metal wheels. “We’d all be hurtling down hairpin turns overtaking them”. Another lasting memory was Riders were greeted by lemurs, Want to buy some beads? Roger Kirby gets the Mardi Gras the group’s visit to a remote whose eerie calls left a treatment from children at a Madagascar village. hospital, “which was incredibly powerful impression. poor”, remembers John. “The place was full of patients However, the greatest remain with all of us for quite as possible with no breaks—just with malaria and other tropical impression was made by the some time”, he says. “They have coasting”, remembers Roger. At diseases being treated with black and white Indri lemurs, a high-pitched shrill that echoes other times, riders had to share virtually no facilities at all”, Roger found only in the Madagascan and reverberates all around. It is the main, two-lane road leading recounts.