Nocturia: Causes, Consequences and Clinical Approaches is the first volume exclusively on the topic of nocturia and is designed to be a comprehensive treatise on the subject. The volume is organized into 11 chapters first introducing and defining nocturia and its impact to patients and society, followed by chapters dealing with predictors and risk factors; relationship to sleep disorders; overactive bladder; and water homeostasis. Therapeutic areas addressing nocturia are covered in specific chapters and include pharmacotherapy affecting the bladder, prostate and kidneys as well as behavioral therapy and surgical intervention. Separate chapters are devoted to alternative therapies as well as the impact of nocturia in the elderly. The volume closes with a chapter presenting avenues for future investigation into the etiology and management of nocturia. Clinical case scenarios inclusive of figures and tables illuminate the evaluation and management of patients with nocturia. Nocturia: Causes, Consequences and Clinical Approaches will give physicians and related healthcare providers the background to understand the conditions causing nocturia, how nocturia affects society and the basis for its rational treatment. It will be used as a state of the art reference by urologists, urogynecologists, internists, nephrologists, pulmonologists, endocrinologists and sleep medicine specialists.

Urolithiasis is a common disorder which is recognised in most parts of the world and occurs in both man and animals. The multifactorial nature of the problem requires an interdisciplinary approach which has always been a feature of this series of International Symposia which started in Leeds in 1968 and has progressed at four-yearly intervals through Madrid, Davos and Williamsburg. The latest Meeting, at Garmisch-Partenkirchen in April 1984, involved 302 participants from all five continents. The major emphasis of the Meeting was to blend the basic and clinical research on urolithiasis. Comprehensive reviews of the major areas of current research were presented by invited speakers, all internationally recognized experts in their fields. From more than 250 submitted abstracts, 18 were selected for oral presentation and the remainder presented at three afternoon poster sessions which provided an opportunity for informal and more lengthy discussions of the work on display. The Meeting also included three ad hoc Evening Discussions on how to approach various unsolved questions in the clinical and laboratory evaluation of stone patients and four Round Table Discussions involving specialists in the field who debated the theoretical aspects of stone formation in the urinary tract, the measurement of inhibitory activity of urine, the treatment of idiopathic stones with drugs, and the nature and treatment of stones arising from urinary tract infection.

A number of chapters present the most novel research on testicular and epididymal functions or on more general fields of hormone action and molecular cell biology as it is now a tradition. However, exceptionally, the book also contains several chapters dealing with the "Approaches and Tools in the Third Millenium." The unusual inclusion of technologies as such in the 2000 edition of the workshop was an absolute necessity, as these technologies are revolutionizing the fields of biology and medicine and, in many instances, how to do research. This volume gives the scientific community essential information about the very latest technical developments and their potential for future progress.

"Endourology" provides a summary of the different endourological modalitites, especially the more advanced and controversial techniques, such as the antegrade resection of urethral valves, the transperineal I 125 seed implanations, the spoonloop resectoscope, flexible endoscopy, teflon injection to correct vesicoureteral reflux, stone manipulation in calyceal diverticula, as well as the extraperitoneal pelvioscopy. These techniques are supported by descriptions of the standard endourological procedures.

This volume contains the text of the main lectures given by interna- tionally recognized scientists at the Tenth European Workshop on Mo- lecular and Cellular Endocrinology of the Testis, held in Capri, Italy, from 28 March to 1 April 1998. Topics include spermatogonial transplantation, germ stem cell biol- ogy, regulation of meiosis and spermiogenesis, growth factors, cell sig- naling and transduction, steroidogenesis, androgen-regulated genes, sperm activation and sperm factors active at fertilization and the mo- lecular basis of specific pathologies of the testis. Looking back at the previous "Capri edition" (1986), the lectures of which were published by Elsevier, it is perhaps not surprising to notice that many of the top- ics addressed at that time are basically the same now. On the other hand, it appears evident that the search for experimental models of sig- nificant physiological value to study testicular function has advanced greatly. In this connection, the use of genetically manipulated animal models in the study of the regulation of spermatogenesis and of the en- docrine role of the testis represents a core part of the present volume. The authors deserve our special thanks not only for delivering ex- cellent state-of-the-art lectures, but also for providing their manuscripts well before the meeting.

An intense discussion has recently begun regarding current standards in the diagnosis and treatment of benign prosta tic hyperplasia (BPH). A number of factors have led to this discussion. In an increasing proportion of aging men, for example, BPH causes so-called obstructive symptoms that must be relieved by medical or operative means. This entails an immense social and economic impact in terms of health costs. In addition, recent data indicate the most frequently performed operation for BPH - transurethral resection of the prostate - is associated with a higher risk of death due to cardiac disease than open prostatectomy. Furthermore, studies using the recently developed technique of uro dynamics to assess bladder outflow obstruction reveal that about 20% -30% of patients treated with transurethral resection or open prostatectomy are actually not obstructed. This means that these patients do not receive the most effective therapy. Finally, various new treatment been developed, including medical treat modalities have ment directed at endocrine pathways in the prostatic cells, balloon dilatation, spirals, temporary or permanent stents, C). nd the application of heat in hyperthermia or thermo therapy. The contributions to this volume were selected from a symposium on the diagnosis and treatment of BPH. They are intended to provide a comprehensive review of the state of the art in treating BPH. Aachen, Liege, Maastricht, September 1992 The Editors Contents Development of Benign Prostatic Hyperplasia 1 J. E. Altwein and H. Baur Bladder Outflow Obstruction: Definition, Clinical Application, and Grading in Benign Prostatic Hyperplasia. . . . . . ."

Laparoscopy is a new frontier of the surgical technique, which recently gained more and more popularity and credit upon the surgical teams, also in Urology. The reason stays in the reduced invasivity and in the advances on the techniques of "video-assisted surgery." More recently the retroperitoneal access to laparoscopy surgery ("retroperitoneoscopy" or "retroperitoneal laparoscopy") opened a new surgical approach to several diagnostic and operative procedures for a large number of urogenital tract diseases. The applications in pediatric and in adult age and the technical challenges are widely debated at the moment. The volume gathers contributions by internationally renowned authors and is a complete overview of the technique. The book addresses urologists, general and abdominal surgeons, pediatric urologists and pediatric surgeons who are interested in minimally invasive procedures and particularly in retroperitoneal laparoscopy.

Professor Egon Diczfalusy, a pioneer in gynaecological endocrinology and in particular female contraception, celebrated his 80th birthday with a scientific symposium. The participants were scientists from all over the world who had been scholars and close collaborators at different points in time. The interdisciplinary meeting consisted of lectures on the epidemiological impacts of ageing, its challenge for the pharmaceutical industry, philosophical aspects of the future of mankind, and the history and future of contraception. Three round table discussions addressed the hormonal control of reproduction and ageing, new approaches and future perspectives of contraception for women and men, and hormone replacement in the elderly.

This volume is concerned with the clinical aspects of urology in childhood; the anatomy, physiology and pathology are discussed only where they have a direct bearing upon the clinical problem, and for a detailed description of these aspects, and of operative technique, the reader is referred to other volumes of this series. Emphasis is laid upon the disorders peculiar to infants and children, so that diseases such as tuberculosis, the manifestations of which in the child differ little from those in the adult, receive less attention. Childhood is deemed to cease with the completion of puberty, though illustrations have sometimes been taken from adolescent cases. The personal views expressed in this work are based upon experience at The Hospital for Sick Children, Great Ormond Street, at St. Peter's and St. Paul's Hospitals, and at the Institute of Urology, University of London. I am deeply indebted to all my colleagues and assistants at these institutions for their help and co-operation both in the trea.tment of cases and in the preparation of this volume. I would particularly wish to thank Mr. T. T. TwrSTINGTON HIGGINS for introducing me to the urology of childhood, Drs. M. BODIAN, R. C. B. PUGH and L. L. R. WHITE for their assistance in matters of pathology, and for preparing specimens for illustration, Dr. "\V. W. PAYNE for his advice on biochemistry, Dr.

In recent years the pace of research in prostate cancer has increased dramatically. Creative ideas in combination with new and emerging technologies have led to an explosion of discovery. These types of advances in prostate cancer research presage an era of new treatment strategies based on an understanding of the cellular and molecular mechanisms of disease.
In creating this book, we aimed to cover a broad "bench to bedside" research spectrum ranging from: genetic, molecular and cellular analyses to epidemiological studies, refinements in local treatment strategies and new biologically based non-hormonal treatments for systemic disease.
Researchers and clinicians will find in this book a group of timely and clinically relevant chapters on prostate cancer research and treatment.

This volume comprises the proceedings of the sixth in a series of International Symposia devoted to basic and clinical aspects of urolithiasis. Previous symposia have been held at intervals of four years in Leeds, Madrid, Davos, Williamsburg, and Garmisch-Partenkirchen. The sixth symposium was held in Vancouver, British Columbia and was attended by over 250 participants from 26 countries around the world. As may be seen from the contents of this volume, the meeting covered many aspects of urolithiasis including the underlying physiology, crystal formation and the effects of inhibitors and promoters on crystallization, endocrinology and abnormalities of urinary composition, analyses, geography and epidemiology, and medical and surgical treatment with a special emphasis on extracorporeal lithotripsy. Internationally-recognized authorities gave invited talks in each of these areas, and from the submitted abstracts 30 were selected for oral presentation and the remainder were presented in either general or theme poster sessions. The nine theme-poster sessions provided a particularly valuable and successful feature of the meeting, giving an opportunity for a group of researchers working in related areas to present their posters and also to give a brief oral summary which was followed by discussion with the audience. Each of these poster sessions was chaired by two experts in the field who have provided an overview of each theme-poster session for this volume.

WEGENER'S GRANULOMATOSIS & ANCA-ASSOCIATED DISEASES: THE STORY CONTINUES The disease now designated as Wegener's granulomatosis (WG) was first described in 1931 by Heinz Klinger, who considered it to be a special form of polyarteritis nodosa. Klinger's friend, Friedrich Wegener, expanded on the first observations and interpreted the pathological and clinical fmdings to represent a distinct disease entity (Wegener, 1939). He described this entity as a "peculiar rhinogenous granulomatosis with a unique participation of the arterial system and the kidneys". Later, Godman and Churg (1954) established the classical diagnostic criteria (the "WG triad"): granuloma, vasculitis, and glomerulonephritis. In 1958 Walton pointed out the poor prognosis of WG based on a small number of published cases (mean survival time: 5 months). In 1966 Carrington and Liebow reported "limited forms" of WG with a defmitely more favorable prognosis. Since then positive results have been reported with cyclophosphamide therapy. In addition, a retrospective study of combined low-dose cyclophosphamide and prednisolone in 85 WG patients over a period of 21 years found a similarly encouraging outcome. The*latter experience led to the current "standard" treatment protocol (FAUCI et al. , 1973 and 1983). More recently, strong evidence has emerged that some of the morbidity and mortality ofWG - and other types of systemic vasculitis - may be a consequence of this treatment (Hoffman et al. , 1992).

Laparoscopic surgery is of paramount importance for achieving minimal invasiveness and respect for the quality of life - two hallmarks of contemporary medicine. Laparoscopy is at the forefront of urology today, with dramatic advances in engineering and surgical technique. Because they promise to be less invasive, the innovations presented in this volume will become tomorrows standard. In utero and pediatric laparoscopic surgery are discussed, as are varying approaches to laparoscopic adrenalectomy. Other topics include radical surgery for renal cell carcinoma and transitional cell carcinoma, nephron-sparing laparoscopic surgery for renal cancer, and retroperitoneal lymphadenectomy for testicular cancer. With sections on pyeloplasty, nephropexy, urolithiasis, stress incontinence, kidney transplantation, and dialysis, this book is an especially valuable source in the fields of endourology, laparoscopic surgery, pediatric surgery, and endocrine surgery.

Proceedings of the FEMS Symposium on Genes and Proteins Underlying Microbial Urinary Tract Virulence: Basic Aspects and Applications, held September 16-19, 1999, in Pecs, Hungary. Urinary tract infections are among the most frequent diseases caused by microbial pathogens. In this volume, researchers, clinical microbiologists and clinicians exchange the latest ideas covering four major aspects of this important topic: * Genetic information, synthesis and assembly of virulence factors in urinary pathogens; * Regulation of genes involved in the phenotypic appearance of virulence; * Host-parasite interactions determining the process and outcome of the infection; * Possible applications of the above aspects in diagnosis, therapy and prevention.

Extracorporeal shock wave lithotripsy (ESWL)" arrived in the United States in February of 1984 with explosive impact in the field of urology. The first ESWL treatment in the United States with the Dornier H~ device occurred at the Methodist Hospital of Indiana, and by the end of 1984, In spite of the rapidly the United StatesESWL study group had accrued over2,5()() ESWL treatments. accumulated experience at the six institutions involved in the FDA trial of the Dornier HM] device, other urologists in this country and around the world had little opportunity to gain knowledge about the utilization of this revolutionary technique. For this reason, the Methodist Hospital of Indiana organized the first symposium on shock wave lithotripsy in February of1985. Interest in this meeting was intense, as approval of the Dornier device had occurred only a few weeks earlier in December of 1984. Because of the success of this initial meeting, subsequent meetings have been held annually in Indianapolis. Following the third annual symposium on extracorporeal shock wave lithotripsy in March of 1987, a number of participants and attendees requested that the information presented at the meeting be made available. Therefore, plans were made to publish the proceedings of the next meeting which occurred March 5 and 6, 1988. The Methodist Hospi tal ofIndiana' s 4th Symposium on Shock Wave Lithotripsy: State of the Art was the best attended meeting to date with over 650 registrants from 36 states and 24 countries.

The field of genito-urinary oncology is rapidly evolving at virtually every level. Significant advances have been made in our understanding of the molecular and cellular events which contribute to the generation of GU malignancies. At the same time, similar advances have been made in the clinical arena which have improved the diagnosis and treatment of urologic cancers. This volume attempts to summarize those advances which most impact us as clinicians, and has been divided into three sections. Section One, 'Diagnostic advances: the use of molecular medicine in the diagnosis and prognosis of GU malignancies', details how epidemiologic studies and new molecular techniques are impacting our ability to diagnose and treat GU tumors. Section Two, 'Surgical and radiation advances', details the recent major advances in the treatment of organ-confined cancers. Section Three, 'Medical advances', addresses major issues in the treatment of metastatic disease. This volume will serve as a compendium of the advances, both at the basic science and clinical levels, which are currently impacting practicing oncologists and urologists.

Male Reproductive Function gives an up-to-date review on the physiology and disease processes associated with the male reproductive system. The first few chapters describe the regulation of the functions of the testis and the integration of its components: germ cells, Sertoli cells and Leydig cells. This is followed by a description of puberty and aging, and the disorders or dysfunction that may be associated with these physiological processes. Discussions on the current methods for the diagnosis and treatment of male hypogonadism, male infertility and male sexual dysfunction follow, with detailed descriptions of types of androgen replacement and the benefits and risks of such treatment. The book concludes with the development of male contraception and the possible influence of the environment on the male reproductive system. Male Reproductive Function represents a conglomeration of the efforts of experts in andrology from all over the world, both in basic cellular/molecular biology as well as in clinical science and practice. This book is suitable for endocrinologists, urologists, general internists, gynecologists and other students in the field of male reproduction.

These proceedings emanate from the Second Prouts Neck Conference on prostate cancer held on October 17-19, 1986, the theme of which was treat ment, with focus on current issues and future research that is needed to answer critical questions related to optimal management of the various stages of prostate cancer. The objective was to reveal the most crucial problems impeding progress and to crystallize the combined multidisci plinary input generated by the conference into focused concepts or recommendations for presentation to the National Cancer Institute (NCI), with the ultimate intent of targeting research to address the priority issues identified. In organizing the workshop, every effort was made to maintain a multidisciplinary balance among nationally renowned authorities on prostate cancer. Thus, leading surgeons, radiation and medical onco logists and biostatisticians were in equal presence. While there were spirited exchanges with careful scrutiny and critique of all data pre sented, there was a common belief that the challenge of prostate cancer would be best approached in this multidisciplinary Organ Systems-oriented fashion. During the course of the conference, it became apparent to all present that major nomenclature and procedural barriers have made it generally difficult, and frequently impossible, to compare results of clinical research."

This book is the record of the proceedings of a NATO Advanced Study Institute held in Erice, Sicily, from the 2nd - 12th June 1981, during which scientists and clinicians interested in the problems presented by cancer of the kidney and the prostate were encouraged to present, to discuss and to challenge the opinions expressed and the beliefs held by the different contributors. It is uncommon for scientist, physician, and surgeon to meet with great regularity or for prolonged periods of time and it must be exceedingly rare for such people to immerse themselves in each other's work and company for aperiod of almost two weeks. For this to occur in a situation of total isolation such as that provided by the marvellous Ettore Majorana Centre in Erice, Sicily must be unique. The fact that differences of opinion remain will be evident to all who read the book, as will the wealth of scientific and clinical work being undertaken within and beyond the NATO countries. We are very much indebted to the Science Committee of NATO for their recommendation for support for this meeting and to the Ente Fiuggi and to several pharmaceutical firms.

During the past two decades research on the testis has created a vast number of publications. New techniques, such as cell and gene clon ing, germ cell manipulation and transplantation, as well as gene ex pression, have surpassed the classical approaches that involved studies on receptor activation and endocrine, paracrine and autocrine regula tory mechanisms. Due to the expansion of this field of research it has become increasingly difficult to integrate the large number of observa tions and relate them to the physiology and pathophysiology of the tes tis. More emphasis must, therefore, be put on the integration of isolated findings and the construction of the total picture. In order to stimulate this specific mental activity we have named this book Testicular Tan gram. We hope that the chapters in this book will be used as pieces of the testicular puzzle and that the reader enjoys composing new shapes. The chapters of this book are representative of the plenary lectures presented at the I ih European Workshop on Molecular and Cellular Endocrinology of the Testis held in Doorwerth The Netherlands, from April 6 - I 0, 2002. Publication of this book has been made possible by the generous support of the Ernst Schering Research Foundation. We would also like to thank the distinguished scientists, who have pro vided us with their excellent manuscripts well before the start of the Workshop. We acknowledge the help of Dr. U. -F. Habenicht, Dr. M.

In the years since its development in West Gennany and particularly since its arrival in the United States, extracorporeal shock wave lithotripsy (ESWL') has become the treatment of choice for most cases of urinary lithiasis. The fIrst shock wave lithotripsy patient in the U.S. was treated with a Domier HM3 in February of 1984 at the Methodist Hospital of Indiana. In response to the great enthusiasm generated by this new treatment modality, the following year the MHI presented its fIrst symposium on shock wave lithotripsy. Each year the meeting generated more and more interest. Following the 1988 symposium, the presentations were published in a book entitled Shock Wave Lithotripsy: State of the Art. Following on the heels of the success of kidney stone treatment with ESWL, the new field of biliary lithotripsy rapidly was gaining momentum. In response to the great interest generated by this additional application of the technology, the 1989 meeting focused special attention on this new method of treating gallstones. Methodist Hospital's 5th Symposium on Shock Wave Lithotripsy, which was presented in March of 1989, had the largest attendance ever, with over 600 physicians from 42 states and 20 countries. The publication of the proceedings of this meeting was made possible by generous educational grants from Domier Medical Systems, Inc., Marietta, Georgia, and the Methodist Hospital of Indiana. The primary purpose of the publication of the proceedings of this symposium is educational.

This book is based on presentations by some of the world's leading experts at the Sixth International Conference on Clinical Cancer Prevention, held in St. Gallen, Switzerland, during March 2010. The main themes are the latest advances in the prevention of breast and prostate cancer and the role of infection in the development of liver and gastric cancer. Special emphasis is given to perspectives on the chemoprevention of breast cancer, as the conference included an international consensus meeting on this subject. New research findings are presented and potentially more effective cancer prevention strategies are discussed, with careful consideration of controversies. The expertise of the contributors encompasses genetics and microbiology, epidemiology, and health economics, as well as clinical cancer prevention. This book will be of interest to all who wish to learn about the most recent progress in combating the development of cancer.

Prostate cancer remains the most common malignant tumor in elderly men. The National Cancer Institute estimated 210,000 new cases of prostate cancer in 1997. There is, however, no means of documenting the true incidence of prostate cancer because of the difficulty in detecting all cases. Even using yearly rectal exams, PSA determinations, and ultrasound-guided prostate biopsies, many cases are missed. Suffice it to say that prostate cancer is a widely occurring disease in men and early detection and treatment are extremely important. When I trained in Urology under Dr. Reed Nesbit at the University of Michigan from 1956 to 1959, the diagnosis of prostate cancer was made by a rectal examination and an acid phosphatase determination. If there was a small nodule in the prostate, then an anterior-posterior X-ray of the pelvis was obtained to look for possible bony metastases. If the acid phosphatase was normal and there was no evidence ofa bony metastasis, the prostate was exposed through the perineal approach and a biopsy of the nodule was obtained and sent for frozen section to Pathology to determine if it was indeed a cancer of the prostate. If the biopsy came back positive, the surgeon then proceeded to do a radical perineal prostatectomy. In those days, we usually did eight to ten radical perineal prostatectomies yearly. Many times the nodule that was biopsied was benign, and the incision was simply closed.

The master tool of logic is the syllogism. If A> Band B> C, then it must follow as the night the day that A > C. If the major and minor premises are true or scientifically correct by current knowledge, the conclusion is true or at least scientifically correct by current knowledge. The demographer of today beams a clear message, which if not true is at least scientifically correct by current knowledge. In the first 80 years of the Twentieth Century, the 'over-65' population of Americans increased eight fold. By century's end it will have increased 12-fold and shortly thereafter will include one in five Americans. While initially a fact of the developed world, the pace of similar graying is accelerating even more rapidly in the Second and Third Worlds. This gray delta constitutes about 35 million living Americans, who may use one-half or more of the health care resources. A would have to be a lot more foolish than B if they failed to recognize that in the coming decade the causation, case-mix, and area of the gray delta demands a change from early, mid-or even later-century medicine. If Homer Smith was right in saying, "We are what we are because we have the kind of kidneys we have" and "The kidneys make the stuff of philosophy", then the who, what, where, when, and why the gray delta will be cared for must focus on the stuff of geriatric nephrology.