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Urologists at NewYork-Presbyterian Hospital will make a presentation on the medical and ethical guidelines for post-mortem sperm retrieval (PMSR) in the context of successful pregnancies resulting from PMSR and increased public demand for the procedure. The presentation is one of several to be made by NewYork-Presbyterian Hospital urologists at the American Urological Association (AUA) meeting in Chicago on April 26.

The AUA meeting is organized and directed by the Association's Secretary, Dr. Carl Olsson, Chairman of Urology and J.K. Lattimer Professor of Urology at Columbia University College of Physicians & Surgeons and Director of the J. Bentley Squier Urological Clinic at Columbia University Medical Center at NewYork-Presbyterian Hospital.

Post-Mortem Sperm Retrieval

Requests for PMSR are occurring with increasing frequency, demonstrating a need for medical and ethical guidelines, said Dr. Peter Schlegel, Acting Chairman of Urology at Weill Cornell Medical College and Acting Urologist-in-Chief at Weill Cornell Medical Center at NewYork-Presbyterian Hospital. The postmortem use of frozen spermatozoa to attempt to achieve a pregnancy has been available for cancer patients, but only recently has assisted reproduction technology offered a realistic chance of success.

Dr. Schlegel will discuss a set of ethical guidelines for PMSR in four categories: (1) intended consent of the deceased man; (2) next-of-kin or legal consent; (3) sudden death; and (4) consent to a one-year period of quarantine of the specimens for bereavement. The PMSR guidelines were first established in 1994, using a multi-specialty panel of physicians, psychologists, legal, ethical and administrative staff.

Dr. Schlegel will also make a presentation on new research on detecting mutations in a gene that is important for sperm production. This gene, potentially a source of infertility, was mutated in one percent of male infertility patients tested.

Urologists from Weill Cornell Medical Center and Columbia University Medical Center at NewYork-Presbyterian Hospital will make presentations at the upcoming AUA meeting on a variety of additional urologic topics.

Additional Urologic Topics

• Male andropause. Dr. Harry Fisch Associate Professor of Clinical Urology at Columbia University College of Physicians & Surgeons and Associate Attending Urologist at Columbia University Medical Center at NewYork-Presbyterian Hospital will make a presentation on male andropause, a cause of decreased libido, muscle mass, and increased depressive symptoms. He will also present on a recent study, showing that use of anti-estrogen clomiphene citrate results in a rise in serum testosterone.
• Clitoral sensitivity and viability. Dr. Dix Poppas Chief of Pediatric Urology at Weill Cornell Children's Hospital of NewYork-Presbyterian and The Richard Rodgers Family Associate Professor of Pediatric Urology at Weill Cornell Medical College will present a study which shows that clitoral sensitivity and viability can be maintained following a modified reduction clitoroplasty.
• Testosterone gel. Dr. Ridwan Shabsigh Associate Professor of Urology at Columbia University College of Physicians & Surgeons and Director of The New York Center for Human Sexuality at NewYork-Presbyterian Hospital Columbia University Medical Center will discuss the use of testosterone gel to enhance the response of men with erectile dysfunction and low testosterone for whom Viagra is not effective.
• High pregnancy rates following vasectomy reversal. Dr. Marc Goldstein Professor of Reproductive Medicine and Urology at Weill Cornell Medical College and Chief of Male Reproductive Surgery at NewYork-Presbyterian Hospital Weill Cornell Medical Center will present a study showing the high pregnancy rates that follow microsurgical vasectomy reversal. He will also discuss the use of ultrasound for varicocelectomy and testicular blood flow.
• Prostate cancer. Dr. Neil H. Bander Josephine and Bernard Chaus Professor of Urology at Weill Cornell Medical College and Attending Urologist at NewYork-Presbyterian Hospital Weill Cornell Medical Center will present on monoclonal antibody-based (mAb) treatment for prostate cancer, the most commonly diagnosed cancer in men.
• Female urinary incontinence. Dr. David R. Staskin Associate Professor of Urology at Weill Cornell Medical College and Director of the Section on Voiding Dysfunction at Weill Cornell Medical Center at NewYork-Presbyterian Hospital will present the latest data on the SPARC (suprapubic-arc) Sling Procedure for female urinary incontinence. Dr. Staskin is the inventor of the procedure, which is the fastest-growing new technique in urology and gynecology for the correction of female incontinence. Dr. Staskin will also co-chair and participate in three postgraduate sessions that highlight advances in pharmacotherapy and surgery in the treatment of urinary incontinence.
• Prostate enlargement. Dr. Steven A. Kaplan Given Foundation Professor and Co-Vice Chairman of at Columbia University College of Physicians & Surgeons and Attending Urologist at Columbia University Medical Center at NewYork-Presbyterian Hospital will give a state-of-the-art presentation on drug treatments for benign prostatic hyperplasia (BPH), or prostate enlargement, a common occurrence in men over the age of 50. A second presentation will analyze an important NIH-sponsored study on Medical Therapy of Prostate Symptoms (MTOPS).
• New laser surgery for enlarged prostates. Dr. Alexis E. Te Associate Professor of Urology at Weill Cornell Medical College and Director of the Brady Prostate Center at Weill Cornell Medical Center at NewYork-Presbyterian Hospital will present the first report on the multicenter study of photoselective laser vaporization of the prostate. (Dr. Te is lead investigator of the study.) His lab will also report on reducing bladder inflammation with a novel procedure for the treatment of interstitial cystitis as well as other advanced therapies for enlarged prostates, such as prostate stents.
• Pharmacological treatment of ureteral obstruction. Data will be presented from the laboratory of Dr. Diane Felsen Associate Research Professor of Pharmacology (in Urology) at Weill Cornell Medical College and Associate Attending Urologist at NewYork-Presbyterian Hospital Weill Cornell Medical Center and Dr. Dix Poppas on potential therapeutic approaches to ureteral obstruction using either losartan, the nitric-oxide-precursor L-arginine, or COX-2 inhibitors among other presentations.
• Genetic markers that aid in the prognosis of kidney cancer. Dr. Mitchell C. Benson Co-Vice Chairman of the Department of Urology and the Director of the Urologic Oncology Center at Columbia University College of Physicians & Surgeons; Dr. James M. McKiernan Assistant Professor of Urology at Columbia University College of Physicians & Surgeons and Assistant Attending Urologist at Columbia University Medical Center at NewYork-Presbyterian Hopsital; and Dr. Carl Olsson will make a presentation on genetic markers that aid in the prognosis of kidney cancer. Additional presentations by the group will include: the role of seminal vesicle following surgical removal of the prostate; cytogenetic findings in renal cell carcinoma; outcomes of females undergoing radical surgery for bladder cancer; outcomes of patients undergoing watchful waiting for prostate cancer; and the outcomes of patients undergoing surgery for renal cell carcinoma that has spread to the heart and vena cava and requires extensive surgery.
• The molecular basis for renal development. Dr. Kenneth Glassberg Director of the Division of Pediatric Urology at Children's Hospital of NewYork-Presbyterian/Columbia and Professor of Urology at Columbia University College of Physicians & Surgeons will give a state-of-the-art presentation on the molecular basis of renal development.
• The use of laparoscopy in urology. Dr. Joseph Del Pizzo Director of Laparoscopic and Robotic Urology and the Brady Urologic Health Center at NewYork-Presbyterian Hospital Weill Cornell Medical Center and Assistant Professor of Urology at Weill Cornell Medical College will make several presentations on advances in the use of laparoscopy in urology.
• Viagra treatment for lower urinary tract symptoms. Dr. John P. Mulhall Director of the Sexual Medicine Program at NewYork-Presbyterian Hospital Weill Cornell Medical Center and Associate Professor of Urology at Weill Cornell Medical College will present research indicating that Viagra may improve the urinary symptoms as well as erectile function in men with erectile dysfunction who also have mild to moderate lower urinary tract symptoms (LUTS). Dr. Mulhall will also present on the genetics of Peyronie's Disease.