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Herbert Lepor

All articles from this author are listed below.

Volume 9, Supplement 2 Review Articles

Self-Assessment Post-Test

Androgen-Independent Prostate Cancer

Volume 9, Supplement 1 Review Articles

New Directions in the Management of Advanced Prostate Cancer

Introduction

Volume 9, Supplement 1 Review Articles

Androgen Deprivation Therapy in the Treatment of Advanced Prostate Cancer

New Directions in the Management of Advanced Prostate Cancer

Mark A Perlmutter Herbert Lepor

This article reviews the issues and controversies relevant to the treatment of advanced prostate cancer with androgen deprivation therapy. Initially, diethylstilbestrol was used for achieving androgen deprivation, but was replaced by luteinizing hormone-releasing hormone (LHRH). Adverse events associated with LHRH agonists include the flare phenomenon, hot flashes, loss of libido, erectile dysfunction, depression, muscle wasting, anemia, and osteoporosis. Intermittent therapy has been advocated to reduce morbidity of treatment. The addition of an antiandrogen provides maximum androgen blockade. There remains controversy regarding the timing of the addition of an antiandrogen. Secondary hormonal therapies include antiandrogens, adrenal androgen inhibitors, and estrogens. [Rev Urol. 2007;9(suppl 1):S3-S8]

Androgen deprivation therapy LHRH agonists Advanced prostate cancer Diethylstilbestrol Maximum androgen blockade

Volume 9, Supplement 1 Review Articles

Self-Assessment Post-Test

New Directions in the Management of Advanced Prostate Cancer

Volume 10, Number 4 Review Articles

Renewing Intimacy: Advances in Treating Erectile Dysfunction Postprostatectomy

Expert Commentary

Jason D Engel Andrew R McCullough Herbert Lepor

Erectile dysfunction following prostatectomy is almost universal. Herbert Lepor, MD, Professor and Martin Spatz Chairperson of Urology and Professor of Pharmacology at New York University School of Medicine and cofounder of Reviews in Urology; Andrew McCullough, MD, Director of the Sexual Health and Male Fertility and Microsurgery Programs at New York University School of Medicine; and Jason D. Engel, MD, Vice Chairman of Urology and Director of Urologic Robotic Surgery at George Washington University Hospital, discuss treatment options for erectile dysfunction postprostatectomy. [Rev Urol. 2008;10(4):245-253]

Volume 10, Number 4 Review Articles

Vascular Targeted Photodynamic Therapy for Localized Prostate Cancer

Treatment Update

Survival for men diagnosed with prostate cancer directly depends on the stage and grade of the disease at diagnosis. Prostate cancer screening has greatly increased the ability to diagnose small and low-grade cancers that are amenable to cure. However, widespread prostate-specific antigen screening exposes many men with low-risk cancers to unnecessary complications associated with treatment for localized disease without any survival advantage. One challenge for urological surgeons is to develop effective treatment options for low-risk disease that are associated with fewer complications. Minimally invasive ablative treatments for localized prostate cancer are under development and may represent a preferred option for men with low-risk disease who want to balance the risks and benefits of treatment. Vascular targeted photodynamic therapy (VTP) is a novel technique that is being developed for treating prostate cancer. Recent advances in photodynamic therapy have led to the development of photosynthesizers that are retained by the vascular system, which provides the opportunity to selectively ablate the prostate with minimal collateral damage to other structures. The rapid clearance of these new agents negates the need to avoid exposure to sunlight for long periods. Presented herein are the rationale and preliminary data for VTP for localized prostate cancer. [Rev Urol. 2008;10(4):254-261]

Vascular targeted photodynamic therapy Photodynamic therapy Prostate cancer, localized Minimally invasive ablative treatment for prostate cancer WST-09 WST-11 Padoporfin Palladium bacteriopheophorbide

Volume 10, Number 4 Case Review

Management of Localized Prostate Cancer and an Incidental Ureteral Duplication With Upper Pole Ectopic Ureter Inserting into the Prostatic Urethra

Case Review

Jonathan Melamed Bachir Taouli Michael D Stifelman Tracy P Marien Ellen Shapiro Herbert Lepor

Ectopic ureters are rare congenital malformations of the renal system that most commonly present in females. It is extremely rare to encounter an ectopic ureter in an older man undergoing radical prostatectomy. We report herein a case of a 66-year-old man with prostate cancer and a complete duplication of the left renal collecting system, with an upper pole ectopic ureter and associated normal functioning renal parenchyma entering into the prostatic urethra. This anomaly was incidentally discovered on preoperative magnetic resonance imaging of the prostate. Open radical retropubic prostatectomy and a left ureteroureterostomy were performed. [Rev Urol. 2008;10(4):297-303]

Prostate cancer Prostatectomy Ectopic ureter Prostatic urethra

Volume 10, Number 2 Review Articles

The QT Interval and Selection of Alpha-Blockers for Benign Prostatic Hyperplasia

Treatment Update

Richard G Trohman Lawrence A Hill Norman E Lepor Herbert Lepor

The QT interval is the electrocardiographic manifestation of ventricular depolarization and repolarization. Drug-induced long QT syndrome is characterized by acquired, corrected QT (QTc) interval prolongation that is associated with increased risk of torsade de pointes. Every physician must recognize if the drugs he or she prescribes prolongs the QTc interval, especially if the drug is prescribed for a chronic condition in older patients who are on polypharmacy. The evolution of alpha-blockers for the treatment of benign prostatic hyperplasia has allowed the development of drugs that are easier to administer and better tolerated. Because alpha-blockers generally have equivalent efficacy, this class of drugs is typically differentiated by safety and side effects. Studies suggest that alpha-blockers may vary in regard to their effect on the QT interval, and, therefore, on their predisposition to cause potentially life-threatening ventricular arrhythmias. [Rev Urol. 2008;10(2):85-91]

Blockers Benign prostatichyperplasia Drug-induced long QT syndrome Torsade de pointes

Volume 10, Number 1 Review Articles

Penile Rehabilitation Postprostatectomy: Is There a Role for MUSE?

Expert Commentary

Andrew R McCullough Herbert Lepor

[Rev Urol. 2008;10(1):1-5]

Volume 11, Supplement 1 Reviews in Urology

Pathophysiology of Benign Prostatic Hyperplasia: Insights From Medical Therapy for the Disease

Advances in the Pharmacologic Treatment of BPH

The medical treatment of benign prostatic hyperplasia (BPH) has its roots in the early 1970s. During this era, the first clinical trials investigating α-blockade and androgen deprivation therapy were reported for men with clinical BPH. The observation that clinical BPH was improved following administration of both α-blockers and androgen deprivation therapy supported the evolving paradigm that clinical BPH resulted from dynamic and static pathways. During the past several decades, the evolution of α-blockers for the treatment of BPH has been impacted by innovations targeted to simplify the administration and improve tolerability while maintaining their effectiveness.[Rev Urol. 2009;11(suppl 1):S9–S13 doi: 10.3909/riu11S1S0002]© 2009 MedReviews®, LLC

Bladder outletobstruction Selectivity Adrenergic Receptors