Richard R. Kerr

Kerr is group content director for Urology Times.

Articles by Richard R. Kerr

Survivors of bladder, kidney, and two other forms of cancer who smoked 20 or more cigarettes a day prior to their cancer diagnoses have an up to fivefold higher risk of developing a second smoking-associated cancer compared to survivors of the same cancers who never smoked.

Individuals with a history of kidney stones should increase their fluid intake to achieve at least 2 liters of urine per day to prevent recurrence, and if this fails, treatment with a thiazide diuretic, citrate, or allopurinol is recommended, according to a new clinical practice guideline from the American College of Physicians.

They are signs of the times for today's practicing urologist: declining reimbursement, increasing overhead, an increasingly stringent regulatory environment, and rising malpractice premiums. Urologists ranked these issues as their most pressing concerns in the 2007 State of the Specialty survey, an exclusive study developed by the editors of Urology Times and Contemporary Urology.

National Report-With another year of Medicare payment cuts looming in 2007, declining reimbursement is no surprise as the number one current concern among practicing urologists, according to an exclusive survey from Urology Times and its sister publication, Contemporary Urology. Changes in reimbursement are followed closely by malpractice, office overhead, pay for performance, and increasing regulations as the top five issues that urologists are extremely or very concerned about, the first State of the Specialty survey found.

Cleveland-A Mayo Clinic study published earlier this year raised more than a few eyebrows when its authors concluded that treatment of renal stones with shockwave lithotripsy appears to heighten the risk of diabetes mellitus and hypertension. More recently, researchers from Northwestern University reported a similar finding in patients with pancreatic stones-that SWL used in these patients may be associated with an increased risk of diabetes.

Cleveland-A staged approach to endoscopic lithotripsy may be a reasonable treatment option in patients with large renal stones who are not ideal candidates for the gold standard of percutaneous nephrolithotomy (PCNL), researchers at the University of Pittsburgh Medical Center reported. Their technique, known as staged retrograde endoscopic lithotripsy (SREL), has a slightly lower success rate than PCNL does, but it is less invasive and associated with fewer complications.

Cleveland-With the growing acceptance of flexible ureteroscopy at academic centers, this endoscopic technique as a treatment for renal stones has made fewer inroads into the practices of community urologists, data from a large U.S. inpatient database indicate. The reasons for the procedure's apparent lack of popularity in the community, at least in the inpatient setting, are unclear.

Atlanta-If you're going to perform a vasectomy reversal, use a microscope. Despite the additional time and cost involved, microsurgical vasovasostomy is superior to the loupe-assisted macroscopic technique, findings from a recent study from Korea confirm.

Montvale, NJ--Computer software ranked at the top of planned purchases by urologists, with one-fourth of respondents to a survey saying they planned to acquire software in 2004. Cystoscopes, ureteral stents, penile prostheses, and BPH thermotherapy devices rounded out the top five planned purchases, according to the survey, conducted exclusively for Urology Times and its sister publication, Contemporary Urology.

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