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HIFU may offer advantages in PCa, but the jury is still outOver the last 20 years, radical retropubic prostatectomy has evolvedto become the standard of care in men with localized prostate cancer. Becauseof the morbidity of this procedure, however, interest has grown in the developmentof non-surgical modalities. Unfortunately, many of these non-surgical approaches,such as monotherapy with radioactive seed implantation, have resulted indisappointing results or excessive morbidity, as in first-generation cryotherapy.
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Wrong testicle removed during surgery"At trial, the urology expert testified that the defendant urologist failed to offer the patient alternative treatments before proceeding with the drastic option of removing the testicle," writes Dawn Collins, JD.
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Low-dose CT stone detection: Safe during pregnancyTreatment for pregnant women who present with renal or ureteral colic may have become easier for physician and patient alike.
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Survey data show positive signs for urology's futureThe most recent Urology Times State of the Specialty survey is notable in confirming some widely accepted urologic practice trends, but challenging the significance of others.
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Robotic radical nephrectomy: Really?None of the comparative studies of robotic radical nephrectomies (RRN) and laparoscopic radical nephrectomies (LRN) has shown benefit of RRN over LRN. Why then are so many minimally invasive RNs performed this way?
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How to administer anesthesia in the urology officeThe procedure should be of a durationand complexity that will permit the patient to recover and be discharged.
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Evolution of ureteral stents: Work is still neededSeveral approaches have been taken to attenuate lower urinary tract symptoms and improve quality of life in the stented patient.
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How to perform metabolic evaluation in stone formersPatients with nephrolithiasis frequently have metabolic abnormalities that promote calculus formation and, when identified and corrected, may attenuate stone activity.
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Newer PNL methods improve safety, reduce morbidityMontreal--Novel approaches to percutaneous nephrolithotomy, includinguse of a stent instead of a tube and using smaller tubes and stone "cones,"are helping to optimize this procedure. Researchers agree that improvingsafety and reducing morbidity are the goals of these new techniques.
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Your high-maintenance urology office staffer: Worth the hassle?Every urology practice faces this situation eventually: a difficult employee who demands disproportionate time and attention from management.
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Preserve assets for heirs after second marriageA relatively simple technique called the spousal lifetime access trust has proven especially advantageous and popular among those who have remarried and want to provide for children from a prior marriage.
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Sword, fire, ice offer options in small renal massesNephron-sparing procedures now have clear advantages over radical nephrectomy for most small renal masses.
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Using bisphosphonates to treat PCa-related bone eventsProstate cancer is the most prevalent non-cutaneous cancer diagnosed in men today, still accounting for a significant amount of morbidity and mortality in spite of increased screening efforts and advances in treatment.
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Letter: Declassifying Gleason 6 as a cancer would do more harm than good"We feel a more appropriate approach would be to retain true Gleason 6 as a cancer of extremely low metastatic potential requiring close follow-up," write Harris et al.
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ABU makes changes to reduce burden during pandemic"During these times of uncertainty, panic, and social distancing associated with COVID-19, the American Board of Urology is sensitive to the additional stress this pandemic has placed on urology practices and urologists’ ability to meet their certificate requirements," writes J. Brantley Thrasher, MD.
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Comet assay may predict assisted reproductive techniques pregnancy successThere is a significant correlation between Comet assay results and the likelihood of pregnancy using ART.
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Bladder cancer data must be taken in contextNew bladder cancer data are food for thought, but are not conclusive proof that urologists are over-treating early-stage bladder cancer and running up costs.
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Study of stone pain stresses personalized treatment"This work is important to our field, because it represents an effort to personalize treatment approaches to particular patients’ needs," writes Brian R. Matlaga, MD, MPH.
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PTNS for overactive bladder: Patient selection and techniqueThis article provides a real-world definition of refractory overactive bladder and its prevalence, then examines treatment options, with a focus on percutaneous tibial nerve stimulation as a noninvasive form of neuromodulation “for the masses.”
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Partial nephrectomy shows increased survival benefitA recently published population-based study reinforces prior evidence from retrospective studies of the increased survival benefit of partial nephrectomy over radical nephrectomy, and suggests a cancer-specific survival benefit for nephron-sparing approaches as well.
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Recurrent stone disease: Steps for practical managementBetween 30% and 60% of calcium oxalate stone patients have hypercalciuria in the absence of raised serum calcium levels.
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Recurrent stone disease: Steps for practical managementBetween 30% and 60% of calcium oxalate stone patients have hypercalciuria in the absence of raised serum calcium levels.
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Prostate cancer and CV risk: The heart of the matter"Perhaps there is another Nobel Prize waiting to be had if we could reduce the cardiovascular effect of ADT and unlock the answer to the controversy surrounding the comparative safety and impact on cardiovascular health between GnRH agonists and antagonists," writes Michael S. Cookson, MD, MMHC.
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Delaying surgery safe in von Hippel-Lindau patientsSan Francisco--Even though patients with von Hippel-Lindau disease are at risk for renal tumors and eventual metastatic RCC, parenchymal-sparing surgery can be delayed until the largest tumor reaches 3 cm with minimal concern that the patient will develop metastatic renal cell carcinoma, according to updated data from an ongoing National Institutes of Health study.
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The male sling for SUI: Indications and techniquesThe male sling achieves continence by unilateral ventral urethral compression that does not require patient activation, allowing volitional and spontaneous voiding.
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The male sling for SUI: Indications and techniquesThe male sling achieves continence by unilateral ventral urethral compression that does not require patient activation, allowing volitional and spontaneous voiding.
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The BCG shortage: What's being done—and what you can doIn this interview, Seth P. Lerner, MD, discusses current recommendations for managing patients during the BCG shortage, what the FDA is doing to resolve the problem, and a SWOG trial testing a new strain of BCG.
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How to bill for catheter placement in the hospital settingIn this "Coding Q&A" column, Ray Painter, MD, and Mark Painter also answer questions regarding bladder instillations and penile modeling during IPP placement.
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Urologists, GYNs demonstrate slings’ safety"An abstract authored by Löppenberg et al is an interesting analysis of information from a respected prospective database examining variations in the quality of care provided to patients undergoing sling placement by gynecologists and urologists," write Seth A. Cohen, MD, and Shlomo Raz, MD.
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Strategies to mitigate impact of intravenous ICM shortage"The global shortage of ICM has necessitated rapid adaptation of workflows and clinical pathways, which are particularly important for practicing urologists who are evaluating patients for hematuria," write Yair Lotan, MD, and colleagues.
