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New York--When a teenager complains of erectile dysfunction, do not assume that the problem is psychogenic, advises John P. Mulhall, MD.

Washington--For children with ambiguous genitalia at birth, surgical techniques have improved vastly, but deciding when and whether to do surgery hasn't gotten easier. That was apparent from the lively and sometimes contentious panel and audience discussion here at the American Academy of Pediatrics Section on Urology annual meeting.

Washington--Long-term experience with bladder augmentation in children is now giving pediatric urologists and parents a true picture of the risks and benefits of different bowel segments. No single segment was the obvious winner in two experimental studies presented here at the American Academy of Pediatrics Section on Urology annual meeting, but the maintenance and surveillance required has become clearer. Other than technical considerations, metabolic, rather than urodynamic considerations, may prove more important in deciding which segment to use.

Washington--The most common anomaly detected on prenatal ultrasound is hydronephrosis. Up to 38% of those patients will have vesicoureteral reflux in early life. What to do about it, however, isn't always clear.

I predict that we will find that MR urography will rapidly develop and eventually come to be the imaging technique of choice in adult and pediatric urology.

Montreal--Spermatogenesis markers that can be easily obtained from a noninvasive testis biopsy may predict which patients will respond to surgical varicocele repair. Testis biopsy, therefore, should be part of the regular workup for male infertility patients, suggest the authors of the 2005 Society for Male Reproduction and Urology Prize paper presented here at the American Society for Reproductive Medicine annual meeting.

Washington--When hydronephrosis is diagnosed antenatally in an infant, is pyeloplasty needed? More often than not, the indication is not clear.

In 2003, more than 48,000 babies were born in the United States as a result of assisted reproductive technology (ART) procedures, according to a new report from the Centers for Disease Control and Prevention. This marks an increase from 45,751 babies in 2002.

Obesity may make it more difficult to detect prostate cancer, leading to delayed diagnosis and putting some men at greater risk of death, according to a multicenter study.

Laserscope, San Jose, CA, has announced that the Centers for Medicare & Medicaid Services has published a technical revision to the 2006 Medicare physician few schedule.

Contrary to previous reports, statins do not appear to reduce the incidence of cancer or cancer deaths, according to a meta-analysis of previous studies (JAMA 2006; 295:74-80). The finding held true for a range of cancers, including prostate cancer.

Trimedyne, Inc., Irvine, CA, has received FDA approval to market its VaporMAX Fiber for use with its Holmium lasers to treat BPH.

Louis R. Kavoussi, MD, has been appointed chairman of the newly combined department of urology at North Shore University Hospital in Manhasset, NY, and Long Island Jewish Medical Center in New Hyde Park, NY.

The NMP22 test (BladderChek, Matritech, Newton, MA) significantly increased the detection of recurrent bladder cancer, finding 99% of the malignancies when used with cystoscopy, according to a study published this week in JAMA (2006; 295:299-305).

Men with erectile dysfunction have a 25% higher risk of subsequent cardiovascular events such as heart attack, stroke, and angina, according to a study published recently in JAMA (2005; 294:2996-3002).

United Healthcare Insurance Co., and sister companies United Healthcare of Georgia Inc., and Golden Rule Insurance Co., have been fined $2.8 million for delaying payment on 75,000 to 80,000 health claims.

Leo Fung, MD, chief of pediatric urology at the University of Minnesota's Medical School, died of cancer on Dec. 10 at the age of 42

A compound found in many fruits and vegetables shows major promise in combating prostate cancer, according to researchers at the University of Wisconsin School of Medicine and Public Health, Madison.

Over the next 2 years, the U.S. Department of Health and Human Services will undertake two key initiatives to expand Medicare beneficiary access to services provided by ambulatory surgery centers, the American Association of Ambulatory Surgery Centers reported.

The FDA has approved sorafenib (Nexavar) for the treatment of advanced renal cell carcinoma.

Paris--Adding a form of high-dose calcitriol to docetaxel (Taxotere) offers improved survival over docetaxel alone in men with metastatic androgen-independent prostate cancer, according to results of a multicenter trial presented at the 13th European Cancer Conference (ECCO-13) here. Further, the addition of the calcitriol formulation, known as DN-101, to the chemotherapy agent produced an unanticipated advantage in a reduced number of serious gastrointestinal and thromboembolic adverse events.

Amsterdam, Netherlands--Participants in an AUA-sponsored laparoscopic videotape mentoring course, offered as part of a skills-based learning course, report an increase in their laparoscopic caseload and in the performance of clinical laparoscopic suturing.

If you perform a diagnostic retrograde (52005) and the insertion of a stent (52332) at the same setting, each should be billed separately.

Practicing urologists as a whole must stay close to the cutting edge of laparoscopic renal surgery.

Amherst, NY--Urologist and author J. Stephen Jones, MD, offers patients a thorough orientation to prostate health in The Complete Prostate Book, published by Prometheus Books. Divided into three sections, the 425-page, illustrated volume covers basic prostate anatomy and function, common benign conditions, and prostate cancer, as well as what to expect in a prostate exam, effect of sexual activity on the prostate, common symptoms, tests, and treatment options.

A phase III study examining the use of the phosphodiesterase type-5 inhibitor tadalafil in men with BPH is planned for 2006. The scheduled trial follows results of a double-blind, placebo-controlled phase II study showing clinically meaningful and statistically significant improvement in lower urinary tract symptoms in men with BPH who were treated for 6 weeks with once-daily tadalafil, 5 mg, according to Lilly ICOS LLC.

Whether you're interested in adding an associate to your practice or are seeking a move yourself, you're likely to en-counter physician recruiters. While working with a recruiter is not for every physician, it can save time and allow you to focus on what really matters: patient care.