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Las Vegas--Which material is better for pelvic floor reconstruction: allografts or synthetic mesh? If you ask two of urology's leading pelvic floor surgeons, each will provide a very different answer. Gary Leach, MD, a proponent of allografts, and Shlomo Raz, MD, a proponent of synthetic slings, made their points known in a verbal face-off at the AUA Western Section annual meeting here

Las Vegas--Radical cystectomy has a different risk profile in women than men, a difference that should be addressed during preoperative patient counseling, say investigators at Stanford (CA) Medical Center.

Las Vegas--The development of a robot-assisted method for laparoscopic radical prostatectomy could lessen morbidity, cut recovery times, and shorten the learning curve for urologists who have not been trained in the procedure.

Las Vegas--Obesity in prostate cancer patients is associated withhigher-grade tumors, cancer recurrence, and more aggressive disease, recentstudies have shown. The research has prompted some urologists to suggestusing body mass index (BMI) as a marker for early screening and treatment.Others suggest that further studies should be undertaken to determine ifweight loss may, in fact, lower prostate cancer risk.

Las Vegas--Brachytherapy is a growing treatment choice for menwith low-risk prostate cancer, although it is still selected by less than22% of men with the disease, according to San Francisco researchers. Theuse of androgen ablation has also increased, the researchers found in ananalysis of data from the CaPSURE database.

Urologist Ramsay L. Kuo, MD, has joined the department of urology at Thomas Jefferson University Hospital, Philadelphia, with an appointment as assistant professor of urology, Jefferson Medical College of Thomas Jefferson University.

The last few years have witnessed an enormous interest in androgen replacement therapy for late-onset hypogonadism-also known as "androgen deficiency in the aging male." As urologists, we frequently deal with sexual dysfunction and are seen as experienced on issues of prostate health.

Montreal--Laparoscopic nephroureterectomy is becoming a widely utilized option in the surgical treatment of upper tract transitional cell carcinoma. As more centers accrue larger series with longer follow-up, assessment of surgical as well as oncologic results is possible and necessary.

All of us see great clinical cases from time to time and make valuableobservations. Often there is an opportunity to present this material asa poster at scientific meetings. Until recently, the production of a high-qualityscientific poster required the use of an outside graphic arts firm at acost of more than $1,000.

Varicocele is a common clinical finding, present in approximately 15%of adult men. When the patient with a varicocele visits a urologist, itis often due to testicular discomfort or fertility-related concerns. Atthe 2003 meeting of the American Society for Reproductive Medicine, bothof these issues were addressed and are discussed in this issue of UrologyTimes.

San Antonio--Repair of clinically significant varicoceles may resultin nearly a 25% chance of natural conception, even in men who do not demonstratesignificant improvements in their postoperative seminal parameters, accordingto University of Iowa researchers.

San Antonio--Biomaterial wraps are a promising adjunct for vasovasostomy,according to results of an animal study that incorporated a biomaterialmatrix and a sealant into the conventional three-suture anastomosis. Researcherscalled this "polishing the gold standard" because of the highpatency rate of the standard procedure.

Our income tax law, the Internal Revenue Code, turned 90 in 2003. Whatstarted as a 400-page tax bill when Woodrow Wilson signed it into law in1913 now contains more than 55,000 pages. In fact, last year, Congress passedand the president quickly signed into law a $330 billion, 10-year tax cutplan-The Jobs and Growth Tax Relief Reconciliation Act of 2003. That billboth added to the page count and made a significant impact on the tax billsof many physician practices.

Many myths surround the Fair Labor Standards Act (FLSA), which governsovertime pay, but the biggest myth may be that FLSA issues are low-riskdecisions for medical practices.

Washington--Physicians who perform services, or have financial interests,in ambulatory surgery centers (ASC) are facing an uncertain future whenit comes to how much they will be paid for serving Medicare patients.

San Antonio--A retrospective study of men with cancer who elected to cryopreservetheir sperm because of cancer therapy found that 20% of men had alreadyreceived one or more cycles of chemotherapy. The recognized toxic effectsof chemotherapy and radiation on sperm cells make this a questionable practice

Q I am in a multiple-physician urology practice. One of our physiciansbelieves that billing 52332 with 52352 or 52353 with a ­59 modifiershould be paid, and that billing 52005 with 52332 with the ­59 modifiershould be paid (ie, 52005-59). When is it appropriate to use the ­59modifier?

Scott Serels, MD, Director, Bladder Control Center of Norwalk, Connecticut This Urology Times supplement was produced by Advanstar Communications, Inc, under an unrestricted educational grant from Ortho-McNeil Pharmaceutical, Inc.The views and opinions expressed in this supplement do not necessarily reflect the views of Advanstar Communications, Inc or Ortho-McNeil Pharmaceutical, Inc.Sponsored and supported by a grant from Ortho-McNeil Pharmaceutical, Inc.Cover image ?Bryson BioMedical/Custom Medical Stock Photo.Copyright ?2004 Advanstar Communications, Inc. All rights reserved.

Quebec City, Quebec--The good news is that most patients being treated for erectile dysfunction report that their treatment is working. The bad news is that a significant percentage of these same patients are often lost to follow-up for that very reason, according to a study by urologists from McGill University.

New Products & Services

Minneapolis-American Medical Systems announces the launch of the AMS 700CXR Penile Prosthesis, which is designed for difficult surgical cases and re-insertion procedures.

Richard D. Williams, MD, has been elected president of the American Foundation for Urologic Disease by its board of directors, the foundation announced.

When it comes to deciding the type of treatment a man with prostate cancer receives, his age often takes precedence over life expectancy, according to a study from the University Health Network in Toronto.