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Urology has always been a fascinating and somewhat hybrid specialty inthe field of medicine. First and foremost, it has been a surgical specialty,requiring many years of intense surgical training to master. Many of ushave been drawn to urology because of the wide assortment of surgical proceduresand the ability to put to use the highest technological advancements inthe course of our work.

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Physician must be immediately available, and the service must be performedby an employee

The out-of-pocket expenditures needed to buy the equipment used in every practice have always been reduced or helped by our tax laws. Today, thanks to the new Jobs and Growth Tax Relief Reconciliation Act of 2003, the needed equipment may be more affordable than ever.

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Chicago-Real-world clinical practice data provide further evidencethat treatment with a 5-alpha-reductase inhibitor significantly reducesthe risks for progression to acute urinary retention (AUR), catheterization,or surgery in men with BPH, according to a retrospective analysis from theUnited Kingdom.

New York-A combination of hormonal therapy, brachytherapy, andexternal beam radiation has demonstrated excellent local control in high-riskprostate cancer patients.

Chicago-Adjuvant androgen ablation following radiation therapysignificantly reduces the risk of local and distant failure and significantlyimproves overall survival in patients with unfavorable-prognosis prostatecancer, according to 10-year results from a large cooperative group trial.

Although antibiotics are commonly used to treat symptoms of chronic pelvicpain syndrome, this approach is beneficial in a relatively small subsetof patients, and urologists must consider alternative treatment modalities,including physical therapy. In this exclusive Urology Times interview, JeannettePotts, MD, discusses current research and her own views on the diagnosisand treatment of chronic prostatitis. Dr. Potts is a member of the staffat the Cleveland Clinic Glickman Urological Institute. The interview wasconducted by Philip M. Hanno, MD, of the department of urology, Universityof Pennsylvania, Philadelphia.

Raritan, NJ-Ortho-McNeil Pharmaceutical has received FDA approval to market levofloxacin (Levaquin) for the treatment of chronic bacterial prostatitis caused by Escherichia coli, Enterococcus faecalis, or Staphylococcus epidermidis.

Prostate 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.

Chicago-The selective endothelin receptor antagonist atrasentan significantly attenuates changes in biochemical markers of bone metabolism and disease progression in a group of patients with advanced hormone-refractory prostate cancer that had progressed on placebo, according to the results of a randomized clinical trial.

Urologists remain high on the list of in-demand medical specialists in the United States, and their services are even more sought-after than in previous years, according to recently released research. To attract them, hospitals and practices are offering more enticing salaries and other incentives.

FDA OKs treatment for men with testosterone deficiency. Livingston, NJ-The FDA has approved Columbia Laboratories' testosterone buccal system (Striant mucoadhesive) for testosterone replacement therapy. The transbuccal treatment is for men with conditions associated with a deficiency or absence of endogenous testosterone, including hypogonadism.

Advances in available ablative and reconstructive laparoscopic technology have expanded our ability to perform minimally invasive partial nephrectomy. Currently, many patients who are candidates for partial nephrectomy can have their procedures performed laparoscopically.

Chicago-New research on efforts to lower the infection rate among men receiving penile prostheses will likely change how urologists approach this challenging problem, say researchers from three leading Southeastern institutions.

Chicago-Pharmacologic treatment of overactive bladder-once the private domain of only two or three agents-is about to expand significantly, providing urologists with a number of new therapeutic options.

Seattle-A new study by American and Dutch researchers suggests that high-resolution magnetic resonance imaging studies using an iron-oxide-containing contrast agent offer the ability to produce a very accurate localization of tumor metastases in prostate cancer patients.

Washington-It's the insurance industry against the trial lawyers,the Republicans against the Democrats. And urologists, like other physicians,are caught in the middle.On July 9, Senate Democrats blocked White House-supported legislationto limit damage awards in medical liability lawsuits, charging that effortsby Senate Majority Leader Bill Frist, MD (R-TN), to force a vote on theissue were political and designed to restore Republican influence with physicians.Dr. Frist pulled the bill after a motion to take up the bill fell 11 votesshy of the 60 needed to cut off a Democratic filibuster.

As a specialty, urology has made significant strides in the area of minimallyinvasive surgery. More work needs to be done, however, if urologists canexpect to keep up with patient demand and stay competitive with generalsurgeons, obstetrician-gynecologists, and other specialists.

Q Can I be reimbursed for in-office injection of botulinum toxin inpatients with refractory overactive bladder? If so, how?

It is a sad reality that few physicians can afford the protection ofhealth insurance for themselves, let alone for their employees. Double-digitincreases in the cost of medical insurance are driving others to severelylimit this popular fringe benefit, if not discarding it altogether. Andmatters are predicted to get worse.

As our overhead costs continue to increase while reimbursements decrease,physicians are motivated to find novel ways to reduce our fixed overheadcosts. Nearly every practice has 15% of "fat" that has to be cut.Just a few cost-saving strategies will reduce thousands of dollars of overhead,and one of these strategies is to implement an electronic system of archivingmedical records.

Chicago-A history of urolithiasis, recent/recurrent urinary tractinfections, and the presence of bilateral stones appear to predict an increasedrisk for the development of complications after stentless ureteroscopy,according to the results of a retrospective study from the University ofMichigan, Ann Arbor.

AUA's 2-year-old Office of Research has taken an active role in suchareas as legislation, data collection, and communication within the urologicresearch community, all of which are designed to advance research and improvethe care of patients with urologic diseases. Monica Liebert, PhD, directorof the Office of Research, discusses these and other key initiatives inthis exclusive Urology Times interview. The interview was conducted by UTEditorial Consultant Richard D. Williams, MD, professor and chairman ofthe department of urology at the University of Iowa, Iowa City.

Wilmington, DE-The federal government will likely pursue urologistsin a second round of investigations surrounding the fraudulent marketingand sale of luteinizing hormone-releasing hormone agonists for prostatecancer. Just how far the probe will extend remains a source of debate amonglegal experts familiar with the case.

Seattle-Leading U.S. prostate cancer thought leaders are expressingwidely divergent opinions on the recent announcement of a 25% reductionin prostate cancer incidence in men treated with finasteride (Proscar),according to interviews conducted by Urology Times. Whereas some expertssee the finding as the beginning of a new era in prostate cancer prevention,others say that more data are needed before urologists can confidently applythe finding to clinical practice.

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