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Presented by Martin G. Sanda, MD, University of Michigan, Ann Arbor.

New Products as presented in the August 1, 2002 issue of Urology Times

Orlando FL-Measuring complexed PSA (cPSA) may provide improved specificity over total PSA (tPSA), according to the results of a multicenter trial. In their study, researchers from Innsbruck, Austria; Houston; New York; Cheyenne, WY; Stanford, CA; Baltimore; and Seattle compared the clinical performance of a cPSA test (Bayer Diagnostics, Tarrytown, NY) versus a standard tPSA test and PSA ratios (percent-free PSA and percent cPSA) as a first-line test for detecting prostate cancer.

Advances in ureteroscope design and instrumentation, along with the ready availability and technical simplicity of shock wave lithotripsy, have made the treatment of ureteral calculi simpler, more available, and more successful than ever. Indeed, the need for salvage open or laparoscopic treatment of ureteral calculi is exceptionally rare.

Minneapolis-For decades, the Gleason grading system has been the de facto standard used to characterize prostatic tumors. Now, with the help of Donald F. Gleason, MD, himself, researchers from the University of Minnesota have found a way to make the system even more useful to clinicians.

Washington-The American Lithotripsy Society (ALS) and the UrologySociety of America (USA) have successfully challenged the Stark II FinalRule designating lithotripsy a "designated health service." Accordingto a summary judgment released July 16 by the U.S. District Court in Washington,lithotripsy services were never intended to be encompassed within physicianself-referrals for "inpatient and outpatient hospital services"subject to the Stark II ban.

Separate group would ensure strong, effective leadership for urologyprogramWashington-Frustrated with a lack of progress at the NationalInstitute of Diabetes and Digestive and Kidney Diseases (NIDDK), AUA isnow pushing for creation of a separate urology division that would give"strong and effective leadership for the urology program" at theNational Institutes of Health.

Trying to name a single theme characterizing the recently convened AUA annual meeting in Orlando is a tough assignment given the meeting's diversity, but one trend is worth noting: A great deal of the news coming out of this year's biggest meeting of urologic surgeons had little do with surgery at all. Perhaps this observation should come as no surprise. The fact that some of the most widely discussed findings focused on drug and "complementary" therapies rather than surgical techniques may well reflect urology's increasing shift away from complex surgery and toward office-based practice. Whether urology is heading toward a formal two-tiered system of office-based urologists and surgical specialists remains to be seen, but some say such a system is already unfolding.

Eye-catching slides are a must for any presentation because they complementyour speech. If you do not want the audience to fall asleep while you'regiving a presentation, you need to employ an armory of public-speaking techniques,and if you deliver content with style and enthusiasm, slides will reinforce,enhance, and support your material.

Miami-Nerve preservation techniques do not alter the margin status orbiochemical-free survival within 5 years of radical prostatectomy in patientswith localized prostate cancer, according to University of Miami urologists.

The incidence of hydronephrosis diagnosed in the neonatal period has increased dramatically with the routine use of ultrasound in obstetrical care. Prior to the mid-1980s, most children with obstructive uropathy secondary to ureteropelvic junction obstruction or ureterovesical junction obstruction were diagnosed after urinary tract infections had occurred or an abdominal mass was noted.

Orlando, FL-A study from the University of Toronto has created a credo for urology patients who purchase products from the $27 billion nutritional supplement industry: "Caveat emptor"-let the buyer beware.

Orlando, FL-A decade's worth of scientific and technological advances appear to have combined to increase society's sensitivity to prostate cancer. Detection rates among younger men have increased, whereas detection rates among older men are falling, according to a study from the Columbia University College of Physicians and Surgeons, New York.

Orlando, FL-Among men with prostate cancer, declines in mortality and hospitalization have exceeded those in cardiovascular and other competing diseases, and most deaths among prostate cancer patients are now due to non-prostate cancer causes.

Orlando, FL-Just as researchers were beginning to quantify the value of PC-SPES in treating advanced prostate cancer, the product was found to be contaminated, was taken off the market, and the manufacturer went out of business.

Orlando, FL-A new analysis of data from the National Cancer Institute'snationwide Prostate, Lung, Colorectal and Ovarian (PLCO) cancer screeningtrial suggests that annual PSA screening may not be necessary for many men.

Orlando, FL-A study by researchers from Memorial Sloan-Kettering Cancer Center in New York has given added strength to the recommendation that patients who develop unilateral testicular germ cell tumors should be followed carefully over their lifetimes. The interval between development of a first and second tumor can be 20 or more years, according to their retrospective, 50-year review.

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Q Why is there such a great price discrepancy between disability insurancepolicies?

Another cut is possibleunless formula used to determine physician payments is fixedWashington-It's the big money squeeze, and that's what members of Congressare facing as they seek to resolve several crucial health policy issuesimportant to urologists over the summer months with Congressional electionson the horizon.

Birmingham, United Kingdom-Using standard x-rays, a digital camera orscanner, and a basic graphics software package, physicians can reliablydetermine the chemical composition of urinary calculi, thereby aiding treatmentplanning, say German urologists.

San Francisco-Prostate cancer bone metastases appear to react favorablyto treatment with a new bisphosphonate and the tyrosine-kinase inhibitorsPKI-166 and STI-571, according to studies presented at the American Associationfor Cancer Research annual meeting here.

The recent review of a large series of patients with bilateral testiculargerm cell cancer treated at Memorial Sloan-Kettering Cancer Center (seearticle, page 8) is interesting and important to practicing urologists whoencounter this disease for three key reasons. First, this study, involving a very large series of patients with bilateraltestis tumors, corroborates the following facts that are well recognizedabout bilateral testicular cancer:

The depreciation deduction is quite flexible. It is an allowance forthe wear and tear, the natural deterioration, or the technical obsolescenceof the assets and property used in a medical practice. It is nothing morethan spreading out the original cost of those business assets over theirestimated life.

San Francisco-Herbal tea from Northern Greece, green tea, and black teaare all cytotoxic to human bladder cancer cells, according to a study conductedat the Medical College of Virginia in Richmond. The Greek herbal beveragehad significant cytotoxicity even at 5% concentration.

An article in the December 2001 issue of Urology Times discussed howurologists approach the difficult or demanding patient ("How does yourpractice deal with difficult patients?" page 22). I was impressed howmost physicians managed this situation, and it prompted me to think abouttechniques I have used to help control patients without losing them or allowingthem to be disruptive to the staff and other patients.

Orlando, FL-Reports of the prophylactic properties of isoflavones and other natural substances on cancer cell lines are common, but few-if any-have demonstrated properties as potentially strong as those evidenced by a Japanese nutritional supplement containing a novel form of genistein.

Recently discovered protein found to be present in 95% of all localizedcancer cells