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More than one-fourth of urologists say they have specific plans to retire within the next 2 years. An ongoing drop in reimbursement, feeling burned out, and government mandates are the primary factors affecting when they will retire, according to the 13th annual Urology Times State of the Specialty survey.

Patients at greatest risk of complications from opioids are older than 65 years, male, obese, have used opioids prior to surgery, or have elevated comorbidity index scores, according to Francis J. McGovern, MD.

Strong evidence has emerged in recent years suggesting opioid prescribers, including well-meaning urologists, have helped to fuel a national crisis and opioid addiction epidemic.

In this interview, J. Quentin Clemens, MD, discusses the work being done by the MAPP (Multidisciplinary Approach to Chronic Pelvic Pain) Research Network and LURN (Symptoms of Lower Urinary Tract Dysfunction Research Network) research initiatives.

Bacteriuria in patients using clean intermittent catheterization is a significant problem that can lead to overuse of antibiotics. J. Quentin Clemens, MD, of the University of Michigan, Ann Arbor, discusses when to treat and when not to treat these patients.

In this Urology Times Q&A, Jessica Nelson, MPAS, PA-C, past president of the Urological Association of Physician Assistants, offers a physician assistant’s perspective on PAs performing urologic procedures, PA training, and more.

Igor Sorokin, MD, presents the case of a woman with a history of microhematuria and two positive cytologies for urothelial carcinoma. Ureteroscopy on the right side reveals three lesions.

“Florida, specifically South Florida, is a very tough place to practice. There’s a fairly prominent infiltration of Medicare HMOs with a lot of obstruction to doing anything for the patient that’s necessary," says one urologist.

“A decade ago it was rare to have advanced practice providers as part of routine urologic care. Now they’re integral and a necessary part of any active urologic practice,” says Bradley A. Erickson, MD, MS.

Optimize patient identification by following these steps.

Personally tailored intervention generates patient interest, QoL improvements.

Benefit evident regardless of metastasis site, phase III analysis shows.

~40% of sipuleucel-T recipients in lowest PSA quartile alive after 5 years.

A bill commonly known as “Right to Try,” or S.204, appears to be a step in the right direction for expanding access to treatment for terminally ill patients who have exhausted all other options.

A 34-year-old male has a known left atrophic kidney. He has been suffering from recurrent bouts of prostatitis and ejaculatory pain radiating to his left flank. An MRI was obtained to evaluate the patient’s anatomy.

"There isn’t any problem as long as it’s done in the context of caring," says one urologist.

"The world of laser vaginal rejuvenation is fast paced, with new companies adding a laser platform nearly each month," write Jessica DeLong, MD, and Jennifer Miles-Thomas, MD.

These videos illustrate a robotic solution to the complex problem of very large prostate glands causing severe lower urinary tract symptoms.

In this video, Trinity J. Bivalacqua, MD, PhD, presents the case of a 63-year-old man with history of carcinoma in situ found to have low-grade Ta non-muscle invasive bladder cancer.

"In order to complete our transformation into urologists, we must learn to understand and respect the multifaceted importance of responsibility for our patients, our teachers, and our mentees," writes Nirmish Singla, MD.

A 75-year-old male with a long history of nephrolithiasis has been suffering with recurrent urinary tract infections and debilitating dysuria. After obtaining urine from the left renal pelvis, which appeared clear, a retrograde pyelogram is performed. What is your next step?

Studies provide clear evidence to support MRI fusion biopsy’s use as the gold standard for men at risk for prostate cancer diagnosis following an initial negative biopsy.

Limitations of MRI fusion biopsy include its cost, interobserver variability, and low diagnostic accuracy for clinically significant cancer in the anterior prostate.

Other products discussed in this round-up include a rectal spacer, an imaging agent for prostate cancer, and an app to help health care professionals choose the safest contrast agent when imaging patients with renal impairment.