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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.

Agents for bladder cancer, mixed incontinence, and interstitial cystitis/bladder pain syndrome are also included in this overview of pipeline developments.

Evidence shows HIFU can provide cancer control outcomes comparable to those associated with radical prostatectomy or radiation therapy in properly selected patients.

Recommending either whole-gland or focal HIFU cannot be justified when their pros and cons are judged relative to the appropriate comparator.

More evidence is needed before blue light cystoscopy becomes the standard of care for diagnosis and treatment and renders white light cystoscopy obsolete.

Biopsy decreases overall uncertainty, is safe, fairly accurate, relatively inexpensive, and improves shared decision-making with patients.

The oral beta-3 agonist vibegron, taken once daily at either 50 mg or 100 mg, is well tolerated and results in clinically and statistically significant reductions in daily micturitions, urge incontinence, and urgency episodes.

Renal mass biopsy provides actionable information, but only under specific circumstances-yet it is an increasingly necessary part of the nuanced patient discussion.

A minority of patients are involved in shared decision-making about prostate cancer screening with PSA, but new strategies to incorporate shared decision-making into practice are being investigated.

"One thing I would like to see some guidance on is what to do about patients who use marijuana recreationally," says one urologist.

"The primary advantage of using an ABLE account is that the savings largely do not affect an individual’s eligibility for Supplemental Security Income (SSI), Medicaid, and the Supplemental Nutrition Assistance Program (SNAP)," write Jeff Witz, CFP, and David Zemon.

In this article, we review the underlying causes of nocturia and outline an approach to its diagnostic evaluation and treatment.

Urologists can claim substantial victories as a result of the Bipartisan Budget Act of 2018, signed into law by President Trump in February-including an end to the Independent Payment Advisory Board, which had been established by the Affordable Care Act to help control Medicare spending.

A 25-year-old male presents with 4 weeks of intermittent right flank pain occasionally radiating to the testicle. CT shows a 7-cm partially necrotic retroperitoneal mass at the level of the right renal vein and a 2-cm lesion overlaying the right psoas muscle.

Imaging reveals a mass at the anterior bladder dome with inflammation extending to the perivesical fat. No pelvic lymphadenopathy or sites of metastatic disease are found.

"In recent years, lawmakers in several states considered legislation to conform their laws and exceptions to those outlined in the Stark law," writes the AACU's Ross E. Weber.

This article examines current developments in robotic urologic surgery and future directions, including the introduction of alternative surgical robots.

James Lifton, MBA, a public (non-physician) director of the American Board of Medical Specialties, shares his observations from the recent American Board of Urology Examination Committee meeting.

A new study suggests that metallic Resonance ureteral stents are a good option for management of malignant ureteral obstruction because they promote strong long-term outcomes.

An elderly male with hypertension, lumbar spinal stenosis, morbid obesity, and ED presents with acute right-sided worsening of his chronic back pain. A distal right ureteral stone is found on CT and his symptoms respond well to medical therapy, but he later develops severe right flank pain.

In this "Coding Q&A" column, Ray Painter, MD, and Mark Painter also answer questions regarding bladder instillations and penile modeling during IPP placement.

"Given the costs of defense and the challenge to defend lawsuits involving [retained surgical items], preventing them from occurring at all is the best solution," writes Brianne Goodwin, JD, RN.

Enhanced Recovery After Surgery, or ERAS, is radically changing and standardizing preoperative, perioperative, and postoperative approaches to major surgeries, including radical cystectomy. And while the changes can seem troublesome at first, urologic surgeons who perform radical cystectomy say letting go of dogma is worth it for patients, physicians, and staff.