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The American Association of Clinical Urologists (AACU) submitted comments on the post-SGR Medicare reimbursement program, MACRA, on June 27, 2016. In its comments to the Centers for Medicare & Medicaid Services, the AACU expressed concern over a number of provisions that stand to negatively affect urologists in their practice of medicine and increase the cost of medical care.

"The fear of a hypothetical situation should not be used to place restrictions on the life of one of our transgender patients," writes Henry Rosevear, MD.

In this "Coding Q&A" column, Ray Painter, MD, and Mark Painter also answer a question about how to code for cystoscopy with stent removal through the stoma in a patient with an ileal loop.

In this second installment in a series, Robert A. Dowling, MD, addresses who is covered by MIPS, how and when you will be measured, and how and when you will receive your payment adjustment.

A recently released guideline on diagnosis and treatment of nonmuscle-invasive bladder cancer from the AUA and the Society of Urologic Oncology provides practitioners with a risk-stratified clinical framework to aid treatment decisions and surveillance strategies, said Sam S. Chang, MD, MBA.

Other basic science research pearls include preliminary evidence from a porcine model suggesting botulinum toxin type A facilitates ureteral stone passage and the identification of two different microdeletions in the NELL1 gene on chromosome 11 in men with Peyronie's disease.

Research on the use of a CO2 laser for penile carcinoma in situ and FDG positron positron emission tomography-computed tomography in identifying inguinal nodal metastasis (with clinically node negative groins) during monitoring after primary treatment for penile squamous cell carcinoma were among key abstracts in the area of penile, testis, and urethral cancer.

The AUA 2016 imaging take-home messages included abstracts about texture analysis, an imaging algorithm using CT and MRI in the evaluation of fat-poor angiomyolipomas, and contrast-enhanced ultrasound. The take-home messages were presented by Gary J. Faerber, MD, of the University of Utah Health Sciences, Salt Lake City.

Studies about ProPublica's Surgeon Scorecard, urology participation in accountable care organizations, and Twitter were among the take-home messages in outcomes analysis at the 2016 AUA annual meeting. The take-homes were presented by Christopher Saigal, MD, MPH, of the University of California, Los Angeles.

An Obama administration plan to reform Medicare Part B payment policy has generated a chorus of bipartisan opposition from influential lawmakers and many in the medical community, including a leading oncologist who told Congress the initiative is simply an effort to cut costs by accusing physicians of prescribing more expensive drugs for profit.

Decisions regarding wills, living trusts, and power of attorney are critical when forming a blended family, according to Joel M. Blau, CFP, and Ronald J. Paprocki, JD, CFP, CHBC.

Concordance with National Cancer Comprehensive Network recommendations about follow-up during active surveillance for low-risk prostate cancer is generally low across urology practices in Michigan, reported researchers from the Michigan Urological Surgery Improvement Collaborative at the AUA annual meeting in San Diego.

A Veterans Administration Cooperative Study investigating chemotherapy after prostatectomy for high-risk prostate cancer was underpowered to show a statistically significant benefit of early adjuvant chemotherapy versus observation as the standard of care in the primary endpoint analysis of progression-free survival.

In this interview, AUA President Richard K. Babayan, MD, discusses his goal to increase member participation in the AUA, the association’s efforts to balance three main priorities, and how the AUA will work with other organizations.

“Patients are definitely running into problems affording these medications,” one urologist told us.

As she nears the end of her residency, Amy Pearlman, MD, reflects on what stressful moments from her time in urology have taught her.

Other kidney cancer research included an 8-gene panel that was able to predict high tumor grade in biopsy specimens and a review of perioperative transfusion’s effect on recurrence-free and overall survival.

Four-year data on the prostatic urethral lift (UroLift) and data on a new water-jet ablation treatment were among BPH/LUTS highlights from this year’s meeting.

More than one-fourth of the U.S. urologist work force plans to retire in next 5 years, according to a new study looking at the near-term impact of retirement on the specialty.

FDA approval of second-line therapies could mean an “embarrassment of riches” in this field, according to one expert.

Other key stone disease/endourology topics from the 2016 AUA annual meeting included the use of aspirin in percutaneous nephrolithotomy patients as well as the continuing debate over the benefit of medical expulsive therapy.

Analyses of the urinary and gut microbiomes and a quality improvement to standardize use of antibiotics after prostate biopsy were among other AUA 2016 highlights in this therapeutic area.

The AUA annual meeting provided learning experiences for Henry Rosevear, MD, on multiple levels. Here are eight observations he brought home from San Diego.

Microdissection testicular sperm extraction retrieval rates, adolescent varicocele repair, and evaluation of testosterone replacement therapy and prostate cancer are additional noteworthy topics in this field.

Fusion biopsy, salvage versus adjuvant radiation therapy, and superextended versus extended pelvic lymph node dissection are also covered in the take home messages on prostate cancer from the 2016 AUA annual meeting.