June 2017 Default Cover Image
How your practice can avoid medical necessity denialsThe practical application of medical necessity has taken many forms, and in this increasingly complex world of health care, understanding these applications has become a critical component of your business.
A chief urology resident’s 7 lessons in leadership"Learning from my junior residents means realizing that sometimes, maybe even oftentimes, they may know more than I do," writes Amy Pearlman, MD.
Vibration therapy promising for treating stone fragmentsBadar M. Mian, MD, discusses a recent study about the use of external physical vibration lithecbole for treating residual stones after retrograde intrarenal surgery.
How often should beneficiaries be reviewed?Following some basic guidelines will ensure the beneficiary designations you make are accurate and up to date.
Verbal anesthesia: How it’s used in urologic procedures
Hospital ratings correlate with Ca surgery outcomesMedicare beneficiaries who undergo major urologic cancer surgery at hospitals with higher Hospital Compare Star Ratings introduced by the Centers for Medicare & Medicaid Services in 2016 have superior short-term outcomes than patients operated on at hospitals with lower Hospital Compare rating, according to data presented at the AUA annual meeting in Boston.
Is focal therapy the future of treatment for localized PCa?"For low-grade disease, it’s certainly worth a try because nothing is really lost. For high-grade disease, I don’t know that it’s appropriate—we don’t have the data," says one urologist.
Congress says 'no' to Trump NIH budget cutsThe fiscal 2017 appropriations wrap-up package approved by Congress in early May included a $2 billion increase for the National Institutes of Health, despite a Trump administration request for a $1.2 billion reduction for the nation’s primary medical research facility. That bipartisan action, which funds the federal government through September, came in the face of President Trump’s demand to slash spending for domestic programs to pay for a huge increase in appropriations for defense.
Data feedback is not enough to change care
MRI-guided PCa detection strategies found cost-effectiveDiagnostic magnetic resonance imaging strategies for the diagnosis of prostate cancer should be considered prior to biopsy of suspicious lesions, according to a recent study.
AUA, ASTRO, SUO release localized PCa guidelineAmong the guideline’s recommendations is that active surveillance should serve as the preferred method of care for low-risk localized prostate cancer.
Hypothermia during RARP: No significant benefit seenAlthough theory and preliminary clinical data indicated that intraoperative regional hypothermia could improve the return to potency and continence after robot-assisted radical prostatectomy, the intervention did not have any significant benefits when put to the more rigorous test of a randomized controlled trial.
Measure practice safety, quality with this DIY tool
Missed kidney cancer diagnosis leads to death, legal action
Robotic prostatectomy usage increasing for BPHThe use of robot-assisted simple prostatectomy is increasing for the management of BPH in the United States. Patients were nearly seven times more likely to undergo RASP in 2011-2015 compared to 2003-2006, after adjusting for confounders.
Immunotherapy treats Ca based on genetic featureThe FDA has approved pembrolizumab (Keytruda) for treating any solid tumors that exhibit DNA mismatch repair deficiency.
PDE-5 inhibitors and melanoma: No causal link foundFindings of a meta-analysis show that phosphodiesterase type 5 inhibitor use is associated with a statistically significant increased risk of melanoma, but they do not support a causal relationship.
Physical inactivity raises bladder cancer riskResearchers have observed an association between a lifetime of inactivity and higher risks for bladder and renal cancers.
How do bladder Ca treatments compare in terms of survival?There are no notable differences in overall survival, disease-specific survival, and progression-free survival between radical cystectomy and bladder-preserving combined modality treatment for muscle-invasive bladder cancer, according to a recent meta-analysis.
Burnout: How can it be prevented?In this interview, Raj S. Pruthi, MD, discusses the factors behind burnout and steps that can be taken to address and prevent it.
Burnout rate lower than believed, but still too highA new look at the burnout rate among practicing urologists shows that the problem may not be as widespread as previously reported. Nevertheless, nearly 40% of urologists are burned out, a number researchers say is still much too high.
Metastatic PCa: Studies point to new standard of care“Abiraterone should change the treatment paradigm for patients with newly diagnosed metastatic prostate cancer and largely displaces chemotherapy from the current paradigm,” said Sumanta Kumar Pal, MD.
Bone supportive therapy increases likelihood of pain palliationAdministering bone supportive therapy within 1 month prior to starting radium Ra 223 dichloride (Xofigo) may increase the likelihood of achieving pain palliation with the radionuclide therapy and reduce the chance of pain flare, according to the findings of a retrospective study.
AUA issues recommendations on surveillance, opioidsContinuing its participation in the Choosing Wisely campaign, the AUA has added five new recommendations about tests and treatments that physicians and patients should question.
[Quiz]: Baby born with atypical genitalia, XY karyotypeA 3-month old baby born with atypical genitalia has an XY karyotype. The baby undergoes diagnostic laparoscopy. The baby is doing clinically well without medication.
Dear USPSTF: Don’t discount value of PSA in men 70+“We strongly believe that PSA-based prostate cancer screening should be made available, especially to men 70 years and older to decrease the morbidity and mortality of prostate cancer,” write Navin Shah, MD, and Vladimir Ioffe, MD.
Is vasectomy always permanent?
How does your practice measure up? This tool will tell you"The health care field does not show any signs of slowing in pace or growth, and as many people view health care as a service, it is important to strive for an environment that is high in quality, care, support, and acceptance," writes SUNA's Amy Hull, MSN, WHNP-BC.
BMI predicts post-RP metastasis, PCa mortalityFindings from a recent study also suggest that obesity may be a factor to consider for men with prostate cancer deciding between active surveillance and definitive treatment.