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    AUA 2015: PSA paper, tough live surgery are lasting memories

    Henry Rosevear, MDDr. RosevearOn my flight home from this year’s AUA, I decided to write down a few valuable lessons I took away from my time in New Orleans.

    Read: Complications bring out urologists’ ‘human’ feelings

    A couple notes about the host city: First, it’s New OR-lins, not New or-LEANS. (It took me nearly 40 years to figure that one out.) Second, when a waitress asks if you “want that to go,” she may not be talking about what’s on your plate. Apparently, walking down the street with an open container is legal. (There is even a phrase, “geaux cups,” to describe the small plastic cups they use for this purpose.)

    More seriously, to the AUA staff, well done. The 2015 AUA annual meeting was an incredible opportunity not only to listen to the true thought leaders describe the state of our field, but also to hear and even watch some of the up-and-coming stars show us where the field is heading. In that respect, I thought the new "Second Opinion Cases" plenary session was particularly useful.

    While numerous abstracts caught my eye, three in particular seemed to resonate. First, some self-validation was provided by Dr. Werntz et al in abstract PD44-02. This paper confirmed a trend that I had suspected and discussed previously in this blog but wasn’t clever enough to prove. The authors showed a significant 50% decrease in the use of PSA testing by a group of primary care doctors after the U.S. Preventive Services Task Force recommendations were released in 2012.

    This finding is terribly important for a few reasons. First, it is confirmation that we are entering a new era (returning to a previous one?) when prostate cancer patients will walk into your office not simply with an elevated PSA but with symptoms. Second, since I, as a small-town plumber, am unable to change the government’s opinion on the importance of detecting early-stage prostate cancer, this abstract stresses how important it is for urologists to educate the primary care physician community that if you’re not going to check PSA, advanced prostate cancer now needs to be included in your differential for all patients who present with either obstructive voiding symptoms or back pain.

    The next two abstracts I found interesting immediately changed the way I practice medicine.

    NEXT: Robotic vs. open RP, predicting recurrence after urethoplasty

    More from Dr. Rosevear

    Taking the boards: Not a bad rite of passage after all

    PSA testing: It's not your choice, it's the patient’s

    Drug reps: Understanding the hand that feeds you

    Henry Rosevear, MD
    Dr. Rosevear, a member of the Urology Times Clinical Practice Board, is in private practice at Pikes Peak Urology, Colorado Springs, CO.

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