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Chicago-Pharmacologic treatment of overactive bladder-once the private domain of only two or three agents-is about to expand significantly, providing urologists with a number of new therapeutic options.

Seattle-A new study by American and Dutch researchers suggests that high-resolution magnetic resonance imaging studies using an iron-oxide-containing contrast agent offer the ability to produce a very accurate localization of tumor metastases in prostate cancer patients.

Washington-It's the insurance industry against the trial lawyers,the Republicans against the Democrats. And urologists, like other physicians,are caught in the middle.On July 9, Senate Democrats blocked White House-supported legislationto limit damage awards in medical liability lawsuits, charging that effortsby Senate Majority Leader Bill Frist, MD (R-TN), to force a vote on theissue were political and designed to restore Republican influence with physicians.Dr. Frist pulled the bill after a motion to take up the bill fell 11 votesshy of the 60 needed to cut off a Democratic filibuster.

As a specialty, urology has made significant strides in the area of minimallyinvasive surgery. More work needs to be done, however, if urologists canexpect to keep up with patient demand and stay competitive with generalsurgeons, obstetrician-gynecologists, and other specialists.

Q Can I be reimbursed for in-office injection of botulinum toxin inpatients with refractory overactive bladder? If so, how?

It is a sad reality that few physicians can afford the protection ofhealth insurance for themselves, let alone for their employees. Double-digitincreases in the cost of medical insurance are driving others to severelylimit this popular fringe benefit, if not discarding it altogether. Andmatters are predicted to get worse.

As our overhead costs continue to increase while reimbursements decrease,physicians are motivated to find novel ways to reduce our fixed overheadcosts. Nearly every practice has 15% of "fat" that has to be cut.Just a few cost-saving strategies will reduce thousands of dollars of overhead,and one of these strategies is to implement an electronic system of archivingmedical records.

Chicago-A history of urolithiasis, recent/recurrent urinary tractinfections, and the presence of bilateral stones appear to predict an increasedrisk for the development of complications after stentless ureteroscopy,according to the results of a retrospective study from the University ofMichigan, Ann Arbor.

AUA's 2-year-old Office of Research has taken an active role in suchareas as legislation, data collection, and communication within the urologicresearch community, all of which are designed to advance research and improvethe care of patients with urologic diseases. Monica Liebert, PhD, directorof the Office of Research, discusses these and other key initiatives inthis exclusive Urology Times interview. The interview was conducted by UTEditorial Consultant Richard D. Williams, MD, professor and chairman ofthe department of urology at the University of Iowa, Iowa City.

Wilmington, DE-The federal government will likely pursue urologistsin a second round of investigations surrounding the fraudulent marketingand sale of luteinizing hormone-releasing hormone agonists for prostatecancer. Just how far the probe will extend remains a source of debate amonglegal experts familiar with the case.

Seattle-Leading U.S. prostate cancer thought leaders are expressingwidely divergent opinions on the recent announcement of a 25% reductionin prostate cancer incidence in men treated with finasteride (Proscar),according to interviews conducted by Urology Times. Whereas some expertssee the finding as the beginning of a new era in prostate cancer prevention,others say that more data are needed before urologists can confidently applythe finding to clinical practice.

References

This Urology Times Meeting Reporter summarizes the CME satellite symposium presented at the 2003 American Urological Association Annual Meeting.

Less than 20 years ago, lymphadenectomy and lymph node dissection were primarily used as staging procedures. Today, studies have shown that the procedures can increase the survival rates in patients with a host of urologic cancers. In this exclusive interview, Urs Studer, MD, professor and chairman of the department of urology, University of Bern, Switzerland, discusses the expanding role of lymph node dissection in bladder, prostate, and kidney cancer. The interview was conducted by UT Editorial Consultant Robert C. Flanigan, MD, professor and chairman of the department of urology at Loyola University Medical Center, Maywood, IL.

Presented by John A. Libertino, MD, Lahey Clinic, Burlington, MA

Presented by Carrie Rinker Schaffer, PhD, University of Chicago

Presented by Mark S. Litwin, MD, University of California, Los Angeles.

Presented by Michael A. O'Donnell, MD, University of Iowa, Iowa City

Presented by Gary D. Grossfeld, MD, Marin Urology Medical Group, Greenbrae,CA.

Presented by Stephen J. Savage, MD, Memorial Sloan-Kettering Cancer Center, New York

Presented by Joseph J. Del Pizzo, MD, New York Presbyterian Hospital

Presented by Philip M. Hanno, MD, University of Pennsylvania, Philadelphia.

Presented by Craig V. Comiter, MD, University of Arizona, Tucson

Presented by Kennon S. Miller, MD, Erie County Medical Center, Buffalo,New York.

Presented by Allen D. Seftel, MD, Case Western Reserve University, Cleveland

Presented by John W. Colberg, MD, Yale University School of Medicine,New Haven, CT.

Presented by Larry Lipshultz, MD, Baylor College of Medicine, Houston.

Presented by Richard Grady, MD, University of Washington, Seattle.

Presented by Ronald Rabinowitz, MD, University of Rochester (NY) MedicalCenter.

Presented by Margaret S. Pearle, MD, University of Texas SouthwesternMedical Center, Dallas.