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The answer may be no if you're not making the most of daily patient interactionsSeveral years ago, I was more than 45 minutes late to see a patient whoalso happened to be a good friend. When I came into the exam room he waslivid and said to me, "Neil, would you go to a physician like you?"

Tissue sealants have been used for several years in a number of surgical specialties, including urology. Of the various types of tissue sealants, fibrin sealants are the most widely used.

Bladder cancer ranks among the most common human malignancies, with over130,000 newly diagnosed cases each year in the United States and Europeand over 1 million active cases undergoing annual follow-up. Given the traditionaltechnique for diagnosis and monitoring based on passage of a cystoscopeinto the bladder, it is only natural that great efforts are now being focusedtoward finding alternative or confirmatory noninvasive techniques usingurine-based assays.

Bethesda, MD-A screening technique based on the interplay of blood proteinsmay help clearly differentiate between prostate cancer and benign conditionslike BPH, according to a National Cancer Institute study. The test, whichis still under investigation, showed a specificity of 71% in men with marginallyelevated PSA levels, NCI researchers reported.

New minimally invasive techniques for the surgical treatment of stressincontinence have been based on novel concepts concerning the surgical supportof the mid-urethra and the utilization of artificial graft materials. Inthis exclusive Urology Times interview, David Staskin, MD, discusses theevolution of sling techniques and the pros and cons of using artificialmaterials. Dr. Staskin is director of the Section of Voiding Dysfunction,New York Presbyterian Hospital, and associate professor of urology and obstetricsand gynecology, Weill Medical College, Cornell University. The interviewwas conducted by UT Editorial Consultant Philip M. Hanno, MD, of the departmentof urology, University of Pennsylvania, Philadelphia.

Any loss sustained duringthe taxable year can be claimed as a tax deduction

Program avoidsthe need to connect to the Internet while delivering a presentation

Urologists can play important part in new research paradigm, Dr. vonEschenbach says

As I travel throughout the country, I have the opportunity to visit withsome very productive urologists, and I have identified a list of traitsthey all have in common. As reimbursements are reduced and expenses rise,physicians look for ways to maintain their income. Practices that placean emphasis on practice efficiency will be more productive and have greaterincomes.

89% of patients satisfied with temporary stent, which is spontaneouslypassed in 8 days

Two agents show long-term efficacy and safety in a broad range of patients

No disease recurrence, infrequent complications seen at up to 3-year follow-up

New Products & Services

Orlando, FL-Treatment of Peyronie's disease with verapamil appears to be effective, but the drug's role is still in question and is still being investigated. In research presented at the annual AUA meeting in Orlando, FL, verapamil showed good results when applied as a topical gel, but a second study suggested that the gel does not appear to be absorbed into the tunica albuginea.

Pittsburgh-Botulinum toxin injections can successfully treat women with neurogenic detrusor-sphincter dyssynergia (DSD) secondary to multiple sclerosis without causing stress urinary incontinence, according to University of Pittsburgh researchers.

Urologists across the country are reporting an average increase of 39% in their medical liability insurance rates for the most current premium year.

At some point in our lives, all physicians have to decide what to do with outdated patient records. Due to the cost of storage space, most practices are unable to maintain patient medical records indefinitely. Consequently, practices will need to develop and implement retention and destruction policies and procedures. This article will review guidelines for retaining and destroying medical records.

Hicksville, NY-Nuclear Associates offers the Urological Radiation Shield, which has been shown to reduce the exposure of radiation dose from scatter by 70%. After the patient has been positioned on the table, the support rail is attached and the shield is slid onto the rail so it hangs in front of the patient, between the radiation source and the surgeon. This shielding system allows maximum radiation protection to be maintained, according to the company.

Orlando, FL-If a physician discovers an abnormal prostate gland by digital rectal examination, the patient should be a candidate for biopsy to determine if that finding is a malignancy-even if the patient has a PSA

In the treatment of urethral stricture disease, overall stricture length dictates the surgical technique to use. Thus, a well-performed retrograde urethrogram to demonstrate the distal aspect and a voiding cystourethrogram to demonstrate the proximal part of the stricture are essential to formulate a surgical plan. Cystoscopy and transperineal urethral ultrasound can further complement the investigations.

Orlando, FL-Men with erectile dysfunction who fail initial treatment with sildenafil citrate (Viagra) are seeing varying degrees of improvement when therapy is supplemented with other agents, vacuum devices, or education and counseling.

Leasing can result in lower payments and an option to buy, but also higherinterest ratesShould you buy or lease your practice's premises, a needed piece of equipment,or even those extra employees? Those are questions that face every urologist.

Primary care specialties now account for more than 75% of the prescriptionswritten for sildenafil citrate (Viagra), and this percentage increases almostmonthly. The number of prescriptions written by urologists has remainedstable, and as the erectile dysfunction market increases, urology's percentageof the whole continues to decline. As a specialty, urologists are very busy, and the ratio of patients tophysicians is high. Urology residents who are finishing training have atremendous number of practice opportunities, ranking second only to residentsin dermatology, according to a recent AMA survey. Just look at the numberof classified pages in this issue of Urology Times, which list some of theseopportunities, and compare it with those in an issue of 5 or 10 years ago.

Self-assessment study demonstrates 80% improvement in 55% of female patients

Orlando, FL-A sizable proportion of women with mixed stress urinaryincontinence who undergo sling surgery will benefit with concomitant resolutionof urge symptoms. However, preoperative sensory urge appears to clear moreoften than motor urge, and de novo urgency is a significant potential problemfor women being operated on for pure stress incontinence, according to resultsof a study conducted at the Cleveland Clinic.

San Francisco-A transdermal testosterone replacement gel provedboth safe and effective in long-term use, UCLA investigators reported atthe Endocrine Society annual meeting here.

Orlando, FL-Combining sildenafil citrate (Viagra) with a popularantidepressant shows positive results for patients with premature ejaculation,according to results from two separate studies from Israel and Italy. Bothpapers were presented at the AUA annual meeting here.

Q What is the current state of prostate cancer markers?With prostate cancer, we are fortunate in that it has the very best markeror combination of markers for any cancer that I'm aware of, short of skincancer where visual markers are quite good. PSA's performance for predictinglocalized prostate cancer probably exceeds the performance of other cancermarkers, such as CA125 for ovarian cancer, CEA for colon cancer, and someof the genetic markers for breast cancer.

Washington-Although urologists were victorious in a recent courtdecision excluding lithotripsy from the Stark II rule, the U.S. Departmentof Health and Human Services said it will appeal the ruling.

Orlando, FL-The use of radiopharmaceutical carbon-11 acetate in positron emission tomography (PET) appears to be more sensitive in picking up recurrent prostate cancer than standard imaging techniques, according to preliminary imaging studies presented at the AUA annual meeting.