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Denison, TX-A non-existent cap on non-economic medical liabilitydamages and the disproportionate number of high jury awards in the country'slargest state have physicians wondering if relief will ever come, even withlegislation in the works.

Philadelphia-The City of Brotherly Love has what many say is theleast friendly climate for physicians when it comes to medical liabilityinsurance. Insurance and reimbursement problems, however, are statewidephenomena in Pennsylvania. In Scranton, located in the northeastern cornerof the state, a seven-urologist group has said it will decide in Januarywhether to close.

Las Vegas-This past summer, some Las Vegas physicians, includingfive urologists, left the emergency room at University Medical Center, sayingthat it put them at a higher risk of medical malpractice lawsuits, and theywere unable to find affordable insurance.

As medical liability insurance policies come up for renewal and legislators work on reforming the system, physicians and other observers say the nation's liability insurance crisis is worsening. The most promising solution appears to be reform at the federal level, although relief will not come soon, according to national and local physician groups, government officials, insurers, and others familiar with the situation.

Glasgow, Scotland-Results of the first prospective comparison of robot-assisted prostatectomy and traditional radical retropubic prostatectomy show comparable outcomes in margin status and complication rates. Although the robotic approach proved to be a slightly longer procedure, patients experienced less blood loss and pain and were discharged earlier from the hospital, researchers report.

Los Angeles-Although they have metastatic disease, nearly one-third of bladder cancer patients with lymph node tumor involvement following radical cystectomy will enjoy long-term survival, and urologists now have some ways of predicting who they are.

Jena, Germany-The fluorescence in situ hybridization (FISH) assay appears to be a useful, noninvasive method to monitor for tumor recurrence in patients with transitional cell carcinoma of the bladder, according to European researchers.

New York-A computer model nomogram that uses three preoperative prostate cancer variables to predict probabilities for cancer recurrence within 5 years has been successfully validated. The nomogram will not only aid physicians in making treatment decisions, but it could also help improve patients' ability to make decisions about their treatment, according to researchers from Memorial Sloan-Kettering Cancer Center in New York.

Income and assets must be accounted differently for both state and federalpurposes

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.