http://contemporaryurology.modernmedicine.com/conturo Contemporary Urology Magazine 2008-07-04T17:51:14Z http://contemporaryurology.modernmedicine.com/conturo/Male-Continence-Expert-Insight/ArticleStandard/Article/detail/507522?ref=25 Highlights of a roundtable discussion on experiences with the next generation of male sling technology. An advancement in the treatment for post-prostatectomy incontinence. 2008-04-01T04:00:00Z http://contemporaryurology.modernmedicine.com/conturo/data/articlestandard/conturo/142008/507522null PDF http://www.modernmedicine.com/modernmedicine/feature/Treatment-principles-for-nonmuscle-invasive-bladde/ArticleStandard/Article/detail/484907?ref=25 The recently updated Guideline for the Management of Nonmuscle Invasive Bladder Cancer contains information designed to help clinicians counsel patients with newly diagnosed and recurrent superficial bladder cancer. 2008-01-01T05:00:00Z http://contemporaryurology.modernmedicine.com/conturo/data/articlestandard/conturo/032008/484907/CNTUR0108_CV_13849_thumbnail.jpg http://contemporaryurology.modernmedicine.com/conturo/data/articlestandard/conturo/032008/484907null XML http://www.modernmedicine.com/modernmedicine/Departments/Malpractice-Corner/ArticleStandard/Article/detail/484791?ref=25 --> 2008-01-01T05:00:00Z http://contemporaryurology.modernmedicine.com/conturo/data/articlestandard/conturo/032008/484791null XML http://www.modernmedicine.com/modernmedicine/Departments/Urology-news-items/ArticleStandard/Article/detail/484785?ref=25 --> 2008-01-01T05:00:00Z http://contemporaryurology.modernmedicine.com/conturo/data/articlestandard/conturo/032008/484785null XML http://www.modernmedicine.com/modernmedicine/Urology+Times+CME/Maintaining-Proper-Fluid-Balance-in-the-Postoperat/ArticleStandard/Article/detail/486397?ref=25 Armed with a good understanding of the fluid physiology of the body and the various types of IV fluid products available, the urologist can prevent or control potentially dangerous postoperative conditions such as postobstructive diuresis and TUR syndrome. 2008-01-01T05:00:00Z http://contemporaryurology.modernmedicine.com/conturo/data/articlestandard/conturo/042008/486397null REMOTE http://www.modernmedicine.com/modernmedicine/feature/2008-urology-coding-update/ArticleStandard/Article/detail/484788?ref=25 Used properly, these new and revised codes will prevent claim denials and ensure timely collection of entitled revenue. 2008-01-01T05:00:00Z http://contemporaryurology.modernmedicine.com/conturo/data/articlestandard/conturo/032008/484788null XML http://www.modernmedicine.com/modernmedicine/Departments/An-enhanced-content-strategy-for-2008/ArticleStandard/Article/detail/484784?ref=25 As we welcome the New Year, I would like to take this opportunity to announce an important editorial initiative from Advanstar Communications, the company that publishes both Contemporary Urology and Urology Times. 2008-01-01T05:00:00Z http://contemporaryurology.modernmedicine.com/conturo/data/articlestandard/conturo/032008/484784null XML http://www.modernmedicine.com/modernmedicine/feature/Stem-cell-therapy-for-SUI/ArticleStandard/Article/detail/484787?ref=25 US-guided transurethral injection of autologous adult stem cells is a minimally invasive procedure that holds hope for treating the pathophysiologic causes of SUI. 2008-01-01T05:00:00Z http://contemporaryurology.modernmedicine.com/conturo/data/articlestandard/conturo/032008/484787null XML http://contemporaryurology.modernmedicine.com/conturo/Interstimreg-Therapy-A-Decade-of-Sacral-Nerve-Stim/ArticleStandard/Article/detail/484198?ref=25 It?s as easy as watching television commercials to appreciate that problems of incontinence and voiding dysfunction are increasingly having an impact on the consciousness of the American public. Today, approximately 33.3 million persons in the United States?16.5% of our population? grapple with the problem of overactive bladder (OAB).1,2 Approximately 30% of these persons are bothered enough to seek treatment.3 Yet roughly 55% of these patients?a group numbering 4 million?cannot tolerate drug therapy and must either live with the problem or seek relief through other conservative treatments such as biofeedback techniques, lifestyle modification, dietary changes, and/or physiotherapy.4 Prior to the introduction of sacral neuromodulation, patients often were faced with the prospect of invasive abdominal surgery such as denervation or bladder augmentation. Sacral neuromodulation was first approved by the US Food and Drug Administration in 1997 to treat urinary retention and then was approved in 1999 to treat the symptoms of OAB, including urinary urge incontinence and significant symptoms of urgency-frequency, in patients with symptoms that are refractory to other treatments. 2008-01-01T05:00:00Z http://contemporaryurology.modernmedicine.com/conturo/data/articlestandard/conturo/032008/484198null PDF http://www.modernmedicine.com/modernmedicine/Features/Failed-Slings-Individualizing-management-for-optim/ArticleStandard/Article/detail/473329?ref=25 The panelists continue with a discussion of how to best treat patients with recurrent SUI, those with obstruction and recurrent SUI, and those with a failed Burch procedure. After sharing tips on setting realistic patient expectations, the panel concludes by discussing the impact of evolving sling technology. 2007-12-01T05:00:00Z http://contemporaryurology.modernmedicine.com/conturo/data/articlestandard/conturo/462007/473329null XML http://www.modernmedicine.com/modernmedicine/Urology+Times+CME/The-Management-of-Severe-Hematuria-and-Clot-Retent/ArticleStandard/Article/detail/486399?ref=25 When severe hematuria fails to resolve on its own, prompt intervention is crucial in preventing clot formation and obstruction. But when preventive measures are unsuccessful, a few maneuvers in a stepwise progression toward more invasive procedures can be used to evacuate a clot that has formed. 2007-12-01T05:00:00Z http://contemporaryurology.modernmedicine.com/conturo/data/articlestandard/conturo/042008/486399null REMOTE http://www.modernmedicine.com/modernmedicine/Departments/Surgeons-Corner/ArticleStandard/Article/detail/473376?ref=25 Appropriate port placement in the abdominal wall is the first step toward operative success. 2007-12-01T05:00:00Z http://contemporaryurology.modernmedicine.com/conturo/data/articlestandard/conturo/462007/473376null XML http://www.modernmedicine.com/modernmedicine/Departments/Editorial/ArticleStandard/Article/detail/473327?ref=25 We need to focus our efforts not only to improve survival, but also to limit long-term health problems related to treatment. 2007-12-01T05:00:00Z http://contemporaryurology.modernmedicine.com/conturo/data/articlestandard/conturo/462007/473327null XML http://www.modernmedicine.com/modernmedicine/Departments/Urology-news-items/ArticleStandard/Article/detail/473328?ref=25 Effect of draw time on various testosterone values; Review of Pca prevention trials predicts success, definitive findings in 2-7 years; Taldalafil aids erectile function after spinal cord injury; Time to PSA failure similar in Gleason score 7 and higher PCa; Location more important than number in prostate biopsies; Value of PSAV in PCa screening questioned; Obesity may be protective in metastatic HRPC; Risk factors for upper tract recurrence following radical cystectomy for TCC 2007-12-01T05:00:00Z http://contemporaryurology.modernmedicine.com/conturo/data/articlestandard/conturo/462007/473328null XML http://www.modernmedicine.com/modernmedicine/Features/Postprostatectomy-incontinence-Prevention-and-ther/ArticleStandard/Article/detail/473373?ref=25 As many as 20% of patients undergoing radical prostatectomy experience postoperative incontinence, which derives from a number of etiologies. Several interventions exist – namely, injection therapy, the male sling procedure, and the implantation of an artificial urinary sphincter – that may greatly improve or resolve persistent incontinence in the majority of patients. 2007-12-01T05:00:00Z http://contemporaryurology.modernmedicine.com/conturo/data/articlestandard/conturo/462007/473373null XML http://contemporaryurology.modernmedicine.com/conturo/First+Home+Page+Supplement/Benign-Prostatic-Hyperplasia-A-Common-and-Manageab/ArticleStandard/Article/detail/469796?ref=25 Many men will face a common problem called benign prostatic hyperplasia (BPH), or enlargement of the prostate gland, as they age. BPH will affect approximately 50% of men between the ages of 51 and 60 years, and up to 90% of men older than 80 years. In the United States, approximately 14 million men have this condition. 2007-12-01T05:00:00Z http://contemporaryurology.modernmedicine.com/conturo/data/articlestandard/conturo/442007/469796null PDF http://www.modernmedicine.com/modernmedicine/Departments/Micronutrients-do-not-reduce-PCa-risk/ArticleStandard/Article/detail/467714?ref=25 LATE-BREAKING ITEMS OF INTEREST FOR UROLOGISTS 2007-11-01T04:00:00Z http://contemporaryurology.modernmedicine.com/conturo/data/articlestandard/conturo/432007/467714null XML http://www.modernmedicine.com/modernmedicine/Features/Radiation-therapy-for-urologic-cancers-state-of-th/ArticleStandard/Article/detail/466196?ref=25 Recent progress has benefited patients with many urologic cancers in all stages of disease. This update describes the latest developments in the application of radiation to treat prostate cancer, urothelial carcinoma of the bladder, and seminoma, and discusses palliative treatment of metastatic prostate cancer and renal cell carcinoma. 2007-11-01T04:00:00Z http://contemporaryurology.modernmedicine.com/conturo/data/articlestandard/conturo/422007/466196null XML http://www.modernmedicine.com/modernmedicine/Features/Failed-Slings-What-to-do-and-when-to-do-it-Part-1-/ArticleStandard/Article/detail/466198?ref=25 Our panel of experts recently met to discuss and debate how to best diagnose and treat patients who present with various types of sling failure. In this issue, they start by defining failure, then discuss how extensively they evaluate different patients, how they quantify and factor in the degree of urethral hypermobility, what value the LPP has, and how they manage failures from obstruction. 2007-11-01T04:00:00Z http://contemporaryurology.modernmedicine.com/conturo/data/articlestandard/conturo/422007/466198/CNTUR1107_CV1-spn_13170_thumbnail.jpg http://contemporaryurology.modernmedicine.com/conturo/data/articlestandard/conturo/422007/466198null XML http://www.modernmedicine.com/modernmedicine/Urology+Times+CME/Radiation-Therapy-for-Urologic-Cancers-State-of-th/ArticleStandard/Article/detail/486402?ref=25 Recent progress has benefited patients with many urologic cancers in all stages of disease. This update describes the latest developments in the application of radiation to treat prostate cancer, urothelial carcinoma of the bladder, and seminoma, and discusses palliative treatment of metastatic prostate cancer and renal cell carcinoma. 2007-11-01T04:00:00Z http://contemporaryurology.modernmedicine.com/conturo/data/articlestandard/conturo/042008/486402null REMOTE http://www.modernmedicine.com/modernmedicine/Features/Tips-and-techniques-for-evaluating-the-indetermina/ArticleStandard/Article/detail/466194?ref=25 In the present era of multidetector CT, color Doppler US, and MRI, the concept of the indeterminate renal mass is rapidly changing. 2007-11-01T04:00:00Z http://contemporaryurology.modernmedicine.com/conturo/data/articlestandard/conturo/422007/466194null XML http://contemporaryurology.modernmedicine.com/conturo/High-dose-chemotherapy-plus-stem-cell-rescue/ArticleStandard/Article/detail/467716?ref=25 LATE-BREAKING ITEMS OF INTEREST FOR UROLOGISTS 2007-11-01T04:00:00Z http://contemporaryurology.modernmedicine.com/conturo/data/articlestandard/conturo/432007/467716null XML http://www.modernmedicine.com/modernmedicine/Departments/Editorial/ArticleStandard/Article/detail/466192?ref=25 After a 5-year study funded by the NIH National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) and developed by a team of epidemiologists, health economists, statisticians, programmers, and urologists, Urologic Diseases in America 2007 has finally been released. 2007-11-01T04:00:00Z http://contemporaryurology.modernmedicine.com/conturo/data/articlestandard/conturo/422007/466192null XML http://www.modernmedicine.com/modernmedicine/Departments/Urology-news-items/ArticleStandard/Article/detail/466193?ref=25 By the Numbers; Literature Review; Laparoscopic partial nephrectomy: Positive margin rate; IC patients often have history of abuse; Finasteride unlikely to induce high-grade Pca; Experience key to limiting Pca recurrence; Receptor gene may identify susceptibility to acute pyelonephritis; Yield of initial and subsequent prostate biopsy; FDA approves first human thrombin since 1954. 2007-11-01T04:00:00Z http://contemporaryurology.modernmedicine.com/conturo/data/articlestandard/conturo/422007/466193null XML http://contemporaryurology.modernmedicine.com/conturo/Hypogonadism-and-Testosterone-Replacement-Therapy-/ArticleStandard/Article/detail/463800?ref=25 Target Audience This program is intended for urologists and primary care physicians who treat patients with hypogonadism by using testosterone replacement therapy. Statement of Need In men, serum testosterone levels decline gradually, from an approximate mean of 600 ng/dL at age 30 years to 400 ng/dL at age 80 years. It has not been determined whether this change is physiologic or pathologic, however. Testosterone and/or its metabolites bind with androgen and estrogen receptors throughout the body. When testosterone levels are insufficient, adverse consequences can emerge. Hypogonadism affects up to 4 million US males and is associated with energy loss; impaired cognition; decreased bone density, muscle mass, and strength; and sexual dysfunction. In addition, low serum testosterone levels have been linked with an adverse metabolic profile and increased mortality of all causes. Testosterone replacement therapy (TRT) is available in several formulations that are approved by the US Food and Drug Administration for treatment of men with a deficiency or absence of endogenous testosterone. Because most TRT clinical trials have enrolled men younger than age 65 years, an Institute of Medicine committee has recommended that short term trials be conducted in elderly men with testosterone concentrations below 300 ng/dL to investigate short-term benefits. Longer-term studies are needed to confirm whether TRT is safe in older men in whom prostate cancer is not suspected and to confirm a favorable benefit/risk ratio. For patients of any age, physicians need to be able to identify the individuals who might benefit from TRT, and they also need to understand how to monitor patients in whom TRT has been initiated. Learning Objectives Upon completion of this program, participants should be able to: Specify the definition and diagnosis of hypogonadism Express the rationale for TRT Describe the risks and benefits of TRT, to the extent that they are known Review why TRT is considered controversial and what further information is needed to resolve the controversies Program Completion Time Based upon trials, the estimated time to complete this program is 1.0 hour. Physician Accreditation Statement This activity has been planned and implemented in accordance with the Essential Areas and Policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of Medical Education Resources, Inc, and cme2, a wholly owned subsidiary of Advanstar Communications, Inc, publisher of Urology Times. Medical Education Resources, Inc, is accredited by the ACCME to provide continuing medical education for physicians. Credit Designation Medical Education Resources, Inc, designates this educational activity for a maximum of 1.0 AMA PRA Category 1 Credit™. Physicians should only claim credit commensurate with the extent of their participation in the activity. Disclosure Policy It is the policy of Medical Education Resources, Inc, to ensure balance, independence, objectivity, and scientific rigor in all its educational activities. All faculty/authors participating in our programs are expected to disclose any relationships they have with commercial companies whose products or services may be mentioned so that participants can evaluate the objectivity of the presentations. 2007-10-15T04:00:00Z http://contemporaryurology.modernmedicine.com/conturo/data/articlestandard/conturo/412007/463800null PDF http://www.modernmedicine.com/modernmedicine/Features/HIFU-for-prostate-cancer/ArticleStandard/Article/detail/458294?ref=25 For more than a decade, HIFU has been investigated as a less invasive alternative to surgical treatment in men with localized prostate cancer. A growing and maturing body of research suggests that HIFU is a safe and efficacious option for several subgroups of patients. 2007-10-01T04:00:00Z http://contemporaryurology.modernmedicine.com/conturo/data/articlestandard/conturo/382007/458294null XML http://www.modernmedicine.com/modernmedicine/Departments/Editorial/ArticleStandard/Article/detail/458288?ref=25 This month's issue of Contemporary Urology is dedicated to several evolving devices and techniques that have the potential to advance our ability to manage many urologic maladies. 2007-10-01T04:00:00Z http://contemporaryurology.modernmedicine.com/conturo/data/articlestandard/conturo/382007/458288null XML http://www.modernmedicine.com/modernmedicine/Urology+Times+CME/Radiosurgery-Development-and-Potential-Urologic-Ap/ArticleStandard/Article/detail/486407?ref=25 By dividing a dose of radiation between a large number of separate beams focused on a single point, radiosurgery has the potential to ablate tumors without the damage to surrounding tissue that is associated with traditional radiation therapy. New tracking technologies may now enable this highly efficacious treatment modality to be used on tumors that move during respiration, such as kidney and prostate. 2007-10-01T04:00:00Z http://contemporaryurology.modernmedicine.com/conturo/data/articlestandard/conturo/042008/486407null REMOTE http://www.modernmedicine.com/modernmedicine/Features/Radiosurgery-potential-urologic-applications/ArticleStandard/Article/detail/458292?ref=25 By dividing a dose of radiation between a large number of separate beams focused on a single point, radiosurgery has the potential to ablate tumors without the damage to surrounding tissue that is associated with traditional radiation therapy. New tracking technologies may now enable this highly efficacious treatment modality to be used on tumors that move during respiration, such as the kidney and prostate. 2007-10-01T04:00:00Z http://contemporaryurology.modernmedicine.com/conturo/data/articlestandard/conturo/382007/458292/CNTUR1007_CV1_12939_thumbnail.jpg http://contemporaryurology.modernmedicine.com/conturo/data/articlestandard/conturo/382007/458292null XML http://www.modernmedicine.com/modernmedicine/Departments/Urology-news-items/ArticleStandard/Article/detail/458289?ref=25 By the Numbers; Literature Review; Racial differences in selenium level may explain variations in cancer incidence; RFA safe, effective for smaller renal tumors. 2007-10-01T04:00:00Z http://contemporaryurology.modernmedicine.com/conturo/data/articlestandard/conturo/382007/458289null XML http://www.modernmedicine.com/modernmedicine/Features/Bladder-cancer-screening-an-update/ArticleStandard/Article/detail/458921?ref=25 Bladder cancer screening has the potential to improve survival in high-risk patients by detecting tumors early, resulting in better outcomes. While some urine-based bladder tumor markers have demonstrated an improvement in bladder cancer detection over cytology or hematuria testing, they need to be evaluated in the setting of screening. More research is required to asess the feasibility and cost-effectiveness of screening prior to widespread use. 2007-10-01T04:00:00Z http://contemporaryurology.modernmedicine.com/conturo/data/articlestandard/conturo/382007/458921null XML http://www.modernmedicine.com/modernmedicine/Departments/Urology-new-products/ArticleStandard/Article/detail/458290?ref=25 Transducer enables high-definition imaging; Flexible metallic stent increases drainage, comfort; Wireless urodynamic testing; Female sling surgical kit; Flexible video-cystoscope; Male sling for patients ineligible for AUS; Retractor provides greater exposure despite smaller incision; High-speed, high-resolution CT; High-speed image information system. 2007-10-01T04:00:00Z http://contemporaryurology.modernmedicine.com/conturo/data/articlestandard/conturo/382007/458290null XML http://www.modernmedicine.com/modernmedicine/Urology+Times+CME/Prostate-Cancer-Searching-for-an-Effective-Predict/ArticleStandard/Article/detail/486410?ref=25 Current prostate cancer screening relies heavily upon PSA measurements and DRE findings, but many other factors can affect a patient’s risk of having cancer. Limitations in study design have kept the use of prediction models from becoming standard practice. With current studies using saturation biopsies, prediction models may soon be developed to enhance the effectiveness of prostate cancer screening guidelines. 2007-09-01T04:00:00Z http://contemporaryurology.modernmedicine.com/conturo/data/articlestandard/conturo/042008/486410null REMOTE http://www.modernmedicine.com/modernmedicine/Features/Prostate-cancer-Effective-prediction/ArticleStandard/Article/detail/451487?ref=25 Current prostate cancer screening relies heavily upon PSA measurements and DRE findings, but many other factors can affect a patient's risk of having cancer. Limitations in study design have kept the use of prediction models from becoming standard practice. With current studies using saturation biopsies, prediction models may soon be developed to enhance the effectiveness of prostate cancer screening guidelines. 2007-09-01T04:00:00Z http://contemporaryurology.modernmedicine.com/conturo/data/articlestandard/conturo/342007/451487/CNTUR0907_CVR1-SPN_12736_thumbnail.jpg http://contemporaryurology.modernmedicine.com/conturo/data/articlestandard/conturo/342007/451487null XML http://www.modernmedicine.com/modernmedicine/Departments/Urology-news-items/ArticleStandard/Article/detail/451485?ref=25 By the Numbers; Literature Review; Intravesical therapy (IVT) may actually lower DFS; Novel SUI therapy shows promise. 2007-09-01T04:00:00Z http://contemporaryurology.modernmedicine.com/conturo/data/articlestandard/conturo/342007/451485null XML http://contemporaryurology.modernmedicine.com/conturo/CME+Home+Page+supplement/Exploring-New-Findings-in-PBSIC/ArticleStandard/Article/detail/453840?ref=25 Release Date: September 1, 2007 Expiration Date: September 30, 2008 Target Audience This program is intended for urologists, primary care physicians, and obstetricians/gynecologists. Statement of Need Painful bladder syndrome/Interstitial cystitis (PBS/IC) is a severely debilitating clinical condition of indeterminate origin that is characterized by excessive urinary urgency and frequency; nocturia; suprapubic pressure or pain, or both; and chronic pelvic pain in the absence of any identifiable cause. PBS/IC interferes—sometimes devastatingly so—with daily activities, work, and personal relationships. Urinary frequency can exceed 60 micturitions per 24 hours, and nocturia may be unrelenting. The pain can vary from a mild burning or discomfort to excruciating pain in the pelvis, lower back, or thighs. It can include pain with intercourse and is often indistinguishable from other causes of pelvic pain. Most patients consult at least 5 physicians, including psychiatrists, during a period of more than 4 years before PBS\IC is diagnosed. Diagnosis is usually based on appropriate symptoms in the absence of mimicking diseases. Therapies include pentosan polysulfate sodium, heparin or hyaluronic acid administered intravesically, tricyclic antidepressants and antihistamines, and, as a last resort, surgery, including cystectomy. The National Institute of Diabetes and Digestive and Kidney Diseases estimates that PBS/IC affects as many as 1 million individuals in the United States, 90% of whom are women. Studies from 2005 in primary care6 and managed care populations7 suggest that PBS/IC may be more common than was previously suspected, however. This activity is aimed at building awareness of the signs and symptoms of PBS/IC, so that a greater number of patients can receive the appropriate diagnosis and treatment. Learning Objectives After completion of this activity, participants should be able to: Discuss the etiology of PBS/IC Explain the new nomenclature used to describe PBS/IC List the barriers to the diagnosis of PBS/IC Summarize pain as a component of PBS/IC Tailor therapies to the individual patient Improve adherence through effective patient counseling Accreditation Statement This continuing medical education activity has been planned and implemented in accordance with the Essential Areas and Policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of Medical Education Resources, Inc, and cme2. Medical Education Resources, Inc, is accredited by the ACCME to provide continuing medical education for physicians. Credit Designation Medical Education Resources, Inc, designates this educational activity for a maximum of 1 AMA PRA Category 1 Credit™. Physicians should only claim credit commensurate with the extent of their participation in the activity. 2007-09-01T04:00:00Z http://contemporaryurology.modernmedicine.com/conturo/data/articlestandard/conturo/352007/453840/pbs_thumbnail.jpg http://contemporaryurology.modernmedicine.com/conturo/data/articlestandard/conturo/352007/453840null PDF http://contemporaryurology.modernmedicine.com/conturo/First+Home+Page+Supplement/BPH-and-Emotional-Stress/ArticleStandard/Article/detail/453804?ref=25 Benign prostatic hyperplasia (BPH) can cause a lot of discomfort, as well as frustration resulting from the inability to urinate normally. For some men, it can also cause emotional stress. Getting the facts right about BPH can help alleviate the emotional stress. 2007-09-01T04:00:00Z http://contemporaryurology.modernmedicine.com/conturo/data/articlestandard/conturo/352007/453804/bph_thumbnail.jpg http://contemporaryurology.modernmedicine.com/conturo/data/articlestandard/conturo/352007/453804null PDF http://www.modernmedicine.com/modernmedicine/feature/Reappraising-varicocele-repair/ArticleStandard/Article/detail/451488?ref=25 Although varicocele repair is considered the treatment of choice for otherwise unexplained infertility, inconsistent findings about its efficacy have given rise to questions and controversy. These authors offer guidance on managing varicoceles, based on their review of the available literature. 2007-09-01T04:00:00Z http://contemporaryurology.modernmedicine.com/conturo/data/articlestandard/conturo/342007/451488null XML http://www.modernmedicine.com/modernmedicine/Departments/Editorial/ArticleStandard/Article/detail/451484?ref=25 Martin I. Resnick, MD will be remembered for the personal touch he imparted to everything he did; for being a loving family man, and for being an exceptional friend, colleague, teacher, and surgeon. 2007-09-01T04:00:00Z http://contemporaryurology.modernmedicine.com/conturo/data/articlestandard/conturo/342007/451484null XML http://www.modernmedicine.com/modernmedicine/Features/Effective-coding-for-office-procedures/ArticleStandard/Article/detail/451486?ref=25 During the past 10 years, the urology office has become the most cost-effective location in which to provide urologic care. Improving your coding and billing process can increase your practice's revenue. This update on changes to office coding rules can help you get started. 2007-09-01T04:00:00Z http://contemporaryurology.modernmedicine.com/conturo/data/articlestandard/conturo/342007/451486null XML http://contemporaryurology.modernmedicine.com/conturo/Early-Penile-Rehabilitation-Following-Prostatectom/ArticleStandard/Article/detail/449169?ref=25 Content Source This continuing medical education (CME) supplement is based on a CME satellite symposium held on April 7, 2007, at Urology Congress™ in San Francisco, California. Release Date: August 15, 2007 Expiration Date: August 31, 2008 Target Audience The target audience for this continuing education activity is urologists and primary care physicians. Statement of Need In 2006, the American Cancer Society predicted the diagnosis of nearly 234,500 cases of prostate cancer. Although rates rose rapidly between 1988 and 1992, they declined sharply between 1992 and 1995, with modest increases since 1995. Due largely to widespread prostate-specific antigen testing, younger and sexually active men are being diagnosed with biopsypositive, localized early-stage disease; the 5-year relative survival rate for these patients with early-stage tumors is approaching 100%. In the past 20 years, the 5-year disease-specific or all-cause survival rate for all stages combined rose from 67% to 96%. A primary reason for improved survival is that more prostate cancer patients mainly seek a “cure” through radical prostatectomy (RP) without adjuvant hormonal or radiation therapy. This approach’s success means men are living longer, but with a known side effect of surgical intervention—erectile dysfunction (ED). Clinical data show early evaluation and treatment of erectile function after prostatectomy is essential for the best quality-of-life outcomes. Recovery improves when erectile function is maintained. Numerous ED treatment options are available after radical retropubic prostatectomy; these include vacuum erection devices, intraurethral agents, and intracavernosal injection therapy. Systemic oral medications, including oral phosphodiesterase type 5 inhibitors, are effective but work best when functional neural tissue is present. Thus, treatment options such as intracavernosal injections or intraurethral therapy with alprostadil should be encouraged while neurologic function is being recovered. More invasive surgical options include insertion of a penile prosthesis. To improve patient outcomes, physicians should be familiar with early penile rehabilitation and the risks and benefits of treatment approaches. A symposium conducted by thought leaders in the field presented during Urology Congress™ addressed this subject and forms the basis of this supplement. Learning Objectives Upon completion of this activity, participants should be able to: Discuss current epidemiology and etiology of postprostatectomy-related ED Address patients’ risk of prostatectomy-related ED Discuss the risks and benefits of available treatment options Counsel patients and prescribe treatment options based on efficacy, safety, and patient preference Joint Sponsorship Accreditation Statement This continuing medical education activity has been planned and implemented in accordance with the Essential Areas and Policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of Medical Education Resources, Inc, and cme2. Medical Education Resources, Inc, is accredited by the ACCME to provide continuing medical education for physicians. Credit Designation Medical Education Resources, Inc, designates this educational activity for a maximum of 1.0 AMA PRA Category 1 Credit™. Physicians should only claim credit commensurate with the extent of their participation in the activity. 2007-08-15T04:00:00Z http://contemporaryurology.modernmedicine.com/conturo/data/articlestandard/conturo/332007/449169null PDF http://www.modernmedicine.com/modernmedicine/Features/Reviewing-the-updated-AUA-prostate-cancer-guidelin/ArticleStandard/Article/detail/442563?ref=25 The recently updated Guideline for the Management of Clinically Localized Prostate Cancer contains features designed to help clinicians counsel men with newly diagnosed, clinically localized prostate cancer. Its discussion of treatment options, based on the most recently published data, carefully considers the importance of outcomes based on risk stratification. 2007-08-01T04:00:00Z http://contemporaryurology.modernmedicine.com/conturo/data/articlestandard/conturo/292007/442563null XML http://www.modernmedicine.com/modernmedicine/Features/Postoperative-bleeding-Prevention-and-management-f/ArticleStandard/Article/detail/442564?ref=25 Postoperative bleeding can occur following virtually any type of urologic procedure. A thorough preoperative history, physical examination, and medication history are crucial to the prevention and effective management of these dangerous complications. 2007-08-01T04:00:00Z http://contemporaryurology.modernmedicine.com/conturo/data/articlestandard/conturo/292007/442564null XML http://www.modernmedicine.com/modernmedicine/Departments/Editorial/ArticleStandard/Article/detail/442619?ref=25 Studies involving unique chemotherapeutic agents and concepts are progressing, and several prostate cancer vaccines are in late-stage investigation. 2007-08-01T04:00:00Z http://contemporaryurology.modernmedicine.com/conturo/data/articlestandard/conturo/292007/442619null XML http://www.modernmedicine.com/modernmedicine/Departments/News-amp-Reviews-Urology-news-items/ArticleStandard/Article/detail/442562?ref=25 By the Numbers; Literature Review; Agent Orange linked to Pca recurrence in blacks; Androgen deprivation therapy shortens time to MI; Risk of preterm delivery linked to nephrolithiasis hospitalization; Alcohol may reduce risk of RCC; Right drug, wrong effect; C-reactive protein predicts survival in androgen-independent PCa; Low testosterone boosts risk of death in older men; Radium-223 promising for PCa pain, may increase survival in patients with bone metastasis; Kidney disease a risk for heart disease and vice versa; Lycopene doesn't help prevent PCa; MRI and MRS identify stage and extent of PCa prior to robotic prostatectomy; Sildenafil may ease jet lag. 2007-08-01T04:00:00Z http://contemporaryurology.modernmedicine.com/conturo/data/articlestandard/conturo/292007/442562null XML http://www.modernmedicine.com/modernmedicine/feature/Endoscopic-treatment-of-VUR-Who-when-and-how/ArticleStandard/Article/detail/442566?ref=25 The minimally invasive nature of endoscopy has raised questions about which children to treat. Are we now treating children who we previously observed? Has the threshold for intervention been lowered? This panel was convened to consider these and other important issues. 2007-08-01T04:00:00Z http://contemporaryurology.modernmedicine.com/conturo/data/articlestandard/conturo/292007/442566/CNTUR0807_CV1-spn_12481-1_thumbnail.jpg http://contemporaryurology.modernmedicine.com/conturo/data/articlestandard/conturo/292007/442566null XML http://www.modernmedicine.com/modernmedicine/Urology+Times+CME/Postoperative-Bleeding-Prevention-and-Management-F/ArticleStandard/Article/detail/486413?ref=25 Postoperative bleeding can occur following virtually any type of urologic procedure. A thorough preoperative history, physical examination, and medication history are crucial to the prevention and effective management of these dangerous complications. 2007-08-01T04:00:00Z http://contemporaryurology.modernmedicine.com/conturo/data/articlestandard/conturo/042008/486413null REMOTE http://contemporaryurology.modernmedicine.com/conturo/Managing-BPH-Finding-Relief-When-Symptoms-Are-Mild/ArticleStandard/Article/detail/441212?ref=25 As many men will attest, lower urinary tract symptoms are a common and bothersome problem that accompanies aging. In many cases, the cause is benign prostatic hyperplasia (BPH). BPH is not cancer, nor does it mean that cancer will eventually develop. The condition results from overgrowth of the prostate gland (see ?When the prostate is healthy—and when it?s not?). 2007-07-15T04:00:00Z http://contemporaryurology.modernmedicine.com/conturo/data/articlestandard/conturo/282007/441212null PDF http://www.modernmedicine.com/modernmedicine/Departments/Editorial/ArticleStandard/Article/detail/436542?ref=25 Few books are worthy of avid recommendation, especially during the summer, when many busy, stressed urologists get some down time. "Better: A Surgeon's Notes on Performance" is one such book. 2007-07-01T04:00:00Z http://contemporaryurology.modernmedicine.com/conturo/data/articlestandard/conturo/252007/436542null XML http://www.modernmedicine.com/modernmedicine/Urology/Scrotal-ultrasound-When-and-what-to-look-for/ArticleStandard/Article/detail/436545?ref=25 Office scrotal ultrasound (US), when properly performed and documented, can provide indispensable information regarding males with scrotal symptoms. Part 1 of this article (June 2007) included a primer on the underlying principles and terminology of scrotal US, explained why artifacts occur (and how to avoid them), and outlined the essential elements of an optimal scrotal exam. Part 2 describes proper assessment of the various indications for scrotal US and offers tips on device selection. 2007-07-01T04:00:00Z http://contemporaryurology.modernmedicine.com/conturo/data/articlestandard/conturo/252007/436545null XML http://www.modernmedicine.com/modernmedicine/Urologic+Surgery/The-expanding-role-of-tissue-sealants-in-urologic-/ArticleStandard/Article/detail/437091?ref=25 This article details the expanding urologic applications of biosurgical agents designed to promote hemostasis and offers tips for their safe and effective use. 2007-07-01T04:00:00Z http://contemporaryurology.modernmedicine.com/conturo/data/articlestandard/conturo/262007/437091null XML http://www.modernmedicine.com/modernmedicine/Urology/Treating-urethral-diverticula-in-women-Strategies-/ArticleStandard/Article/detail/436547?ref=25 Advances in imaging have expanded our understanding of these complex lesions and enhanced planning of surgical repair. Excision and reconstruction remains the treatment of choice for most patients. Meticulous technique is key to a good outcome. 2007-07-01T04:00:00Z http://contemporaryurology.modernmedicine.com/conturo/data/articlestandard/conturo/252007/436547/CNTUR0707_CV1_12291_thumbnail.jpg http://contemporaryurology.modernmedicine.com/conturo/data/articlestandard/conturo/252007/436547null XML http://www.modernmedicine.com/modernmedicine/Departments/News-amp-Reviews-Urology-news-items/ArticleStandard/Article/detail/437090?ref=25 By the Numbers; Prostate cancer more likely to recur in blacks; Literature Review; Multivitamin overuse linked to aggressive PCa; Finasteride improves sensitivity of DRE; Sperm DNA damage greater in diabetic men 2007-07-01T04:00:00Z http://contemporaryurology.modernmedicine.com/conturo/data/articlestandard/conturo/262007/437090null XML http://www.modernmedicine.com/modernmedicine/Urology/Childhood-bed-wetting-The-case-for-combination-the/ArticleStandard/Article/detail/436546?ref=25 When families seek your help for primary nocturnal enuresis, they want results quickly. Multimodal therapy, including medications and an alarm, achieves dryness after just 3 months, easing enuresis-associated social and family problems along the way. 2007-07-01T04:00:00Z http://contemporaryurology.modernmedicine.com/conturo/data/articlestandard/conturo/252007/436546null XML http://www.modernmedicine.com/modernmedicine/Features/Scrotal-ultrasound-Focusing-on-the-principles-and-/ArticleStandard/Article/detail/427338?ref=25 An understanding of the testicular anatomy and the fundamental principles of ultrasound are prerequisites of an optimal scrotal exam. These essentials and a systematic scanning protocol ensure patient safety and guide the urologist in selecting the best transducer and optimizing image quality. 2007-06-01T04:00:00Z http://contemporaryurology.modernmedicine.com/conturo/data/articlestandard/conturo/202007/427338/CNTUR0607-CV1-SPN_12043_thumbnail.jpg http://contemporaryurology.modernmedicine.com/conturo/data/articlestandard/conturo/202007/427338null XML http://www.modernmedicine.com/modernmedicine/Features/Critical-evaluation-and-risk-assessment-of-the-eld/ArticleStandard/Article/detail/427340?ref=25 Elderly patients have traditionally been viewed as poor candidates for urologic surgery. However, a review of bladder and prostate cancer literature supports what most urologists know intuitively: properly selected elderly patients are safe to operate on and can potentially gain survival benefits from surgery. What is needed is an accurate set of risk assessment tools that facilitate proper patient selection. 2007-06-01T04:00:00Z http://contemporaryurology.modernmedicine.com/conturo/data/articlestandard/conturo/202007/427340null XML http://www.modernmedicine.com/modernmedicine/Features/Penile-cancer-Timing-and-technique-of-node-dissect/ArticleStandard/Article/detail/427339?ref=25 When squamous carcinoma of the penis is diagnosed, up to 50% of patients may harbor metastatic cancer in their inguinal nodes. Timely surgical intervention is often curative. However, determining which patients require surgery and how extensive it should be remains a major challenge. 2007-06-01T04:00:00Z http://contemporaryurology.modernmedicine.com/conturo/data/articlestandard/conturo/202007/427339null XML http://www.modernmedicine.com/modernmedicine/Editorial/Editorial/ArticleStandard/Article/detail/427555?ref=25 Urology has always been and will remain a specialty that is weighted towards elderly patients, since many of the malignant diseases and nonmalignant conditions we treat increase in incidence with increasing age. 2007-06-01T04:00:00Z http://contemporaryurology.modernmedicine.com/conturo/data/articlestandard/conturo/202007/427555null XML http://www.modernmedicine.com/modernmedicine/Medical+Economics/Tech-Talk-Can-Google-make-you-a-better-doctor/ArticleStandard/Article/detail/427342?ref=25 This gargantuan answer machine in cyberspace may strike you as a poor resource, particularly when you can turn to authoritative healthcare websites to research a perplexing clinical problem. But Google has more medical credentials than you might imagine. 2007-06-01T04:00:00Z http://contemporaryurology.modernmedicine.com/conturo/data/articlestandard/conturo/202007/427342null XML http://www.modernmedicine.com/modernmedicine/Kidney+%26+Bladder+Cancer/Renal-cell-carcinoma-Can-some-be-observed/ArticleStandard/Article/detail/422613?ref=25 The increased early detection of small enjancing renal masses presumed to be RCC has not led to a decrease in disease-associated mortality, suggesting an overtreatment bias. The critical question--can we correctly determine which masses can be safely followed with active surveillance? 2007-05-01T04:00:00Z http://contemporaryurology.modernmedicine.com/conturo/data/articlestandard/conturo/172007/422613null XML http://www.modernmedicine.com/modernmedicine/Featured+this+Month/PSA-based-screening-for-prostate-cancer-Where-are-/ArticleStandard/Article/detail/422834?ref=25 While the total PSA level remains a useful predictor for both current and future prostate cancer risk, adjunctive measurements have been developed that increase the specificity for prostate cancer detection. These parameters are also useful predictors of prostate cancer aggressiveness. 2007-05-01T04:00:00Z http://contemporaryurology.modernmedicine.com/conturo/data/articlestandard/conturo/172007/422834/CNTUR0507_CV1-Spin_11901_thumbnail.jpg http://contemporaryurology.modernmedicine.com/conturo/data/articlestandard/conturo/172007/422834null XML http://www.modernmedicine.com/modernmedicine/BPH/Editorial/ArticleStandard/Article/detail/422611?ref=25 Since the introduction of TURP in the 1930s, Urologists have been confronted with a huge array of options for the treatment of BPH. 2007-05-01T04:00:00Z http://contemporaryurology.modernmedicine.com/conturo/data/articlestandard/conturo/172007/422611null XML http://www.modernmedicine.com/modernmedicine/Departments/News-amp-Reviews/ArticleStandard/Article/detail/422612?ref=25 By the numbers: Patient perceptions of care; Effect of fertility treatment on reproductive health of male offspring; In the pipeline: RCC treatment granted priority status; Literature Review 2007-05-01T04:00:00Z http://contemporaryurology.modernmedicine.com/conturo/data/articlestandard/conturo/172007/422612null XML http://www.modernmedicine.com/modernmedicine/Urology/About-the-size-of/ArticleStandard/Article/detail/422617?ref=25 Doctors use analogies to commonplace things every day. But we really should be careful with those comparisons. Golf balls and ping-pong balls aren't much different in diameter, but they have different characteristics. Here are the actual measurements of some items commonly referred to. 2007-05-01T04:00:00Z http://contemporaryurology.modernmedicine.com/conturo/data/articlestandard/conturo/172007/422617null XML http://www.modernmedicine.com/modernmedicine/Hypogonadism/Optimizing-testosterone-replacement-therapy-in-hyp/ArticleStandard/Article/detail/422615?ref=25 A panel of experts in men's health and endocrinology recently discussed the impact of hypogonadism on men's health, the benefits and risks of testosterone replacement therapy, and the awareness in the medical community of these issues. This article was developed from the proceedings of that meeting. 2007-05-01T04:00:00Z http://contemporaryurology.modernmedicine.com/conturo/data/articlestandard/conturo/172007/422615null XML http://www.modernmedicine.com/modernmedicine/Urologic+Surgery/Abdominal-fascial-wound-and-skin-closure-Current-t/ArticleStandard/Article/detail/422616?ref=25 A surgeon's selection of a technique for closure of abdominal fascial wounds still depends upon his or her experience and preference. Though various clinicians have supported specific closure techniques or suture materials, a gold standard has not yet been established using evidence-based principles. The authors review techniques and materials available for closure of abdominal fascial wounds and share their recommendations. 2007-05-01T04:00:00Z http://contemporaryurology.modernmedicine.com/conturo/data/articlestandard/conturo/172007/422616null XML http://www.modernmedicine.com/modernmedicine/Urology/News-amp-Reviews/ArticleStandard/Article/detail/421157?ref=25 The US still leads... in healthcare spending; PSA nadir within 12 months of Pca radiotherapy predicts risk of progression; Green tea component, combined with COX-2 inhibitor, increases PCa tumor suppression; Literature Review: One-stage reconstruction for recurrent stricture after urethral stent placement 2007-04-01T04:00:00Z http://contemporaryurology.modernmedicine.com/conturo/data/articlestandard/conturo/162007/421157null XML http://www.modernmedicine.com/modernmedicine/feature/Urinary-tract-infection-in-females-Case-and-commen/ArticleStandard/Article/detail/421159?ref=25 Most urinary tract infections in women are effectively treated with a short course of antimicrobial therapy. However, a number of patients-particularly those with recurrent, persistent, or complicated infections—present more challenging diagnostic and treatment situations. The authors offer a practical approach to managing both straightforward and complex cases based on a simple clinical classification system. 2007-04-01T04:00:00Z http://contemporaryurology.modernmedicine.com/conturo/data/articlestandard/conturo/162007/421159null XML http://www.modernmedicine.com/modernmedicine/feature/Is-bone-mineral-density-monitoring-necessary-in-ur/ArticleStandard/Article/detail/421161?ref=25 The majority of patients with renal stone disease have a metabolic disorder that could result in decreased bone mass. Through careful assessment of patient-specific risk factors, it is possible to determine which patients are at greatest risk for BMD loss. By regularly monitoring these patients, physicians can help to minimize the risk of bone fractures. 2007-04-01T04:00:00Z http://contemporaryurology.modernmedicine.com/conturo/data/articlestandard/conturo/162007/421161null XML http://www.modernmedicine.com/modernmedicine/Urology/Malpractice-Corner/ArticleStandard/Article/detail/421158?ref=25 Claim of lack of treatment options for prostate cancer; Claim of delay in diagnosis of kidney cancer; Hypospadias surgery lawsuit; Testicular deformity; Death after bladder cancer diagnosis; Complications after bladder removal 2007-04-01T04:00:00Z http://contemporaryurology.modernmedicine.com/conturo/data/articlestandard/conturo/162007/421158null XML http://www.modernmedicine.com/modernmedicine/feature/Penile-revascularization-after-pelvic-trauma-Curre/ArticleStandard/Article/detail/421160?ref=25 In the vast majority of pelvic trauma patients, urethral reconstruction without penile revascularization is successful. However, revascularization is appropriate in select patients: those who have bilateral injury without reconstitution. 2007-04-01T04:00:00Z http://contemporaryurology.modernmedicine.com/conturo/data/articlestandard/conturo/162007/421160null XML http://www.modernmedicine.com/modernmedicine/Urology/Editorial/ArticleStandard/Article/detail/421156?ref=25 A viable healthcare plan would engage physicians as part of the solution, not brand us as part of the problem. 2007-04-01T04:00:00Z http://contemporaryurology.modernmedicine.com/conturo/data/articlestandard/conturo/162007/421156null XML http://www.modernmedicine.com/modernmedicine/percutaneous+surgery/Percutaneous-renal-surgery-Tools-and-tricks-of-the/ArticleStandard/Article/detail/407129?ref=25 Modern percutaneous renal surgery has the potential to improve patient care and decrease operative morbidity. The authors describe the tools used and offer their tips and techniques for improving outcome. 2007-03-01T05:00:00Z http://contemporaryurology.modernmedicine.com/conturo/data/articlestandard/conturo/082007/407129/407129_thumbnail.jpg http://contemporaryurology.modernmedicine.com/conturo/data/articlestandard/conturo/082007/407129null XML http://contemporaryurology.modernmedicine.com/conturo/Editorial/Editorial/ArticleStandard/Article/detail/407159?ref=25 Nearly 2 of every 3 US adults is over-weight or obese—currently, 127 million are overweight (BMI ≥25), 60 million are obese (BMI≥30), and more than 9 million are severely obese (BMI ≥40).1,2 While progress has been made against smoking and other unhealthy behaviors, obesity remains unchecked. 2007-03-01T05:00:00Z http://contemporaryurology.modernmedicine.com/conturo/data/articlestandard/conturo/082007/407159null XML http://contemporaryurology.modernmedicine.com/conturo/Debates-in-the-Treatment-of-Urolithiasis/ArticleStandard/Article/detail/408682?ref=25 Highlights of an industry-sponsored educational program at the 24th World Congress of Endourology. The 24th World Congress of Endourology was jointly sponsored by The Cleveland Clinic Center for Continuing Education and the Endourological Society and was held on The Cleveland Clinic campus in Ohio, August 17?20, 2006. 2007-03-01T05:00:00Z http://contemporaryurology.modernmedicine.com/conturo/data/articlestandard/conturo/092007/408682null PDF http://www.modernmedicine.com/modernmedicine/Symposium/Minimally-invasive-surgery-for-GU-cancer-How-and-w/ArticleStandard/Article/detail/407128?ref=25 Our panel of experts was convened to discuss the past, present, and future role of minimally invasive technologies and techniques in urologic oncology. Part 1 of this 2-part discussion (which appeared in the February 2007 issue) focused on the use of these techniques for renal and prostate malignancies; the process whereby new procedures are investigated, marketed, and accepted; and how this process has influenced recent surgical trends. 2007-03-01T05:00:00Z http://contemporaryurology.modernmedicine.com/conturo/data/articlestandard/conturo/082007/407128null XML http://www.modernmedicine.com/modernmedicine/Pulmonary+Embolism/Pulmonary-embolism-New-algorithms-for-diagnosis-an/ArticleStandard/Article/detail/407130?ref=25 Pulmonary embolism (PE) is a troubling postoperative complication associated with urologic surgery. Recently refined algorithms can aid in the timely diagnosis and treatment of this potentially life-threatening condition. 2007-03-01T05:00:00Z http://contemporaryurology.modernmedicine.com/conturo/data/articlestandard/conturo/082007/407130null XML http://contemporaryurology.modernmedicine.com/conturo/2007-Media-Kit/ArticleStandard/Article/detail/405629?ref=25 2007-02-16T05:00:00Z http://contemporaryurology.modernmedicine.com/conturo/data/articlestandard/conturo/072007/405629null PDF http://contemporaryurology.modernmedicine.com/conturo/2007-Rate-Card/ArticleStandard/Article/detail/405628?ref=25 2007-02-16T05:00:00Z http://contemporaryurology.modernmedicine.com/conturo/data/articlestandard/conturo/072007/405628null PDF http://www.modernmedicine.com/modernmedicine/Editorial/Editorial/ArticleStandard/Article/detail/400108?ref=25 Are we facing another paradigm shift for prostate cancer? 2007-02-01T05:00:00Z http://contemporaryurology.modernmedicine.com/conturo/data/articlestandard/conturo/042007/400108null XML http://www.modernmedicine.com/modernmedicine/sexual+dysfunction/Minimally-invasive-surgery-for-GU-cancer-Challengi/ArticleStandard/Article/detail/400354?ref=25 There have been major improvements in surgery during the last 150 years in the treatment of genitourinary (GU) oncologic conditions and we're all very aware of its curative nature. Over the past century, great strides have also been made in terms of decreasing mortality rates in patients undergoing surgery, as well as in decreasing morbidity and complications. In the past 15 years, increasing attention has been given to addressing secondary issues such as postoperative pain and the length of hospitalization and recuperation, fostering the development of minimally invasive technologies. 2007-02-01T05:00:00Z http://contemporaryurology.modernmedicine.com/conturo/data/articlestandard/conturo/042007/400354/MPE_034_thumbnail.jpg http://contemporaryurology.modernmedicine.com/conturo/data/articlestandard/conturo/042007/400354null XML http://www.modernmedicine.com/modernmedicine/Kidney+Stones/Uric-acid-calculi-a-practical-approach-to-diagnosi/ArticleStandard/Article/detail/400112?ref=25 Uric acid calculi are most effectively managed and prevented medically. With optimal medical management, a pure uric acid stone can be expected to dissolve completely in the majority of compliant patients. 2007-02-01T05:00:00Z http://contemporaryurology.modernmedicine.com/conturo/data/articlestandard/conturo/042007/400112null XML http://www.modernmedicine.com/modernmedicine/sexual+dysfunction/Male-orgasmic-disorders-What-do-we-know/ArticleStandard/Article/detail/400110?ref=25 Orgasm is one of the least understood phases of the sexual response cycle. A physician's understanding of the nature of orgasmic disorders and awareness of available treatment options can have important implications for a patient's and his partner's quality of life. 2007-02-01T05:00:00Z http://contemporaryurology.modernmedicine.com/conturo/data/articlestandard/conturo/042007/400110null XML http://www.modernmedicine.com/modernmedicine/Pathology+Quiz/Bladder-lesion-in-a-59-year-old-man/ArticleStandard/Article/detail/400114?ref=25 A 59-year-old man consulted his urologist after passing bloody tissue in his urine. His history included biopsy-proven cystitis glandularis in 1991, the symptoms of which had been stable and moderate. A urine cytology performed 1 year earlier was negative for malignancy. 2007-02-01T05:00:00Z http://contemporaryurology.modernmedicine.com/conturo/data/articlestandard/conturo/042007/400114/400114_thumbnail.jpg http://contemporaryurology.modernmedicine.com/conturo/data/articlestandard/conturo/042007/400114null XML http://contemporaryurology.modernmedicine.com/conturo/Urology-Congress-2007-Full-Agenda/ArticleStandard/Article/detail/400382?ref=25 2007-01-26T05:00:00Z http://contemporaryurology.modernmedicine.com/conturo/data/articlestandard/conturo/042007/400382null PDF http://www.modernmedicine.com/modernmedicine/Pediatric+Urology/A-simple-step-wise-approach-to-the-child-with-dayt/ArticleStandard/Article/detail/395070?ref=25 A careful history, thorough physical examination, and limited diagnostic studies often point the way to the cause and successful treatment of this distressing disorder. 2007-01-01T05:00:00Z http://contemporaryurology.modernmedicine.com/conturo/data/articlestandard/conturo/522006/395070null XML http://www.modernmedicine.com/modernmedicine/Coding/Endourology-coding-update-for-2007/ArticleStandard/Article/detail/395068?ref=25 In order to be paid by an insurance carrier, a urologist must describe, by means of coding, any care given to a patient—a task for which most urologists are not trained. Learn what endoscopic and endourologic procedures you are entitled to be paid for and how to correctly code for these services. 2007-01-01T05:00:00Z http://contemporaryurology.modernmedicine.com/conturo/data/articlestandard/conturo/522006/395068null XML http://www.modernmedicine.com/modernmedicine/ureteral+access+sheath/Is-routine-ureteral-access-sheath-use-warranted-An/ArticleStandard/Article/detail/395069?ref=25 The use of a UAS during ureteroscopy has been associated with less fluid absorption, higher stone-free rates, and shorter operative times in some studies. But does the evidence support the routine use of these devices? 2007-01-01T05:00:00Z http://contemporaryurology.modernmedicine.com/conturo/data/articlestandard/conturo/522006/395069null XML http://www.modernmedicine.com/modernmedicine/Oncology/Wide-excision-radical-prostatectomy-Indications-an/ArticleStandard/Article/detail/395071?ref=25 The majority of men undergoing radical prostatectomy today are candidates for bilateral NVB preservation. Performed appropriately, bilateral NVB preservation optimizes patient recovery of potency without compromising cancer control. Some men, however, require more extensive dissection of the periprostatic tissue to optimize their likelihood of cure. The decision to modify surgical technique should be individualized and based on preoperative and intraoperative findings. 2007-01-01T05:00:00Z http://contemporaryurology.modernmedicine.com/conturo/data/articlestandard/conturo/522006/395071/CNTUR_0107-CovSpn_11040_thumbnail.jpg http://contemporaryurology.modernmedicine.com/conturo/data/articlestandard/conturo/522006/395071null XML http://www.modernmedicine.com/modernmedicine/Voiding+Dysfunction/Case-Studies-in-Voiding-Dysfunction/ArticleStandard/Article/detail/395072?ref=25 A 63-year-old male with severe pelvic pain and difficulty voiding after undergoing male sling 2007-01-01T05:00:00Z http://contemporaryurology.modernmedicine.com/conturo/data/articlestandard/conturo/522006/395072null XML http://www.modernmedicine.com/modernmedicine/Editorial/Editorial/ArticleStandard/Article/detail/395067?ref=25 In more difficult-to-treat patients, expansion of the usual margins of surgical dissection can lead to a reduction in the rate of recurrence. 2007-01-01T05:00:00Z http://contemporaryurology.modernmedicine.com/conturo/data/articlestandard/conturo/522006/395067null XML http://www.modernmedicine.com/modernmedicine/Renal+Stones/Lower-pole-renal-calculi-Choosing-the-optimal-mana/ArticleStandard/Article/detail/388951?ref=25 While there is still no consensus regarding the optimal management of lower pole stones, multiple studies have provided information on stone-free rates and complications of SWL, percutaneous nephrostolithotomy, and ureteroscopy. The emerging consensus—in the right clinical scenario, each procedure can be highly successful, but when used inappropriately each may also produce suboptimal results. 2006-12-01T05:00:00Z http://contemporaryurology.modernmedicine.com/conturo/data/articlestandard/conturo/482006/388951/CNTUR1206_CV1_10842_thumbnail.jpg http://contemporaryurology.modernmedicine.com/conturo/data/articlestandard/conturo/482006/388951null XML http://www.modernmedicine.com/modernmedicine/Kidney+%26+Bladder+Cancer/Small-renal-masses-Examining-the-management-option/ArticleStandard/Article/detail/388950?ref=25 In part 1 of this roundtable (November 2006), our panel of experts discussed how the presentation of the renal mass has changed during the past several decades, the importance of lesion size, the use of imaging and repeat imaging, when observation with active surveillance is an appropriate option, and the role of preoperative percutaneous renal biopsy. 2006-12-01T05:00:00Z http://contemporaryurology.modernmedicine.com/conturo/data/articlestandard/conturo/482006/388950null XML http://www.modernmedicine.com/modernmedicine/Prostate+Cancer/Viable-options-for-managing-elevated-postprostatec/ArticleStandard/Article/detail/388952?ref=25 The natural history of progression to distant metastasis and death after PSA recurrence or persistence is variable, but can be prolonged. Salvage radiotherapy and hormonal therapy are options, but treatment must be based on each patient's risk of progression, the likelihood of treatment success, and the risks involved with therapy. 2006-12-01T05:00:00Z http://contemporaryurology.modernmedicine.com/conturo/data/articlestandard/conturo/482006/388952null XML http://www.modernmedicine.com/modernmedicine/Malpractice/Malpractice-Corner/ArticleStandard/Article/detail/388955?ref=25 Delay in diagnosing prostate cancer; Injury alleged during penile prosthesis insertion; Ureteral stent removed after 2 years; Loss of testicle following hernia repair 2006-12-01T05:00:00Z http://contemporaryurology.modernmedicine.com/conturo/data/articlestandard/conturo/482006/388955null XML http://www.modernmedicine.com/modernmedicine/Editorial/Editorial/ArticleStandard/Article/detail/388948?ref=25 Circumcision: An ancient procedure remains a modern dilemma 2006-12-01T05:00:00Z http://contemporaryurology.modernmedicine.com/conturo/data/articlestandard/conturo/482006/388948null XML http://www.modernmedicine.com/modernmedicine/Oncology/Wilms-tumor-Updated-strategies-for-evaluation-and-/ArticleStandard/Article/detail/382421?ref=25 While Wilms' tumor is the most common genitourinary tumor of childhood, it is still quite rare, with approximately 500 new cases in the United States annually.1 The mean age at presentation is approximately 3 years. The vast majority of Wilms' tumors are sporadic, although familial transmission is noted in 1% to 2%.1 2006-11-01T05:00:00Z http://contemporaryurology.modernmedicine.com/conturo/data/articlestandard/conturo/432006/382421/CNTUR1106_CV1_10624_thumbnail.gif http://contemporaryurology.modernmedicine.com/conturo/data/articlestandard/conturo/432006/382421null XML http://www.modernmedicine.com/modernmedicine/Oncology/The-ABCs-of-radiation-therapy/ArticleStandard/Article/detail/381618?ref=25 Referring your patient for radiation therapy? Here's what you—and your patient—can expect. This primer reviews common terms in radiation oncology and presents a case study illustrating how these terms apply to the collaborative efforts between radiation oncologists and urologists. 2006-11-01T05:00:00Z http://contemporaryurology.modernmedicine.com/conturo/data/articlestandard/conturo/432006/381618null XML http://www.modernmedicine.com/modernmedicine/Pathology/Pathology-Quiz/ArticleStandard/Article/detail/381620?ref=25 During a routine physical examination, a 46-year-old man was found to have a rock-hard left testicular mass. Ultrasound demonstrated a 3-cm heterogeneous, partially calcified, solid mass within the left testis. A radical orchiectomy was performed. The tumor was well circumscribed, tan, and firm, with granular, calcific foci. The microscopic appearance is shown in Figures 1 through 4. 2006-11-01T05:00:00Z http://contemporaryurology.modernmedicine.com/conturo/data/articlestandard/conturo/432006/381620null XML http://www.modernmedicine.com/modernmedicine/Editorial/Editorial/ArticleStandard/Article/detail/381615?ref=25 Malignant renal cell carcinoma (RCC) represents fewer than 5% of malignancies but accounts for more than 13,000 deaths in the US annually out of fewer than 40,000 cases diagnosed. For unknown reasons, the age-adjusted incidence of this lethal disease has been rising at a rate of about 3% per year in the US. For patients presenting with early-stage disease, radical nephrectomy remains the gold standard treatment. However, as many as 30% of those patients treated in the early stage relapse and develop metastases. Patients presenting with metastatic RCC have an even grimmer outlook, as fewer than 50% of such patients survive 1 year and fewer than 10% survive 5 years or more. 2006-11-01T05:00:00Z http://contemporaryurology.modernmedicine.com/conturo/data/articlestandard/conturo/432006/381615null XML