Pediatrics

Although routine, the practice of automatically reviewing pathology slides that accompany referred bladder cancer patients nets little gain for physicians or patients. In an overwhelming majority of instances, the practice does little more than add unnecessarily to the cost of treatment, according to a study presented here yesterday.

Clinical research in the field of trauma and reconstructive urologic surgery shows a recent focus on challenging cases, and study results are providing useful insight about their management, said Allen F. Morey, MD.

When Howard M. Snyder, MD, was asked to moderate a session on the latest developments in pediatric urology at the American College of Surgeons clinical congress last fall, he didn't have to think twice about the topics he wanted to cover.

Istanbul, Turkey--Swiss data add to growing evidence that injecting botulinum toxin A (Botox) into the detrusor muscle is a safe and efficient treatment option in patients suffering from overactive bladder, particularly in cases that prove refractory to other more conventional treatment modalities, like anticholinergic agents and physiotherapy.

Yamanouchi Pharmaceutical Co., Ltd., and Fujisawa Pharmaceutical Co., Ltd., merged to form a new corporation named Astellas Pharma, Inc.

San Francisco--Environmental factors have emerged as potential contributors to genetic anomalies affecting male genitalia, according to studies reported at the American Academy of Pediatrics Section on Urology annual meeting.

San Francisco--Considerable agreement exists among pediatric urologists regarding gender assignment in newborns with ambiguous genitalia, according to results of a survey of the American Academy of Pediatrics Section on Urology.

San Francisco--Environmental factors have emerged as potential contributors to genetic anomalies affecting male genitalia, according to studies reported at the American Academy of Pediatrics Section on Urology annual meeting.

San Francisco--Lifestyle factors may play a role in fertility among formerly unilateral cryptorchid men who have demonstrated fertility, according to a study reported at the American Academy of Pediatrics Section on Urology annual meeting here.

San Francisco—New contralateral vesicoureteral reflux occurs more often than previously thought following endoscopic treatment of unilateral VUR and may warrant further treatment, according to a report presented at the American Academy of Pediatrics Section on Urology meeting here.

Newly released data add further evidence that erectile dysfunction may be the earliest sign of a more significant cardiovascular problem (The Journal of Sexual Medicine 2005; 2:40-50).

Chicago--A phase II clinical trial now enrolling patients aims to test the efficacy of an immunophilin ligand in assisting the regeneration of penile nerves following radical prostatectomy.

Laptop computers used in the lap position significantly increase scrotal temperature as a result of heat exposure and posture-related effects, according to a report in Human Reproduction (published online Dec. 9, 2004).

After years of debate, the American Board of Urology has voted to submit an application to the American Board of Medical Specialties for approval of a Certificate of Added Qualification (CAQ) in pediatric urology.

Q A pediatric urologist I code for is concerned that we cannot bill/code for both orchiopexy and a hernia repair done during the same operating room session. Do you have any documentation on this matter? When you look up 54640 in CPT 2004, it references, "For inguinal hernia repair performed in conjunction with inguinal orchiopexy, see 49495-49525." In the Medicare Correct Coding Guidelines, I do not see any edits stating not to bill both procedures together.

Shrewsbury, United Kingdom--Over the past 30 years, the incidence of bladder cancer has increased almost 60% among females in the United Kingdom. But this upward trend does not appear to be related to changes in smoking habits, as researchers from Royal Shrewsbury Hospital had previously thought.

Dextranomer/hyaluronic acid has the potential to lower the cost and also the morbidity of repeated voiding cystourethrograms in children.

San Francisco--The microsurgical approach is an effective method for varicocele repair in adolescents and offers the advantages of lower rates of persistence, recurrence, and hydrocele formation than alternative methods, according to the findings of two independent studies presented at the AUA annual meeting.

Group strives for world-class care and excellent quality of life for its urologists

Do you think the three available phosphodiesterase type-5 inhibitors-vardenafil hydrochloride (Levitra), tadalafil (Cialis), and sildenafil citrate (Viagra)-are essentially the same, or do they have distinct advantages in the treatment of ED?

Here's how to code when LHRH injection, cystoscopy, and biopsy are providedon the same day

San Francisco--Continuing a trend of mixed results seen in previousstudies, neoadjuvant chemotherapy with docetaxel (Taxotere) resulted ina significant PSA response but failed to induce any histologic changes inlocally advanced prostate cancer, Cleveland Clinic investigators reportedat the AUA annual meeting.

If you're looking for articles about urologic surgery in this issue ofUrology Times, you may be disappointed. The "leading newsmagazine forurologists" is still just that-an important source of news and informationfor individuals who practice what has always been a surgical specialty.But the articles in this issue's special "State of Urology" seriesclearly show that surgery-especially traditional open surgery-continuesto give way to drug therapy and minimally invasive procedures for managingmost common urologic conditions.

In many ways, the practice of urology in children is substantially differentfrom that in adults. But, at present, two of the most exciting trends inpediatric urology mirror developments in adult urology.

Events around San Francisco in May

Current lack of support may stem from misinterpretation of OIG guidelines

Inappropriate wetting and voiding habits are common in children, constituting 20% to 25% of new patients seen in the pediatric urology office setting.

Use of the popular seasonal allergy drug loratadine (Claritin) in early pregnancy does not influence the occurrence of hypospadias in infants, according to a report from the Centers for Disease Control and Prevention.

The endoscopic treatment of vesicoureteral reflux and the pathology oftestis tumors were the subject of both important new research and livelydiscussion during the 2003 American Academy of Pediatrics Section on Urologymeeting. Although many important topics were discussed at what is arguablythe finest annual meeting on pediatric urology in the world, these two subjectsdeserve particular attention and are the focus of articles in this issueof Urology Times.

Anthony Atala, MD, a pediatric urologist and internationally recognized leader in tissue engineering, has joined Wake Forest University Baptist Medical Center in Winston-Salem, NC.