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Bladder CancerView Articles

Volume 23, Number 3Bladder Cancer

Immune Checkpoint Inhibitors for the Treatment of Non–Muscle-Invasive Bladder Cancer: An Overview of Ongoing Clinical Trials

Neal D Shore

Treatment of non–muscle-invasive bladder cancer (NMIBC) is evolving, seeking new treatments to overcome the limitations of bacille Calmette-Guérin therapy and alternatives to radical cystectomy. Studies are currently evaluating the safety and efficacy of immune checkpoint inhibitors in combination with bacille Calmette-Guérin vs bacille Calmette-Guérin monotherapy for patients with high-risk NMIBC that is bacille Calmette-Guérin naive or recurrent after bacille Calmette-Guérin induction. We briefly summarize 4 studies that are evaluating intravenous immune checkpoint inhibitors (atezolizumab, durvalumab, and pembrolizumab) and 1 subcutaneous immune checkpoint inhibitor (sasanlimab). These studies may substantially change standard-of-care treatment for patients with high-risk NMIBC.

immune checkpoint inhibitorsMonoclonal antibodiesClinical trialsnon-muscle invasive bladder neoplasms

Bladder Cancer AcademyView Articles
Book ReviewsView Articles
Business of UrologyView Articles

Volume 23, Number 3Business of Urology

The Business of Independent Urologic Medicine: Caring for Patients While Operating a Business in a Post–COVID-19 Era of Private Practice

Nathan P. DillerMara Holton

Primum non nocere—“First, do no harm.” Independent medicine is challenged not only to achieve outcomes that patients value but also not to intentionally harm their business in the process. The COVID-19 pandemic and postpandemic regulatory environment have added new limitations on and restrictions to independent practices’ ability to innovate, grow, and provide stable access to meet their communities’ urologic needs. In the face of these challenges, independent medicine is at its strongest when it continues to press toward meeting its social contract with its community. Conversely, but just as importantly, society needs to be mindful of its social contract with the health care workforce.

UrologyPrivate practiceCOVID-19

Case of the QuarterView Articles

Volume 23, Number 2Case of the Quarter

Case of the Quarter: Kaposi Sarcoma in a Patient With Testicular Germ Cell Tumor and HIV: A Case Report and Literature Review

Daniela V. CastroDonald HannounTanya B. DorffAlexander Chehrazi-RaffleWesley YipAbhishek TripathiBenjamin MercierRegina Barragan-CarrilloHedyeh EbrahimiSalvador Jaime-Casas

Testicular germ cell tumors are the leading cause of cancer in male patients 15 to 39 years old. Extensive treatments are available, and the regimen of choice depends on clinical, laboratory, and histopathologic characteristics. Patients with HIV are at increased risk of developing solid malignancies, including testicular germ cell tumors. All patients with HIV should start on highly active antiretroviral therapy, but the drug interactions between chemotherapy for testicular germ cell tumor and highly active antiretroviral therapy have not been extensively evaluated. This case review highlights the importance of optimal therapeutic agent selection in patients with HIV and solid malignancies.

Testicular neoplasmGerm cellHIVTesticular neoplasmsSarcoma

Case ReviewView Articles

Volume 9, Number 4Case Review

Bilateral Testicular Infarction and Orchiectomy as a Complication of Polyarteritis Nodosa

Case Review

Donald S CrainShannon R HerreraSean P Stroup

We report an unusual case of a 28-year-old male with constitutional symptoms and bilateral testicular pain. After diagnosis of cytomegalovirus (CMV) hepatitis, his constitutional symptoms and testicular pain worsened despite treatment for epididymoorchitis. Ultrasound was concerning for infarction. Exploration in the operating room revealed bilateral testicular infarction requiring bilateral orchiectomy with subsequent androgen hormone replacement. Pathologic diagnosis was polyarteritis nodosa (PAN). PAN is a rare systemic vasculitis that affects multiple organs. There are no previous reports of PAN-induced vasculitis leading to bilateral testicular infarction and bilateral orchiectomy. [Rev Urol. 2007;9(4):235-238]

Testicular infarctionPolyarteritis nodosaAndrogen replacement therapy

Coding CornerView Articles

Volume 23, Number 2Coding Corner

Coding Corner: Healthcare Common Procedure Coding System Code G2211, Visit Complexity Inherent to Evaluation and Management

Jonathan RubensteinMark PainterCeleste Kirschner

For this issue, we reviewed the Healthcare Common Procedure Coding System (HCPCS) level 2 code G2211. Though the code has existed for a few years, Medicare began reimbursing physicians for reporting the code in January 2024. The code is used to describe the complexity of an evaluation and management (E&M) visit associated with an ongoing, longitudinal care relationship, focusing on a circumstance rather than a specific service. The circumstance described in this code differs from the prolonged services described by Current Procedural Terminology (CPT) codes 99358 through 99418; the case management services described by CPT codes 99366 through 99368; and the chronic care management services described by CPT codes 99490, 99491, and 99437 through 99489:

Benign prostatic hyperplasiaEvaluation and management servicesCurrent Procedural Terminology codes

CommentaryView Articles
CorrigendaView Articles
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