Reviews in UrologyAn interview with Shailendra Sharma, CEO, Specialty NetworksNeal D ShoreThe LUGPA board, in partnership with Specialty Networks, was thrilled to announce the return of Reviews in Urology in 2024, and no one more so than Specialty Networks’ CEO, Shailendra Sharma. “We are honored for our Reviews in Urology publication to be designated as the official journal of LUGPA and to further strengthen our partnership and commitment to LUGPA’s mission of preserving and advancing the independent practice of urology,” he said. Reviews in Urology first launched in 1999 as a PubMed-indexed, quarterly journal featuring peer-reviewed research, case studies, thought leader interviews, and insights on emerging trends and research shaping the field of urology. Mr Sharma says that Specialty Networks now plans to build on the journal’s long-standing focus on cutting-edge urology advances while offering expanded coverage of a broad range of urologic conditions and specialty care concerns. Mr Sharma sat down to talk with Neal Shore, MD, editor in chief of Reviews in Urology, to discuss the journal’s history and his hopes for the future of the journal and the profession.
Reviews in UrologyLetter from the President of LUGPAEvan R GoldfischerAs LUGPA president, it is with great enthusiasm, excitement, and pride that I announce the relaunch of Reviews in Urology, the official journal of LUGPA.
LUGPA NewsLUGPA NewsCeleste KirschnerEvan R GoldfischerAs the leading voice of independent urology group practices in the United States, LUGPA educates poli- cymakers on the benefits of integrated urologic care. LUGPA’s Health Policy and Political Affairs commit- tees drive grassroots efforts by developing thoughtful analysis and engaging public officials through comment letters on major legislative and regulatory proposals.
Treatment ReviewConsistency in Care Opportunities for Prostate CancerWanda WiltNicole SmithKatie GrantJayme NalleyJody PinkertonThrough data analysis and multiple interviews and insights, this study attempted to address the inconsistency in care for patients with prostate cancer who shared similar journey time points, demographics, and care center expertise. The Consistency of Care Project aimed to evaluate the impact of efforts to improve targeted metrics surrounding crucial clinical interventions of prostate-specific antigen monitoring, surveillance scanning, and pharmacologic interventions over a 9-month period. For comparison, 15 private urology practices of like size, patient population, and demographics were monitored. Ten of the practices benefitted from reviewed workflow training on the PPS Analytics data platform; access to a PPS Analytics Clinical Analyst, who supported education for identification of actionable patients; consistent data analysis; workflow support; and regular check-in meetings to monitor progress. The 5 control sites were monitored without additional, purposeful intervention. Outcomes support the hypothesis that inconsistency in care can begin to be addressed through focused workflows, strong navigation, and attention to key performance indicators. Attrition rate differences of 32% vs 6% improvements (reengaging patients for care who had no next appointment scheduled). On average, the experimental group increased the metastatic castration-sensitive prostate cancer diagnosis rate by 10%. However, the treatment rates measured a relative increase of 35% but an average of 11% absolute improvement at the supported sites vs 6% at the control sites. Patients with metastatic castration-resistant prostate cancer at the supported sites improved by 20%, compared with those in the control group, who improved by 4%. Care teams with strong workflows, supportive resources, and consistent care pathways—when combined with data analytics—can influence care and drive increased, measurable differences.Prostate cancerProstatic neoplasmsUrologyNeoplasmpatient navigation
Literature ReviewsMethods for Prostate Cancer Risk Stratification: Serum-Based and Urine-Based Biomarkers for Biopsy ConsiderationAlex S. BartRyan D. T. Badre-HumeMeghan E. RobertsGriffen KempskieAlyssa N. GiannascaProstate cancer (PCa) is one of the most commonly occurring cancers in men globally. In 2024, it is estimated that there will be 99 010 PCa diagnoses and 35 250 PCa-related deaths in American patients. Given the high incidence and virulence of the disease, proper screening methods are crucial to reduce overdiagnosis and overtreatment of PCa. Using biomarkers with high tumor sensitivity and specificity is therefore crucial to effectively distinguish PCa from benign tissue.Prostate cancer
Prostate CancerContemporary Approaches to Diagnosing Prostate CancerAshley E. RossAlon LazarovichAaron S. DahmenAbhinav SidanaJack MillotJonathan E. ShoagHangcheng FuJohn EiflerThe diagnosis of prostate cancer (PCa) has changed substantially over the last decade. An increased understanding of disease behavior has led to the development of more specific biomarkers that may limit the numbers of prostate biopsies performed as well as the overdiagnosis of low-grade disease. We have concurrently seen the refinement of imaging techniques such as multiparametric magnetic resonance imaging (mpMRI), which can also limit overdiagnosis and aid in the discovery of clinically significant disease. We now have various options for performing ultrasound-guided biopsies, including transperineal and transrectal approaches. In this article, we gather perspectives on contemporary pathways toward the diagnosis of PCa from experts practicing in large urology practice groups and academia.Prostatic neoplasmsBiomarkersMagnetic resonance imaging (MRI)
Prostate CancerSpecialty Networks Unveils Revised Advanced Prostate Cancer Clinical GuidelinesDavid MorrisBenjamin H. LowentrittIn an ongoing effort to support independent urology practices’ work to provide first-class cancer care, Specialty Networks recently unveiled new, expanded clinical guidelines for advanced prostate cancer (PCa) treatment. (See the guidelines, packaged with this issue of Reviews in Urology.)Prostatic neoplasmsNeoplasmpractice guidelinesclinical decision-making
Men's HealthContemporary Management of Male HypogonadismAndrew Y SunMale hypogonadism affects up to 40% of men and is becoming more prominent because of increasingly prevalent medical comorbidities. Because various forms of treatment are available today, physicians should discuss drug efficacy and safety while simultaneously ensuring that therapy forms are in alignment with patient preferences. Treatment adherence is critical to sustaining patient health outcomes.HypogonadismHormone replacementtestosterone deficiency
Men's HealthClinical Impact of a UroCuff Navigation Protocol for Patients With Medically Managed Benign Prostatic HyperplasiaAaron BergerArpeet ShahThis study conducted noninvasive urodynamic testing before renewing patients’ benign prostatic hyperplasia (BPH) medication prescriptions and assessed the impact of that urodynamic information on patients’ clinical course of treatment.UrodynamicsUrinary bladderProstatic hyperplasiapatient navigation
Literature ReviewsComparison of Methods for Ureteral Patency VisualizationMichelle BoytimMatthew J. JonesAlex S. BartPavel SvintozelskiyThe most common cause of ureteral trauma occurs during open, laparoscopic, or endoscopic procedures across multiple specialties. Ureteral injuries are often unrecognized or mismanaged. Early recognition of ureteral injuries by cystoscopy allows for prompt intervention. Visualization can be enhanced using agents that color or improve the contrast of ureteral flow.Cystoscopydiagnostic imagingindigo carminemethylene bluefluorescein
Meet The ExpertMeet the Expert: Erika Ferrozzo, MHADavid M. AlbalaErika FerrozzoIn-office dispensaries (IODs) are frequently discussed but rarely implemented in urology private group practices. In this interview, Erika Ferrozzo, MHA, CEO of the Idaho Urologic Institute and a member of the LUGPA Executive Leadership Program’s class of 2023, explains how the Idaho Urologic Institute identified an opportunity that helped its patients experience improved adherence and ease of access to treatment and that earned the practice a year-over-year $250 000 increase in net revenue.UrologyGroup practiceequipment and supplies
Business of UrologyPhysician-Owned Hospitals: A Look at the NumbersRobert A. DowlingMara HoltonPhysician-owned hospitals are sometimes characterized as examples of inappropriate self-referral. This perception contributes to legislation and regulation that constrain physician ownership. The true scope of physician ownership and its impact are incompletely understood. This study aimed to better define the current landscape of physician ownership in US hospitals to inform policy making in this area.Ownershipfinancial managementproprietaryhospitals
Coding CornerCoding Corner: Current Procedural Terminology Code 99459, Female Pelvic ExaminationJonathan RubensteinMark PainterCeleste KirschnerIn this issue of Reviews in Urology, we tackle the new 2024 CPT code 99459, female pelvic examination (used in addition to the code for the primary procedure).Current Procedural Terminology codesgynecological examinationclinical coding