Impact of Urology Trainee Debt Levels on Future Practice Choices and Expectations.

Introduction: Excessive trainee debt continues to be a problem. Little is known about how debt influences future practice decisions. We sought to examine the correlation between educational debt and anticipated practice choices and career expectations to better understand the impact of debt on urology trainees to inform urology workforce policy.

Burnout in Urology: Findings from the 2016 AUA Annual Census.

Introduction: Physician burnout is linked to decreased job performance, increased medical errors, interpersonal conflicts and depression. Two recent multispecialty studies showed that urologists had the highest rate of burnout. However, these reports were limited by a low sample size of urologists (119).

The AUA Quality Registry: Engaging Stakeholders to Improve the Quality of Care for Patients with Prostate Cancer.

Introduction: Determining the most effective treatments for complex medical conditions requires robust clinical data. Clinical registries comprise real-world observational data, which allow rapid assessment of the effectiveness of treatments and care processes. In 2014 the AUA (American Urological Association) launched the AQUA (AUA Quality) Registry, a national urological disease registry intended to measure and report health care quality and patient outcomes, and support health services and comparative effectiveness research.

Optimization of initial prostate biopsy in clinical practice: sampling, labeling and specimen processing.

Purpose: An optimal prostate biopsy in clinical practice is based on a balance among adequate detection of clinically significant prostate cancers (sensitivity), assuredness regarding the accuracy of negative sampling (negative predictive value), limited detection of clinically insignificant cancers and good concordance with whole gland surgical pathology results to allow accurate risk stratification and disease localization for treatment selection. Inherent within this optimization is variation of the core number, location, labeling and processing for pathological evaluation. To date, there is no consensus in this regard.

Supergroups and economies of scale.

With the changing environment for medical practice, physician practice models will continue to evolve. These "supergoups'' create economies of scale, but their advantage is not only in the traditional economic sense. Practices with enough size are able to better meet the challenges of medical practice with increasing regulatory demands, explosion of clinical knowledge, quality and information technology initiatives, and an increasingly tight labor market.

Management of recurrent anastomotic stenosis following radical prostatectomy using holmium laser and steroid injection.

Objective: To present our experience with the management of recurrent and resistant anastomotic stenosis following radical prostatectomy (RP) using transurethral laser incision of the stenotic area and injection of steroids.

Patients And Methods: Between January 1999 and April 2006, we evaluated 24 patients with anastomotic stenosis that would not allow the passage of the flexible cystoscope (17 F). Using the paediatric 7.

Long-term followup for excision and primary anastomosis for anterior urethral strictures.

Purpose: We report our experience and long-term followup of patients undergoing excision and primary anastomotic reconstruction for anterior urethral strictures.

Materials And Methods: From July 1986 to May 2006 the charts of 260 patients who underwent excision with primary anastomosis at our center for bulbar urethral stricture were reviewed. Patient age ranged from 14 to 78 years (mean 38.

Excision and primary anastomosis for anterior urethral stricture.

Excision with spatulated primary anastomosis (EPA) is an excellent reconstructive option for short bulbar urethral strictures with success rates between 90 and 95% in appropriately selected patients. Patient selection requires a careful history, physical examination, and radiographic staging. Failure with this reliable method is caused by inadequate excision of urethral stricture and incomplete mobilization of the urethra with excessive anastomotic tension.