Check out the Men's Health Checklist by the AUA

The American Urological Association recently released a "Men's Health Checklist" as a pamphlet and as mobile apps for Apple and Android.


Here is a link to the pamphlet. 


Here is a link to the app for Android.


Here is a link to the app for Apple.


The checklist breakdowns the health concerns by age: (18-39, 40-49, 50-69, 70+) as well as "Urology Specific" vs. "Related Health".


I think it's a great reference for men and healthcare providers alike. So, check them out and share them with the men in your lives!

AMA tells USPSTF to incorporate specialists in guideline creation

Resolutions were passed at the American Medical Association House of Delegates Meeting admonishing the USPSTF regarding their screening guidelines on mammography and PSA screening.


Here are the passed resolutions: (Source: AUA e-mail alert)

RESOLVED, That our AMA expresses concern regarding recent recommendations by the USPSTF on screening mammography and PSA screening and the effects these USPSTF recommendations have on limiting access to preventive care for Americans.

RESOLVED, That our AMA encourage the USPSTF to implement procedures that allow for meaningful input on recommendation development from specialists and stakeholders in the topic area under study.

Here is coverage from ABC News on the topic. 


The recent USPSTF guidelines for PSA screening were done without the input from the American Urological Association.  This is a big tripping point for me on the guidelines since we urologists are the main doctors who take care of men with prostate cancer.


Further, the USPSTF membership lacks oncologists and urologists. Here are the current members of the USPSTF: 


I applaud the AMA for taking a stand on this. Specialists represent a great resource for the crafting of these guidelines and need to be involved at the ground level, not after the fact.  Not involving main stakeholders who implement such guidelines reduces buy-in from the medical community as well as patients.

My take on USPSTF final prostate cancer screening guidelines

The US Preventive Services Task Force (USPSTF) released its final prostate cancer screening guidelines on May 21st, 2012, during the American Urological Association Annual Meeting (curious timing...in my opinion).


The task force recommended against PSA-based screening altogether for prostate cancer by giving the practice a "D" rating.  From the USPSTF grade definitions site this means: "The USPSTF recommends against the service. There is moderate or high certainty that the service has no net benefit or that the harms outweigh the benefits."  The task force suggests that healthcare providers: "Discourage the use of this service." This recommendation is no different than the draft recommendations issued in October, 2012 despite vocal opposition from many sources.


The American Urological Association (AUA), American Cancer Society (ACS), and National Comprehensive Cancer Network (NCCN) have issued guidelines recommending men to have discussions with their healthcare providers regarding the risks and benefits of prostate cancer screening.


AUA Guideline
ACS Guideline
NCCN Guideline


The AUA has expressed its vigorous opposition to the the final USPSTF recommendation.  AUA President, Dr. Sushil Lacy, released this statement about it on behalf of its members.  The AUA also has a website about the issue and prepared a fact sheet about PSA testing for its members.


My take:
The PSA screening controversy is a complex issue.  There are many factors involved in screening such as age, expected longevity, race, family history, and urologic symptoms.  I believe that at this time, the USPSTF blanket recommendation is too simplistic.  I urge men to talk further with their healthcare providers regarding this issue and consider referral to a urologist if there are still lingering questions about prostate cancer screening.  Also, the diagnosis of prostate cancer does not necessarily mandate treatment.  Depending on the clinical scenario, monitoring of the disease or "active surveillance" can be a viable option for many men.

Bladder Pal at the AUA Annual Meeting

Entrance to the AUA Meeting - Georgia World Congress Center
Photo Credit - Ronald Yap, MD

I recently returned from the American Urological Association Annual Meeting in Atlanta.

I did a few things at the meeting, but wanted to focus this post on "Bladder Pal".  If you want to read about what I was doing altogether at the meeting please check out this prior blog post.  For more background info on "Bladder Pal" check this post out.

On Sunday, May 20th, I demonstrated "Bladder Pal" to members of the AUA Foundation (AUAF) and Overactive Bladder (OAB) Expert Panel.  New guidelines for the management of OAB were released at the meeting and the AUAF is doing a patient outreach initiative to increase awareness and treatment of this condition.  To help support this effort, "Bladder Pal" will be highlighted as a tool to empower patients to track their urologic health in conjunction with their healthcare providers.  I'm honored and excited to be working with the AUAF on this and hope that "Prostate Pal" can also be helpful to the Foundation in the future.

Me demonstrating "Bladder Pal" at the AUA Foundation Booth
Photo courtesy of Alaina Willing - AUA Foundation

As you can see from the picture, my tie looks quite short.  Prior to my booth appearance, I taught a "hands on" course on laser prostate surgery and had to tuck it in my tie to keep it out of the way.  The only problem is that I forgot to untuck it and was walking around most of the day with it looking like that.  I was talking to all sorts of people with that thing tucked in and no one said a thing!  

On Tuesday, May 22nd, "Bladder Pal" was discussed during a podium presentation at the meeting.  The reception was very positive and the downloads skyrocketed after the presentation.  The abstract even made it to the highlight reel for the meeting.  Click on the Urodynamics/Female Urology link and "Bladder Pal" is profiled starting at 7:53.  

I'd also like to give some kudos to Dr. Ben Herrick, a Dartmouth Urology resident, who presented the "Bladder Pal" abstract and two other abstracts with me at the meeting.  He has been part of my research group for the past year and has been doing one heck of a job.  

ACPE "Share Your Story" session up on their website

The American College of Physician Executives have placed all the posters from the "Share Your Story"
session from the recent 2012 Annual Meeting on their website.  The poster session highlighted various ways physicians are changing healthcare at their institutions.

I was honored to present in this forum regarding mobile healthcare technology.  Through "Bladder Pal" and "Prostate Pal", to date several thousand users have been empowered to track their urologic health.

With the American Urological Association Annual Meeting presentations coming up, there will be more awareness of the apps and hopefully increased usage of these helpful tools.

Gearing up for the 2012 AUA Annual Meeting

The American Urological Association (AUA), has its annual meeting coming up this month from May 19-23.  It's a huge convention with over 11,000 attendees from all over the world.  The topics cover the entire spectrum of urology.  There are so many things going on during the meeting that it is important to be systematic and selective about your learning goals.

For those who have never heard of this meeting, it's probably shocking to know that there will be 11,000 urologists in one city at the same time. Since most urologists are male, I can also tell you that it's one of the few times I've seen the bathroom line being longer for the men's room than for the ladies'.  Leave it to a urologist like me to make such an observation!

It will be a busy meeting for me this year.  Here's what I'll be doing:

- I will help teach a class on laser prostate surgery for BPH  (108HO: Modern Alternatives to TURP: Lasers and Bipolar Sunday, May 20, 2012, 8 – 11 a.m.).  

- From 11a - noon that day, I'll will be at the AUA Foundation (AUAF) booth in the exhibit hall to talk about the Bladder Pal app.   I'm very excited to announce that the AUAF has approached me to collaborate via this app on their new overactive bladder awareness campaign.  By working together we will be able to increase recognition and patient empowerment for this condition.  

- Later in the week, I will be presenting 3 abstracts:

1. Abstract 1548: "Bladder Pal" - Empowering Patients to Monitor Urologic Health with Mobile Technology
2. Abstract 2010: "Prostate Pal" - Empowering Patients to Monitor Urologic Health with Mobile Technology
3. Abstract 2170: It Is Safe to Teach Residents Laser Prostatectomy in the Private Practice Setting

Here is a link to the abstracts if you want to read them.

I hope to catch the BPH and men's health related sessions and as many plenary talks as I can since they are particularly informative and contemporary.

If you are reading this and will be at the meeting, please grab me and say hi!

What is a urologist and how do you become one?

The public, my patients, and even some colleagues ask what a urologist does.

Here is some general information regarding the speciality of urology, including some material gleaned from the American Urological Association (AUA) and the American Board of Urology (ABU) websites:

What is urology?

Urology is a surgical specialty that deals with diseases of the male and female urinary tract and the male reproductive organs.  This includes organs such as the kidneys, bladder, and prostate gland.  In addition to surgical knowledge, urologists also must be familiar with specialties such as internal medicine, pediatrics, and gynecology to care for the broad spectrum of problems that affect these systems. 

What is particularly enjoyable about this specialty is that we can care for patients of all ages.   Many medical students are drawn to urology because of our stereotypical easy demeanor and our facility with both the medical and surgical treatment of genitourinary diseases.

How does someone become train to become urologist?

Urologists complete at least 4 years of medical school after college to obtain a MD. Thereafter, urologic graduate medical education occurs at training hospitals.  This consists of 1 to 2 years of general surgery followed by urologic training for a total of 5 to 6 years after medical school.  Some urologists do fellowships ranging from 1 to 3 additional years of training to further subspecialize.

 

The AUA has identified seven subspecialty areas within urology:

• Pediatric Urology
• Urologic cancer such as prostate, kidney, bladder, and testicular cancer
• Kidney Transplantation
• Male Infertility
• Stone disease of the urinary tract
• Female Urology 
• Neurourology

How is a urologist certified? 

In America, board certification is done by the American Board of Urology.  There are generally correlate bodies in other countries of the world.

The certification process consists of two parts:

1. First part - qualifying written examination as well as a review of credentials, education, and training.
2. Second part - After passage of part one and a minimum of 16 months of practice, candidates can then submit a practice log and undergo peer review and review by the board.  If the candidate is qualified, he or she can take the second oral certifying exam.

Beginning in 2007, ABU has initiated a maintenance of certification process for those who become certified or recertified.

Here are the reference links:

American Board of Urology

American Urological Association - What is urology?

We’re quite enthusiastic about our craft and enjoy discussing it with any interested party. So please talk to one of us for further information!