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This week on BackTable Urology, Dr. Seth Lerner (Baylor College of Medicine) discusses the intricacies of lymph node dissection in bladder cancer management, including an overview of patterns of metastasis, genomic classifiers, and recent clinical trials.
The discussion highlights the evolution of bladder cancer treatment, from the use of cytotoxic chemotherapy to the current practice of neoadjuvant chemotherapy and radical cystectomy. Dr. Lerner and Dr. Bagrodia further explore diagnostic and treatment strategies, including the role of Decipher Prostate Genomic Classifier in tailoring patient treatment plans. The podcast delves into the necessity of a multidisciplinary approach to bladder cancer, the benefits of multimodal therapy, and the integration of circulating tumor DNA in management plans. Dr. Lerner then discusses clinical trials assessing the impact of extended lymph node dissection during cystectomies and emphasizes the importance of surgical quality and adherence to established protocols in bladder cancer treatment.
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CHECK OUT OUR SPONSOR
Veracyte
https://www.veracyte.com/decipher
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SHOW NOTES
00:00 - Introduction
06:17 - The Role of Imaging in Bladder Cancer Staging
08:00 - Exploring the Potential of Genomic Classifiers
16:55 - Debating the Efficacy of Extended Lymph Node Dissection
27:47 - Update on Bladder Cancer Clinical Trials
48:54 - Final Thoughts and the Future of Bladder Cancer Treatment -
This week on BackTable Urology, Dr. Aditya Bagrodia speaks with Dr. Ganesh Palapattu, Chair of Urology at the University of Michigan about the evolving role of a surgeon scientist, the balance between clinical work and research, and the importance of mentorship and positivity.
Dr. Palapattu shares his personal journey from being inspired by mentors like Dr. Don Coffey to becoming Chief of Urologic Oncologist at Houston Methodist and his focus on fostering the next generation of medical professionals. The episode emphasizes the need for self-reflection, understanding one’s motivations, and the importance of maintaining relationships outside of the professional sphere. Additionally, the doctors discuss financial pressures on surgeon scientists and the importance of a supportive environment, along with the unique position of urologists in driving significant scientific and clinical advancements.
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SHOW NOTES
00:00 - Introduction
07:30 - The Challenges and Importance of Being a Surgeon Scientist
13:36 - The Impact of Clinical Practice on Scientific Research
18:40 - Structuring Success in Academic Medicine
25:41 - Reflecting on the Culture of Collaboration and Support
27:24 - The Importance of Time and Resources in Academic Medicine
43:40 - Advice for Aspiring Surgeon Scientists
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RESOURCES
Dr. Ganesh Palapattu’s Faculty Profile
https://medicine.umich.edu/dept/urology/ganesh-s-palapattu-md-facs -
Saknas det avsnitt?
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This week on BackTable Urology, Dr. Ramon Virasoro, a reconstructive urologist in Eastern Colorado, interviews his mentor, Dr. Gerald Jordan, Professor Emeritus of Urology at Eastern Virginia Medical School.
First, they explore Dr. Jordan’s multifaceted career, starting from his upbringing in El Paso and his military career, which eventually led him to medicine and urology. Dr. Jordan shares anecdotes from his time as a Navy fighter pilot and how his service influenced his medical path. He eventually chose to focus on reconstructive urology and played a pivotal role in the formation of the Society of Genitourinary Reconstructive Surgeons (GURS). Significant emphasis is placed on global surgical education and Dr. Jordan’s involvement in establishing and contributing to key nonprofits aimed at improving urological care worldwide. The podcast also delves into Dr. Jordan’s tenure at the American Board of Urology, and the urologists also discuss the evolving landscape of urology education and certification. Finally, Dr. Jordan reflects on the importance of mentorship, the joy of lifelong learning, and the future of urology as a fulfilling specialty.
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SHOW NOTES
00:00 - From Fighter Pilot to Urologist
07:32 - Transitioning from the Military to a Medical Career
14:21 - The Evolution of Reconstructive Urology and Global Surgical Education
22:01 - Dr. Jordan’s Role in the American Board of Urology
26:31 - Reflecting on a Distinguished Career and Looking Ahead
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RESOURCES
Society of Genitourinary Reconstructive Surgeons
https://societygurs.org/
BackTable Urology Episode 52- Legends in Urology: Dr. Jack McAninch
https://open.spotify.com/episode/46wrxyhB2XCwERp4Z2ySc0?si=fe62e35cff934e74 -
Disclaimer: This podcast episode contains occasional profanity. While we strive to maintain a respectful and professional tone in our content, there may be instances where language is used to emphasize points or express strong emotions. Listener discretion is advised.
This week on BackTable Urology, Dr. Ruchika Talwar interviews Emmy nominated writer and comedian, Nimesh Patel, about his personal experience with testicular cancer.
Sharing about his diagnosis, treatment, and recovery, Nimesh describes how he processed his cancer and used it as a source of comedic material for his 2023 comedy special, “Lucky Lefty”. His story has contributed to testicular cancer awareness by encouraging men to do self-checks and seek medical attention. Nimesh also underlines the importance of swift medical attention, open communication with medical professionals, and finding a healthy outlet for processing the fear and stress that can accompany a cancer diagnosis. Finally, he emphasizes the importance of the patient-physician relationship, as his anxiety about his diagnosis was eased his physician’s calm demeanor and reassurance.
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SHOW NOTES
00:00 - Introduction
02:06 - The Testicular Cancer Diagnosis and Personal Reflections
11:39 - Sharing His Cancer Journey through Comedy
19:56 - Advice for Physicians and Physicians
25:11 - Advice for Men Facing Testicular Cancer
27:36 - The Importance of Not Making Cancer Your Personality
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RESOURCES
Nimesh Patel’s “Lucky Lefty” Comedy Special
https://www.youtube.com/watch?v=A2Rdh82XGrY
Episode 91- When Providers Become Patients: Testicular Cancer and Beyond with Dr. William Flanary aka. Dr. Glaucomflecken
https://open.spotify.com/episode/4JSXDRJ8BwzFhBBpCymCU3?si=8c58881f9b274cd0 -
In this episode of BackTable Urology, Dr. James Eastham, chief of urology at Memorial Sloan Kettering Cancer Center, discusses evolving approaches and treatments in prostate cancer.
First, he discusses topics such as patient preparation, pre-treatment discussions, and individualized treatment options based on the patient's risk levels. Dr. Eastham also summarizes crucial advancements in testing and imaging prostate cancers, including the use of genetic and biochemical markers, like PSA levels. Additionally, he emphasizes how advances in radiation therapy have improved treatment outcomes and patient experiences. Finally, Dr. Eastham emphasizes the need for consistent monitoring and communication with patients during and post-treatment.
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CHECK OUT OUR SPONSOR
Veracyte
https://www.veracyte.com/decipher
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SHOW NOTES
00:00 - Introduction
06:24 - Treatment Strategies and Patient Preferences
11:30 - Exploring the Role of Imaging in Prostate Cancer Treatment
18:29 - Dealing with Persistently Detectable PSA and Pre-op Staging
27:48 - Understanding Prostate Cancer Recurrence
36:08 - The Role of PSA Doubling Time in Treatment Decisions
43:34 - The Future of Personalized Medicine and Genomic Classifiers in Prostate Cancer
52:42 - The Importance of Patient Education and Preparation
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RESOURCES
Decipher Prostate by Veracyte:
https://www.veracyte.com/decipher-prostate/ -
In this episode of BackTable Urology, Dr. Aditya Begrodia interviews Dr. Mara Holton, a urologist and healthcare policy expert, on the recent healthcare policy changes that have affected the field of urology.
First, Dr. Holton shares her educational journey, which included healthcare policy lobbying even before she started medical school. She eventually became involved in leadership positions within the Maryland Patient Care and Access Coalition and the Large Urology Group Practice Association (LUGPA). The discussion then turns to challenges surrounding health policies, such as the persistent use of fee-for-service reimbursement guidelines despite the benefits of value-based care. Dr. Holton also highlights the critical issue of workforce shortages, particularly the need for urologists within rural areas and the impact of healthcare policy on patient access. She ends the episode by emphasizing the necessity for urologists to participate in policy advocacy efforts.
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SHOW NOTES
00:00 - Introduction
04:58 - The Impact and Complexities of Healthcare Policies
07:27 - Success Stories in Healthcare Policy Advocacy
12:37 - The Impact of Prior Authorization Rules
14:27 - The Role of Pharmacy Benefit Managers in Healthcare
21:18 - The Challenges of Value-Based Care
32:48 - The Importance of Patient Access in Healthcare
41:24 - The Importance of Advocacy in Health Policy
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RESOURCES
LUGPA website
https://www.lugpa.org/
Episode 82: Advocacy Basics for the Urologist: From Your Clinic to Capitol Hill with Dr. Ruchika Talwar
https://open.spotify.com/episode/0hcLrKuf5QU7TZCHSErs4Z?si=f4d06ffe6cff4cc4 -
In this episode, Dr. Edward Schaeffer, chair of urology at Feinberg School of Medicine, discusses precision medicine in prostate cancer with Dr. Aditya Bagrodia.
First, Dr. Schaeffer introduces the importance of using a defined screening strategy for prostate cancer that includes analyzing a patient’s genomic and germline risk. Then, he summarizes existing and new diagnostic tools for prostate cancer. Additionally, Dr. Schaeffer discusses genomic testing and PSMA testing and explains how he applies them to individual patient cases depending on their cancer stage and grade. Finally, the doctors highlight the ability of future tools, like PET PSMA scans, to advance precision medicine.
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EARN CME
Reflect on how this Podcast applies to your day-to-day and earn free AMA PRA Category 1 CMEs: https://earnc.me/3XO8iL
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SHOW NOTES
00:00 - Introduction
10:32 - Precision Medicine and Prostate Cancer
16:17 - Screening and Diagnosis of Prostate Cancer
29:41 - Personalizing Surveillance and Disease Management
33:11 - The Role of Genomic Testing in Prostate Cancer
45:00 - The Use of PET PSMA Scans in Prostate Cancer Staging
48:08 - The Future of Precision Medicine in Prostate Cancer -
This week on BackTable Urology, Dr. Ben Chew, professor and clinical researcher with the University of British Columbia, provides valuable insights on laser treatments for kidney stones.
First, Dr. Chew provides a comprehensive overview of the current landscape of laser treatment for kidney stones. Dr. Silva and Dr. Chew then discuss the unique characteristics of different laser types, such as the Holmium and the Thulium lasers. Dr. Chew also covers critical safety considerations, like maintaining low intravenous pressure, using cold irrigation, and taking breaks during sustained laser treatment. Additionally, they delve into emerging technology, such as the use of electromagnetic guidance, for more accurate laser application.
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SHOW NOTES
00:00 - Introduction
06:49 - Choosing the Right Laser
12:11 - Energy Settings for Lasers
18:49 - Upper Tract Tumors and Lasers
23:54 - Preventing Thermal Injuries During Laser Treatment
27:03 - Dusting vs Fragmentation with Lasers
34:27 - The Impact of New Technologies on Kidney Stone Treatment
41:30 - Final Thoughts and Safety Recommendations -
This week on BackTable Urology, Dr. Aditya Bagrodia invites Dr. Stacy Loeb, Professor of Urology at NYU Grossman School of Medicine, to discuss the role of lifestyle medicine in prostate cancer prevention.
First, the doctors discuss the negative impacts of red and processed meat consumption as cancer-causing agents and encourage a shift towards whole, plant-based foods. They also emphasize the importance of engaging in regular physical activity and maintaining a healthy sleep schedule. Additionally, Dr. Loeb highlights substance abuse, particularly smoking and opioid consumption, as a health threat that needs to be managed. Lastly, the doctors discuss the importance of maintaining social connections and managing stress effectively in order to optimize preventative health.
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CHECK OUT OUR SPONSOR
Veracyte
https://www.veracyte.com/decipher
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SHOW NOTES
00:00 - Introduction
03:32 - The Importance of Lifestyle Medicine in Urology
07:57 - The Role of Nutrition in Cancer Prevention
14:07 - The Importance of Physical Activity
15:50 - The Impact of Sleep on Health
19:57 - Avoidance of Toxic Substances
34:02 - The Importance of Social Connections and Stress Management
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RESOURCES
BackTable Urology Ep. 54 Smoking Cessation for the Urologist with Dr. Christian Fankhauser and Dr. Richard Matulewicz
https://open.spotify.com/episode/1LUfPqJY4eEiaMJFW2VCwt?si=03ce7b67cdce4cf5
BackTable Urology Ep. 28 Holistic and Integrative Approaches to Prostate Cancer with Dr. Geo Espinosa
https://open.spotify.com/episode/0XhnjdUGXXfZoU51miHhlS?si=7e743f1937044640 -
In this episode, host Dr. Aditya Bagrodia speaks with guests Dr. C.J. Stimson and Dr. Ruchika Talwar from Vanderbilt University about the relationship between physicians and big business in modern healthcare.
First, the doctors discuss significant transformation in the healthcare sector, with multiple corporations like Amazon, Walmart, and Best Buy entering the healthcare realm. Although earlier practices were physician-centric, the evolving trends show an inclination towards a more consumer-centric approach focusing on efficiency and value. The guests share their views on the necessity of doctors asserting their role in the changing landscape, emphasizing the importance of the doctor-patient relationship. The conversation also addresses innovations in the field such as value-based arrangements that prioritize patient experience while reducing costs.
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SHOW NOTES
00:00 - Understanding Market Dynamics in Urology
02:18 - The Role of Big Corporations in Healthcare
07:14 - The Shift from Doctor-Centric to Patient-Centric Care
13:07 - The Commodification of Healthcare Services
19:36 - The Future of Healthcare: Vertical Integration
21:22 - The Impact of Value-Based Care on Healthcare
29:28 - The Role of Employers in Healthcare
41:50 - The Future of Healthcare: An Optimistic Outlook -
This week on BackTable Urology, urologic oncologist Dr. Bogdana Schmidt (University of Utah) hosts a discussion with medical oncology experts Dr. Rana McKay (UC San Diego) and Dr. Neeraj Agarwal (University of Utah) on recent clinical trials from bladder, kidney, and prostate cancer research presented at the 2023 European Society for Medical Oncology (ESMO) Meeting.
First, they discuss impactful data regarding bladder cancers, specifically the CheckMate 901 and the EV-302 trials which show improvement in overall survival and promise for urothelial carcinoma patients’ quality of life. The conversation moves onto kidney-specific trials such as the LITESPARK-005, which offers improved progression-free survival for patients through the use of belzutifan. The panel rounds off by discussing the progress made in prostate-specific trials with emphasis on the EMBARK and SPLASH trials involving Lutetium therapy. Finally, the doctors discuss the trend towards personalized treatment plans based on the unique goals and health requirements of the patients.
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SHOW NOTES
00:00 - Discussion on Urothelial Carcinoma: CheckMate 901 and EV-302
11:22 - Discussion on Kidney Cancer: LITESPARK-005
23:53 - Discussion on Prostate Cancer: EMBARK
31:41 - Discussion on Prostate Cancer: SPLASH vs PSMA
36:39 - Future Directions for Lutetium Therapy for Prostate Cancer
37:50 - Closing Remarks and Future Expectations
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RESOURCES
CheckMate 901 Trial Investigators. Nivolumab plus Gemcitabine-Cisplatin in Advanced Urothelial Carcinoma.
https://www.nejm.org/doi/full/10.1056/NEJMoa2309863
LBA6 EV-302/KEYNOTE-A39: Open-label, randomized phase III study of enfortumab vedotin in combination with pembrolizumab (EV+P) vs chemotherapy (Chemo) in previously untreated locally advanced metastatic urothelial carcinoma (la/mUC).
https://www.sciencedirect.com/science/article/pii/S0923753423042709
LBA88 Belzutifan versus everolimus in participants (pts) with previously treated advanced clear cell renal cell carcinoma (ccRCC): Randomized open-label phase III LITESPARK-005 study.
https://www.sciencedirect.com/science/article/pii/S0923753423042345
LBA02-09 EMBARK: A Phase 3 Randomized Study of Enzalutamide or Placebo Plus Leuprolide Acetate and Enzalutamide Monotherapy in High-risk Biochemically Recurrent Prostate Cancer.
https://pubmed.ncbi.nlm.nih.gov/37119051/
177Lu-Labeled Prostate-Specific Membrane Antigen Radioligand Therapy of Metastatic Castration-Resistant Prostate Cancer: Safety and Efficacy.
https://pubmed.ncbi.nlm.nih.gov/26795286/ -
In this episode, Dr. Wayne Kuang (MD for Men LLC in Albuquerque, NM) discusses his initiative to redefine the benign prostatic hyperplasia (BPH) care pathway for patients, doctors, and the healthcare industry.
One of his main focuses is to prioritize bladder health and end the polypharmacy approach to BPH. Dr. Kuang also introduces the 5 Stages of Bladder Health, emphasizing the risks if BPH is not treated effectively and earlier. He underlines the importance of strategic treatment planning based on detailed data collection of the patient’s prostate and bladder health. Dr. Kuang also examines different surgical and medical treatments for BPH. He ends the episode by explaining the Man vs. Prostate initiative and the significant global impact of his advocacy.
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SHOW NOTES
00:00 - Introduction
02:01 - The Impact of BPH on Patients
05:57 - The Importance of Bladder Health
10:38 - The Five Stages of Bladder Health
23:00 - The Role of Primary Care Physicians in BPH Treatment
26:03 - The Role of Medications in Treating BPH
34:06 - The Role of Urologists in BPH Treatment
39:07 - The Importance of Personalized Therapy in BPH Treatment
44:17 - The Man vs. Prostate Initiative
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RESOURCES
Dr. Wayne Kuang on LinkedIn
https://www.linkedin.com/in/wayne-kuang-md/
Man vs. Prostate
https://www.manvsprostate.com/ -
In this episode, host Dr. Suzette Sutherland is joined by Dr. Kelly Casperson, a urologist who specializes in women’s sexual health, to discuss the importance of education, therapy, and hormone replacement in female sexual health.
They explore topics such as the role of estrogen and testosterone in women’s sexual desire, FDA-approved medications for hypoactive sexual desire disorder, and the importance of sex education and communication within relationships. They also highlight the topic of gender inequality in sexual health care delivery and the lack of clinical resources specifically tailored to women’s needs. In sum, they aim to provide a deeper understanding of female sexual health and offer strategies for practitioners to provide more effective care.
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SHOW NOTES
00:00 - Introduction
05:53 - The Role of Urologists in Women’s Sexual Health
07:18 - The Importance of Communication in Addressing Sexual Dysfunction
10:23 - The Role of the Clitoris in Female Orgasm
19:52 - Understanding the Hormones Behind Female Sexual Desire
25:32 - The Misconceptions and Gender Bias Surrounding Hormones
26:04 - The Role of Testosterone in Menopause and Sexual Desire
30:02 - The Challenges of Commercially Available Testosterone Products
32:52 - Non-Hormonal Treatments for Low Libido
42:41 - The Importance of Referring to Sex Therapists and Other Resources
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RESOURCES
Dr. Kelly Casperson’s Website
https://kellycaspersonmd.com/
You Are Not Broken Podcast
https://kellycaspersonmd.com/you-are-not-broken-podcast/
“You Are Not Broken” by Kelly Casperson
https://kellycaspersonmd.com/you-are-not-broken-book/
“Magnificent Sex” by Peggy Kleinplatz
https://www.amazon.com/Magnificent-Sex-Lessons-Extraordinary-Lovers/dp/0367181371
American Association of Sexuality Educators, Counselors, and Therapists
https://www.aasect.org/ -
In this episode, Dr. Suzette Sutherland and Dr. Alana Desai from the University of Washington discuss the management of urinary tract stones in pregnant patients, considerations for ureteroscopy, and consequences of radiation exposure in the fetus.
First, the doctors underscore the importance of ultrasound as the first line imaging modality to minimize fetal exposure to radiation. Dr. Sutherland and Dr. Desai also delve into nausea and pain management options, recommended diets for prevention of stone formation during pregnancy, and the necessity of involving a multidisciplinary team in such cases. The episode concludes with a remarkable case study from Dr. Desai’s experience.
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SHOW NOTES
00:00 - Introduction
02:06 - Incidence and Risk Factors of Kidney Stones in Pregnancy
03:29 - Physiological Changes and Stone Formation in Pregnancy
07:04 - Diagnosing Kidney Stones in Pregnancy
13:08 - Expectant Management vs. Intervention
14:41 - Managing Pain and Nausea in Pregnant Patients with Kidney Stones
17:13 - Decompression Methods for Kidney Stones in Pregnancy
23:13 - Ureteroscopy as a Preferred Intervention
26:05 - Case Description from Dr. Desai
30:04 - Considerations for Ureteroscopy in Pregnant Patients
31:14 - Preventing Kidney Stones in Pregnancy
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RESOURCES
Lyon, M., Sun, A., Shah, A., Llarena, N., Dempster, C., Sivalingam, S., Calle, J., Gadani, S., Zampini, A., & De, S. (2023). Comparison of Radiation Exposure for Pregnant Patients Requiring Intervention for Suspected Obstructing Nephrolithiasis. Urology, 182, 61–66. https://doi.org/10.1016/j.urology.2023.09.023
Thongprayoon, C., Vaughan, L. E., Chewcharat, A., Kattah, A. G., Enders, F. T., Kumar, R., Lieske, J. C., Pais, V. M., Garovic, V. D., & Rule, A. D. (2021). Risk of Symptomatic Kidney Stones During and After Pregnancy. American journal of kidney diseases : the official journal of the National Kidney Foundation, 78(3), 409–417. https://doi.org/10.1053/j.ajkd.2021.01.008 -
In this episode, Dr. Aditya Bagrodia (UC San Diego), Dr. Lindsay Hampson (UC San Francisco) and Dr. Gina Badalato (Columbia University) discuss the impact of the COVID-19 pandemic on urology education.
They discuss the conception and impact of virtual lecture series like EMPIRE and Urology COVID on residents’ education. They also underline how being adaptive and open to change can help residents shape the future of their own learning. The doctors also explain how resident-led and resident-focused educational resources came into existence, and what more is envisioned for education in urology. The episode ends with a discussion about unmet needs in education and the significance of diverse perspectives in teaching surgical procedures.
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SHOW NOTES
00:00 - Introduction
01:15 - Reflections on Urology Education and Early Career Experiences
04:08 - The Evolution of Learning and Engagement in Medical Training
07:55 - Transitioning from Medical School to Residency
08:34 - The Creation of the Intern Academy for the American Urological Association
14:24 - The Impact of COVID-19 on Virtual Learning
16:12 - The Role of Residents in Virtual Learning
19:24 - The Future of Virtual Learning and Education
20:00 - The Role of Innovation and Adaptability in Education
23:07 - The Role of Residents in Shaping Their Own Learning
42:28 - The Future of Education in Urology
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RESOURCES
AUA Intern Academy
https://auau.auanet.org/content/intern-academy-2023
AUA EMPIRE Lecture Series
https://nyaua.com/empire/
UCSF Urology Collaborative Online Virtual Didactics (COViD) Lecture Series
https://urologycovid.ucsf.edu/ -
In this crossover episode of BackTable OBGYN with Urology, Dr. Suzette Sutherland, Director of Female Urology at the University of Washington, and Dr. Anne Cameron, Professor of Urology at the University of Michigan, share their insights on the prevention and management of urinary tract infections (UTIs).
First, they emphasize the importance of dispelling misconceptions about recurrent UTIs being a result of poor hygiene or incorrect behaviors, explaining that they can stem from genetic or hormonal risk factors. Dr. Cameron describes her algorithm for managing UTIs in specific patient populations. She further discusses the impact of factors such as fluid intake, bowel habits, and vaginal health on the incidence of UTIs. Dr. Cameron also highlights the potential for UTIs in diabetic patients on certain medications and the importance of a collaborative approach with diabetic healthcare teams. Additionally, the doctors explore various treatment strategies, such as cranberry supplements and gentamicin bladder installations, cautioning against antibiotic overuse due to the risk of resistance.
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EARN CME
Reflect on how this Podcast applies to your day-to-day and earn free AMA PRA Category 1 CMEs: https://earnc.me/2P5fzK
---
SHOW NOTES
00:00 - Introduction
02:13 - Understanding UTIs: Definitions, Symptoms, and Prevalence
04:39 - Recurrent UTIs: Definitions, Causes, and Treatment Challenges
12:00 - Understanding Asymptomatic Bacteriuria
15:00 - Cystitis vs. Pyelonephritis vs. Urosepsis
20:57 - Antimicrobial Resistance and Antibiotic Stewardship
24:36 - Treatment Guidelines for UTIs
31:13 - Self-start Antibiotic Therapy for UTIs
34:37 - Preventing UTIs: Hydration, Lifestyle Factors, and Bowel Health
38:33 - The Connection Between Vaginal Health and UTIs
42:40 - The Role of Supplements in UTI Prevention: D-Mannose and Cranberry, and Methenamine Hippurate
57:18 - Identification and Treatment of UTIs in Patients with Indwelling Catheters
01:00:04 - The Role of Gentamicin Bladder Installations in UTI Prevention
01:04:27 - The Impact of Diabetes Medications on UTIs
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RESOURCES
AUA Guidelines for UTI Treatment:
https://www.auanet.org/guidelines-and-quality/guidelines/recurrent-uti -
In this episode, host Dr. Jose Silva and Dr. Padraic O’Malley, a urologic oncologist from University of Florida Health, discuss how to diagnose and treat upper tract urothelial carcinoma.
Referencing official guidelines and personal experiences, the doctors discuss various treatments such as tumor ablation, JELMYTO, neoadjuvant chemotherapy, and nephroureterectomy. They also discuss the role of lymph node dissection and the significance of Lynch syndrome. Additionally, they touch upon the Thulium laser and updated staging guidelines. The episode concludes with discussions about follow-up care, and the doctors agree on the need for a standardized reporting system and risk stratification guidelines for improved patient management.
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SHOW NOTES
00:00 - Introduction
02:09 - Initial Presentation of Patients with Upper Tract Urothelial Carcinoma
10:54 - Discussion on Lynch Syndrome
14:27 - Risk Stratification in Patients
15:37 - Tumor Ablation and Intracavitary Therapies
26:47 - The Use of Thulium Laser in Treatment
28:50 - Discussion on High Volume Disease
32:39 - Discussion on High Grade Tumors
38:23 - The Role of Neoadjuvant Chemotherapy
43:02 - Post-Treatment Follow Up
45:18 - Standardized Reporting in Guidelines -
In this episode of the Backtable Urology Podcast, Dr. Jose Silva invites Dr. Ali Kasraeian, urologic oncologist in Jacksonville, Florida, to discuss his experiences with the Aquablation technique for treating benign prostatic hyperplasia (BPH).
First, Dr. Kasraeian shares the process of learning Aquablation, the initial challenges he faced, and the benefits it offers patients. He explains that Aquablation is a procedure that democratizes the treatment of any size of the prostate by removing inconsistencies in management and offering a consistent, reproducible method. The doctors also discuss Aquablation outcomes and patient considerations, focusing on quality of life improvement and preserving ejaculatory function. Dr. Kasraeian also shares some insights on insurance coverage and billing for this procedure.
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SHOW NOTES
00:00 - Introduction
03:34 - Dr. Ali Kasraeian’s Journey with Aquablation
07:31 - The Evolution of Aquablation Technique
12:14 - Criteria for Aquablation Candidates
29:59 - Starting Out with Aquablation: Tips and Tricks
33:24 - Preserving Ejaculatory Function: Patient Discussions and Planning
35:08 - Post-Procedure Follow-ups and Revisions
49:42 - Billing and Insurance Considerations for Aquablation
54:36 - Final Thoughts on Aquablation and Urology Innovation
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RESOURCES
Kasraeian Urology
https://kasraeianurology.com/
Aquablation
https://aquablation.com/ -
In this episode, Dr. Aaron Fritts and Dr. Jose Silva invite interventional radiologist Dr. Jamil Muasher to highlight the potential that interventional radiologists possess in offering prostate biopsy work alongside Urology colleagues.
Given the advancement in MRI guidance, the discussion addresses the opportunity for radiologists to step in and provide crucial expertise to optimize patient outcomes. Dr. Muasher talks about his approach of using an MR imaging to guide the biopsy procedure. He further expresses importance in understanding the grading, reading, interpreting systems like Prostate Imaging-Reporting and Data System (PI-RADS) and significant experience needed for accurate results. The doctors also explain various biopsy procedures, details about post-procedure care and follow-ups, and observations about billing for the services.
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CHECK OUT OUR SPONSOR
Veracyte
https://www.veracyte.com/decipher
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SHOW NOTES
00:00 - Introduction
07:29 - Learning to Read Prostate MRI
09:43 - The Role of Radiologists and Grading Systems in Prostate Biopsies
24:00 - Techniques in Prostate Biopsy
31:16 - The Role of Antibiotics in Biopsy
32:34 - The Debate Between Transperineal and Transrectal Biopsy
40:36 - Post-Procedure Care and Follow-Up
45:49 - The Future of Biopsy
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RESOURCES
Decipher Prostate Genomic Classifier by Veracyte:
https://decipherbio.com/ - Visa fler
