BackTable Urology

Menopause isn’t just a diagnosis—it’s a transition, and the way we treat it needs to change. Dr. Kelly Casperson joins Dr. Suzette Sutherland in this urogynecology crossover episode of BackTable to challenge outdated beliefs about menopause and hormone replacement therapy (HRT). They revisit the impact of the 1990s Women’s Health Initiative (WHI) study and explain how its findings—especially around synthetic hormones—were widely misinterpreted and continue to adversely influence patient and provider decisions today. --- SYNPOSIS Dr. Casperson breaks down the differences between the hormones used in WHI and the safer, more targeted options available today. The conversation explores the broad benefits of modern HRT, including reduced risks of cardiovascular disease, osteoporosis-related fractures, and even dementia. Beyond the science, the episode also addresses the urgent need for better medical education and updated guidelines around menopause care.Dr. Casperson and Dr. Sutherland make the case for empowering patients through informed consent and better clinician training. They also discuss Dr. Casperson’s upcoming book, The Menopause Moment, which aims to equip women with the tools and knowledge to navigate this life stage with confidence. --- TIMESTAMPS 00:00 - Introduction02:50 - Focus on Menopause and Hormone Replacement Therapy04:20 - The Women's Health Initiative (WHI) Study05:39 - Understanding Risks and Misconceptions12:43 - Reevaluation of the Women’s Health Initiative Study18:31 - Impact of Media and Physician Education19:58 - Current State of Hormone Therapy22:17 - Broader Implications and Future Directions27:17 - Evaluating FDA Warnings and Gender Bias in Hormone Treatments29:49 - The Impact of Hormone Therapy on Women's Health32:11 - Risks of Not Using Hormones35:44 - Hormones and Brain Health: Debunking Myths40:41 - The Timing Hypothesis and Long-Term Hormone Use46:32 - Advocacy and Education for Menopause Awareness48:04 - Conclusion and Upcoming Resources --- RESOURCES PBS: The M Factor: Shredding the Silence on Menopause:https://www.pbs.org/show/the-m-factor-shredding-the-silence-on-menopause/ The Menopause Moment by Dr. Kelly Casperson: https://kellycaspersonmd.com/the-menopause-moment-book/ Systematic review and meta-analysis of the effects of menopause hormone therapy on risk of Alzheimer's disease and dementia:https://pmc.ncbi.nlm.nih.gov/articles/PMC10625913/

With BCG in short supply and recurrence rates still high, the race is on for better intravesical options. In this episode of BackTable Tumor Board, Dr. Lindsey Herrel, urologic oncologist at the University of Michigan, joins Dr. Ruchika Talwar to explore the evolving landscape of intravesical therapy for intermediate risk bladder cancer. --- This podcast is supported by an educational grant from UroGen Pharma. --- SYNPOSIS The doctors break down the nuances of defining this risk category and the clinical gray zones that complicate treatment decisions. Dr. Herrell shares her patient-centered approach to surveillance and therapy, and introduces promising new agents, including Anktiva, UGN-102, and the gemcitabine-releasing TAR-200 "pretzel" device. The discussion also highlights how advances in molecular profiling are reshaping care strategies.This episode underscores the urgent need for clearer guidelines and continued innovation to improve outcomes and quality of life for patients with this nuanced disease subtype. --- TIMESTAMPS 00:00 - Introduction02:03 - Defining Intermediate Risk Bladder Cancer06:12 - Intravesical Therapy Options08:47 - Quality of Life and Patient Counseling10:18 - New Treatments on the Horizon12:56 - Practical Tips for TURBT Recovery17:03 - In-Office Procedure Management21:38 - Managing Symptoms and Quality of Life31:50 - A Note on Smoking Cessation33:37 - Conclusion and Future Directions

Global medical missions bring unique challenges and powerful rewards—something Dr. Spencer Hiller and Dr. Kenneth Peters know firsthand. In this episode of BackTable Urology, they join host Dr. Jose Silva to reflect on their work in global health, focusing on their surgical missions to Zambia to treat complex urologic conditions, including vesicovaginal fistula, and a variety of general urologic cases. --- SYNPOSIS The discussion covers the origins and evolution of their missions, the preparation required for high-volume surgical trips, and the clinical impact on both patients and participating healthcare providers. Dr. Peters and Dr. Hiller detail the logistical and financial hurdles involved, the emphasis on sustainable care models, and their strategies for fundraising. They also emphasize the value of cultural immersion and the long-term goal of establishing educational and medical infrastructure within the communities they serve. --- TIMESTAMPS 00:00 - Introduction 01:23 - The Mission to Africa: How It All Began02:32 - Challenges and Logistics of Medical Missions06:02 - Resident Involvement and Impact09:10 - Preparation and Experiences in Africa11:38 - Overcoming Obstacles: Supplies and Customs19:18 - Types of Procedures and Medical Work in Africa21:45 - Upgrading Equipment and Training Local Staff28:28 - Daily Operations and Patient Management31:00 - Post-Trip Activities and Community Engagement34:26 - Funding and Sustainability Efforts40:31 - Personal Reflections and Future Plans

Counseling patients with intermediate-risk non-muscle invasive bladder cancer can be complex, with a wide range of treatment options and care pathways. In this episode of BackTable Urology, urologic oncologists Dr. Ruchika Talwar and Dr. Kelly Bree explore how to approach this challenge with clarity and compassion. --- This podcast is supported by an educational grant from UroGen Pharma. --- SYNPOSIS They emphasize a shift toward patient-centered, less aggressive treatment strategies, highlighting the importance of quality of life in clinical decision-making. The discussion includes risk stratification, the use of intravesical gemcitabine, and ongoing clinical trials. Dr. Bree also offers actionable tips for optimizing patient preparation and recovery. This episode underscores the growing importance of listening to patient voices to shape future standards of care. --- TIMESTAMPS 00:00 - Introduction and Overview02:09 - Risk Stratification and Treatment Approaches06:12 - Intravesical Therapy Options08:47 - Quality of Life and Patient Counseling12:56 - Practical Tips for TURBT Recovery17:03 - In-Office Procedures and Patient Management21:23 - Resources and Support for Patients24:13 - Future Directions and Final Thoughts --- RESOURCES Society of Urologic Oncologyhttps://suonet.org/home.aspx

This week, we present an inspiring episode for anyone interested in the history, present, and future of prostate cancer care. In this Legends in Urology installment of the BackTable Urology Podcast, Dr. Gerald Andriole joins guest host Dr. Niraj Badhiwala to reflect on a career that has left a lasting impact on the field. --- SYNPOSIS Dr. Andriole shares personal stories from his upbringing in Northeastern Pennsylvania and his journey into medicine. He reflects on his expedited education through Penn State and Jefferson Medical College and his path to urology. He discusses his pivotal work in prostate cancer screening, including the influence of major trials like The Prostate, Lung, Colorectal and Ovarian (PLCO) Cancer Screening Trial, and traces the evolution of surgical and diagnostic techniques. The conversation also touches on current innovations and the future of prostate cancer management, offering valuable advice for the next generation of urologists. --- TIMESTAMPS 00:00 - Introduction01:59 - From Childhood to Medical School06:48 - Discovering Urology16:52 - Pioneering Prostate Cancer Screening24:07 - The PLCO Study: Design and Challenges28:57 - Controversies and Criticisms in Prostate Cancer Screening33:29 - Evolving Practices in Prostate Cancer Management44:19 - Future of Prostate Cancer Treatment

How do the experts balance organ preservation, oncologic control, and emerging therapies in both localized and metastatic cases of penile cancer? This episode of BackTable Tumor Board focuses on penile cancer diagnosis and treatment, featuring urologic oncologist Dr. Charles Peyton (UAB), radiation oncologist Dr. Juanita Crook (UBC), and medical oncologist Dr. Andrea Apolo (NCI). --- This podcast is supported by:Ferring Pharmaceuticals --- SYNPOSIS This session covers case studies ranging from localized to advanced penile cancer, diagnostic practices, imaging preferences (MRI vs. CT), and treatment options, including surgery, brachytherapy, chemoradiation, and neoadjuvant chemotherapy. The multidisciplinary team highlights the complexities of treating this rare cancer, underscores the importance of physical exams, and stresses the necessity of personalized treatment plans. They also delve into the challenges of managing metastatic stages, potential salvage therapies, and the importance of clinical trials in enhancing treatment efficacy. The doctors also emphasize the potential of immunotherapy and chemotherapy combinations for metastatic disease. --- TIMESTAMPS 00:00 - Introduction02:23 - Imaging Preferences03:29 - Biopsy vs Immediate Surgery06:04 - Lymph Node Dissection vs Radiation13:48 - Brachytherapy Techniques and Case Study23:21 - Challenges in Advanced Penile Cancer27:03 - Chemotherapy and Chemoradiation30:15 - InPACT Trial37:12 - Salvage Therapies and Exploring New Treatment Frontiers44:25 - Support and Awareness for Penile Cancer51:29 - Final Thoughts --- RESOURCES Society of Urologic Oncologyhttps://suonet.org/home.aspx

Can we do more than prescribe pills to address men’s sexual health complaints? In this episode of the BackTable Urology Podcast, men’s health expert Dr. Mohit Khera from Baylor College of Medicine joins guest host Dr. Amy Pearlman for a deep dive into testosterone management and the full spectrum of erectile dysfunction therapies. --- SYNPOSIS The conversation covers daily tadalafil use, lifestyle optimization, and the nuanced role of off-label medications. Dr. Khera also highlights emerging technologies like the Tech Ring and radiofrequency treatments, alongside practical insights into semen analysis and hormonal health markers. Throughout, he emphasizes a holistic, patient-centered approach to sexual health—blending medical therapy with meaningful lifestyle change. This is a must-listen for general urologists, men’s health specialists, and trainees looking to expand their toolkit in this evolving field. --- TIMESTAMPS 00:00 - Introduction02:13 - Erectile Dysfunction and Testosterone08:05 - Young Men's Health and Early Detection10:20 - Semen Analysis for Overall Health12:50 - Daily Tadalafil and Its Benefits16:40 - Proactive Sexual Health Management21:28 - Female Sexual Health25:16 - Treating Delayed Ejaculation28:53 - Psychogenic Erectile Dysfunction31:16 - Technology in Sexual Health35:54 - Lifestyle Modifications for Better Sexual Health41:55 - Resources and Referrals for Patients44:30 - Final Thoughts

With so many treatment modalities for upper tract urothelial carcinoma, how does new evidence inform optimal care? In this episode of BackTable Tumor Board, urologic oncologist Dr. Nirmish Singla (Johns Hopkins), medical oncologist Dr. Jeannie Hoffman-Censits (Johns Hopkins), and urologic oncologist Dr. Bogdana Schmidt discuss treatment and diagnosis of upper tract urothelial carcinoma (UTUC). --- This podcast is supported by: Ferring Pharmaceuticalshttps://ad.doubleclick.net/ddm/trackclk/N2165306.5658203BACKTABLE/B33008413.420220578;dc_trk_aid=612466359;dc_trk_cid=234162109;dc_lat=;dc_rdid=;tag_for_child_directed_treatment=;tfua=;gdpr=${GDPR};gdpr_consent=${GDPR_CONSENT_755};gpp=${GPP_STRING_755};gpp_sid=${GPP_SID};ltd=;dc_tdv=1 --- SYNPOSIS The discussion covers real-world UTUC cases, highlighting diagnostic challenges, treatment options, and evidence-based management strategies. They address scenarios ranging from localized to advanced UTUC, the role of systemic therapies, perioperative treatments, and the potential for novel approaches with immune checkpoint inhibitors. The episode underscores the evolving landscape of UTUC treatment and the importance of clinical trials and emerging biomarkers in improving patient outcomes. --- TIMESTAMPS 00:00 - Introduction 02:49 - Case Study 1: 66-Year-Old Male with UTUC11:19 - Case Study 2: 73-Year-Old Male with High-Grade Urothelial Carcinoma28:11 - Intravesical Chemotherapy Protocols30:44 - Case Study 3: 57-Year-Old Male with Recurrent Urothelial Cancer41:25 Clinical Trials and Emerging Treatments45:40 Case Study: 55-Year-Old Female with Bulky Lymphadenopathy 56:45 Concluding Remarks and Future Directions --- RESOURCES Society of Urologic Oncologyhttps://suonet.org/home.aspx

With fewer incisions and faster recovery, single port robotic surgery is changing the game—hear from the urologic surgeons leading the charge. This episode of BackTable Urology features an insightful discussion of the transformative impact of single port robotic surgery with Dr. Richard Link, Dr. Michael Stifelman and guest host Dr. Mihir Shah. --- SYNPOSIS This episode explores the benefits of single port (SP) robotic surgery, highlighting improved access, greater efficiency, and shorter patient recovery times. The doctors discuss the evolution of single port technology and the challenges that remain. They also share practical tips around case selection, building community support, and tracking outcomes to enhance efficacy. Whether you're new to SP or a seasoned surgeon, this episode offers valuable insights on how to refine your surgical practice. --- TIMESTAMPS 00:00 - Introduction04:18 - Early Adoption06:50 - Commitment and Learning Curve15:45 - Innovations and Best Practices19:10 - The Magic of Single Port Access29:29 - Practical Tips and Instrumentation32:14 - Instrument Spread and Force Bipolar34:25 - Benefits of Single-Port Surgery35:57 - Challenges and Cognitive Load in SP Surgery42:55 - Adoption and Resistance to SP Technology50:52 - Final Thoughts

What if the key to better cancer outcomes lies not just in surgery or chemotherapy, but also in mindfulness, movement, and diet? In this episode of the BackTable Tumor Board, host Dr. Aditya Bagrodia interviews urologic oncologist Dr. Viraj Master, Professor of Urology at Emory University, about his role in developing the integrative oncology and survivorship service line at Winship Cancer Institute. --- This podcast is supported by: Ferring Pharmaceuticals https://ad.doubleclick.net/ddm/trackclk/N2165306.5658203BACKTABLE/B33008413.420220578;dc_trk_aid=612466359;dc_trk_cid=234162109;dc_lat=;dc_rdid=;tag_for_child_directed_treatment=;tfua=;gdpr=${GDPR};gdpr_consent=${GDPR_CONSENT_755};gpp=${GPP_STRING_755};gpp_sid=${GPP_SID};ltd=;dc_tdv=1 --- SYNPOSIS They discuss the evidence-based use of complementary therapies alongside conventional cancer treatments, touching on various integrative methods including diet, exercise, mindfulness, acupuncture, yoga, and supplements. Dr. Master emphasizes the importance of physicians being open to these practices and understanding their potential benefits for improving patient outcomes and quality of life, even in highly acute cases like muscle-invasive bladder cancer. The conversation covers the importance of honesty and understanding across patient journeys–from initial diagnosis to survivorship–highlighting the value of holistic approaches in cancer care. ---TIMESTAMPS00:00 - Integrative Oncology: Definitions and Basics06:28 - Exercise and Its Impact on Cancer Treatment08:12 - Physician Perspectives on Complementary Medicine20:58 - Acupuncture and Acupressure in Cancer Care25:28 - Practical Implementation of Integrative Approaches31:30 - Supplements and Immuno Nutrition36:25 - Cannabis, CBD, and Ayurveda in Cancer Care44:39 - Conclusion and Final Thoughts --- RESOURCES Society of Urologic Oncologyhttps://suonet.org/home.aspx