BackTable Urology

Have you checked out the AUA/ASTRO/SUO’s recently released guidelines for salvage therapy in prostate cancer biochemical recurrence? In this episode of the BackTable Urology Podcast, guest Dr. Todd Morgan from the University of Michigan and host Dr. Aditya Bagrodia continue with part two of our series on prostate cancer biochemical recurrence management.---This podcast is supported by:Veracytehttps://www.veracyte.com/decipher---SYNPOSISThe doctors focus on the difficulty in declaring a patient 'cured' and the implications of biochemical recurrence after treatment. Dr. Morgan highlights the importance of PSA in the postoperative setting and explores the role of the Decipher Prostate Genomic Classifier in personalizing treatment. He talks through the latest AUA/ASTRO/SUO consensus on biochemical recurrence guidelines, including the significance of early salvage therapy and the integration of advanced imaging techniques like PSMA PET scans. Further, Dr. Morgan emphasizes the role for multidisciplinary evaluation, patient counseling, and future directions of research to refine treatment options.This discussion underscores the transition from adjuvant to early salvage radiation as a standard practice and considers emerging biomarker strategies to inform treatment decisions.---TIMESTAMPS00:00 - Introduction03:41 - Consensus Biochemical Recurrence Guidelines08:56 - Evolution of Post-Prostatectomy Biochemical Recurrence Management13:24 - Patient Counseling and Risk of Recurrence17:42 - PSMA PET Scans20:44 - Postoperative PSA Monitoring28:35 - The Role of Radiation31:56 - Hormone Therapy39:00 - Salvage Lymphadenectomy46:30 - Future Directions and Concluding Thoughts---RESOURCESVeracytehttps://www.veracyte.com/Salvage Therapy for Prostate Cancer: AUA/ASTRO/SUO Guideline (2024)https://www.auanet.org/guidelines-and-quality/guidelines/salvage-therapy-for-prostate-cancer

Dr. Shawn West, a Urologist at McIver Clinic in Florida, dives into contemporary BPH treatment strategies. He discusses the shift from medication-focused care to prioritizing long-term bladder health and individualized treatments. Key highlights include the use of modern techniques like UroLift and Aquablation, as well as the importance of patient engagement in decision-making. Dr. West further emphasizes the significance of the International Prostate Symptom Score in assessing urinary symptoms and the value of post-treatment expectations for better recovery outcomes.

Dr. Betsy Koehne specializes in bladder cancer at the University of Wisconsin, while Dr. Amir Salmasi is known for his impactful work at UC San Diego. They discuss contemporary strategies for managing low and intermediate-risk bladder cancer, emphasizing personalized care and effective patient communication. The conversation highlights the importance of understanding patient distress, advancements in intravesical therapies, and ongoing clinical trials aimed at improving outcomes. They also delve into the intricacies of postoperative surveillance and the role of pathology in treatment decisions.

Recent research is changing how we manage low risk prostate cancer. In this BackTable Urology Podcast episode, Dr. Dan Lin, a urologist at the University of Washington, walks through contemporary diagnosis, surveillance, and management of Grade Group 2 prostate cancer with host Dr. Aditya Bagrodia.---This podcast is supported by:Veracytehttps://www.veracyte.com/decipher---SYNPOSISThe doctors delve into real-world implementation of active surveillance, alongside the use of advanced diagnostics, biopsy methods, and personalized care plans. The conversation highlights the Canary Prostate Active Surveillance Study (PASS) and the prognostic role of biomarkers and genomic testing. Dr. Lin and Dr. Bagrodia also discuss how lifestyle factors such as diet impact cancer progression and how patients can be empowered to manage their disease. Strategies for transitioning patients off surveillance are highlighted. Finally, the two experts discuss insights from recent clinical trials like PIVOT, PROTECT, and SPCG and how they’re impacting prostate cancer management.---TIMESTAMPS00:00 - Introduction02:54 - Active Surveillance and Canary PASS Data12:02 - Biopsy Considerations19:44 - Active Surveillance Protocols26:58 - Patient Concerns and Risk Reduction30:52 - Transitioning Off Surveillance33:39 - Grade Group 2: Treatment vs. Monitoring46:24 - Surgical Considerations and Node Dissection49:25 - Future Directions---RESOURCESVeracytehttps://www.veracyte.com/

Join us for part two of our post-chemotherapy RPLND discussion with Society of Urologic Oncologists (SUO) members Tim Masterson from Indiana University and Rob Hamilton from Princess Margaret Hospital, University of Toronto.---This podcast was developed in collaboration with:Society of Urologic Oncologyhttps://suonet.org/home.aspx---SYNPOSISThe conversation covers critical aspects of RPLND, including surgical techniques, preoperative considerations, common complications like chyle leaks, and post-operative care. Both surgeons emphasize the importance of humility, constant learning, and interprofessional collaboration to enhance surgical outcomes. The experts provide valuable insights and detailed discussions meant to guide urologists.---TIMESTAMPS00:00 - Introduction01:16 - General Steps for RPLND Surgery07:23 - Finding the Ureters11:53 - Vascular Control23:26 - Mitigating Chyle Leak32:32 - Conclusion---RESOURCESExpert Approaches to Complex PC RPLND Cases Part 1:https://www.backtable.com/shows/urology/podcasts/201/expert-approaches-to-complex-pc-rplnd-cases-part-1Society of Urologic Oncology:https://suonet.org/home.aspx

Retroperitoneal lymph node dissection (RPLND) for testicular cancer can be a challenging surgery, even for the most experienced urologic oncologists. In part one of this special two-part series, host Dr. Aditya Bagrodia invites Society of Urologic Oncologists (SUO) members Dr. Timothy Masterson (Indiana University) and Dr. Robert Hamilton (Princess Margaret Hospital/University of Toronto) to cover current approaches to post-chemotherapy RPLND.---SYNPOSISFirst, the urologists delve into the technical considerations and perioperative planning for post-chemotherapy retroperitoneal lymph node dissections (RPLND) in patients with germ cell tumors. They discuss the importance of patient preparation, imaging assessments, and surgical approaches. Additionally, they explain their own surgical techniques as well as tips for dealing with operative complications. To end, their discussion addresses the importance of a multidisciplinary team and practical tips for ensuring successful surgical outcomes.---TIMESTAMPS00:00 - Introduction01:37 - Preparing for Post-Chemotherapy RPLND08:10 - Intraoperative Considerations11:02 - Handling Complications20:11 - Vascular Anatomy and Preoperative Planning27:13 - Anesthesia Considerations and Pain Management29:22 - Essential Tools and Techniques for Surgery38:24 - Incision Strategies and Post-Chemotherapy Considerations46:32 - Extraperitoneal Approach and Future Research---RESOURCESSociety of Urologic Oncologistshttps://suonet.org/home.aspx

Dr. Amar Kishan, a Professor of Radiation Oncology at UCLA, dives into the challenges of managing biochemical recurrence after prostate radiation. He discusses alternatives to androgen deprivation therapy and the importance of PSA monitoring. The episode highlights advancements like PSMA PET scans for better detection and modern treatments such as focal therapy and re-irradiation. Dr. Kishan emphasizes the need for personalized, multidisciplinary approaches to improve patient outcomes in prostate cancer care.

How do you care for patients with penile cancer? As urologists, we’re trained to think about diagnosis and treatment, but how can we help manage the psychological impacts of penile cancer? In this episode of BackTable Urology, host Dr. Ben Ayres, a urologic oncologist specializing in penile cancer, discusses the unique psychological challenges faced by penile cancer patients with bladder cancer survivor Dr. Rick Bangs and nurse Rob Cornes.---This podcast is supported by:Photocurehttps://www.photocure.com/---SYNPOSISThis episode emphasizes the importance of awareness and peer support in reducing isolation and stigma associated with penile cancer. The conversation also explores the role of multidisciplinary care and the benefits of holistic approaches to patient decision-making.---TIMESTAMPS00:00 - Introduction04:05 - Isolation in Penile Cancer06:38 - The Role of Advocacy and Peer Support15:29 - Shared Decision Making in Penile Cancer Care23:22 - Value of Multidisciplinary Care---RESOURCESPhotocurehttps://www.photocure.com/Global Society of Rare GU Tumors (GSRGT)https://www.gsrgt.com

En este episodio de BackTable Urology, Dr. José Silva da la bienvenida a su colega de residencia, el Dr. Omar Soto, para profundizar en el viaje y los desafíos del Dr. Soto al establecer una práctica de urología reconstructiva en Puerto Rico después de su extensa capacitación y práctica en Detroit.---This podcast is supported by:Photocurehttps://www.photocure.com/---SYNPOSISLos doctores exploran las complejidades de navegar la atención urológica, la importancia de cumplir con el estándar de atención a pesar de las limitaciones sistémicas y el panorama en evolución de la urología reconstructiva y protésica. El Dr. Soto comparte anécdotas personales, el impacto de la pandemia de COVID-19 en su práctica y el papel crucial de la colaboración comunitaria y profesional en el avance de los servicios urológicos en Puerto Rico. El episodio destaca la dedicación necesaria para mejorar la calidad de vida del paciente y adaptarse a las nuevas tecnologías médicas.---TIMESTAMPS00:00 - Viaje a la Urología Reconstructiva08:32 - Decisión de Quedarse en Detroit13:31 - Regresando al Puerto Rico27:47 - Tratamientos Urológicos en América Latina30:18 - Equilibrio entre la Práctica Privada y las Necesidades de la Comunidad36:32 - Prácticas y Técnicas Quirúrgicas41:25 - La Importancia del Aprendizaje Continuo52:45 - Pensamientos Finales---RESOURCESPhotocurehttps://www.photocure.com/

Frustrated with stone retrieval after a long lithotripsy case? In this episode of the BackTable Urology Podcast, host Aditya Bagrodia, MD, and guest Roger Sur, MD, director of the Comprehensive Kidney Stone Center at UC San Diego Health, delve into the latest technological advancements in the treatment of kidney stones. The episode focuses on the CVAC (continuous vacuum aspiration and irrigation) device as a suction platform for endourologists.---This podcast is supported by:Photocurehttps://www.photocure.com/---SYNPOSISTheir conversation offers interesting historical detail on the evolution of kidney stone treatment, from open surgery to modern techniques including percutaneous nephrolithotomy, shockwave lithotripsy, and ureteroscopy. As one of the original visionaries behind CVAC, Dr. Sur highlights the development journey from lab experiments to FDA approval. The episode covers data on CVAC’s superiority in patient outcomes and stone-free rates compared to other technologies. Key insights from recent studies, such as the ASPIRE trial, underscore the benefits of CVAC in reducing postoperative events and stone regrowth. The conversation also explores practical aspects of integrating suction platforms into practices and looks ahead towards the potential for machine learning to refine these technologies.---TIMESTAMPS00:00 - Introduction04:29 - The Rise of Ureteroscopy10:38 - Development of Suction Devices12:22 - The CVAC Device: History and Functionality21:05 - Comparing Suction Device Systems31:34 - Looking Into the Data37:42 - Considerations for Real-World Practice---RESOURCESPhotocurehttps://www.photocure.com/