BackTable Urology

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.---SHOW NOTES00:00 - Introduction02:01 - The Impact of BPH on Patients05:57 - The Importance of Bladder Health10:38 - The Five Stages of Bladder Health23:00 - The Role of Primary Care Physicians in BPH Treatment26:03 - The Role of Medications in Treating BPH34:06 - The Role of Urologists in BPH Treatment39:07 - The Importance of Personalized Therapy in BPH Treatment44:17 - The Man vs. Prostate Initiative---RESOURCESDr. Wayne Kuang on LinkedInhttps://www.linkedin.com/in/wayne-kuang-md/Man vs. Prostatehttps://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.---SHOW NOTES00:00 - Introduction05:53 - The Role of Urologists in Women’s Sexual Health07:18 - The Importance of Communication in Addressing Sexual Dysfunction10:23 - The Role of the Clitoris in Female Orgasm19:52 - Understanding the Hormones Behind Female Sexual Desire25:32 - The Misconceptions and Gender Bias Surrounding Hormones26:04 - The Role of Testosterone in Menopause and Sexual Desire30:02 - The Challenges of Commercially Available Testosterone Products32:52 - Non-Hormonal Treatments for Low Libido42:41 - The Importance of Referring to Sex Therapists and Other Resources---RESOURCESDr. Kelly Casperson’s Websitehttps://kellycaspersonmd.com/You Are Not Broken Podcasthttps://kellycaspersonmd.com/you-are-not-broken-podcast/“You Are Not Broken” by Kelly Caspersonhttps://kellycaspersonmd.com/you-are-not-broken-book/“Magnificent Sex” by Peggy Kleinplatzhttps://www.amazon.com/Magnificent-Sex-Lessons-Extraordinary-Lovers/dp/0367181371American Association of Sexuality Educators, Counselors, and Therapistshttps://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.---SHOW NOTES00:00 - Introduction02:06 - Incidence and Risk Factors of Kidney Stones in Pregnancy03:29 - Physiological Changes and Stone Formation in Pregnancy07:04 - Diagnosing Kidney Stones in Pregnancy13:08 - Expectant Management vs. Intervention14:41 - Managing Pain and Nausea in Pregnant Patients with Kidney Stones17:13 - Decompression Methods for Kidney Stones in Pregnancy23:13 - Ureteroscopy as a Preferred Intervention26:05 - Case Description from Dr. Desai30:04 - Considerations for Ureteroscopy in Pregnant Patients31:14 - Preventing Kidney Stones in Pregnancy---RESOURCESLyon, 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.2023.09.023Thongprayoon, 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.---SHOW NOTES00:00 - Introduction01:15 - Reflections on Urology Education and Early Career Experiences04:08 - The Evolution of Learning and Engagement in Medical Training07:55 - Transitioning from Medical School to Residency08:34 - The Creation of the Intern Academy for the American Urological Association14:24 - The Impact of COVID-19 on Virtual Learning16:12 - The Role of Residents in Virtual Learning19:24 - The Future of Virtual Learning and Education20:00 - The Role of Innovation and Adaptability in Education23:07 - The Role of Residents in Shaping Their Own Learning42:28 - The Future of Education in Urology---RESOURCESAUA Intern Academyhttps://auau.auanet.org/content/intern-academy-2023AUA EMPIRE Lecture Serieshttps://nyaua.com/empire/UCSF Urology Collaborative Online Virtual Didactics (COViD) Lecture Serieshttps://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.---EARN CMEReflect on how this Podcast applies to your day-to-day and earn free AMA PRA Category 1 CMEs: https://earnc.me/2P5fzK---SHOW NOTES00:00 - Introduction02:13 - Understanding UTIs: Definitions, Symptoms, and Prevalence04:39 - Recurrent UTIs: Definitions, Causes, and Treatment Challenges12:00 - Understanding Asymptomatic Bacteriuria15:00 - Cystitis vs. Pyelonephritis vs. Urosepsis20:57 - Antimicrobial Resistance and Antibiotic Stewardship24:36 - Treatment Guidelines for UTIs31:13 - Self-start Antibiotic Therapy for UTIs34:37 - Preventing UTIs: Hydration, Lifestyle Factors, and Bowel Health38:33 - The Connection Between Vaginal Health and UTIs42:40 - The Role of Supplements in UTI Prevention: D-Mannose and Cranberry, and Methenamine Hippurate57:18 - Identification and Treatment of UTIs in Patients with Indwelling Catheters01:00:04 - The Role of Gentamicin Bladder Installations in UTI Prevention01:04:27 - The Impact of Diabetes Medications on UTIs---RESOURCESAUA Guidelines for UTI Treatment:https://www.auanet.org/guidelines-and-quality/guidelines/recurrent-uti

Dr. Padraic O'Malley, a urologic oncologist from the University of Florida Health, dives deep into upper tract urothelial carcinoma diagnosis and treatment. He discusses innovative approaches like tumor ablation and the role of neoadjuvant chemotherapy. The conversation touches on the significance of Lynch syndrome, updated staging guidelines, and the use of the Thulium laser. Dr. O'Malley emphasizes the need for risk stratification and standardized reporting to enhance patient management and improve treatment outcomes.

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.---SHOW NOTES00:00 - Introduction03:34 - Dr. Ali Kasraeian’s Journey with Aquablation07:31 - The Evolution of Aquablation Technique12:14 - Criteria for Aquablation Candidates29:59 - Starting Out with Aquablation: Tips and Tricks33:24 - Preserving Ejaculatory Function: Patient Discussions and Planning35:08 - Post-Procedure Follow-ups and Revisions49:42 - Billing and Insurance Considerations for Aquablation54:36 - Final Thoughts on Aquablation and Urology Innovation---RESOURCESKasraeian Urologyhttps://kasraeianurology.com/Aquablationhttps://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.---CHECK OUT OUR SPONSORVeracytehttps://www.veracyte.com/decipher---SHOW NOTES00:00 - Introduction07:29 - Learning to Read Prostate MRI09:43 - The Role of Radiologists and Grading Systems in Prostate Biopsies24:00 - Techniques in Prostate Biopsy31:16 - The Role of Antibiotics in Biopsy32:34 - The Debate Between Transperineal and Transrectal Biopsy40:36 - Post-Procedure Care and Follow-Up45:49 - The Future of Biopsy---RESOURCESDecipher Prostate Genomic Classifier by Veracyte:https://decipherbio.com/

In this episode of the Backtable Urology Podcast, host Dr. Suzette Sutherland (University of Washington) and Dr. Tamsin Greenwell (University College London Hospitals) discuss surgical treatments for incontinence and their comparative efficacies.They focus mainly on midurethral slings and a new urethral bulking agent called Bulkamid. They further analyze how conditions like product expectations, surgeon expertise, data availability, patient preferences, and financial costs influence the choice of procedure. Additionally, they discuss the impact of mesh-related complications and how they affected the usage of synthetic slings in the UK. Finally, they touch on the role of shared decision making in choosing treatment strategies.---EARN CMEReflect on how this Podcast applies to your day-to-day and earn free AMA PRA Category 1 CMEs: https://earnc.me/p4RNfi---SHOW NOTES00:00 - Introduction03:48 - Discussion on Midurethral Slings11:05 - The Mesh Controversy and Its Impact22:21 - Shared Decision Making in Treatment Options26:47 - The Role of Urethral Bulking Agents32:51 - Comparative Trial and EAU Guidelines42:12 - Conclusion and Closing Remarks---RESOURCESBulkamid Injectionshttps://bulkamid.com/en-US

In this week’s BackTable Podcast, guests Dr. Sarah Psutka and Dr. Rachel Rubin join host Dr. Aditya Bagrodia to discuss the importance of considering women’s sexual health in urologic oncology surgeries.The doctors go on to discuss how to ensure proper patient education and setting realistic expectations about post-surgery recovery. Additionally, they highlight the need for open conversation about sexual health and the use of hormone therapies to improve menopause symptoms. Finally, they touch on the need for more research in women’s sexual health and the use of pelvic floor physical therapy.---EARN CMEReflect on how this Podcast applies to your day-to-day and earn free AMA PRA Category 1 CMEs: https://earnc.me/uYv0Hm---SHOW NOTES02:30 - The Importance of Open Conversations about Sexual Health03:55 - Addressing Sexual Health in Cancer Patients11:47 - The Role of Hormones in Women’s Health25:05 - The Renewed Interest in Gynecologic Organ Sparing29:39 - Importance of Risks and Oncologic Outcomes in Bladder Cancer Treatment35:56 - The Role of Pelvic Floor Physical Therapy in Bladder Cancer Recovery44:24 - The Role of Hormone Therapy in Bladder Cancer Recovery53:59 - Conclusion: The Future of Bladder Cancer Treatment---RESOURCESMark Cuban's Cost Plus Drug Company:https://costplusdrugs.com/