BackTable Urology

New FDA-approved therapies for BCG-refractory non-muscle invasive bladder cancer (NMIBC)–where do they fit in the treatment algorithm, and how do you administer them? This installment of the 2025 NMIBC Creator Weekend™ series features host Dr. Bogdana Schmidt, assistant professor of Urologic Oncology at the University of Utah, and leading urologic oncologists Dr. Mark Tyson from Mayo Clinic Arizona and Dr. Suzanne Merrill from Colorado Urology. --- This podcast is supported by:Ferring Pharmaceuticals --- SYNPOSIS The discussion delves into the newest treatment strategies and FDA-approved therapies for non-muscle invasive bladder cancer with an emphasis on BCG-refractory patients. They highlight their approaches to sequencing therapies, the real-world applicability of these treatments, and the impact of patient factors in clinical decision-making. The panel also explores emerging trials and innovative treatment mechanisms, emphasizing the importance of personalized care in oncology. --- TIMESTAMPS 00:00 - Introduction05:09 - Challenges and Strategies in Treatment10:55 - Bladder Sparing Therapies21:41 - Practical Tips for Therapy Administration30:39 - Challenges and Considerations in Reinduction37:05 - Clinical Trials and Future Directions44:11 - Counseling Patients on Treatment Options57:36 - Concluding Thoughts and Future Outlook --- RESOURCES CORE-008 Clinical Trial https://www.sciencedirect.com/science/article/abs/pii/S1078143924010147 Legend Clinical Trial:https://ascopubs.org/doi/10.1200/JCO.2025.43.5_suppl.802 CISTO Studyhttps://pubmed.ncbi.nlm.nih.gov/37980511/

When a patient is diagnosed with non-muscle invasive bladder cancer (NMIBC), how do you tailor the conversation and treatment plan to their individual needs (and fears)? In part two of the 2025 NMIBC Creator Weekend™ series, host Dr. Vignesh Packiam is joined by Dr. Sima Porten from UCSF and Dr. Patrick Hensley from the University of Kentucky to discuss patient-centered diagnostic and therapeutic approaches for non-muscle invasive bladder cancer. --- This podcast is supported by:Ferring Pharmaceuticals --- SYNPOSIS The conversation covers initial patient consultations, discussing diagnoses, personalized treatment options such as BCG, gemcitabine, clinical trials, and managing side effects. The experts emphasize the importance of clear communication, understanding patient preferences, and tailoring approaches to enhance the patient's quality of life. They also explore insights from recent studies like the CISTO trial and highlight novel research directions. --- TIMESTAMPS 00:00 - Introduction04:28 - Counseling Patients on Diagnostic Findings12:03 - Symptom Management and Patient Care19:30 - Post-Procedure Care and Counseling28:50 - Recovery After TURBT: Medications and Patient Care44:16 - The Impact of Radical Cystectomy on Quality of Life49:15 - Final Thoughts and Future Directions in Bladder Cancer Care --- RESOURCES NIMBUS Studyhttps://pubmed.ncbi.nlm.nih.gov/32446864/

For patients with ischemic priapism, time to treatment can mean the difference between recovery and long-term dysfunction. In this episode, Dr. Maia VanDyke (UT Southwestern Medical Center) joins host Dr. Juan Andino (UCLA Health) for a high-yield discussion on managing this urologic emergency, from early recognition to advanced surgical options.---SYNPOSISTogether, they cover diagnosis, patient demographics, and traditional versus advanced interventions, with special attention to the role of penoscrotal decompression in prolonged ischemic priapism. The conversation highlights surgical techniques, postoperative care strategies, and patient counseling, including the hard but essential discussions about long-term erectile dysfunction risk. Drs. Andino and VanDyke also emphasize the importance of collaboration, encouraging general urologists to adopt these approaches while leaning on colleagues and centers of excellence for complex cases.---TIMESTAMPS00:00 - Introduction02:18 - Understanding Priapism07:52 - Diagnosis and Initial Management16:51 - Advanced Management and Surgical Interventions28:21 - Patient Retention Challenges29:59 - Surgical Planning and Techniques37:29 - Post-Operative Care and Patient Rehabilitation44:13 - Future Directions in Research and Treatment51:28 - The Role of General Urology---RESOURCESDr. David Ralph article on use of MRI in management of priapismhttps://doi.org/10.1111/j.1464-410X.2010.09368.xDr. Tom Lue article on corporal aspirationhttps://doi.org/10.1038/nrurol.2009.50Arthur “Bud” Burnett article on corporal tunnelinghttps://doi.org/10.1016/j.juro.2012.08.245Allen “Al” Morey article on penoscrotal decompression erectile function outcomeshttps://doi.org/10.1111/bju.15127Survey on current management practices of ischemic priapismhttps://doi.org/10.1038/s41443-019-0120-4Risk factors, diagnosis, and long-term erectile dysfunction outcomes in priapismhttps://doi.org/10.1038/s41443-025-01076-9Video Journal of Sexual Medicine (VJSM) on Penoscrotal decompression: A better method for priapism managementhttps://www.vjsm.info/videos/all/penoscrotal-decompression-a-better-method-for-priapism-managementSurgical Management of Ischemic Priapism: what are the New Options? https://doi.org/10.1590/S1677-5538.IBJU.2024.0497The Impact of Immediate Salvage Surgery on Corporeal Length Preservationhttps://doi.org/10.1016/j.juro.2018.01.082

How are leading urologic oncologists using advanced biomarkers and artificial intelligence to refine the diagnosis and management of non-muscle invasive bladder cancer (NMIBC)? In the opening episode of our 2025 NMIBC Creator Weekend™ series, host Dr. Bogdana Schmidt engages in an insightful, in-studio discussion with Dr. Anne Schuckman and Dr. Piyush Agarwal about contemporary strategies and challenges in the diagnosis of non-muscle invasive bladder cancer. --- This podcast is supported by: Ferring Pharmaceuticals --- SYNPOSIS The doctors emphasize the importance of having an experienced cytopathologist and discuss the use of different biomarkers and imaging modalities in bladder cancer diagnosis. The conversation delves into risk stratification, patient management strategies, and the evolving role of technology and artificial intelligence in enhancing diagnostic accuracy. The experts also share their perspectives on future advancements and their potential impact on clinical practice. --- TIMESTAMPS 00:00 - Introduction04:05 - Surveillance and Follow-Up Strategies10:10 - Biomarkers in Bladder Cancer18:02 - Blue Light Cystoscopy and Patient Comfort30:56 - Risk Assessment and Counseling42:56 - Future of Bladder Cancer Diagnostics47:00 - Concluding Thoughts --- RESOURCES CxBladder Studyhttps://www.sciencedirect.com/science/article/pii/S1078143923000091 Lars Dyrsakjot Study on Tumor Markershttps://pmc.ncbi.nlm.nih.gov/articles/PMC7690647/ The Bridge Trialhttps://pmc.ncbi.nlm.nih.gov/articles/PMC10515442/

Kidney cancer management is evolving. How are experts adapting? In this installment of BackTable Tumor Board, Dr. Brandon Manley (Urologic Oncology, Moffitt Cancer Center), Dr. Raquibul Hannan (Radiation Oncology, UT Southwestern), and Dr. Rana McKay (Medical Oncology, UC San Diego) join guest host Mark Ball (Urologic Oncology, National Cancer Institute) to share their multidisciplinary perspectives on challenging, real-world kidney cancer cases. --- This podcast is supported by: Ferring Pharmaceuticals--- SYNPOSIS The conversation covers diagnostic dilemmas, navigating the treatment options of surgery, systemic therapy, and radiation, and the importance of a multidisciplinary approach. Through detailed case reviews, the panel highlights practical pearls, emerging clinical trials, and collaborative approaches that exemplify modern kidney cancer care. --- TIMESTAMPS 0:00 - Introduction02:20 - Case 1 (Incidental Renal Mass)16:52 - Case 2 (Bilateral Renal Masses)37:22 - Case 3 (Locally Advanced Renal Mass)56:34 - Case 4 (Symptomatic, Metastatic Disease)01:14:00 - Final Takeaways

What is the role of the American Medical Association (AMA) in 2025 and how does it affect your practice? Join Dr. Ruchika Talwar in this insightful episode of the BackTable Urology podcast as she converses with Dr. Willie Underwood, a urologic oncologist and president-elect of the American Medical Association.---SYNPOSISDr. Underwood shares his journey into medical advocacy, the pivotal role of the AMA in advancing healthcare, and the importance of physician engagement in legislative processes. The discussion highlights key issues such as Medicare and Medicaid reforms, physician burnout, and the implementation of technology in healthcare. This episode is a must-listen for anyone in the medical field who wants to understand the significance of collective efforts in improving patient care and the future of healthcare. Stay tuned to learn how you can make a difference in organized medicine.---TIMESTAMPS00:00 - Introduction04:01 - The Role of the AMA08:33 - AMA's Legislative Actions14:40 - Engaging with the AMA17:57 - Balancing Diverse Physician Values30:38 - Importance of Physician Participation and PACs40:13 - Final Thoughts and Call to Action

Kids with kidney stones–how do you treat them, prevent recurrence, and provide effective longitudinal care? In this episode of BackTable Urology, Dr. Nicholas Kavoussi and Dr. Scott Sparks join co-hosts Dr. Arthi Hannallah and Dr. Niccolo Passoni for a high-yield discussion on pediatric and adolescent stone disease.---SYNPOSISTogether, they explore best practices for managing complex kidney stones in children, surgical techniques like supine PCNL, and the use of novel technologies such as thulium lasers and suction sheaths. The doctors also address strategies to reduce procedural trauma, manage pain, and minimize infection risk. Beyond the OR, they emphasize the psychological toll of recurrent interventions and the importance of thoughtful counseling, patient education, and a multidisciplinary approach to help patients successfully transition into adult care.---TIMESTAMPS00:00 - Introduction03:06 - Managing Complex Cases Without PCNL10:25 - Approach to Supine PCNL18:21 - Balancing Surgical Risks24:21 - Shared Decision-Making and Setting Expectations33:16 - Minimizing Postoperative Pain37:47 - Innovations in Technology55:55 - Transitioning from Pediatric to Adult Urology

What does it take to build a successful reconstructive urology practice while balancing the worlds of academia and private practice? In this episode of BackTable Urology, reconstructive urologist Dr. Lucas Wiegand joins host Dr. Jose Silva to explore his career journey from training at the University of South Florida and fellowship at Washington University, to establishing his practice at Orlando Health.---SYNPOSISDr. Wiegand shares insights on the evolution of robotic surgery, from laparoscopic to single-port systems, and how these advances have improved patient recovery and expanded the possibilities for outpatient care.The conversation also dives into the shifting boundaries between academic and private practice, the growing demand for reconstructive urology, and practical advice for residents considering fellowship training. Dr. Wiegand emphasizes the enduring value of subspecialty education, the increasing recognition (and even financial premium) placed on fellowship training, and the importance of continuous learning, collaboration, and patient-centered care.---TIMESTAMPS00:00 - Introduction03:12 - Robotic Surgery in Urology04:08 - Choosing a Fellowship07:18 - Single Port Robotics11:36 - Open vs. Robotic Surgery24:33 - The Growing Demand for Urologic Care in Florida27:53 - Building a Reconstructive Urology Practice32:48 - The Role of Fellowship in Reconstructive Urology36:46 - Staying Current and Engaged Post-Residency42:19 - Final Thoughts and Contact Information

Could ongoing trials redefine the management of oligometastatic and advanced prostate cancer? In this installment of BackTable Tumor Board, leading prostate cancer experts Dr. Neeraj Agarwal, a medical oncologist from the University of Utah, and Dr. Tyler Seibert, a radiation oncologist from UC San Diego, join host Dr. Parth Modi to share their insights on the latest clinical trials and persistent challenges in managing prostate cancer. --- This podcast is supported by:Ferring Pharmaceuticals --- SYNPOSIS The multidisciplinary discussion addresses clinical decision-making in active surveillance versus early intervention, the role of PSMA PET imaging in detection and treatment planning, and evolving strategies for metastatic and castration-resistant disease. They also evaluate the therapeutic potential of alpha emitters and radioligand therapies, consider the evidence behind treatment intensification and de-intensification, and explore how these approaches can be individualized to optimize patient outcomes. --- TIMESTAMPS 0:00 - Introduction1:48 - Active Surveillance in Low-Risk Prostate Cancer7:08 - Molecular Testing and Risk Stratification8:28 - Radiation Therapy Approaches20:16 - PSA Recurrence and PSMA PET Scans32:40 - The Role of ADT37:15 - PSMA PET Scans40:58 - Genetic Testing in High-Risk and Metastatic Prostate Cancer46:54 - Treatment Intensification vs. De-Intensification Trials55:59 - Castration-Resistant Prostate Cancer

When it comes to menopause care, the facts are better than the fears. In this Urology/OBGYN crossover episode of the BackTable Podcast, host Dr. Suzette Sutherland welcomes renowned urologist Dr. Rachel Rubin to explore various aspects of sexual health and hormone replacement therapy (HRT), particularly for menopausal women. ---SYNPOSISDr. Rachel Rubin shares her career journey, expertise in sexual health, and the critical role of hormone replacement therapy (HRT) in managing menopause. She addresses common challenges and misconceptions, particularly around estrogen use, by demystifying the Women’s Health Initiative studies and emphasizing the proven safety and benefits of systemic and vaginal HRT. Dr. Rubin offers practical guidance on prescribing estrogen, progesterone, testosterone, and DHEA, while highlighting her advocacy to remove outdated FDA black box warnings on vaginal estrogen. Through personal anecdotes and professional insights, she empowers practitioners with evidence-based strategies and underscores the importance of education and research in advancing women’s health.---TIMESTAMPS00:00 - Introduction03:41 - Challenges in Menopause Medicine07:21 - Misconceptions and Risks of HRT15:35 - Understanding Bioidentical Hormones18:48 - WHI Studies and Their Impact23:21 - Practical Guide to Prescribing HRT33:47 - Understanding Estrogen Levels and Risks36:04 - Debating Gels vs. Patches37:51 - Concerns with Compounded Products and Pellets38:50 - Patient Education and Meeting Them Where They Are42:12 - Progesterone Benefits and Sensitivities46:38 - Testosterone Therapy for Women51:36 - The Importance of Lab Tests55:39 - DHEA and Vaginal Health57:14 - Advocacy for Accurate Hormone Therapy Information01:00:05 - Conclusion and Final Thoughts---RESOURCESThe Peter Attia Drive episode with Dr. Rachel Rubin:https://peterattiamd.com/rachelrubin/ FDA Expert Panel on Menopause and Hormone Replacement Therapy for Women:https://www.youtube.com/live/_2ZRlOivC5M?si=-Xynb_BmWz2sWf4mDr. Rachel Rubin’s Hormone Therapy for Early Adopters Course:https://rachelrubinmd.thinkific.com/courses/MHTCME