David Utz

David Utz

Disclosures:

Talks by David Utz

The Case for Standard Imaging

L. Michael Glodé, MD, FACP, Professor Emeritus of Medical Oncology and the former Robert Rifkin Chair for Prostate Cancer Research at the University of Colorado Cancer Center in Aurora, Colorado, presents the case for standard imaging over second-generation technology in urologic oncology. One compelling reason to consider standard imaging like bone scans is the extensive data that have culminated in criteria on when to order routine scans such as these. Advanced imaging currently lacks both the wealth of data and scanning criteria, leading to questions about the frequency of false positives and false negatives and whether radiologist training is consistent. Dr. Glodé observes that we understand the limitations of conventional imaging, adding that there is insufficient data to make any such determination about the accuracy of second-generation scans. Since trials studying second-generation anti-androgens over the last few years have employed conventional imaging, Dr. Glodé suggests the more sensitive second-generation imaging could potentially deny patients with now-visible metastases access to some drugs based on eligibility criteria. The cost of newer imaging techniques is also prohibitive, especially if they do not replace current scans or change approaches to treatment. He concludes that the level 1 evidence on treatment of non-metastatic castration-resistant prostate cancer using conventional scans weighed against the cost of second-generation scans and the potential for inconsistent application of newer technology suggest that doctors should better utilize current standard imaging.

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Innovation in the Treatment of Male Urinary Incontinence

Culley C. Carson III, MD, Emeritus Rhodes Distinguished Professor in the Department of Urology at the University of North Carolina School of Medicine, discusses innovations in the treatment of male urinary incontinence. He outlines different treatments and their various pros and cons, including some cutting-edge technology that is not yet available in the US. He also goes over innovations, which still need to be made in order to further improve certain technologies like the artificial urinary sphincter. He highlights how important it is to come up with a more cost-effective model because, currently, artificial urinary sphincters are extremely expensive. There are also several significant causes of revision surgery for artificial urinary sphincters, demonstrating the need for further innovation. Dr. Carson also emphasizes the importance of customizing the pumps to individual patients, and goes over current research intended to improve patient outcomes.

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TMPRSS2, ACE 2, and the Potential Role of 5ARIs and GNRH Analogues in Inhibiting COVID-19 Infection

L. Michael Glodé, MD, FACP, Professor Emeritus at the University of Colorado Cancer Center and a medical oncologist at the Shaw Regional Cancer Center in Edwards, Colorado, discusses the mechanism of action of the TMPRSS2 and ACE2 pathways, and their relationship to the host-cell entry of COVID-19. He goes on to discuss a clinical trial using the serine protease inhibitor Camostat, noting how 5ARIs and GNRH analogues could act as a target for prevention and possible treatment of COVID-19. He also discusses the results of an Italian observational study which demonstrated how prostate cancer patients receiving ADT appear to be partially protected from COVID-19 infection.

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New Paradigm for the Treatment of Peyronie’s Disease

Culley C. Carson III, MD, Professor Emeritus at the University of North Carolina School of Medicine, reviews the history of treatment options for Peyronie’s Disease. He then compares clinical results of oral therapies, injection techniques, shock wave therapy, and penile prosthesis. Since first being developed, the efficacy of several of these protocols has improved and patients have experienced a reduction in curvature. Patients with Peyronie’s Disease often report significant negative emotional toll as a result of the condition, and new advances in treatment, such as the combination of drug and lengthening device that improves penile angulation can also improve depression and emotional problems.

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Next Generation Sequencing + PCR: The Key to Clearing Chronic Urological Infections

Rick Martin, CEO of MicroGen DX, discusses how his company is working to better detect microbes. He outlines their use of Next Generation Sequencing (NGS) which is faster, cheaper, more accurate, and allows the casting of a broader net in identifying microbe species than previously used tests. Patients with rare and hard to treat UTI infections particularly benefit from this type of testing. This is because bacteria adaption can result in culture ID evasion making these types of tests ineffective, but NGS tests DNA so this issue is not a problem. Martin emphasizes that the real strength of NGS is its database of sequence codes, which to date had more than 50,000 more than any other company or academic center.

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