Michael A. Gorin, MD

Michael A. Gorin, MD

Icahn School of Medicine at Mount Sinai

New York, New York

Dr. Gorin is an Associate Professor of Urology in the Milton and Carroll Petrie Department of Urology at the Icahn School of Medicine at Mount Sinai. Dr. Gorin attended college at the University of Michigan, earning a Bachelor of Science in Cellular and Molecular Biology. He then attended medical school at the University of Miami Leonard M. Miller School of Medicine, where he graduated as an inductee to the Alpha Omega Alpha Honor Medical Society. Following medical school, Dr. Gorin completed a general surgery internship, urology residency, and fellowship in endoscopic and minimally invasive urology at the James Buchanan Brady Urological Institute at Johns Hopkins University School of Medicine. Dr. Gorin is an internationally recognized expert on the use of molecular imaging techniques in the diagnosis and management of urologic malignancies. He is also widely recognized for his work developing novel methods for performing MRI-guided transperineal prostate biopsy and focal ablative treatments for prostate cancer. As a fellowship-trained endourologist, Dr. Gorin’s clinical practice primarily focuses on caring for patients with kidney stones, lower urinary tract symptoms, and prostate cancer. Dr. Gorin has published over 300 articles in peer-reviewed journals with collaborators from around the world. Additionally, he has contributed to multiple medical textbooks, including chapters in Campbell-Walsh-Wein Urology, The 5-Minute Urology Consult, and Gray’s Anatomy. In July 2022, Dr. Gorin was selected to serve as Editor-in-Chief of BJUI Compass, the open-access companion journal to the BJU International. Dr. Gorin also serves on the editorial boards of several other journals, including UROLOGY (the Gold Journal), Urologic Oncology: Seminars and Original Investigations, and the World Journal of Urology. Dr. Gorin has received numerous honors and awards for his scholarly work, including the Drs. Carl and Barbara Alving Endowed Award for Outstanding Biomedical Research from the University of Miami Miller School of Medicine and the William F. Rienhoff, Jr., M.D. Scholar Award from Johns Hopkins University School of Medicine.

Disclosures:

Dr. Gorin is Director of Medical Affairs for Perineologic.

Talks by Michael A. Gorin, MD

Focal Cryoablation

Focal Cryoablation

Posted by | Mar 2024

Michael A. Gorin, MD, discusses the value of focal cryoablation as a treatment option for prostate cancer in modern practice. He begins by providing a brief overview of negative patient outcomes after whole-gland treatment, and the benefits of subtotal gland treatments in the form of focal ablation therapies like cryoablation and High Intensity Focused Ultrasound (HIFU) therapy.

Dr. Gorin notes that HIFU and cryoablation are the two most commonly used and studied modalities for prostate cancer treatment. He discusses the benefits and weaknesses of focal HIFU, with particular focus on the possibility of incomplete cancer treatment, and compares them to those of focal cryoablation.

Dr. Gorin presents the elements of focal cryoablation which reduce the risk of incomplete treatment. He presents current guidelines and devices for performing focal cryoablation which protect the patient against side effects, like urethral sloughing, which had been previously associated with cryotherapy.

Dr. Gorin concludes by demonstrating the long-term success rate for patients treated using focal cryoablation. He compares the QOL outcomes of focal cryoablation to those of HIFU, and presents a recording of a real focal cryoablation procedure.

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Transperineal Fusion Biopsy

Transperineal Fusion Biopsy

Posted by | Oct 2023

Michael A. Gorin, MD, discusses transperineal fusion biopsy as a viable alternative to transrectal prostate biopsy and its complications. He emphasizes the gravity of the risk of infection, given the large number of prostate biopsies performed.

Dr. Gorin then displays American Urological Association (AUA) recommendations for infection avoidance, highlighting the strategy of transperineal biopsy. He explains that the European Association of Urology (EAU) recommends transperineal biopsy as the first choice for infection avoidance, citing data from a meta-analysis that show a decrease in complications with transperineal biopsies versus transrectal biopsies by more than half.

Further, he shares data showing improved detection of anterior tumors with transperineal biopsy and explains the positioning of the biopsy cores in transperineal biopsy is superior to that of transrectal biopsy. Dr. Gorin shares further data illustrating improved cancer detection with transperineal biopsy before turning to methods of performing transperineal prostate biopsy. 

Dr. Gorin addresses magnetic resonance imaging (MRI) targeting, explaining that as of 2020, the AUA endorses the use of pre-biopsy MRI. He displays data showing improved cancer detection with MRI-targeted biopsy and addresses cognitive fusion and explains that a lack of mapping cores is a drawback but explains that today, there are many options for transperineal MRI/transrectal ultrasound (TRUS) fusion prostate biopsy that include grid, mini-grid, and freehand elements.

Dr. Gorin concludes that transrectal prostate biopsy carries a significant risk of infectious complications and transperineal prostate biopsy reduces these risks and can be performed under local anesthesia. Additionally, multiple systems are available to perform transperineal prostate biopsy with TRUS/MRI fusion.

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Freehand Transperineal Prostate Biopsy Under Local Anesthesia

Freehand Transperineal Prostate Biopsy Under Local Anesthesia

Posted by | May 2021

Michael A. Gorin, MD, a urologist with Urology Associates of Cumberland, Maryland, explains the benefits of transperineal prostate biopsy compared to the transrectal approach for prostate cancer patients. First, he discusses the complications of transrectal biopsy, specifically infection risk, and demonstrates how the transperineal approach can decrease this risk without contributing to antibiotic resistance. He then explains how transperineal biopsy aids in improved detection and cancer upgrading. Dr. Gorin goes on to review transperineal biopsy methods, including the use of the Precisionpoint Transperineal access system. Finally, he summarizes block techniques and biopsy templates for freehand transperineal prostate biopsy under local anesthesia in the outpatient setting.

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In My Opinion: Biomarkers for the Diagnosis of Prostate Cancer

In My Opinion: Biomarkers for the Diagnosis of Prostate Cancer

Posted by | Dec 2020

Michael A. Gorin, MD, discusses biomarkers for diagnosing prostate cancer, including PSA, mpMRI, and serum and urine tests. He gives an overview of the history of prostate specific antigen (PSA), emphasizing that PSA screening is beneficial even as he acknowledges that PSA’s high sensitivity and low specificity result in many unnecessary biopsies. There are now many serum and urine biomarker tests that can help provide more specificity, including 4KScore, Prostate Health Index, SelectMDx, and ExoDx Prostate IntelliScore (EPI), all of which are endorsed by the NCCN Guidelines. Dr. Gorin notes that, when price is considered, SelectMDx and EPI outperform the other tests. Dr. Gorin concludes the presentation by discussing how multiparametric MRI should be used in prostate cancer diagnosis, noting that while there is little official guidance on this yet, he uses it in his own practice if a patient has a PSA ≥3 and receives an abnormal result from a serum or urine biomarker test.

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Crossing the Divide from Transrectal to Transperineal Biopsy

Crossing the Divide from Transrectal to Transperineal Biopsy

Posted by | Jun 2020

Michael A. Gorin, MD, a urologist at Urology Associates of Cumberland, Maryland, and Director of Medical Affairs for Perineologic, discusses the benefits of transperineal prostate biopsy over transrectal biopsy. He notes that transrectal prostate biopsy leads to infections in 5-7% of patients, and argues that transperineal biopsy is the best alternative for avoiding infection. Dr. Gorin acknowledges that the use of a grid-stepper unit for performing transperineal biopsy can be uncomfortable for patients, but suggests that new technology like the PrecisionPoint™ Transperineal Access System solves many of these issues. The presentation is followed by a Q&A in which Dr. Gorin discusses the importance of new coding for transperineal biopsy and the potential of variable length needles.

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