Raj S. Pruthi, MD, MHA, FACS

Raj S. Pruthi, MD, MHA, FACS

University of California, San Francisco

San Francisco, California

Dr. Pruthi is a Professor in the Department of Urology at the University of California, San Francisco. He previously served as chair of the Department of Urology at the University of North Carolina at Chapel Hill, where he was on faculty for nineteen years. Serving first as its Chief and then as its inaugural chair, he took the UNC Department of Urology from an unranked program to one of the best in the nation.

Dr. Pruthi was a member of the ABU/AUA Examination Committee and serves as an examiner for the Certifying Exam for the ABU. He is also on the Executive Committee for the Society of Academic Urology, as well as the Chair of the Advisory Council for Urology of the American College of Surgeons.

Dr. Pruthi helped to develop the American Urological Association’s Guidelines on the Management of Non-muscle Invasive Bladder Cancer. He also served on the Bladder Cancer Guidelines Committee of the International Consultation on Urological Diseases.

He is an elected member of the Urologic Research Society, the Society of Pelvic surgeons, the American Association of Genitourinary Surgeons, and the Clinical Society of Genitourinary Surgeons.

Dr. Pruthi is a graduate of Stanford University, where he double majored in economics and in biology and became interested in health economics. He received his MD from Duke University School of Medicine. Following medical school, he completed his residency and post-graduate training at Stanford University. Most recently, he completed the executive MHA program at UNC.

Dr. Pruthi’s area of clinical expertise is urologic oncology, including prostate and bladder cancer. He is committed to a multi-disciplinary, holistic, and patient-centric approach to care. Dr. Pruthi is a recognized expert in minimally-invasive, robotic surgery for prostate and bladder cancer. He incorporates nerve-sparing techniques to improve recovery and long-term quality of life. He is committed to compassionate, comprehensive, innovative, and patient-centered care that balances long-term survivorship with a high-level of functioning and an optimal quality of life.

Dr. Pruthi’s research is focused on surgical innovation, care pathways, and quality of care. Most recently, this primary research has addressed topics related to health economics, including characterizing the urologic workforce, understanding compensation, productivity, and burnout.

Dr. Pruthi has been tackling health economic issues to better understand the drivers of faculty productivity, compensation, and burnout. He has explored urologic workforce, projections, gender disparity issues, factors impacting career earnings, predictors of dissatisfaction and burnout, and understanding the impact of workflow initiatives, including the implementation of scribes. His work in these areas has been recognized nationally and has had an impact on the understanding of the practice of urology.

Talks by Raj S. Pruthi, MD, MHA, FACS

Obstacles to Optimal Outcomes for Patients Undergoing Radical Cystectomy

Obstacles to Optimal Outcomes for Patients Undergoing Radical Cystectomy

Posted by | Aug 2024

Dr. Raj S. Pruthi discusses the obstacles to achieving optimal outcomes for patients undergoing radical cystectomy. He meticulously analyzes the multifaceted challenges encountered in the preoperative, intraoperative, and postoperative phases of radical cystectomy, a complex surgical procedure primarily performed for muscle-invasive bladder cancer.

Preoperative factors that can impede optimal outcomes, including patient comorbidities, nutritional status, and the importance of thorough preoperative assessment and optimization. He emphasizes the role of prehabilitation in enhancing patient readiness for surgery.

During the intraoperative phase, Dr. Pruthi highlights the technical intricacies of radical cystectomy, stressing the importance of surgical expertise and meticulous technique in minimizing perioperative complications. He discusses the role of minimally invasive techniques, such as robotic-assisted surgery, in potentially reducing blood loss, shortening hospital stays, and enhancing recovery.

Postoperatively, Dr. Pruthi identifies key factors that influence recovery and long-term outcomes. He underscores the significance of effective pain management, early mobilization, and comprehensive postoperative care in mitigating complications. Dr. Pruthi also discusses the challenges related to urinary diversion, including the management of neobladder and ileal conduit complications, and the impact of these diversions on patients’ quality of life.

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Obstacles to Optimal Outcomes for Patients Undergoing Radical Cystectomy

Obstacles to Optimal Outcomes for Patients Undergoing Radical Cystectomy

Posted by | Feb 2023

Dr. Raj S. Pruthi discusses the obstacles to achieving optimal outcomes for patients undergoing radical cystectomy. He meticulously analyzes the multifaceted challenges encountered in the preoperative, intraoperative, and postoperative phases of radical cystectomy, a complex surgical procedure primarily performed for muscle-invasive bladder cancer.

Preoperative factors that can impede optimal outcomes, including patient comorbidities, nutritional status, and the importance of thorough preoperative assessment and optimization. He emphasizes the role of prehabilitation in enhancing patient readiness for surgery.

During the intraoperative phase, Dr. Pruthi highlights the technical intricacies of radical cystectomy, stressing the importance of surgical expertise and meticulous technique in minimizing perioperative complications. He discusses the role of minimally invasive techniques, such as robotic-assisted surgery, in potentially reducing blood loss, shortening hospital stays, and enhancing recovery.

Postoperatively, Dr. Pruthi identifies key factors that influence recovery and long-term outcomes. He underscores the significance of effective pain management, early mobilization, and comprehensive postoperative care in mitigating complications. Dr. Pruthi also discusses the challenges related to urinary diversion, including the management of neobladder and ileal conduit complications, and the impact of these diversions on patients’ quality of life.

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Non-Muscle Invasive Bladder Cancer: Guidelines-Based Approach

Posted by | May 2022

Raj S. Pruthi, MD, MHA, FACS, Professor in the Department of Urology at the University of California, San Francisco, reviews the American Urological Association (AUA)-Society of Urologic Oncology (SUO) guidelines on diagnosing and treating non-muscle invasive bladder cancer (NMIBC). He begins with some statistics, relating that in 2017, there were approximately 79,000 new cases of bladder cancer, 16,800 deaths, and greater than 500,000 survivors. Dr. Pruthi observes that bladder cancer is a disease of older individuals, and he predicts that the population of bladder cancer patients will increase as the population ages. He then highlights key facts about NMIBC, explaining that most patients recur, some progress, and the ability to predict recurrence and progression is based on patient-specific disease characteristics. Dr. Pruthi introduces the 2016 AUA/SUO guidelines, noting that the panel featured a patient advocate. He goes over the guidelines point by point, starting with diagnosis. Dr. Pruthi underscores the importance of performing a complete visual transurethral resection of bladder tumor (TURBT) at initial diagnosis, explaining that incomplete TURBT is a contributing factor to early recurrences. He notes that risk calculators for NMIBC are limited by lack of applicability to current populations, and also that no study has evaluated the effectiveness of urinary biomarkers to decrease mortality or improve outcomes compared with standard diagnostic methods. When discussing guidelines around treatment, Dr. Pruthi emphasizes the importance of re-resecting T1 disease since understaging occurs in about 30% of cases and patients with residual T1 (after presumed complete resection) have up to an 80% chance of progression. He also discusses guidelines around BCG administration and BCG relapse. Dr. Pruthi then looks at cystectomy, arguing that waiting until progression to muscle invasion may prove fatal. He concludes by discussing guidelines around follow up.

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