Ryan P. Terlecki, MD, FACS

Ryan P. Terlecki, MD, FACS

Atrium Health Wake Forest Baptist

Winston-Salem, North Carolina

Ryan P. Terlecki, MD, FACS, is a reconstructive urologist for Atrium Health Wake Forest Baptist Medical Center, an academic Level 1 trauma center in Winston-Salem, North Carolina. Dr. Terlecki holds the rank of Professor and the title of Vice Chair of Research for the Department of Urology. In addition, Dr. Terlecki is Director of the Men’s Health Clinic, Director of Medical Student Education, and Fellowship Director for Reconstructive Urology. He holds a joint appointment in the Department of Obstetrics and Gynecology.

Dr. Terlecki earned his medical degree from Wayne State University School of Medicine and completed residency in general surgery and urology at Detroit Medical Center. Following his residency, Dr. Terlecki completed two separate fellowships in reconstructive surgery. He completed a fellowship at the University of Colorado’s Denver School of Medicine and at UT Southwestern Medical Center in Dallas, Texas.

Dr. Terlecki’s publications cover multiple areas of trauma and reconstruction and his research is focused primarily on models of wound healing and regeneration in the lower genitourinary system. Dr. Terlecki’s areas of expertise include urethral stricture disease, male sexual dysfunction, male incontinence, Peyronie’s disease, chronic testicular pain, hypogonadism, and infertility. He is a member of the Society of Genitourinary Reconstructive Surgeons (GURS), a member of the American Urological Association (AUA), and past president of the North Carolina Urological Association (NCUA).

Talks by Ryan P. Terlecki, MD, FACS

Anterior Urethroplasty – Bulbar (A Primer For Part-Time Plumbers)

Anterior Urethroplasty – Bulbar (A Primer For Part-Time Plumbers)

Posted by | Jan 2025

Ryan P. Terlecki, MD, FACS, emphasizes key elements for success in urethral surgery, focusing on preoperative planning, technical precision, and effective patient management.

A central message in this 11-minute presentation is to set realistic patient expectations while acknowledging that success is never guaranteed even with advanced surgical techniques. Terlecki compares conservative endoscopic management with surgical options, emphasizing that surgical planning requires careful consideration of anatomy, patient history, and the specifics of the stricture.

Dr. Terlecki stresses meticulous preparation, including the importance of standard protocols. Preoperative collaboration with anesthesia and other specialties is encouraged, along with video primers to prepare team members. Intraoperative decisions, such as when to transition from endoscopic to open surgery, are highlighted as critical moments requiring flexibility. He stresses that surgeons should stay calm under pressure and stick to their plan, even when faced with unexpected challenges.

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Simplified Management of Male Genital Pain

Simplified Management of Male Genital Pain

Posted by | Aug 2024

Ryan P. Terlecki, MD, FACS, presents a focused and practical approach to managing male genital pain, emphasizing simplification in both diagnosis and treatment. In this presentation, he stresses the importance of thorough patient history and physical examination and introduces a streamlined diagnostic framework to identify the underlying causes of genital pain.

Dr. Terlecki advocates for an intake questionnaire, physical exam, and lab work, focusing on symptom relief and quality of life as primary treatment goals. He reviews various medical causes of symptoms and possible treatment solutions, including referrals to other health practitioners, such as pain management specialists, orthopedists, or even alternative medicine providers. His insights provide a clear and actionable framework for urologists seeking to improve outcomes for patients suffering from this often debilitating condition.

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Avoiding the Problem Patient in Penile Prosthetic Surgery

Avoiding the Problem Patient in Penile Prosthetic Surgery

Posted by | Aug 2024

Ryan P. Terlecki, MD, FACS, provides physicians with tips for effective communication in prosthetic candidates, recognizing behaviors that might suggest patients have unrealistic expectations, and the best practices for assessing and counseling patients prior to prosthetic surgery.

While urologists familiar with this procedure commonly cite infection and erosion as the most troublesome issues in these patients, Dr. Terlecki argues that patient expectations are the hardest to manage. Oftentimes, patients will exhibit characteristics in the mnemonic CURSED Patient (Compulsive/obsessive, Unrealistic, Revision, Surgeon Shopping, Entitled, Denial, and Psychiatric). Preoperative counseling can help immensely in managing these patients’ expectations. Stressing that the goal of this procedure is not penile lengthening, but rather creating rigidity on demand; the device length is custom-fit to the patient’s anatomy; future lengthening is possible, but not guaranteed; and the truth behind common misconceptions can attribute to patient contentedness.

Planning in all stages of approaching these cases will set up physicians for success, mitigating backlash and pressure to make rash decisions from the patient. Starting with patient selection, it is imperative to judge surgery suitability, health status, relevant history, and body habitus carefully. In addition to these medical considerations, the role of the patient’s partner is a key factor in this decision. Scheduling confirmations on insurance preoperatively; ensuring all products, devices/instruments, and graft materials are available at the time of the surgery; and educating the operating room support staff on specifics in advance can alleviate stressors and complications during the procedure. Confidence in choice of device, surgical approach (penoscrotal vs infrapubic vs subcoronal), and reservoir positioning is also crucial to ensuring optimal outcomes.

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YouTube Surgeons – The Role of Video Learning in Urology

YouTube Surgeons – The Role of Video Learning in Urology

Posted by | Aug 2024

Ryan P. Terlecki, MD, FACS, explores current resources for lifelong learning and metrics for measuring success for urologic surgeons. He begins by reviewing the skills and technology-based challenges facing urologists today.

Dr. Terlecki explores the evolution of expectations and goals of medical education across generations. He reviews the history of surgical training from the Halsted Model to present day educational standards for continuous professional education, including the increasing ubiquity of video in daily practice.

Dr. Terlecki concludes by highlighting the benefits and dangers of using videos to train, provided that feedback from an expert source is incorporated in the training. He illustrates different models for trainees and established surgeons to improve their performance using a combination of expert insights and video analysis.

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Optilume for BPH – Considerations for Use

Optilume for BPH – Considerations for Use

Posted by | Jun 2024

Ryan P. Terlecki, MD, FACS, examines the use of Optilume, a novel drug-coated balloon technology, in treating benign prostatic hyperplasia (BPH), focusing on its efficacy, safety, and clinical considerations.

He begins by explaining the mechanism of action of Optilume and reviews clinical trial data demonstrating its effectiveness in improving urinary flow rates and reducing symptom severity in patients with BPH. He highlights key findings, such as significant improvements in International Prostate Symptom Score (IPSS) and quality of life metrics, underscoring the potential of Optilume as an alternative to traditional BPH treatments like pharmacotherapy and surgical interventions.
He discusses patient selection criteria, potential contraindications, and the need for thorough patient evaluation before opting for this treatment. Dr. Terlecki delves into the procedural aspects of Optilume use, including technical considerations for optimal deployment and strategies to minimize complications.
Furthermore, Dr. Terlecki explores the comparative advantages of Optilume over existing BPH treatments and considers the economic implications.

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