Fernando J. Kim, MD, MBA, FACS, focuses on innovations and emerging technologies in functional urology. In this 14-minute presentation, he highlights recent advancements in areas like 3D printing, robotics, and telemedicine, emphasizing their potential to transform clinical practice.
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Brian J. Flynn, MD, discusses bladder neck contracture, its frequency, causes, and management options. This 10-minute presentation begins with an overview of bladder neck stenosis terminology, emphasizing its iatrogenic nature primarily resulting from surgical interventions on the prostate, such as transurethral procedures. Flynn highlights the importance of understanding patient history and conducting thorough evaluations, including uroflow studies, post-void residual measurements, and cystoscopy.
Different surgical techniques for reconstruction are covered, with photographs, videos, and illustrations aiding the discussion. Dr. Flynn also reviews preventive measures to avoid subsequent complications, emphasizing precise surgical techniques, including careful incision placements and energy application to minimize damage. Flynn shares personal experiences with cases, highlighting the importance of accurate diagnosis and treatment planning.
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Brian J. Flynn, MD, delves into the categorization and management of devices for male stress incontinence, focusing on both passive and active options.
In this 20-minute presentation, he discusses passive devices, such as the advanced sling and newer adjustable slings like ARGUS and ATOMS, which offer various solutions for managing low-to-moderate leakage in non-radiated patients. He also introduces active devices, particularly the artificial urinary sphincter (AUS), but cautions that cognitive and dexterity issues often develop over time in long-term users. This has spurred interest in creating adjustable AUS devices that reduce the need for manual operation, potentially leading to fewer complications like urethral erosion.
Dr. Flynn then transitions to sharing a ProAct implantation technique, providing images and videos of procedures. He gives step-by-step instructions, beginning with optimal operating room setup. To provide the best learning opportunity, he also shares images of poor device placement and discusses correction, stressing the importance of learning from the mistakes of others.
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Brian J. Flynn, MD, discusses the opioid crisis in the United States, and the role of urologists in taking action against this growing problem. Dr. Flynn begins by highlighting factors that contribute to the opioid epidemic’s growth, with a specific focus on Colorado. He drives home the urgency behind addressing this epidemic by emphasizing the ubiquity of opioid related deaths across all ages, genders and socio-economic strata.
Dr. Flynn argues that the problem lies specifically in prescribing opioids in far excess post-surgery, as most patients take only a fraction of what is prescribed, with extra pills then being distributed to, and consumed by, non-patients. He underlines the correlation between the number of opioids prescribed and the number of opioid related deaths.
Dr. Flynn examines the role of Urology in prescribing opioids relative to other fields of medicine in prescribing opioids, finding that urologists land somewhere in the middle in terms of prescribing opioids to patients. He looks at different urology surgeries and recommends alternatives to opioids to address patients post-op pain.
Dr. Flynn concludes with a review of the ALTO project from Colorado that aims to offer alternatives to fentanyl whenever possible. He provides practical solutions to address the opioid epidemic at the physician level, but recognizes that changes at multiple levels of practice and legislature are needed to address it effectively on a national scale.
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In this Industry Perspective, supported by Telix Pharmaceuticals, Bradley Fehrenbach, MD, MBA, presents Illuccix® for 68Ga-PSMA-11 PET imaging of prostate cancer. Dr. Fehrenbach begins by listing the FDA-approved indications for the use of Illuccix® during initial prostate cancer staging, after biochemical recurrence of prostate cancer, and before treating mCRPC.
Dr. Fehrenbach reviews data supporting the high diagnostic value, reproducibility, and accuracy of Illuccix®. He presents studies demonstrating its high true-positive rate, its ability to detect clinically significant disease when PSA level is as low as 0.02 ng/ml, and high inter-reader agreement.
Dr. Fehrenback concludes by listing the clinical benefits and practical accessibility of Gallium radiotracers for PET scans. At the conclusion of his presentation, he briefly answers questions posed to him by the Program Chair.
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