Video Archives

Micro-ultrasound and MRI for Visualization of Prostate Cancer

Posted by Wayne G. Brisbane, MD | May 2024

Wayne Brisbane, MD, explores micro-ultrasound (micro-US) and MRI in visualizing prostate cancer, highlighting their respective strengths and applications in clinical practice.
Micro-ultrasound has emerged as a promising imaging modality for prostate cancer detection due to its high resolution and real-time capabilities. This technology enhances the identification and characterization of suspicious lesions, offering superior spatial resolution. In contrast, MRI, particularly multiparametric MRI (mpMRI), excels in detecting larger and more complex tumors.
Dr. Brisbane emphasizes that while mpMRI remains pivotal in pre-biopsy evaluations and treatment planning, micro-ultrasound complements these efforts by enhancing real-time visualization during targeted biopsies and focal therapies. Combining the strengths of both modalities allows clinicians to leverage the high sensitivity of mpMRI for initial lesion detection and the high resolution and real-time capabilities of micro-ultrasound for precise biopsy guidance and treatment monitoring.

Interviews with Icons: Alan Wein, MD, PhD, FACS

Posted by Neil H. Baum, MD | May 2024

Grand Rounds in Urology Contributing Editor Neil H. Baum, MD, interviews Alan Wein, MD, PhD, FACS, on the past, present, and future of overactive bladder treatment in Urology. Among his many achievements, Dr. Wein has co-written or co-edited +30 books on Urology, including several editions of the textbook, Campbell Walsh Wein Urology, and holds editorial board positions on 14 journals. Additionally, Dr. Wein is largely credited as the researcher who lead the charge to rename “unstable bladder” to overactive bladder.

In this interview, they discuss Dr. Wein’s perspective on:
The History of Overactive Bladder
The Role of Pharmacology in Lower Urinary Tract Dysfunction
The Evolution of Incontinence and Overactive Bladder Treatments
The Role of AI and Telemedicine in Treatment
The Future of Urinary Incontinence and Overactive Bladder Management

Effective Strategies for Priapism

Posted by R. Caleb Kovell, MD | May 2024

R. Caleb Kovell, MD, discusses management strategies for acute refractory ischemic priapism, including shunting, tunneling, and prosthesis. Dr. Kovell begins his lecture by reviewing the erectile recovery windows and imaging techniques for establishing acute ischemic priapism.

Dr. Kovell then turns to effective treatment options after intracavernosal phenylephrine and corporal aspiration fail. He outlines various types of distal shunting, corporal tunneling, penoscrotal decompression, and early prosthesis placement.

Dr. Kovell concludes by discussing outpatient management of acute ischemic priapism. He highlights the importance of establishing the patient’s Sickle Cell Disease status, and cautioning against immediately prescribing PDE5is to outpatients.

Bone Health and Non-Cardiovascular Side Effects of ADT

Posted by Scott B. Sellinger, MD | May 2024

Scott B. Sellinger, MD, FACS, addresses ADT’s impact on bone health and other non-cardiovascular side effects of the therapy. He begins by noting that men on ADT are at significant risk of bone fracture, and reviewing the mechanisms behind the increased bone loss and fracture risk in these patients.

Dr. Sellinger presents best practices for assessing and treating patients with increased risk of fracture. He discusses lifestyle interventions, vitamin supplements, and other therapies to prevent bone loss.

Dr. Sellinger concludes by touching on non-cardiovascular side effects of ADT. He discusses best practices for combatting declines in mental, physical, and sexual health that result from ADT.

TRAVERSE Trial Update

Posted by Mohit Khera, MD, MBA, MPH | Apr 2024

Mohit Khera, MD, MBA, MPH, presents the latest updates from the TRAVERSE Trial, examining the cardiovascular effects of testosterone therapy. This presentation is an update to Dr. Khera’s “Results from the TRAVERSE Trial” lecture, which was presented to the Grand Rounds in Urology audience in August 2023.

Dr. Khera begins by reviewing the history of the TRAVERSE Trial and its initial results regarding the impact of testosterone therapy on cardiovascular health. He outlines the design of the TRAVERSE Trial, which concluded in January 2024 with a final enrollment count of 5,246 men.

In addition to the original secondary and tertiary endpoints regarding cardiovascular safety and prostate safety, Dr. Khera discusses other secondary endpoints in the trial. These endpoints were sexual function, depression, bone fractures, diabetes, and anemia.

Dr. Khera concludes by delving into the final results of testosterone therapy on all endpoints in the trial. He notes that the results indicate that testosterone therapy does not significantly worsen BPH symptoms and may protect against the development of anemia. However, he notes that testosterone therapy may raise the risk of bone fractures and pulmonary embolisms.