Video

Update on the PROFILE and IMPACT Studies

Jana McHugh, MB Bch BAO (Hons), MRCPI, FFR, discusses the IMPACT and PROFILE studies, which focus on prostate cancer risk and detection in genetically predisposed populations.

In this 11-minute presentation, McHugh shows that both studies emphasize early detection in genetically high-risk men, particularly BRCA mutation and Lynch syndrome carriers. Updated methodologies incorporate multi-ancestry PRS and expanded genetic sequencing to refine risk assessment and address disparities. These findings highlight the importance of precision screening in managing prostate cancer in diverse, high-risk populations.

Read More

Climacturia After Radical Prostatectomy: What is It? Why is It? How Do We Treat It?

Brian S. Christine, MD, Brian S. Christine, MD, addresses the overlooked issue of climacturia in men who have undergone radical prostatectomy.

In this 19-minute talk, Dr. Christine outlines both conservative and surgical management strategies for climacturia. Simple approaches include bladder emptying before intercourse and the use of constriction rings, pharmacologic treatments, and surgical options like suburethral slings. For patients with severe erectile dysfunction requiring penile implants, he discusses an innovative approach using a Mini Jupette sling.

Dr. Christine emphasizes the need for better preoperative counseling on climacturia and highlights the range of available treatment options tailored to individual patient needs, from conservative measures to advanced surgical interventions.

Read More

Approach to Pyeloplasty Failure

Kirk D. Redger, MD, provides a comprehensive discussion on recurrent ureteropelvic junction (UPJ) obstruction, emphasizing diagnostic approaches, treatment strategies, and the importance of tailored patient care.

In this 13-minute presentation, Redger highlights the importance of knowing a patient’s prior interventions when determining the next steps for treatment. Treatment plans are individualized, taking into account patient goals, age, comorbidities, and previous surgeries. Frail patients, those with active malignancies, or those with poor renal function may benefit from non-surgical management like stent placement. For surgical candidates, options range from endoscopic procedures and balloon dilation to complex reconstructive surgeries, such as robotic or open pyeloplasties.

Read More

Horizons of Diagnosis and Treatment with PSMA PET MRI

Paul D. Maroni, MD, discusses advancements in prostate cancer imaging, emphasizing PSMA PET/MRI. Recent trends show that most new patients arrive with MRIs or even PSMA PET/CT scans; however, access to PSMA PET/MRI remains limited due to approval issues.

In this 10-minute presentation, Dr. Maroni highlights findings from the Primary Trial, which combines MRI and PSMA PET to screen for clinically significant cancers. This fusion is highly specific in identifying high-risk patients, potentially bypassing biopsies in specific cases. Moreover, studies in Canada are investigating PSMA PET/MRI’s role in guiding treatments like SBRT and focal ablation, indicating its potential as a prognostic and predictive biomarker.

Maroni suggests PSMA PET/MRI could serve in initial workups, replacing PET/CT, and aiding in post-treatment follow-up to assess cure or recurrence. There’s also interest in advancing fusion technology to overlay PSMA PET with pre-existing MRIs, optimizing cost-effectiveness and patient care by minimizing additional radiation.

Read More