Video Archives

Update of Changes in the Early Detection of Prostate Cancer NCCN Guidelines 2024

Posted by Preston C. Sprenkle, MD | Dec 2024

Preston C. Sprenkle, MD, Associate Professor of Urology at Yale University, delivers a comprehensive update on the 2024 National Comprehensive Cancer Network (NCCN) guidelines for early detection of prostate cancer.

In this 9-minute presentation, Dr. Sprenkle highlights the importance of early detection in identifying aggressive cancers while avoiding overtreatment of indolent disease, with shared decision-making and individualized risk assessment remaining central to guiding screening and treatment decisions. Refinements include clearer recommendations for younger patients with low PSA levels and adjusted screening intervals for men over 75. Genetic risk assessment and counseling are emphasized.

Sprenkle shares that the guidelines now recognize MRI as the standard of care for pre-biopsy evaluation. High-quality MRI imaging and expert interpretation are underscored to address variability in diagnostic practices. Systematic and MRI-targeted biopsies are preferred for improved accuracy in cancer detection. Dr. Frankel underscores the importance of integrating advanced imaging and equitable access to care to transform prostate cancer outcomes.

GSM, UTI Discussion

Posted by Suzette E. Sutherland, MD, MS, URPS | Dec 2024

Suzette E. Sutherland, MD, MS, URPS, presented “Bladder Microbiome and Recurrent UTIs: Preventing...

Complications of Focal Therapy – Risk Factors, Timepoints, Management

Posted by Amir Lebastchi, MD | Dec 2024

Amir Lebastchi, MD, explores complications associated with focal therapy for prostate cancer, emphasizing the variability influenced by patient characteristics, disease features, treatment factors, and operator experience.

In this 14-minute keynote presentation, Dr. Lebastchi highlights studies reporting a 13-32% overall complication rate. Bleeding complications, sensory changes like penile numbness, and functional impacts such as erectile dysfunction and transient urinary incontinence are discussed.

To minimize risks, operator expertise and careful patient selection are emphasized. Strategies for prevention and management include tailored ablation templates, urethra-sparing techniques, and post-procedure interventions like alpha-blockers and antibiotics. Advanced techniques such as hydro-dissection and real-time monitoring with temperature probes further mitigate risks.

Dr. Lebastchi stresses the safety profile of focal therapy, noting its significantly lower morbidity compared to radical treatments like prostatectomy or radiation. Close postoperative monitoring is recommended to ensure patient recovery and address complications promptly.

KEYNOTE LECTURE – Introduction of Disruptive Technologies The Lessons From the Minimally Invasive Surgery

Posted by Ralph V. Clayman, MD | Dec 2024

Ralph V. Clayman, MD, offers an inspiring and pragmatic perspective on fostering innovation and navigating the challenges of medical advancements. He begins this 34-minute keynote presentation by emphasizing the importance of curiosity and intellectual humility.

Dr. Clayman underscores how disruptive technologies have evolved in urology by presenting historical examples. He traces the creative and collaborative processes that turned initial skepticism into groundbreaking techniques, emphasizing the philosophical, practical, and personal factors required to drive innovation. These include having a clear vision, protected time, effective partnerships, and a multidisciplinary team.

Clayman discusses the future intersection of robotics and artificial intelligence, foreseeing advancements like automated anastomoses and enhanced focal therapies. He stresses that meaningful progress will require collaboration, resourcefulness, and a willingness to challenge conventional norms. He offers practical advice for aspiring innovators and recommends building diverse teams with complementary strengths, as innovation is inherently collaborative.

Mechanisms and Management of Recurrences

Posted by Abhinav Sidana, MD, MPH | Dec 2024

Abhinav Sidana, MD, MPH, delves into the mechanisms and management of recurrences in patients undergoing focal therapy. This 17-minute presentation underscores the absence of a consistent surveillance strategy and advocates for a standardized approach, combining PSA tests, MRI, and biopsies to detect clinically significant cancer.

Dr. Sidana identifies factors such as patient selection, multifocal disease, and tumor biology as primary contributors to failures. His talk also addresses the challenges of inadequate margins and the spatial localization of lesions. Management strategies for recurrences focus on returning to foundational clinical assessments, considering patient life expectancy, comorbidities, cancer grade, and preferences. Cases illustrating success and challenges in treatment strategies reinforce the need for individualized patient care.

Dr. Sidana advocates for integrating biopsies and MRIs into surveillance protocols and highlights patient selection as pivotal to reducing therapy failures. This comprehensive analysis aims to refine focal therapy practices and improve patient outcomes.