Video

Pediatric to Adult Transition in Urology

Pediatric to Adult Transition in Urology

Posted by | Dec 2024

Daniel Wood, MBBS, PhD, FRCS, provides an overview of the transition from pediatric to adult care for patients with complex urological conditions. This 6-minute talk highlights the challenges patients face as they move from a trusted pediatric care team to adult providers, emphasizing the need for continuity of care. Dr. Wood explains that transition is not merely the transfer of care but involves preparing young adults to manage their health, develop long-term care plans, and ensure they are connected with adult healthcare providers.

Wood touches on the significance of managing neuropathic bladder conditions in patients transitioning from pediatric to adult care. He underscores the necessity of addressing sexual health and fertility, topics often overlooked. The speaker also stresses the role of multidisciplinary care, involving nephrologists and urologists, to optimize patient outcomes.

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Can Imaging Replace Prostate Biopsy – Primary Detection, Active Surveillance and Recurrent PCa?

Can Imaging Replace Prostate Biopsy – Primary Detection, Active Surveillance and Recurrent PCa?

Posted by | Dec 2024

Veeru Kasivisvanathan, MBBS, BSc, FRCS, PhD, MSc, PGCert, reflects on the significant advancements in prostate imaging over the last decade, emphasizing the transformative role of MRI. A central question in this 15-minute presentation is whether prostate cancer can be diagnosed and managed without a biopsy. While biopsies are the current standard, they carry risks such as sepsis, patient discomfort, and financial burden.

The PROMIS study demonstrated MRI’s ability to detect all Gleason 4+3 cancers, though it also revealed MRI’s high number of false positives. Combining PSMA PET with MRI improves sensitivity to 97%, particularly for detecting clinically significant cancers, but specificity remains a challenge, raising concerns about unnecessary treatment. New scoring systems, like the P score, integrate PET avidity and PI-RADS scores to refine risk assessment and treatment decisions.

Kasivisvanathan discusses the concept of “biopsy-light” pathways, citing cohorts where patients undergo fewer biopsies, with monitoring driven by MRI and PSA changes. This approach shows promising compliance and oncological outcomes comparable to standard active surveillance but with less patient burden. Despite advancements, a fully biopsy-free pathway remains unfeasible due to limitations in MRI standardization, interpretation variability, and a lack of high-volume data.

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