Video Archives

Transmeatal Urethral Surgery: Distal, Proximal, and Short Stricture Repair

Posted by J. Nicholas Warner, MD | Sep 2024

J. Nicholas Warner, MD, outlines techniques for managing anterior urethral strictures through endoscopic urethroplasty. In this 8-minute presentation, Dr. Warner discusses different approaches—distal, proximal, and management of short strictures.

Dr. Warner shares cases, including images and surgical videos illustrating the steps for each approach. He discusses patient criteria for each methodology and success rates.

Transurethral Incision and Transverse Mucosal Realignment

Posted by J. Nicholas Warner, MD | Sep 2024

J. Nicholas Warner, MD, discusses advancements in endoscopic urethroplasty, focusing on techniques for addressing bladder neck and vesicourethral anastomotic stenosis. In this 7-minute presentation, which includes a video of a procedure, Dr. Warner outlines the transurethral incision and transverse mucosal realignment technique, emphasizing the initial scar identification, resection, and dilation strategies.

Warner asserts that advancements in endoscopic techniques have shown promising results in treating urethral strictures, with a focus on optimizing patient outcomes through refined surgical strategies.

How to Implement Research Findings in Our Daily Urological Practice?

Posted by Reynaldo Gomez, MD, FACS | Sep 2024

Reynaldo Gómez, MD, FACS, introduces the importance of translational research in modern medicine. The core issue addressed is the slow adoption of research findings into clinical practice, resulting in a significant gap between cutting-edge research and real-world medical applications.

In this 20-minute presentation, Gómez stresses that translational research bridges this gap by focusing on transforming scientific discoveries into practical treatments. He divides the process into two stages: T1, which involves laboratory research and the development of new treatments, and T2, which focuses on applying these findings in clinical settings. Dr. Gómez proceeds to share the challenges associated with each stage.

Dr. Gómez highlights that for real change to occur, institutions must prioritize evidence-based practice supported by proper resources and public policies. Furthermore, integrating patient values with scientific evidence is crucial. Overall, translational research is a vital discipline to ensure that advancements in medical knowledge are swiftly and effectively translated into improved patient care.

Endoscopic Management Including Drug-Coated Balloon – Optilume

Posted by Ty Higuchi, MD, PhD | Sep 2024

Ty Higuchi, MD, PhD, explores the endoscopic management of urethral strictures, focusing on the drug-coated balloon technology. In this 10-minute presentation, Dr. Higuchi shares that urethral strictures, common in urology practices, are traditionally treated with dilations and direct vision internal urethrotomies (DVIU). Data shows that DVIU has a success rate of about 50% on the first attempt, with diminishing returns on repeated procedures. Adjunctive treatments like steroids or self-dilation have been explored but show limited efficacy in preventing stricture recurrence.

Higuchi highlights a newer approach with the FDA-approved drug-coated balloon (Optilume). He shares studies such as the Robust I and II trials, which have demonstrated promising results. Dr. Higuchi recommends the drug-coated balloon for ease of use and minimally invasive nature.

Who Needs a Prostate Biopsy? Risk-stratification Strategies Before Prostate Biopsy

Posted by Sigrid V. Carlsson, MD, PhD, MPH | Sep 2024

Sigrid V. Carlsson, MD, PhD, MPH, discusses the evolving paradigm in prostate cancer diagnostics, moving away from the traditional model where an elevated prostate-specific antigen (PSA) level directly leads to a biopsy. In this 8-minute talk, she emphasizes the importance of incorporating risk stratification methods before proceeding to biopsy, which helps reduce unnecessary interventions.

Dr. Carlsson discusses current guidelines that recommend using MRI as part of the initial biopsy strategy, with a more mandatory role in repeat biopsy settings if it has not previously been performed. Risk calculators provide a cost-effective and accessible means to estimate the likelihood of high-grade disease, further refining the decision-making process.

The presentation also highlights the rapid advancement in biomarkers and the integration of artificial intelligence (AI) in improving MRI interpretation and enhancing prostate cancer diagnostics’ accuracy and efficiency.