Video Archives

Should MIST be First Line Treatment for BPH?

Posted by Seth K. Bechis, MD | Sep 2024

Seth K. Bechis, MD, explores the question of whether or not minimally invasive surgical therapies (MIST) should be first line treatment for BPH. He begins by highlighting the prevalence of BPH in men over 60. He acknowledges that combination therapy is extremely effective in combating BPH in the short-term, but it has several long-term risks which impact patient QoL.

Dr. Bechis highlights the negative side-effects of 5-ARIs, alpha blockers, and surgery post-medication-failure. Side-effects included increased risk of cardiac failure, dementia, depression, and sexual dysfunction.

Dr. Bechis then examines current MIST procedures for BPH treatment, including prostatic urethral lifts, water vapor thermal therapy, temporarily implanted nitinol devices, and balloons. He examines the durability, effectiveness, and side-effects for each procedure, and compares them to patients on medication

Dr. Bechis concludes by comparing the cost effectiveness of MIST procedures to the cost of medication, taking into account IPSS improvement and Quality-Adjusted Life Years over time. Overall, he suggests that MIST procedures should be explored as a first line treatment for BPH.

Brian Moran Distinguished Lecture: Mobilizing Moran’s Army from Seed to Shining Seed

Posted by Peter F. Orio III, DO, MS | Sep 2024

Over the course of his career to date, Dr. Moran’s emphasis on quality of life issues and long-term outcomes for prostate cancer patients is evident, and his contributions to the fight against prostate cancer, such as performing over 30,000 prostate seed implant procedures and founding the Chicago Prostate Cancer Center, are innumerable.

Dr. Moran is a member of multiple specialty societies, including the American Society of Therapeutic Radiology and Oncology, the American College of Radiology, and the American Brachytherapy Society. To learn more about Dr. Moran, please visit his Author Page on Grand Rounds in Urology.

The inaugural lecture was given at IPCU 34 by Peter F. Orio III, DO, MS.

Financial Toxicity of APC Management

Posted by R. Jonathan Henderson, MD | Sep 2024

R. Jonathan Henderson, MD, addresses the economic burden and stress experienced by patients due to high treatment costs in advanced prostate cancer (APC) management. He stresses that this aspect of APC care often goes under-discussed.

In this 9-minute presentation, Dr. Henderson highlights direct costs such as medications, hospital stays, and physician fees, as well as indirect costs including lost income and travel expenses. He emphasizes that these financial strains can lead to treatment non-adherence, delayed care, and worsened clinical outcomes.

Dr. Henderson discusses various strategies and interventions to address these challenges, underscoring the importance of policy changes at the institutional and governmental levels to improve access to affordable care.

The Prostatic Urethral Lift (Urolift): Back to Basics

Posted by Matthew C. Ercolani, MD, FACS | Sep 2024

Matthew C. Ercolani, MD, FACS, provides an overview of UroLift, a minimally invasive procedure for benign prostatic hyperplasia (BPH). In this 11-minute presentation, Ercolani explains his reasoning for performing the UroLift procedure and its benefits compared to other options.

Dr. Ercolani reviews the optimal patient profile, best placement locations, and areas to avoid when performing the implant procedure. He then shares a video of implantation, illustrating how to customize Urolift placement and providing a “before and after” comparison.

Game Changers in Prostate Cancer Diagnostics: Imaging Probably Wins the Most

Posted by John W. Davis, MD | Sep 2024

John W. Davis, MD, FACS, discusses significant advancements in prostate cancer diagnostics, emphasizing the transformative role of imaging as a tool that enhances the accuracy of prostate cancer detection and management. Davis highlights that advanced imaging techniques, rather than traditional diagnostic methods such as PSA levels and biopsies, have revolutionized the diagnostic landscape.
In this 18-minute talk, Dr. Davis asserts that mpMRI offers superior sensitivity and specificity to conventional methods. Davis elaborates on integrating mpMRI in active surveillance protocols, improving the monitoring of low-risk patients, and reducing the burden of invasive procedures. Furthermore, Davis addresses the evolving role of PSMA PET/CT scans, which provide exceptional accuracy in detecting metastatic and recurrent prostate cancer. In addition, biomarkers are discussed in detail, complementary with imaging tools.