Video

Asymptomatic Stones: Remove Each Piece? Or Leave in Peace?

Benjamin K. Canales, MD, MPH discusses the prevalence and natural history of asymptomatic kidney stones, emphasizing that while these stones may not initially cause symptoms, they have the potential to lead to significant complications, including pain, infection, and obstruction. He identifies various factors that influence the decision-making process, such as stone size, location, composition, and patient-specific factors including age, comorbidities, and risk of future stone-related events.

Dr. Canales discusses the current guidelines and evidence-based practices for managing asymptomatic stones, including the benefits and risks associated with both intervention and observation. He highlights the criteria for selecting patients who may benefit from proactive treatment, such as those with high-risk anatomical features or a history of recurrent stones, and scenarios where a conservative approach, involving regular monitoring and preventive measures, may be more appropriate.

Technological advancements and surgical techniques have improved the safety and efficacy of stone removal procedures. Dr. Canales reviews minimally invasive options, such as ureteroscopy and percutaneous nephrolithotomy, and their role in the management of asymptomatic stones. The presentation includes a discussion on the potential complications of these procedures and the importance of patient counseling to set realistic expectations.

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Priapism: How Do We Manage, and How Do We Learn How to Manage in 2024?

Thomas J. Walsh, MD, MBA, MS, discusses practical strategies for evaluating, diagnosing, and managing ischemic priapism. He begins with an overview of the symptoms, diagnosis, associated risks, and standard treatment procedures for the management of ischemic priapism.

Dr. Walsh then turns to effective treatment options after intracavernosal phenylephrine and corporal aspiration fail. He outlines various types of distal shunting, corporal tunneling, penoscrotal decompression, and early prosthesis placement.

Dr. Walsh concludes by addressing the lack of standardized training for treating ischemic priapism. He outlines a simulation curriculum designed to quickly train and presents the results from the pilot study.

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Pathological Aspects of BPH, Prostatitis, and Other Painful Co-Occurrences

Francisco G. LaRosa, MD, FCAP, explores the pathology of benign prostatic hyperplasia (BPH), prostatitis, and associated urological conditions. He begins by reviewing the pathophysiology of BPH, presenting examples of usual and specific patterns of BPH and their progression.

Transitioning to prostatitis, Dr. LaRosa examines acute and chronic prostatitis. He highlights the mechanisms behind its close association with BPH, despite its frequent misdiagnosis and mismanagement in BPH patients.

Dr. LaRosa concludes by providing examples of other non-cancerous co-occurrences which can be discovered after prostate biopsy. He focuses on fibromas, thromboembolisms, and calcification.

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YouTube Surgeons – The Role of Video Learning in Urology

Ryan P. Terlecki, MD, FACS, explores current resources for lifelong learning and metrics for measuring success for urologic surgeons. He begins by reviewing the skills and technology-based challenges facing urologists today.

Dr. Terlecki explores the evolution of expectations and goals of medical education across generations. He reviews the history of surgical training from the Halsted Model to present day educational standards for continuous professional education, including the increasing ubiquity of video in daily practice.

Dr. Terlecki concludes by highlighting the benefits and dangers of using videos to train, provided that feedback from an expert source is incorporated in the training. He illustrates different models for trainees and established surgeons to improve their performance using a combination of expert insights and video analysis.

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Cannabis Use and Male Reproductive Health: Who Knew?

Thomas J. Walsh, MD, MBA, MS, discusses the impact of habitual cannabis use on male fertility and reproductive health. He begins by establishing the current landscape and demographics of cannabis users globally, and the mechanisms behind its popularity as a recreational and medicinal substance.

Dr. Walsh then discusses emerging data on the impacts of cannabis on male fertility. He explores the deleterious influence of cannabis on Anandamide (nM) production and sperm morphology.

Dr. Walsh concludes with an examination of his own prospective analysis on the fertility of men presenting at his clinic for reproductive issues after current or past cannabis use. He underscores the importance of counseling patients using the available evidence, and strongly recommends against cannabinoid use while planning for a family.

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