Video Archives

Ablative Local Technologies (HIFU, Cryo, SBRT, Laser, and Other Forms of Energy)

Posted by David M. Albala, MD | Jun 2024

David M. Albala, MD, provides an overview and comparison of current options for focal ablative therapy in prostate cancer treatment. He begins by briefly touching on the benefits of focal therapy as a whole, before exploring the different types of focal therapy.

Dr. Albala categorizes focal therapies into temperature-based therapies and non-temperature-based therapies. He places High Intensity Focused Ultrasound, Laser Ablation, and Cryotherapy in the temperature-based focal therapies. Radiotherapies like seed, HDR, and EBRT join Photodynamic Therapy, Radiofrequency Ablation, Electroporation, and partial prostatectomy in the non-temperature-based category.

Dr. Albala discusses the importance of weighing cancer control with preservation of function and patient QoL when considering focal therapies. He discusses the assessment process and the rate of failure for focal therapies. He underscores the process of patient selection and treatment planning prior to selecting a therapy.

He concludes by reviewing the delivery methods currently available for focal therapy. For each method, he presents the advantages, disadvantages, and ideal patient profile for each treatment.

The Business of Medicine: What Residency and Fellowship Failed to Teach Me

Posted by Colin E. Kleinguetl, MD | Jun 2024

Colin E. Kleinguetl, MD, shares insights regarding some of the practical knowledge gaps faced by urologists in residencies and fellowships. In this presentation, he outlines areas that those entering a residency or fellowship should be familiar with ahead of time, including:

Types of Practice
Practice Management
Tips and Tricks for Medical Coding
Contract Evaluation
Financial Management

Doublets and Triplets: Patient Selection

Posted by David S. Morris, MD, FACS | Jun 2024

David S. Morris, MD, FACS, explores the nuances of patient selection for doublet and triplet therapies in prostate cancer, providing an in-depth analysis of current strategies and emerging evidence. He begins by outlining the principles behind using doublet and triplet therapies, focusing on the rationale for combining multiple agents to enhance therapeutic efficacy and overcome resistance mechanisms.
Dr. Morris discusses the critical factors influencing patient selection. He examines the role of clinical and molecular biomarkers in guiding therapy choices, highlighting how these markers can predict response to treatment and help identify patients who are most likely to benefit from more intensive therapeutic regimens. By leveraging biomarkers, clinicians can tailor treatments to achieve the best possible outcomes while minimizing adverse effects.
He reviews key clinical trials that have investigated doublet and triplet therapies, providing a detailed analysis of their design, results, and implications for clinical practice. His analysis includes a discussion on how to balance the potential advantages of aggressive treatment with the need to manage toxicity and maintain patient quality of life.
Dr. Morris also addresses the practical aspects of implementing doublet and triplet therapies, including considerations related to dosing, administration, and monitoring. He emphasizes the importance of a multidisciplinary approach in managing patients receiving these complex regimens, involving collaboration among oncologists, urologists, and other healthcare professionals to optimize care.

Tips and Tricks of Endoscopic and Robotic Correction of POP/fSUI

Posted by Catherine A. Matthews, MD, FACS, FACOG, FPMRS | Jun 2024

Catherine A. Matthews, MD, FACS, FACOG, FPMRS, shares key steps for safe and effective endoscopic and robotic correction of POP/fSUI. In this presentation, Dr. Matthews provides guidance on:

Sacral Anatomy and Landmarks
Surgical Planes for Vaginal Dissection
Optimizing Mesh Attachment
Steps to Prevent Common Complications

Should MIST be First Line Treatment for BPH?

Posted by Seth K. Bechis, MD | Jun 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 the 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.