Latest Videos Archives

Surgical BPH: 2024 Updates and Where Are We Going

Posted by Nicole L. Miller, MD, FACS | Jan 2025

Nicole L. Miller, MD, FACS, delivers an incisive update on the surgical management of benign prostatic hyperplasia (BPH). In this 11-minute presentation, Dr. Miller outlines the current AUA guidelines, highlighting a broad spectrum of treatments tailored to prostate size. Trends in national data reveal that transurethral resection of the prostate (TURP) remains the dominant procedure, while minimally invasive options like UroLift have gained substantial traction.

Dr. Miller discusses emerging technologies, including the OptilumeⓇ BPH System. She also reviews promising data on MRI-guided transurethral ultrasound ablation (TULSA). Advanced laser techniques, particularly holmium pulse modulation, and thulium fiber laser, are explored for their efficacy in enucleation procedures, showing advantages in operative time, hemostasis, and same-day discharge rates. Miller highlights evolving techniques like en bloc enucleation with early apical release. A brief discussion on robotic-assisted simple prostatectomy includes recent shifts toward single-port approaches.

Dr. Miller stresses the importance of aligning treatment with patient preferences and quality-of-life goals, emphasizing shared decision-making as central to optimizing outcomes in this rapidly advancing field.

Multi-Disciplinary Approach to Advanced Prostate Cancer Care

Posted by Kelvin A. Moses, MD, PhD, FACS | Jan 2025

Kelvin A. Moses, MD, PhD, FACS, explores a multidisciplinary approach to advanced prostate cancer care and treatment.

Oral Abstracts – SV Recurrences After Radiation

Posted by Aaron E. Katz, MD, FACS | Jan 2025

Aaron E. Katz, MD, FACS, examines the clinical management of seminal vesicle (SV) invasion following radiation therapy in prostate cancer patients. In this 18-minute presentation, Dr. Katz highlights its significance in recurrence and treatment, emphasizing the anatomy, detection, prognosis, and ablative techniques for managing SV invasion.

Dr. Katz shares emerging management options, including robotic excision of SVs and cryotherapy. Integrating PSMA PET scans and MRI enhances diagnostic accuracy, aiding surgical planning.

Dr. Katz calls for a multidisciplinary approach, emphasizing careful patient selection and robust imaging protocols. Ablative therapies, while feasible, require expertise and may benefit from combining modalities for optimal outcomes.

Through the Perineum or Through the Rectum: How to Best Biopsy the Prostate

Posted by Guilherme Godoy, MD, MS | Jan 2025

Guilherme Godoy, MD, MS, addresses prostate biopsy techniques, contrasting transrectal and transperineal approaches.

In this 20-minute presentation, Dr. Godoy highlights the current debate between transrectal and transperineal approaches. Transrectal biopsy remains a familiar, office-based procedure requiring only local anesthesia, offering easy access and minimal patient discomfort. However, it poses infection risks. Conversely, the transperineal approach minimizes infection risk. This approach, however, is often more painful, typically requires sedation, and may incur higher equipment and procedural costs, as well as a longer learning curve for practitioners. Godoy also discusses recent studies comparing the effectiveness of these techniques. Research indicates no significant difference in cancer detection rates between transrectal and transperineal biopsies.

The integration of MRI-ultrasound fusion and cognitive fusion biopsy techniques continues to enhance the precision of both approaches, especially in targeting smaller, more localized prostate lesions. Godoy feels biopsy methods may evolve further as MRI technology improves, potentially eliminating the need for whole-prostate sampling. Instead, biopsies could focus more on specific, MRI-identified lesions, reducing patient discomfort and procedural risks while improving diagnostic accuracy.

Energy Selection Ablative Technologies for Focal Therapy

Posted by Andre Abreu, MD | Jan 2025

Andre Abreu, MD, delves into energy modalities for focal therapy in prostate cancer, presented with a comprehensive and practical approach. This 16-minute presentation explores multiple energy options, including cryoablation, high-intensity focused ultrasound (HIFU), irreversible electroporation (IRE), laser ablation, and microwave ablation. Dr. Abreu emphasizes the importance of aligning energy selection with institutional expertise and patient-specific factors.

Patient-specific considerations guide technology selection, including rectal wall thickness and proximity to critical structures. Transition zone lesions benefit from tools like aqua ablation, while anterior lesions present challenges for certain devices. The speaker emphasizes the need for personalized management, integrating oncologic characteristics with procedural capabilities.

Dr. Abreu optimistically frames the future of focal therapy, with ongoing trials like vapor ablation and the potential for low-dose radiation therapy combined with IRE promising advancements. He calls for practical recommendations and an invitation for ongoing exploration in the evolving field of prostate cancer management.