Latest Videos

New Horizons in Robotic Reconstructive Urology

New Horizons in Robotic Reconstructive Urology

Posted by | Jun 2023

Brian J. Flynn, MD, discusses the emerging field of robotic reconstructive urology, shedding light on its emergence as a distinct specialty within the medical community.

In this 20-minute presentation, Dr. Flynn covers current trends and perspectives on robotic reconstructive urology from the Society of Genitourinary Reconstructive Surgeons, barriers to adoption, implementation strategies, and practical examples of robotic reconstructive surgery in sacrocolpopexy and vesicovaginal fistula repair.

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Case Discussion: Early Detection of Prostate Cancer

Case Discussion: Early Detection of Prostate Cancer

Posted by | Jun 2023

Thomas E. Keane, MD, leads a discussion with Dr. Kader and Dr. Crawford concerning the case study of a 63-year-old patient presenting with increasing PSA levels. The panel navigates through the various considerations and next steps in patient management, with an emphasis on personalized care in prostate cancer management.

After reiterating the importance of gathering comprehensive medical history and meticulously examining the patient’s PSA history, the panel discusses the range of options available, including ordering further tests such as blood or urine tests, an MRI, or even performing a biopsy. The panel explores the complexities behind treatment decision-making, emphasizing the need to carefully weigh the risks and benefits of each approach.

Drawing upon their vast experience, the panel discusses the significance of risk calculators in evaluating the patient’s condition. While these tools provide valuable insights, the panel underscores their limitations, emphasizing the need for continued research and refinement. Additionally, they explore the emerging role of MRI in detecting high-grade prostate cancer, emphasizing the importance of standardized and high-quality interpretation to ensure accurate diagnoses.

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Early Detection of Prostate Cancer: Navigating the Challenges in 2023

Early Detection of Prostate Cancer: Navigating the Challenges in 2023

Posted by | Jun 2023

E. David Crawford, MD, Editor-in-Chief of Grand Rounds in Urology and Professor of Urology at the University of California, San Diego, discusses the challenges of early detection of prostate cancer (PCa) and recommends a prostate-specific antigen (PSA) cut-off of 1.5 ng/ml. Because most diagnostic testing is completed by primary care physicians who may not understand the nuances of PSA testing, Dr. Crawford recognizes that they need a simple message from urologists. Dr. Crawford contends that PSA testing should be considered as routine as measuring a patient’s cholesterol, especially since more than 70% of men will have a PSA of less than 1.5 and will not require further screening for another 5 to 10 years.

He states that a PSA of 1.5 ng/ml to 4.0 ng/ml may be in a “danger zone” and require additional testing for benign prostatic hyperplasia (BPH), PCa, and PCa risk. Dr. Crawford concludes by reiterating the importance of simple messaging to move forward with effective screening and early detection of PCa.

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Radioligand Therapy in Prostate Cancer

Radioligand Therapy in Prostate Cancer

Posted by | Jun 2023

Geoffrey B. Johnson, MD, PhD, Chair of the Division of Nuclear Medicine at the Mayo Clinic in Rochester, MN, discusses radioligand therapy in prostate cancer. Dr. Johnson briefly reviews the specific activity of this therapy, with a focus on Lutetium-177-PSMA-617.
Dr. Johnson highlights the benefits and tolerable side-effects of Lutetium-177-PSMA-617, and mentions the therapy is approved for patients with metastatic castrate-resistant prostate cancer who have been previously treated with androgen receptor pathway inhibition and taxane-based therapy.

The presentation further explores the process of patient selection for PSMA imaging, with the requirement of at least one lesion that shows higher PSMA expression than the liver. Dr. Johnson showcases post-therapy imaging examples, and discusses the potential of advanced scanning techniques, such as CZT-based scanners, which offer higher sensitivity and faster scans for accurate tracking of therapy response.

Dr. Johnson emphasizes the promising future of radionuclide therapy. He mentions the potential combinations of PSMA therapy with hormonal therapy, chemotherapy, immunotherapy, and external radiation. Additionally, he mentions ongoing trials exploring the use of alpha and beta emitters and the incorporation of different targets.

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