Update: Studies Combining Secondary Biomarkers and MRI
Leonard G. Gomella, MD, FACS, presents a comprehensive overview of combining secondary biomarkers with MRI.
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Latest Videos
Climacturia After Radical Prostatectomy: What is It? Why is It? How Do We Treat It?
Brian S. Christine, MD, Brian S. Christine, MD, addresses the overlooked issue of climacturia in men who have undergone radical prostatectomy.
In this 19-minute talk, Dr. Christine outlines both conservative and surgical management strategies for climacturia. Simple approaches include bladder emptying before intercourse and the use of constriction rings, pharmacologic treatments, and surgical options like suburethral slings. For patients with severe erectile dysfunction requiring penile implants, he discusses an innovative approach using a Mini Jupette sling.
Dr. Christine emphasizes the need for better preoperative counseling on climacturia and highlights the range of available treatment options tailored to individual patient needs, from conservative measures to advanced surgical interventions.
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Approach to Pyeloplasty Failure
Kirk D. Redger, MD, provides a comprehensive discussion on recurrent ureteropelvic junction (UPJ) obstruction, emphasizing diagnostic approaches, treatment strategies, and the importance of tailored patient care.
In this 13-minute presentation, Redger highlights the importance of knowing a patient’s prior interventions when determining the next steps for treatment. Treatment plans are individualized, taking into account patient goals, age, comorbidities, and previous surgeries. Frail patients, those with active malignancies, or those with poor renal function may benefit from non-surgical management like stent placement. For surgical candidates, options range from endoscopic procedures and balloon dilation to complex reconstructive surgeries, such as robotic or open pyeloplasties.
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Horizons of Diagnosis and Treatment with PSMA PET MRI
Paul D. Maroni, MD, discusses advancements in prostate cancer imaging, emphasizing PSMA PET/MRI. Recent trends show that most new patients arrive with MRIs or even PSMA PET/CT scans; however, access to PSMA PET/MRI remains limited due to approval issues.
In this 10-minute presentation, Dr. Maroni highlights findings from the Primary Trial, which combines MRI and PSMA PET to screen for clinically significant cancers. This fusion is highly specific in identifying high-risk patients, potentially bypassing biopsies in specific cases. Moreover, studies in Canada are investigating PSMA PET/MRI’s role in guiding treatments like SBRT and focal ablation, indicating its potential as a prognostic and predictive biomarker.
Maroni suggests PSMA PET/MRI could serve in initial workups, replacing PET/CT, and aiding in post-treatment follow-up to assess cure or recurrence. There’s also interest in advancing fusion technology to overlay PSMA PET with pre-existing MRIs, optimizing cost-effectiveness and patient care by minimizing additional radiation.
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Robotic Urinary Diversion Ilial Conduit
Janet B. Kukreja, MD, MPH, FACS, provides a detailed overview of performing robotic-assisted ileal conduit surgery, focusing on practical techniques and strategies for effective urinary diversion.
In this 12-minute presentation, Dr. Kukreja shares a video of one of her procedures, beginning with port placement and tool selection. Using both handheld and robotic staplers, she demonstrates methods to minimize complications and ensure precision during bowel anastomosis. She discusses techniques to avoid complications, such as meticulous ureter preparation, vascular supply preservation, and strategic suture placement. The demonstration covers methods for managing the ureters, including tunneling under the sigmoid and spatulating to ensure optimal flow and reduce the risk of narrowing.
This comprehensive overview provides practical insights into optimizing robotic urinary diversion procedures, making it a valuable guide for surgeons managing complex cases requiring ileal conduits.