Latest Videos Archives

Recurrent Uncomplicated Urinary Tract Infections in Women: AUA/CUA/SUFU Guideline 2019

Posted by Jennifer T. Anger, MD, MPH | May 2020

Jennifer T. Anger, MD, MPH, Associate Professor of Urology at Cedars-Sinai Medical Center, discusses recurrent uncomplicated urinary tract infections (UTIs) in women. Dr. Anger chairs the AUA committee on guidelines for infections, and she discusses the rationale behind recent changes to recommendations. She outlines how the thinking about recurrent infections has changed over time, and highlights the collateral damage that a one-size-fits-all antibiotic treatment can cause, noting that the new guidelines emphasize treating individual urinary cultures. She goes on to discuss patient profiles, common symptoms, and what the guidelines recommend for initial work-ups as well as treatments. Dr. Anger further delves into ways to prevent or decrease the risk of UTIs with antibiotic prophylaxis, along with the possible risks of doing so.

Panel Discussion on Integration of Stakeholders in Healthcare: The Kaiser Permanente Experience

Posted by Eugene Y. Rhee, MD, MBA | May 2020

Eugene Y. Rhee, MD, MBA, Regional Coordinating Chief of Urology at Kaiser Permanente in Southern California (KPSCAL) discusses the Kaiser Permanente model and how doctors, hospitals, and health plans work together on coordinated care. Focusing on San Diego, he notes several unique geographic factors that make the city an island in terms of care and which have led to a long history of risk-sharing between medical groups. Dr. Rhee goes on to demonstrate their shared decision-making model for prostate cancer biomarkers and explains how they decide when to deploy fusion MRI for prostate biopsy. He also notes that the 13 medical centers in the KPSCAL region rotate their fusion MRI machine, making coordination and cooperation among physicians paramount.

Panel Discussion on Integration of Stakeholders in Healthcare: Academic Urology

Posted by Christopher J. Kane, MD, FACS | May 2020

Christopher J. Kane, MD, FACS, Dean of Clinical Affairs at the University of California San Diego School of Medicine, discusses the role of academic institutions in supporting the wider urology community, using USCD as an example. He notes that the UC medical system is the 4th largest provider of healthcare in California and UCSD is the 8th producer of scientific output in life sciences of any institution globally, therefore contributing greatly to the medical field as a whole. USCD Urology provides numerous specific benefits to the greater urology community, including practitioners in LUGPAs and integrated practice systems. These benefits include subspecialty coordinated care, CME opportunities, principled defense and professional support, and a clinically integrated network, among others.

The Role of Immunonutrition in Bladder Cancer & the SIMMUNE Trial (S1600)

Posted by Jeffrey M. Holzbeierlein, MD | May 2020

Jeffrey M. Holzbeierlein, MD, Director of the Division of Urologic Oncology at the University of Kansas Hospital and Director of Clinical Research for the Urology Department at KUMC, discusses the role of immunonutrition in bladder cancer. He highlights some of the research showing why nutrition should play an important role in improving outcomes for radical cystectomy, a treatment for bladder cancer that is underutilized due to the high number of poor outcomes. Dr. Holzbeierlein goes on to discuss the SIMMUNE trial (S1600), which he is leading at the KU Medical Center. In the pilot, they gave patients a specialized immunomodulating drink, which Dr. Holzbeierlein emphasizes is a commercially available drink that patients can purchase themselves online, prior to surgery. He outlines the methods of the study as well as the results and the conclusions that were drawn. Finally, Dr. Holzbeierlein stresses that this is an easy intervention that most doctors could implement immediately.

Adaptive Immune Resistance to Intravesical BCG in NMIBC: Implications for Ongoing and Future BCG Unresponsive Clinical Trials

Posted by Trinity J. Bivalacqua, MD, PhD | May 2020

Trinity J. Bivalacqua, MD, PhD, Director of Urologic Oncology at Johns Hopkins Medicine, discusses potential solutions to the issues with bacillus Calmette-Guérin (BCG) as a treatment for high-risk non-muscle invasive bladder cancer (NMIBC). Intravesical BCG is more effective than chemotherapy for NMIBC, but approximately ⅓ of high-risk patients are BCG-unresponsive, and there is also a BCG shortage. Dr. Bivalacqua lists potential solutions to both these problems, including early cystectomy, increasing the availability of BCG by using alternative strains, and enhancing immunotherapy. He concludes by discussing research intended to characterize immune cell expression among patients with NMIBC treated with BCG which found that immune checkpoint inhibition with BCG may be beneficial in a subset of patients who experience tumor recurrence after BCG.