International Functional and Reconstructive Urology Update Archives

Update on PROBASE Trial: Baseline PSA in Young Men (Aged 45 and 50)

Posted by Jeffrey M. Spier, MD | Oct 2024

Jeffrey M. Spier, MD, focuses on reimbursement, healthcare policy, and the role of advocacy in the current urology healthcare landscape. In this 10-minute presentation, Spier highlights LUGPA, which represents independent urology practices, promoting best practices, business acumen in urology, and policy advocacy.

Spier emphasizes the importance of urologists and healthcare professionals engaging in legislative advocacy to address issues such as reimbursement cuts, regulatory burdens, and rising operational costs. He notes that healthcare consolidation can negatively impact patient care and stresses the need for reform, particularly in areas like the Medicare fee schedule.

Spear advocates for unity within the urology community. He remains optimistic, calling for collective efforts to secure better outcomes for both physicians and patients while urging professionals to engage at local and national levels to make meaningful change.

Transmeatal Urethral Surgery: Distal, Proximal, and Short Stricture Repair

Posted by J. Nicholas Warner, MD | Sep 2024

J. Nicholas Warner, MD, outlines techniques for managing anterior urethral strictures through endoscopic urethroplasty. In this 8-minute presentation, Dr. Warner discusses different approaches—distal, proximal, and management of short strictures.

Dr. Warner shares cases, including images and surgical videos illustrating the steps for each approach. He discusses patient criteria for each methodology and success rates.

Transurethral Incision and Transverse Mucosal Realignment

Posted by J. Nicholas Warner, MD | Sep 2024

J. Nicholas Warner, MD, discusses advancements in endoscopic urethroplasty, focusing on techniques for addressing bladder neck and vesicourethral anastomotic stenosis. In this 7-minute presentation, which includes a video of a procedure, Dr. Warner outlines the transurethral incision and transverse mucosal realignment technique, emphasizing the initial scar identification, resection, and dilation strategies.

Warner asserts that advancements in endoscopic techniques have shown promising results in treating urethral strictures, with a focus on optimizing patient outcomes through refined surgical strategies.

How to Implement Research Findings in Our Daily Urological Practice?

Posted by Reynaldo Gomez, MD, FACS | Sep 2024

Reynaldo Gómez, MD, FACS, introduces the importance of translational research in modern medicine. The core issue addressed is the slow adoption of research findings into clinical practice, resulting in a significant gap between cutting-edge research and real-world medical applications.

In this 20-minute presentation, Gómez stresses that translational research bridges this gap by focusing on transforming scientific discoveries into practical treatments. He divides the process into two stages: T1, which involves laboratory research and the development of new treatments, and T2, which focuses on applying these findings in clinical settings. Dr. Gómez proceeds to share the challenges associated with each stage.

Dr. Gómez highlights that for real change to occur, institutions must prioritize evidence-based practice supported by proper resources and public policies. Furthermore, integrating patient values with scientific evidence is crucial. Overall, translational research is a vital discipline to ensure that advancements in medical knowledge are swiftly and effectively translated into improved patient care.

Endoscopic Management Including Drug-Coated Balloon – Optilume

Posted by Ty Higuchi, MD, PhD | Sep 2024

Ty Higuchi, MD, PhD, explores the endoscopic management of urethral strictures, focusing on the drug-coated balloon technology. In this 10-minute presentation, Dr. Higuchi shares that urethral strictures, common in urology practices, are traditionally treated with dilations and direct vision internal urethrotomies (DVIU). Data shows that DVIU has a success rate of about 50% on the first attempt, with diminishing returns on repeated procedures. Adjunctive treatments like steroids or self-dilation have been explored but show limited efficacy in preventing stricture recurrence.

Higuchi highlights a newer approach with the FDA-approved drug-coated balloon (Optilume). He shares studies such as the Robust I and II trials, which have demonstrated promising results. Dr. Higuchi recommends the drug-coated balloon for ease of use and minimally invasive nature.