Obstacles to Optimal Outcomes for Patients Undergoing Radical Cystectomy

Posted by Raj S. Pruthi, MD, MHA, FACS | Aug 2024

Raj S. Pruthi, MD, MHA, FACS presented “Obstacles to Optimal Outcomes for Patients Undergoing Radical Cystectomy” during the 41st Annual Ralph E. Hopkins Urology Seminar on February 4, 2022, in Jackson Hole, Wyoming.

How to cite: Pruthi, Raj S. “Obstacles to Optimal Outcomes for Patients Undergoing Radical Cystectomy.” February 4, 2022. Accessed Aug 2024. https://grandroundsinurology.com/obstacles-to-optimal-outcomes-for-patients-undergoing-radical-cystectomy-2/

Obstacles to Optimal Outcomes for Patients Undergoing Radical Cystectomy – Summary

Dr. Raj S. Pruthi discusses the obstacles to achieving optimal outcomes for patients undergoing radical cystectomy. He meticulously analyzes the multifaceted challenges encountered in the preoperative, intraoperative, and postoperative phases of radical cystectomy, a complex surgical procedure primarily performed for muscle-invasive bladder cancer.

Preoperative factors that can impede optimal outcomes, including patient comorbidities, nutritional status, and the importance of thorough preoperative assessment and optimization. He emphasizes the role of prehabilitation in enhancing patient readiness for surgery.

During the intraoperative phase, Dr. Pruthi highlights the technical intricacies of radical cystectomy, stressing the importance of surgical expertise and meticulous technique in minimizing perioperative complications. He discusses the role of minimally invasive techniques, such as robotic-assisted surgery, in potentially reducing blood loss, shortening hospital stays, and enhancing recovery.

Postoperatively, Dr. Pruthi identifies key factors that influence recovery and long-term outcomes. He underscores the significance of effective pain management, early mobilization, and comprehensive postoperative care in mitigating complications. Dr. Pruthi also discusses the challenges related to urinary diversion, including the management of neobladder and ileal conduit complications, and the impact of these diversions on patients’ quality of life.

About The 41st Annual Ralph E. Hopkins Urology Seminar:

The Ralph E. Hopkins Urology Seminar is a multi-day meeting focused on training urologists in the latest in assessing, diagnosing, and treating urologic conditions in the clinical setting. Updates are provided on urologic cancers, stone disease, urologic reconstruction, female urology, infertility, sexual function, emerging surgical techniques, and general urology. The 41st iteration of the meeting took place from February 2nd to 5th, 2022, in Jackson Hole, Wyoming.

For further educational activities from this conference, visit our collection page.

About The Author

Raj S. Pruthi, MD, MHA, FACS

Dr. Pruthi is a Professor in the Department of Urology at the University of California, San Francisco. He previously served as chair of the Department of Urology at the University of North Carolina at Chapel Hill, where he was on faculty for nineteen years. Serving first as its Chief and then as its inaugural chair, he took the UNC Department of Urology from an unranked program to one of the best in the nation. Dr. Pruthi was a member of the ABU/AUA Examination Committee and serves as an examiner for the Certifying Exam for the ABU. He is also on the Executive Committee for the Society of Academic Urology, as well as the Chair of the Advisory Council for Urology of the American College of Surgeons. Dr. Pruthi helped to develop the American Urological Association’s Guidelines on the Management of Non-muscle Invasive Bladder Cancer. He also served on the Bladder Cancer Guidelines Committee of the International Consultation on Urological Diseases. He is an elected member of the Urologic Research Society, the Society of Pelvic surgeons, the American Association of Genitourinary Surgeons, and the Clinical Society of Genitourinary Surgeons. Dr. Pruthi is a graduate of Stanford University, where he double majored in economics and in biology and became interested in health economics. He received his MD from Duke University School of Medicine. Following medical school, he completed his residency and post-graduate training at Stanford University. Most recently, he completed the executive MHA program at UNC. Dr. Pruthi’s area of clinical expertise is urologic oncology, including prostate and bladder cancer. He is committed to a multi-disciplinary, holistic, and patient-centric approach to care. Dr. Pruthi is a recognized expert in minimally-invasive, robotic surgery for prostate and bladder cancer. He incorporates nerve-sparing techniques to improve recovery and long-term quality of life. He is committed to compassionate, comprehensive, innovative, and patient-centered care that balances long-term survivorship with a high-level of functioning and an optimal quality of life. Dr. Pruthi’s research is focused on surgical innovation, care pathways, and quality of care. Most recently, this primary research has addressed topics related to health economics, including characterizing the urologic workforce, understanding compensation, productivity, and burnout. Dr. Pruthi has been tackling health economic issues to better understand the drivers of faculty productivity, compensation, and burnout. He has explored urologic workforce, projections, gender disparity issues, factors impacting career earnings, predictors of dissatisfaction and burnout, and understanding the impact of workflow initiatives, including the implementation of scribes. His work in these areas has been recognized nationally and has had an impact on the understanding of the practice of urology.

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