Ralph E. Hopkins Urology Seminar

2018 Update on Peyronie’s Disease: What’s Around the Bend

Mohit Khera, MD, MBA, MPH, a panel member for the 2015 American Urological Association (AUA) Peyronie’s disease (PD) guidelines, discusses the prevalence of PD and its correlation to low testosterone. Furthermore, he summarizes the AUA statements on intralesional injections, penile stretching devices, and surgical options. He explains future directions in this setting, as well, including data from animal models testing platelet-rich plasma (PRP) and stem cells.

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Management of Renal Trauma

Rodrigo Donalisio da Silva, MD urges urologists to manage blunt and penetrating renal trauma conservatively. He uses the 2017 American Urological Association (AUA) Urotrauma guidelines to outline this conservative approach, specifically when to perform diagnostic imaging with intravenous (IV) contrast enhanced computed tomography (CT), non-invasive management strategies, proper injury classification, and when it is necessary to intervene.

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Haemocomponents for Non Transfusional Use: Biological Aspects and New Urological Clinical Applications

Pierluigi Bove, MD, discusses the urological applications of haemocomponents, specifically using fibrin glue in the management of hemorrhagic cystitis. He explains the possibility of managing chronic cystitis, bladder pain syndrome, and chronic pelvic pain with platelet-rich plasma (PRP). Furthermore, he describes his upcoming project to test the effects of hyaluronic acid and PRP on the human epithelium.

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Technology and its Impact on Patient Care

Peter Schulam, MD, PhD, argues that adopting robotic assisted surgery into urological practices can reduce medical errors and surgeon performance variability. Furthermore, he explains the need for larger and more structured medical data sets. This will enable machine learning when developing artificial intelligence (AI) to enhance prognostic and diagnostic accuracy, cancer mortality prediction, and interpretation of digitized images.

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AUA/ASTRO/SUO Guidelines on Clinically Localized Prostate Cancer

Riccardo Autorino, MD, PhD, FEBU, summarizes the American Urological Association (AUA), the American Society for Radiation Oncology (ASTRO), and the Society of Urologic Oncology (SUO) guidelines on clinically localized prostate cancer. Specifically, he highlights recommendations on shared decision making, risk stratification to dictate the therapy, care options, active surveillance, and directions for future research.

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Utilization of Advanced Practice Providers

Chris M. Gonzalez, MD, MBA, FACS, explains how integrating advanced practice providers (APPs) into the urology workforce may provide a solution to increasing physician demand in the United States. He then discusses the American Urological Association’s (AUA’s) perspective of the physician led, team-based approaches to integrating APPs, state scope of practice laws, on-site and didactic training options, the possibility of inpatient APP consultation, and reimbursement for APP services.

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Biomarkers for Prostate Cancer: Whom to Treat

Gerald L. Andriole, Jr., MD, discusses the limitations and successes in the design of the Prostate, Lung, Colorectal and Ovarian Cancer Screening Trial (PLCO) and European Randomized Study of Screening for Prostate Cancer (ERSPC) trials. He also emphasizes the importance of patient selection in PSA screening and utilizing other diagnostic methods.

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En Bloc TURB – More Than a Safe and Feasible Surgical Technique

Salvatore Micali, MD, discusses the pros and cons of en bloc transurethral resection of bladder (TURB) and its advantages over classical TURB. Specifically, he describes how en bloc TURB lends itself to correct specimen orientation, easier identification of the tumor growth front and whether the disease has invaded the chorion, and better determination of the deep surgical margin.

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AUA Urethral Stricture Guidelines

Chris Gonzalez MD, MBA, FACS, who served on the 2016 American Urological Association (AUA) Male Urethral Stricture Panel, summarizes the guidelines his panel drafted and provides commentary. He analyzes the indications for evaluation, diagnosis, treatment, and follow up in bulbar, penile, and prostatic urethral strictures, as well as in pelvic fracture urethral injury (PFUI). Furthermore, he discusses the future research needed to perfect urethral stricture management practices.

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