The King of Enucleations: HoLEP
Mitchell R. Humphreys, MD, MPH, delves into benign prostatic hyperplasia management and holmium laser enucleation (HoLEP).
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Topic: Men’s Health
Penile Filling with Hyaluronic Acid – Where are We
Fernando Tardelli, MD, explores penile enlargement, particularly using hyaluronic acid (HA) fillers as a minimally invasive approach.
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New Approaches to the Management of Priapism: Guidelines Commentary
Arthur L. Burnett II, MD, MBA, FACS, reflects on over 30 years of research on priapism.
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5-Alpha Reductase Inhibitors Increase the Risk of Aggressive Prostate Cancer: Fact or Myth
Gerald L. Andriole, Jr., MD, challenges misconceptions about 5-ARIs in urology, focusing on their role in prostate cancer.
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IPP and Penile Curvature Decisions: Doing Nothing, Something or Everything
Jay Simhan, MD, FACS, examines the challenges of penile implants in patients with refractory erectile dysfunction and Peyronie’s disease.
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The Future of Male SUI Surgery is Now
Brian J. Flynn, MD, explores advancements in treating male stress urinary incontinence, and the shift toward passive and adjustable devices.
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Managing the Post Radiation Bladder Neck and Proximal Urethral Stricture Challenges
Jay Simhan, MD, FACS, explores the challenges of post-radiation bladder neck and proximal urethral strictures.
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Morcellation and Potential HoLEP Complications
Amy E. Krambeck, MD, discusses HoLEP morcellation and its associated complications, emphasizing procedural refinements and patient safety.
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MIST Procedures and Sexual Dysfunction
Faysal A. Yafi, MD, FRCSC, discusses minimally invasive surgical procedures and their impact on sexual dysfunction.
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Urodynamics Review
Stephen R. Kraus, MD, MBA, FACS, provides a comprehensive review of urodynamics, discussing key concepts and practical applications in evaluating lower urinary tract function. This 14-minute presentation emphasizes the importance of understanding both the storage and emptying phases of bladder function.
Dr. Kraus details how dysfunction can arise from a bladder issue, an outlet problem, or both. Specific examples are given and complex cases are also included. Kraus notes results from various tests, such as those for stress incontinence, overactive bladder, and neurogenic bladder, help guide the use of urodynamics in clinical practice. He highlights the need for careful interpretation of test results to ensure accurate diagnosis and treatment planning.
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Post-Vasectomy Pain Syndrome
Jeffrey C. Morrison, MD, addresses post-vasectomy pain syndrome (PVPS) following vasectomy. In this 11-minute presentation, he highlights the significant challenge PVPS presents to patients and clinicians, emphasizing that a broad differential and comprehensive workup, including physical exams and diagnostic tests, is essential.
Although the cause of PVPS remains uncertain, Dr. Morrison discusses possible contributing factors, such as neuropathic, obstructive, or immune-driven etiologies. He presents treatments, both conservative approaches like scrotal support and anti-inflammatory medications, and options like neuromodulator therapy, pelvic floor physical therapy, and acupuncture.
Dr. Morrison also discusses treatment for those who require additional management, such as spermatic cord block, and surgical options, including microdenervation and vasectomy reversal.
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Surgical BPH: 2024 Updates and Where Are We Going
Nicole L. Miller, MD, FACS, delivers an incisive update on the surgical management of benign prostatic hyperplasia (BPH). In this 11-minute presentation, Dr. Miller outlines the current AUA guidelines, highlighting a broad spectrum of treatments tailored to prostate size. Trends in national data reveal that transurethral resection of the prostate (TURP) remains the dominant procedure, while minimally invasive options like UroLift have gained substantial traction.
Dr. Miller discusses emerging technologies, including the OptilumeⓇ BPH System. She also reviews promising data on MRI-guided transurethral ultrasound ablation (TULSA). Advanced laser techniques, particularly holmium pulse modulation, and thulium fiber laser, are explored for their efficacy in enucleation procedures, showing advantages in operative time, hemostasis, and same-day discharge rates. Miller highlights evolving techniques like en bloc enucleation with early apical release. A brief discussion on robotic-assisted simple prostatectomy includes recent shifts toward single-port approaches.
Dr. Miller stresses the importance of aligning treatment with patient preferences and quality-of-life goals, emphasizing shared decision-making as central to optimizing outcomes in this rapidly advancing field.
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