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2024

APC Pathways – The Large Urology Group Practice Model

APC Pathways – The Large Urology Group Practice Model

Posted by | Aug 2024

Jeffrey M. Spier, MD, and Travis Mendel, MD, discuss the use of Advanced Prostate Cancer (APC) Pathways within large urology group practices. Dr. Spier begins by reviewing the impact of oral options and other advances in treatment collaboration between APC patients and their physicians which led to the formation of large urology group practices.

Dr. Spier then discusses the factors which contribute to the success of large urology groups in treating patients with APC, with an emphasis on improved quality of care. He highlights the importance of combining real-world clinical intelligence with a multidisciplinary approach for continuous improvement in the quality of care received by patients.

Dr. Mendel takes over from Dr. Spier by explaining the differences between clinical guidelines and clinical pathways. He presents examples of treatment pathways for various stages of APC, with a focus on the impact of PSMA-PET.

Dr. Mendel concludes by discussing the potential use of these pathways in creating better AI treatment aids for physicians. Dr. Spier ends the presentation with an emphasis on the positive impact of a multidisciplinary team.

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Optilume® BPH Catheter System: Surgical Procedure and BPH Patient Management

Optilume® BPH Catheter System: Surgical Procedure and BPH Patient Management

Posted by | Aug 2024

E. David Crawford, MD, Dean S. Elterman, MD, MSC, FRCSC, and Garrett D. Pohlman, MD, explore the practical functionality of the Optilume® BPH Catheter System, a novel minimally-invasive surgical therapy (MIST). This is the third in a series supported by Laborie.

Dr. Elterman begins with a step-by-step demonstration of the Optilume® BPH Catheter System’s surgical procedure. For each step, he provides his perspective on best practices during the procedure.

Dr. Pohlman then discusses the management of BPH patients and the patient’s perspective on what successful treatment looks like. He addresses pretreatment guidance and counseling for BPH patients who are eligible for the Optilume® BPH Catheter System, i.e., patients looking for a minimally-invasive BPH treatment without the need for medication.

Dr. Crawford concludes by asking Dr. Elterman and Dr. Pohlman for their perspectives on patient and physician reception of the Optilume® BPH Catheter System in their practices. Dr. Pohlman discusses his experiences with reimbursement, significant flow improvement, and options for balloon sizing. Dr. Elterman discusses the durability of patient QoL improvement, limited catheter time, and sexual function preservation.

To see the first part of this series, click here. To see the second part of this series, click here.

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Competing Risks for Small Renal Masses

Competing Risks for Small Renal Masses

Posted by | Aug 2024

Jeremy Slawin, MD, MBA, addresses competing risks in managing small renal masses (SRM), balancing treatment versus active surveillance of low risk disease. He begins by illustrating the characteristics of SRMs.

Dr. Slawin recognizes the low metastatic potential of SRMs. In combination with their average slow growth rate, SRMs under 3cm often do not need intervention beyond surveillance.

Dr. Slawin concludes by comparing the 5-year survival rates of patients with SRM versus all other causes. He offers online tools, like the RCC Competing Risk Model, and framing techniques to help clinicians effectively communicate the risks of SRM treatments to individual patients.

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Therapeutic Modalities for BPH

Therapeutic Modalities for BPH

Posted by | Aug 2024

Brian T. Helfand, MD, PhD, explores therapeutic modalities to prevent non-compliance in patients with Benign Prostatic Hyperplasia (BPH). He begins by establishing the pattern of medication-based non-compliance in BPH patients due to the impact on sexual function, and the evolution of BPH management.

Dr. Helfand then discusses recent technologies for BPH management which preserves sexual function. He presents current options for surgical intervention for BPH ranging from minimally-invasive surgical therapies to prostatectomies. For each option, he explores the treatment’s durability and impact on quality of life.

Dr. Helfand concludes by presenting resources to help urologists and patients choose the most appropriate treatment modality for their individual cases. He emphasizes the importance of involving the patient in the decision-making process in order to ensure compliance.

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Priapism: How Do We Manage, and How Do We Learn How to Manage in 2024?

Priapism: How Do We Manage, and How Do We Learn How to Manage in 2024?

Posted by | Aug 2024

Thomas J. Walsh, MD, MBA, MS, discusses practical strategies for evaluating, diagnosing, and managing ischemic priapism. He begins with an overview of the symptoms, diagnosis, associated risks, and standard treatment procedures for the management of ischemic priapism.

Dr. Walsh then turns to effective treatment options after intracavernosal phenylephrine and corporal aspiration fail. He outlines various types of distal shunting, corporal tunneling, penoscrotal decompression, and early prosthesis placement.

Dr. Walsh concludes by addressing the lack of standardized training for treating ischemic priapism. He outlines a simulation curriculum designed to quickly train and presents the results from the pilot study.

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