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2024

The Artificial Urinary Sphincter in Complex Situations

The Artificial Urinary Sphincter in Complex Situations

Posted by | Jul 2024

Margit M. Fisch, MD, FEAPU, FEBU, discusses the use of artificial urinary sphincters for the management of complex male Stress Urinary Incontinence (SUI) cases. She begins with a review of the body of data supporting the success rates of artificial urinary sphincters in straightforward cases.

Dr. Fisch then addresses the complications and their impact on the success of artificial urinary sphincter implantation, including:

Comorbidities
Post-Irradiation Status
Post-Urethroplasty Status
Reimplantation
Use of Transcorporal Cuff

For each of these complications, Dr. Fisch demonstrates strategies and best practices for minimizing their impact on surgical and patient outcomes.

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The Future of AI in Pathologic Evaluation of Prostate Cancer

The Future of AI in Pathologic Evaluation of Prostate Cancer

Posted by | Jul 2024

Francisco G. LaRosa, MD, FCAP, explores possible applications for artificial intelligence (AI) in prostate cancer detection and treatment. He begins by outlining the potential benefits of AI in prostate cancer evaluation.

Dr. LaRosa then discusses the technological innovations which allowed AI to be incorporated as a tool in prostate cancer detection. He presents current examples of AI being used in prostate cancer screening.

However, Dr. LaRosa concludes by cautioning against relying on AI He outlines current issues with machine-vision capabilities, detection models, unclear objectives, and contaminated training data.

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Cognitive Bias in Practice and Training

Cognitive Bias in Practice and Training

Posted by | Jul 2024

Justin J. Badal, MD, examines the impact of cognitive bias in medical training and practice on clinical decision-making, diagnostic accuracy, and patient outcomes. He begins by defining cognitive bias, and analyzing common biases, including:

Representativeness Bias
Misconception of Regression Bias
Availability Bias
Adjustment and Anchoring Bias

Dr. Badal demonstrates examples of the impact of each bias in diagnostic testing, clinical decision-making, and patient outcomes. He concludes by making recommendations for counteracting cognitive bias in practice with evidence that bias training improves overall clinician performance.

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Success with Sacral Neuromodulation

Success with Sacral Neuromodulation

Posted by | Jul 2024

Robert J. Evans, MD, FACS, provides practical guidance on successfully incorporating sacral neuromodulation (SNM) into a urology practice. He begins by discussing proper documentation strategies to avoid SNM being rejected by insurance.

Dr. Evans then shares his approach to patient education and engagement. He presents the available options for SNM devices and implantation procedures. He outlines the ideal patient profile for staged versus peripheral nerve evaluation procedures, and he discusses the level of patient engagement required for rechargeable versus non-rechargeable SNM devices.

Dr. Evans concludes by providing guidance on troubleshooting. He presents common technical issues and patient experiences with SNM devices. For each issue, he presents solutions which can be implemented in-office.

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Optilume® BPH Catheter System: Optilume® Care Pathway and Treatment Options

Optilume® BPH Catheter System: Optilume® Care Pathway and Treatment Options

Posted by | Jul 2024

E. David Crawford, MD, Stephen Kaplan, MD, and Kevin T. McVary, MD, FACS, explore the utility of the Optilume® BPH Catheter System, a novel minimally-invasive surgical therapy (MIST). This is the second in a series supported by Laborie.

Dr. McVary begins with an overview of the current BPH market, diagnostic, and treatment algorithms and pharmaceutical/surgical treatment pathways. He illustrates the growing population of men with BPH who are underserved by pharmaceuticals, and those who are concerned about long-term effects of medication on their sexual function. Additionally, he discusses the dangers of delaying surgical management when it is indicated.

Dr. Kaplan then compares the function and outcomes of the Optilume® BPH Catheter System to those of current MIST and invasive surgeries. With an emphasis on the preservation of sexual function and low intraoperative risk, Dr. Kaplan and Dr. McVary discuss the clinical data, their experience with using the Optilume® BPH Catheter System, and their expectations for real-world data.

To see the Thought Leader Q&A session on this topic, click here [link to Q+A on GRU]. To see the first part of this series, click here. For more informational content on the latest developments on men’s health topics like BPH, please visit our Men’s Health Next-Generation Learning Center.

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