2024 Archives

Artificial Intelligence and Machine Learning in Diagnosis of Urologic Cancer – Current Trends and Future Perspectives

Priya N. Werahera, PhD | Nov 2024

Priya N. Werahera, PhD emphasizes integrating artificial intelligence (AI) into clinical practice, highlighting this evolving field’s potential benefits and challenges. In this 13-minute presentation, Dr. Werahera underscores that AI must be carefully balanced with the expertise of doctors and pathologists, a crucial part of the diagnostic and decision-making processes.

Dr. Werehera discusses both Virtual AI (diagnosis, symptom management) and Physical AI (robotic surgery, nanotechnology for drug delivery). He notes the benefits of integrating AI into practice, such as precision diagnoses, individualized therapies, and cost savings. He also discusses the importance of supervised and unsupervised learning for AI models, providing a renal cancer example to illustrate different approaches using AI.

Looking towards the future, the speaker expresses optimism about AI’s potential to transform healthcare by enhancing diagnostic accuracy, improving patient outcomes, and streamlining healthcare delivery. This collaborative approach, where AI supports but does not supplant clinicians, is seen as the key to unlocking a bright future in healthcare characterized by innovation and improved quality of care.

Functional Urology: A New Sub-Specialty or Rebranding?

Brian J. Flynn, MD | Nov 2024

Brian J. Flynn, MD, focuses on defining and exploring the evolving specialties of functional and reconstructive urology, emphasizing the need for rebranding within the field. In this 11-minute talk, he stresses that functional urology, similar to specialties like female pelvic medicine and pediatric urology, deserves rebranding efforts.

Dr. Flynn advocates for collaboration between urologists and non-physicians to expand the field’s influence, particularly in addressing lower urinary tract dysfunctions. He also discusses how urologists can better integrate into the broader medical community, learning from global models, especially in Europe and Canada, where functional and integrative approaches are more advanced.

Functional urology is a comprehensive, patient-centered specialty with a broad scope of practice encompassing all lower urinary tract disorders.

Tales from the GME Crypt: Managing Challenging (and Scary) Residency Dilemmas

Wesley A. Mayer, MD | Nov 2024

Wesley A. Mayer, MD, focuses on effectively managing challenges faced in residency programs, emphasizing remediation strategies over punitive measures. Drawing from his experience as a program director and assistant dean of Graduate Medical Education (GME), Dr. Mayer addresses dilemmas common in residency, outlining a practical approach to navigating issues such as technical skill deficiencies, communication breakdowns, and personal crises among trainees.

In this 20-minute presentation, Dr. Mayer differentiates remediation from probation, advocating for remediation as a supportive, non-reportable process for skill enhancement. The importance of recognizing warning signs, such as poor performance or behavioral changes, is highlighted, stressing early intervention and the role of the GME office in offering support and resources.

Current State of the Art in Bladder-Preserving Trimodality Therapy for Muscle-Invasive Bladder Cancer

Jason A. Efstathiou, MD, DPhil | Nov 2024

Jason A. Efstathiou, MD, DPhil, FASTRO, FACRO, emphasizes the growing interest in bladder preservation therapies as an alternative to radical cystectomy for muscle-invasive bladder cancer (MIBC). While cystectomy remains an effective treatment, it is not performed in about half of eligible patients. Trimodality therapy (TMT), combining maximal transurethral resection (TUR), chemotherapy, and radiation, offers a promising bladder-sparing approach.

In this 11-minute presentation, Dr. Efstathiou compares outcomes between TMT and cystectomy, showing no significant difference in metastasis-free or cancer-specific survival. A shift toward biomarker-driven management is also highlighted, with specific markers, such as MRE11 and immune signatures, indicating better responses to chemoradiation. Immunotherapy is increasingly integrated into treatment regimens, with promising trials like SWOG 1806 exploring the addition of immune checkpoint inhibitors to chemoradiation.

TMT, now recognized by major guidelines, offers patients a viable option with preserved bladder function, improved quality of life, and less life interference. The presentation stresses the need for improved staging, expanded access to bladder-sparing options, and informed decision-making to optimize outcomes for MIBC patients.

Management of Peyronie’s Disease

Ayman Soubra, MD | Nov 2024

Ayman Soubra, MD, addresses the treatment of Peyronie’s disease. In this 24-minute presentation, he begins by reviewing the condition, its pathophysiology, and its prevalence. Dr. Soubra also discusses the evaluation of Peyronie’s disease, including a thorough medical history, examination for familial traits (such as Dupuytren’s contractures), and physical examination.

Several treatment options exist, from noninvasive oral and topical therapies to mechanical therapies like vacuum and traction devices. Dr. Soubra discusses intralesional collagenase injections at length. This therapy is FDA-approved based on clinical trials and significantly improves penile curvature. For severe cases, surgical options such as tunical plication or grafting may be necessary, especially for patients with significant deformities or erectile dysfunction. Soubra shares indications and techniques for this procedure in detail.

Dr. Soubra recommends multimodal approaches tailored to the patient’s specific goals and severity of symptoms.