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2024

Loops, Lasers, Robots, Staples, and Steam: What to Offer for BPH Today and Tomorrow?

Loops, Lasers, Robots, Staples, and Steam: What to Offer for BPH Today and Tomorrow?

Posted by | Jan 2024

Ricardo R. Gonzalez, MD, presents current and emerging novel treatment options for benign prostatic hyperplasia (BPH). He begins by establishing appropriate categorization of Minimally Invasive Surgical Therapies (MIST) versus Surgical (OR) treatment options for BPH, and the patient criteria for each.

Dr. Gonzalez then presents current FDA-approved MIST options for BPH, including steam-based treatments, devices, and implant options, and FDA-approved OR options, including water-based ablation treatments. He then presents patient examples of the presented treatment options, discussing the pros and cons of each option for the patient.

Dr. Gonzalez then discusses emerging treatment options for BPH which have not yet been approved by the FDA. He discusses nitinol prostate stents as an emerging MIST option, and laparoscopic shunting to decrease testosterone around the prostate as an emerging OR option.

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Focal and Salvage Therapies for Prostate Cancer: What’s Worth It and What’s Not?

Focal and Salvage Therapies for Prostate Cancer: What’s Worth It and What’s Not?

Posted by | Jan 2024

Peter A. Pinto, MD, examines the current state of focal and salvage therapies for the treatment of prostate cancer, and offers his insights into which therapies are worth pursuing. He begins by addressing various kinds of salvage therapy, acknowledging that salvage therapy is a response to failed focal, radiation, or surgical therapy, and specifying that this presentation will focus on salvage therapy after failed radiation therapy.

Dr. Pinto explains that focal ablation therapy, whole gland ablation therapy, and surgical therapy are the most common salvage therapies after a radiation therapy failure. He recommends using an MRI-based biopsy method over more traditional methods to maximize accuracy in identifying lesions.

Dr. Pinto then recommends focal ablation over whole gland ablation as a salvage therapy after failed radiation therapy due to the high morbidity associated with whole gland ablation. Dr. Pinto concludes by listing the many ablation options for salvage therapy, and presents studies which examined the pros and cons of each option, offering his insights on each study.

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Programmatic and Institutional Paradigms for Building and Sustaining a Successful Wellness Program

Programmatic and Institutional Paradigms for Building and Sustaining a Successful Wellness Program

Posted by | Jan 2024

Wesley A. Mayer, MD, presents actionable programmatic and institutional paradigms for building and sustaining a successful wellness program within one’s practice or institution while avoiding burnout. He begins by defining the elements of burnout, their impact on institution-wide productivity, and the high rate of burnout in the field of Urology.

Dr. Mayer then turns to the ACGME’s well-being requirements for Urology programs. While these requirements were intended to preserve the wellness of faculty and residents in theory, Dr. Mayer highlights that the lack of specific goals in institutional wellness programs can lead to “hedonistic” initiatives and inconsistent results.

Dr. Mayer then turns to how his own institution, the Scott Department of Urology at Baylor Medical School, sought to consistently address burnout. He outlines the paradigm created by his department, the tools they used to evaluate the success of their efforts, and the results.

He concludes by enumerating the steps other institutions can take to implement similar anti-burnout programs. He provides suggestions for national-level interventions, and reinforces the need for intentionality behind wellness programs.

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Female Chronic Pelvic Pain Made Simple

Female Chronic Pelvic Pain Made Simple

Posted by | Jan 2024

Robert J. Evans, MD, FACS, discusses the complexities of female chronic pelvic pain. Over the course of his presentation, Dr. Evans explores:

Challenges in Diagnosis
Multimodal Treatment Approaches
Medication Strategies
Importance of Physical Therapy
Patient Empowerment

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A Urologist’s Nightmare: Evaluation and Management of CP/CPPS Patient

A Urologist’s Nightmare: Evaluation and Management of CP/CPPS Patient

Posted by | Jan 2024

Christopher P. Smith, MD, MBA, MSS, discusses the diagnosis and management of chronic prostatitis and pelvic pain syndrome (CP/CPPS). He begins by presenting an algorithm for diagnosis, noting that CP/CPPS is non-specific and often a diagnosis of exclusion with unclear causes.

Dr. Smith presents the UPONT classification system for CP/CPPS as a tool to categorize and diagnose CP/CPPS based on the individual patient’s symptoms. He notes that most CP/CPPS patients have symptoms of at least two domains of the UPONT classification system.

Dr. Smith discusses the role of patient history, labs, and imagining in CP/CPPS diagnosis. He presents tools which can be used by both patient and physician to find a more specific diagnosis.

Dr. Smith concludes by addressing symptom relief and management of CP/CPPS. He reviews the benefits and drawbacks of interventions ranging from dietary and behavioral changes to low-intensity shockwave therapy.

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