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BackTable Urology

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The BackTable Urology Podcast is a resource for practicing urologists to learn tips, techniques, and practical advice from their peers in the field. Listen here or on the streaming platform of your choice.

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  • 20 episodes
  • weekly
  • Avg 49 min
  • English

Episodes 20

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  • Tuesday · 1 hr

    Ep. 329 Surgical Approaches to Bladder Outlet Obstruction with Dr. John DiBianco

    With so many treatment options for bladder outlet obstruction, how do you select the best approach for each patient? On this episode of BackTable Urology, host Dr. Jose Silva is joined by Dr. John DiBianco for a practical discussion on evaluating lower urinary tract symptoms and matching patients with the right intervention. They emphasize confirming that symptoms are truly due to benign prostatic hyperplasia (BPH) before proceeding, and walk through triggers for intervention, including quality-of-life impact, UTIs, renal impairment, high post-void residual, bladder stones, and retention. --- Get the BackTable app https://www.backtable.com/app --- Timestamps 00:00 - Introduction 03:24 - Complex BPH Referrals and Symptom Assessment 06:07 - Deciding When to Operate 11:12 - Imaging and Prostate Sizing 14:27 - When to Use Cystoscopy and Urodynamics 16:43 - Incorporating Patient Preferences 21:53 - Medical Therapy and Pills 23:45 - Decision Aids and Personal Experience 27:13 - Managing HoLEP Complications and Leakage 32:57 - Advances in HoLEP Technique 36:07 - TURP Indications and Outcomes 38:36 - Special Considerations: Radiation and UroLift 39:58 - ThULEP vs. HoLEP 41:17 - Redo Surgery Strategies 43:52 - Counseling Through Case Scenarios 56:16 - Future Directions in BPH Treatment 59:05 - Wrap Up and Credits --- More about this episode The conversation covers everything from surveillance and imaging-based prostate sizing to when to use cystoscopy and urodynamics for complex or high-risk patients. Drs. Silva and DiBianco compare procedure options like HoLEP, TURP, GreenLight, UroLift, PAE, iTind, and aquablation, highlighting how factors like prostate size, morphology, history, and patient goals drive decision-making. They discuss durability, redo surgery issues, management of radiation patients, and postoperative care including leakage management and pelvic floor therapy. The episode wraps up with future directions in BPH procedures and practical counseling tips for patient satisfaction. --- Resources Love this episode? Check out BackTable.com and search “BPH” to get more information on a variety of the surgical options discussed in this episode, including HoLEP, Aquablation, PAE, and more! Further resources include the BackTable App, which has a course on treating Benign Prostatic Hyperplasia. --- BackTable Urology is the go-to podcast for urologists, urologic oncologists, and urogynecologists. Download the free BackTable app to get early access to new episodes, cases, and courses curated by physicians in your specialty. ► https://www.backtable.com/app

  • September 8 · 56 min

    Ep. 328 Shared Decision-Making in Overactive Bladder Care with Dr. Jannah Thompson

    Can shared decision-making and patient support change the treatment journey for overactive bladder? On this episode of BackTable Urology, host Dr. Suzette Sutherland and OAB expert Dr. Jannah Thompson discuss how patient education, clear counseling, and ongoing follow-up improve care for patients with overactive bladder and urge incontinence. They cover practical strategies for building an effective OAB care pathway, staff training for better patient navigation, and proactive approaches that increase adherence and access to advanced therapies. --- Get the BackTable app https://www.backtable.com/app --- This podcast is supported by Medtronic Pelvic Health https://urgencyisreal.com/ --- Timestamps 00:00 - Introduction 04:00 - Shared Decision-Making 06:51 - Clinic Efficiency 10:38 - Expanding OAB Therapy Options 12:27 - Long-Term OAB Care 17:41 - Building an OAB Program 18:18 - Staff Training and Follow-Up 25:32 - OAB Navigator Implementation 27:14 - Navigation Outcomes 28:39 - Scaling with Staff and Epic 30:35 - Algorithm Resources 34:08 - Neuromodulation Advances 38:37 - New Tibial and Battery-Free Devices 40:56 - Quality of Life in OAB Care 46:11 - Access and Adoption 51:22 - Streamlining Therapy Discussions 52:47 - Closing Remarks --- More about this episode The conversation explores the diverse landscape of OAB treatment options, the evolving role of neuromodulation, and how new technologies are enabling more personalized care. Dr. Thompson shares insights on empowering staff as part of the clinical team, leveraging patient navigators to boost follow-up and advanced therapy uptake, and the importance of integrating patient preferences and lifestyle factors into every decision. They emphasize that quality of life, not just symptom control, should be central to OAB management, and discuss how to engage patients as partners throughout their treatment journey. --- Resources Patient navigation for overactive bladder improves access to care https://link.springer.com/article/10.1007/s00192-019-04085-7 --- BackTable Urology is the go-to podcast for urologists, urologic oncologists, and urogynecologists. Download the free BackTable app to get early access to new episodes, cases, and courses curated by physicians in your specialty. ► https://www.backtable.com/app

  • September 1 · 48 min

    Ep. 327 Clinical Approaches to Testicular Cancer Management with Dr. Sean Kern and Dr. Sam Funt

    What are the key considerations for choosing between surveillance, surgery, and chemotherapy in testicular cancer? On this episode of BackTable Urology, host Dr. Rich Matulewicz is joined by Dr. Sean Kern and Dr. Sam Funt for an in-depth discussion on clinical approaches to testicular cancer. They start with a real-world case, reviewing initial evaluation, imaging, tumor markers, and counseling on fertility, body image, and hypogonadism. The conversation highlights how nuanced patient selection influences decisions between surveillance, surgical intervention, and adjuvant chemotherapy. --- Get the BackTable app https://www.backtable.com/app --- Timestamps 00:00 - Introduction 01:40 - Initial Case Workup and Counseling 06:28 - Why Testicular Cancer Happens 09:17 - Management Considerations with Post-Orchiectomy Pathology 19:21 - RPLND Benefits and Drawbacks 23:39 - Surveillance Schedule and Long Term Follow Up 28:17 - Second Tumor Risk 30:36 - Evolving Seminoma Treatment 37:57 - RPLND Selection Factors 40:10 - Adjuvant Chemo Debate and Pathology 46:06 - Closing Takeaways --- More about this episode The episode explores postoperative management, including long-term surveillance, risk of a second tumor, and strategies for lifelong follow-up. The doctors discuss evolving practice in the management of low-volume stage II seminoma, the increasing use of RPLND to reduce chemo and radiation exposure, and the importance of extended patient counseling over multiple visits. The discussion emphasizes individualized care, the role of new diagnostics, and the need for reassurance and support throughout the treatment journey. --- Resources Society of Urologic Oncology https://suonet.org/home.aspx --- BackTable Urology is the go-to podcast for urologists, urologic oncologists, and urogynecologists. Download the free BackTable app to get early access to new episodes, cases, and courses curated by physicians in your specialty. ► https://www.backtable.com/app

  • August 27 · 50 min

    Ep. 326 Strategies for Surgical Training During High-Stakes Operations with Dr. Kelvin Moses

    How can high-stakes surgical cases be optimized for teaching while ensuring patient safety and trainee growth? On this episode of BackTable Urology, Dr. Ruchika Talwar interviews Dr. Kelvin Moses about intentional strategies for surgical education, especially during complex urologic oncology operations. They discuss workflows that prioritize preoperative planning, structured debriefs, and progressive autonomy for trainees, as well as the importance of psychological safety and open communication with patients and families. --- Get the BackTable app https://www.backtable.com/app --- Timestamps 00:00 - Introduction 02:19 - Teaching In High Stakes Cases 07:57 - Rethinking See One, Do One, Teach One 10:24 - Assessing Trainee Readiness 14:29 - Preop Preparation 16:06 - Teaching Cues in the OR 17:42 - Tips for Trainees 21:40 - Intentional Teaching 24:02 - Teaching Rare and Complex Cases 26:40 - Anticipating Complications and Debrief After Disaster 33:09 - Psychological Safety In the OR 37:41 - Reflections on Past, Current, and Future Training Models 43:56 - Patients And Trainees 46:51 - Takeways --- More about this episode The conversation explores practical intraoperative teaching cues, tips for trainees such as visualization, recording cases, and repetition, and methods for relating rare cases to more common procedures. Dr. Moses reflects on the strengths and challenges of past, present, and future training models, including the debate over whether surgical education has gone “too soft.” The episode emphasizes the value of mentorship, transparency with patients, and the need to continually adapt surgical training for the next generation. --- BackTable Urology is the go-to podcast for urologists, urologic oncologists, and urogynecologists. Download the free BackTable app to get early access to new episodes, cases, and courses curated by physicians in your specialty. ► https://www.backtable.com/app

  • August 25 · 45 min

    Ep. 325 Navigating the PSA Maze in Urology with Dr. Tarik Benidir

    Is an elevated prostate-specific antigen (PSA) the beginning or the end of the prostate cancer workup? On this episode of BackTable Urology, Dr. Ruchika Talwar interviews Dr. Tarik Benidir to explore the “PSA problem,” explaining why PSA is biologically useful but clinically imprecise, often leading to false positives, unnecessary biopsies, and detection of indolent disease. They discuss a rational, patient-centered approach to elevated PSA, including when to repeat the test, how to interpret results in the context of age, race, family history, and prostate size, and the use of PSA density and age-adjusted norms instead of rigid cutoffs. --- Get the BackTable app https://www.backtable.com/app --- This podcast is supported by Cleveland Diagnostics https://www.isopsa.com/ --- Timestamps 00:00 - Introduction 04:03 - Why PSA Can Be Misleading 06:43 - Approach to Elevated PSA and Initial Workup 09:51 - MRI, PSA Density, and Biomarker Testing 14:31 - Guidelines, Diagnostics, and When to Biopsy 20:16 - Comparing 4K, IsoPSA, and Other Biomarkers 25:23 - Choosing Between Transperineal and Transrectal Biopsy 28:42 - Management Considerations for Elderly and Comorbid Patients 33:09 - Active Surveillance, Recurrence, and Long-Term Monitoring 40:47 - Key Takeaways and Closing Remarks --- More about this episode The conversation highlights the role of reflex biomarkers, MRI scans, and selective biopsy strategies to reduce unnecessary procedures and focus on identifying clinically significant cancers. Dr. Benidir explains how to weigh MRI results, when to use biomarkers, and how to approach decisions in elderly or comorbid patients. They also discuss new biopsy modalities, active surveillance, and future directions for optimizing PSA-based screening and management. --- BackTable Urology is the go-to podcast for urologists, urologic oncologists, and urogynecologists. Download the free BackTable app to get early access to new episodes, cases, and courses curated by physicians in your specialty. ► https://www.backtable.com/app

  • August 18 · 41 min

    Ep. 324 Recurrent UTI: Diagnostics & Management Strategies with Dr. Glenn Werneburg

    What should you do differently when a UTI becomes a recurring problem? In this episode of the Backtable Podcast, host Dr. Anjali Kapur is joined by physician-scientist Dr. Glenn Werneburg to discuss the latest approaches to recurrent urinary tract infections, including key updates from the 2025 AUA, CUA, and SUFU guidelines. They use real clinical cases to explore diagnosis, prevention, antibiotic selection, and the management of complex patients. --- Get the BackTable app https://www.backtable.com/app --- This podcast is supported by Medtronic https://www.medtronic.com/en-us/e/patients-caregivers/urinary/overactive-bladder.html --- Timestamps 00:00 - Introduction 04:05 - Case One: Recurrent UTIs 05:19 - Workup Basics 08:50 - Non-Antibiotic Prevention 11:42 - Antibiotic Prophylaxis Options 15:16 - Case Two: Asymptomatic Bacteriuria 19:14 - Case Three: Complex Patients 19:58 - Male vs. Female UTIs 21:22 - Neurogenic Bladder Workup 22:52 - Elderly Patients and ID Consults 25:01 - Case Four: Transplant ESBL 25:23 - Machine Learning for Antibiotics 29:49 - Catheter Biofilms 31:55 - Embedded Bladder Reservoirs 35:23 - Recurrent UTI Vaccine 36:23 - Future of Recurrent UTIs 39:04 - Wrap Up --- More about this episode The doctors define recurrent UTI and outline the standard workup, including history, physical and pelvic exam, urinalysis, urine culture, and antibiotic sensitivities. They also review occasions where additional testing may be warranted. The discussion covers interpretation of urinalysis, non-antibiotic prevention options, and antibiotic prophylaxis strategies, with consideration of antibiotic resistance and microbiome disruption. They address asymptomatic bacteriuria and when treatment is indicated, along with management considerations for men, patients with neurogenic bladder or CIC, and elderly patients. Dr. Werneburg also discusses his work with machine learning tools to predict antibiotic susceptibility earlier, catheter biofilms, the concept of embedded bladder bacteria reservoirs, and his multidisciplinary complex UTI clinic. --- Resources Recurrent Uncomplicated Urinary Tract Infections in Women: AUA/CUA/SUFU Guideline (2025) https://www.auanet.org/guidelines-and-quality/guidelines/recurrent-uti --- BackTable Urology is the go-to podcast for urologists, urologic oncologists, and urogynecologists. Download the free BackTable app to get early access to new episodes, cases, and courses curated by physicians in your specialty. ► https://www.backtable.com/app

  • August 11 · 38 min

    Ep. 323 Managing Intermediate-Risk Bladder Cancer with Dr. Charles Peyton

    Recurrent low-grade, intermediate-risk bladder cancer presents a unique treatment challenge: recurrence is common, progression is uncommon, and the burden of repeated procedures can add up quickly. On this episode of the BackTable Urology Podcast, Dr. Ruchika Talwar interviews Dr. Charles “Chas” Peyton about how to manage intermediate-risk bladder cancer patients while balancing disease control and quality of life. They discuss the cumulative impact of repeated TURBTs and explore the evolving role of office-based treatments and chemoablative therapies as alternatives to the traditional treatment cycle. --- Get the BackTable app https://www.backtable.com/app --- Timestamps 00:00 - Introduction 05:58 - Comparing Office Ablation and OR TURBT 08:26 - TURBT Impact on Quality of Life 11:37 - Uncovering Hidden Patient Burdens and Costs 14:44 - Integrating Chemoablation into Practice 18:20 - ENVISION QoL Study Setup 22:04 - Comparing TURBT Preferences 27:40 - Counseling Risk-Averse Patients 29:10 - Community Adoption Advice 31:59 - Upcoming Clinical Trials 35:28 - Biomarkers and Expanding Access 36:23 - Final Thoughts and Closing Remarks --- More about this episode The conversation covers practical strategies like office-based surveillance and fulguration for small recurrences, identifying triggers for returning to the OR, and recognizing the hidden burdens of TURBT complications such as hematuria, incontinence, and unplanned ER visits. Dr. Peyton reviews the role of chemoablative options for selected patients, discusses trial data on patient-reported outcomes, and addresses the mixed evidence, high costs, and need for individualized decision-making. The episode also explores new intravesical and FGFR-targeted therapies, underscores the importance of cost-conscious adoption and biomarkers, and considers how management approaches must evolve, especially in community practice settings. --- BackTable Urology is the go-to podcast for urologists, urologic oncologists, and urogynecologists. Download the free BackTable app to get early access to new episodes, cases, and courses curated by physicians in your specialty. ► https://www.backtable.com/app

  • August 6 · 50 min

    Ep. 322 Social Media's Role in Urologic Education with Dr. Rena Malik & Dr. Fenwa Milhouse

    How can you use social media to educate, empower, and inspire as a physician while staying true to your professional values? On this episode of BackTable Urology, guest host Dr. Maheetha Bharadwaj talks with Dr. Rena Malik and Dr. Fenwa Milhouse about building an authentic online presence that educates, inspires, and connects. The conversation highlights the power of visibility, the challenges of professional boundaries and misinformation, and the potential for social media to expand both patient outreach and career opportunities. --- Get the BackTable app https://www.backtable.com/app --- Timestamps 00:00 - Introduction 04:17 - Getting Started on Social Media 12:24 - Finding Your Niche 17:04 - Being a Woman in Urology 18:40 - Impact On Patient Care 23:59 - Doctor-Patient Boundaries 28:33 - Social Media Pitfalls 38:53 - Creator Monetization 45:58 - Advice for New Creators --- More about this episode They share insights from years of content creation, including tips for getting started, finding your niche, and balancing clinical work with online engagement. The discussion covers issues unique to women in urology, the impact of social media on patient care and doctor-patient boundaries, how to avoid burnout, and strategies for monetization and staying true to your message. The episode wraps up with practical advice for new creators and reflections on the privilege and responsibility of inspiring future urologists. --- BackTable Urology is the go-to podcast for urologists, urologic oncologists, and urogynecologists. Download the free BackTable app to get early access to new episodes, cases, and courses curated by physicians in your specialty. ► https://www.backtable.com/app

  • August 4 · 41 min

    Ep. 321 Exploring Hypospadias: Treatment Approaches and Patient Care with Dr. Vinaya Bhatia

    Hypospadias can be surgically corrected early in life, but many patients drop out of care before puberty or adulthood, leaving important urinary and sexual health concerns unaddressed. On this episode of BackTable Urology, Dr. Arthi Hannallah and Dr. Nicco Passoni talk with Dr. Vinaya Bhatia about improving lifelong engagement for people with hypospadias. They highlight advances in surgical technique, the role of research, and how digital tools like the WYSH platform help keep patients and families connected to care. --- Get the BackTable app https://www.backtable.com/app --- Timestamps 00:00 - Introduction 04:22 - Hypospadias Overview and Symptom Chronology 09:14 - Not A One Size Fits All: Developing WYSH 13:28 - Reengaging Families and Patients 20:04 - Adult Urology Sequelae 25:08 - Demystifying Surgery and Improving Training 34:00 - Centers of Excellence Debate 36:56 - Future Goals and Wrap Up --- More about this episode The discussion covers the development and impact of the WYSH platform, strategies for supporting long-term follow-up, and the learning curve of hypospadias surgery. Dr. Bhatia shares insights on better training, the creation of centers of excellence, and the importance of ongoing research and family engagement to improve quality of life at every stage. --- Resources Worldwide Yearly Screening for Hypospadias: https://clinicaltrials.gov/study/NCT06966375 --- BackTable Urology is the go-to podcast for urologists, urologic oncologists, and urogynecologists. Download the free BackTable app to get early access to new episodes, cases, and courses curated by physicians in your specialty. ► https://www.backtable.com/app

  • July 31 · 50 min

    Ep. 320 Gem-iDRS for BCG Unresponsive Bladder Cancer: A Deep Dive with Dr. Sarah Psutka

    Can a drug-eluting bladder device change the treatment algorithm for BCG-unresponsive non–muscle invasive bladder cancer (NMIBC)? In this episode of BackTable Urology, Dr. Ruchi Talwar interviews Dr. Sarah Psutka to explore the emerging role of a novel intravesical device that delivers sustained gemcitabine therapy for patients refusing or ineligible for cystectomy. They highlight new FDA-approved treatment options, real-world workflow considerations, and the clinical potential for continuous intravesical chemotherapy in a crowded therapeutic landscape. --- Get the BackTable app https://www.backtable.com/app --- This podcast is supported by Johnson & Johnson https://www.inlexzohcp.com/ --- Timestamps 00:00 - Introduction 02:40 - Why Focus on TAR-200 05:35 - Device Basics 07:05 - Dosing Schedule Explained 11:17 - SUNRISE-01 Trial Results 15:07 - Patient Selection and Contraindications 20:52 - Indications for Device Removal 23:26 - Clinic Workflow Learning Curve 25:56 - Tips for Insertion and Device Deployment 28:52 - Cystoscopy Findings and Surveillance Protocol 32:16 - Treatment Sequencing 38:43 - Future Trial and Research Directions 45:16 - Biomarkers, AI, and Personalizing Care 46:35 - Cost, Supportive Care, and Patient Burden 48:42 - Closing Thoughts --- More about this episode The conversation dives into patient selection, preparation, and side effect management for TAR-200, as well as the key findings from the SUNRISE-01 trial. Dr. Psutka discusses dosing schedules, when to remove the device, and how to handle complications like UTI, hematuria, and LUTS. The episode also covers surveillance protocols, the impact on clinic operations, and the importance of balancing vigilant cancer surveillance with patient burden. Finally, they touch on future directions, including biomarkers, AI-assisted pathology, and optimizing the timing of cystectomy and supportive care for a more personalized approach to NMIBC. --- Resources TAR-200 for Bacillus Calmette-Guérin–Unresponsive High-Risk Non–Muscle-Invasive Bladder Cancer: Results From the Phase IIb SunRISe-1 Study https://ascopubs.org/doi/10.1200/JCO-25-01651 SUO 2024: SunRISe-5: A Phase III, Randomized, Open-label Study of TAR-200 Compared with Intravesical Chemotherapy After Bacillus Calmette-Guerin in Recurrent, High-risk, Non-muscle Invasive Bladder Cancer SUO 2024: SunRISe-5: A Phase III, Randomized, Open-label Study of TAR-200 Compared with Intravesical Chemotherapy After Bacillus Calmette-Guerin in Recurrent, High-risk, Non-mushttps://www.urotoday.com/conference-highlights/suo-2024/suo-2024-bladder-cancer/156723-suo-2024-sunrise-5-a-phase-iii-randomized-open-label-study-of-tar-200-compared-with-intravesical-chemotherapy-after-bacillus-calmette-guerin-in-recurrent-high-risk-non-muscle-invasive-bladder-cancer.htmlcle Invasive Bladder Cancer Gemcitabine Intravesical System Plus Cetrelimab or Cetrelimab Alone as Neoadjuvant Therapy in Muscle-Invasive Bladder Cancer: SunRISe-4 Primary Analysis and Biomarker Results https://ascopubs.org/doi/10.1200/JCO-25-02382 INLEXZO - SunRISe-3 Study https://www.jnjmedicalconnect.com/products/inlexzo/medical-content/inlexzo-sunrise-3-study --- BackTable Urology is the go-to podcast for urologists, urologic oncologists, and urogynecologists. Download the free BackTable app to get early access to new episodes, cases, and courses curated by physicians in your specialty. ► https://www.backtable.com/app

  • July 28 · 1 hr 16 min

    Ep. 319 Reconstructive Techniques for Adult Buried Penis with Dr. Paul Rusilko

    The definitive treatment for adult acquired buried penis is surgery, but successful treatment depends on having a well-coordinated network of patient support, multidisciplinary care teams, and reconstructive urologic surgery expertise. This episode of Backtable Urology overviews this multifaceted disease and dives into reconstructive surgery techniques, featuring Dr. George Koch and Dr. Paul Rusilko. --- Get the BackTable app https://www.backtable.com/app --- Timestamps 00:00 - Introduction 04:10 - History of Buried Penis Treatment 08:47 - Grafts Versus Flaps 11:34 - Hidden Pathologies and Informed Consent 13:46 - Research and Insurance Approval 18:24 - Delayed Care and Disease Burden 22:31 - Deciding When to Operate and Temporizing Procedures 30:23 - Building Referral Networks 33:13 - Future Directions 36:42 - Infection Risk 41:15 - Technique Evolution 45:57 - Preop Evaluation Essentials 50:50 - Intraop Keys to Success and Graft Protection 59:26 - Postop Pathway and Teamwork 01:02:54 - W-Plasty Video Walkthrough 01:13:52 - Wrap Up --- More about this episode The doctors explore the nuances of surgical treatment, emphasizing the importance of thorough preoperative counseling given the high likelihood of unexpected intraoperative findings and the need to adjust the surgical plan. Dr. Rusilko also discusses the broader burden of disease, including depression, strictures, occult penile cancer, and the high rate of postoperative complications, most of which are low grade. He stresses that earlier referral may improve patient care. The episode concludes with practical surgical tips, guidance on building a buried penis practice, strategies for setting realistic recovery expectations, and an in-depth case review of his novel W-plasty technique. --- Resources W-plasty: A novel procedure for the repair of adult-acquired buried penis https://doi.org/10.1016/j.urolvj.2023.100219 --- BackTable Urology is the go-to podcast for urologists, urologic oncologists, and urogynecologists. Download the free BackTable app to get early access to new episodes, cases, and courses curated by physicians in your specialty. ► https://www.backtable.com/app

  • July 21 · 1 hr

    Ep. 318 Exploring Neuromodulation: Sacral vs Tibial Approaches with Dr. Ken Peters and Dr. Tracey Wilson

    More neuromodulation options mean more opportunities to personalize care. In this episode, Dr. Ken Peters and Dr. Tracey Wilson join Dr. Jannah Thompson to discuss the latest implantable tibial nerve stimulation and sacral neuromodulation technologies for OAB and UUI. They compare available devices, share practical insights on patient selection, and explore how shared decision making, advanced practice providers, and equitable access influence treatment adoption. --- Get the BackTable app https://www.backtable.com/app --- This podcast was developed in collaboration with Society of Urodynamics, Female Pelvic Medicine & Urogenital Reconstruction (SUFU) https://sufuorg.com/home.aspx --- Timestamps 00:00 - Introduction 07:59 - Overview of Nerve Stimulation Therapies 13:22 - Case #1 22:00 - Case #2 28:23 - Nuspera 34:21 - APPs in Practice 39:21 - Reimbursement Roadblocks 47:03 - Multimodal Therapy 49:51 - Case #3 56:06 - Final Advice --- Resources Randomized trial of percutaneous tibial nerve stimulation versus Sham efficacy in the treatment of overactive bladder syndrome: results from the SUmiT trial https://www.auajournals.org/doi/10.1016/j.juro.2009.12.036 Neuspera Medical Announces 12-Month Pivotal Trial Results for the Company’s Integrated Sacral Neuromodulation System for Urinary Urge Incontinence https://neuspera.com/neuspera-medical-announces-12-month-pivotal-trial-results-for-the-companys-integrated-sacral-neuromodulation-system-for-urinary-urge-incontinence/ Racial and Socioeconomic Factors Influence Utilization of Advanced Therapies in Commercially Insured OAB Patients: An Analysis of Over 800,000 OAB Patients https://www.sciencedirect.com/science/article/pii/S0090429520305574?via%3Dihub --- BackTable Urology is the go-to podcast for urologists, urologic oncologists, and urogynecologists. Download the free BackTable app to get early access to new episodes, cases, and courses curated by physicians in your specialty. ► https://www.backtable.com/app

  • July 16 · 47 min

    Ep. 317 Focal Therapy in Prostate Cancer Treatment with Dr. George R. Schade

    Can focal therapy truly “thread the needle” between active surveillance and radical prostate cancer treatment? In this episode of BackTable Urology, host Dr. Tiwa Akinsola is joined by Dr. George Schade from the University of Washington to explore focal therapy as a middle ground between active surveillance and radical treatments. Dr. Schade reviews non-radiation energy modalities including HIFU, TULSA/HI-DU, cryotherapy, and irreversible electroporation, highlighting patient selection, institutional experience, technical nuances, and quality-of-life outcomes from recent trials. --- Get the BackTable app https://www.backtable.com/app --- Timestamps 00:00 - Introduction 02:09 - Overview of Focal Therapy Modalities 04:46 - Deciding Between HIFU and IRE 06:56 - Evidence and Trials 09:40 - Counseling Patients on Outcomes 12:09 - Building a Focal Therapy Program 16:12 - Navigating Insurance and Appeals 21:48 - Managing Large Glands And TURP 25:12 - Preop Workup Essentials and OR Workflow 32:32 - Overcoming the Learning Curve 35:52 - PostOp Recovery and Surveillance 39:04 - Options for Managing Recurrence 42:44 - Challenges with Repeat Ablation 44:56 - Final Takeaways --- More about this episode The conversation covers candidate selection and confirmatory biopsy, perioperative technique and recovery, and ongoing surveillance with PSA, MRI, and biopsy. Dr. Schade also discusses challenges with insurance approvals, building a focal therapy practice, and options for managing recurrence, including repeat ablation, surgery, or radiation. The episode examines how to balance cancer control with quality of life and reviews the evolving evidence base supporting focal therapy’s role in prostate cancer treatment. --- Resources Irreversible Electroporation for Prostate Tissue Ablation in Patients with Intermediate-risk Prostate Cancer: Results from the PRESERVE Trial: https://www.sciencedirect.com/science/article/pii/S030228382500346X Focal therapy of localized prostate cancer https://pubmed.ncbi.nlm.nih.gov/35996758/ Focal Therapy for Prostate Cancer: Available Technologies, Patient Selection, Follow-Up Protocols and Reported Outcomes https://pubmed.ncbi.nlm.nih.gov/41339218/ --- BackTable Urology is the go-to podcast for urologists, urologic oncologists, and urogynecologists. Download the free BackTable app to get early access to new episodes, cases, and courses curated by physicians in your specialty. ► https://www.backtable.com/app

  • July 14 · 48 min

    Ep. 316 Bladder Cancer in the Community: Meeting Patients Where They Are with Dr. Adam J. Gadzinski

    As bladder cancer treatment options expand, so do the challenges of delivering them in real-world practice. On this episode of BackTable Urology, community urologic oncologist Dr. Adam Gadzinski joins Dr. Ruchika Talwar to discuss how evolving therapies for non–muscle-invasive bladder cancer (NMIBC) are changing the landscape for both patients and providers. They explore the financial, logistical, and workflow hurdles to adopting new treatments in community settings, as well as the unique opportunities for expanding access through local clinical trials. --- Get the BackTable app https://www.backtable.com/app --- This podcast is supported by Urogen https://www.zusduri.com --- Timestamps 00:00 - Introduction 02:51 - Delivering Bladder Cancer Care in the Community 09:08 - Navigating Treatment Choices 13:05 - Patient Expectations and Insurance Coverage 19:01 - Ablation Strategies for Low and Intermediate Risk 22:34 - Making Therapies Community Friendly 27:12 - Launching Community Trials 31:08 - Referrals and Community Practice Advice 36:36 - Cystectomy Counseling Pearls 44:46 - Closing Takeaways --- More about this episode The conversation covers decision-making for bladder-preserving therapies, radical cystectomy, and trimodal approaches, along with strategies for guiding patients through these complex choices. Dr. Gadzinski shares insights on navigating insurance, launching community trials, and sustaining practice growth while maintaining high-quality care. The episode also offers practical advice on referrals, patient counseling, and finding the right practice environment for long-term success in bladder cancer care. --- Resources Bladder Cancer Basics Handbooks https://bcan.org/bladder-cancer-basics-handbook/ Wellprept https://wellprept.com/foundation --- BackTable Urology is the go-to podcast for urologists, urologic oncologists, and urogynecologists. Download the free BackTable app to get early access to new episodes, cases, and courses curated by physicians in your specialty. ► https://www.backtable.com/app

  • July 10 · 48 min

    Ep. 315 Private Equity's Impact on Urology Practices with Dr. Benjamin Lowentritt

    What opportunities and challenges does private equity bring to urology practices, and how can physicians engage in ways that strengthen their practice and preserve clinical priorities? On this episode of BackTable Urology, Dr. Ruchika Talwar interviews Dr. Benjamin Lowentritt of Chesapeake Urology and United Urology Group to unpack the realities of private equity involvement in medicine. They discuss the motivations behind consolidation, the role of management services organizations, and strategies for building mutually beneficial partnerships while upholding physician autonomy and patient care. --- Get the BackTable app https://www.backtable.com/app --- Timestamps 00:00 - Introduction 02:58 - Why Urology Drew Private Equity 07:06 - Bad Headlines vs. Reality 11:14 - MSOs and Contracts Explained 15:24 - Timelines and After Private Equity 22:47 - Efficiency and Autonomy Fears 27:15 - Why Private Equity Gets Vilified 31:23 - Young Urologist Job Market 35:42 - Advice for New Grads 40:26 - Urology in 2035 and Fair Critiques of Private Equity 44:40 - Closing Thoughts --- More about this episode Dr. Lowentritt outlines the history of private equity in healthcare, noting that consolidation predated private equity and was driven by payer and hospital market power, reimbursement pressure, administrative burden, staffing, and capital needs. He distinguishes private equity’s role in hospitals from physician practice management, describing management services organization (MSOs) as structures that handle back-office functions and provide capital while preserving physician control over patient care and local governance. He also discusses private equity’s limited investment timeline, shaped by the ultimate goal of selling a profitable company, and potential end-states such as acquisition or public ownership, reflecting on his own experiences with United Urology’s acquisition. The conversation further explores recruiting new graduates, evolving partner tracks, mentorship, and maintaining physician leadership to preserve independent practice. --- Resources Dr. Benjamin Lowentritt is the current treasurer of LUGPA (Large Urology Group Practice Association) https://www.lugpa.org/, the Chesapeake Urology group (https://chesuro.com/), and United Urology Group (which was acquired by One Oncology https://www.oneoncology.com/UnitedUrologyGroup/). One Oncology eventually was acquired by Cencora (https://www.cencora.com/). Dr. Benjamin Lowentritt email: blowentritt@chesuro.com --- BackTable Urology is the go-to podcast for urologists, urologic oncologists, and urogynecologists. Download the free BackTable app to get early access to new episodes, cases, and courses curated by physicians in your specialty. ► https://www.backtable.com/app

  • July 7 · 51 min

    Ep. 314 Exploring PARP Inhibitor Combinations in Prostate Cancer with Dr. Rana McKay and Dr. Emmanuel Antonarakis

    With multiple clinical trials evaluating PARP inhibitor combinations, how do clinicians determine the best approach for advanced prostate cancer? In this episode of BackTable Urology, Dr. Alan Tan is joined by Dr. Rana McKay and Dr. Emmanuel Antonarakis to discuss how evolving evidence, patient selection, timing, toxicity, and genetic testing are shaping the use of PARP inhibitor combinations in clinical practice. --- Get the BackTable app https://www.backtable.com/app --- This podcast is supported by an educational grant from Pfizer. --- Timestamps 00:00 - Introduction 02:51 - PARPi Basics 14:12 - Major Study Differences 19:00 - Timing and Selection of PARPi Combinations 26:39 - Case: Somatic BRCA2 loss and mHSPC 35:51 - Case Continued: BRCA2 Reversion 39:57 - BRCAAway Study 42:59 - Takeaways from the 2026 APCCC --- More about this episode The conversation reviews lessons learned from major clinical trials, including PROpel, MAGNITUDE, TALAPRO-2, and AMPLITUDE, and addresses how these studies inform real-world treatment choices. The doctors dig into case examples, such as BRCA2 loss and reversion, and highlight practical strategies for using germline and somatic testing to personalize care. Key insights from the 2026 Advanced Prostate Cancer Consensus Conference are also shared, emphasizing the importance of precision medicine in this rapidly evolving field. --- Resources Study on Olaparib Plus Abiraterone as First-line Therapy in Men With Metastatic Castration-resistant Prostate Cancer (PROpel) https://clinicaltrials.gov/study/NCT03732820 A Study of Niraparib in Combination With Abiraterone Acetate and Prednisone Versus Abiraterone Acetate and Prednisone for Treatment of Participants With Metastatic Prostate Cancer (MAGNITUDE) https://clinicaltrials.gov/study/NCT03748641?tab=study Talazoparib + Enzalutamide vs. Enzalutamide Monotherapy in mCRPC (TALAPRO-2) https://clinicaltrials.gov/study/NCT03395197 A Study of Niraparib in Combination With Abiraterone Acetate and Prednisone Versus Abiraterone Acetate and Prednisone for the Treatment of Participants With Deleterious Germline or Somatic Homologous Recombination Repair (HRR) Gene-Mutated Metastatic Castration-Sensitive Prostate Cancer (mCSPC) (AMPLITUDE) https://clinicaltrials.gov/study/NCT04497844 BRCAAway: A randomized phase 2 trial of abiraterone, olaparib, or abiraterone + olaparib in patients with metastatic castration-resistant prostate cancer (mCRPC) bearing homologous recombination-repair mutations (HRRm) https://pubmed.ncbi.nlm.nih.gov/39115414/ --- BackTable Urology is the go-to podcast for urologists, urologic oncologists, and urogynecologists. Download the free BackTable app to get early access to new episodes, cases, and courses curated by physicians in your specialty. ► https://www.backtable.com/app

  • June 30 · 35 min

    Ep. 313 Approaches to Pelvic Lymph Node Dissection in Contemporary Prostate Cancer Surgery with Dr. Kristen Greene

    Is pelvic lymph node dissection still necessary in the era of PSMA PET imaging? In this episode of BackTable Urology, Dr. Ruchi Talwar interviews Dr. Kirsten Greene about how advanced imaging is influencing decisions for radical prostatectomy. They examine the strengths and limits of PSMA PET, the risks and benefits of PLND, and why careful, evidence-based decision-making remains essential. --- Get the BackTable app https://www.backtable.com/app --- Timestamps 00:00 - Introduction 03:12 - Risk Calculators and Consent 04:39 - Nomograms vs. Complications 09:57 - Endpoints That Matter 11:38 - PSMA PET Strengths and Limits 13:51 - Negative PET Decision-Making 15:08 - Positive PET and Multimodal Care 18:02 - Fluorescence Guided Surgery 19:10 - Counseling on Complications 22:27 - Preventing Lymphocele 24:56 - How Lahey Wrap Works 26:45 - Future Mapping and Therapy 28:47 - Research Gaps and Dogma 31:07 - Key Pearls and Wrap Up --- More about this episode Dr. Greene explains her approach using MSK and Briganti nomograms alongside PSMA PET, noting that PET scans may miss small nodal disease and quality varies between centers. She emphasizes PLND as a staging tool rather than a curative procedure, outlining potential complications like lymphocele, lymphedema, vascular and ureteral injury, and neuropraxia. The episode highlights her shared decision-making process, surgical techniques for limiting risk, and the importance of multimodal planning, especially for PET-positive nodal disease. Dr. Greene also shares practical tips for lymphocele prevention, including the use of metal clips and the Lahey wrap. --- Resources Different lymph node dissection ranges during radical prostatectomy for patients with prostate cancer: a systematic review and network meta-analysis https://pubmed.ncbi.nlm.nih.gov/36872312/ Limited versus Extended Pelvic Lymph Node Dissection for Prostate Cancer: A Randomized Clinical Trial https://pubmed.ncbi.nlm.nih.gov/33865797/ --- BackTable Urology is the go-to podcast for urologists, urologic oncologists, and urogynecologists. Download the free BackTable app to get early access to new episodes, cases, and courses curated by physicians in your specialty. ► https://www.backtable.com/app

  • June 25 · 30 min

    Ep. 312 Managing Intravesical Therapy Toxicities in Bladder Cancer with Dr. Meredith Donahue and Mary Dunn, NP

    How can clinics minimize toxicity and maximize outcomes in intravesical bladder cancer treatment? In this episode of BackTable Urology, host Dr. Vignesh Packiam talks with nurse practitioners Mary Dunn (UNC) and Meredith Donahue (Vanderbilt) about how advanced practice providers (APP) workflows and hands-on management are transforming care for non-muscle-invasive bladder cancer. The discussion highlights innovative strategies for symptom management, patient education, catheter techniques, and streamlined operational protocols across both established and emerging intravesical therapies. --- Get the BackTable app https://www.backtable.com/app --- This podcast is supported by an educational grant from Johnson & Johnson. --- Timestamps 00:00 - Introduction 04:25 - Non Drug Symptom Tips 09:39 - Day Of Treatment Clearance 14:50 - Post Treatment Triage 20:36 - Treatment Fatigue Strategies 24:48 - Pelvic Floor And IC Tools 27:33 - Teamwork Final Pearls --- More about this episode They share individualized pharmacologic and non-pharmacologic approaches for managing lower urinary tract symptoms, such as NSAIDs, anticholinergics, beta-3 agonists, Pyridium, timed voiding, avoidance of irritants, and constipation management. The episode covers patient education resources from the Bladder Cancer Advocacy Network (BCAN), catheterization techniques tailored to patient needs, and a gravity installation method to reduce spasms. The conversation also reviews day-of-treatment clearance and triage protocols, operational considerations for new agents like Enlexo, Adstiladrin, and gemcitabine/docetaxel, as well as financial workflows that prevent drug wastage. Additional topics include managing cumulative bladder toxicity, pelvic floor PT, addressing treatment fatigue, and integrating multifactorial evaluation and exercise into patient care. --- Resources Bladder Cancer Advocacy Network (BCAN) Basic Handbook & Patient Resources https://bcan.org/bladder-cancer-basics-handbook/ --- BackTable Urology is the go-to podcast for urologists, urologic oncologists, and urogynecologists. Download the free BackTable app to get early access to new episodes, cases, and courses curated by physicians in your specialty. ► https://www.backtable.com/app

  • June 23 · 54 min

    Ep. 311 Career Diversification for Urologists Beyond the Clinic with Dr. Pat Keegan and Dr. Kelly Parsons

    What happens when urologists look beyond the clinic and take on leadership in the life sciences industry? In this episode of BackTable Urology, host Dr. Raj Pruthi talks with Dr. Kelly Parsons and Dr. Pat Keegan about their journeys from academic urology to executive roles in biotech and pharma. They discuss what motivated their transitions, how physician expertise adds value in industry, and the realities of life outside of traditional clinical practice. --- Get the BackTable app https://www.backtable.com/app --- Timestamps 00:00 - Introduction 05:36 - Choosing a Non-Clinical Path 11:07 - Reactions from Mentors and Peers 14:31 - What Feels Most Fulfilling 18:31 - A Typical Week in Biotech 26:04 - Working with Investors 31:21 - Additional Degrees and MBA Debate 35:31 - Is it Risky to Leave Clinical Practice? 44:13 - Networking and Next Steps 47:59 - Wrap Up --- More about this episode The conversation explores the day-to-day work of industry leaders, the impact of advanced degrees like MBAs, and the importance of networking for physicians considering a nonclinical path. Drs. Parsons and Keegan reflect on the challenges and rewards of leaving clinical medicine, the support and reactions from mentors and peers, and what they miss most about patient care. They also share practical advice for urologists and other specialists who are curious about new career opportunities beyond the exam room. --- BackTable Urology is the go-to podcast for urologists, urologic oncologists, and urogynecologists. Download the free BackTable app to get early access to new episodes, cases, and courses curated by physicians in your specialty. ► https://www.backtable.com/app

  • June 18 · 43 min

    Ep. 310 Bladder Cancer Risk Stratification: Best Practices with Dr. Sunil Patel and Dr. Kristen Scarpato

    Why does up to 10% of bladder cancer pathology change on expert review, and what does that mean for your intermediate and high-risk patients? In this episode of BackTable, Dr. Bogdana Schmidt interviews urologists Dr. Kristen Scarpato and Dr. Sunil Patel to explore the complexities of diagnosis and risk assessment in non–muscle invasive bladder cancer (NMIBC). They discuss the real-world challenges of pathology interpretation, risk-group assignment, evolving diagnostic tools, and the impact these factors have on treatment decisions and patient outcomes. --- Get the BackTable app https://www.backtable.com/app --- This podcast is supported by an educational grant from Johnson & Johnson. --- Timestamps 00:00 - Introduction 01:02 - Risk Stratification 07:22 - Upstaging to High Risk 10:06 - Calculators and Patient Education 15:22 - Specific Tests Use Cases 18:50 - Conflicting Biomarker Results 21:36 - Adjunct Tests and Counseling 24:03 - Recurrence After Chemo Next Steps 27:01 - Escalation Deescalation Balance 32:48 - Future Research Priorities 35:43 - Biology Based Risk Stratification 38:03 - Clinical Pearls and Wrap Up --- More about this episode The conversation highlights the heterogeneity of intermediate-risk disease, the role and importance of expert pathology over-reads, and the need to accurately document the risk category for ongoing care. They discuss selective use of urinary and genomic assays and how these tests fit alongside cystoscopy and blue light endoscopy. Practical treatment approaches are reviewed, including when to use intravesical gemcitabine or BCG, managing care during BCG shortages, and balancing escalation versus de-escalation of therapy. Additional topics include strategies for long-term surveillance, upper tract imaging, rising rates of bladder cancer in younger patients, and why thorough TURBT and strong patient-provider communication remain central to optimal management. --- Resources The Memorial Study https://www.mskcc.org/cancer-care/clinical-trials/19-288 The BRIDGE Study https://www.nejm.org/doi/full/10.1056/NEJMoa1501035 --- BackTable Urology is the go-to podcast for urologists, urologic oncologists, and urogynecologists. Download the free BackTable app to get early access to new episodes, cases, and courses curated by physicians in your specialty. ► https://www.backtable.com/app

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