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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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  • 26 episodes
  • weekly
  • Avg 50 min
  • English

Episodes 26

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  • Yesterday · 52 min

    Ep. 335 Diagnosis & Management of Neurogenic Bladder with Dr. Benjamin Brucker

    How do you decide if a neurogenic bladder is a safety problem or a quality of life problem for each patient, and how do you move from guideline risk categories to a real surveillance plan? On this episode of BackTable Urology, Dr. Anjali Kapur interviews Dr. Benjamin Brucker, professor of urology and director of neuro-urology at NYU Langone Health, about navigating neurogenic lower urinary tract dysfunction. They start with the AUA and SUFU guideline framework, covering history, physical exam, mobility, cognition, voiding diaries, and risk stratification to sort patients into low, unknown, or high risk. Dr. Brucker outlines the findings that move a patient between categories and the workup needed, from renal ultrasound and urodynamics to identifying unsafe storage pressures and elevated post-void residual. --- Get the BackTable app https://www.backtable.com/app --- This podcast is supported by Medtronic --- Timestamps 00:00 - Introduction 03:20 - Initial Evaluation Under the AUA and SUFU Guidelines 05:39 - Risk Stratification and Surveillance 13:08 - Role of Fluoroscopy in Urodynamics 14:55 - Spinal Cord Injury and Detrusor Sphincter Dyssynergia 17:35 - Multiple Sclerosis, Parkinson Disease, and Stroke 23:13 - Cognitive and Functional Status in Therapy Selection 25:16 - Neuromodulation in the Neurogenic Population 29:07 - Catheter Management and Sphincterotomy 35:49 - Medical Therapy, Chemodenervation, and Surgical Escalation 42:50 - Asymptomatic Bacteriuria and Antibiotic Stewardship 46:04 - Gaps in Practice and Research on the Horizon 50:48 - Closing Remarks --- More about this episode The conversation dives into the nuances of managing neurogenic bladder by underlying disease, from detrusor sphincter dyssynergia after spinal cord injury to the variable patterns in multiple sclerosis, Parkinson disease, and stroke. Dr. Brucker explains the role of videourodynamics, the importance of matching therapy to cognition and mobility, and how to counsel patients on medical therapy, neuromodulation, catheterization, and surgery. They discuss antibiotic stewardship for asymptomatic bacteriuria, gaps between guidelines and real-world care, and what new devices and bladder transplant might mean for the future. The episode closes with a reminder that management is about treating the whole person, not just the diagnosis. --- Resources Neurogenic Lower Urinary Tract Dysfunction: AUA/SUFU Guideline https://www.auanet.org/guidelines-and-quality/guidelines/adult-neurogenic-lower-urinary-tract-dysfunction Ginsberg DA, Boone TB, Cameron AP, et al. The AUA/SUFU Guideline on Adult Neurogenic Lower Urinary Tract Dysfunction: Diagnosis and Evaluation. J Urol. 2021 https://doi.org/10.1097/JU.0000000000002235 Ginsberg DA, Boone TB, Cameron AP, et al. The AUA/SUFU Guideline on Adult Neurogenic Lower Urinary Tract Dysfunction: Treatment and Follow-up. J Urol. 2021 https://doi.org/10.1097/JU.0000000000002239 Vurture G, Peyronnet B, Palma JA, et al. Urodynamic Mechanisms Underlying Overactive Bladder Symptoms in Patients With Parkinson Disease. Int Neurourol J. 2019. https://doi.org/10.5213/inj.1938086.043 Society of Urodynamics, Female Pelvic Medicine and Urogenital Reconstruction (SUFU). https://sufuorg.com/ American Urological Association (AUA) https://www.auanet.org/ First human bladder transplant, UCLA Health, 2025. https://www.uclahealth.org/news/release/first-human-bladder-transplant-performed-ucla Dr. Benjamin Brucker, NYU Langone Health physician profile https://nyulangone.org/doctors/1235295619/benjamin-m-brucker Dr. Benjamin Brucker, BackTable Urology contributor page https://www.backtable.com/shows/urology/contributors/dr-benjamin-brucker Dr. Anjali Kapur, BackTable Urology contributor page https://www.backtable.com/shows/urology/contributors/dr-anjali-kapur --- 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

  • Thursday · 54 min

    Ep. 334 Optimizing Professional Growth with Career Coaching with Dr. Emilie Johnson and Dr. Angie Smith

    What is the difference between mentorship, sponsorship, and coaching in a physician’s career, and how can coaching influence your professional development? On this episode of BackTable Urology, Dr. Helen Bernie interviews Dr. Emilie Johnson and Dr. Angie Smith about the transformative impact of career coaching for urologists. They break down how coaching differs from mentorship and sponsorship, who stands to benefit most, and the real value of having a conversation focused entirely on your goals and growth. --- Get the BackTable app https://www.backtable.com/app --- This podcast was developed in collaboration with Society of Women in Urology https://swiu.org/home.aspx --- Timestamps 00:00 - Introduction 03:21 - Mentorship, Sponsorship, and Coaching 06:23 - Paths Into Physician Coaching 11:39 - Who Should Seek a Coach 15:56 - What a Coach Does Differently 22:57 - Anatomy of a Coaching Session 28:21 - Coaching Frameworks and Tools 35:14 - Uncovering Unrecognized Goals 42:12 - Coaching Beyond the Workplace 47:16 - Advice for the Undecided Urologist 52:08 - Closing Remarks --- More about this episode The discussion explores what a coaching session looks like, from low-stakes one-offs to multi-month programs, and the frameworks and tools that stick, like strengths-based assessments, DiSC, and the career portfolio exercise. Dr. Smith shares insights from her credentialed coaching program, while Dr. Johnson explains how coaching changes everything from listening at home to decision-making in the OR. The episode closes with advice on finding the right coach, recognizing when you are ready, and why coaching is about unlocking what you already know. --- Resources Society of Women in Urology (SWIU) https://www.swiu.org/ Effect of a Professional Coaching Intervention on the Well-being and Distress of Physicians: A Pilot Randomized Clinical Trial (Dyrbye et al., JAMA Internal Medicine, 2019) https://doi.org/10.1001/jamainternmed.2019.2425 International Coaching Federation, credentialing and coach education requirements (ACC, PCC, MCC) https://coachingfederation.org/credentialing/prepare-for-icf-credential-application/education-training-requirements/ UNC School of Medicine coaching programs, Office of Faculty Affairs and Leadership Development https://www.med.unc.edu/facultyaffairs/coaching-culture/ VIA Character Strengths Survey, the free strengths assessment Dr. Smith recommends https://www.viacharacter.org/ CliftonStrengths (Gallup) https://www.gallup.com/cliftonstrengths/en/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

  • October 6 · 50 min

    Ep. 333 Evaluating Adrenal Incidentalomas: A Urologist's Guide with Dr. Chris Anderson and Dr. Ben Ristau

    Adrenal lesions now turn up on four to ten percent of cross-sectional scans, and every urologist needs a reliable way to sort out the harmless ones from the dangerous ones. On this episode of BackTable Urology, co-hosts Dr. Gina Badalato and Dr. Chris Anderson speak with Dr. Ben Ristau to share a practical, case-based framework for evaluating adrenal lesions. They walk through imaging criteria, the essential hormonal workup, size thresholds for surgery, the rare but crucial role of biopsy, and the operative planning that separates a smooth adrenalectomy from a crisis. --- Get the BackTable app https://www.backtable.com/app --- This podcast was developed in collaboration with Society of Academic Urologists https://sauweb.org/ --- Timestamps 00:00 - Introduction 03:42 - Imaging Criteria for Adrenal Adenoma 08:15 - Framework for Hormonal Workup 12:48 - Mild Autonomous Cortisol Secretion 16:20 - Adrenal Venous Sampling 21:12 - Genetic Syndromes and Pheochromocytoma 25:40 - Suspected Pheochromocytoma Case 31:19 - Alpha Blockade Before Surgery 35:36 - Intraoperative Hemodynamic Swings 40:50 - Adrenocortical Carcinoma Case 45:00 - Managing Adrenal Vein Avulsion 48:00 - Closing Remarks --- More about this episode The discussion opens with a 3.4 centimeter lipid-rich adenoma and the two questions that drive every evaluation, whether the lesion is malignant and whether it is functional. Dr. Ristau walks through the overnight 1 mg dexamethasone suppression test, the aldosterone to renin ratio, plasma free metanephrines and adrenal venous sampling, then explains why mild autonomous cortisol secretion is the most commonly missed diagnosis. Later cases cover preoperative alpha blockade for pheochromocytoma, the blood pressure swing that follows adrenal vein ligation, and open resection for suspected adrenocortical carcinoma. They close with pearls on surgical judgment, resident teaching, and the importance of systematic protocols in adrenal mass evaluation. --- Resources CUA guideline: Diagnosis, management, and follow-up of the incidentally discovered adrenal mass (endorsed by the AUA, Rowe et al., CUAJ 2023) https://cuaj.ca/index.php/journal/article/view/8248 European Society of Endocrinology clinical practice guidelines on the management of adrenal incidentalomas, with ENSAT (Fassnacht et al., Eur J Endocrinol 2023) https://doi.org/10.1093/ejendo/lvad066 AACE / AAES Medical Guidelines for the Management of Adrenal Incidentalomas https://pro.aace.com/disease-state-resources/pituitary-and-neuroendocrine/clinical-practice-guidelines/american Discrepancies in the Recommended Management of Adrenal Incidentalomas by Various Guidelines (Journal of Urology) https://www.auajournals.org/doi/10.1097/JU.0000000000001342 Society of Academic Urologists https://sauweb.org/ --- 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 29 · 48 min

    Ep. 332 The Basics of Advanced Prostate Cancer Management for Urologists with Dr. Kristen Scarpato and Dr. Jason Hafron

    What does a urologist actually need to know to confidently manage advanced prostate cancer in the clinic? On this episode of BackTable Urology, host Dr. Ruchika Talwar interviews Dr. Kristen Scarpato, director of the advanced prostate cancer clinic at Vanderbilt University Medical Center, and Dr. Jason Hafron, chief medical officer of the Michigan Institute of Urology. They break down how the landscape has shifted, why more patients stay in urology for treatment, and how to select and monitor therapy based on disease state, comorbidities, and patient goals. --- Get the BackTable app https://www.backtable.com/app --- This podcast is supported by Bayer https://www.bayer.com --- Timestamps 00:00 - Introduction 02:41 - Shift to Urology-Led Advanced Prostate Management 07:07 - Sorting Therapies by Disease State 10:33 - Treatment Intensification and Doublet Therapy 17:54 - ARPI Selection and the Four Ps Framework 25:46 - Managing Financial Toxicity 29:30 - Monitoring, Labs, and Imaging 34:11 - Red Flags and Comanagement 36:49 - When to Refer to Medical Oncology 41:11 - Future Directions and Practice Economics 46:33 - Closing Remarks --- More about this episode The discussion covers sorting therapies by disease state rather than drug class, doublet and triplet intensification, the nuances of choosing between abiraterone, enzalutamide, apalutamide, and darolutamide, and Dr. Hafron’s “four Ps” framework for drug selection. Dr. Scarpato addresses financial toxicity, surveillance protocols, and red flag symptoms. Both guests share their referral triggers for medical oncology, approaches for oligometastatic disease and metastasis-directed therapy, and practical tips for running an advanced prostate cancer clinic. --- Resources Advanced Prostate Cancer: AUA/SUO Guideline https://www.auanet.org/guidelines-and-quality/guidelines/advanced-prostate-cancer Trial Design and Objectives for Patients With Prostate Cancer: Recommendations From the Prostate Cancer Working Group 4 (JCO) https://ascopubs.org/doi/10.1200/JCO-25-02834 ARACOG (AFT-47): Darolutamide vs Enzalutamide and Cognitive Function, ClinicalTrials.gov NCT04335682 https://clinicaltrials.gov/study/NCT04335682 ARASENS: Darolutamide and Survival in Metastatic, Hormone-Sensitive Prostate Cancer (NEJM) https://www.nejm.org/doi/full/10.1056/NEJMoa2119115 PSMAddition: 177Lu-PSMA-617 Plus Standard of Care in mHSPC, ClinicalTrials.gov NCT04720157 https://clinicaltrials.gov/study/NCT04720157 Medicare Plan Finder, referenced on air for comparing Part D out-of-pocket drug costs https://www.medicare.gov/plan-compare/ --- 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 24 · 1 hr 5 min

    Ep. 331 Transitioning an Independent Practice to an Academic Urology Program with Dr. Javier Castillo

    How can private practice and academic residency programs work together to shape the next generation of urologists? On this episode of BackTable Urology, Dr. Jose Silva interviews Dr. Javier Castillo about launching an academic residency within a busy private urology group in Puerto Rico. They highlight the business, training, and research challenges involved, as well as the innovations that make real collaboration possible. Dr. Castillo also reflects on why building character in trainees is just as important as teaching surgical skill. --- Get the BackTable app https://www.backtable.com/app --- Timestamps 00:00 - Introduction 04:04 - Launching a Residency and Building the Practice 08:13 - Teaching in the OR and Progressive Responsibility 13:58 - Clinic, Administration, and Resident Training 16:38 - Expanding BPH Treatment Options 25:21 - Creating a Research Culture and AI Projects 32:42 - AI Uroflow Project and Follow Up 40:21 - BPH Case Workup and Shared Decision-Making 47:11 - Patient Goals and Procedure Selection 55:43 - Sacral Neuromodulation and New Technologies 01:00:19 - Teaching Character and Mentorship 01:03:07 - Closing Remarks --- More about this episode The conversation explores how to teach residents in the OR while maintaining efficiency, build a research culture, and leverage advanced technologies like AI-driven home uroflowmetry. Dr. Castillo and Dr. Silva discuss individualized BPH treatment, expanding procedural options, and aligning care with patient goals. The episode closes with practical lessons on mentorship, character, and the strategies that make a residency program thrive for both trainees and patients. --- 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 22 · 1 hr 4 min

    Ep. 330 Establishing a Comprehensive Cancer Survivorship Practice with Dr. Hiren Patel

    How can reconstructive urologists improve quality of life for cancer survivors beyond the initial cure? On this episode of BackTable Urology, Dr. George Koch interviews Dr. Hiren Patel about building a comprehensive survivorship practice that addresses the long-term needs of patients following genitourinary cancer treatment. They discuss moving beyond post-prostatectomy ED and incontinence to include management of radiation sequelae, immunotherapy effects, and urethral strictures, as well as the role of patient-centered communication, care coordination, and technology. --- Get the BackTable app https://www.backtable.com/app --- Timestamps 00:00 - Introduction 04:26 - Redefining Survivorship 11:29 - Why Survivorship Practices Matter 17:53 - Workup and Aligning Care 21:05 - Managing Active Cancer Scenarios 27:20 - Building a Survivorship Program 30:12 - Growing Referrals and Optimizing Workflow 39:24 - System Support and Research Gaps 44:04 - Tech Advances in Reconstruction 48:50 - Single-Port Retroperitoneal Case 59:55 - Tips, Tricks, and Wrap-Up --- More about this episode The conversation covers patient expectation setting, logistics of establishing a survivorship clinic, aligning care with patient goals, and multidisciplinary collaboration with oncology and primary care. Dr. Patel highlights strategies to reduce ER visits and system burden, the importance of continuity, and advances such as single-port robotic retroperitoneal ureteral reconstruction. The episode concludes with practical tips on trust-building, workflow optimization, and advocating for survivorship programs within larger health systems. --- 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 15 · 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

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