BackTable Urology

As new genetic and AI-powered tools emerge for bladder cancer screening, are we getting closer to reducing the need for invasive cystoscopies? In part five of the 2025 BackTable NMIBC Creator Weekend™ series, host Dr. Vignesh Packiam engages in an insightful discussion with Dr. Sarah Psutka from the University of Washington and Dr. Katie Murray from NYU about the complexities and potential benefits of using biomarkers in non-muscle invasive bladder cancer (NMIBC). --- This podcast is supported by: Ferring Pharmaceuticals https://www.ferring.com/home-classic/people-and-families/uro-uro-oncology/bladder-cancer/ --- SYNPOSIS The conversation covers the current challenges of interpreting positive biomarkers without clinical correlates, the gold standard of biopsies, and the potential of various biomarkers such as urine cytology, FISH, and newer genomic tests like the Decipher Bladder Genomic Classifier. They also touch upon the role of AI in pathology, the cost implications of biomarkers, and how these tools might influence future clinical practices and patient decisions. The episode emphasizes the need for precision medicine, careful patient counseling, and the impact of false positives and negatives on both patients and healthcare providers. --- TIMESTAMPS 00:00 - Introduction05:25 - Challenges with Current Biomarkers08:10 - New Biomarkers and Genomic Classifiers21:10 - AI and Pathology in Bladder Cancer35:13 - Screening and Future Directions41:20 - Challenges and Future Directions in Bladder Cancer Surveillance57:51 - Conclusion --- RESOURCES DaBlaCa-15 Trialhttps://pubmed.ncbi.nlm.nih.gov/40280776/ Sam Chang CHAI Studyhttps://pubmed.ncbi.nlm.nih.gov/40514253/

Considering a reconstructive urology fellowship or already in the thick of it? This episode is for you. Dr. Rachel Mann (University of Minnesota) sits down with Dr. George Koch (Ohio State University) to discuss her journey in reconstructive urology and the mentors who shaped it. Together, they explore how creativity, adaptability, and mentorship fuel progress in this evolving subspecialty.---SYNPOSISDr. Mann also shares practical advice for residents and fellows who are planning their next steps in training. She reflects on how to identify the right fellowship, make the most of a unique learning year, and transition effectively into independent practice. The episode closes with a discussion of the future of reconstructive urology, including global health opportunities, the potential for dedicated transgender surgery fellowships, and the mindset required to continue evolving as a reconstructive surgeon.---TIMESTAMPS00:00 - Introduction03:01 - Training and Mentorship11:09 - The Evolution and Scope of Reconstructive Urology32:49 - The Future of Reconstructive Urology35:01 - Expanding Internationally38:24 - Rapid Fire Advice for Residents45:59 - Advice for Fellows---RESOURCESThe Trauma and Urologic Reconstructive Network of Surgeons (TURNS)https://www.turnsresearch.org/Optilume ROBUST III trialhttps://bjui-journals.onlinelibrary.wiley.com/doi/10.1002/bco2.312RD-180 Suture Devicehttps://pubmed.ncbi.nlm.nih.gov/35070820/

We have relied on PSA for decades, but what’s next in precision screening for prostate cancer? In this episode of BackTable Urology, Dr. Jason Hafron from the Michigan Institute of Urology joins host Dr. Ruchika Talwar to discuss the evolving role of biomarkers and artificial intelligence in prostate cancer screening.---This podcast is supported by:Cleveland Diagnosticshttps://www.isopsa.com/---SYNPOSISTogether, Dr. Hafron and Dr. Talwar examine the ongoing challenges of PSA testing and the promise of next-generation blood-based biomarkers, including 4Kscore and IsoPSA tests. They explore how these advancements are reshaping detection, diagnosis, and risk stratification. The episode also highlights how these tools may improve active surveillance protocols, reduce unnecessary biopsies, and better personalize prostate cancer management for better outcomes.---TIMESTAMPS0:00 - Introduction2:23 - Limitations of PSA10:21 - Limitations of MRI18:08 - Overview of Biomarkers (IsoPSA, 4K, PHI, SelectMDx, MIPS, ExoDx)26:30 - Artificial Intelligence---RESOURCESProstate Cancer Screening With PSA, Kallikrein Panel, and MRI: The ProScreen Randomized Trialhttps://jamanetwork.com/journals/jama/fullarticle/2817323 Using IsoPSA With Prostate Imaging Reporting and Data System Score May Help Refine Biopsy Decision Making in Patients With Elevated PSAhttps://pubmed.ncbi.nlm.nih.gov/36965817/ Clinical validation of IsoPSA, a single parameter, structure-focused assay for improved detection of prostate cancer: A prospective, multicenter studyhttps://pubmed.ncbi.nlm.nih.gov/35840465/

With the introduction of checkpoint inhibitors into non-muscle invasive bladder cancer (NMIBC) management, who’s on point for planning, administering, and optimizing combination therapies? Is it still the urologist, or does medical oncology play a more significant role now than it did before? In this episode of the BackTable 2025 NMIBC Creator Weekend™ series, host Dr. Bogdana Schmidt sits down with Dr. Tyler Stewart, medical oncologist from the University of California San Diego, to discuss the contemporary role of medical and surgical oncology in treating non-muscle invasive bladder cancer.---This podcast is supported by:Ferring Pharmaceuticalshttps://www.ferring.com/home-classic/people-and-families/uro-uro-oncology/bladder-cancer/---SYNPOSISThe conversation covers the efficacy and safety of checkpoint inhibitors like pembrolizumab, the importance of a multidisciplinary approach, and the challenges of balancing systemic and localized treatments. They also touch upon the potential future role of biomarkers in reducing invasive procedures and improving patient outcomes.---TIMESTAMPS00:00 - Introduction02:04 - The Role of Medical Oncologists in Bladder Cancer12:58 - Combination Therapies and Patient Outcomes21:18 - The CREST Study26:59 - Managing Adverse Events34:44 - Collaboration Between Urologists and Oncologists41:06 - Conclusion and Final Thoughts---RESOURCESCREST Trialhttps://www.nature.com/articles/s41591-025-03738-zCISTO Studyhttps://pubmed.ncbi.nlm.nih.gov/37980511/

New FDA-approved therapies for BCG-refractory non-muscle invasive bladder cancer (NMIBC)–where do they fit in the treatment algorithm, and how do you administer them? This installment of the 2025 NMIBC Creator Weekend™ series features host Dr. Bogdana Schmidt, assistant professor of Urologic Oncology at the University of Utah, and leading urologic oncologists Dr. Mark Tyson from Mayo Clinic Arizona and Dr. Suzanne Merrill from Colorado Urology.---This podcast is supported by:Ferring Pharmaceuticalshttps://www.ferring.com/home-classic/people-and-families/uro-uro-oncology/bladder-cancer/---SYNPOSISThe discussion delves into the newest treatment strategies and FDA-approved therapies for non-muscle invasive bladder cancer with an emphasis on BCG-refractory patients. They highlight their approaches to sequencing therapies, the real-world applicability of these treatments, and the impact of patient factors in clinical decision-making. The panel also explores emerging trials and innovative treatment mechanisms, emphasizing the importance of personalized care in oncology.---TIMESTAMPS00:00 - Introduction05:09 - Challenges and Strategies in Treatment10:55 - Bladder Sparing Therapies21:41 - Practical Tips for Therapy Administration30:39 - Challenges and Considerations in Reinduction37:05 - Clinical Trials and Future Directions44:11 - Counseling Patients on Treatment Options57:36 - Concluding Thoughts and Future Outlook---RESOURCESCORE-008 Clinical Trial https://www.sciencedirect.com/science/article/abs/pii/S1078143924010147Legend Clinical Trial:https://ascopubs.org/doi/10.1200/JCO.2025.43.5_suppl.802CISTO Studyhttps://pubmed.ncbi.nlm.nih.gov/37980511/

When a patient is diagnosed with non-muscle invasive bladder cancer (NMIBC), how do you tailor the conversation and treatment plan to their individual needs (and fears)? In part two of the 2025 NMIBC Creator Weekend™ series, host Dr. Vignesh Packiam is joined by Dr. Sima Porten from UCSF and Dr. Patrick Hensley from the University of Kentucky to discuss patient-centered diagnostic and therapeutic approaches for non-muscle invasive bladder cancer.---This podcast is supported by:Ferring Pharmaceuticalshttps://www.ferring.com/home-classic/people-and-families/uro-uro-oncology/bladder-cancer/---SYNPOSISThe conversation covers initial patient consultations, discussing diagnoses, personalized treatment options such as BCG, gemcitabine, clinical trials, and managing side effects. The experts emphasize the importance of clear communication, understanding patient preferences, and tailoring approaches to enhance the patient's quality of life. They also explore insights from recent studies like the CISTO trial and highlight novel research directions.---TIMESTAMPS00:00 - Introduction04:28 - Counseling Patients on Diagnostic Findings12:03 - Symptom Management and Patient Care19:30 - Post-Procedure Care and Counseling28:50 - Recovery After TURBT: Medications and Patient Care44:16 - The Impact of Radical Cystectomy on Quality of Life49:15 - Final Thoughts and Future Directions in Bladder Cancer Care---RESOURCESNIMBUS Studyhttps://pubmed.ncbi.nlm.nih.gov/32446864/

For patients with ischemic priapism, time to treatment can mean the difference between recovery and long-term dysfunction. In this episode, Dr. Maia VanDyke (UT Southwestern Medical Center) joins host Dr. Juan Andino (UCLA Health) for a high-yield discussion on managing this urologic emergency, from early recognition to advanced surgical options.---SYNPOSISTogether, they cover diagnosis, patient demographics, and traditional versus advanced interventions, with special attention to the role of penoscrotal decompression in prolonged ischemic priapism. The conversation highlights surgical techniques, postoperative care strategies, and patient counseling, including the hard but essential discussions about long-term erectile dysfunction risk. Drs. Andino and VanDyke also emphasize the importance of collaboration, encouraging general urologists to adopt these approaches while leaning on colleagues and centers of excellence for complex cases.---TIMESTAMPS00:00 - Introduction02:18 - Understanding Priapism07:52 - Diagnosis and Initial Management16:51 - Advanced Management and Surgical Interventions28:21 - Patient Retention Challenges29:59 - Surgical Planning and Techniques37:29 - Post-Operative Care and Patient Rehabilitation44:13 - Future Directions in Research and Treatment51:28 - The Role of General Urology---RESOURCESDr. David Ralph article on use of MRI in management of priapismhttps://doi.org/10.1111/j.1464-410X.2010.09368.xDr. Tom Lue article on corporal aspirationhttps://doi.org/10.1038/nrurol.2009.50Arthur “Bud” Burnett article on corporal tunnelinghttps://doi.org/10.1016/j.juro.2012.08.245Allen “Al” Morey article on penoscrotal decompression erectile function outcomeshttps://doi.org/10.1111/bju.15127Survey on current management practices of ischemic priapismhttps://doi.org/10.1038/s41443-019-0120-4Risk factors, diagnosis, and long-term erectile dysfunction outcomes in priapismhttps://doi.org/10.1038/s41443-025-01076-9Video Journal of Sexual Medicine (VJSM) on Penoscrotal decompression: A better method for priapism managementhttps://www.vjsm.info/videos/all/penoscrotal-decompression-a-better-method-for-priapism-managementSurgical Management of Ischemic Priapism: what are the New Options? https://doi.org/10.1590/S1677-5538.IBJU.2024.0497The Impact of Immediate Salvage Surgery on Corporeal Length Preservationhttps://doi.org/10.1016/j.juro.2018.01.082

How are leading urologic oncologists using advanced biomarkers and artificial intelligence to refine the diagnosis and management of non-muscle invasive bladder cancer (NMIBC)? In the opening episode of our 2025 NMIBC Creator Weekend™ series, host Dr. Bogdana Schmidt engages in an insightful, in-studio discussion with Dr. Anne Schuckman and Dr. Piyush Agarwal about contemporary strategies and challenges in the diagnosis of non-muscle invasive bladder cancer. --- This podcast is supported by: Ferring Pharmaceuticals --- SYNPOSIS The doctors emphasize the importance of having an experienced cytopathologist and discuss the use of different biomarkers and imaging modalities in bladder cancer diagnosis. The conversation delves into risk stratification, patient management strategies, and the evolving role of technology and artificial intelligence in enhancing diagnostic accuracy. The experts also share their perspectives on future advancements and their potential impact on clinical practice. --- TIMESTAMPS 00:00 - Introduction04:05 - Surveillance and Follow-Up Strategies10:10 - Biomarkers in Bladder Cancer18:02 - Blue Light Cystoscopy and Patient Comfort30:56 - Risk Assessment and Counseling42:56 - Future of Bladder Cancer Diagnostics47:00 - Concluding Thoughts --- RESOURCES CxBladder Studyhttps://www.sciencedirect.com/science/article/pii/S1078143923000091 Lars Dyrsakjot Study on Tumor Markershttps://pmc.ncbi.nlm.nih.gov/articles/PMC7690647/ The Bridge Trialhttps://pmc.ncbi.nlm.nih.gov/articles/PMC10515442/

Kidney cancer management is evolving. How are experts adapting? In this installment of BackTable Tumor Board, Dr. Brandon Manley (Urologic Oncology, Moffitt Cancer Center), Dr. Raquibul Hannan (Radiation Oncology, UT Southwestern), and Dr. Rana McKay (Medical Oncology, UC San Diego) join guest host Mark Ball (Urologic Oncology, National Cancer Institute) to share their multidisciplinary perspectives on challenging, real-world kidney cancer cases.---This podcast is supported by:Ferring Pharmaceuticalshttps://ad.doubleclick.net/ddm/trackclk/N2165306.5658203BACKTABLE/B33008413.420220578;dc_trk_aid=612466359;dc_trk_cid=234162109;dc_lat=;dc_rdid=;tag_for_child_directed_treatment=;tfua=;gdpr=${GDPR};gdpr_consent=${GDPR_CONSENT_755};gpp=${GPP_STRING_755};gpp_sid=${GPP_SID};ltd=;dc_tdv=1---SYNPOSISThe conversation covers diagnostic dilemmas, navigating the treatment options of surgery, systemic therapy, and radiation, and the importance of a multidisciplinary approach. Through detailed case reviews, the panel highlights practical pearls, emerging clinical trials, and collaborative approaches that exemplify modern kidney cancer care.---TIMESTAMPS0:00 - Introduction02:20 - Case 1 (Incidental Renal Mass)16:52 - Case 2 (Bilateral Renal Masses)37:22 - Case 3 (Locally Advanced Renal Mass)56:34 - Case 4 (Symptomatic, Metastatic Disease)01:14:00 - Final Takeaways

What is the role of the American Medical Association (AMA) in 2025 and how does it affect your practice? Join Dr. Ruchika Talwar in this insightful episode of the BackTable Urology podcast as she converses with Dr. Willie Underwood, a urologic oncologist and president-elect of the American Medical Association.---SYNPOSISDr. Underwood shares his journey into medical advocacy, the pivotal role of the AMA in advancing healthcare, and the importance of physician engagement in legislative processes. The discussion highlights key issues such as Medicare and Medicaid reforms, physician burnout, and the implementation of technology in healthcare. This episode is a must-listen for anyone in the medical field who wants to understand the significance of collective efforts in improving patient care and the future of healthcare. Stay tuned to learn how you can make a difference in organized medicine.---TIMESTAMPS00:00 - Introduction04:01 - The Role of the AMA08:33 - AMA's Legislative Actions14:40 - Engaging with the AMA17:57 - Balancing Diverse Physician Values30:38 - Importance of Physician Participation and PACs40:13 - Final Thoughts and Call to Action

Kids with kidney stones–how do you treat them, prevent recurrence, and provide effective longitudinal care? In this episode of BackTable Urology, Dr. Nicholas Kavoussi and Dr. Scott Sparks join co-hosts Dr. Arthi Hannallah and Dr. Niccolo Passoni for a high-yield discussion on pediatric and adolescent stone disease.---SYNPOSISTogether, they explore best practices for managing complex kidney stones in children, surgical techniques like supine PCNL, and the use of novel technologies such as thulium lasers and suction sheaths. The doctors also address strategies to reduce procedural trauma, manage pain, and minimize infection risk. Beyond the OR, they emphasize the psychological toll of recurrent interventions and the importance of thoughtful counseling, patient education, and a multidisciplinary approach to help patients successfully transition into adult care.---TIMESTAMPS00:00 - Introduction03:06 - Managing Complex Cases Without PCNL10:25 - Approach to Supine PCNL18:21 - Balancing Surgical Risks24:21 - Shared Decision-Making and Setting Expectations33:16 - Minimizing Postoperative Pain37:47 - Innovations in Technology55:55 - Transitioning from Pediatric to Adult Urology

What does it take to build a successful reconstructive urology practice while balancing the worlds of academia and private practice? In this episode of BackTable Urology, reconstructive urologist Dr. Lucas Wiegand joins host Dr. Jose Silva to explore his career journey from training at the University of South Florida and fellowship at Washington University, to establishing his practice at Orlando Health.---SYNPOSISDr. Wiegand shares insights on the evolution of robotic surgery, from laparoscopic to single-port systems, and how these advances have improved patient recovery and expanded the possibilities for outpatient care.The conversation also dives into the shifting boundaries between academic and private practice, the growing demand for reconstructive urology, and practical advice for residents considering fellowship training. Dr. Wiegand emphasizes the enduring value of subspecialty education, the increasing recognition (and even financial premium) placed on fellowship training, and the importance of continuous learning, collaboration, and patient-centered care.---TIMESTAMPS00:00 - Introduction03:12 - Robotic Surgery in Urology04:08 - Choosing a Fellowship07:18 - Single Port Robotics11:36 - Open vs. Robotic Surgery24:33 - The Growing Demand for Urologic Care in Florida27:53 - Building a Reconstructive Urology Practice32:48 - The Role of Fellowship in Reconstructive Urology36:46 - Staying Current and Engaged Post-Residency42:19 - Final Thoughts and Contact Information

Could ongoing trials redefine the management of oligometastatic and advanced prostate cancer? In this installment of BackTable Tumor Board, leading prostate cancer experts Dr. Neeraj Agarwal, a medical oncologist from the University of Utah, and Dr. Tyler Seibert, a radiation oncologist from UC San Diego, join host Dr. Parth Modi to share their insights on the latest clinical trials and persistent challenges in managing prostate cancer. --- This podcast is supported by:Ferring Pharmaceuticals --- SYNPOSIS The multidisciplinary discussion addresses clinical decision-making in active surveillance versus early intervention, the role of PSMA PET imaging in detection and treatment planning, and evolving strategies for metastatic and castration-resistant disease. They also evaluate the therapeutic potential of alpha emitters and radioligand therapies, consider the evidence behind treatment intensification and de-intensification, and explore how these approaches can be individualized to optimize patient outcomes. --- TIMESTAMPS 0:00 - Introduction1:48 - Active Surveillance in Low-Risk Prostate Cancer7:08 - Molecular Testing and Risk Stratification8:28 - Radiation Therapy Approaches20:16 - PSA Recurrence and PSMA PET Scans32:40 - The Role of ADT37:15 - PSMA PET Scans40:58 - Genetic Testing in High-Risk and Metastatic Prostate Cancer46:54 - Treatment Intensification vs. De-Intensification Trials55:59 - Castration-Resistant Prostate Cancer

When it comes to menopause care, the facts are better than the fears. In this Urology/OBGYN crossover episode of the BackTable Podcast, host Dr. Suzette Sutherland welcomes renowned urologist Dr. Rachel Rubin to explore various aspects of sexual health and hormone replacement therapy (HRT), particularly for menopausal women. ---SYNPOSISDr. Rachel Rubin shares her career journey, expertise in sexual health, and the critical role of hormone replacement therapy (HRT) in managing menopause. She addresses common challenges and misconceptions, particularly around estrogen use, by demystifying the Women’s Health Initiative studies and emphasizing the proven safety and benefits of systemic and vaginal HRT. Dr. Rubin offers practical guidance on prescribing estrogen, progesterone, testosterone, and DHEA, while highlighting her advocacy to remove outdated FDA black box warnings on vaginal estrogen. Through personal anecdotes and professional insights, she empowers practitioners with evidence-based strategies and underscores the importance of education and research in advancing women’s health.---TIMESTAMPS00:00 - Introduction03:41 - Challenges in Menopause Medicine07:21 - Misconceptions and Risks of HRT15:35 - Understanding Bioidentical Hormones18:48 - WHI Studies and Their Impact23:21 - Practical Guide to Prescribing HRT33:47 - Understanding Estrogen Levels and Risks36:04 - Debating Gels vs. Patches37:51 - Concerns with Compounded Products and Pellets38:50 - Patient Education and Meeting Them Where They Are42:12 - Progesterone Benefits and Sensitivities46:38 - Testosterone Therapy for Women51:36 - The Importance of Lab Tests55:39 - DHEA and Vaginal Health57:14 - Advocacy for Accurate Hormone Therapy Information01:00:05 - Conclusion and Final Thoughts---RESOURCESThe Peter Attia Drive episode with Dr. Rachel Rubin:https://peterattiamd.com/rachelrubin/ FDA Expert Panel on Menopause and Hormone Replacement Therapy for Women:https://www.youtube.com/live/_2ZRlOivC5M?si=-Xynb_BmWz2sWf4mDr. Rachel Rubin’s Hormone Therapy for Early Adopters Course:https://rachelrubinmd.thinkific.com/courses/MHTCME

Residency teaches you how to save lives, but does it teach you how to save money? In this episode of BackTable Urology, Dr. Sammy Elsamra joins host Dr. Gina Badalato to unpack the essentials of financial planning during and after urology residency. From budgeting and managing loans to covering living expenses, Dr. Elsamra emphasizes the importance of building an emergency fund, addressing high-interest debt, and following the 50-30-20 rule to maintain stability.---SYNPOSISThe conversation also dives into long-term strategies like Roth IRAs, tax-advantaged accounts, and the role of disability and life insurance in protecting your future. With recommendations such as The White Coat Investor and foundational financial books, Dr. Elsamra equips trainees with the knowledge and resources they need to set themselves up for lasting success. This episode is a must-listen for residents aiming to take control of both their careers and their financial futures.---TIMESTAMPS00:00 - Introduction01:56 - Post-Residency Financial Realities04:43 - Budgeting During Residency07:23 - The 50-30-20 Rule08:06 - Investing During Residency15:29 - Financial Planning for Attending Physicians24:42 - Understanding Insurance: Life and Disability33:11 - Resources and Advice for Financial Success---RESOURCESThe White Coat Investor (podcast and books):https://www.whitecoatinvestor.com/The Millionaire Next Door (book):https://themillionairenextdoor.com/

Could ctDNA testing allow us to treat bladder cancer earlier, smarter, and more effectively? In this episode of BackTable Urology, Dr. Alberto Pieretti, a urologic oncologist at Cleveland Clinic Weston Hospital, joins host Dr. Jose Silva to explore the emerging role of ctDNA in bladder cancer management. --- This podcast is supported by: Ferring Pharmaceuticals --- SYNPOSIS Dr. Pieretti and Dr. Silva discuss how ctDNA can refine staging, identify patients at risk of recurrence, and guide decisions on when to intensify treatment. The conversation also examines its potential to detect actionable mutations, inform precision therapies, and shape the design of future clinical trials in urologic oncology. --- TIMESTAMPS 0:00 - Introduction2:50 - Overview of Bladder Cancer12:59 - Overview of ctDNA20:34 - Current ctDNA Trials27:21 - Clinical Implications of ctDNA31:20 - Conclusion --- RESOURCES Updated Overall Survival by Circulating Tumor DNA Status from the Phase 3 IMvigor010 Trial: Adjuvant Atezolizumab Versus Observation in Muscle-invasive Urothelial Carcinoma - PubMedhttps://pubmed.ncbi.nlm.nih.gov/37500339/ Perioperative Durvalumab with Neoadjuvant Chemotherapy in Operable Bladder Cancer | New England Journal of Medicinehttps://www.nejm.org/doi/abs/10.1056/NEJMoa2408154

In medicine, the hardest critic you’ll face is often yourself. In this episode of BackTable Urology, Dr. Michelle Van Kuiken joins host Dr. Lindsay Hampson to unpack the realities of imposter syndrome in urology practice and discuss its impact on trainees and professionals --- This podcast is supported by: ⁠Ferring Pharmaceuticals⁠ --- SYNPOSIS Dr. Van Kuiken and Dr. Hampson explain the basics of imposter syndrome, its prevalence, and the many ways it can show up in medical training and practice. They also share candid personal experiences and practical strategies for overcoming self-doubt, from reframing negative thoughts to embracing feedback as a tool for growth. The doctors highlight the value of mentorship, peer support, and celebrating achievements, as well as the importance of creating a culture where vulnerability and open conversations are encouraged. --- TIMESTAMPS 00:00 - Introduction02:29 - Defining Imposter Syndrome04:24 - Personal Experiences with Imposter Syndrome08:44 - Impact of Imposter Syndrome in Medicine10:39 - Strategies to Overcome Imposter Syndrome13:59 - The Role of Mentorship16:28 - Gender and Mentorship in Medicine27:24 - Peer Support and Building Community32:13 - Final Thoughts and Takeaways --- RESOURCES Medical Trainees and the Dunning–Kruger Effect: When They Don't Know What They Don't Know:https://doi.org/10.4300/JGME-D-20-00134.1 Imposter Syndrome in Surgical Trainees: Clance Imposter Phenomenon Scale Assessment in General Surgery Residents:https://doi.org/10.1016/j.jamcollsurg.2021.07.681 Defining the Incidence of the Impostor Phenomenon in Academic Plastic Surgery: A Multi-Institutional Survey Study:https://doi.org/10.1097/prs.0000000000010821 Academic Urology Endowments and Leadership Roles are Disproportionately Held by Male Urologists:https://doi.org/10.1016/j.urology.2025.04.038 Implementation of a “Best Self” Exercise to Decrease Imposter Phenomenon in Residents:https://doi.org/10.4300/JGME-D-23-00873.1 Keep-Stop-Start Framework:https://meded.ucsf.edu/sites/meded.ucsf.edu/files/2024-06/TipSheet-Feedback.pdf Lean In: https://leanin.org/ W. Brad Johnson, PhD: https://www.wbradjohnson.com/

The guidelines are in and the myths are out. In this episode of the BackTable Podcast, Dr. Suzette Sutherland hosts Dr. Melissa Kaufman and Dr. Giulia Ippolito to discuss the new 2025 AUA/SUFU guidelines on genitourinary syndrome of menopause (GSM). ---SYNPOSISThe doctors delve into what GSM is, its symptoms, and the new evidence-based clinical guidelines for screening, diagnosing, and treating this condition. The episode emphasizes shared decision-making, safe use of local low-dose vaginal estrogen, and addresses concerns related to hormone therapy and cancer risks. Additionally, the doctors cover non-hormonal interventions, the role of vaginal moisturizers and lubricants, and the use of vaginal lasers. The importance of follow-up and ongoing patient education is also highlighted. The conversation aims to equip clinicians with the knowledge to better manage GSM and improve patient outcomes.---TIMESTAMPS00:00 - Introduction 01:35 - Overview of the 2025 AUA/SUFU Guidelines02:27 - Guideline Development Process05:48 - Categories of Guidelines07:03 - Understanding GSM: Symptoms and Diagnosis10:28 - Patient Education and Shared Decision Making15:22 - Hormonal Interventions and Safety Concerns17:17 - Local Vaginal Estrogen: Recommendations and Usage23:12 - Compounded Estrogens and Alternative Therapies25:48 - Understanding Estrogen Dosage Forms26:11 - Introduction to DHEA and Its Benefits27:15 - Exploring Ospemifene as an Alternative28:05 - Guidelines for Treating GSM Symptoms30:11 - The Role of Vaginal Estrogen in UTI Prevention33:01 - Non-Hormonal Interventions for GSM35:39 - Laser Treatments for GSM39:59 - Addressing Cancer Risks with Vaginal Estrogen44:48 - Endometrial Surveillance and Follow-Up49:14 - Advocating for Vaginal Estrogen Use51:13 - Conclusion and Final Thoughts

How do you effectively treat your bladder cancer population with an insufficient supply of BCG? Dr. Amy Luckenbaugh, a urologic oncologist at Vanderbilt University Medical Center, joins host Dr. Ruchika Talwar to highlight challenges and solutions to managing bladder cancer amidst ongoing BCG shortages. --- This podcast is supported by an educational grant from UroGen Pharma. UGN-102 was approved by the FDA on June 12, 2025. --- SYNPOSIS Dr. Luckenbaugh and Dr. Talwar delve into the history and significance of BCG in bladder cancer treatment, exploring the reasons behind the shortages and discussing various coping strategies, including split dosing and alternative intravesical therapies like gemcitabine, docetaxel, and the new mitomycin hydrogel. The conversation also covers emerging treatments for high-risk patients, the role of radical cystectomy, and the importance of standardization and innovation in dealing with medication shortages. Dr. Luckenbaugh highlights the importance of patient quality of life, cost considerations, and the need for resilient pharmaceutical supply chains. --- TIMESTAMPS 00:00 - Introduction01:56 - History and Importance of BCG in Bladder Cancer03:21 - Challenges and Shortages of BCG06:36 - Managing BCG Shortages in Clinical Practice12:33 - New Alternatives and Treatments for Bladder Cancer23:28 - The Role of Cystectomy in Bladder Cancer Treatment26:12 - Future Directions and Final Thoughts --- RESOURCES BCG Shortage AUA Recommendations:https://www.auanet.org/about-us/bcg-shortage-info Reduced-dose bacillus Calmette-Guérin (BCG) in an era of BCG shortage: real-world experience from a tertiary cancer centre: https://pmc.ncbi.nlm.nih.gov/articles/PMC11951178/ Bladder Cancer Advocacy Network (BCAN):https://bcan.org/ Primary Chemoablation of Recurrent Low-Grade Intermediate-Risk Nonmuscle-Invasive Bladder Cancer With UGN-102: A Single-Arm, Open-Label, Phase 3 Trial (ENVISION)https://pubmed.ncbi.nlm.nih.gov/39446087/b FDA Approves Intravesical Mitomycin in Non–Muscle-Invasive Bladder Cancer:https://www.fda.gov/drugs/resources-information-approved-drugs/fda-approves-mitomycin-intravesical-solution-recurrent-low-grade-intermediate-risk-non-muscle TAR-200 - SunRISe-3 Study:https://www.jnjmedicalconnect.com/products/tar-200/medical-content/tar-200-sunrise-3-study First results from TAR-200 - SunRISe-1 Study:https://www.jnj.com/media-center/press-releases/johnson-johnsons-tar-200-monotherapy-achieves-high-disease-free-survival-of-more-than-80-percent-in-bcg-unresponsive-high-risk-papillary-nmibcN-803 Plus BCG Treatment for BCG-Naïve or -Unresponsive Non-Muscle Invasive Bladder Cancer: A Plain Language Review:https://pmc.ncbi.nlm.nih.gov/articles/PMC11524197/

Physical performance, recovery, longevity–are these outcomes part of your urology practice? In this episode of BackTable Urology, Dr. Vonda Wright, a renowned orthopedic surgeon and expert in aging and longevity, joins Dr. Amy Pearlman to discuss the intersection of surgical practice, longevity medicine, and patient-centered healthcare in urology. --- SYNPOSIS The discussion covers the significance of whole-person care in surgery and the critical role of empathy in surgical practice. Dr. Wright shares her experiences from her extensive career and research, including her innovative work in hip arthroscopy and advocacy for performance-based care for middle-aged patients. The surgeons also explore the impact of hormonal health on physical performance and quality of life, the value of tailored exercise and nutrition plans, and practical strategies for optimizing long-term vitality in both men and women. Dr. Wright emphasizes the need for healthcare professionals to lead by example in prioritizing their own well-being while staying informed on emerging science that supports longevity and quality of life. --- TIMESTAMPS 00:00 - Introduction13:50 - Urology Applications in Orthopedics24:18 - Optimizing Longevity and Lifestyle29:08 - Musculoskeletal Syndrome of Menopause42:12 - Approach to Protein Intake and Supplements50:48 - Practicing Longevity Medicine53:26 - Final Thoughts --- RESOURCES Unbreakable: A Woman’s Guide to Aging with Power by Dr. Vonda Wright:https://www.drvondawright.com/resources/books/unbreakable