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BackTable Urology

A Medicine , Health & Fitness and Education podcast

#86 in Medicine · 🇺🇸 #171 in Medicine · 🇿🇦

About the show

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.

Newest episodes

Ep. 343 Direct Contracting in Healthcare with Mark Cuban

Nov 12, 2026 55 min

“No cancer patient ever got healthier because their claim was denied and delayed. None. Not one.” Mark Cuban's verdict will ring true for any urologist who has fought a denied or delayed claim, and his alternative is a contract that starts by trusting the doctor. On this episode of BackTable Urology, Dr. Ruchika Talwar, urologic oncologist and value-based care leader, talks with Mark Cuban, entrepreneur and founder of Mark Cuban Cost Plus Drug Company, about who actually sets the price of care in the United States. They trace how a cold email about drug shortages led to Cost Plus Drugs and then Cost Plus Wellness, an open source library of direct contracts between self-insured employers and providers, and why he believes the contract, not the published price, is where the real problems hide. By his estimate, 67% of people with job-based coverage get it through a self-insured employer, which makes employers, not insurers, the real payers in American healthcare. --- Get the BackTable apphttps://www.backtable.com/app --- Timestamps00:00 - Introduction01:53 - From Drug Shortages to Cost Plus Drugs06:08 - Cost Plus Wellness and Direct Contracts11:04 - Publishing Provider Contracts16:39 - Using AI to Review Contracts and RFPs20:16 - Direct Contracting Advice for Hospitals and Physicians26:33 - Value-Based Care, Brokers, and Self-Insured Hospitals32:09 - Direct Contracting for Independent Practices34:20 - AI as a Business Adviser for Physicians38:39 - National Policy and Who Pays for Healthcare46:59 - Misaligned Incentives and Corporate Culture51:00 - Key Takeaways54:04 - Closing Remarks --- More about this episodeThe conversation then turns practical for physicians. Mark Cuban lays out how hospitals, clinics, and independent practices can find the self-insured employers among their own patients and offer direct contracts or carve-outs, why a promise to trust the doctor can earn employers a better rate, and how he runs contracts that stretch past a thousand pages thr...

Ep. 342 Mid-Career Urology: Understanding Career Evolution & Challenges with Dr. Debra Fromer and Dr. Anne Suskind

Nov 10, 2026 35 min

Mid-career is the stretch when you are no longer the new person on the block, but not yet the one in charge, and it gets far less attention than the years on either side of it. On this episode of BackTable Urology, presented in collaboration with the Society of Women in Urology (SWIU), Dr. Michelle Van Kuiken talks with Dr. Debra Fromer and Dr. Anne Suskind, both urology division chiefs and faculty vice chairs, about what no one tells you about mid-career. They describe how to know you have arrived there, why boredom can be the clearest signal that it is time to change, and why mid-career is the moment to say yes to a leadership role you have never trained for, even if what you learn is that you do not like it. --- Get the BackTable apphttps://www.backtable.com/app --- This podcast was developed in collaboration with Society of Women in Urologyhttps://swiu.org/home.aspx --- Timestamps 00:00 - Introduction01:50 - Defining Mid-Career04:05 - Career as an Evolution07:21 - Plateaus, Boredom, and Burnout09:55 - Imposter Syndrome and New Leadership Roles11:37 - Traps That Stall Mid-Career Growth15:14 - Changing Expectations at Work and at Home18:17 - Redefining Success20:51 - Mentorship at Every Career Stage22:26 - Phasing Out and Legacy25:11 - Staying Motivated27:38 - Life Outside Work31:10 - Parting Words and Closing Remarks --- More about this episode The three surgeons then name the traps that stall growth, from support that falls away after the junior years to unrecognized, unpaid roles and the competing demands of young children and aging parents. Dr. Fromer explains why control over her own time has always been her measure of success, and Dr. Suskind makes the case for new mentors and peer mentors at every stage. They close on phasing out and legacy, what keeps them motivated, and how challenges outside the hospital, from leading a urology Battle of the Bands to tournament golf, can feed a career. --- Resources Society of Women in Urology (SWIU)https:/...

Ep. 341 Understanding Overactive Bladder in Male Patients with Dr. Bilal Chughtai

Nov 5, 2026 40 min

How many prostate medications and procedures should a man try before anyone checks his bladder? Dr. Bilal Chughtai has met men who worked through an alpha blocker, add-on medications, a minimally invasive prostate procedure, and even resective surgery before anyone named overactive bladder as part of the problem. On this episode of BackTable Urology, Dr. Anjali Kapur, urogynecologist at Hackensack Meridian Health, welcomes Dr. Chughtai, chief of urology at Northwell Health's Plainview and Syosset hospitals, to rethink how urologists separate overactive bladder (OAB) from benign prostatic hyperplasia (BPH) in men. Dr. Chughtai explains how he reads the storage and voiding items of the International Prostate Symptom Score (IPSS), why he usually starts with a beta-3 agonist rather than an anticholinergic, how he trims polypharmacy one medication holiday at a time, and when urodynamics helps decide whether to treat the prostate, the bladder, or both. --- Get the BackTable apphttps://www.backtable.com/app --- This podcast is supported by Sumitomo Pharma America, Inc.https://www.us.sumitomo-pharma.com/ --- Timestamps 00:00 - Introduction02:37 - Initial Evaluation and First-Line Therapy06:11 - Combination Therapy and Medication Holidays09:37 - Reassessing Symptoms After an Outlet Procedure11:59 - Botox and Neuromodulation in Men15:14 - Persistent Symptoms After Prior BPH Treatment18:44 - The COURAGE Trial and Urge Incontinence23:22 - Combining Therapies and Setting Goals25:48 - Questionnaires, Bladder Diaries, and Underreporting29:05 - OAB Awareness in Primary Care31:14 - Nocturia and Sleep Apnea33:23 - Timing of Intervention and Bladder Health38:04 - Final Takeaways and Closing Remarks --- More about this episode The two then turn to third-line therapy in men, including intradetrusor botulinum toxin, sacral neuromodulation, and tibial nerve stimulation, and to men whose storage symptoms persist or appear after an outlet procedure. Dr. Chughtai shares what the C...

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All episodes

The newest 50 of 342 episodes

Ep. 343 Direct Contracting in Healthcare with Mark Cuban

Nov 12, 2026 55 min

Ep. 342 Mid-Career Urology: Understanding Career Evolution & Challenges with Dr. Debra Fromer and Dr. Anne Suskind

Nov 10, 2026 35 min

Ep. 341 Understanding Overactive Bladder in Male Patients with Dr. Bilal Chughtai

Nov 5, 2026 40 min

Ep. 340 Understanding Intermediate-Risk Bladder Cancer with Dr. Wesley Yip

Nov 3, 2026 43 min

By one estimate, half or more of all non-muscle invasive bladder cancer (NMIBC) is intermediate risk, yet the major guidelines still do not define it the same way, which leaves urologists sorting a large, mixed group of patients without a shared playbook for when to resect again, treat in the office, or start intravesical therapy. On this episode of BackTable Urology, Dr. Ruchika Talwar welcomes Dr. Wesley Yip, urologic oncologist at City of Hope, to rethink what she calls the forgotten stepchild of bladder cancer: intermediate-risk non-muscle invasive bladder cancer (NMIBC). Dr. Yip explains why he sees the category as a catch-all rather than a single biological entity, by his estimate covering 50 to 60 percent of NMIBC, why he now relies on the International Bladder Cancer Group (IBCG) definition, and why tumor grade comes first, ahead of multiplicity, size, and recurrence timing. --- Get the BackTable apphttps://www.backtable.com/app --- Timestamps 00:00 - Introduction02:24 - Defining Intermediate-Risk NMIBC07:53 - Case Presentation and the Initial TURBT10:42 - Evaluating the First Recurrence13:09 - High-Grade Cytology and Blue Light Cystoscopy15:01 - The Burden of Repeat TURBT16:57 - Office Fulguration and Chemoablation20:23 - Chemoablation Tolerability and Patient Selection24:24 - Intravesical Chemotherapy and Treatment Barriers28:08 - New Formulations and Upcoming Trials33:12 - Recurrence After Chemoablation and De-escalation38:00 - Future Directions and Patient-Centered Endpoints42:39 - Closing Remarks --- More about this episode Working through the case of a healthy 67-year-old man with recurrent low-grade Ta disease, the two discuss what to document at the first resection, how to counsel patients, when to return to the operating room, and when office fulguration, intravesical chemoablation, or intravesical chemotherapy with gemcitabine and docetaxel makes more sense. They cover the cumulative burden of repeat transurethral resection, practical lesso...

Ep. 339 AI's Role in Enhancing Urology Care with Dr. David Canes

Oct 29, 2026 58 min

By his own estimate, an AI scribe gives one urologist about two hours of his day back, and an evidence tool built into it has taught him something new in the clinic almost every day. On this episode of BackTable Urology, Dr. Ruchika Talwar welcomes back Dr. David Canes, urologist at Lahey Hospital & Medical Center and founder of WellPrept, to talk about how urologists can practically put AI to work. Dr. Canes explains why he sees this moment as a renaissance for physicians, how an AI scribe turned him from author into proofreader, by his estimate saving about two hours a day, and why evidence tools running alongside the scribe now answer questions in the exam room, including a question about post-prostatectomy dysorgasmia, a complaint that rarely comes up in clinic. --- Get the BackTable apphttps://www.backtable.com/app --- Timestamps 00:00 - Introduction03:32 - Getting Started With AI in Practice07:24 - AI Scribes and Cognitive Load14:18 - AI Evidence Tools at the Point of Care18:41 - Context, Pre-Charting, and Evidence in the Exam Room24:52 - AI for Email and Personal Workflow29:09 - Building a Permanent AI Memory34:20 - AI Skepticism, Privacy, and Intellectual Honesty40:47 - Will AI Replace Physicians?46:39 - Pre-Charting, Patient Education, and Care Journeys49:27 - Reducing the In-Basket Burden53:04 - Where to Start With AI55:27 - Closing Remarks --- More about this episode The conversation then moves beyond the clinic. Dr. Canes describes an AI layer on email that flags what cannot wait, and a permanent AI memory built from plain text files that keeps research, licenses, talks, and family life organized, with a firm rule that no protected health information goes anywhere without a business associate agreement. He and Dr. Talwar discuss what work is worth delegating to AI, push back on a recent JAMA perspective arguing that autonomous AI may outperform physicians, and run through tools for pre-charting, patient education, postoperative care journeys, and...

Ep. 338 From Numbers to Decisions: Clinical Utility of Biomarkers in Prostate Cancer Diagnosis with Dr. Amir Lebastchi

Oct 27, 2026 48 min

Every prostate cancer biomarker returns a number, but the real question is whether that number changes what you do next for the patient. On this episode of BackTable Urology, Dr. Ruchika Talwar welcomes Dr. Amir Lebastchi, urologic oncologist at Keck Medicine of USC, to discuss how biomarkers are moving prostate cancer care from numbers to meaningful clinical decisions. They define what makes a biomarker clinically useful, organize the growing list of blood, urine, and tissue tests into pre-biopsy, post-negative-biopsy, and post-diagnosis settings, and talk through where these tests fit alongside MRI after an elevated PSA. --- Get the BackTable apphttps://www.backtable.com/app --- This podcast is supported by Cleveland Diagnosticshttps://www.isopsa.com/ --- Timestamps 00:00 - Introduction02:59 - Clinical Utility and a Framework for Biomarkers08:43 - Workup of an Elevated PSA11:42 - Pre-Biopsy Blood and Urine Tests13:29 - Equivocal MRI, Outside Imaging, and Community Practice20:26 - Patient Factors and Practical Considerations24:44 - Case: Elevated PSA and a Negative MRI30:11 - Case: Biopsy Approach and Discordant Results34:41 - Counseling on PSA Limitations and Overdiagnosis37:05 - Biomarkers in Active Surveillance and Renaming Grade Group 140:56 - AI and the Future of Biomarkers44:38 - Take-Home Points and Closing Remarks --- More about this episode The discussion covers equivocal MRI findings, patient counseling, and the practical impact of age, family history, and race when interpreting PSA levels. Through real cases, Dr. Lebastchi explains when he repeats a PSA, how he performs a templated transperineal biopsy, and why a negative MRI plus a negative biomarker can give him the confidence to forgo a biopsy. They also touch on active surveillance, the debate over renaming grade group 1 prostate cancer, and how AI may help future tests guide treatment intensity rather than just risk category. Dr. Lebastchi closes with the clinician’s obligation to know al...

Ep. 337 Advancements in Ureteroscopy for Stone Management with Dr. Karen Stern

Oct 20, 2026 25 min

How is suction technology changing what it means to be “stone-free” after ureteroscopy? On this episode of BackTable Urology, Dr. Ruchika Talwar welcomes Dr. Karen Stern, endourologist at Mayo Clinic Arizona, for a practical discussion of how ureteroscopy is evolving in the era of suction. They discuss how thin-slice CT has revealed just how much stone typically remains after surgery, why dusting versus fragmenting is now a patient-dependent choice, and what to consider when selecting between suction sheaths, aspiration scopes, and traditional access. --- Get the BackTable apphttps://www.backtable.com/app --- This podcast is supported by Dornierhttps://www.dornier.com/backtable --- Timestamps 00:00 - Introduction02:16 - Residual Stone and Defining Success04:59 - Dusting, Fragmentation and Suction Devices07:15 - Patient Selection, OR Setup and Laser Settings11:39 - Evidence, Stone Clearance and Infection Risk15:39 - Community Adoption and Technique Pearls20:05 - Integrated Systems and Artificial Intelligence22:29 - Take-Home Points and Closing Remarks --- More about this episode The doctors discuss patient selection, OR setup, stenting, and why stones over a centimeter benefit most from a suction approach. Dr. Stern shares her tips for suction device setup, irrigation and suction settings, and how even a short learning curve can make these techniques routine. They review infection risks, evidence on residual stone volume, pearls for community adoption, and look ahead to integrated laser-suction platforms and AI tools that may one day help define when a case is truly finished. Dr. Karen Stern closes with advice for urologists on the fence: every technology works, but the best choice is the one that fits your practice. --- Resources Are We Overreporting Post-Op Sepsis? The Difference Between Reported and Verified Rates of Post-Ureteroscopy Sepsis Using the Sepsis 3 Criteria at a Single Institution. J Endourol. 2026https://doi.org/10.1177/08927790251394736...

Ep. 336 Biomarkers in Treatment Intensification for Prostate Cancer with Dr. Angela Jia

Oct 15, 2026 47 min

Same risk group, very different benefit. Can biomarkers help identify who needs treatment intensification in prostate cancer? On this episode of BackTable Urology, Dr. Ruchika Talwar and Dr. Angela Jia, a radiation oncologist at University Hospitals Cleveland Medical Center, break down the difference between prognostic and predictive biomarkers and how genomic testing is informing the way clinicians counsel patients. They review trial data suggesting that men with a low genomic score may gain little from adding hormone therapy, along with early prospective evidence that the luminal B subtype may help identify who benefits most from intensification. --- Get the BackTable apphttps://www.backtable.com/app --- This podcast is supported by Verasytehttps://www.veracyte.com/ --- Timestamps 00:00 - Introduction02:08 - Prognostic vs. Predictive Biomarkers06:34 - The NRG/RTOG 0815 Biomarker Cohort10:15 - Applying a Low Genomic Score in Clinic15:16 - Genomic Classifiers After Prostatectomy18:52 - RTOG 9601, SPPORT and the Salvage Evidence24:39 - Stage Migration and the Case for an ARPI28:13 - Ordering and Reading the Genomic Report34:31 - Common Mistakes in Interpretation37:31 - Where Genomics Could Go Next41:03 - Reflex Testing, EMR Integration and AI44:44 - Closing Remarks --- More about this episode The conversation covers practical application of test results, counseling with absolute risk numbers, and the pitfalls of stretching predictive claims beyond their evidence. Dr. Jia explains the limits of biopsy sampling, how stage migration with advanced imaging may shift baseline risk, and why a large portion of the genomic score remains unexplained by standard variables. The episode closes with a look at reflex testing, the potential role of AI, and the longer-term goal of giving patients clear, individualized benefit estimates for each treatment option. --- Resources NRG/RTOG 0815: A Phase III Prospective Randomized Trial of Dose-Escalated Radiotherapy With or...

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

Oct 13, 2026 52 min

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 apphttps://www.backtable.com/app --- This podcast is supported byMedtronic --- Timestamps 00:00 - Introduction03:20 - Initial Evaluation Under the AUA and SUFU Guidelines05:39 - Risk Stratification and Surveillance13:08 - Role of Fluoroscopy in Urodynamics14:55 - Spinal Cord Injury and Detrusor Sphincter Dyssynergia17:35 - Multiple Sclerosis, Parkinson Disease, and Stroke23:13 - Cognitive and Functional Status in Therapy Selection25:16 - Neuromodulation in the Neurogenic Population29:07 - Catheter Management and Sphincterotomy35:49 - Medical Therapy, Chemodenervation, and Surgical Escalation42:50 - Asymptomatic Bacteriuria and Antibiotic Stewardship46:04 - Gaps in Practice and Research on the Horizon50:48 - 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 the...

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

Oct 8, 2026 54 min

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 apphttps://www.backtable.com/app --- This podcast was developed in collaboration withSociety of Women in Urologyhttps://swiu.org/home.aspx --- Timestamps 00:00 - Introduction03:21 - Mentorship, Sponsorship, and Coaching06:23 - Paths Into Physician Coaching11:39 - Who Should Seek a Coach15:56 - What a Coach Does Differently22:57 - Anatomy of a Coaching Session28:21 - Coaching Frameworks and Tools35:14 - Uncovering Unrecognized Goals42:12 - Coaching Beyond the Workplace47:16 - Advice for the Undecided Urologist52:08 - 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, credent...

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

Oct 6, 2026 50 min

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 apphttps://www.backtable.com/app --- This podcast was developed in collaboration with Society of Academic Urologistshttps://sauweb.org/ --- Timestamps 00:00 - Introduction03:42 - Imaging Criteria for Adrenal Adenoma08:15 - Framework for Hormonal Workup12:48 - Mild Autonomous Cortisol Secretion16:20 - Adrenal Venous Sampling21:12 - Genetic Syndromes and Pheochromocytoma25:40 - Suspected Pheochromocytoma Case31:19 - Alpha Blockade Before Surgery35:36 - Intraoperative Hemodynamic Swings40:50 - Adrenocortical Carcinoma Case45:00 - Managing Adrenal Vein Avulsion48:00 - 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 gui...

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

Sep 29, 2026 48 min

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 apphttps://www.backtable.com/app --- This podcast is supported by Bayer https://www.bayer.com --- Timestamps 00:00 - Introduction02:41 - Shift to Urology-Led Advanced Prostate Management07:07 - Sorting Therapies by Disease State10:33 - Treatment Intensification and Doublet Therapy17:54 - ARPI Selection and the Four Ps Framework25:46 - Managing Financial Toxicity29:30 - Monitoring, Labs, and Imaging34:11 - Red Flags and Comanagement36:49 - When to Refer to Medical Oncology41:11 - Future Directions and Practice Economics46:33 - 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 Guidelinehttps://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)h...

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

Sep 24, 2026 1 hr 5 min

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 apphttps://www.backtable.com/app --- Timestamps 00:00 - Introduction04:04 - Launching a Residency and Building the Practice08:13 - Teaching in the OR and Progressive Responsibility13:58 - Clinic, Administration, and Resident Training16:38 - Expanding BPH Treatment Options25:21 - Creating a Research Culture and AI Projects32:42 - AI Uroflow Project and Follow Up40:21 - BPH Case Workup and Shared Decision-Making47:11 - Patient Goals and Procedure Selection55:43 - Sacral Neuromodulation and New Technologies01:00:19 - Teaching Character and Mentorship01:03:07 - 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

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

Sep 22, 2026 1 hr 4 min

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 apphttps://www.backtable.com/app --- Timestamps 00:00 - Introduction04:26 - Redefining Survivorship11:29 - Why Survivorship Practices Matter17:53 - Workup and Aligning Care21:05 - Managing Active Cancer Scenarios27:20 - Building a Survivorship Program30:12 - Growing Referrals and Optimizing Workflow39:24 - System Support and Research Gaps44:04 - Tech Advances in Reconstruction48:50 - Single-Port Retroperitoneal Case59:55 - 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

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

Sep 15, 2026 1 hr 0 min

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 apphttps://www.backtable.com/app --- Timestamps 00:00 - Introduction03:24 - Complex BPH Referrals and Symptom Assessment06:07 - Deciding When to Operate11:12 - Imaging and Prostate Sizing14:27 - When to Use Cystoscopy and Urodynamics16:43 - Incorporating Patient Preferences21:53 - Medical Therapy and Pills23:45 - Decision Aids and Personal Experience27:13 - Managing HoLEP Complications and Leakage32:57 - Advances in HoLEP Technique36:07 - TURP Indications and Outcomes38:36 - Special Considerations: Radiation and UroLift39:58 - ThULEP vs. HoLEP41:17 - Redo Surgery Strategies43:52 - Counseling Through Case Scenarios56:16 - Future Directions in BPH Treatment59:05 - 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 sati...

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

Sep 8, 2026 56 min

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 apphttps://www.backtable.com/app --- This podcast is supported by Medtronic Pelvic Healthhttps://urgencyisreal.com/ --- Timestamps 00:00 - Introduction04:00 - Shared Decision-Making06:51 - Clinic Efficiency10:38 - Expanding OAB Therapy Options12:27 - Long-Term OAB Care17:41 - Building an OAB Program18:18 - Staff Training and Follow-Up25:32 - OAB Navigator Implementation27:14 - Navigation Outcomes28:39 - Scaling with Staff and Epic30:35 - Algorithm Resources34:08 - Neuromodulation Advances38:37 - New Tibial and Battery-Free Devices40:56 - Quality of Life in OAB Care46:11 - Access and Adoption51:22 - Streamlining Therapy Discussions52:47 - 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 carehttps://link.springer.com/article/...

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

Sep 1, 2026 48 min

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 apphttps://www.backtable.com/app --- Timestamps 00:00 - Introduction01:40 - Initial Case Workup and Counseling06:28 - Why Testicular Cancer Happens09:17 - Management Considerations with Post-Orchiectomy Pathology19:21 - RPLND Benefits and Drawbacks23:39 - Surveillance Schedule and Long Term Follow Up28:17 - Second Tumor Risk30:36 - Evolving Seminoma Treatment37:57 - RPLND Selection Factors40:10 - Adjuvant Chemo Debate and Pathology46:06 - 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

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

Aug 27, 2026 50 min

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 apphttps://www.backtable.com/app --- Timestamps 00:00 - Introduction02:19 - Teaching In High Stakes Cases07:57 - Rethinking See One, Do One, Teach One10:24 - Assessing Trainee Readiness14:29 - Preop Preparation 16:06 - Teaching Cues in the OR 17:42 - Tips for Trainees21:40 - Intentional Teaching24:02 - Teaching Rare and Complex Cases26:40 - Anticipating Complications and Debrief After Disaster33:09 - Psychological Safety In the OR37:41 - Reflections on Past, Current, and Future Training Models43:56 - Patients And Trainees46:51 - 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

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

Aug 25, 2026 45 min

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 apphttps://www.backtable.com/app --- This podcast is supported byCleveland Diagnosticshttps://www.isopsa.com/ --- Timestamps 00:00 - Introduction04:03 - Why PSA Can Be Misleading06:43 - Approach to Elevated PSA and Initial Workup09:51 - MRI, PSA Density, and Biomarker Testing14:31 - Guidelines, Diagnostics, and When to Biopsy20:16 - Comparing 4K, IsoPSA, and Other Biomarkers25:23 - Choosing Between Transperineal and Transrectal Biopsy28:42 - Management Considerations for Elderly and Comorbid Patients33:09 - Active Surveillance, Recurrence, and Long-Term Monitoring40:47 - 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 yo...

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

Aug 18, 2026 41 min

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 apphttps://www.backtable.com/app --- This podcast is supported by Medtronichttps://www.medtronic.com/en-us/e/patients-caregivers/urinary/overactive-bladder.html --- Timestamps 00:00 - Introduction04:05 - Case One: Recurrent UTIs05:19 - Workup Basics08:50 - Non-Antibiotic Prevention11:42 - Antibiotic Prophylaxis Options15:16 - Case Two: Asymptomatic Bacteriuria 19:14 - Case Three: Complex Patients19:58 - Male vs. Female UTIs21:22 - Neurogenic Bladder Workup22:52 - Elderly Patients and ID Consults25:01 - Case Four: Transplant ESBL25:23 - Machine Learning for Antibiotics 29:49 - Catheter Biofilms31:55 - Embedded Bladder Reservoirs35:23 - Recurrent UTI Vaccine36:23 - Future of Recurrent UTIs39:04 - 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 bladd...

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

Aug 11, 2026 38 min

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 - Introduction05:58 - Comparing Office Ablation and OR TURBT08:26 - TURBT Impact on Quality of Life11:37 - Uncovering Hidden Patient Burdens and Costs14:44 - Integrating Chemoablation into Practice18:20 - ENVISION QoL Study Setup22:04 - Comparing TURBT Preferences27:40 - Counseling Risk-Averse Patients29:10 - Community Adoption Advice31:59 - Upcoming Clinical Trials35:28 - Biomarkers and Expanding Access36:23 - 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 urogyn...

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

Aug 6, 2026 50 min

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 apphttps://www.backtable.com/app --- Timestamps 00:00 - Introduction04:17 - Getting Started on Social Media12:24 - Finding Your Niche17:04 - Being a Woman in Urology18:40 - Impact On Patient Care23:59 - Doctor-Patient Boundaries28:33 - Social Media Pitfalls38:53 - Creator Monetization45:58 - 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

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

Aug 4, 2026 41 min

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 apphttps://www.backtable.com/app --- Timestamps00:00 - Introduction04:22 - Hypospadias Overview and Symptom Chronology09:14 - Not A One Size Fits All: Developing WYSH13:28 - Reengaging Families and Patients20:04 - Adult Urology Sequelae25:08 - Demystifying Surgery and Improving Training34:00 - Centers of Excellence Debate36:56 - Future Goals and Wrap Up --- More about this episodeThe 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. --- ResourcesWorldwide 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

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

Jul 31, 2026 50 min

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 apphttps://www.backtable.com/app --- This podcast is supported by Johnson & Johnson https://www.inlexzohcp.com/ --- Timestamps 00:00 - Introduction02:40 - Why Focus on TAR-20005:35 - Device Basics07:05 - Dosing Schedule Explained11:17 - SUNRISE-01 Trial Results15:07 - Patient Selection and Contraindications20:52 - Indications for Device Removal23:26 - Clinic Workflow Learning Curve25:56 - Tips for Insertion and Device Deployment28:52 - Cystoscopy Findings and Surveillance Protocol32:16 - Treatment Sequencing38:43 - Future Trial and Research Directions45:16 - Biomarkers, AI, and Personalizing Care46:35 - Cost, Supportive Care, and Patient Burden48:42 - 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–Unresponsi...

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

Jul 28, 2026 1 hr 16 min

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 apphttps://www.backtable.com/app --- Timestamps 00:00 - Introduction04:10 - History of Buried Penis Treatment08:47 - Grafts Versus Flaps11:34 - Hidden Pathologies and Informed Consent13:46 - Research and Insurance Approval18:24 - Delayed Care and Disease Burden22:31 - Deciding When to Operate and Temporizing Procedures30:23 - Building Referral Networks33:13 - Future Directions36:42 - Infection Risk 41:15 - Technique Evolution45:57 - Preop Evaluation Essentials50:50 - Intraop Keys to Success and Graft Protection59:26 - Postop Pathway and Teamwork01:02:54 - W-Plasty Video Walkthrough01:13:52 - 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...

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

Jul 21, 2026 1 hr 0 min

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 apphttps://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 - Introduction07:59 - Overview of Nerve Stimulation Therapies13:22 - Case #122:00 - Case #228:23 - Nuspera 34:21 - APPs in Practice39:21 - Reimbursement Roadblocks47:03 - Multimodal Therapy49:51 - Case #356:06 - Final Advice --- Resources Randomized trial of percutaneous tibial nerve stimulation versus Sham efficacy in the treatment of overactive bladder syndrome: results from the SUmiT trialhttps://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 Incontinencehttps://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 Patientshttps://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

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

Jul 16, 2026 47 min

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 apphttps://www.backtable.com/app --- Timestamps00:00 - Introduction02:09 - Overview of Focal Therapy Modalities04:46 - Deciding Between HIFU and IRE06:56 - Evidence and Trials09:40 - Counseling Patients on Outcomes12:09 - Building a Focal Therapy Program16:12 - Navigating Insurance and Appeals21:48 - Managing Large Glands And TURP25:12 - Preop Workup Essentials and OR Workflow32:32 - Overcoming the Learning Curve35:52 - PostOp Recovery and Surveillance39:04 - Options for Managing Recurrence42:44 - Challenges with Repeat Ablation44:56 - Final Takeaways --- More about this episodeThe 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 cancerhttps://pubme...

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

Jul 14, 2026 48 min

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 apphttps://www.backtable.com/app --- This podcast is supported by Urogenhttps://www.zusduri.com --- Timestamps 00:00 - Introduction02:51 - Delivering Bladder Cancer Care in the Community 09:08 - Navigating Treatment Choices 13:05 - Patient Expectations and Insurance Coverage19:01 - Ablation Strategies for Low and Intermediate Risk22:34 - Making Therapies Community Friendly27:12 - Launching Community Trials31:08 - Referrals and Community Practice Advice36:36 - Cystectomy Counseling Pearls44:46 - 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 Handbookshttps://bcan.org/bladder-cancer-basics-handbook/ Wellprepthttps://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 physicia...

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

Jul 10, 2026 48 min

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 apphttps://www.backtable.com/app --- Timestamps 00:00 - Introduction02:58 - Why Urology Drew Private Equity07:06 - Bad Headlines vs. Reality11:14 - MSOs and Contracts Explained15:24 - Timelines and After Private Equity22:47 - Efficiency and Autonomy Fears27:15 - Why Private Equity Gets Vilified31:23 - Young Urologist Job Market35:42 - Advice for New Grads40:26 - Urology in 2035 and Fair Critiques of Private Equity44:40 - 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 maintain...

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

Jul 7, 2026 51 min

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 apphttps://www.backtable.com/app --- This podcast is supported by an educational grant from Pfizer. --- Timestamps 00:00 - Introduction02:51 - PARPi Basics14:12 - Major Study Differences19:00 - Timing and Selection of PARPi Combinations26:39 - Case: Somatic BRCA2 loss and mHSPC35:51 - Case Continued: BRCA2 Reversion39:57 - BRCAAway Study42:59 - 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 A...

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

Jun 30, 2026 35 min

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 apphttps://www.backtable.com/app --- Timestamps 00:00 - Introduction03:12 - Risk Calculators and Consent04:39 - Nomograms vs. Complications09:57 - Endpoints That Matter11:38 - PSMA PET Strengths and Limits13:51 - Negative PET Decision-Making15:08 - Positive PET and Multimodal Care18:02 - Fluorescence Guided Surgery19:10 - Counseling on Complications22:27 - Preventing Lymphocele24:56 - How Lahey Wrap Works26:45 - Future Mapping and Therapy28:47 - Research Gaps and Dogma31:07 - 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-analysishttps://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-t...

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

Jun 25, 2026 30 min

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 apphttps://www.backtable.com/app --- This podcast is supported by an educational grant from Johnson & Johnson. --- Timestamps 00:00 - Introduction04:25 - Non Drug Symptom Tips09:39 - Day Of Treatment Clearance14:50 - Post Treatment Triage20:36 - Treatment Fatigue Strategies24:48 - Pelvic Floor And IC Tools27:33 - 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/ ---...

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

Jun 23, 2026 54 min

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 apphttps://www.backtable.com/app --- Timestamps 00:00 - Introduction05:36 - Choosing a Non-Clinical Path11:07 - Reactions from Mentors and Peers14:31 - What Feels Most Fulfilling18:31 - A Typical Week in Biotech26:04 - Working with Investors31:21 - Additional Degrees and MBA Debate35:31 - Is it Risky to Leave Clinical Practice?44:13 - Networking and Next Steps47:59 - 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

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

Jun 18, 2026 43 min

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 apphttps://www.backtable.com/app --- This podcast is supported by an educational grant from Johnson & Johnson. --- Timestamps00:00 - Introduction01:02 - Risk Stratification07:22 - Upstaging to High Risk10:06 - Calculators and Patient Education15:22 - Specific Tests Use Cases18:50 - Conflicting Biomarker Results21:36 - Adjunct Tests and Counseling24:03 - Recurrence After Chemo Next Steps27:01 - Escalation Deescalation Balance32:48 - Future Research Priorities35:43 - Biology Based Risk Stratification38:03 - Clinical Pearls and Wrap Up --- More about this episodeThe 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 Studyhttps://www.mskcc.org/cancer-care/clinical...

Ep. 309 Advancing Urologic Reconstruction with Robotics with Dr. Ziho Lee

Jun 16, 2026 43 min

Robotic technology is expanding what’s possible in reconstructive urology, prompting surgeons to rethink traditional approaches and consider new minimally invasive procedures. In this episode of BackTable Urology, Dr. Ziho Lee joins host Dr. George Koch to explore the rapid evolution of robotic reconstructive surgery and its expanding role in complex pelvic and retroperitoneal procedures.They discuss the the role of single-port platforms, new strategies for managing ureteral strictures and urinary diversion, and how research, training, and patient-reported outcomes are shaping the future of minimally invasive urologic care. --- Get the BackTable apphttps://www.backtable.com/app --- Timestamps00:00 - Introduction03:10 - Bridging Reconstruction and Robotics07:41 - Where Robots Help Most14:33 - Ureteral Rest16:41 - 20% Nephrectomy Rule19:04 - Single Port Indications20:55 - Ileal Ureter Tips and Tricks22:34 - Robotic Reconstruction Course28:55 - Case: VUAS Repair39:35 - Final Advice --- ResourcesUreteral Rest is Associated With Improved Outcomes in Patients Undergoing Robotic Ureteral Reconstruction of Proximal and Middle Ureteral Strictureshttps://pubmed.ncbi.nlm.nih.gov/33639184/ --- 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

Ep. 308 Navigating Shared Decision-Making in Bladder Cancer Treatment with Dr. Kelly Bree, Dr. Meredith Donahue, and Dr. Saum Ghodoussipour

Jun 11, 2026 48 min

What matters most to patients with non-muscle invasive bladder cancer (NMIBC)? In this episode of BackTable Urology, Dr. Kelly Bree, Dr. Saum Ghodoussipour, and Meredith Donahue, N.P., join host Dr. Vignesh Packiam to discuss the power of shared decision-making across the NMIBC spectrum. They explore risk-adapted treatment selection, when to escalate or de-escalate therapy, and how to navigate conversations about recurrence risk, treatment burden, quality of life, and the possibility of cystectomy. --- Get the BackTable apphttps://www.backtable.com/app --- This podcast is supported by an educational grant from Johnson & Johnson. --- Timestamps 00:00 - Introduction01:55 - Second Opinions and Patient Counseling06:08 - Intermediate Risk Stratification12:13 - Treatment Options for Intermediate Risk NMIBC16:20 - BCG and Alternative Treatments for High Risk NMIBC26:49 - Options for BCG-Unresponsive NMIBC31:42 - Sequencing and Cystectomy37:03 - Financial and Time Toxicity41:08 - Biomarkers and ctDNA44:04 - Future Trials and NMIBC Innovations --- More about this episode They also review emerging therapies such as ZUSDURI, the evolving role of intravesical treatments, and the promise of biomarkers and ctDNA for personalized care. The discussion covers practical strategies for patient counseling, key updates to clinical guidelines, and a preview of innovations shaping the future of NMIBC management. --- Resources Active Surveillance Versus Intravesical Bacillus Calmette-Guérin for High-grade T1 Bladder Cancer with Negative Second Transurethral Resection: The Randomized Noninferiority Phase 3 JCOG1019 Trial:https://pubmed.ncbi.nlm.nih.gov/41571573/ Twelve-Month Results From the CISTO Study Comparing Radical Cystectomy Versus Bladder-Sparing Therapy for Recurrent High-Grade Non–Muscle-Invasive Bladder Cancerhttps://ascopubs.org/doi/10.1200/JCO-25-01324 CIRCULATING TUMOR DNA AS A BIOMARKER FOR UPSTAGING AND ADVERSE PATHOLOGY IN HIGH-RISK NON–MUSCLE-INVASIVE BLADDE...

Ep. 307 Germline & Somatic Testing in Prostate Cancer Therapy with Dr. Tanya Dorff and Dr. Evan Yu

Jun 9, 2026 40 min

Can you really treat prostate cancer effectively without knowing the genetics? In this episode of BackTable Urology, Dr. Evan Yu and Dr. Tanya Dorff join host Dr. Alan Tan to discuss why genetic testing is essential in personalized prostate cancer care. They discuss when and how to perform germline and somatic testing, address common barriers, and share best practices for counseling patients. --- Get the BackTable apphttps://www.backtable.com/app --- This podcast is supported by an educational grant from Pfizer. --- Timestamps 00:00 - Introduction02:18 - Who Gets Somatic Testing?06:43 - Patient Barriers to Testing09:00 - Genetic Testing Workflow12:28 - Treating BRCA2 Alterations24:18 - Monitoring Progression: ctDNA vs. PSA vs. Imaging29:32 - Treating mCRPC with ATM Mutations34:39 - CDK12 Classification 37:43 - Closing Takeaways --- More about this episode The doctors explore how BRCA2 and other DNA repair alterations can directly shape treatment decisions, focusing on the roles of PARP inhibitors and platinum therapy in advanced cases. The discussion highlights why both germline and somatic testing are critical for identifying actionable mutations and discuss the nuances of interpreting test results, including current limitations and emerging biomarkers. They also examine challenges such as insurance coverage, patient misconceptions, and workflow integration, as well as the movement toward truly personalized, biology-driven approaches in prostate cancer care. --- Resources Niraparib and abiraterone acetate plus prednisone for HRR-deficient metastatic castration-sensitive prostate cancer: a randomized phase 3 trial:https://pmc.ncbi.nlm.nih.gov/articles/PMC12705445/ Capivasertib plus abiraterone in PTEN-deficient metastatic hormone-sensitive prostate cancer: CAPItello-281 phase III study:https://www.annalsofoncology.org/article/S0923-7534(25)04936-1/fulltext Apalutamide for Metastatic, Castration-Sensitive Prostate Cancer:https://www.nejm.org/doi/full/1...

Ep. 306 Ep. 306 Launching Co-Managed APP/MD Clinics for Bladder Cancer with Dr. Amy Luckenbaugh and Meredith Donahue DNP

Jun 4, 2026 44 min

Are traditional bladder cancer care models falling behind as new therapies flood the field and reshape the landscape? In this episode of BackTable Urology, Dr. Bogdana Schmidt talks with Dr. Amy Luckenbaugh and DNP/APP Meredith Donahue about building a co-managed intravesical therapy clinic that rethinks care for patients with non–muscle invasive bladder cancer (NMIBC). With innovative agents increasing patient volume and complexity, the team discusses adapting care models to new realities. --- Get the BackTable apphttps://www.backtable.com/app --- This podcast is supported by an educational grant from Johnson & Johnson. --- Timestamps 00:00 - Why Clinic Models Need to Change Now04:03 - Overcoming Financial and J-Code Hurdles11:04 - High Volume Workflow14:10 - Pharmacy Coordination And Timing19:02 - Proactive Lower Urinary Tract SYmptom Management22:25 - Handling Difficult Catheters32:08 - Defining Clinic Success --- More about this episode The conversation covers prioritizing clinical trials, managing operational challenges such as prior authorizations and billing hurdles, and the importance of pharmacy coordination and predictable clinic workflows. Donahue describes a high-efficiency installation day model managing up to 50 patients a week with specialized staff, real-time decisions, and tailored logistics for therapies like Adstiladrin. They also discuss symptom prevention, patient triage, and clinic success measures including therapy availability, patient satisfaction, and opportunities to preserve bladder function. --- Resources Gemcitabine IDRS Drug Delivery Trialhttps://ascopubs.org/doi/10.1200/JCO.2026.44.7_suppl.635 BCG-IO Combination Trialhttps://www.astrazeneca.com/media-centre/press-releases/2026/imfinzi-approved-in-us-for-early-bladder-cancer.html --- 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 c...

Ep. 305 Immune Therapy Innovations for BCG Unresponsive Cancer with Dr. Sam Chang

Jun 2, 2026 48 min

Ready to move beyond “one-size-fits-all” for BCG-unresponsive NMIBC? In this episode of BackTable Urology, Dr. Ruchika Talwar hosts Dr. Sam Chang to discuss the evolving treatment landscape for BCG-unresponsive non-muscle invasive bladder cancer (NMIBC). They explore why BCG may fail, the science and clinical rationale behind new immunotherapies and gene therapies, practical approaches to patient selection, treatment sequencing, and surveillance, and the value of emerging biomarkers, empowering urologists to make more informed, personalized decisions in complex cases of NMIBC. --- Get the BackTable apphttps://www.backtable.com/app --- This podcast is supported by ImmunityBiohttps://anktiva.com/ --- Timestamps 00:00 - Introduction03:48 - BCG: How it Works and Why it Fails11:13 - Pembrolizumab Role and Limits14:38 - Nadofaragene firadenovec 16:34 - Cretostimogene grenadenorepvec18:39 - BCG + Anktiva Rationale29:50 - Explaining Options to Patients33:05 - Post Treatment Surveillance37:32 - Future of Biomarkers and AI42:05 - Key Takeaways --- Resources N-803 Plus BCG Treatment for BCG-Naïve or -Unresponsive Non-Muscle Invasive Bladder Cancer: A Plain Language Reviewhttps://pmc.ncbi.nlm.nih.gov/articles/PMC11524197/ Safety, Tolerability, and Long-Term Clinical Outcomes of an IL-15 analogue (N-803) Admixed with Bacillus Calmette-Guérin (BCG) for the Treatment of Bladder Cancerhttps://doi.org/10.1080/2162402X.2021.1912885 IL-15 Superagonist NAI in BCG-Unresponsive Non–Muscle-Invasive Bladder Cancerhttps://evidence.nejm.org/doi/full/10.1056/EVIDoa2200167 --- More about this episode This podcast is for informational purposes only. The views and opinions expressed in this podcast are solely those of the moderator and individual guest. --- 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 specia...

Ep. 304 Optimizing Office Protocols for Urological Incontinence Procedures with Dr. Michael Kennelly and Dr. Jason Kim

May 26, 2026 41 min

How do you keep no-shows low and patient satisfaction high in an office-based overactive bladder (OAB) practice? In this episode of BackTable Urology, Dr. Michael Kennelly and Dr. Jason Kim join guest host Dr. Polina Reyblat to share practical strategies for improving efficiency, reducing cancellations, and optimizing the patient experience for OAB and urinary incontinence procedures. --- Get the BackTable app https://www.backtable.com/app --- This podcast was developed in collaboration withSociety of Urodynamics, Female Pelvic Medicine & Urogenital Reconstruction (SUFU) https://sufuorg.com/home.aspx --- Timestamps 00:00 - Introduction02:08 - Pre Visit Optimization05:49 - Botox Protocol11:31 - Spa-Style Comfort14:46 - Prior Auth and Medicare LCD21:25 - PTNS Workflow Challenges24:52 - Stacking Procedures27:55 - Bulking Agent Clinic Workflow36:17 - Rapid Fire Tips --- More about this episode The panel discusses streamlined Botox workflows, patient-centered approaches to anxiety and pain management, percutaneous tibial nerve stimulation (PTNS) and peripheral nerve evaluation (PNE) scheduling, office-based bulking procedures, and the evolving Medicare LCD documentation requirements. They also share tips for procedure-day planning, staffing, prior authorizations, and reducing no-shows while maintaining high-quality care. --- Resources Relaxing Environment Lowers Anxiety During Chemodenervation: a Randomized Trialhttps://journals.lww.com/fpmrs/abstract/2026/04000/relaxing_environment_lowers_anxiety_during.6.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

Ep. 303 PARP Inhibitors: Clinical Trials & Real-World Applications with Dr. Neeraj Agarwal and Dr. Arun Azad

May 19, 2026 1 hr 15 min

Keeping patients on PARP inhibitors long enough to see real benefit often comes down to proactive side effect management. In this episode of BackTable Urology, Dr. Neeraj Agarwal and Dr. Arun Azad join host Dr. Alan Tan to discuss practical, evidence-based strategies for managing hematologic and GI toxicities in advanced prostate cancer patients receiving PARP inhibitors. --- Get the BackTable apphttps://www.backtable.com/app --- This podcast is supported by an educational grant from Pfizer. --- Timestamps 00:00 - Introduction06:17 - Managing Anemia11:12 - Side Effect Profiles19:33 - Transfusions vs ESAs26:43 - Docetaxel vs PARP Inhibitors30:27 - Side Effect Management Pearls40:18 - Team Based Monitoring52:27 - Tissue Versus Liquid01:01:24 - Genetic Counseling Workflow01:07:07 - Trial Equity and Access --- More about this episode The doctors discuss the importance of close anemia monitoring during the critical first 3 to 4 months of therapy, maintaining dose intensity, proactive antiemetic use, and the role of exercise and resistance training in combating fatigue. The conversation also covers differences in toxicity profiles between PARP agents, the value of multidisciplinary care teams, molecular advances in molecular and germline testing, and the evolving landscape of emerging therapies in prostate care. --- Resources Talazoparib plus enzalutamide in men with metastatic castration-resistant prostate cancer: final overall survival results from the randomised, placebo-controlled, phase 3 TALAPRO-2 trialhttps://www.thelancet.com/journals/lancet/article/PIIS0140-6736(25)00684-1/abstract 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://ascopubs.org/doi/10.1200/JCO.2024.42.4_suppl.19 --- BackTable Urology is the go-to podcast for urologists, urologic oncologists, and urogynecolog...

Ep. 302 Male Infertility: Diagnosis & Guidelines Update with Dr. Robert E. Brannigan

May 12, 2026 46 min

Male factor infertility accounts for nearly half of all infertility cases, yet male evaluation is often delayed or overlooked. In this episode of BackTable Urology, Dr. Robert Brannigan joins guest host Dr. Catherine Nam to unpack the 2024 AUA/ASRM Male Infertility Guideline update and discuss how the field is evolving beyond basic semen analysis. --- Get the BackTable apphttps://www.backtable.com/app --- Timestamps 00:00 - Introduction04:12 - Rationale Behind the Updates09:37 - Concurrent Couple Evaluation15:01 - Diagnosis, Assessment and Evaluation20:33 - Y Chromosome Microdeletion Testing23:54 - Workup for Recurrent Pregnancy Loss33:57 - Pelvic MRI for EDO36:46 - MicroTESE40:15 - Future Research Directions44:09 - Closing Takeaways --- More about this episode They review updated definitions of infertility, challenges with WHO semen reference ranges, and the need for comprehensive male assessment. The discussion also covers sperm DNA fragmentation, recurrent pregnancy loss, the role of pelvic MRI for ejaculatory duct obstruction, micro-TESE for nonobstructive azoospermia, and the latest directions in male infertility research. --- Resources Increased risk of incident chronic medical conditions in infertile men: analysis of United States claims data:https://pubmed.ncbi.nlm.nih.gov/26674559/ Diagnosis and Treatment of Infertility in Men: AUA/ASRM Guidelinehttps://www.auanet.org/guidelines-and-quality/guidelines/male-infertility Sixth edition of the World Health Organization laboratory manual of semen analysis: Updates and essential take away for busy clinicianshttps://pmc.ncbi.nlm.nih.gov/articles/PMC10929669/ --- 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

Ep. 301 Integrating Biomarkers in Prostate Cancer Treatment with Dr. Udit Singhal

May 5, 2026 34 min

Are biomarkers the missing link in personalized prostate cancer care? What is the practical role of biomarkers across the prostate cancer treatment continuum? In this episode of BackTable Urology, Dr. Udit Singhal (University of Michigan) joins Dr. Ruchika Talwar (Vanderbilt University) to explore the evolving role of genomic classifiers and biomarkers in prostate cancer care. --- Get the BackTable apphttps://www.backtable.com/app --- This podcast is supported byVeracytehttps://www.veracyte.com/decipher-prostate --- Timestamps 00:00 - Introduction04:58 - Current State10:07 - Interpreting High Risk Scores13:25 - Intermediate Risk Decisions16:18 - Imaging vs. Genomics18:26 - Advanced Disease Evidence22:02 - AI and Clinical Trials29:52 - Conclusions --- More about this episode They review commonly used assays, including Prolaris, Oncotype Dx, Decipher, and ConfirmMDx and emphasize how these tools complement traditional clinical and pathologic risk factors. The discussion highlights practical applications across the disease continuum from initial diagnosis and active surveillance to intermediate-risk management and post-prostatectomy salvage decisions. They also explore emerging AI-driven tools and ongoing trials, highlighting the importance of contextualizing biomarker data within the broader clinical picture and using it to inform, rather than dictate, patient-centered care. --- 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

Ep. 300 Renal Cell Carcinoma and Venous Thrombus: A Deep Dive with Dr. Vidit Sharma

Apr 28, 2026 1 hr 43 min

When Renal Cell Carcinoma (RCC) invades the veins, the stakes and the surgical challenges rise. Are you prepared? In this episode, Dr. Vidit Sharma (Mayo Clinic) joins guest host Dr. Daniel Roberson to review Renal Cell Carcinoma (RCC) with Venous Tumor Thrombus (VTT), seen in 4 to 10% of cases. They review Mayo level classification and how CT and MRI venography guide surgical planning by defining thrombus extent and IVC involvement. --- Get the BackTable apphttps://www.backtable.com/app --- Timestamps 00:00 - Introduction03:03 - What is a Venous Tumor Thrombus?12:32 - Presentation and Workup31:49 - Preoperative Considerations40:26 - Building the Dream Team46:06 - Preop Counseling and Risks51:24 - The Operation01:31:01 - Outcomes and Adjuvant Immunotherapy01:36:40 - Future Neoadjuvant Shrinkage01:39:40 - Final Takeaways --- More about this episode They also cover key management decisions, including when anticoagulation is appropriate and why embolic urgency is often overestimated. Dr. Sharma highlights the importance of experienced multidisciplinary teams, reviews surgical considerations across thrombus levels, and discusses outcomes, including risk stratification with the TeNNiS model and evolving roles for systemic therapy. --- Resources Outcomes for patients with renal tumors and venous tumor thrombushttps://www.mayoclinic.org/medical-professionals/urology/news/outcomes-for-patients-with-renal-tumors-and-venous-tumor-thrombus/mac-20570379 TeNNiS Scorehttps://www.goldjournal.net/article/S0090-4295(26)00078-6/fulltext --- 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

Ep. 299 Clinical Decision-Making in Urodynamics: From Stress Incontinence to Neurogenic Bladders with Dr. Howard Goldman and Dr. David Ginsberg

Apr 21, 2026 52 min

When does urodynamics actually change management and when is it unnecessary? In BackTable Urology’s latest collaboration with the Society of Urodynamics, Female Pelvic Medicine & Urogenital Reconstruction (SUFU), Dr. Howard Goldman and Dr. David Ginsberg join Dr. Giulia Ippolito to discuss the evidence-based use of urodynamics across a range of clinical scenarios. --- Get the BackTable apphttps://www.backtable.com/app --- Timestamps 00:00 - Introduction 05:04 - Case: Male Urinary Retention12:38 - Case: Failed Sling18:44 - Case: Parkinson’s OAB21:50 - Case: Post-Prostatectomy26:48 - Prolapse Without Urodynamics32:29 - Obstruction Workup36:16 - Refractory OAB42:49 - Interstitial Cystitis45:18 - Recurrent UTI Evaluation50:16 - Conclusions --- More about this episode They review guideline-driven indications and limitations of urodynamic testing, emphasizing that many common conditions do not routinely require testing. Through case-based discussion, they highlight situations where urodynamics can meaningfully inform care, such as complex neurogenic patients and cases requiring differentiation between obstruction and detrusor underactivity. The conversation highlights the importance of clinical judgment, targeted use of adjuncts such as uroflow, and aligning testing with decision-making to optimize patient outcomes.This podcast is supported by the Society of Urodynamics, Female Pelvic Medicine & Urogenital Reconstruction (SUFU). --- Resources Female Urgency, Trial of Urodynamics as Routine Evaluation (FUTURE study)https://pubmed.ncbi.nlm.nih.gov/34702331/ --- 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

Ep. 298 Saying Yes (and No): Strategic Career Decisions with Dr. Anne Cameron

Apr 14, 2026 47 min

Is your “yes” advancing your career or just adding to your workload? In collaboration with the Society of Women in Urology (SWIU), this episode of BackTable Urology features timely professional advice from Dr. Anne Cameron (University of Michigan, former SWIU president) and Dr. Helen Bernie (Indiana University) on how to approach yes and no decisions with intention across different stages of your medical career. --- Get the BackTable apphttps://www.backtable.com/app --- Timestamps 00:00 - Introduction02:43 - How Yes Changes Over Time11:34 - Power Dynamics For Trainees16:11 - Housekeeping Work18:46 - Kind Versus Nice22:52 - Delegating And Mentoring28:07 - Decision-Making Framework36:21 - FOMO Versus Opportunity40:30 - Mentorship45:02 - Final Takeaways --- More about this episode Early in training, saying yes is often driven by power dynamics, while later in a career, it’s competing priorities that make those decisions harder. According to Dr. Cameron, a clear, timely “no” is not only acceptable but often more professional than a delayed response, and leaders play a key role in reinforcing this by giving trainees the space to decline opportunities. This episode also highlights the disproportionate share of “housekeeping” work taken on by women and junior faculty, adding another layer to these decisions. To navigate these challenges, Dr. Cameron offers a practical framework that considers time, role expectations, energy, personal fulfillment, CV value, and long-term goals, while emphasizing the role of mentors and trusted colleagues in providing perspective. --- Resources Society of Women in Urology (SWIU)https://swiu.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

Ep. 297 How Prostate Artery Embolization Optimizes Radiation Outcomes with Dr. Nainesh Parikh and Dr. Kosj Yamoah

Apr 7, 2026 46 min

What role does prostate artery embolization (PAE) play in modern prostate cancer care? In this episode of BackTable Urology, Dr. Nainesh Parikh (Interventional Radiology at Moffitt Cancer Center) and Dr. Kosj Yamoah (Radiation Oncology at Moffitt Cancer Center) join Dr. Ruchika Talwar (Vanderbilt University) to discuss how PAE could become a key adjunct in optimizing radiation therapy outcomes. --- Get the BackTable app https://www.backtable.com/app --- Timestamps 00:00 - Introduction01:44 - Why Use PAE in Cancer04:08 - Neoadjuvant and Salvage Use07:26 - Radiation Planning Benefits12:51 - PAE vs. Surgery18:36 - SBRT Access20:48 - Current Evidence and Trials25:29 - Patient Selection32:18 - PAE After Radiation36:56 - When to Avoid PAE40:29 - Long-Term Implications44:28 - Conclusions --- More about this episode They review how PAE can improve lower urinary tract symptoms and reduce prostate volume, potentially optimizing patients for radiation therapy, including stereotactic body radiotherapy (SBRT) and brachytherapy. The discussion highlights early clinical data and patient selection considerations such as gland size and symptom burden. Finally, they examine post-radiation applications, technical challenges, and current limitations, emphasizing the need for larger, multicenter trials to better define PAE’s role in prostate cancer treatment pathways. --- Resources Prostate Artery Embolization in the Setting of Prostate Cancer: Review and Opinionhttps://pmc.ncbi.nlm.nih.gov/articles/PMC11775958/

Ep. 296 Overactive Bladder Management: Updates and Guidelines with Dr. Jason Kim

Mar 31, 2026 44 min

What if we’re waiting too long to offer our OAB patients the treatments that actually work? In this episode of BackTable Urology, Dr. Jason Kim joins host Dr. Anjali Kapur to discuss updates in overactive bladder management and evolving guidelines, including a shift away from rigid stepwise care toward shared decision-making. --- Get the BackTable apphttps://www.backtable.com/app --- Timestamps 00:00 - Introduction03:06 - 2024 AUA/SUFU Idiopathic OAB Guideline07:32 - Patient Experience with OAB11:59 - Beta-3 Agonists vs Anticholinergics15:15 - Botox Counseling and Dosing18:11 - Tibial Nerve Stimulation25:47 - Sacral Neuromodulation32:09 - Cost Burden of OAB39:38 - Evolution of OAB Care41:39 - Future Research Directions --- More about this episode The conversation positions OAB as a clinical diagnosis, supported by focused initial evaluation and selective use of advanced testing, with attention to the emerging role of ambulatory urodynamics. Dr. Kim and Dr. Kapur review management across the care continuum, including behavioral strategies, pelvic floor physical therapy, and pharmacologic options, with consideration of beta-3 agonists in older patients. The discussion also focuses on earlier use of minimally invasive therapies such as intradetrusor Botox and neuromodulation, and how introducing these options sooner may improve follow-up, reduce delays, and help patients achieve symptom control more efficiently. --- Resources The AUA/SUFU Guideline on the Diagnosis and Treatment of Idiopathic Overactive Bladder (2024)https://www.auanet.org/guidelines-and-quality/guidelines/idiopathic-overactive-bladder Anticholinergic Drug Exposure and the Risk of Dementiahttps://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2736353 Randomized trial of percutaneous tibial nerve stimulation versus Sham efficacy in the treatment of overactive bladder syndrome: results from the SUmiT trial https://pubmed.ncbi.nlm.nih.gov/20171677/ Trends in Utilization of Sacral...

Ep. 295 How to Manage Genitourinary Injuries: ACS Best Practices Explained with Dr. Niels Johnsen

Mar 24, 2026 47 min

What are the key decision points in managing renal, bladder, and urethral trauma? In this episode of BackTable Urology, Dr. Niels Johnson (Vanderbilt University Medical Center) joins host Dr. George Koch (Ohio State University) to discuss the 2025 American College of Surgeons (ACS) best practice guidelines for genitourinary trauma. --- Get the BackTable app https://www.backtable.com/app --- Timestamps 00:00 - Introduction05:09 - Who Manages GU Trauma?13:53 - Purpose of ACS Guidelines16:13 - Development of ACS Guidelines20:01 - Foley Catheter Debate23:26 - Renal Trauma26:40 - Imaging Protocols and Delays29:30 - Bladder Trauma and Special Populations33:15 - Urethral Injuries38:02 - Genital Wounds and Antibiotics39:42 - Transfer Criteria and Resources41:26 - Conclusions --- More about this episode Dr. Johnson and Dr. Koch review the rationale for developing multidisciplinary guidelines and the variability in genitourinary trauma care across institutions. The discussion highlights key management principles, including non-operative strategies for renal trauma, decision-making in bladder and urethral injuries, and how urinary diversion impacts orthopedic and trauma surgical planning. The episode also addresses considerations for special populations, long-term functional outcomes, and practical implementation tools, such as the ACS gap analysis checklist, designed to improve coordination and quality of care across trauma systems. --- Resources ACS Best Practices Guidelines: Management of Genitourinary Injuries (August 2025)https://www.facs.org/media/ya5hcu0s/genitourinary_guidelines.pdf

Ep. 294 Updated Vasectomy Guidelines & Patient Counseling Best Practices with Dr. Akanksha Mehta

Mar 17, 2026 41 min

What are the key practice changes introduced in the new American Urological Association (AUA) vasectomy guidelines? In this episode of BackTable Urology, Dr. Akanksha Mehta (Emory University), Vice Chair of the AUA Vasectomy Guidelines Committee, joins Dr. Catherine Nam (University of Michigan) to discuss the latest updates to vasectomy practice. --- SYNPOSIS Dr. Mehta and Dr. Nam review the key changes in vasectomy guidelines. They address common misconceptions about sexual function and long-term health risks, as well as the role of telemedicine consultation and day-of-procedure examination. Their discussion also covers recommended surgical techniques and updated guidance on post-vasectomy semen analysis, including mail-in testing options. Finally, Dr. Mehta outlines fertility considerations after vasectomy, including cryopreservation, reversal, and sperm retrieval with IVF, and how clinicians can counsel patients about expectations and referral pathways. --- TIMESTAMPS00:00 - Introduction02:07 - Why Update the Guidelines05:38 - Key Guideline Changes11:02 - Sexual Function Concerns17:19 - Health Risks Debunked21:28 - Periprocedural Best Practices28:25 - Semen Analysis Follow Up37:12 - Future of Male Contraception39:11 - Conclusions --- RESOURCES Vasectomy: AUA Guideline (2026)https://www.auanet.org/guidelines-and-quality/guidelines/vasectomy-guideline

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Podcast details

Created by: BackTable Inc.
Status: Active
Latest episode: Nov 12, 2026
Episodes: 342
Release period: Weekly
Avg. episode length: 49 min
Explicit: No
Language: English

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