Episodes
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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.
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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
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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.
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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/
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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 -
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.
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This podcast is supported by an educational grant from Johnson & Johnson.
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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
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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.
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Resources
Bladder Cancer Advocacy Network (BCAN) Basic Handbook & Patient Resources
https://bcan.org/bladder-cancer-basics-handbook/
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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.
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Missing episodes?
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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.
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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
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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.
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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 -
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.
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This podcast is supported by an educational grant from Johnson & Johnson.
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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
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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.
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Resources
The Memorial Studyhttps://www.mskcc.org/cancer-care/clinical-trials/19-288
The BRIDGE Studyhttps://www.nejm.org/doi/full/10.1056/NEJMoa1501035
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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 -
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.
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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
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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/
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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 -
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.
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This podcast is supported by an educational grant from Johnson & Johnson.
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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
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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.
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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 BLADDER CANCER:https://www.auajournals.org/doi/abs/10.1097/01.JU.0001191388.74345.c9.09
Preoperative Circulating Tumor DNA Predicts Upstaging and Recurrence in High-Risk Nonmuscle-Invasive Bladder Cancer Undergoing Radical Cystectomyhttps://pubmed.ncbi.nlm.nih.gov/41843048/
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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.
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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.
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This podcast is supported by an educational grant from Pfizer.
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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
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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.
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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/10.1056/NEJMoa1903307
ARCHES 5-year Survival with Enzalutamide Plus Androgen-deprivation Therapy in Metastatic Hormone-sensitive Prostate Cancer Patientshttps://www.sciencedirect.com/science/article/pii/S0302283825048766
First-Line Camizestrant for Emerging ESR1-Mutated Advanced Breast Cancer:https://www.nejm.org/doi/abs/10.1056/NEJMoa2502929
PROMISE Registry:https://www.prostatecancerpromise.org/
Talazoparib plus enzalutamide in men with HRR-deficient metastatic castration-resistant prostate cancer: final overall survival results from the randomised, placebo-controlled, phase 3 TALAPRO-2 trial:https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(25)00683-X/abstract
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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 -
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.
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This podcast is supported by an educational grant from Johnson & Johnson.
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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
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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.
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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
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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.
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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.
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This podcast is supported by
ImmunityBiohttps://anktiva.com/
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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
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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
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This podcast is for informational purposes only. The views and opinions expressed in this podcast are solely those of the moderator and individual guest.
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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 -
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.
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This podcast was developed in collaboration withSociety of Urodynamics, Female Pelvic Medicine & Urogenital Reconstruction (SUFU)
https://sufuorg.com/home.aspx
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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
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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.
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Resources
Relaxing Environment Lowers Anxiety During Chemodenervation: a Randomized Trialhttps://journals.lww.com/fpmrs/abstract/2026/04000/relaxing_environment_lowers_anxiety_during.6.aspx
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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 -
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.
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This podcast is supported by an educational grant from Pfizer.
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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
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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.
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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
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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.
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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.
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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
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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.
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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/
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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 -
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.
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This podcast is supported byVeracytehttps://www.veracyte.com/decipher-prostate
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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
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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.
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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 -
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.
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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
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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.
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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
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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 -
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.
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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
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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).
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Resources
Female Urgency, Trial of Urodynamics as Routine Evaluation (FUTURE study)https://pubmed.ncbi.nlm.nih.gov/34702331/
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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 -
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.
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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
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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.
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Resources
Society of Women in Urology (SWIU)https://swiu.org/home.aspx
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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.
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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
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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.
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Resources
Prostate Artery Embolization in the Setting of Prostate Cancer: Review and Opinionhttps://pmc.ncbi.nlm.nih.gov/articles/PMC11775958/ -
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.
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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
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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.
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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 Neuromodulation for Overactive Bladder: Insight From the AUA AQUA Registryhttps://www.auajournals.org/doi/10.1097/UPJ.0000000000000916
A retrospective longitudinal evaluation of new overactive bladder patients in an FPMRS urologist practice: Are patients following up and utilizing third-line therapies?https://pubmed.ncbi.nlm.nih.gov/33197059/ -
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.
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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
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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.
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Resources
ACS Best Practices Guidelines: Management of Genitourinary Injuries (August 2025)https://www.facs.org/media/ya5hcu0s/genitourinary_guidelines.pdf -
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.
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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.
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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
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RESOURCES
Vasectomy: AUA Guideline (2026)https://www.auanet.org/guidelines-and-quality/guidelines/vasectomy-guideline - Show more
