BackTable Urology

Epizódok

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  Ep. 318 Exploring Neuromodulation: Sacral vs Tibial Approaches with Dr. Ken Peters and Dr. Tracey Wilson 21.07.2026 1ó

  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
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  Ep. 317 Focal Therapy in Prostate Cancer Treatment with Dr. George R. Schade 16.07.2026 47p

  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://pubmed.ncbi.nlm.nih.gov/35996758/ Focal Therapy for Prostate Cancer: Available Technologies, Patient Selection, Follow-Up Protocols and Reported Outcomeshttps://pubmed.ncbi.nlm.nih.gov/41339218/ --- BackTable Urology is the go-to podcast for urologists, urologic oncologists, and urogynecologists. Download the free BackTable app to get early access to new episodes, cases, and courses curated by physicians in your specialty.► https://www.backtable.com/app
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  Ep. 316 Bladder Cancer in the Community: Meeting Patients Where They Are with Dr. Adam J. Gadzinski 14.07.2026 49p

  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 physicians in your specialty. ► https://www.backtable.com/app
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  Ep. 315 Private Equity's Impact on Urology Practices with Dr. Benjamin Lowentritt 10.07.2026 48p

  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 maintaining physician leadership to preserve independent practice. --- Resources Dr. Benjamin Lowentritt is the current treasurer of LUGPA (Large Urology Group Practice Association) https://www.lugpa.org/, the Chesapeake Urology group (https://chesuro.com/), and United Urology Group (which was acquired by One Oncology https://www.oneoncology.com/UnitedUrologyGroup/). One Oncology eventually was acquired by Cencora (https://www.cencora.com/). Dr. Benjamin Lowentritt email: blowentritt@chesuro.com --- BackTable Urology is the go-to podcast for urologists, urologic oncologists, and urogynecologists. Download the free BackTable app to get early access to new episodes, cases, and courses curated by physicians in your specialty. ► https://www.backtable.com/app
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  Ep. 314 Exploring PARP Inhibitor Combinations in Prostate Cancer with Dr. Rana McKay and Dr. Emmanuel Antonarakis 07.07.2026 51p

  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 Acetate and Prednisone Versus Abiraterone Acetate and Prednisone for the Treatment of Participants With Deleterious Germline or Somatic Homologous Recombination Repair (HRR) Gene-Mutated Metastatic Castration-Sensitive Prostate Cancer (mCSPC) (AMPLITUDE) https://clinicaltrials.gov/study/NCT04497844 BRCAAway: A randomized phase 2 trial of abiraterone, olaparib, or abiraterone + olaparib in patients with metastatic castration-resistant prostate cancer (mCRPC) bearing homologous recombination-repair mutations (HRRm) https://pubmed.ncbi.nlm.nih.gov/39115414/ --- BackTable Urology is the go-to podcast for urologists, urologic oncologists, and urogynecologists. Download the free BackTable app to get early access to new episodes, cases, and courses curated by physicians in your specialty. ► https://www.backtable.com/app
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  Ep. 313 Approaches to Pelvic Lymph Node Dissection in Contemporary Prostate Cancer Surgery with Dr. Kristen Greene 30.06.2026 35p

  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-to podcast for urologists, urologic oncologists, and urogynecologists. Download the free BackTable app to get early access to new episodes, cases, and courses curated by physicians in your specialty. ► https://www.backtable.com/app
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  Ep. 312 Managing Intravesical Therapy Toxicities in Bladder Cancer with Dr. Meredith Donahue and Mary Dunn, NP 25.06.2026 30p

  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/ --- BackTable Urology is the go-to podcast for urologists, urologic oncologists, and urogynecologists. Download the free BackTable app to get early access to new episodes, cases, and courses curated by physicians in your specialty. ► https://www.backtable.com/app
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  Ep. 311 Career Diversification for Urologists Beyond the Clinic with Dr. Pat Keegan and Dr. Kelly Parsons 23.06.2026 54p

  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
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  Ep. 310 Bladder Cancer Risk Stratification: Best Practices with Dr. Sunil Patel and Dr. Kristen Scarpato 18.06.2026 43p

  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-trials/19-288 The BRIDGE Studyhttps://www.nejm.org/doi/full/10.1056/NEJMoa1501035 --- BackTable Urology is the go-to podcast for urologists, urologic oncologists, and urogynecologists. Download the free BackTable app to get early access to new episodes, cases, and courses curated by physicians in your specialty.► https://www.backtable.com/app
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  Ep. 309 Advancing Urologic Reconstruction with Robotics with Dr. Ziho Lee 16.06.2026 43p

  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
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  Ep. 308 Navigating Shared Decision-Making in Bladder Cancer Treatment with Dr. Kelly Bree, Dr. Meredith Donahue, and Dr. Saum Ghodoussipour 11.06.2026 48p

  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 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/ --- BackTable Urology is the go-to podcast for urologists, urologic oncologists, and urogynecologists. Download the free BackTable app to get early access to new episodes, cases, and courses curated by physicians in your specialty. ► https://www.backtable.com/app
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  Ep. 307 Germline & Somatic Testing in Prostate Cancer Therapy with Dr. Tanya Dorff and Dr. Evan Yu 09.06.2026 40p

  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/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 --- BackTable Urology is the go-to podcast for urologists, urologic oncologists, and urogynecologists. Download the free BackTable app to get early access to new episodes, cases, and courses curated by physicians in your specialty. ► https://www.backtable.com/app
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  Ep. 306 Ep. 306 Launching Co-Managed APP/MD Clinics for Bladder Cancer with Dr. Amy Luckenbaugh and Meredith Donahue DNP 04.06.2026 44p

  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 curated by physicians in your specialty. ► https://www.backtable.com/app
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  Ep. 305 Immune Therapy Innovations for BCG Unresponsive Cancer with Dr. Sam Chang 02.06.2026 48p

  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 specialty. ► https://www.backtable.com/app
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  Ep. 304 Optimizing Office Protocols for Urological Incontinence Procedures with Dr. Michael Kennelly and Dr. Jason Kim 26.05.2026 41p

  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
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  Ep. 303 PARP Inhibitors: Clinical Trials & Real-World Applications with Dr. Neeraj Agarwal and Dr. Arun Azad 19.05.2026 1ó 15p

  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 urogynecologists. Download the free BackTable app to get early access to new episodes, cases, and courses curated by physicians in your specialty. ► https://www.backtable.com/app
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  Ep. 302 Male Infertility: Diagnosis & Guidelines Update with Dr. Robert E. Brannigan 12.05.2026 46p

  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
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  Ep. 301 Integrating Biomarkers in Prostate Cancer Treatment with Dr. Udit Singhal 05.05.2026 34p

  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
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  Ep. 300 Renal Cell Carcinoma and Venous Thrombus: A Deep Dive with Dr. Vidit Sharma 28.04.2026 1ó 43p

  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
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  Ep. 299 Clinical Decision-Making in Urodynamics: From Stress Incontinence to Neurogenic Bladders with Dr. Howard Goldman and Dr. David Ginsberg 21.04.2026 52p

  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