AUAUniversity

This course will focus on what general urologists who have not had fellowship or specialty training in male infertility can do to evaluate and treat male reproductive disorders. Basic science presented will be limited to that which is absolutely essential to understand the basic evaluation and treatment. In 90% of male infertility cases, a good history and careful physical examination, along with a basic semen analysis, which can often be performed by the doctor himself, will allow the general urologist to come up with a tentative diagnosis and treatment plan. More advanced testing is primarily designed to confirm the diagnosis. Key points of history, including inheritance issues, will be discussed. The finer points of physical examination, which in male infertility, due to the ready accessibility of the male reproductive organs to physical examination of a relaxed scrotum, allows the diagnosis to be made without the necessity for imaging studies in the majority of men. Interpretation of semen analysis will be discussed. When and what endocrine evaluations should be performed, including indications for genetic testing such as microY deletion assays and karyotype. When more advanced sperm testing, such as DNA fragmentation and anti-sperm antibody assays, are indicated as well as indications for imaging such a scrotal ultrasound, transrectal ultrasound and testis biopsy. The performance of basic office ultrasound, done by the general urologist, will be explained and the images obtained will be interpreted. The most likely diagnoses resulting from this evaluation will be discussed and treatments that can be employed by general urologists without fellowship training will be gone over in great detail. This will include medical treatments, basic surgical treatments that can be performed by general urologists with minimal microsurgical training and lifestyle recommendations, including supplements that may be of value. A limited presentation of advanced evaluation and treatment methods employed by fellowship trained specialists will be described and the indications for referral to such specialists presented.

Upon completion of the course, participant will be able to:

1. Perform a practical, cost-effective office and laboratory evaluation of the infertile male.

2. Select which medical and surgical treatments are effective and can be employed by general urologists without specialty training.

3. Know when to refer to fellowship- trained specialists, and when to collaborate with IVF doctors.

4. Identify the risk factors for both future infertility and androgen deficiency and how to treat them.

5. Select appropriate diagnostic treatment codes to get the best reimbursements.

This course will teach the urologist and advanced practice provider the skills needed to better communicate with the female patient about her sexual health needs and better manage her sexual dysfunctions. The course will start with normal physiology and pathophysiology of the genitals including how to examine them under magnification in order to better understand sexual dysfunctions in women. Diagnostic tools and treatment strategies for the management of desire, arousal, orgasm and pain disorders including unusual arousal/orgasm issues such as persistent genital arousal disorder will be discussed. Included in this course is an overview of to use the latest FDA approved drugs, off label options, devices such as CO2 fractional laser and surgical therapies. Women with distressing sexual health concerns should undergo biopsychosocial diagnostic evaluations to assess pathophysiology, starting with a history and physical with vulvoscopy. Risks and benefits of hormone therapy for pre- and post-menopausal women will be included, as well as information about neurologic issues affecting sexual function. Also discussed are risk factors for female sexual dysfunction and co-morbid conditions such as genitourinary syndrome of menopause, interstitial cystitis and sexual dysfunction, clitoral phimosis and previous genital surgeries including mid-urethral surgical slings. Women presenting with urologic concerns may, in fact, have sexual dysfunction as the primary issue.

Upon completion of this activity, participants will be able to:

1. Associate basic science principles with physiology and pathophysiology of female sexual function and dysfunction.

2. Apply principles of history and physical examination to the woman with sexual dysfunction.

3. Characterize the consensus paradigms for identification of sexual problems in women, hypoactive sexual desire disorder, and persistent genital arousal disorder developed by the International Society for the Study of Women’s Sexual Health.

4. Diagnose and treat woman with sexual dysfunction presenting in a community setting with FDA-approved and off label medical therapies including estrogen (and progesterone) and androgen therapies as well as centrally-acting drugs.

5. Identify when sexual pain should be treated surgically.

Our ability to diagnose, treat, and manage rUTI has evolved due to additional insights into the pathophysiology of rUTI, a new appreciation for the adverse effects of antimicrobial therapy, rising rates of bacterial antimicrobial resistance, and improved reporting of the natural history and clinical outcomes of acute cystitis and rUTI. This course will review the new AUA guideline on recurrent UTIs in the index female patient. The guidelines encompass rUTI diagnosis, treatment, antibiotic and other methods of prophylaxis. The evidence supporting the guidelines will be presented in a case-based fashion. A treatment algorithm which includes the most current and safe antibiotic regimens will be provided. Faculty are all members of the AUA 2019 guideline panel and include urologists and an internist with expertise in Infectious Diseases.

Upon completion of this activity, participants will be able to:

1. Demonstrate knowledge of the evidence and rationale behind the 2019 recurrent UTI guidelines.

2. Formulate a treatment algorithm for recurrent UTIs in women.

3. Define the concept of antibiotic stewardship, treating patients with the safest methods possible, thereby avoiding collateral damage.

4. Recognize the importance of shared decision making in recurrent UTI management.

Join Drs. Kevin McVary and Charles Welliver with host Dr. Brian Matlaga as they present BPH findings from the Urologic Diseases in America Report.

Host: Brian Matlaga, MD, MPH, Johns Hopkins University School of Medicine

Guests: Kevin McVary, MD, Loyola University Medical Center and Charles Welliver, MD, Albany Medical College

This project has been funded in whole or in part with Federal funds from the National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Department of Health and Human Services, under Contract No. 75N94019F00260.

This course on IC/BPS is designed for the urologist, gynecologist, and advanced practice providers who see these patients and are responsible for their medical care. It is designed to focus on what we know, what we have learned from recent research efforts, how we can best use our knowledge in the care of these patients, and what may be coming in the future. We will discuss definition, nomenclature, epidemiology, possible etiology, and review the latest American Urological Association guideline which provides a working framework from which to practice. The issue of phenotyping, an important new focus on clinical trials, will be highlighted. We will review the major findings of the NIDDK Multidisciplinary Approach to the study of Pelvic Pain (MAPP) which is completing a decade of intensive research on this syndrome. How might this research inform and translate into the clinical arena and help our patients.

Upon completion of the activity, participants will be able to:

1. Recall the AUA guidelines and describe how to apply them to care of their patients.

2. Describe the major findings for the 10-year NIDDK MAPP research effort and its current and potential future impact on patient care.

3. Determine how the syndrome is viewed in Europe and identify new treatments and innovations that may impact care.

4. Define the importance of phenotyping patients to improve outcomes.

5. Recognize the controversy regarding whether Hunner lesions comprise a distinct disease.

To utilize a case-based and interactive approach to highlight key components of the current AUA Guidelines for the Medical and Surgical Management of Kidney Stones. The course will additionally provide updated literature and topics in the management of stone disease which may impact future Guideline statements. During this course, representative basic and complex clinical cases/vignettes will be discussed with the use of data from the comprehensive guidelines to demonstrate critical points. Use of the audience response system and Q/A between cases amongst the faculty and audience members will be critical to the success of the course. Important aspects regarding metabolic evaluation, medical management, preoperative evaluation, imaging techniques, and surgical treatment recommendations (as well as surgical approaches and complications) in adult, pediatric, pregnant, and complex patients will be illustrated. The faculty will also reference the Guideline Statements that provide the framework for their decision-making process.

Upon completion of this activity, participants will be able to:

1. Interpret metabolic evaluations for patients with kidney stones, based on an understanding of the published guidelines, and provide appropriate therapy.

2. Demonstrate how to increase the use of medications in the prevention of kidney stones, including understanding potential side effects.

3. Apply dietary recommendations for the prevention of stones.

4. Demonstrate the recommended preoperative evaluation for patients considering kidney stone surgery (including laboratory studies and imaging).

5. Formulate a surgical treatment plan for patients with kidney and/or ureteral stones in adult, pediatric, and pregnant patients, including surgical approach and discussion of complications.

Hav0cEVY5BzlqG7EvgUE

Host: Victor Nitti, MD

Guest: David Shin, MD

Chronic orchialgia or testicular pain is a challenging disease to treat for both the patient and urologist because the perception and resolution of pain is often subjective in nature. With a national trend towards treatment away from opioid use, it is important that clinicians utilize an algorithm focusing on non-narcotic use for medication treatment as well as be able to offer office-based or surgical therapies when medical therapy fails.

After today’s podcast, learners will be able to:

1. Compare and contrast pathological and non-pathological etiologies of scrotal pain

2. Summarize the rationale for different medication therapies and incorporate an algorithm for treatment

3. Distinguish various surgical treatment options depending upon etiology

Co-Host: Dr. Rena Malik, Assistant Professor of Surgery, Division of Urology and Director of Female Pelvic Medicine & Reconstructive Surgery at University of Maryland School of Medicine

Co-Host: Amy E. Krambeck, MD

Michael O. Koch Professor of Urology, Indiana University and IU Health

At the conclusion of this activity, participants will be able to:

1. Interpret metabolic evaluations for patients with stones

2. Determine when to genetically test patients with stones

3. Analyze current gene panels available and options for patients

This podcast was funded by and developed in collaboration with Alnylam Pharmaceuticals, Inc

Join Drs. Brian Matlaga, Kathleen Kobashi, and Una Lee as they discuss urinary incontinence findings from the Urologic Diseases in America Report.

Host: Brian Matlaga, MD, MPH, Johns Hopkins University School of Medicine

Guests: Kathleen Kobashi, MD and Una Lee, MD, Virginia Mason Medical Center

This project has been funded in whole or in part with Federal funds from the National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Department of Health and Human Services, under Contract No. 75N94019F00260.