What should you do differently when a UTI becomes a recurring problem? In this episode of the Backtable Podcast, host Dr. Anjali Kapur is joined by physician-scientist Dr. Glenn Werneburg to discuss the latest approaches to recurrent urinary tract infections, including key updates from the 2025 AUA, CUA, and SUFU guidelines. They use real clinical cases to explore diagnosis, prevention, antibiotic selection, and the management of complex patients.

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This podcast is supported by

Medtronic
https://www.medtronic.com/en-us/e/patients-caregivers/urinary/overactive-bladder.html

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Timestamps

00:00 - Introduction
04:05 - Case One: Recurrent UTIs
05:19 - Workup Basics
08:50 - Non-Antibiotic Prevention
11:42 - Antibiotic Prophylaxis Options
15:16 - Case Two: Asymptomatic Bacteriuria
19:14 - Case Three: Complex Patients
19:58 - Male vs. Female UTIs
21:22 - Neurogenic Bladder Workup
22:52 - Elderly Patients and ID Consults
25:01 - Case Four: Transplant ESBL
25:23 - Machine Learning for Antibiotics
29:49 - Catheter Biofilms
31:55 - Embedded Bladder Reservoirs
35:23 - Recurrent UTI Vaccine
36:23 - Future of Recurrent UTIs
39:04 - Wrap Up

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More about this episode

The doctors define recurrent UTI and outline the standard workup, including history, physical and pelvic exam, urinalysis, urine culture, and antibiotic sensitivities. They also review occasions where additional testing may be warranted. The discussion covers interpretation of urinalysis, non-antibiotic prevention options, and antibiotic prophylaxis strategies, with consideration of antibiotic resistance and microbiome disruption. They address asymptomatic bacteriuria and when treatment is indicated, along with management considerations for men, patients with neurogenic bladder or CIC, and elderly patients. Dr. Werneburg also discusses his work with machine learning tools to predict antibiotic susceptibility earlier, catheter biofilms, the concept of embedded bladder bacteria reservoirs, and his multidisciplinary complex UTI clinic.

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Resources

Recurrent Uncomplicated Urinary Tract Infections in Women: AUA/CUA/SUFU Guideline (2025)
https://www.auanet.org/guidelines-and-quality/guidelines/recurrent-uti

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BackTable Urology is the go-to podcast for urologists, urologic oncologists, and urogynecologists.

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Recurrent low-grade, intermediate-risk bladder cancer presents a unique treatment challenge: recurrence is common, progression is uncommon, and the burden of repeated procedures can add up quickly. On this episode of the BackTable Urology Podcast, Dr. Ruchika Talwar interviews Dr. Charles “Chas” Peyton about how to manage intermediate-risk bladder cancer patients while balancing disease control and quality of life. They discuss the cumulative impact of repeated TURBTs and explore the evolving role of office-based treatments and chemoablative therapies as alternatives to the traditional treatment cycle.

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Timestamps

00:00 - Introduction
05:58 - Comparing Office Ablation and OR TURBT
08:26 - TURBT Impact on Quality of Life
11:37 - Uncovering Hidden Patient Burdens and Costs
14:44 - Integrating Chemoablation into Practice
18:20 - ENVISION QoL Study Setup
22:04 - Comparing TURBT Preferences
27:40 - Counseling Risk-Averse Patients
29:10 - Community Adoption Advice
31:59 - Upcoming Clinical Trials
35:28 - Biomarkers and Expanding Access
36:23 - Final Thoughts and Closing Remarks

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More about this episode

The conversation covers practical strategies like office-based surveillance and fulguration for small recurrences, identifying triggers for returning to the OR, and recognizing the hidden burdens of TURBT complications such as hematuria, incontinence, and unplanned ER visits. Dr. Peyton reviews the role of chemoablative options for selected patients, discusses trial data on patient-reported outcomes, and addresses the mixed evidence, high costs, and need for individualized decision-making. The episode also explores new intravesical and FGFR-targeted therapies, underscores the importance of cost-conscious adoption and biomarkers, and considers how management approaches must evolve, especially in community practice settings.

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BackTable Urology is the go-to podcast for urologists, urologic oncologists, and urogynecologists.

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How can you use social media to educate, empower, and inspire as a physician while staying true to your professional values? On this episode of BackTable Urology, guest host Dr. Maheetha Bharadwaj talks with Dr. Rena Malik and Dr. Fenwa Milhouse about building an authentic online presence that educates, inspires, and connects. The conversation highlights the power of visibility, the challenges of professional boundaries and misinformation, and the potential for social media to expand both patient outreach and career opportunities.

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Timestamps

00:00 - Introduction
04:17 - Getting Started on Social Media
12:24 - Finding Your Niche
17:04 - Being a Woman in Urology
18:40 - Impact On Patient Care
23:59 - Doctor-Patient Boundaries
28:33 - Social Media Pitfalls
38:53 - Creator Monetization
45:58 - Advice for New Creators

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More about this episode

They share insights from years of content creation, including tips for getting started, finding your niche, and balancing clinical work with online engagement. The discussion covers issues unique to women in urology, the impact of social media on patient care and doctor-patient boundaries, how to avoid burnout, and strategies for monetization and staying true to your message. The episode wraps up with practical advice for new creators and reflections on the privilege and responsibility of inspiring future urologists.

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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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Hypospadias can be surgically corrected early in life, but many patients drop out of care before puberty or adulthood, leaving important urinary and sexual health concerns unaddressed. On this episode of BackTable Urology, Dr. Arthi Hannallah and Dr. Nicco Passoni talk with Dr. Vinaya Bhatia about improving lifelong engagement for people with hypospadias. They highlight advances in surgical technique, the role of research, and how digital tools like the WYSH platform help keep patients and families connected to care.

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Timestamps
00:00 - Introduction
04:22 - Hypospadias Overview and Symptom Chronology
09:14 - Not A One Size Fits All: Developing WYSH
13:28 - Reengaging Families and Patients
20:04 - Adult Urology Sequelae
25:08 - Demystifying Surgery and Improving Training
34:00 - Centers of Excellence Debate
36:56 - Future Goals and Wrap Up

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More about this episode
The discussion covers the development and impact of the WYSH platform, strategies for supporting long-term follow-up, and the learning curve of hypospadias surgery. Dr. Bhatia shares insights on better training, the creation of centers of excellence, and the importance of ongoing research and family engagement to improve quality of life at every stage.

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Resources
Worldwide Yearly Screening for Hypospadias: https://clinicaltrials.gov/study/NCT06966375

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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 a drug-eluting bladder device change the treatment algorithm for BCG-unresponsive non–muscle invasive bladder cancer (NMIBC)? In this episode of BackTable Urology, Dr. Ruchi Talwar interviews Dr. Sarah Psutka to explore the emerging role of a novel intravesical device that delivers sustained gemcitabine therapy for patients refusing or ineligible for cystectomy. They highlight new FDA-approved treatment options, real-world workflow considerations, and the clinical potential for continuous intravesical chemotherapy in a crowded therapeutic landscape.

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This podcast is supported by

Johnson & Johnson

https://www.inlexzohcp.com/

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Timestamps

00:00 - Introduction
02:40 - Why Focus on TAR-200
05:35 - Device Basics
07:05 - Dosing Schedule Explained
11:17 - SUNRISE-01 Trial Results
15:07 - Patient Selection and Contraindications
20:52 - Indications for Device Removal
23:26 - Clinic Workflow Learning Curve
25:56 - Tips for Insertion and Device Deployment
28:52 - Cystoscopy Findings and Surveillance Protocol
32:16 - Treatment Sequencing
38:43 - Future Trial and Research Directions
45:16 - Biomarkers, AI, and Personalizing Care
46:35 - Cost, Supportive Care, and Patient Burden
48:42 - Closing Thoughts

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More about this episode

The conversation dives into patient selection, preparation, and side effect management for TAR-200, as well as the key findings from the SUNRISE-01 trial. Dr. Psutka discusses dosing schedules, when to remove the device, and how to handle complications like UTI, hematuria, and LUTS. The episode also covers surveillance protocols, the impact on clinic operations, and the importance of balancing vigilant cancer surveillance with patient burden. Finally, they touch on future directions, including biomarkers, AI-assisted pathology, and optimizing the timing of cystectomy and supportive care for a more personalized approach to NMIBC.

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Resources

TAR-200 for Bacillus Calmette-Guérin–Unresponsive High-Risk Non–Muscle-Invasive Bladder Cancer: Results From the Phase IIb SunRISe-1 Study
https://ascopubs.org/doi/10.1200/JCO-25-01651

SUO 2024: SunRISe-5: A Phase III, Randomized, Open-label Study of TAR-200 Compared with Intravesical Chemotherapy After Bacillus Calmette-Guerin in Recurrent, High-risk, Non-muscle Invasive Bladder Cancer

SUO 2024: SunRISe-5: A Phase III, Randomized, Open-label Study of TAR-200 Compared with Intravesical Chemotherapy After Bacillus Calmette-Guerin in Recurrent, High-risk, Non-mushttps://www.urotoday.com/conference-highlights/suo-2024/suo-2024-bladder-cancer/156723-suo-2024-sunrise-5-a-phase-iii-randomized-open-label-study-of-tar-200-compared-with-intravesical-chemotherapy-after-bacillus-calmette-guerin-in-recurrent-high-risk-non-muscle-invasive-bladder-cancer.htmlcle Invasive Bladder Cancer

Gemcitabine Intravesical System Plus Cetrelimab or Cetrelimab Alone as Neoadjuvant Therapy in Muscle-Invasive Bladder Cancer: SunRISe-4 Primary Analysis and Biomarker Results
https://ascopubs.org/doi/10.1200/JCO-25-02382

INLEXZO - SunRISe-3 Study
https://www.jnjmedicalconnect.com/products/inlexzo/medical-content/inlexzo-sunrise-3-study

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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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The definitive treatment for adult acquired buried penis is surgery, but successful treatment depends on having a well-coordinated network of patient support, multidisciplinary care teams, and reconstructive urologic surgery expertise. This episode of Backtable Urology overviews this multifaceted disease and dives into reconstructive surgery techniques, featuring Dr. George Koch and Dr. Paul Rusilko.

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Timestamps

00:00 - Introduction
04:10 - History of Buried Penis Treatment
08:47 - Grafts Versus Flaps
11:34 - Hidden Pathologies and Informed Consent
13:46 - Research and Insurance Approval
18:24 - Delayed Care and Disease Burden
22:31 - Deciding When to Operate and Temporizing Procedures
30:23 - Building Referral Networks
33:13 - Future Directions
36:42 - Infection Risk
41:15 - Technique Evolution
45:57 - Preop Evaluation Essentials
50:50 - Intraop Keys to Success and Graft Protection
59:26 - Postop Pathway and Teamwork
01:02:54 - W-Plasty Video Walkthrough
01:13:52 - Wrap Up

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More about this episode

The doctors explore the nuances of surgical treatment, emphasizing the importance of thorough preoperative counseling given the high likelihood of unexpected intraoperative findings and the need to adjust the surgical plan. Dr. Rusilko also discusses the broader burden of disease, including depression, strictures, occult penile cancer, and the high rate of postoperative complications, most of which are low grade. He stresses that earlier referral may improve patient care. The episode concludes with practical surgical tips, guidance on building a buried penis practice, strategies for setting realistic recovery expectations, and an in-depth case review of his novel W-plasty technique.

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Resources

W-plasty: A novel procedure for the repair of adult-acquired buried penis https://doi.org/10.1016/j.urolvj.2023.100219

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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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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.

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This podcast was developed in collaboration with

Society of Urodynamics, Female Pelvic Medicine & Urogenital Reconstruction (SUFU)

https://sufuorg.com/home.aspx

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Timestamps

00:00 - Introduction
07:59 - Overview of Nerve Stimulation Therapies
13:22 - Case #1
22:00 - Case #2
28:23 - Nuspera
34:21 - APPs in Practice
39:21 - Reimbursement Roadblocks
47:03 - Multimodal Therapy
49:51 - Case #3
56:06 - Final Advice

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Resources

Randomized trial of percutaneous tibial nerve stimulation versus Sham efficacy in the treatment of overactive bladder syndrome: results from the SUmiT trial
https://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 Incontinence
https://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 Patients
https://www.sciencedirect.com/science/article/pii/S0090429520305574?via%3Dihub

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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 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.

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Timestamps
00:00 - Introduction
02:09 - Overview of Focal Therapy Modalities
04:46 - Deciding Between HIFU and IRE
06:56 - Evidence and Trials
09:40 - Counseling Patients on Outcomes
12:09 - Building a Focal Therapy Program
16:12 - Navigating Insurance and Appeals
21:48 - Managing Large Glands And TURP
25:12 - Preop Workup Essentials and OR Workflow
32:32 - Overcoming the Learning Curve
35:52 - PostOp Recovery and Surveillance
39:04 - Options for Managing Recurrence
42:44 - Challenges with Repeat Ablation
44:56 - Final Takeaways

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More about this episode
The 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.

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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 cancer
https://pubmed.ncbi.nlm.nih.gov/35996758/

Focal Therapy for Prostate Cancer: Available Technologies, Patient Selection, Follow-Up Protocols and Reported Outcomes
https://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.
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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.

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This podcast is supported by

Urogen
https://www.zusduri.com

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Timestamps

00:00 - Introduction
02:51 - Delivering Bladder Cancer Care in the Community
09:08 - Navigating Treatment Choices
13:05 - Patient Expectations and Insurance Coverage
19:01 - Ablation Strategies for Low and Intermediate Risk
22:34 - Making Therapies Community Friendly
27:12 - Launching Community Trials
31:08 - Referrals and Community Practice Advice
36:36 - Cystectomy Counseling Pearls
44:46 - Closing Takeaways

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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.

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Resources

Bladder Cancer Basics Handbooks
https://bcan.org/bladder-cancer-basics-handbook/

Wellprept
https://wellprept.com/foundation

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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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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.

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Timestamps

00:00 - Introduction
02:58 - Why Urology Drew Private Equity
07:06 - Bad Headlines vs. Reality
11:14 - MSOs and Contracts Explained
15:24 - Timelines and After Private Equity
22:47 - Efficiency and Autonomy Fears
27:15 - Why Private Equity Gets Vilified
31:23 - Young Urologist Job Market
35:42 - Advice for New Grads
40:26 - Urology in 2035 and Fair Critiques of Private Equity
44:40 - Closing Thoughts

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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.

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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: [email protected]

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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