BackTable Urology

By his own estimate, an AI scribe gives one urologist about two hours of his day back, and an evidence tool built into it has taught him something new in the clinic almost every day. On this episode of BackTable Urology, Dr. Ruchika Talwar welcomes back Dr. David Canes, urologist at Lahey Hospital & Medical Center and founder of WellPrept, to talk about how urologists can practically put AI to work. Dr. Canes explains why he sees this moment as a renaissance for physicians, how an AI scribe turned him from author into proofreader, by his estimate saving about two hours a day, and why evidence tools running alongside the scribe now answer questions in the exam room, including a question about post-prostatectomy dysorgasmia, a complaint that rarely comes up in clinic.

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Get the BackTable app
https://www.backtable.com/app

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Timestamps

00:00 - Introduction
03:32 - Getting Started With AI in Practice
07:24 - AI Scribes and Cognitive Load
14:18 - AI Evidence Tools at the Point of Care
18:41 - Context, Pre-Charting, and Evidence in the Exam Room
24:52 - AI for Email and Personal Workflow
29:09 - Building a Permanent AI Memory
34:20 - AI Skepticism, Privacy, and Intellectual Honesty
40:47 - Will AI Replace Physicians?
46:39 - Pre-Charting, Patient Education, and Care Journeys
49:27 - Reducing the In-Basket Burden
53:04 - Where to Start With AI
55:27 - Closing Remarks

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More about this episode

The conversation then moves beyond the clinic. Dr. Canes describes an AI layer on email that flags what cannot wait, and a permanent AI memory built from plain text files that keeps research, licenses, talks, and family life organized, with a firm rule that no protected health information goes anywhere without a business associate agreement. He and Dr. Talwar discuss what work is worth delegating to AI, push back on a recent JAMA perspective arguing that autonomous AI may outperform physicians, and run through tools for pre-charting, patient education, postoperative care journeys, and front-desk calls. Dr. Canes closes with simple advice for exhausted physicians: ask the AI you already use to build you a 90-day plan.

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Resources

Will Autonomous AI Exceed AI-Aided Physicians as the Best Medical Care? JAMA. 2026
https://jamanetwork.com/journals/jama/fullarticle/2852952

The utility of tamsulosin in the management of orgasm-associated pain: a pilot analysis. Eur Urol. 2005
https://pubmed.ncbi.nlm.nih.gov/15716202/

WellPrept
https://www.wellprept.com

BackTable Urology Episode 55: Patient Preparation Made Easy: The WellPrept Story
https://www.backtable.com/shows/urology/podcasts/55/patient-preparation-made-easy-the-wellprept-story

Dr. David Canes, BackTable Urology contributor page
https://www.backtable.com/shows/urology/contributors/dr-david-canes

Dr. Ruchika Talwar, BackTable Urology contributor page
https://www.backtable.com/shows/urology/contributors/dr-ruchika-talwar

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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

Every prostate cancer biomarker returns a number, but the real question is whether that number changes what you do next for the patient. On this episode of BackTable Urology, Dr. Ruchika Talwar welcomes Dr. Amir Lebastchi, urologic oncologist at Keck Medicine of USC, to discuss how biomarkers are moving prostate cancer care from numbers to meaningful clinical decisions. They define what makes a biomarker clinically useful, organize the growing list of blood, urine, and tissue tests into pre-biopsy, post-negative-biopsy, and post-diagnosis settings, and talk through where these tests fit alongside MRI after an elevated PSA.

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Get the BackTable app
https://www.backtable.com/app

---

This podcast is supported by

Cleveland Diagnostics
https://www.isopsa.com/

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Timestamps

00:00 - Introduction
02:59 - Clinical Utility and a Framework for Biomarkers
08:43 - Workup of an Elevated PSA
11:42 - Pre-Biopsy Blood and Urine Tests
13:29 - Equivocal MRI, Outside Imaging, and Community Practice
20:26 - Patient Factors and Practical Considerations
24:44 - Case: Elevated PSA and a Negative MRI
30:11 - Case: Biopsy Approach and Discordant Results
34:41 - Counseling on PSA Limitations and Overdiagnosis
37:05 - Biomarkers in Active Surveillance and Renaming Grade Group 1
40:56 - AI and the Future of Biomarkers
44:38 - Take-Home Points and Closing Remarks

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More about this episode

The discussion covers equivocal MRI findings, patient counseling, and the practical impact of age, family history, and race when interpreting PSA levels. Through real cases, Dr. Lebastchi explains when he repeats a PSA, how he performs a templated transperineal biopsy, and why a negative MRI plus a negative biomarker can give him the confidence to forgo a biopsy. They also touch on active surveillance, the debate over renaming grade group 1 prostate cancer, and how AI may help future tests guide treatment intensity rather than just risk category. Dr. Lebastchi closes with the clinician’s obligation to know all available tests and use those that truly inform management.

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Resources

Early Detection of Prostate Cancer: AUA/SUO Guideline (2023)
https://www.auanet.org/guidelines-and-quality/guidelines/early-detection-of-prostate-cancer-guidelines

Clinical validation of IsoPSA, a single parameter, structure-focused assay for improved detection of prostate cancer: A prospective, multicenter study. Urol Oncol. 2022
https://pubmed.ncbi.nlm.nih.gov/35840465/

Using IsoPSA With Prostate Imaging Reporting and Data System Score May Help Refine Biopsy Decision Making in Patients With Elevated PSA. Urology. 2023
https://pubmed.ncbi.nlm.nih.gov/36965817/

Low-Grade Prostate Cancer: Time to Stop Calling It Cancer. J Clin Oncol. 2022
https://pubmed.ncbi.nlm.nih.gov/35436144/

The influence of the "cancer" label on perceptions and management decisions for low-grade prostate cancer. J Natl Cancer Inst. 2023
https://pubmed.ncbi.nlm.nih.gov/37285311/

Dr. Amir Lebastchi, Keck Medicine of USC physician profile
https://keckmedicine.org/provider/amir-h-lebastchi

Dr. Ruchika Talwar, BackTable Urology contributor page
https://www.backtable.com/shows/urology/contributors/dr-ruchika-talwar

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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 is suction technology changing what it means to be “stone-free” after ureteroscopy? On this episode of BackTable Urology, Dr. Ruchika Talwar welcomes Dr. Karen Stern, endourologist at Mayo Clinic Arizona, for a practical discussion of how ureteroscopy is evolving in the era of suction. They discuss how thin-slice CT has revealed just how much stone typically remains after surgery, why dusting versus fragmenting is now a patient-dependent choice, and what to consider when selecting between suction sheaths, aspiration scopes, and traditional access.

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Get the BackTable app
https://www.backtable.com/app

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This podcast is supported by

Dornier
https://www.dornier.com/backtable

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Timestamps

00:00 - Introduction
02:16 - Residual Stone and Defining Success
04:59 - Dusting, Fragmentation and Suction Devices
07:15 - Patient Selection, OR Setup and Laser Settings
11:39 - Evidence, Stone Clearance and Infection Risk
15:39 - Community Adoption and Technique Pearls
20:05 - Integrated Systems and Artificial Intelligence
22:29 - Take-Home Points and Closing Remarks

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More about this episode

The doctors discuss patient selection, OR setup, stenting, and why stones over a centimeter benefit most from a suction approach. Dr. Stern shares her tips for suction device setup, irrigation and suction settings, and how even a short learning curve can make these techniques routine. They review infection risks, evidence on residual stone volume, pearls for community adoption, and look ahead to integrated laser-suction platforms and AI tools that may one day help define when a case is truly finished. Dr. Karen Stern closes with advice for urologists on the fence: every technology works, but the best choice is the one that fits your practice.

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Resources

Are We Overreporting Post-Op Sepsis? The Difference Between Reported and Verified Rates of Post-Ureteroscopy Sepsis Using the Sepsis 3 Criteria at a Single Institution. J Endourol. 2026
https://doi.org/10.1177/08927790251394736

Flexible Ureteroscopy with a Flexible and Navigable Suction Ureteral Access Sheath Versus Mini-Percutaneous Nephrolithotomy for Treatment of 2-3 cm Renal Stones: An International, Multicenter, Randomized, Noninferiority Trial. Eur Urol. 2026
https://doi.org/10.1016/j.eururo.2025.06.001

Dr. Karen Stern, Mayo Clinic physician profile
https://www.mayoclinic.org/biographies/stern-karen-l-m-d/bio-20464490

Dr. Ruchika Talwar, BackTable Urology contributor page
https://www.backtable.com/shows/urology/contributors/dr-ruchika-talwar

---

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

Same risk group, very different benefit. Can biomarkers help identify who needs treatment intensification in prostate cancer? On this episode of BackTable Urology, Dr. Ruchika Talwar and Dr. Angela Jia, a radiation oncologist at University Hospitals Cleveland Medical Center, break down the difference between prognostic and predictive biomarkers and how genomic testing is informing the way clinicians counsel patients. They review trial data suggesting that men with a low genomic score may gain little from adding hormone therapy, along with early prospective evidence that the luminal B subtype may help identify who benefits most from intensification.

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Get the BackTable app
https://www.backtable.com/app

---

This podcast is supported by

Verasyte
https://www.veracyte.com/

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Timestamps

00:00 - Introduction
02:08 - Prognostic vs. Predictive Biomarkers
06:34 - The NRG/RTOG 0815 Biomarker Cohort
10:15 - Applying a Low Genomic Score in Clinic
15:16 - Genomic Classifiers After Prostatectomy
18:52 - RTOG 9601, SPPORT and the Salvage Evidence
24:39 - Stage Migration and the Case for an ARPI
28:13 - Ordering and Reading the Genomic Report
34:31 - Common Mistakes in Interpretation
37:31 - Where Genomics Could Go Next
41:03 - Reflex Testing, EMR Integration and AI
44:44 - Closing Remarks

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More about this episode

The conversation covers practical application of test results, counseling with absolute risk numbers, and the pitfalls of stretching predictive claims beyond their evidence. Dr. Jia explains the limits of biopsy sampling, how stage migration with advanced imaging may shift baseline risk, and why a large portion of the genomic score remains unexplained by standard variables. The episode closes with a look at reflex testing, the potential role of AI, and the longer-term goal of giving patients clear, individualized benefit estimates for each treatment option.

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Resources

NRG/RTOG 0815: A Phase III Prospective Randomized Trial of Dose-Escalated Radiotherapy With or Without Short-Term Androgen Deprivation Therapy for Patients With Intermediate-Risk Prostate Cancer (trial record)
https://clinicaltrials.gov/study/NCT00936390

NRG-GU006 (BALANCE): A Phase II Randomized Trial of Salvage Radiotherapy With or Without Apalutamide in Recurrent Prostate Cancer (trial record)
https://clinicaltrials.gov/study/NCT03371719

Feng FY, et al. Validation of a 22-Gene Genomic Classifier in Patients With Recurrent Prostate Cancer: An Ancillary Study of the NRG/RTOG 9601 Randomized Clinical Trial. JAMA Oncol. 2021
https://pubmed.ncbi.nlm.nih.gov/33570548/

Pollack A, et al. The addition of androgen deprivation therapy and pelvic lymph node treatment to prostate bed salvage radiotherapy (NRG Oncology/RTOG 0534 SPPORT). Lancet. 2022
https://pubmed.ncbi.nlm.nih.gov/35569466/

Zhao SG, et al. Associations of Luminal and Basal Subtyping of Prostate Cancer With Prognosis and Response to Androgen Deprivation Therapy. JAMA Oncol. 2017
https://pubmed.ncbi.nlm.nih.gov/28494073/

Patel KR, Nguyen PL, et al. Biopsy-based Basal-luminal Subtyping Classifier in High-risk Prostate Cancer: A Combined Analysis of the NRG Oncology/RTOG 9202, 9413 and 9902 Phase 3 Trials. Eur Urol Oncol. 2026
https://pubmed.ncbi.nlm.nih.gov/39542826/

Grist E, et al. Tumor transcriptome-wide expression classifiers predict treatment sensitivity in advanced prostate cancers (STAMPEDE). Cell. 2025
https://pubmed.ncbi.nlm.nih.gov/40865526/

Jia AY, et al. Cross-Comparison Individual Patient-Level Analysis of Three Gene Expression Signatures in Localized Prostate Cancer in Over 50,000 Men. JCO Precis Oncol. 2025
https://pubmed.ncbi.nlm.nih.gov/40479622/

Dr. Angela Jia, University Hospitals physician profile
https://www.uhhospitals.org/doctors/Jia-Angela-1902338718

Dr. Ruchika Talwar, BackTable Urology contributor page
https://www.backtable.com/shows/urology/contributors/dr-ruchika-talwar

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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 decide if a neurogenic bladder is a safety problem or a quality of life problem for each patient, and how do you move from guideline risk categories to a real surveillance plan? On this episode of BackTable Urology, Dr. Anjali Kapur interviews Dr. Benjamin Brucker, professor of urology and director of neuro-urology at NYU Langone Health, about navigating neurogenic lower urinary tract dysfunction. They start with the AUA and SUFU guideline framework, covering history, physical exam, mobility, cognition, voiding diaries, and risk stratification to sort patients into low, unknown, or high risk. Dr. Brucker outlines the findings that move a patient between categories and the workup needed, from renal ultrasound and urodynamics to identifying unsafe storage pressures and elevated post-void residual.

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Get the BackTable app
https://www.backtable.com/app

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This podcast is supported by
Medtronic

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Timestamps

00:00 - Introduction
03:20 - Initial Evaluation Under the AUA and SUFU Guidelines
05:39 - Risk Stratification and Surveillance
13:08 - Role of Fluoroscopy in Urodynamics
14:55 - Spinal Cord Injury and Detrusor Sphincter Dyssynergia
17:35 - Multiple Sclerosis, Parkinson Disease, and Stroke
23:13 - Cognitive and Functional Status in Therapy Selection
25:16 - Neuromodulation in the Neurogenic Population
29:07 - Catheter Management and Sphincterotomy
35:49 - Medical Therapy, Chemodenervation, and Surgical Escalation
42:50 - Asymptomatic Bacteriuria and Antibiotic Stewardship
46:04 - Gaps in Practice and Research on the Horizon
50:48 - Closing Remarks

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More about this episode

The conversation dives into the nuances of managing neurogenic bladder by underlying disease, from detrusor sphincter dyssynergia after spinal cord injury to the variable patterns in multiple sclerosis, Parkinson disease, and stroke. Dr. Brucker explains the role of videourodynamics, the importance of matching therapy to cognition and mobility, and how to counsel patients on medical therapy, neuromodulation, catheterization, and surgery. They discuss antibiotic stewardship for asymptomatic bacteriuria, gaps between guidelines and real-world care, and what new devices and bladder transplant might mean for the future. The episode closes with a reminder that management is about treating the whole person, not just the diagnosis.

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Resources

Neurogenic Lower Urinary Tract Dysfunction: AUA/SUFU Guideline
https://www.auanet.org/guidelines-and-quality/guidelines/adult-neurogenic-lower-urinary-tract-dysfunction

Ginsberg DA, Boone TB, Cameron AP, et al. The AUA/SUFU Guideline on Adult Neurogenic Lower Urinary Tract Dysfunction: Diagnosis and Evaluation. J Urol. 2021
https://doi.org/10.1097/JU.0000000000002235

Ginsberg DA, Boone TB, Cameron AP, et al. The AUA/SUFU Guideline on Adult Neurogenic Lower Urinary Tract Dysfunction: Treatment and Follow-up. J Urol. 2021
https://doi.org/10.1097/JU.0000000000002239

Vurture G, Peyronnet B, Palma JA, et al. Urodynamic Mechanisms Underlying Overactive Bladder Symptoms in Patients With Parkinson Disease. Int Neurourol J. 2019.
https://doi.org/10.5213/inj.1938086.043

Society of Urodynamics, Female Pelvic Medicine and Urogenital Reconstruction (SUFU).
https://sufuorg.com/

American Urological Association (AUA)
https://www.auanet.org/

First human bladder transplant, UCLA Health, 2025.
https://www.uclahealth.org/news/release/first-human-bladder-transplant-performed-ucla

Dr. Benjamin Brucker, NYU Langone Health physician profile
https://nyulangone.org/doctors/1235295619/benjamin-m-brucker

Dr. Benjamin Brucker, BackTable Urology contributor page
https://www.backtable.com/shows/urology/contributors/dr-benjamin-brucker

Dr. Anjali Kapur, BackTable Urology contributor page
https://www.backtable.com/shows/urology/contributors/dr-anjali-kapur

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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 is the difference between mentorship, sponsorship, and coaching in a physician’s career, and how can coaching influence your professional development? On this episode of BackTable Urology, Dr. Helen Bernie interviews Dr. Emilie Johnson and Dr. Angie Smith about the transformative impact of career coaching for urologists. They break down how coaching differs from mentorship and sponsorship, who stands to benefit most, and the real value of having a conversation focused entirely on your goals and growth.

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Get the BackTable app
https://www.backtable.com/app

---

This podcast was developed in collaboration with
Society of Women in Urology
https://swiu.org/home.aspx

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Timestamps

00:00 - Introduction
03:21 - Mentorship, Sponsorship, and Coaching
06:23 - Paths Into Physician Coaching
11:39 - Who Should Seek a Coach
15:56 - What a Coach Does Differently
22:57 - Anatomy of a Coaching Session
28:21 - Coaching Frameworks and Tools
35:14 - Uncovering Unrecognized Goals
42:12 - Coaching Beyond the Workplace
47:16 - Advice for the Undecided Urologist
52:08 - Closing Remarks

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More about this episode

The discussion explores what a coaching session looks like, from low-stakes one-offs to multi-month programs, and the frameworks and tools that stick, like strengths-based assessments, DiSC, and the career portfolio exercise. Dr. Smith shares insights from her credentialed coaching program, while Dr. Johnson explains how coaching changes everything from listening at home to decision-making in the OR. The episode closes with advice on finding the right coach, recognizing when you are ready, and why coaching is about unlocking what you already know.

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Resources

Society of Women in Urology (SWIU)
https://www.swiu.org/

Effect of a Professional Coaching Intervention on the Well-being and Distress of Physicians: A Pilot Randomized Clinical Trial (Dyrbye et al., JAMA Internal Medicine, 2019)
https://doi.org/10.1001/jamainternmed.2019.2425

International Coaching Federation, credentialing and coach education requirements (ACC, PCC, MCC)
https://coachingfederation.org/credentialing/prepare-for-icf-credential-application/education-training-requirements/

UNC School of Medicine coaching programs, Office of Faculty Affairs and Leadership Development
https://www.med.unc.edu/facultyaffairs/coaching-culture/

VIA Character Strengths Survey, the free strengths assessment Dr. Smith recommends
https://www.viacharacter.org/

CliftonStrengths (Gallup)
https://www.gallup.com/cliftonstrengths/en/home.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

Adrenal lesions now turn up on four to ten percent of cross-sectional scans, and every urologist needs a reliable way to sort out the harmless ones from the dangerous ones. On this episode of BackTable Urology, co-hosts Dr. Gina Badalato and Dr. Chris Anderson speak with Dr. Ben Ristau to share a practical, case-based framework for evaluating adrenal lesions. They walk through imaging criteria, the essential hormonal workup, size thresholds for surgery, the rare but crucial role of biopsy, and the operative planning that separates a smooth adrenalectomy from a crisis.

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Get the BackTable app
https://www.backtable.com/app

---

This podcast was developed in collaboration with

Society of Academic Urologists
https://sauweb.org/

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Timestamps

00:00 - Introduction
03:42 - Imaging Criteria for Adrenal Adenoma
08:15 - Framework for Hormonal Workup
12:48 - Mild Autonomous Cortisol Secretion
16:20 - Adrenal Venous Sampling
21:12 - Genetic Syndromes and Pheochromocytoma
25:40 - Suspected Pheochromocytoma Case
31:19 - Alpha Blockade Before Surgery
35:36 - Intraoperative Hemodynamic Swings
40:50 - Adrenocortical Carcinoma Case
45:00 - Managing Adrenal Vein Avulsion
48:00 - Closing Remarks

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More about this episode

The discussion opens with a 3.4 centimeter lipid-rich adenoma and the two questions that drive every evaluation, whether the lesion is malignant and whether it is functional. Dr. Ristau walks through the overnight 1 mg dexamethasone suppression test, the aldosterone to renin ratio, plasma free metanephrines and adrenal venous sampling, then explains why mild autonomous cortisol secretion is the most commonly missed diagnosis. Later cases cover preoperative alpha blockade for pheochromocytoma, the blood pressure swing that follows adrenal vein ligation, and open resection for suspected adrenocortical carcinoma. They close with pearls on surgical judgment, resident teaching, and the importance of systematic protocols in adrenal mass evaluation.

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Resources

CUA guideline: Diagnosis, management, and follow-up of the incidentally discovered adrenal mass (endorsed by the AUA, Rowe et al., CUAJ 2023)
https://cuaj.ca/index.php/journal/article/view/8248

European Society of Endocrinology clinical practice guidelines on the management of adrenal incidentalomas, with ENSAT (Fassnacht et al., Eur J Endocrinol 2023)
https://doi.org/10.1093/ejendo/lvad066

AACE / AAES Medical Guidelines for the Management of Adrenal Incidentalomas
https://pro.aace.com/disease-state-resources/pituitary-and-neuroendocrine/clinical-practice-guidelines/american

Discrepancies in the Recommended Management of Adrenal Incidentalomas by Various Guidelines (Journal of Urology)
https://www.auajournals.org/doi/10.1097/JU.0000000000001342

Society of Academic Urologists
https://sauweb.org/

---

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 does a urologist actually need to know to confidently manage advanced prostate cancer in the clinic? On this episode of BackTable Urology, host Dr. Ruchika Talwar interviews Dr. Kristen Scarpato, director of the advanced prostate cancer clinic at Vanderbilt University Medical Center, and Dr. Jason Hafron, chief medical officer of the Michigan Institute of Urology. They break down how the landscape has shifted, why more patients stay in urology for treatment, and how to select and monitor therapy based on disease state, comorbidities, and patient goals.

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Get the BackTable app
https://www.backtable.com/app

---

This podcast is supported by

Bayer

https://www.bayer.com

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Timestamps

00:00 - Introduction
02:41 - Shift to Urology-Led Advanced Prostate Management
07:07 - Sorting Therapies by Disease State
10:33 - Treatment Intensification and Doublet Therapy
17:54 - ARPI Selection and the Four Ps Framework
25:46 - Managing Financial Toxicity
29:30 - Monitoring, Labs, and Imaging
34:11 - Red Flags and Comanagement
36:49 - When to Refer to Medical Oncology
41:11 - Future Directions and Practice Economics
46:33 - Closing Remarks

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More about this episode

The discussion covers sorting therapies by disease state rather than drug class, doublet and triplet intensification, the nuances of choosing between abiraterone, enzalutamide, apalutamide, and darolutamide, and Dr. Hafron’s “four Ps” framework for drug selection. Dr. Scarpato addresses financial toxicity, surveillance protocols, and red flag symptoms. Both guests share their referral triggers for medical oncology, approaches for oligometastatic disease and metastasis-directed therapy, and practical tips for running an advanced prostate cancer clinic.

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Resources

Advanced Prostate Cancer: AUA/SUO Guideline
https://www.auanet.org/guidelines-and-quality/guidelines/advanced-prostate-cancer

Trial Design and Objectives for Patients With Prostate Cancer: Recommendations From the Prostate Cancer Working Group 4 (JCO)
https://ascopubs.org/doi/10.1200/JCO-25-02834

ARACOG (AFT-47): Darolutamide vs Enzalutamide and Cognitive Function, ClinicalTrials.gov NCT04335682
https://clinicaltrials.gov/study/NCT04335682

ARASENS: Darolutamide and Survival in Metastatic, Hormone-Sensitive Prostate Cancer (NEJM)
https://www.nejm.org/doi/full/10.1056/NEJMoa2119115

PSMAddition: 177Lu-PSMA-617 Plus Standard of Care in mHSPC, ClinicalTrials.gov NCT04720157
https://clinicaltrials.gov/study/NCT04720157

Medicare Plan Finder, referenced on air for comparing Part D out-of-pocket drug costs
https://www.medicare.gov/plan-compare/

---

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 private practice and academic residency programs work together to shape the next generation of urologists? On this episode of BackTable Urology, Dr. Jose Silva interviews Dr. Javier Castillo about launching an academic residency within a busy private urology group in Puerto Rico. They highlight the business, training, and research challenges involved, as well as the innovations that make real collaboration possible. Dr. Castillo also reflects on why building character in trainees is just as important as teaching surgical skill.

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Get the BackTable app
https://www.backtable.com/app

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Timestamps

00:00 - Introduction
04:04 - Launching a Residency and Building the Practice
08:13 - Teaching in the OR and Progressive Responsibility
13:58 - Clinic, Administration, and Resident Training
16:38 - Expanding BPH Treatment Options
25:21 - Creating a Research Culture and AI Projects
32:42 - AI Uroflow Project and Follow Up
40:21 - BPH Case Workup and Shared Decision-Making
47:11 - Patient Goals and Procedure Selection
55:43 - Sacral Neuromodulation and New Technologies
01:00:19 - Teaching Character and Mentorship
01:03:07 - Closing Remarks

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More about this episode

The conversation explores how to teach residents in the OR while maintaining efficiency, build a research culture, and leverage advanced technologies like AI-driven home uroflowmetry. Dr. Castillo and Dr. Silva discuss individualized BPH treatment, expanding procedural options, and aligning care with patient goals. The episode closes with practical lessons on mentorship, character, and the strategies that make a residency program thrive for both trainees and patients.

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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 reconstructive urologists improve quality of life for cancer survivors beyond the initial cure? On this episode of BackTable Urology, Dr. George Koch interviews Dr. Hiren Patel about building a comprehensive survivorship practice that addresses the long-term needs of patients following genitourinary cancer treatment. They discuss moving beyond post-prostatectomy ED and incontinence to include management of radiation sequelae, immunotherapy effects, and urethral strictures, as well as the role of patient-centered communication, care coordination, and technology.

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Get the BackTable app
https://www.backtable.com/app

---

Timestamps

00:00 - Introduction
04:26 - Redefining Survivorship
11:29 - Why Survivorship Practices Matter
17:53 - Workup and Aligning Care
21:05 - Managing Active Cancer Scenarios
27:20 - Building a Survivorship Program
30:12 - Growing Referrals and Optimizing Workflow
39:24 - System Support and Research Gaps
44:04 - Tech Advances in Reconstruction
48:50 - Single-Port Retroperitoneal Case
59:55 - Tips, Tricks, and Wrap-Up

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More about this episode

The conversation covers patient expectation setting, logistics of establishing a survivorship clinic, aligning care with patient goals, and multidisciplinary collaboration with oncology and primary care. Dr. Patel highlights strategies to reduce ER visits and system burden, the importance of continuity, and advances such as single-port robotic retroperitoneal ureteral reconstruction. The episode concludes with practical tips on trust-building, workflow optimization, and advocating for survivorship programs within larger health systems.

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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