Robotic technology is expanding what’s possible in reconstructive urology, prompting surgeons to rethink traditional approaches and consider new minimally invasive procedures. In this episode of BackTable Urology, Dr. Ziho Lee joins host Dr. George Koch to explore the rapid evolution of robotic reconstructive surgery and its expanding role in complex pelvic and retroperitoneal procedures.They discuss the the role of single-port platforms, new strategies for managing ureteral strictures and urinary diversion, and how research, training, and patient-reported outcomes are shaping the future of minimally invasive urologic care.

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Timestamps
00:00 - Introduction
03:10 - Bridging Reconstruction and Robotics
07:41 - Where Robots Help Most
14:33 - Ureteral Rest
16:41 - 20% Nephrectomy Rule
19:04 - Single Port Indications
20:55 - Ileal Ureter Tips and Tricks
22:34 - Robotic Reconstruction Course
28:55 - Case: VUAS Repair
39:35 - Final Advice

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Resources
Ureteral Rest is Associated With Improved Outcomes in Patients Undergoing Robotic Ureteral Reconstruction of Proximal and Middle Ureteral Strictures
https://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.
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What matters most to patients with non-muscle invasive bladder cancer (NMIBC)? In this episode of BackTable Urology, Dr. Kelly Bree, Dr. Saum Ghodoussipour, and Meredith Donahue, N.P., join host Dr. Vignesh Packiam to discuss the power of shared decision-making across the NMIBC spectrum. They explore risk-adapted treatment selection, when to escalate or de-escalate therapy, and how to navigate conversations about recurrence risk, treatment burden, quality of life, and the possibility of cystectomy.

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This podcast is supported by an educational grant from Johnson & Johnson.

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Timestamps

00:00 - Introduction
01:55 - Second Opinions and Patient Counseling
06:08 - Intermediate Risk Stratification
12:13 - Treatment Options for Intermediate Risk NMIBC
16:20 - BCG and Alternative Treatments for High Risk NMIBC
26:49 - Options for BCG-Unresponsive NMIBC
31:42 - Sequencing and Cystectomy
37:03 - Financial and Time Toxicity
41:08 - Biomarkers and ctDNA
44:04 - Future Trials and NMIBC Innovations

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More about this episode

They also review emerging therapies such as ZUSDURI, the evolving role of intravesical treatments, and the promise of biomarkers and ctDNA for personalized care. The discussion covers practical strategies for patient counseling, key updates to clinical guidelines, and a preview of innovations shaping the future of NMIBC management.

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Resources

Active Surveillance Versus Intravesical Bacillus Calmette-Guérin for High-grade T1 Bladder Cancer with Negative Second Transurethral Resection: The Randomized Noninferiority Phase 3 JCOG1019 Trial:
https://pubmed.ncbi.nlm.nih.gov/41571573/

Twelve-Month Results From the CISTO Study Comparing Radical Cystectomy Versus Bladder-Sparing Therapy for Recurrent High-Grade Non–Muscle-Invasive Bladder Cancer
https://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 Cystectomy
https://pubmed.ncbi.nlm.nih.gov/41843048/

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

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Can you really treat prostate cancer effectively without knowing the genetics? In this episode of BackTable Urology, Dr. Evan Yu and Dr. Tanya Dorff join host Dr. Alan Tan to discuss why genetic testing is essential in personalized prostate cancer care. They discuss when and how to perform germline and somatic testing, address common barriers, and share best practices for counseling patients.

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This podcast is supported by an educational grant from Pfizer.

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Timestamps

00:00 - Introduction
02:18 - Who Gets Somatic Testing?
06:43 - Patient Barriers to Testing
09:00 - Genetic Testing Workflow
12:28 - Treating BRCA2 Alterations
24:18 - Monitoring Progression: ctDNA vs. PSA vs. Imaging
29:32 - Treating mCRPC with ATM Mutations
34:39 - CDK12 Classification
37:43 - Closing Takeaways

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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.

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Resources

Niraparib and abiraterone acetate plus prednisone for HRR-deficient metastatic castration-sensitive prostate cancer: a randomized phase 3 trial:
https://pmc.ncbi.nlm.nih.gov/articles/PMC12705445/

Capivasertib plus abiraterone in PTEN-deficient metastatic hormone-sensitive prostate cancer: CAPItello-281 phase III study:
https://www.annalsofoncology.org/article/S0923-7534(25)04936-1/fulltext

Apalutamide for Metastatic, Castration-Sensitive Prostate Cancer:
https://www.nejm.org/doi/full/10.1056/NEJMoa1903307

ARCHES 5-year Survival with Enzalutamide Plus Androgen-deprivation Therapy in Metastatic Hormone-sensitive Prostate Cancer Patients
https://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.

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Are traditional bladder cancer care models falling behind as new therapies flood the field and reshape the landscape? In this episode of BackTable Urology, Dr. Bogdana Schmidt talks with Dr. Amy Luckenbaugh and DNP/APP Meredith Donahue about building a co-managed intravesical therapy clinic that rethinks care for patients with non–muscle invasive bladder cancer (NMIBC). With innovative agents increasing patient volume and complexity, the team discusses adapting care models to new realities.

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This podcast is supported by an educational grant from Johnson & Johnson.

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Timestamps

00:00 - Why Clinic Models Need to Change Now
04:03 - Overcoming Financial and J-Code Hurdles
11:04 - High Volume Workflow
14:10 - Pharmacy Coordination And Timing
19:02 - Proactive Lower Urinary Tract SYmptom Management
22:25 - Handling Difficult Catheters
32:08 - Defining Clinic Success

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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.

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Resources

Gemcitabine IDRS Drug Delivery Trial
https://ascopubs.org/doi/10.1200/JCO.2026.44.7_suppl.635

BCG-IO Combination Trial
https://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.

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Ready to move beyond “one-size-fits-all” for BCG-unresponsive NMIBC? In this episode of BackTable Urology, Dr. Ruchika Talwar hosts Dr. Sam Chang to discuss the evolving treatment landscape for BCG-unresponsive non-muscle invasive bladder cancer (NMIBC). They explore why BCG may fail, the science and clinical rationale behind new immunotherapies and gene therapies, practical approaches to patient selection, treatment sequencing, and surveillance, and the value of emerging biomarkers, empowering urologists to make more informed, personalized decisions in complex cases of NMIBC.

---

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---

This podcast is supported by

ImmunityBio
https://anktiva.com/

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Timestamps

00:00 - Introduction
03:48 - BCG: How it Works and Why it Fails
11:13 - Pembrolizumab Role and Limits
14:38 - Nadofaragene firadenovec
16:34 - Cretostimogene grenadenorepvec
18:39 - BCG + Anktiva Rationale
29:50 - Explaining Options to Patients
33:05 - Post Treatment Surveillance
37:32 - Future of Biomarkers and AI
42:05 - Key Takeaways

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Resources

N-803 Plus BCG Treatment for BCG-Naïve or -Unresponsive Non-Muscle Invasive Bladder Cancer: A Plain Language Review
https://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 Cancer
https://doi.org/10.1080/2162402X.2021.1912885

IL-15 Superagonist NAI in BCG-Unresponsive Non–Muscle-Invasive Bladder Cancer
https://evidence.nejm.org/doi/full/10.1056/EVIDoa2200167

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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.

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How do you keep no-shows low and patient satisfaction high in an office-based overactive bladder (OAB) practice? In this episode of BackTable Urology, Dr. Michael Kennelly and Dr. Jason Kim join guest host Dr. Polina Reyblat to share practical strategies for improving efficiency, reducing cancellations, and optimizing the patient experience for OAB and urinary incontinence procedures.

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---

This podcast was developed in collaboration with
Society of Urodynamics, Female Pelvic Medicine & Urogenital Reconstruction (SUFU)

https://sufuorg.com/home.aspx

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Timestamps

00:00 - Introduction
02:08 - Pre Visit Optimization
05:49 - Botox Protocol
11:31 - Spa-Style Comfort
14:46 - Prior Auth and Medicare LCD
21:25 - PTNS Workflow Challenges
24:52 - Stacking Procedures
27:55 - Bulking Agent Clinic Workflow
36:17 - Rapid Fire Tips

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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.

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Resources

Relaxing Environment Lowers Anxiety During Chemodenervation: a Randomized Trial
https://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.

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Keeping patients on PARP inhibitors long enough to see real benefit often comes down to proactive side effect management. In this episode of BackTable Urology, Dr. Neeraj Agarwal and Dr. Arun Azad join host Dr. Alan Tan to discuss practical, evidence-based strategies for managing hematologic and GI toxicities in advanced prostate cancer patients receiving PARP inhibitors.

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---

This podcast is supported by an educational grant from Pfizer.

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Timestamps

00:00 - Introduction
06:17 - Managing Anemia
11:12 - Side Effect Profiles
19:33 - Transfusions vs ESAs
26:43 - Docetaxel vs PARP Inhibitors
30:27 - Side Effect Management Pearls
40:18 - Team Based Monitoring
52:27 - Tissue Versus Liquid
01:01:24 - Genetic Counseling Workflow
01:07:07 - Trial Equity and Access

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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.

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Resources

Talazoparib plus enzalutamide in men with metastatic castration-resistant prostate cancer: final overall survival results from the randomised, placebo-controlled, phase 3 TALAPRO-2 trial
https://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.

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Male factor infertility accounts for nearly half of all infertility cases, yet male evaluation is often delayed or overlooked. In this episode of BackTable Urology, Dr. Robert Brannigan joins guest host Dr. Catherine Nam to unpack the 2024 AUA/ASRM Male Infertility Guideline update and discuss how the field is evolving beyond basic semen analysis.

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Timestamps

00:00 - Introduction
04:12 - Rationale Behind the Updates
09:37 - Concurrent Couple Evaluation
15:01 - Diagnosis, Assessment and Evaluation
20:33 - Y Chromosome Microdeletion Testing
23:54 - Workup for Recurrent Pregnancy Loss
33:57 - Pelvic MRI for EDO
36:46 - MicroTESE
40:15 - Future Research Directions
44:09 - Closing Takeaways

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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.

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Resources

Increased risk of incident chronic medical conditions in infertile men: analysis of United States claims data:
https://pubmed.ncbi.nlm.nih.gov/26674559/

Diagnosis and Treatment of Infertility in Men: AUA/ASRM Guideline
https://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 clinicians
https://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.

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Are biomarkers the missing link in personalized prostate cancer care? What is the practical role of biomarkers across the prostate cancer treatment continuum? In this episode of BackTable Urology, Dr. Udit Singhal (University of Michigan) joins Dr. Ruchika Talwar (Vanderbilt University) to explore the evolving role of genomic classifiers and biomarkers in prostate cancer care.

---

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This podcast is supported by
Veracyte
https://www.veracyte.com/decipher-prostate

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Timestamps

00:00 - Introduction
04:58 - Current State
10:07 - Interpreting High Risk Scores
13:25 - Intermediate Risk Decisions
16:18 - Imaging vs. Genomics
18:26 - Advanced Disease Evidence
22:02 - AI and Clinical Trials
29:52 - Conclusions

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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.

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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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When Renal Cell Carcinoma (RCC) invades the veins, the stakes and the surgical challenges rise. Are you prepared? In this episode, Dr. Vidit Sharma (Mayo Clinic) joins guest host Dr. Daniel Roberson to review Renal Cell Carcinoma (RCC) with Venous Tumor Thrombus (VTT), seen in 4 to 10% of cases. They review Mayo level classification and how CT and MRI venography guide surgical planning by defining thrombus extent and IVC involvement.

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Timestamps

00:00 - Introduction
03:03 - What is a Venous Tumor Thrombus?
12:32 - Presentation and Workup
31:49 - Preoperative Considerations
40:26 - Building the Dream Team
46:06 - Preop Counseling and Risks
51:24 - The Operation
01:31:01 - Outcomes and Adjuvant Immunotherapy
01:36:40 - Future Neoadjuvant Shrinkage
01:39:40 - Final Takeaways

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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.

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Resources

Outcomes for patients with renal tumors and venous tumor thrombus
https://www.mayoclinic.org/medical-professionals/urology/news/outcomes-for-patients-with-renal-tumors-and-venous-tumor-thrombus/mac-20570379

TeNNiS Score
https://www.goldjournal.net/article/S0090-4295(26)00078-6/fulltext

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

Download the free BackTable app to get early access to new episodes, cases, and courses curated by physicians in your specialty.

► https://www.backtable.com/app