Is transecting urethroplasty still the default, or is reconstructive urology moving beyond it? In this episode of BackTable Urology, Dr. Ben Breyer (University of California San Francisco) joins host Dr. George Koch (Ohio State University) to discuss evolving approaches in reconstructive urology with an emphasis on complex stricture cases.

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SYNPOSIS

Throughout the conversation, Dr. Breyer reflects on his path into the subspecialty and breaks down the evolution of reconstructive practice, particularly the shift from anastomotic urethroplasty to non-transecting techniques. Dr. Breyer and Dr. Koch also discuss managing complex urethral strictures, including cases involving prior radiation and inflammatory conditions, while emphasizing thoughtful patient selection and surgical planning. Finally, they explore the current training landscape, challenges in patient access to subspecialty reconstructive care, and why patient-reported outcomes will play a central role in shaping future innovation in urethral reconstruction.

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TIMESTAMPS

00:00 - Introduction
05:40 - Evolution of Surgical Techniques
10:01 - Managing Complex Cases
14:19 - Education and Training in Reconstructive Urology
23:45 - The Future of Reconstructive Urology
28:45 - The Journey of a Reconstructive Urologist
30:45 - Challenges in Urology Training and Practice
35:35 - Addressing Urologist Shortages in Rural Areas
48:34 - Innovations and Research in Reconstructive Urology
57:25 - Final Thoughts