In this episode of Pearls and Perspectives, host Amy Pearlman, MD, is joined by Polly Rodriguez, CEO and co-founder of Unbound, for a candid and wide-ranging conversation at the intersection of sexual health, innovation, and patient advocacy. Rodriguez shares the deeply personal experience that shaped her mission: a cancer diagnosis at age 21 that led to early menopause—without warning from her care team about the profound sexual health consequences that would follow. That gap in care became the catalyst for building a company focused on accessible, body-safe, and stigma-free sexual wellness products.

Together, Pearlman and Rodriguez explore the persistent disconnect between medical treatment and quality-of-life conversations, particularly when it comes to sexual health. Rodriguez reflects on how discussions during her cancer care centered on fertility but overlooked equally critical issues such as pain with sex, loss of libido, and vaginal dryness—symptoms that significantly affect long-term well-being. Pearlman builds on this by emphasizing the importance of normalizing these conversations in clinical practice, offering practical frameworks for clinicians to introduce sexual health in a way that is brief, inclusive, and non-intimidating for patients.

The discussion then shifts to the broader landscape of sexual wellness, where Rodriguez outlines the challenges of building a company in a largely unregulated and stigmatized industry. She highlights gaps in safety standards, noting that many sexual wellness products are not subject to FDA oversight, and explains how Unbound prioritizes body-safe materials, affordability, and modern design. The conversation also touches on systemic disparities in how products for male vs female sexual health are marketed and regulated, underscoring the ongoing barriers to innovation and education in this space.

From a clinical perspective, the episode offers practical insights into how sexual wellness products—such as lubricants and vibrators—can play a meaningful role in patient care, particularly for individuals recovering from cancer treatment or experiencing menopause-related symptoms. Rodriguez and Pearlman discuss the nuances of different product types, from water-based vs silicone lubricants to emerging technologies like suction-based stimulation, framing these tools not as luxury items but as essential components of sexual health and recovery.

Importantly, the conversation expands beyond products to address the psychological and relational dimensions of intimacy. Rodriguez speaks to the process of reconnecting with one’s body after illness, while Pearlman highlights how open communication and a willingness to explore can transform partnered relationships. Both emphasize that pleasure, curiosity, and agency are lifelong aspects of health—ones that deserve the same attention and normalization as any other clinical outcome.

The episode ultimately reinforces a central message: Sexual health is not ancillary to overall health—it is integral. By bridging the gap between medicine, innovation, and patient experience, Pearlman and Rodriguez advocate for a more holistic, informed, and stigma-free approach to care.

In this episode of The Expert APProach: Conversations in Uro-Oncology, host Joy Maulik, CRNP, sits down with Melissa Kestler, DNP, FNP-BC, for a thoughtful discussion centered on advanced practice provider (APP) leadership, clinical growth, and the evolving role of APPs in urologic oncology.

Kestler shares her professional journey into urology, reflecting on how curiosity, mentorship, and a willingness to step outside of traditional role expectations helped shape her career. What stands out in her story is not just the acquisition of clinical skills, but the intentional development of confidence—particularly in procedural competency and independent clinical decision-making. She emphasizes that growth in this field often requires APPs to advocate for their own training opportunities while also being supported by forward-thinking physician partners.

A central theme of the conversation is the importance of practicing at the top of one’s license. Kestler highlights how APPs can meaningfully expand access to care, improve efficiency, and enhance patient outcomes when they are empowered to take on more advanced responsibilities. This includes not only clinic-based care but also procedural work, care coordination, and longitudinal patient management. She underscores that this evolution is not about replacing physicians, but about strengthening the care team in a way that meets the increasing demands of modern health care.

Maulik and Kestler also explore the realities of navigating complex patient populations in uro-oncology. From managing treatment adverse events to supporting patients through emotionally and physically taxing diagnoses, Kestler speaks to the depth of the APP–patient relationship. Education emerges as a recurring pillar—ensuring patients understand their disease, treatment options, and expectations is just as critical as the treatments themselves.

Leadership is another key focus. Kestler discusses how APPs are increasingly stepping into leadership roles, whether formally through administrative titles or informally through mentorship, program development, and clinical innovation. She encourages APPs to seek out these opportunities, noting that leadership does not always require a title—it often begins with initiative, consistency, and a commitment to improving care delivery.

The conversation also touches on interdisciplinary collaboration. Kestler reinforces the value of strong partnerships between APPs, physicians, nurses, and administrative teams, particularly in complex fields like uro-oncology where coordinated care is essential. These collaborative models not only improve patient outcomes but also help reduce provider burnout by distributing responsibilities more effectively.

Ultimately, this episode paints a clear picture of a field in transition—one where APPs are no longer seen solely as support roles, but as integral contributors to both clinical excellence and healthcare innovation. Kestler’s insights serve as both a roadmap and an encouragement for APPs looking to expand their impact, reminding listeners that growth in this space is driven by curiosity, collaboration, and a willingness to lead.

In this episode of Pearls & Perspectives, host Amy Pearlman, MD, is joined by Bishara Korkor, MS, for a forward-looking discussion on how innovation is reshaping everyday urologic care. Centered around Emano Flow, the conversation explores how a seemingly routine diagnostic tool—uroflowmetry—can be reimagined to better serve both patients and providers.

What quickly becomes clear is that traditional uroflow testing, although foundational, often falls short of capturing how patients truly void in real life. The clinical setting can feel unnatural and even uncomfortable, leading to results that may not fully reflect a patient’s true physiology. Emano Flow seeks to address this gap by creating a more intuitive, patient-centered experience—one that allows individuals to void more naturally, ultimately producing more meaningful and reliable data.

A major emphasis throughout the discussion is the patient experience. Urologic testing can carry a level of anxiety and awkwardness that is often underestimated. By reducing these barriers and making the process feel less clinical and more organic, patients are more at ease, more engaged, and better able to participate in their own care. This shift doesn’t just improve comfort—it enhances the quality of the diagnostic information clinicians rely on.

At the same time, the conversation highlights the realities of modern practice management. Efficiency is no longer optional. With increasing demands on time and staffing, tools like Emano Flow are designed not only to improve diagnostics but also to integrate seamlessly into clinical workflows. By minimizing disruptions, reducing staff burden, and streamlining processes, the technology aligns with the broader goal of delivering high-quality care without sacrificing operational efficiency.

Underlying all of this is a larger movement within urology toward more data-driven decision-making. As tools evolve to capture more accurate and actionable information, clinicians are better equipped to move beyond subjective symptom reporting and toward more precise, individualized care strategies.

Of course, innovation only succeeds if it can be adopted in the real world. The discussion acknowledges that new technologies must be intuitive, clinically meaningful, and easy to incorporate into existing systems. When done right, they don’t add complexity—they remove friction.

Ultimately, this episode reflects a broader shift in the field: a move toward diagnostics that are not only more accurate, but also more human-centered. Through platforms like Emano Flow, urology continues to evolve in a way that elevates both the patient experience and the efficiency of care delivery.

In this episode of The Expert APProach: Conversations in Uro-Oncology, the conversation expands beyond clinical care to explore leadership, advocacy, workforce evolution, and the future of independent urology.

Host Joy Maulik, CRNP, sits down with Celeste Kirscher, CAE, MHSA, CEO of LUGPA, and LUGPA President Scott Sellinger, MD, FACS, who discuss how the definition of “independent practice” has evolved into a broader concept: physician-directed care. In an era of hospital consolidation and complex ownership models, LUGPA serves as a counterweight—supporting practices that remain led by physicians and focused on patient access and quality outcomes.

A central theme is the widening gap between clinical work and health care policy. Most physicians, Sellinger notes, understandably prioritize patient care over reimbursement models, regulatory changes, and payer dynamics. This makes strong dyad leadership—physician and administrator working together—essential. Kirscher emphasizes that advocacy is everyone’s responsibility, even if not everyone feels comfortable engaging in it. Through structured advocacy efforts in Washington, DC, LUGPA helps clinicians translate bedside realities into policy conversations that directly affect patient access to care.

The discussion also highlights the expanding role of advanced practice providers (APPs). Over the past 25 years, APP integration has grown from novel to indispensable. With workforce shortages and increasing patient demand, APPs now function across office, hospital, procedural, and leadership settings. Both guests affirm that utilizing clinicians at the top of their licensure is no longer optional—it is necessary for sustainable, high-quality urologic care.

Technology and innovation round out the conversation. Artificial intelligence is expected to first transform administrative workflows—scheduling, billing, and operational efficiencies—whereas clinical AI applications in radiology, pathology, and precision oncology continue to mature. Sellinger underscores the importance of germline and somatic genetic testing in advanced prostate cancer, noting that despite clear guideline recommendations, testing remains underutilized nationwide. Expanding access to precision medicine remains a critical opportunity.

Finally, Kirscher highlights LUGPA’s commitment to educating residents and early-career urologists—not only in clinical excellence but also in the business and leadership aspects of practice. The message is clear: choosing a physician-directed path does not mean going it alone.

The episode closes on a powerful reminder from Sellinger about why urology remains deeply rewarding: its breadth, its diversity of patients, and—most importantly—the ability to offer meaningful solutions that improve and extend lives.

This conversation reinforces that sustaining independent, physician-directed urology requires more than clinical skill—it demands advocacy, leadership development, workforce integration, and a commitment to shaping the future of health care.