Urology Times Podcasts

In this episode of The UroOnc Minute, host Adam B. Weiner, MD, is joined by Keyan Salari, MD, PhD, to examine the results of the PROTEUS trial and their implications for managing high-risk localized prostate cancer.

In this episode of Pearls & Perspectives, host Amy Pearlman, MD, is joined by Larry Lipshultz, MD, and Rachel Rubin, MD, for a conversation on advocacy, sexual medicine, and the evolving role of urologists in women’s health.

In this episode of The UroOnc Minute, host Adam Weiner, MD, is joined by Lourdes Guerrios-Rivera, MD, MSc, for a discussion on strategies to improve patient engagement and adherence during active surveillance for prostate cancer. Guerrios-Rivera highlights the critical roles of education, communication, and structured follow-up.

In this episode of Pearls & Perspectives, host Amy Pearlman, MD, is joined by longtime colleague and fellow podcast host Larry Lipshultz, MD, for a conversation with Thomas F. Stringer, MD, FACS, who is president elect of the American Urological Association (AUA). Recorded on-site at the 2026 AUA Annual Meeting, the discussion offers a personal look at Stringer’s professional journey, leadership philosophy, and vision for the future of urology.

In this episode of The UroOnc Minute, recorded at the 2026 American Urological Association Meeting, host Adam B. Weiner, MD, speaks with Carissa Chu, MD, about the evolving understanding of variant histology in bladder cancer and its implications for clinical practice.

In this episode, Amy Pearlman, MD, and Annah J. Vollstedt, MD, discuss emerging innovations in female pelvic medicine, including implantable tibial nerve stimulation, the role of pelvic floor physical therapy, and the future of incontinence care.

In this episode of The UroOnc Minute, host Adam B. Weiner, MD, is joined by Chad Tang, MD, to discusses findings from the WOLVERINE meta-analysis, evaluating the effectiveness of metastasis-directed therapy for oligometastatic prostate cancer.

In this episode of Pearls & Perspectives, host Amy Pearlman, MD, speaks with Tom Riester of LTR Pharma about the development of a novel intranasal therapy for erectile dysfunction, exploring its potential implications for sexual health, prostate cancer survivorship, and broader engagement in men's health care.

In this episode of Pearls & Perspectives, host Amy Pearlman, MD, is joined by Larry I. Lipshultz, MD, to discuss the growing interest in peptides, including their potential applications in men’s health, evolving regulatory landscape, and what urologists need to know as patient demand continues to rise.

In this episode of Pearls & Perspectives, Amy Pearlman speaks with Heather Florio about the evolving role of evidence-based nutraceuticals and nonhormonal therapies in managing interstitial cystitis, chronic pelvic pain, recurrent urinary symptoms, and menopausal bladder health.

In this episode of The UroOnc Minute, host Adam B. Weiner, MD, speaks with Hashim U. Ahmed, BM BCh (Oxon), about patient selection, imaging, and the future direction of focal therapy for localized prostate cancer.

In this episode of The UroOnc Minute, host Adam B. Weiner, MD, is joined by Mary Beth Westerman, MD, FACS, of the University of North Carolina to discuss the landmark CISTO trial—a large pragmatic study examining patient-reported outcomes among individuals with high-risk non–muscle invasive bladder cancer who underwent either bladder-sparing therapy or radical cystectomy.

Objective performance indicators captured during robotic surgery are opening a window into surgical quality that has never before existed—and the data emerging from early work at Hackensack Meridian Health suggest the technology may ultimately transform not only how surgery is taught, but how it is performed in real time, according to Michael Stifelman, MD, professor and chair of urology at Hackensack Meridian Health.Stifelman described the fundamental shift that objective performance indicators represent."When we think about what good surgery looks like, there was never an objective way to quantify it," he said. Intuitive Surgical's platform processes surgical video using artificial intelligence to segment procedures into discrete steps, then captures more than 150 quantitative metrics across those steps—including tissue force, instrument smoothness, camera movement frequency, energy delivery, and fourth-arm utilization."For the first time in the history of surgery, we actually have this new technology that can objectively quantify what we're doing," Stifelman said.Early signal data from a machine learning analysis of more than 100 prostatectomy cases with linked pre- and postoperative outcomes have identified performance indicators associated with sexual function and continence recovery. The left and right neurovascular bundles and the posterior dissection emerged as the steps most predictive of sexual function outcomes—confirming clinical intuition with quantitative evidence for the first time. Among the OPI signals emerging from those steps, lower tissue force, smoother instrument movements, and reduced energy application during neurovascular bundle dissection appear to correlate with better functional recovery."We thought we knew what parts of the operation were important—but now we can prove it," Stifelman said.The commercially available Case Insights platform—distinct from the research-phase OPI work—is already in use at Hackensack for surgical education. Every week, Stifelman reviews a specific operative segment with a resident, comparing video side by side with approximately 10 available performance metrics. The process has surfaced consistent patterns: Residents move the camera less than attendings, underutilize the fourth arm, and apply substantially more energy."It's not now subjective—we're able to pick a very specific part of the operation, review it with them, and layer on the data," he said. Residents engaging with the platform appear to be progressing faster and producing better early outcomes, with targeted simulation exercises addressing specific identified deficiencies.Stifelman also confronted the governance questions the technology raises head-on. When the platform launched at Hackensack, surgeons immediately asked about data ownership and discoverability. The institution convened compliance, legal, IT, strategy, clinical, and perioperative stakeholders to establish a framework, ultimately placing OPI data under a patient safety organization structure—limiting its use to performance improvement and shielding it from discovery."We are not using it for credentialing, for PHP, for OP, or during complication rounds," he said. "We're using it only for the purpose of letting surgeons develop their skills more quickly."Looking ahead, Stifelman said he envisions the technology evolving from a tool for post-procedure reflection to one that informs surgeons intraoperatively in real time."Rather than doing it post-procedure, we're going to do it intraoperatively—use the data to help us in terms of augmented dexterity and augmented knowledge in real time," he said. He described a future where real-time alerts—analogous to a lane-departure warning—could notify a surgeon that tissue force is exceeding safe thresholds during neurovascular bundle dissection, or that energy has been applied beyond an established limit."That," he said, "is going to be the next step."

In this episode of The UroOnc Minute, Adam B. Weiner, MD, is joined by Nikita R. Bhatt, MBBS, MCh, MMed, FRCS, to discuss the WASHOUT study, a prospective international collaboration examining outcomes among patients admitted with emergency hematuria.

In this episode of The UroOnc Minute, recorded live at the 2026 European Association of Urology Annual Congress in London, host Adam B. Weiner, MD, welcomes Maarten Albersen, MD, PhD, of University Hospitals Leuven, Belgium, for a focused discussion on the evolving molecular landscape of penile cancer. Framing the conversation around a rare but impactful genitourinary malignancy, the episode highlights both the current limitations and future promise of biomarker-driven care in a space that has historically lacked personalization.

In this episode, Adam B. Weiner, MD, sits down with Giorgio Gandaglia, MD, to discuss the ongoing controversy surrounding pelvic lymph node dissection in prostate cancer.

In this episode of The UroOnc Minute, host Adam B. Weiner, MD, is joined by Dr. Alfonso Gomez de Liaño Lista for a timely discussion on a practice-changing development in muscle-invasive bladder cancer: the phase 3 KEYNOTE-B15 trial.

In this episode of The UroOnc Minute, Adam B. Weiner, MD, speaks with Alexander Light, MBBS, about evolving strategies for salvage treatment in patients with radiorecurrent prostate cancer.

In this episode of the UroOnc Minute, Wesley Yip, MD, joins host Adam B. Weiner, MD, to discuss key takeaways from the LITESPARK-022 trial, exploring the role for adjuvant pembrolizumab plus belzutifan in patients with clear cell renal cell carcinoma.

 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 The UroOnc Minute, host Adam B. Weiner, MD, is joined by Veeru Kasivisvanathan, MBBS, MSc, PhD, FRCS, to discuss the role of biparametric vs multiparametric MRI for prostate cancer detection.

At EAU 2026, Adam B. Weiner, MD, spoke with Nikita Bhatt, MD, about the growing interest in prehabilitation to optimize patients ahead of cystectomy.

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 UroOnc Minute, recorded at the 41st Annual Congress of the European Association of Urology, host Adam B. Weiner, MD, connects with Giancarlo Marra, MD, of the University of Turin, Italy, to discuss a highly relevant and evolving topic in urologic oncology: transperineal vs transrectal prostate biopsy.

In this episode of The UroOnc Minute, host Adam B. Weiner, MD, speaks with Christian D. Fankhauser, MD, MPH, leader of the Urology Clinic Kantonsspital Winterthur in Zürich, Switzerland. The discussion focuses on the evolving role of biomarkers in testicular cancer, a disease that is highly curable but still poses important challenges related to treatment toxicity and long-term survivorship.

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.

In this episode, host Amy Pearlman, MD, sits down with Bruce R. Kava, MD, for a a discussion on his career path from oncologic surgery to sexual medicine, revision penile prosthetics, and cancer survivorship.

In this episode of The Expert APProach: Conversations in Uro-Oncology, host Joy Maulik, CRNP, sits down with Michael Ritmiller, PA-C, MPAS, a neuro-urology physician assistant whose career has been defined by deep clinical expertise, procedural skill, and a commitment to comprehensive, patient-centered care.Ritmiller shares his background as a Navy veteran and surgical corpsman and describes his transition into physician assistant practice, where he has spent more than 2 decades caring for patients with complex neurogenic bladder conditions. His work spans spinal cord injury, stroke, traumatic brain injury, and other neurologic disorders that profoundly affect bladder function.A major focus of the discussion is the role of video urodynamics in evaluating voiding dysfunction. Ritmiller explains how advanced urodynamic testing allows clinicians to assess not only bladder pressures and flow, but also bladder anatomy, sphincter coordination, reflux, and long-term risk to the upper urinary tract. He emphasizes that voiding dysfunction is often neurologic in origin and reflects impaired communication between the brain, spinal cord, and bladder rather than a purely urologic problem.The conversation explores how he formulates individualized treatment plans by evaluating the patient as a whole—incorporating neurologic exam findings, caregiver input, functional status, cognition, and risk factors. Management strategies may include medications, intermittent catheterization, Botox injections, urethral bulking agents, suprapubic tube placement, or staged procedural interventions, with careful attention to safety, bleeding risk, autonomic dysreflexia, and patient education.Ritmiller also provides a nuanced discussion of urinary tract infections in neurogenic patients, highlighting the importance of symptom-based treatment rather than relying solely on urine cultures. He outlines his approach to recurrent infections, reflux-associated risk, and advanced management options such as intravesical gentamicin instillations for select patients.Beyond clinical care, the episode highlights the evolving role of advanced practice providers in urology. Ritmiller advocates for APPs practicing at the top of their license to address workforce shortages, reduce burnout, and improve access to high-quality care. He reflects on the importance of mentorship, humility, lifelong learning, and institutional support in developing procedural confidence and subspecialty expertise.The conversation concludes with a shared emphasis on team-based care, professional growth, and the impact that empowered APPs can have on patients, practices, and communities.

In this special Urology on the Beach edition of Pearls & Perspectives, host Amy Pearlman, MD, sits down with Laura Horodyski, MD, thoughtful conversation on what fellowship truly teaches, the evolving challenges of reconstructive urology, and the importance of offering patients a full spectrum of treatment options.Horodyski reflects on her fellowship with Michael Metro, MD, sharing that although surgical technique is expected, the most valuable lessons were in patient management—navigating complications, guiding patients through emotionally charged decisions, and mastering bedside communication. These “hidden curriculum” skills, she notes, often take years to develop without dedicated mentorship.The discussion transitions to practical pearls, including techniques for performing comfortable office cystoscopy—emphasizing gentle lidocaine instillation, minimal irrigation, and patient-centered distraction strategies to improve the experience.A major focus of the episode is reconstructive urology, particularly the unpredictable and long-term effects of pelvic radiation. Horodyski describes radiation as an “X factor,” noting the wide variability in tissue response and the delayed complications—such as strictures and calcifications—that may arise years after treatment. She underscores the importance of multidisciplinary collaboration with radiation oncology and ongoing patient education about potential late effects.The conversation also highlights her passion for treating male stress urinary incontinence. For Horodyski, these cases are among the most rewarding in urology due to their profound impact on quality of life. She emphasizes the importance of offering personalized options—including slings, artificial urinary sphincters, and emerging interest in adjustable continence balloons (ProACT)—so that treatment aligns with each patient’s goals and comfort level.Finally, she reflects on the value of operating alongside trusted colleagues and the strength of collaborative subspecialty practice, where shared expertise leads to innovative solutions for complex cases.This episode underscores that excellence in reconstructive urology extends beyond surgical skill—it requires empathy, adaptability, multidisciplinary partnership, and a commitment to expanding options that restore dignity and quality of life.

In this special Urology on the Beach edition of Pearls & Perspectives, host Amy Pearlman, MD, sits down with Emad Ibrahim, MD, HCLD, to tackle a topic that is both critically important and routinely overlooked: sexual and reproductive health in patients with spinal cord injury.

In this episode, Amy Pearlman, MD, speaks with Phillip M. Pierorazio, MD, about integrating mindfulness and wellness into a demanding surgical career and the evolving complexities of modern prostate cancer care.

In this episode of The UroOnc Minute, host Adam B. Weiner, MD, is joined by Brian M. Shuch, MD, associate professor of urology at the University of California, Los Angeles and a nationally recognized expert in kidney cancer, for a concise yet wide-ranging update on the evolving role of adjuvant therapy in renal cell carcinoma (RCC).

In this special Urology on the Beach edition of Pearls & Perspectives, host Amy Pearlman, MD, speaks with Thomas Masterson, MD, assistant professor of clinical urology at Desai Sethi Urology Institute in Miami, Florida, about emerging tools and evolving concepts in male infertility and men’s health, with a focus on what lies beyond the traditional semen analysis.Masterson explains that although semen analysis remains the cornerstone of male fertility evaluation, it only assesses external sperm characteristics—concentration, motility, and morphology—and provides limited insight into the genetic integrity of sperm. DNA fragmentation testing offers a window into the quality of the DNA carried by sperm and may help identify potentially correctable contributors to recurrent pregnancy loss, repeated in vitro fertilization failure, and cases of unexplained infertility.The conversation explores the growing role of at-home semen testing kits as screening tools, their advantages in accessibility and privacy, and their limitations compared with in-lab testing—particularly for detecting very low sperm counts and accurately assessing motility. Masterson emphasizes the importance of establishing a baseline semen analysis in men considering or already receiving testosterone therapy, as exogenous testosterone commonly suppresses sperm production and can complicate later fertility evaluation.Pearlman and Masterson also discuss advanced paternal age, noting that although men can produce sperm throughout life, sperm quality may decline over time, with small increases in risks such as autism and certain genetic conditions. Options such as sperm cryopreservation are reviewed as a consideration for select men, particularly those facing gonadotoxic therapies.Beyond fertility, the episode touches on erectile function as a general marker of health, the limitations of using morning erections as a diagnostic tool, and the broader need to normalize conversations around male sexual health. The discussion closes with reflections on gender differences in health-seeking behavior and the importance of creating spaces that encourage men to engage more openly in discussions about sexual and reproductive health.

In this special Urology on the Beach edition of Pearls & Perspectives, host Amy Pearlman, MD, sits down with Gerard Henry, MD, to reflect on more than 2 decades of progress in penile prosthetics and how meticulous technique, data collection, and innovation—often driven from private practice—have reshaped infection prevention and device outcomes. Henry recounts his early work demonstrating that bacteria are commonly present even in clinically “uninfected” penile implant revisions and how revision washout protocols dramatically reduced infection rates, helping establish what is now standard of care. He shares longitudinal data showing a steady decline in culture-positive bacteria over the past 40 years and discusses emerging research comparing traditional cultures with DNA-based testing, which may reveal organisms missed by standard methods.The conversation explores evolving strategies that have further lowered infection risk, including no-touch principles, chlorhexidine skin preparation, antibiotic and customizable implant coatings, and growing interest in antiseptic-based solutions rather than antibiotics alone. Henry emphasizes that gram-negative organisms, particularly Pseudomonas, are more commonly implicated than historically taught, underscoring the need to rethink antimicrobial targeting.Beyond infection prevention, Henry highlights practical surgical innovations such as the “mummy wrap” and finger-sweep dissection, along with the importance of maintaining long-term clinical databases to generate meaningful real-world evidence. He advocates for innovation within private practice, encouraging clinicians to start with procedures they perform most often, systematically collect data, and consider intellectual property development through patents.The episode closes with a look toward future technologies, including Henry’s work on seal-based vasectomy using ligation energy technology, and a broader discussion of how cross-pollination from other specialties can inspire the next generation of urologic advances.

In this special Urology on the Beach edition of Pearls & Perspectives, host Amy Pearlman, MD, sits down with Raveen Syan, MD, FPMRS, to discuss the rapidly evolving landscape of female pelvic medicine and reconstructive surgery, with a focus on overactive bladder, voiding dysfunction, and patient-centered innovation.Syan shares how she designs real-world case discussions that mirror the longitudinal nature of urologic care, emphasizing that many patients require ongoing management rather than one-time fixes. She reflects on what she learns from moderating expert panels, including how leaders in the field evaluate emerging technologies, interpret new data, and individualize decisions around medical vs procedural therapies.The conversation highlights the steady pace of innovation in urogynecology, from onabotulinumtoxinA and sacral neuromodulation to improvements in device technology and implantable neuromodulation options. Syan explains how updated American Urological Association/ Society of Urodynamics, Female Pelvic Medicine & Urogenital Reconstruction guidelines now allow clinicians to move directly to minimally invasive therapies without requiring medication trials, a shift that better aligns with patient preferences and avoids the adverse-event burden of anticholinergics.They also explore why so many patients with urinary incontinence remain untreated, pointing to lack of awareness, stigma, and limited screening in primary care. Syan underscores the importance of education and outreach, particularly in underserved populations, and notes that patients today are increasingly informed and engaged in shared decision-making.The episode closes with a personal reflection on surgeon wellness, the value of developing interests outside of medicine, and how embracing discomfort through new hobbies can build resilience—both in life and in the operating room.

In this episode of First Assist: GU Oncology Unpacked, host Taylor Goodstein, MD, is joined by Katie S. Murray, DO, MS, professor of urology at New York University Grossman School of Medicine chief of the Urology Service at Bellevue Hospital Center, New York, New York, for a comprehensive, case-based discussion on modern testicular cancer management, with a focus on thoughtful risk stratification, multidisciplinary collaboration, and surgical judgment in challenging clinical scenarios.Murray walks through key principles in evaluating patients with seminoma and nonseminomatous germ cell tumors, including how tumor markers, histology, and pre-chemotherapy imaging shape treatment pathways. She highlights the unique role of PET imaging in the post-chemotherapy seminoma setting, where surveillance can often be safely pursued, while reinforcing why surgery remains essential for residual disease in nonseminomatous tumors.The conversation explores complex post-chemotherapy decision-making, including how to interpret residual masses, when observation may be appropriate, and how intraoperative assessment can influence the extent of resection. Murray shares practical insights into surgical planning, lymph node template selection, management of pelvic and low retroperitoneal disease, and strategies to minimize vascular and bowel complications.Beyond operative technique, the episode addresses patient counseling, including expectations around fertility, anejaculation, and postoperative complications such as chyle leak. The discussion also covers high-stakes scenarios such as desperation RPLND, emphasizing that these cases require multidisciplinary consensus, careful imaging review, and an all-or-none surgical approach.Murray closes with advice for trainees and practicing clinicians alike: Know the guidelines, prepare deliberately for each case, and never manage testicular cancer in isolation. With its blend of technical pearls and big-picture perspective, this episode offers practical guidance for clinicians caring for patients across the full spectrum of testicular cancer.

In this episode of Pearls and Perspectives, host Amy Pearlman, MD, sits down with Ariana L. Smith, MD, to explore how clinicians navigate evidence gaps, evolving guidelines, and emerging innovation in overactive bladder care.

In this special Urology on the Beach edition of Pearls and Perspectives, host Amy Pearlman, MD, sits down with Mark L. Gonzalgo, MD, PhD, MBA, to discuss his recent appointment as chair of the Department of Urology at the University of Miami and his vision for leading a large academic urology department. Gonzalgo shares how the role has shifted his daily focus toward supporting faculty, trainees, and patients, emphasizing that advocacy is one of the most important responsibilities of a department chair.The conversation then turns to prostate cancer screening and second opinions, particularly in men with rising prostate-specific antigen (PSA) levels who may be considering testosterone therapy. Gonzalgo highlights the importance of baseline PSA testing, individualized risk assessment, and thoughtful, evidence-based evaluation before initiating testosterone, underscoring the value of informed patient counseling and comprehensive workup.Gonzalgo also explores how prostate cancer diagnosis and management continue to evolve, including the growing role of molecular testing, advanced imaging, and emerging blood-based biomarkers. He stresses that new technologies should be adopted only when supported by high-quality clinical trial data, ensuring safety, accuracy, and real-world benefit for patients.The episode concludes with a discussion of the collaborative energy and educational value of Urology on the Beach, and why meetings like this remain critical for staying current in a rapidly changing field.

In this episode of The UroOnc Minute, host Adam B. Weiner, MD, speaks with Stephen J. Freedland, MD, about the role of diet and nutrition in prostate cancer risk and outcomes.

In this episode of The Expert APProach: Conversations in Uro-Oncology, host Joy Maulik, CRNP, sits down with Jennifer Bepple, MD, MMCi—a dual board-certified urologist and informaticist—to explore how digital health, artificial intelligence (AI), and data-driven innovation are reshaping urologic care. Bepple brings a pragmatic, patient-first lens to technology, emphasizing that meaningful innovation starts not with shiny tools, but with real clinical problems that demand better solutions.Bepple reframes AI as a broad umbrella rather than a single solution, cautioning against buzzwords while highlighting its potential to streamline workflows, restore human connection, and return clinicians’ focus to patients. Rather than replacing providers, she advocates for a “centaur model” of care—where clinicians remain the decision-makers and technology serves as the engine supporting efficiency, access, and safety.A central theme of the conversation is access to care. Bepple discusses how digital health tools, including telehealth and AI-enabled workflows, can meet patients where they are—geographically, socially, and emotionally—while reducing no-show rates and improving continuity of care. She challenges the notion that technology makes medicine impersonal, arguing instead that it can help clinicians reclaim the relational aspects of care that have been eroded by administrative burden.The discussion also spotlights the evolving and expanding role of advanced practice providers (APPs). Bepple emphasizes APP subspecialization, leadership development, and inclusion in operational, strategic, and business decisions as essential solutions to workforce shortages and fragmented care. She underscores the importance of maximizing every provider to the top of their license and fostering cultures rooted in mutual respect, autonomy, and shared purpose.Closing the episode, Bepple offers practical advice for APPs interested in leadership or digital health: start with the problem that keeps you thinking, not the technology itself. She encourages clinicians to stay technologically literate, critically evaluate digital tools for safety, value, and scalability, and expand their professional networks beyond traditional silos.This episode delivers an empowering, forward-looking conversation on how APPs and physicians alike can lead healthcare transformation—by staying curious, embracing innovation thoughtfully, and keeping patients at the center of every solution.

In this episode of Pearls & Perspectives, Amy Pearlman, MD, sits down with Nicoletta Heidegger, MA, MEd, LMFT, a certified sex therapist, licensed marriage and family therapist, educator, and host of the award-nominated podcast Sluts and Scholars. Their conversation bridges sexual medicine and sex therapy, offering urologists and clinicians practical insight into how multidisciplinary collaboration can dramatically improve patient care and sexual outcomes.Why sex therapy matters in urologyHeidegger emphasizes that sexual concerns are almost never purely biological or purely psychological—they are biopsychosocial. Although urologists play a critical role in diagnosing and managing physical contributors (hormones, pain, medications, anatomy), sex therapists address shame, trauma, communication, desire, and relationship dynamics that often determine whether treatment succeeds.Key clinical takeawaysPatients want to talk about sex—they just need permission. Even clinicians receive limited sexual health training, making proactive, curious questioning essential.Anatomy education is foundational. Many patients have never learned basic sexual anatomy or seen accurate models of structures like the clitoris, contributing to misinformation, frustration, and poor outcomes.Pain should never be normalized. Outside of consensual kink, sexual pain should always be taken seriously and addressed collaboratively.Sex therapy is not “it’s all in your head.” Framing referrals as part of comprehensive care—not a dismissal—improves patient acceptance and outcomes.Who should be referred to a sex therapist?Heidegger notes that sex therapy can benefit:• patients with persistent sexual pain or dysfunction• individuals struggling with desire, arousal, orgasm, or anxiety around sex• couples with mismatched desire or communication issues• patients navigating gender, orientation, trauma, or shame• individuals or couples who want to proactively improve pleasure and intimacy.Desire, libido, and common mythsThe episode challenges several pervasive myths:• Libido is not simply “high” or “low.”• Many people experience responsive (not spontaneous) desire.• Needing lube, toys, or medication does not mean lack of attraction.• Orgasms and pleasure look different for every body and every relationship.Delayed ejaculation and male sexual performanceHeidegger and Pearlman explore delayed ejaculation, noting contributors such as:• conditioning from self-pleasure that doesn’t translate to partnered sex• performance pressure and partner expectations• medications (e.g., SSRIs)• pelvic floor tension and anxiety.Solutions include normalizing diverse orgasm pathways, adjusting self-stimulation patterns, reducing outcome pressure, and improving communication.Safer sex, STI disclosure, and communicationThe conversation highlights:• the importance of comprehensive STI testing (including oral and rectal sites)• normalizing STI discussions and moving away from shame-based language• giving patients scripts for disclosure and consent conversations• introducing frameworks like the STARS model (Safety, Turn-ons, Avoids, Relationship expectations, STI status).Sexual technique and skill-buildingGood sex is not about being “good at sex”—it’s about attunement, curiosity, and feedback. Heidegger shares resources for skill-building, including:• educational platforms (e.g., OMGYES, Pleasure Mechanics, Beducated)• sex coaching and workshops• somatic sex education (where legally available).Equine-assisted therapyHeidegger also discusses her work with equine-assisted therapy, using horse-human interactions to help patients develop boundaries, communication, nervous system regulation, and relational awareness—skills that translate directly into intimacy and sexual relationships.Bottom line for cliniciansThis episode reinforces that:• No single provider can (or should) address every aspect of sexual health.• Collaboration between urology and sex therapy leads to better, more sustainable outcomes.• Empowering patients with education, language, and referrals is a form of care—not abdication.Chapters2:22 How Heidegger got into the field7:01 Talking about anatomy with patients10:11 Who should see a sex therapist?27:03 Talking about sex30:18 Discussing STIs48:41 Dispelling myths56:34 How to direct patients on having better sex

In this episode, Jeremy Y.C. Teoh, MBBS, FRCSEd (Urol), FCSHK, FHKAM (Surgery), joins host Adam Weiner, MD, to discuss the evolving role of en bloc resection of bladder tumor (ERBT) in the management of non–muscle-invasive bladder cancer (NMIBC).

In this episode, Timothy Daskivich, MD, joins host Adam Weiner, MD, to discuss survivorship and long-term quality-of-life considerations in prostate cancer care.

In this episode, Farnoosh Nik-Ahd, MD, joins host Adam Weiner, MD, to discuss emerging guidance on prostate cancer screening in transgender women.

In this episode of First Assist: GU Oncology Unpacked, host Taylor Goodstein, MD, welcomes back Pretesh Patel, MD, associate professor of radiation oncology at Emory University, for an in-depth discussion on the evolving role of radiation therapy across the spectrum of advanced prostate cancer. Building on their prior conversation about localized disease, Patel focuses on treatment intensification, post-prostatectomy management, and the expanding role of metastasis-directed therapy.The conversation opens with emerging evidence supporting triplet therapy—radiation, androgen deprivation therapy (ADT), and abiraterone acetate (Zytiga)—for very high-risk localized prostate cancer. Patel explains how data from STAMPEDE have influenced practice patterns, leading to closer collaboration with medical oncology and more frequent use of systemic intensification alongside dose-escalated radiation.The discussion then shifts to the post-prostatectomy setting, where recent trials have reshaped the adjuvant vs early salvage radiation debate. Patel outlines how PSA kinetics, imaging, and modern PSMA-PET scanning inform decision-making, while emphasizing that early salvage radiation remains beneficial even when PET imaging is negative. The role of genomic classifiers is explored, particularly in guiding decisions around adding ADT to salvage radiation, though prospective predictive data are still evolving.A significant portion of the episode is dedicated to oligometastatic and oligoprogressive disease. Patel reviews how SBRT is increasingly used to treat limited metastatic lesions, delay systemic therapy, and preserve quality of life. He highlights practical considerations, including patient selection, bone health, fracture risk, and the balance between local control and systemic disease management. The nuances of treating nodal-only recurrence and comprehensive nodal irradiation are also addressed, supported by emerging randomized data.The episode concludes with a forward-looking discussion on innovations shaping radiation oncology, including PSMA-guided treatment planning, AI-driven prognostic tools, and the growing role of radioligand therapy such as lutetium-177 PSMA. Patel emphasizes the importance of multidisciplinary collaboration as imaging, systemic therapies, and radiation techniques continue to converge.This episode offers practical insights for clinicians navigating complex prostate cancer cases and underscores how precision imaging and tailored radiation strategies are redefining care for patients with advanced disease.Chapters0:38 Triplet therapy for high-risk localized disease3:48 Salvage vs adjuvant radiation therapy13:52 Radiating a prostatectomy bed vs radiating a prostate17:13 PSMA-PET21:34 Oligometastatic disease33:12 Bone health

In this episode of Pearls & Perspectives, host Amy Pearlman, MD, sits down with Emad Ibrahim, MD, HCLD, associate professor of Urology & Neurological Surgery, director of the Clinical Andrology Laboratory, and director of the Male Fertility Research Program of The Miami Project to Cure Paralysis. With over 20 years of experience, Ibrahim offers an unparalleled look into the intersection of male fertility, sexual health, and spinal cord injury—an area where few clinicians have specialized training.Ibrahim explains the unique challenges men face after spinal cord injury, including neurogenic erectile dysfunction, ejaculatory dysfunction, and particularly the distinctive sperm abnormalities seen in this population (high counts but low motility/viability). He walks through the stepwise approach used in his program—from specialized vibratory stimulation devices to office-based electroejaculation—highlighting how these techniques can reliably produce ejaculates for fertility use without the need for surgery.A major portion of the conversation centers on his cutting-edge research, including a $3.25M Department of Defense grant studying probenecid as a treatment to reduce inflammasome-driven sperm dysfunction in spinal-cord-injured men. He also discusses the difficulty of recruiting patients for double-blind trials and the promise this work holds for transforming future care.The episode also dives into:• how spinal cord injury affects sexual function differently in men vs women• practical guidance for primary care and urology clinicians on counseling these patients• the use of vibratory devices (including the Ferticare and Viberect Pro)• the role of electroejaculation and how few providers are trained to perform it• cryopreservation workflows, including infectious disease requirements and coordination with IVF centers• the impact of lifestyle factors like heat exposure• counseling men on testosterone therapy, vasectomy, and age-related fertility• why in-lab semen analysis is far more reliable than at-home testing• the future of reproductive medicine, including prepubertal testicular tissue preservation.Ibrahim emphasizes the importance of awareness: many men with spinal cord injury are never told that fertility and sexual function support is available. His program is designed not just to provide options—but to provide hope.Chapters2:55 Ibrahim's clinical journey11:03 Offering sexual/fertility services to patients with spinal cord injuries19:29 Devices Ibrahim offers to patients31:34 Device use in patients without spinal cord injury41:28 Cryopreservation49:26 Saunas/hot tubs and sperm count

In this inaugural episode of The UroOnc Minute from Urology Times, host Adam Weiner, MD, sits down with Michael S. Leapman, MD, MHS, associate professor of urology at Yale School of Medicine, to discuss evolving approaches to active surveillance in prostate cancer, particularly among patients with intermediate-risk disease.

In this debut episode of The UroOnc Minute, host Adam Weiner, MD, a urologic oncologist and surgeon-scientist at Cedars-Sinai Medical Center, introduces listeners to a new Urology Times podcast designed for busy clinicians who want concise, high-impact insights into genitourinary oncology.