BackTable Urology

Is your “yes” advancing your career or just adding to your workload? In collaboration with the Society of Women in Urology (SWIU), this episode of BackTable Urology features timely professional advice from Dr. Anne Cameron (University of Michigan, former SWIU president) and Dr. Helen Bernie (Indiana University) on how to approach yes and no decisions with intention across different stages of your medical career.

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Timestamps

00:00 - Introduction02:43 - How Yes Changes Over Time11:34 - Power Dynamics For Trainees16:11 - Housekeeping Work18:46 - Kind Versus Nice22:52 - Delegating And Mentoring28:07 - Decision-Making Framework36:21 - FOMO Versus Opportunity40:30 - Mentorship45:02 - Final Takeaways

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More about this episode

Early in training, saying yes is often driven by power dynamics, while later in a career, it’s competing priorities that make those decisions harder. According to Dr. Cameron, a clear, timely “no” is not only acceptable but often more professional than a delayed response, and leaders play a key role in reinforcing this by giving trainees the space to decline opportunities. This episode also highlights the disproportionate share of “housekeeping” work taken on by women and junior faculty, adding another layer to these decisions. To navigate these challenges, Dr. Cameron offers a practical framework that considers time, role expectations, energy, personal fulfillment, CV value, and long-term goals, while emphasizing the role of mentors and trusted colleagues in providing perspective.

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Resources

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

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

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What role does prostate artery embolization (PAE) play in modern prostate cancer care? In this episode of BackTable Urology, Dr. Nainesh Parikh (Interventional Radiology at Moffitt Cancer Center) and Dr. Kosj Yamoah (Radiation Oncology at Moffitt Cancer Center) join Dr. Ruchika Talwar (Vanderbilt University) to discuss how PAE could become a key adjunct in optimizing radiation therapy outcomes.

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Timestamps

00:00 - Introduction01:44 - Why Use PAE in Cancer04:08 - Neoadjuvant and Salvage Use07:26 - Radiation Planning Benefits12:51 - PAE vs. Surgery18:36 - SBRT Access20:48 - Current Evidence and Trials25:29 - Patient Selection32:18 - PAE After Radiation36:56 - When to Avoid PAE40:29 - Long-Term Implications44:28 - Conclusions

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More about this episode

They review how PAE can improve lower urinary tract symptoms and reduce prostate volume, potentially optimizing patients for radiation therapy, including stereotactic body radiotherapy (SBRT) and brachytherapy. The discussion highlights early clinical data and patient selection considerations such as gland size and symptom burden. Finally, they examine post-radiation applications, technical challenges, and current limitations, emphasizing the need for larger, multicenter trials to better define PAE’s role in prostate cancer treatment pathways.

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Resources

Prostate Artery Embolization in the Setting of Prostate Cancer: Review and Opinionhttps://pmc.ncbi.nlm.nih.gov/articles/PMC11775958/

What if we’re waiting too long to offer our OAB patients the treatments that actually work? In this episode of BackTable Urology, Dr. Jason Kim joins host Dr. Anjali Kapur to discuss updates in overactive bladder management and evolving guidelines, including a shift away from rigid stepwise care toward shared decision-making.

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Timestamps

00:00 - Introduction03:06 - 2024 AUA/SUFU Idiopathic OAB Guideline07:32 - Patient Experience with OAB11:59 - Beta-3 Agonists vs Anticholinergics15:15 - Botox Counseling and Dosing18:11 - Tibial Nerve Stimulation25:47 - Sacral Neuromodulation32:09 - Cost Burden of OAB39:38 - Evolution of OAB Care41:39 - Future Research Directions

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More about this episode

The conversation positions OAB as a clinical diagnosis, supported by focused initial evaluation and selective use of advanced testing, with attention to the emerging role of ambulatory urodynamics. Dr. Kim and Dr. Kapur review management across the care continuum, including behavioral strategies, pelvic floor physical therapy, and pharmacologic options, with consideration of beta-3 agonists in older patients. The discussion also focuses on earlier use of minimally invasive therapies such as intradetrusor Botox and neuromodulation, and how introducing these options sooner may improve follow-up, reduce delays, and help patients achieve symptom control more efficiently.

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Resources

The AUA/SUFU Guideline on the Diagnosis and Treatment of Idiopathic Overactive Bladder (2024)https://www.auanet.org/guidelines-and-quality/guidelines/idiopathic-overactive-bladder

Anticholinergic Drug Exposure and the Risk of Dementiahttps://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2736353

Randomized trial of percutaneous tibial nerve stimulation versus Sham efficacy in the treatment of overactive bladder syndrome: results from the SUmiT trial

https://pubmed.ncbi.nlm.nih.gov/20171677/

Trends in Utilization of Sacral Neuromodulation for Overactive Bladder: Insight From the AUA AQUA Registryhttps://www.auajournals.org/doi/10.1097/UPJ.0000000000000916

A retrospective longitudinal evaluation of new overactive bladder patients in an FPMRS urologist practice: Are patients following up and utilizing third-line therapies?https://pubmed.ncbi.nlm.nih.gov/33197059/

What are the key decision points in managing renal, bladder, and urethral trauma? In this episode of BackTable Urology, Dr. Niels Johnson (Vanderbilt University Medical Center) joins host Dr. George Koch (Ohio State University) to discuss the 2025 American College of Surgeons (ACS) best practice guidelines for genitourinary trauma.

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Timestamps

00:00 - Introduction05:09 - Who Manages GU Trauma?13:53 - Purpose of ACS Guidelines16:13 - Development of ACS Guidelines20:01 - Foley Catheter Debate23:26 - Renal Trauma26:40 - Imaging Protocols and Delays29:30 - Bladder Trauma and Special Populations33:15 - Urethral Injuries38:02 - Genital Wounds and Antibiotics39:42 - Transfer Criteria and Resources41:26 - Conclusions

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More about this episode

Dr. Johnson and Dr. Koch review the rationale for developing multidisciplinary guidelines and the variability in genitourinary trauma care across institutions. The discussion highlights key management principles, including non-operative strategies for renal trauma, decision-making in bladder and urethral injuries, and how urinary diversion impacts orthopedic and trauma surgical planning. The episode also addresses considerations for special populations, long-term functional outcomes, and practical implementation tools, such as the ACS gap analysis checklist, designed to improve coordination and quality of care across trauma systems.

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Resources

ACS Best Practices Guidelines: Management of Genitourinary Injuries (August 2025)https://www.facs.org/media/ya5hcu0s/genitourinary_guidelines.pdf

What are the key practice changes introduced in the new American Urological Association (AUA) vasectomy guidelines? In this episode of BackTable Urology, Dr. Akanksha Mehta (Emory University), Vice Chair of the AUA Vasectomy Guidelines Committee, joins Dr. Catherine Nam (University of Michigan) to discuss the latest updates to vasectomy practice.

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SYNPOSIS

Dr. Mehta and Dr. Nam review the key changes in vasectomy guidelines. They address common misconceptions about sexual function and long-term health risks, as well as the role of telemedicine consultation and day-of-procedure examination. Their discussion also covers recommended surgical techniques and updated guidance on post-vasectomy semen analysis, including mail-in testing options. Finally, Dr. Mehta outlines fertility considerations after vasectomy, including cryopreservation, reversal, and sperm retrieval with IVF, and how clinicians can counsel patients about expectations and referral pathways.

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TIMESTAMPS00:00 - Introduction02:07 - Why Update the Guidelines05:38 - Key Guideline Changes11:02 - Sexual Function Concerns17:19 - Health Risks Debunked21:28 - Periprocedural Best Practices28:25 - Semen Analysis Follow Up37:12 - Future of Male Contraception39:11 - Conclusions

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RESOURCES

Vasectomy: AUA Guideline (2026)https://www.auanet.org/guidelines-and-quality/guidelines/vasectomy-guideline