Podcasts about Prostatectomy

November is National Men's Health Awareness Month in the United States. Registered Pharmacist Greg McKettrick is on the show today to talk about important men's health topics. Our conversation covers the Post Prostatectomy Penile Rehabilitation Protocol Greg developed, post-op urinary incontinence, erectile dysfunction, regaining sexual intimacy, mental health, medical devices, and more.    Patients, pharmacists, student pharmacists, urologists, and other healthcare professionals need to hear our conversation. If you know at least one person who could use the information in this episode, please share it with them.   Greg is a Men's Health Specialist and a compounding pharmacist. If men's health or compounding interests you as a pharmacist or a pharmacy student, reach out to Greg McKettrick, RPh. Connect on LinkedIn, Email Greg@revelationpharma.com, or call 704-883-2895.    Thank you for listening to episode 303 of The Pharmacist's Voice ® Podcast.   To read the FULL show notes (including all links), visit https://www.thepharmacistsvoice.com/podcast.  Select episode 303.   Subscribe for all future episodes.  This podcast is on all major podcast players and YouTube.  Links to popular podcast players are below. ⬇️   Apple Podcasts   https://apple.co/42yqXOG  Spotify  https://spoti.fi/3qAk3uY  Amazon/Audible  https://adbl.co/43tM45P YouTube https://bit.ly/43Rnrjt   Bio - Greg McKettrick (October 2024)   With over three decades of experience in the compounding industry, Greg McKettrick serves as a Clinical Liaison - Men's Health Specialist at Revelation Pharma, a national network of 503A and 503B compounding pharmacies dedicated to providing industry-leading pharmaceutical compounding services. Previously a compounding pharmacist at Stanley Specialty Pharmacy, Greg is a powerful voice in the world of men's health and men's sexual; wellness, drawing on his years of experience to elevate Revelation Pharma's industry presence.    In addition to his role at Revelation Pharma, Greg is a Chief Medical Advisor for the BHRT Training Academy, having designed the organization's Men's Health Module, and is on the Scientific Advisory Board for Berkeley Life Nitric Oxide. Greg is also a frequent speaker for Zerocancer groups and presentations.    A true thought leader in the industry, Greg developed his Post Prostatectomy Penile Rehabilitation Protocol, which is used by Urology clinics around the country. He has also been featured in numerous articles and as a guest on many webinars and podcasts.    Links from this episode Revelation Pharma Website https://revelationpharma.com/ Penile Rehab Protocol Website Penilerehabprotocol.com ConsultRX Website https://revconsultrx.com/    Learn more about the protocol on YouTube https://youtu.be/__ibcRJup48?si=3ogFWKw_Fy29BYuB  YouTube Video (Men's Sexual Health Overview with Pharmacist Greg McKettrick) Greg on LinkedIn https://www.linkedin.com/in/greg-mckettrick-a21404163/  Greg's email Greg@revelationpharma.com Greg's phone number 704-883-2895 Zero Prostate Cancer https://zerocancer.org/    Kim's websites and social media links: ✅ Business website https://www.thepharmacistsvoice.com ✅ The Pharmacist's Voice ® Podcast https://www.thepharmacistsvoice.com/podcast ✅ The Perrysburg Podcast (service project/hobby podcast) www.perrysburgpodcast.com  ✅ Pronounce Drug Names Like a Pro © Online Course https://www.kimnewlove.com  ✅ Self-paced, online podcast-planning Course https://www.kimnewlove.com  ✅ FREE eBook and audiobook about podcasting https://www.kimnewlove.com/podcasting  ✅ LinkedIn https://www.linkedin.com/in/kimnewlove ✅ Facebook https://www.facebook.com/kim.newlove.96 ✅ Twitter https://twitter.com/KimNewloveVO ✅ Instagram https://www.instagram.com/kimnewlovevo/ ✅ YouTube https://www.youtube.com/channel/UCA3UyhNBi9CCqIMP8t1wRZQ ✅ ACX (Audiobook Narrator Profile) https://www.acx.com/narrator?p=A10FSORRTANJ4Z ✅ Start a podcast with the same coach who helped me get started (Dave Jackson from The School of Podcasting)! **Affiliate Link - NEW 9-8-23**      Thank you for listening to episode 303 of The Pharmacist's Voice ® Podcast.  If you know someone who would like this episode, please share it with them!

In this insightful episode, Dr. Geo welcomes Dr. James Eastham, a renowned urologist from Memorial Sloan Kettering Cancer Center. They discuss the ideal candidates for prostate removal (prostatectomy), the latest surgical approaches, and Dr. Eastham's experiences and philosophy as a surgeon. Dr. Eastham shares valuable insights on robotic vs. open surgery, the evolving landscape of prostate cancer treatments, and how he balances professional success with personal wellness. Listeners also get a glimpse into Dr. Eastham's personal health practices and how lifestyle choices can impact long-term outcomes for both patients and medical professionals.Key Takeaways:Ideal Candidates for Prostatectomy: Who should consider surgery, and when is it appropriate.Robotic vs. Open Surgery: How technology has evolved and when open surgery is still preferred.Recovery and Outcomes: Discussing incontinence, sexual function, and long-term recovery after prostatectomy.Lifestyle and Wellness: Dr. Eastham's personal approach to maintaining health and work-life balance.AI and the Future of Prostate Surgery: Insights into how technology will shape the future of urology and patient care.Tune in to learn more about the latest in prostate cancer treatments and gain practical advice on improving prostate health.----------------We are excited to introduce our October Sponsors:XY Wellness: XY Wellness provides a high-value roadmap to health and wellness for men with prostate cancer. Co-founded by our Chief Medical Officer, they aim to help men thrive post-diagnosis. [Learn more about XY Wellness here [https://bit.ly/3uJPC7Z].AG1 (Athletic Greens): AG1 contains 75 high-quality vitamins, minerals, whole-food sourced ingredients, probiotics, and adaptogens to help you start your day right. This special blend of ingredients supports your gut health, nervous system, immune system, energy, recovery, focus, and aging. All the things. Enjoy AG2 (Athletic Greens) [https://bit.ly/3mA2tVV] here----------------Thanks for listening to this week's episode. Subscribe to The Dr. Geo YouTube Channel to get more content like this and learn how you can live better with age.You can also listen to this episode and future episodes of the Dr. Geo Podcast by clicking HERE.----------------Follow Dr. Geo on social media. Facebook, Instagram Click here to become a member of Dr. Geo's Health Community.Improve your urological health with Dr. Geo's formulated supplement lines:XY Wellness for Prostate cancer lifestyle and nutrition: Mr. Happy Nutraceutical Supplements for prostate health and male optimal living.You can also check out Dr. Geo's online dispensary for other supplement recommendations Dr. Geo's Supplement...

Oncotarget #published this #editorial on September 30, 2024, in Volume 15, entitled “Lessons from the ACDC-RP trial: Clinical trial design for radical prostatectomy neoadjuvant therapy trials” by Rashid K. Sayyid and Neil E. Fleshner from the Division of Urologic Oncology, Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada. DOI - https://doi.org/10.18632/oncotarget.28648 Correspondence to - Rashid K. Sayyid - rksayyid@gmail.com Video short - https://www.youtube.com/watch?v=APkPoTlXBWY Sign up for free Altmetric alerts about this article - https://oncotarget.altmetric.com/details/email_updates?id=10.18632%2Foncotarget.28648 Subscribe for free publication alerts from Oncotarget - https://www.oncotarget.com/subscribe/ Keywords - cancer, clinical trial, prostatic neoplasms, neoadjuvant therapy, chemotherapy; androgen receptor agonist About Oncotarget Oncotarget (a primarily oncology-focused, peer-reviewed, open access journal) aims to maximize research impact through insightful peer-review; eliminate borders between specialties by linking different fields of oncology, cancer research and biomedical sciences; and foster application of basic and clinical science. Oncotarget is indexed and archived by PubMed/Medline, PubMed Central, Scopus, EMBASE, META (Chan Zuckerberg Initiative) (2018-2022), and Dimensions (Digital Science). To learn more about Oncotarget, please visit https://www.oncotarget.com and connect with us: Facebook - https://www.facebook.com/Oncotarget/ X - https://twitter.com/oncotarget Instagram - https://www.instagram.com/oncotargetjrnl/ YouTube - https://www.youtube.com/@OncotargetJournal LinkedIn - https://www.linkedin.com/company/oncotarget Pinterest - https://www.pinterest.com/oncotarget/ Reddit - https://www.reddit.com/user/Oncotarget/ Spotify - https://open.spotify.com/show/0gRwT6BqYWJzxzmjPJwtVh MEDIA@IMPACTJOURNALS.COM

More than 500 salvage radical prostatectomies!!! Yep it would be fair enough to describe Dr Paul Cathcart as being "experienced" in the most challenging scenario  we face as prostate cancer surgeons. Surgery for cancer recurrence in the prostate following radiotherapy or various forms of ablative therapy is never easy, and can all too often lead to issues with healing and quality of life recovery due to the impact of prior failed treatments, so we are always keen to see how we can improve outcomes.  Paul dropped into the GU Cast studio when back in Melbourne this week, a little over ten years on from his Fellowship training here. He is a Consultant Urologist at Guy's & St Thomas' NHS Foundation Trust in London, where his main area of expertise is indeed salvage robotic radical prostatectomy. Paul shares his perspectives and tips and tricks for performing this procedure to try and give patients the best possible outcome, and also explains why he prefers the da Vinci Surgical System over the new robot kids on the block. This is a Themed Podcast supported by our Silver Partners, Device Technologies, distributors of the da Vinci Surgical System. Even better on our YouTube channel

Why is prostate cancer a problem?  - It occurs in the prostate, a gland that sits below the bladder and produces fluid for semen.  - It's the second highest cause of cancer death in men. 4000 are diagnosed a year, and 700 men die a year.  - Over time the number of people being diagnosed, and death rate is dropping due to increased testing.  - If you are diagnosed: 90% of men are alive after 5 years, and 90% alive after 10 years due to early treatment, and sometimes the cancer is slow growing.       Are there symptoms that can indicate prostate cancer?  Things to look out for:  - A need to urinate urgently, difficulty with getting started and weak urine stream, dribbling after finish, blood in the urine.  - However, these can be due to other ‘benign' prostate problems:  - BPH – Benign Prostatic Hypertrophy: the prostate getting larger with age, but it's not cancerous  - Prostatitis: an infection of the prostate  If you notice any of these symptoms you need to talk to your GP.     Should we be doing anything to check for prostate cancer?  - Yes. From the age of 50 years, talk to your doctor about a two-yearly prostate check.  - If you have a family history —father, brother— then you may need to start earlier at 40 years.  - The check is very simple: a blood test called a PSA and quick rectal examination to feel for the size of the prostate.     If a problem is detected what are the treatments?  - If the blood test indicates a possible problem, then more tests are done: further bloods, possible MRI scan, a biopsy of the prostate to look for cancer.  - If cancer is detected there are four main approaches:  - Watch and wait: because the cancer is early and is considered low risk, slow growing, and may not cause a problem.    - Radiotherapy to destroy the cancer.  - Prostatectomy: where an operation is preformed to remove the prostate.  - Hormone injections that shrink and control the cancer.  Like all cancers can be treated if found early: if you are 50, a man, visit your GP and discuss a prostate check!    LISTEN ABOVE  See omnystudio.com/listener for privacy information.

Dr. April Dominick // #ICEPelvic // www.ptonice.com 

One of the most influential thinkers and voices in men's pelvic health, Jo Milios is sharing her research and treatment techniques at PelviCon this year!In this fantastic conversation we discuss what it's really like to treat men in the clinic, apprehensions about working in men's pelvic health, collaborating with urologists and surgeons, how to 'pre-hab' for prostatectomy surgery, treating Peyrnonie's disease and much more!You'll also hear about Jo's research and some of her initiatives that are changing the game in men's health and post-prostatectomy treatment.Make sure to check out this interview; it's going to whet your appetite for PelviCon 2024!Jo MiliosFounder of Complete Physiotherapy and Men's Health in Perth, Australia, make sure you're checking out all Jo has to offer and following her @drjomiliosphysioPelviCon 2024!Coming up September 27-28th!  The 'Super Bowl of Pelvic Rehab' as one participant called it - incredible speakers, great community and the magic of being in the room.If you're coming, make sure you've reserved your add-ons and start getting excited!If you couldn't make it this year, the recordings of all the talks, the PelviCon Manual and other resources will be available for pre-sale starting in September.  All info at www.pelvicon.com and follow @pelvicon_official!About UsNicole and Jesse Cozean founded Pelvic PT Rising to provide clinical and business resources to physical therapists to change the way we treat pelvic health.   PelvicSanity Physical Therapy (www.pelvicsanity.com) together in 2016.  It grew quickly into one of the largest cash-based physical therapy practices in the country.Through Pelvic PT Rising, Nicole has created clinical courses (www.pelvicptrising.com/clinical) to help pelvic health providers gain confidence in their skills and provide frameworks to get better patient outcomes.  Together, Jesse and Nicole have helped 600+ pelvic practices start and grow through the Pelvic PT Rising Business Programs (www.pelvicptrising.com/business) to build a practice that works for them!  Get in Touch!Learn more at www.pelvicptrising.com, follow Nicole @nicolecozeandpt (www.instagram.com/nicolecozeandpt) or reach out via email (nicole@pelvicsanity.com).Check out our Clinical Courses, Business Resources and learn more about us at Pelvic PT Rising...Let's Continue to Rise!

In the second of our special episodes focussing on GU Oncology in China, we are delighted to welcome back our GU Cast China Editor. Professor Yao Zhu, who has put together this cracking epsiode focussing on radical prostatectomy in China. We are joined by Professor Ming Liu (Beijing Hospital, Beijing) and Professor Jiahua Pan (Ren Ji Hospital, Shanghai) to discuss everything from current practices of pelvic lymph node dissection up to tantalising details of the new surgical robots which are in clinical use in China. This is a Themed Podcast as part of our Gold Partnership with Bayer Pharmaceuticals in China. We are very grateful to Bayer China for helping us promote GU Cast in China and supporting these Themed Episodes. Even better on our YouTube channel

Cancer just will not get the best of Don Helgeson.  A retired member of the Royal Canadian Mounted Police, he survived malignant melanoma in 1996 and colorectal cancer in 2007.  Just when he thought the disease was in his past, he was diagnosed with Stage 3B prostate cancer in 2020.  He opted to have his prostate removed, but thanks to a successful surgery, he achieved survivorship and enjoys excellent urinary and sexual function.

Dr. April Dominick // #ICEPelvic // www.ptonice.com  In today's episode of the PT on ICE Daily Show, #ICEPelvic faculty member April Dominick shares how YOU can make a huge impact on the quality of life of a client with an upcoming prostatectomy simply through education on pelvic floor muscle retraining, lifestyle changes and physical activity AND learn the ESSENTIAL clinical pearls to include in a pre-operative physical therapy session when working with this population. Take a listen to learn how to better serve this population of patients & athletes or check out the full show notes on our blog at www.ptonice.com/blog. If you're looking to learn more about our live pregnancy and postpartum physical therapy courses or our online physical therapy courses, check our entire list of continuing education courses for physical therapy including our physical therapy certifications by checking out our website. Don't forget about all of our FREE eBooks, prebuilt workshops, free CEUs, and other physical therapy continuing education on our Resources tab. Are you looking for more information on how to keep lifting weights while pregnant? Check out the ICE Pelvic bi-weekly newsletter! EPISODE TRANSCRIPTION APRIL DOMINICK This is Dr. April Dominick. I am on faculty with the ICE Pelvic Division. Today we are chatting about prehab for a prostatectomy surgery. Why is prehab important and what should be included in your PT session with that pre prostatectomy client? This topic, it is so near and dear to my heart. it's because these humans just don't have the treatment or education that they deserve prior to going into these surgeries and afterwards when they come out. And if I can convince you why it is so important to be able to connect with these humans and to even just educate them on, hey, there is Help for you. There's pelvic floor muscle training that can be done education about behaviors whether that is you actually doing the PT session or you referring them to someone else it can have incredible outcomes for them post-op just because they are aware of pelvic floor physical therapy for their surgery the prostatectomy so Let's dive into what a prostatectomy surgery actually is. It is something to treat prostate cancer, and that's going to be by removing part or the full gland of the prostate. They're also going to remove surrounding tissues and seminal vesicles. The gold standard for surgery is a radical prostatectomy where they remove the entire prostate gland. I didn't have a walnut, so here's what we're working with. This fig represents the prostate. So let's run through some real estate of where everything is situated in someone with a prostate in terms of the pelvic floor and the organs. So we have our bladder here and then we have the bladder neck with the urethra that goes through our prostate. and this is going to be representative of the urethra itself. So the urethra goes from the bladder neck through this fig or the prostate and then down into the penis and that is how everything is set up. With a prostatectomy, after the prostate is removed, that extra support around the urethra is now lost, and the remaining bit of that urethra now needs to be reconnected back to the bladder. This reconnection, we can think about it like a bridge, or a fancy term is the anastomosis, and that anastomosis needs time to heal. So a Foley catheter is placed in for about five to ten days. That means that the bladder is or the urine is emptying passively. The bladder is not doing its job. It's off on vacation. And then once the catheter is removed, the bladder acts like it forgot how to start or how to store urine. It doesn't know what to do with it. And so we have a lot of urinary leakage. So among other things, this is why urinary incontinence or urinary leakage is a major side effect with these prostatectomy surgeries. post-op, the external urethral sphincter is relied on for maintaining continence. So good news for us, the pelvic floor muscles help to close that sphincter and keep pee in until it's appropriate to release it. And that's why pelvic floor muscle training with physical therapy can be so important pre-op and post-op, at least from the bladder side of things. So who does the prostatectomy surgery affect? Well, obviously those diagnosed with prostate cancer. It is the second leading cause of death from cancer in males. It's going to affect our individuals who are older than 50 years old and who are African-American. So if you think about who you are treating currently, if you're treating individuals who have prostates who are older than 50, one in eight of them are probably gonna have some run-in with prostate cancer, whether that's treated with a surgery or not. That's where you come in. You could have such a profound effect with these individuals just by educating them that pelvic floor muscle training exists And whether you're again, whether you're doing the treatment or you're referring out to someone else, you can have such an incredible impact on their post-op outcomes potentially. So, We talked about with a post-prostatectomy, we talked about that surgery can result in urinary incontinence or leakage. It can also affect sexual function. There can be reduced physical function. Think about it. If you're leaking all the time, is that really going to convince or motivate you to go work out? For some, no. And then it'll also affect the overall health-related quality of life. Take 65 year old Phil. You've got a Phil in your clinic. You're already treating him for low back pain, um, with his hikes and his weightlifting, say. And he went in for his annual physical, and then he walked out with a date for a surgery for radical prostatectomy. Besides being in shock that he now has this potentially life threatening diagnosis, Phil comes in and is like, this happened. He's like, am I, am I ever going to be able to hike with my hiking group and not be the person that smells like pee? Am I going to be able to be cool with being in the changing room in the, in the locker room after my weightlifting session, like removing this soggy pair of underwear, or am I going to be able to enjoy sexy times with his partner? Well, since you're here and you intently are listening to this podcast, You, your first line of question is, hey, Phil, did they recommend any sort of physical therapy for you? Um, whether it's pre-op or post-op. And of course, Phil's like, no. So you teach him that pelvic floor muscle training can be so effective and helpful, um, and play a huge role in those side effects that he's worried about. Y'all, what if we could have an incredibly bigger impact, building the foundation, setting the stage for what to expect post-surgery, just with PT sessions? Clinically, I've been treating this population, hopefully you can hear my passion behind it, for about seven years. I've interacted with so many fills that come in, if they even get to me, right? and they are just slapped with that surgery date, and the side effects are kind of breezed through during their appointment, it seems like. And their concerns aren't really heard, their well-being and their questions, they're just kind of like not given a lot of attention. I didn't always do pre-op sessions, but once I started, hoo-wee, I was just blown away by how different the clinical outcomes were in terms of improving, whether that was decreasing the volume of urinary leakage for some or having them return back to their ADLs exercise a little bit sooner. The biggest thing, which was so powerful for me, is these people came in extremely uncertain, having no idea even why, if their doctor did send them to PT, why they were there. And they were just uncertain about these really scary side effects, about how maybe for the first time they were going to experience some sort of losing control of their bodies, from peeing unexpectedly to changes in their erections. And they walked out of that first session feeling a little more confident, a little more certain. And that is the power, I believe, of these pre-op sessions. And then from a research side of things, what's shaking out in the few RCTs that we have for these pre-op sessions and their effects on prostatectomy, some may be helpful in improving quality of life. they may affect a shorter hospital stay. They may reduce post-op urinary leakage in the short term. So some studies find around month one, three, or six, that the individual is leaking less, meaning they're drier faster. Now, when you compare someone who had some pre-op PT to someone who did not around 12 months, they are about the same with their rate. But I would argue that I bet folks are going to be a lot more satisfied if they did that prehab and they are drier sooner, right? So let's go into what a prostatectomy PT session entails before that surgery. We've got these sessions already in place. for folks who are going in for surgery for their ACL repair, for their hip replacement. But just like we're fighting with our pregnant and postpartum population, we are somehow having to fight for someone to have a pre-obsession for something like a prostatectomy, and that impacts so many daily functions. Let's outline what is involved in that pre-op PT session. Again, you can educate someone on what to expect if you're referring them to someone to do this. So we'll go over subjective, objective, and the treatment. From an assessment side of things, from that subjective piece, what you can be talking to your patient about is what are their current bladder and sexual habits? How many voids do they have during the day? How many times do they go pee? Do they have an urge? Do they have urinary leakage or hesitancy? And there are some outcome measures that go over these things. The International Prostate Symptom Score goes over those things. Plus they ask about nocturia or nighttime urination. And then the NIH Chronic Prostatitis Symptom Index is another outcome measure. And I love it because it asks about the impact of these symptoms. How is it affecting your quality of life? Then you want to also ask about their sexual function. How would they rate their erection strength or their satisfaction with their sexual life? From an outcome measure standpoint, you can give them the International Index of Erectile Function. This is something that asks them to rate qualities of their erection from the past four weeks. Then you want to also get a good idea of their current physical activity regimen. What a wonderful time to, if they're already a little physically inactive, hey, let's like plug in for, here's why it would be really great if you could up that physical activity. Not just for that immediate post-op surgical outcome, but also, hey, we can lower all cause mortality. And then from an objective side of things, so we went over the subjective, objectively speaking, we want to get a pelvic assessment. Whether that is over the clothes, external, near that midline, or it is a visual or tactile palpation, or an internal rectal assessment, if that's what you're trained in. So we're looking for, what's their awareness? Do they even know that they have this group of muscles that they can control? called the pelvic floor. We want to be looking at their coordination, timing of the pelvic floor, and then also getting an idea of what is their breathing and bracing strategies for things that increase interabdominal pressure, like fitness activities or functional lifting of the groceries, coughing, running, weightlifting. Typically, this population tends to be a breath holder. So we're gonna spend some time, there's just so much that we can do to help them in this area, to help them have improvements in their methods with that. And then we also wanna be doing some sort of general orthoscreen because what if their hips are cranky? Obviously that's gonna affect pelvic floor, low back, and all those surgical outcomes. From a treatment side of things, so we went over subjective, objective, highlights from the treatment side of things. where we'll talk about education, what to expect post-op, and some homework for them to work on. Education. I cannot stress this enough. The education piece here is vital for affecting their outcomes and well-being. Let's educate them on the pelvic floor. Here's what it is. Here's the anatomy and physiology. Here's how it affects your penis. whether that's for sexual health or for the urethra for urination. Here is what happens during the surgery. Get to know the surgeons in your area and which methods they use. What are their outcomes, right? And then you want to be explaining the risk factors for these side effects like urinary leakage and sexual function. dysfunction. Non-modifiable factors. If you're older, it's not going to help you as much. And if you already have some reductions in urinary function, like you're already leaking, that is not going to help you on the backside. Modifiable factors, tons. So things like smoking, poor nutrition, That is gonna delay healing post-op. Can we identify some current bladder irritants and reduce those immediately post-op? What about poor mental health? Things like low self-efficacy or if they're experiencing anxiety or depression, helping them ID these things and finding them some psychosocial support to have upcoming for the surgery and post-op, so key. and then reduced physical activity. Hard health is heart health. What do I mean by that? Erections, ejaculation, is related to vascular health. Hard health is heart health. So what affects our vascular system? Aerobic and resistance training exercise. If we can have them and talk to them about how it's important and how increasing that physical activity is going to improve their physiologic resilience to the surgery itself and any complications that come up, that is gonna be having such a huge impact on their quality of life. Regarding physical activity, in a 2014 RCT by Mina et al, they found that men who were meeting physical activity guidelines prior to surgery had greater health-related quality of life at six and 26 weeks post-op compared to men who were not meeting those physical activity guidelines. So, from a post-op perspective, we want to tell them what to expect. Urinary incontinence and sexual dysfunction. From the urinary incontinence side of things, they will have a Foley catheter in for five to 10 days. Remember, the bladder doesn't work during this time. Once that catheter is removed, we gotta retrain that neural pathway to help control the bladder so that they know, oh, my bladder is filling, or this is how I'm gonna stop that leakage from coming out, and how to fully empty the bladder. Another huge tip, have them bring a hygiene product, whether that's a pad or a diaper or something, with them to the hospital so that when they are discharged, they have something to help protect them on their way home or on their way to the store to grab their meds. And then urinary incontinence could be present from a couple of months to a year post-op. We see a significant improvement in that three to six month range, but it could be affected by things like, hey, it gets worse at the end of the day because the pelvic floor muscles are tired, or with transitional movements like sitting to stand. So working on these movements with them is gonna be super helpful pre-op. And then maybe talking to them about how, if you're not going to see them for 10 days or so post-op, we may be using the pad weight or the number of pads in a 24-hour period as a marker for our progress. So just having that in the back of their mind. When it comes to what to expect from a sexual function standpoint post-op, it can take up to two years to recover to baseline function from an erection standpoint. We want to set these expectations from an ejaculation standpoint. Dry ejaculate is going to happen now because those seminal vesicles were removed, and that's what helps produce that ejaculate. There may be some changes in their orgasm sensation. Erections, it could be dependent on surgery outcomes. How much nerve sparing was there in that procedure? They have the potential to get better with this, especially with pelvic floor muscle training or things like pumps. And then loss of penile length. This is something that we want to let them know can happen so they don't get a little surprise. Homework wise, we want to address any of those pelvic floor deficits we found from that objective piece, especially that breathing and bracing strategy. We can do that with biofeedback, whether that's with a mirror, with a palpation from the therapist or from them, and just to really improve their awareness and coordination there. And then giving them cues that connect them to the pelvic floor. Evidence supports, hey, pelvic floor contractions with the following cues, like shortening the penis, though I've been told nobody wants to have that. So something like nuts to guts or stopping the flow of urine is great for that. One side of the range of motion, the contraction side of the range of motion of the pelvic floor, and then something for the relaxation side, like let the testicles or base of penis hang loose. I did an Instagram post recently, so you can check that out on the ICE or Revitalize Pelvic Physio page. And then we wanna be, for homework, modifying their poor lifestyle habits. Can we reduce those bladder irritants, process sugar? Can we increase your physical activity and mental health? And then finally, we want to be scheduling their followup visits on the calendar. So whether that's for pre-op, a couple more sessions, or as early as 10 days, once that catheter is removed, they can pop back in to your office. SUMMARY So, I hope you found that information helpful. We reviewed how prevalent prostate cancer is, especially for those who are 50 plus. We know that radical prostatectomy is the gold standard for treatment. Two major things that are affected post-op are urinary incontinence and erectile dysfunction. Pre-op PT sessions are fairly new, but we have some evidence that says, hey, those who partake in pre-op sessions are drier sooner than their counterparts. And then from a PT session standpoint, thinking about asking what their current bladder and sexual function is, asking them about physical activity, mental health, objectively getting a measurement of the pelvic area, and helping them connect with that area a little bit more. Treatment-wise, we want to really harp on that education. about what the pelvic floor is, how it can help with their function, and also what to expect, possible side effects, modifiable risk factors, and then giving them homework to work on those deficits, and then finally scheduling that additional follow-up before surgery and then getting their post-op session on the calendar. My next podcast, I'm going to go into detail on what a post-op session post prostatectomy looks like. So tune in for that. And then if you want to learn more about pelvic floor examination, join us live. We have our next two courses. One is July 20th, 21st in Cincinnati, Ohio. And then July 27th and 28th, we are gonna be in Laramie, Wyoming. If you're wanting more of a virtual option, we have our two different courses that are eight weeks, L1 and L2. And in L2, we go over the male pelvic health conditions as well. Thank y'all so much for tuning in from my prostate slash walnut. Happy Monday, and I'll see you next time. OUTRO Hey, thanks for tuning in to the PT on Ice daily show. If you enjoyed this content, head on over to iTunes and leave us a review, and be sure to check us out on Facebook and Instagram at the Institute of Clinical Excellence. If you're interested in getting plugged into more ice content on a weekly basis while earning CEUs from home, check out our virtual ice online mentorship program at ptonice.com. While you're there, sign up for our Hump Day Hustling newsletter for a free email every Wednesday morning with our top five research articles and social media posts that we think are worth reading. Head over to ptonice.com and scroll to the bottom of the page to sign up.

Men have many challenges to deal with when battling prostate cancer, including managing the side effects of their treatment.  One common issue men face after a radical prostatectomy is erectile dysfunction. As June is Men's Health Month, we are fortunate to have men's health expert Dr. Helen Bernie joining us today to provide a modern perspective on restoring erectile function post-prostatectomy through penile rehabilitation. Dr. Bernie is a board-certified and fellowship-trained urologist. She is the Director of Sexual and Reproductive Medicine, the Andrology Fellowship Program Director, and the Assistant Professor of Urology at the Indiana University School of Medicine, where she teaches medical students. She is passionate about men's health, cancer survivorship, and fertility preservation, and she treats all aspects of men's health, including male sexual dysfunctions and infertility. Dr. Bernie completed her residency in urology at the University of Rochester Medical Center and did a two-year fellowship in sexual and reproductive medicine at Memorial Sloan Kettering Cancer Centre and New York Presbyterian Weill Cornell Medical College. She has presented award-winning research on sexual medicine, testosterone replacement, prostate cancer, and male fertility. Stay tuned as Dr. Bernie shares her expert insights and practical advice on how men can reclaim their sexual health after prostate cancer treatment. Disclaimer: The Prostate Health Podcast is for informational purposes only. Nothing in this podcast should be construed as medical advice. By listening to the podcast, no physician-patient relationship has been formed. For more information and counseling, you must contact your personal physician or urologist with questions about your unique situation.   Show Highlights: How prostate removal or prostate cancer may affect men's sexual function How often does erectile dysfunction occur after a radical prostatectomy? Dr. Bernie shares some of the many options available for men to regain erectile function after a prostatectomy. Some of the barriers that exist in instituting penile rehabilitation Dr. Bernie shares her current approach to penile rehabilitation.  Why it is crucial for anyone diagnosed with prostate cancer or experiencing erectile dysfunction to find out what a penile rehabilitation program is and what it involves. Links:  Follow Dr. Pohlman on Twitter and Instagram - @gpohlmanmd  Get your free What To Expect Guide (or find the link on our podcast website)   Join our Facebook group  Follow Dr. Pohlman on Twitter and Instagram  Go to the Prostate Health Academy to sign up.  You can access Dr. Pohlman's free mini webinar, where he discusses his top three tips to promote men's prostate health, longevity, and quality of life here. Indiana University School of Medicine   Indiana University Andrology Fellowship Program Indiana University Urology Services

As part of the 2024 Prostate Cancer Patient Conference, Dr. Matthew Cooperberg discusses surgery as treatment for localized prostate cancer, including risk stratification, how prostatectomy is performed, surgery outcomes and potential side effects. Series: "Prostate Cancer Patient Conference" [Health and Medicine] [Show ID: 39758]

As part of the 2024 Prostate Cancer Patient Conference, Dr. Matthew Cooperberg discusses surgery as treatment for localized prostate cancer, including risk stratification, how prostatectomy is performed, surgery outcomes and potential side effects. Series: "Prostate Cancer Patient Conference" [Health and Medicine] [Show ID: 39758]

As part of the 2024 Prostate Cancer Patient Conference, Dr. Matthew Cooperberg discusses surgery as treatment for localized prostate cancer, including risk stratification, how prostatectomy is performed, surgery outcomes and potential side effects. Series: "Prostate Cancer Patient Conference" [Health and Medicine] [Show ID: 39758]

As part of the 2024 Prostate Cancer Patient Conference, Dr. Matthew Cooperberg discusses surgery as treatment for localized prostate cancer, including risk stratification, how prostatectomy is performed, surgery outcomes and potential side effects. Series: "Prostate Cancer Patient Conference" [Health and Medicine] [Show ID: 39758]

As part of the 2024 Prostate Cancer Patient Conference, Dr. Matthew Cooperberg discusses surgery as treatment for localized prostate cancer, including risk stratification, how prostatectomy is performed, surgery outcomes and potential side effects. Series: "Prostate Cancer Patient Conference" [Health and Medicine] [Show ID: 39758]

In this Freedom Talks Short Episode, Joe Ogden discusses the different Men's Health issues that Physical Therapy can treat. From bladder urgency, pelvic pain, and bowel disorders, there are many different issues that can be helped through Physical Therapy.

Date: 4/16/24Name of podcast: Dr. PatientEpisode title and number: 15 Race and Healthcare: One Man's Story Episode summary: Last week we heard from Linda Villarosa on the impact slavery still has on our modern healthcare system and how it leads to racial health disparities in the US. Today we'll hear from Michael Tyler, children's author, about his specific experience with race impacting his care.Guest(s): Michael Tyler, children's author: www.michaeltylerwrites.comKey Terms: [00:36] – link to something about how all old studies were on white men[07:02] PSA – prostate specific antigen, a blood-based screening tool for prostate cancer [08:30] BPH – Benign Prostate Hypertrophy, a condition where the prostate enlarges and causes urinary symptoms. Annoying, but generally not dangerous[08:38] Biomarkers - https://www.health.harvard.edu/mens-health/biomarkers-for-better-prostate-cancer-screening#:~:text=Biomarkers%20are%20%22chemicals%22%20that%20can,and%20potentially%20catch%20it%20early  [10:35] “Broke the seal” and Prostatectomy – a tumor has “broken the seal” of the prostate when it grows outside of the actual prostate wall. A prostatectomy is the partial or complete removal of the prostate[19:35] “Prostate cancer gene” – some cases of prostate cancer are caused by genetics. There are some genes that can be inherited (sort of like the BRCA breast cancer genes for women. Men with variants in these genes have a high risk of developing prostate cancer and, in some cases, other cancers during their lifetimesReferences: 2014 Study about the difference in location of prostate biopsies depending on race: “Pathological examination of Radical Prostatectomy Specimens in Men with Very Low Risk Disease at Biopsy Reveals Distinct Zonal Distribution of Cancer in Black American Men”:  https://www.auajournals.org/doi/abs/10.1016/j.juro.2013.06.021

Only a few sleeps to EAU 2024!. And to entertain you as you travel to Paris, here is the 2nd episode of the European Urology Oncology (EUO) podcast. Host, Dr Renu Eapen (Melbourne) dives into 2 key papers from the Feb edition of the journal, featuring interviews with the lead authors. Includes a very special EUO bio segment with EU managing editor (for almost 20 years!), Cathy Pierce. Enjoy!Priority papers:1.     First-in-human Evaluation of a Prostate-specific Membrane Antigen-targeted Near-infrared Fluorescent Small Molecule for Fluorescence-based Identification of Prostate Cancer in Patients with High-risk Prostate Cancer Undergoing Robotic-assisted Prostatectomy.https://euoncology.europeanurology.com/article/S2588-9311(23)00146-3/fulltext Featured authors – Professor Peter Carroll and Associate Professor Hao Nguyen (UCSF) 2.     Retroperitoneal Lymph Node Dissection in Clinical Stage IIA/B Metastatic Seminoma: Results of the COlogne Trial of Retroperitoneal Lymphadenectomy in Metastatic Seminoma (COTRIMS).https://euoncology.europeanurology.com/article/S2588-9311(23)00117-7/abstractFeatured authors – Professor Axel Heidenreich (Cologne, Germany) Full index to European Urology Oncology February 2024 issue https://euoncology.europeanurology.com/issue/S2588-9311(24)X0002-4 

On this episode of #mensexpleasure, I chat with Jo Milios, Ph.D. Jo is a Physiotherapist with a special interest in Men's Health, Yoga, and Pilates. Since establishing a Men's Health service in 2005, she has treated over 3000 prostatectomy patients, over 500 chronic pelvic pain patients, and 100's of men with Erectile Dysfunction. Among achievements such as delivering Men's Health courses to Physiotherapists in Australia, England, Ireland, Portugal, New Zealand, and South Africa, Jo also established PROST! Exercise 4 Prostate Cancer, a not-for-profit community education and exercise program for men in 2012. Key Points: - Jo introduces herself - Prostate health protocols - Kegels vs Reverse Kegels: Pelvic floor exercises - Prostatectomy recovery - Shockwave therapy for erectile dysfunction - The importance of intimacy Relevant links: Jo's website: http://www.menshealthphysiotherapy.com.au/ --- Send in a voice message: https://podcasters.spotify.com/pod/show/cam-fraser/message

In this episode of BackTable Urology, Dr. James Eastham, chief of urology at Memorial Sloan Kettering Cancer Center, discusses evolving approaches and treatments in prostate cancer. First, he discusses topics such as patient preparation, pre-treatment discussions, and individualized treatment options based on the patient's risk levels. Dr. Eastham also summarizes crucial advancements in testing and imaging prostate cancers, including the use of genetic and biochemical markers, like PSA levels. Additionally, he emphasizes how advances in radiation therapy have improved treatment outcomes and patient experiences. Finally, Dr. Eastham emphasizes the need for consistent monitoring and communication with patients during and post-treatment. --- CHECK OUT OUR SPONSOR Veracyte https://www.veracyte.com/decipher --- SHOW NOTES 00:00 - Introduction 06:24 - Treatment Strategies and Patient Preferences 11:30 - Exploring the Role of Imaging in Prostate Cancer Treatment 18:29 - Dealing with Persistently Detectable PSA and Pre-op Staging 27:48 - Understanding Prostate Cancer Recurrence 36:08 - The Role of PSA Doubling Time in Treatment Decisions 43:34 - The Future of Personalized Medicine and Genomic Classifiers in Prostate Cancer 52:42 - The Importance of Patient Education and Preparation --- RESOURCES Decipher Prostate by Veracyte: https://www.veracyte.com/decipher-prostate/

Patients with high-risk prostate cancer who have been treated with radical prostatectomy gain no additional advantage and face extra toxicity if they choose to have adjuvant radiotherapy. That’s according to the findings of the randomized RADICALS study, reported at the ESMO Congress 2023. These results support the use of early salvage radiotherapy for PSA failure after radical prostatectomy rather than early adjuvant intervention. After the conference, OncTimesTalk’s Peter M. Goodwin travelled to Manchester, England, to discuss the RADICALS study with lead author Noel Clarke, MBBS, FRCS, ChM, Chair of Urological Oncology at Manchester University and the Christie Hospital in Manchester.

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December 22, 2023Mark, Ray, and Scott answer questions from the PRS Urology Coding Community:I have multiple providers who want to bill 55867 & 51860 for the same procedure. While there's isn't an NCCI Edit for these codes, you can see that the procedure description includes both the making of an incision in the bladder wall and then later the suture repair. Coding guidelines dictate that since you could not perform the main surgical procedure without the minor one, then the minor is bundled into the major. As a coder I don't feel that there is support for separate reimbursement when the two codes are routinely billed together. Their contention is that there are 2 ways to do a simple prostatectomy. The first is through the capsule of the prostate gland without a bladder incision. The simple prostatectomy code has traditionally encompassed the first way of not making a bladder incision and if an incision was made then a cystorrhaphy was billed. With the addition of the new code specifically for the simple prostatectomy, I would like some direction on how these codes should be billed.Have you been able to lookup what the reimbursement will be for the new CPT code 99459 for female pelvic exam?Can 51741 and/or 51798 be billed twice on the same day?For example, if a patient does the first urofow and the volume is not adequate and then we have him drink and come back later for a second uroflow. When billing 51700 for voiding trial post-op after prostatectomy (90 day global), is a modifier needed ? Such as modifier 58 Urology Advanced Coding and Reimbursement Seminar(Click Here for More information and Registration) New Orleans, January 26 & 27, 20248 am - 4:30 pm Friday, 8 am - 3:30 pm SaturdayReserve your spot and save! Get signed up today and get peace of mind knowing you will be prepared for all the upcoming changes.The Thriving Urology Practice Facebook group.The Thriving Urology Practice Facebook Group link to join:https://www.facebook.com/groups/ThrivingPractice/ Join the discussion:Urology Coding and Reimbursement Group - Join for free and ask your questions, and share your wisdom.Click Here to Start Your Free Trial of AUACodingToday.com

Patients with high-risk prostate cancer who have been treated with radical prostatectomy gain no additional advantage and face extra toxicity if they choose to have adjuvant radiotherapy. That’s according to the findings of the randomized RADICALS study, reported at the 2023 annual congress of the European Society for Medical Oncology (ESMO) held in Madrid, Spain. These results support the use of early salvage radiotherapy for PSA failure after radical prostatectomy rather than early adjuvant intervention. After the conference OncTimes Talk’s Peter Goodwin travelled to Manchester, England, to discuss the RADICALS study with lead author Noel Clarke, MBBS, FRCS, ChM, FRCS, Chair of Urological Oncology at Manchester University and the Christie Hospital.

Jim Catto describes the 17 yr follow up data from this large prostate cancer study.

Many people struggle with the loss of sexual sensation after surgery, but all is not lost. Procedures like hysterectomies, prostatectomies, and mastectomies may leave you feeling disconnected from your body and pleasures. Although surgery alters us physically, our energetic imprint remains alive, allowing possibilities for arousal and orgasm. By using visualization, breathwork, and loving touch, we can reconnect to numbness and reignite erotic aliveness.Tune-in and discover:Learn techniques to increase sensitivity in areas impacted by surgeryDiscover how to access full-body energy orgasmsExperience renewed sexual confidence and embodimentRestore intimacy and pleasure with self and partnersLet go of grief and reclaim your wholeness through embodied presenceAwaken Arousal Oil Lubricant "I had a 3-minute orgasm and then a 5-minute orgasm. All I know is that I had transcended and felt like I was surfing in a perpetual wave pool of pleasure." - BethSupport the showSxR Hotline | SxR Website | YouTube | TikTok | Pinterest | Instagram | Dr. Willow's Website | Leah's Website

Kenny joins Gabby on the anniversary of his Prostatectomy to talk about how the diagnosis affected him and the changes his body has gone through in the year since his operation. It's also a frank and honest chat about how the couple have navigated this together – and yes, there is quite a lot of chat about erectile function! They also discuss the fear of saying the wrong thing in today's world, how signing up to challenges can really help to keep you motivated around the 50 mark, and a rather memorable holiday story involving one delirious Kenny and a thermometer!If you or someone you know have recently been diagnosed with prostate cancer, you might like to listen back to the special episode Gabby and Kenny recorded alongside Kenny's Consultant Urologist, Declan Cahill. If you want to know more about Declan Cahill's work you will find his website here, and Prostate Cancer UK has some very useful links and resources, too. Crucially, like many men, Kenny did not experience any symptoms before his diagnosis and sadly we know that 1 man dies of prostate cancer every 45 minutes, so if you or someone close to you wants to get checked, ask your GP for a Prostate-Specific Antigen (PSA) and urine test - two simple tests that save lives. Hosted on Acast. See acast.com/privacy for more information.

April 14, 2023Mark, Ray, and Scott revisit coding for Optilume and provide an update, and also discuss two questions about robotic prostatectomy coding. Can you share your thoughts on billing 51990 & 55866?  I saw your post in 2018 however wanted to see if you have the same stance in regards to not billing 51990 when performed without incontinence. When coding a robotic radical prostatectomy with BPLND- 55866 states it includes use of robot so S2900 should not be billed but since 38571 is done as well does that support reporting the S2900?Join the discussion:Urology Coding and Reimbursement Group - Join for free and ask your questions, and share your wisdom.Click Here to Start Your Free Trial of AUACodingToday.com 

 March 24, 2023Mark, Ray, and Scott discuss FAQs:  Would you consider interposition of peritoneal flaps separately billable with a Prostatectomy/lymphadenectomy? “The peritoneum at the dome of the bladder was folded over itself and anchored to the front sides of the bladder”. There is no guidance out there that I can find for coding, other than studies that show it is more of a prophylactic procedure to prevent lymphoceles. I am currently not coding for it but was wanting a second opinion. With the PHE ending on 5/11/2023, but telehealth being extended thru 12/31/2024, what is the ruling on using non HIPAA compliant platforms such as Facetime?  Will this exception being going away with the 1135 waiver ending ?If a provider is only interested to do a post void residual (51798) and do not have a bladder scanner, can we use the ultrasound information (76857) as a post void residual and charge that way? Can you bill 76857 since the provider interprets the result of the post void residual?  Thank you.   Join The Urology Coding Compliance and Education Network and get started today!Pricing and More Information The Thriving Urology Practice Facebook Grouphttps://www.facebook.com/groups/ThrivingPractice  Join the discussion:Urology Coding and Reimbursement Group - Join for free and ask your questions, and share your wisdom.Click Here to Start Your Free Trial of AUACodingToday.com 

Once Derrill Holly saw his Gleason scores were high, he ran not from, but toward the prospect of a prostate cancer diagnosis.  He was diagnosed Stage IV and opted for a prostatectomy.  He followed that up with an implant procedure and enjoys an active lifestyle, which includes being a happy husband and grandfather. 

Our males need our help too! Urinary incontinence and erectile dysfunction are two common side effects of undergoing a radical prostatectomy. In todays episode, Christina gives you the 101 of RP and how clinicians can be involved in conservative management. Want to make sure you stay on top of all things geriatrics? Go to http://PTonICE.com/resources to check out our Free eBooks, Lectures, & the MMOA Digest!

Christina Prevett // #GeriOnICE // www.ptonice.com 

Director of the Center of Advanced Robotic and Image-Guided Surgery at Cleveland Clinic's Glickman Urological & Kidney Institute, Jihad Kaouk, MD joins the Cancer Advances podcast to discuss single-port transvesical robot assisted radical prostatectomy. Listen as Dr. Kaouk explains advancements that have been made to prostatectomies and how we are continuing to innovate.

  Today, we speak with Palmer who, in the middle of the episode, transformed into Bruce Banner (the green hulk). You'll get to know how this happened when you click the play button below.   Anyway, Palmer err Bruce will talk about his prostate cancer journey which happened to be quite recent, just the 23rd of May this year!  We wanted to share Palmer's story with all of you this 3rd week of the Prostate Cancer (PC) awareness month to let you know that it's not always gloom and doom when one gets a PC diagnosis.  Palmer will navigate us through the process he took to help him decide what treatment option to choose (amongst three choices), who helped him do this, and his overall experience after surgery. So, for anyone who just got diagnosed with PC and is somewhat confused about what the next big steps are, Palmer's story can be a great guide for you.   One very interesting question that came up during this episode, that is question… Do you poo and wee at the same time? Send us your answers and we might make an episode about this too and see if there's some meaning behind it.    Further in the episode, we discussed the importance of pelvic floor exercises, orgasms that aren't messy, penile rehabilitation using a Vacurect pump ie., making your penis look like the Hulk, PDE 5s, and so much more.  Have a great time listening to our week's info-packed episode. And if you have the time, make sure to take down some notes and leave a review so we can help more people just like you.     Also posted in:  https://thepenisproject.org/103-palmers-open-prostatectomy-journey-and-more/ ---------- Websites: https://thepenisproject.org/ https://rshealth.com.au/ https://penilerehabilitationprogram.com/ http://www.menshealthphysiotherapy.com.au/ http://prost.com.au/     Facebook: https://www.facebook.com/Restorativeshealthclinic   Instagram: https://www.instagram.com/rshealth_perth/   Linkedin: https://www.linkedin.com/in/melissa-hadley-barrett/   Music David Mercy https://open.spotify.com/artist/1HbvnltKu4XbWTmk0kpVB9?si=D1xP5dDVQK-zzNU3rViRWg   Producer Thomas Evans: The SOTA Process https://www.instagram.com/thesotaprocess/ https://open.spotify.com/show/4Jf2IYXRlgfsiqNARsY8fi

For this episode, we talk with Pedro.   Pedro was 52 years old when he was diagnosed with Prostate Cancer in 2021. Apart from taking his PSA tests since his late 40s (due to his family history), this early detection is also thanks to his great GP who encouraged him to see a specialist when his PSA results started to fluctuate.   Pedro, however, had a unique predicament.   He had a history of extensive bowel surgery which was important to consider when choosing the next course of action (surgery). Will robotic prostatectomy work? How about the Cyberknife or even the Nanoknife?   After tons of research, interviews, and complete dedication of his healthcare team, Pedro was confident enough to opt for an open prostatectomy - an operation that is not often considered now for patients with Prostate Cancer. This was considered the best approach with his history.  His operation took 3 to 4 hours, and he was out of the hospital after 4-5 days.   What were the worries of Pedro during the operation? What made him confident about this choice? Did he have infections post-surgery? How are his continence and sexual function today?   All of these questions and more will be answered by Pedro.  A few key takeaways that Pedro would like to share with everyone listening are to NOT be afraid to go to your medical team with a list of questions. And another is (which we also always reiterate) to GET TO IT early, take your tests - since early detection      opens more available solutions for you.    Our big takeaway is not one treatment is best for everyone, your case is unique and needs to be considered as such.   To listen to Pedro and his journey of open prostatectomy and after, click the button below.     Resources:  Episode on stomas - https://thepenisproject.org/94-steve-and-his-drive-to-change-lives-for-patients-with-stomas/  Buy your Vacurect Pump - https://rshealth.com.au/product/vacurect-penis-pump/     And if you find this episode helpful, please share it with your folks or networks. One way for us to aid those suffering in silence is to share information that could help them.   ---------- Websites: https://thepenisproject.org/ https://rshealth.com.au/ http://www.menshealthphysiotherapy.com.au/ http://prost.com.au/ https://www.theyogavine.com.au   Facebook: https://www.facebook.com/Restorativeshealthclinic   Music David Mercy https://open.spotify.com/artist/1HbvnltKu4XbWTmk0kpVB9?si=D1xP5dDVQK-zzNU3rViRWg   Producer Thomas Evans: The SOTA Process https://www.instagram.com/thesotaprocess/ https://open.spotify.com/show/4Jf2IYXRlgfsiqNARsY8fi  

May 6, 2022Mark, Scott, and Ray discuss a question about a scenario regarding coding the most comprehensive code:Scenario 6 module 9, Cystectomy, with continent diversion, bilateral pelvic lymphadenectomy and prostatectomy. I captured both 55845 and 51596 and I also looked at the possibility of 51575 (Cystectomy with bilat lymphadenectomy, 50825 continent diversion including intestine anastomosis, and 55840 proctectomy. Do I not choose the 50825 (along with other codes) because of the intestine anastomosis? I tend to overthink px coding, am I over coding or under coding? What would y'all suggest to help, when I get lost in the "forest"? :) Thank you, RhondaMark, Scott, and Ray talk about past AUA Annual Meetings and look forward to the upcoming meeting in May 2022. ​NEW ONLINE WORKSHOP - Urologists' Coding WorkshopSpecial 5-hour virtual, intensive, and interactive workshop for practicing urologists and APPs (coders, billers and admins are welcome to participate)."Beef Up" On General Coding KnowledgePRS Network Presentation TeamDr. John LinMark PainterScott PainterFrom the perspective of a practicing Urologist and experts In Urology Coding.The majority of your income is from what you do in the clinic...It's a great idea to make your life as easy as possible. Mastering medical coding will ensure you reach the pinnacle of your game, so you can have time and energy for patient care and a happy life.Join us for the Urologists' Coding Workshop so we can help you get there!Register NowHappy Coding!  Join the discussion:Urology Coding and Reimbursement Group - Join for free and ask your questions, and share your wisdom.Click Here to Start Your Free Trial of AUACodingToday.com 

For today's episode, we talk to Tony who at 49, underwent nerve-sparing radical prostatectomy.   Tony learned about nerve grafting whilst listening to the radio. And almost immediately, he knew this was what he needed for his penis. So together with his wife, he booked an appointment and the rest is history.   Tony will share with you his nerve grafting journey – from the pros to the cons. He will talk about a lot of things like:   That One major side effect that came with the surgery (numbness, nope not of the penis)  How long did his recovery take (rule: no touch for 9 months)   Who qualifies for the surgery  The costs  His surgery timeline and procedure; and,  His intent to not offend anyone above 70   Have a listen to this honest and raw account of Tony. We know you'll be able to learn a lot.   For the links mentioned, please see below:     https://www.europeanurology.com/article/S0302-2838(19)30265-9/fulltext  https://www.cucare.com.au/erectile-restoration-surgery/  ----- If you feel The Penis Project is valuable to you then, please review and subscribe as this will ensure more people get to hear what we have to say. ---------- Websites: https://thepenisproject.org/ https://rshealth.com.au/ http://www.menshealthphysiotherapy.com.au/ http://prost.com.au/ https://www.theyogavine.com.au   Facebook: https://www.facebook.com/Restorativeshealthclinic   Music David Mercy https://open.spotify.com/artist/1HbvnltKu4XbWTmk0kpVB9?si=D1xP5dDVQK-zzNU3rViRWg   Producer Thomas Evans: The SOTA Process https://www.instagram.com/thesotaprocess/ https://open.spotify.com/show/4Jf2IYXRlgfsiqNARsY8fi  

Somatics nerds gather 'round. This discussion with somatics expert and doyen sexological bodyworker Ellen Heed PhD, is a grand schooling into the machinations of sex, arousal, the body, pleasure and how these things work together. Not a light discussion, but a meaty inquiry, Ellen & Cyndi dive deep into how our bodies really work and how these functions inform sex and pleasure. https://ellenheed.com/  https://www.scartissueremediation.com/  https://www.facebook.com/ellenheed.somatic.educator  https://www.instagram.com/ellenheed/

Dr. Linda Chu interviews Dr. Hannah Lamberg to discuss "Preoperative Prostate MRI Predictors of Urinary Continence Following Radical Prostatectomy". Preoperative Prostate MRI Predictors of Urinary Continence Following Radical Prostatectomy. Lamberg et al. Radiology 2022; 303:99–109.

Available April 8, 2022Mark, Scott, and Ray answer questions1) My clinic is trying out the app through Emano Flow that tracks a patients urine flow for 14 days and then the Urologist goes over the results with the patient when the trial is finished. My clinic is very confused on whether or not each individual day needs an interpretation written by the doctor in order to bill a uroflow (51741) on a particular day?2)  [9:05]  I am working on an appeal letter to Regence Blue Shield for in Interstim device.  In their criteria for coverage, the covered diagnoses for this type of treatment are: a. Urge Incontinence (N39.41), b. Non-obstructive urinary retention (R33.8), c. Overactive bladder (N32.81) and d. Urgency-Frequency syndrome (??).  For D, I could use the symptom codes of R39.15 and R35.0.........but is there anything else that might be better?  The documentation states the female patient has Fowler's Syndrome, but there isn't an ICD-10 for that either!  Suggestions???3) If a Medicare has a TURP 52601 and then two months later has a bladder scan in the office 51700 should Medicare pay for that bladder scan?4) What is the difference betweent simple prostatectomy codes 55821 and 55831.  What is the best way to code for Robot-assisted laparoscopic simple prostatectomy on a Medicare patient?  And, same question for a commercially insured patient?UTI – PCR UPDATEThe following Medicare Administrative Contractors (MAC) aka Carriers, have issued a proposed multi-jurisdictional Local Coverage Decision (LCD) for Multiplex Nucleic Acid Amplification Test (NAAT) PANELS FOR INFECTIOUS DISEASE Testing, Wisconsin Physician Services Insurance Corporation, CGS Administrators, LLC., Noridian Healthcare Services, LLC., and Palmetto GBA.Each has also issued an associated Local Coverage Article (LCA) with coding instructions and limitations on coverage. Each of these states participate in the MolDX program administered by Palmetto GBA. The coverage change takes effect April 17, 2022 in all states within each jurisdiction...​[READ MORE]​ Join the discussion:Urology Coding and Reimbursement Group - Join for free and ask your questions, and share your wisdom.Click Here to Start Your Free Trial of AUACodingToday.com 

Thanks for tuning in to the Armor Men's Health Hour Podcast today, where we bring you the latest and greatest in urology care and the best urology humor out there.In this segment, Dr. Mistry and Donna Lee talk about a subject much dreaded by aging men: the radical prostatectomy. While no one wants to have their prostate removed, recent medical advances have seriously improved surgery outcomes and reduced the well-known side effects of impotence and incontinence. Dr. Mistry and his team of surgeons frequently perform radical prostatectomies robotically using state-of-the-art tools. If you are interested in having a robotic prostatectomy, finding a surgeon who is experienced in this operation and comfortable performing it is key. Whether you've heard horror stories from family or friends who have had their prostate removed and are afraid of a similar outcome or you've had a cancer diagnosis and don't know what your options are, call us today!This episode was previously aired on 6.5.21. Don't forget to like, subscribe, and share us with a friend! As always, be well!Check our our award winning podcast!https://blog.feedspot.com/sex_therapy_podcasts/https://blog.feedspot.com/mens_health_podcasts/Dr. Mistry is a board-certified urologist and has been treating patients in the Austin and Greater Williamson County area since he started his private practice in 2007.We enjoy hearing from you! Email us at armormenshealth@gmail.com and we'll answer your question in an upcoming episode!Our Locations:Round Rock Office970 Hester's Crossing RoadSuite 101Round Rock, TX 78681South Austin Office6501 South CongressSuite 1-103Austin, TX 78745Lakeline Office12505 Hymeadow DriveSuite 2CAustin, TX 78750Dripping Springs Office170 Benney LaneSuite 202Dripping Springs, TX 78620

In this episode we discuss robotic radical prostatectomy as a treatment option for prostate cancer. Over the last 20 years, robotic radical prostatectomy has become the gold standard for surgical management of prostate cancer.  While the concept of robotic surgery is exciting, it also leads to a lot of questions amongst men faced with a decision as to how to treat their prostate cancer.  How does the procedure actually work?  Is the surgery performed by a surgeon or by a robot?  What are the risks and side effects? Are all men good candidates for the procedure.  And, of course, how effectively does it cure prostate cancer?  To answer these questions we turned to Dr. Alexander Kutikov.  Dr. Kutikov is a Professor and Chief of Urology and Urologic Oncology at the Fox Chase Cancer Center. He is a board certified, academic urologic surgical oncologist who treats urologic tumors using minimally invasive (robotic / laparoscopic) and traditional surgical techniques. Dr. Kutikov received an MD from Harvard Medical School's Harvard-MIT Health Sciences and Technology Program in 2003. He then completed his Urologic residency training at the University of Pennsylvania in 2008 and finished a 2-year Society of Urologic Oncology fellowship at the Fox Chase Cancer Center in Philadelphia, USA. He has co-authored more than 170 original manuscripts in peer-reviewed journals and has published chapters in leading urologic textbooks as well as holding leadership positions both in the American College of Surgeons and the American Urological Association.

Dr. Sepehr Nowfar is board-certified by the American Board of Urology and serves in many areas of physician leadership. He brings an extensive background in general urology, combined with specialized training in urologic surgical oncology and advanced endoscopic, laparoscopic, and robotic surgery. In this episode, Dr. Nowfar joins the show to discuss all things surgery when it comes to prostate cancer. You can find show notes and more information by clicking here: https://cancerfromatoz.com/episodes/11  

In this episode we discuss robotic simple prostatectomy for men with urinary symptoms due to an enlarged prostate (BPH).  In prior episodes, we have discussed several treatment options for BPH including medications and a variety of procedures.  But what if the medications don't work and the prostate is just too big to qualify for minimally invasive surgical procedures?  Fortunately, robotic simple prostatectomy has emerged as a potential option for men in this situation.  But, how does this procedure work?  What are the risks?  How long is the recovery?  And how successful is it in relieving urinary symptoms of BPH for the long haul.  To help us answer these questions, we are fortunate to be joined by Dr. Daniel Eun.  Dr. Eun is a professor of urology and director of the Robotic Urologic Surgery Clinical Fellowship Program at the Lewis Katz School of Medicine at Temple University.  He is also the chief of robotic surgery and the director of minimally invasive robotic urologic oncology and reconstructive surgery at Temple University Hospital.  Aside from performing over 1000 robotic surgical procedures, Dr Eun has also extensively published peer-reviewed journal articles, book chapters, and video teaching guides and travels nationally and internationally as an invited lecturer to present research and to train robotic surgeons.

In the episode we hear from Chris Tubbs who is a husband, father and has a PhD in Biochemistry. If that wasn't enough, Chris also invests in real estate, has started a charity walk that grew to the point he had to enlist help to manage it and is a Prostate Cancer survivor. After being diagnosed with cancer, Chris started journaling as a way to document his thoughts and emotions. After Chris shared his journal with a few close friends they encouraged him to transition to blogging so that he could share his experience publicly in the hopes that someone who might be facing a similar situation would find comfort in the knowledge they aren't only facing adversity.Chris shares that during his junior and senior years of high school in Los Angeles, CA he was ranked in the Top 25 swimmers in the city. He then took a 25 year hiatus before finding Triathlon in his mid-40s. We spend a few minutes talking about family, high school swimming, and Chris sets me straight on how long it takes to get a PhD. I ask Chris if Ironman would allow my idea on how to get faster in the pool by getting cosmetic surgery. We talk about Chris' blog journeyto140. Chris reminds us of the importance of documenting our progress as most progress comes in small incremental steps that are more obvious when viewed over a longer period of time. Chris a 2X Ironman Finisher with both of his races being at Ironman Florida. Chris explains how he came to race Florida twice through a series of deferrals and needing time for his body to recover. Being completely open about all things, Chris shares that he was diagnosed with Prostate Cancer and had a complete Prostatectomy just weeks after completing Ironman Florida in 2020. Chris acknowledges that considers himself lucky as his Cancer was initially discovered through a blood test when he went in for a “regular” physical.Because Chris raced Ironman Florida in back to back years, I take to opportunity to ask him to compare the differences from one year to the next. Chris walks me through his experience this year on the swim. At one point he thought he might have been swept out to sea as he lost sight of all the buoys and the pier that the swim course follows. Chris is very honest about how his body is still recovering from surgery and spent more time than intended off the bike. Because of his experience with the change in weather the days leading into race weekend, I agree to pack a light jacket regardless of the venue moving forward.After getting distracted talking about Ironman 70.3 Texas, Chris explains how he had planned to attack the run course this year with a much different plan than in 2020. Chris' plan to run at a slower pace while walking the Aid Stations got him to mile 18 but soon found himself walking more than running. Luckily for Chris, another athlete whom he had run with earlier in the day, provided the encouragement that was needed to finish strong.We discuss the benefits of talking to others on the run course. Chris admits he enjoys the connection he is able to make through the community that is triathlon. Because I follow Chris on Instagram, I know that he has added Yoga to his workout routine, so I put him on the spot and ask him to share his favorite yoga pose. Because the Warrior pose is what gives him the most challenge, Chris list it as his favorite at this moment. We agree that adding yoga to your triathlon training is key to developing core strength.We talk about Chris' customized QR tri bike, and I ask him his thoughts on those athletes that ride a non-traditional bike to increase the difficulty of the race. We laugh at the notion of someone riding a bike from the early 1900s. And Chris share what's on the race schedule for 2022.You can follow Chris on Instagram @journeytoironmantexas

Dr. Aditya Bagrodia interviews urologist Dr. Steve Hudak from UT Southwestern Medical Center about post-prostatectomy incontinence. They cover an array of topics including, incontinence evaluation, managing patient expectations, kegel exercises and pelvic floor therapy, and slings vs. artificial urinary sphincters. --- EARN CME Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs: https://earnc.me/pk6zeG --- SHOW NOTES In this episode of BackTable Urology, Dr. Aditya Bagrodia discusses post-prostatectomy incontinence with UT Southwestern urologist Dr. Steve Hudak. Urinary leakage is very common after the post-prostatectomy catheter is removed. Although the majority of men will regain continence in the long-term, 10-20% will need further treatment for their incontinence. First, Dr. Hudak emphasizes the importance of comprehensive incontinence evaluation in the clinic. He prefers to schedule two different appointments to make incontinent patients feel more comfortable; he will only take a good medical history in the first appointment and save the cystoscopy and more provocative maneuvers for the second appointment. Dr. Hudak's clinical evaluation consists of a variety of quality of life questions as well as specific questions about pad weight, pad quantity, and pad size. Further incontinence treatment can be non-surgical or surgical. Among the non-surgical therapies, Dr. Hudak suggests Kegel exercises and pelvic floor physical therapy. Dr. Hudak encourages urologists to explore these non-surgical options with their patients first. When deciding to move onto surgical intervention, Dr. Hudak explains that the trajectory of improvement is more important than a generalized timeframe because surgery is most effective in the time period in which a patient's progress plateaus. Pelvic slings and the artificial urethral sphincter (AUS) are the two most common surgical techniques for resolving urinary incontinence. Urologists must take into account their incontinence patients' medical status, progress, goals, severity of leakage, and age before deciding whether to place a pelvic sling or an AUS. Dr. Hudak notes that the AUS is preferable in patients with severe arthritis, patients who have received radiation therapy, and patients with gravity incontinence. Two possible complications with the AUS are infection and erosion, as the AUS is a mechanical device with a half-life of seven to ten years. The sling is preferable in patients with mild incontinence, as it is a less invasive surgical technique and has a minimal risk of infection. In some cases, it is possible that post-prostatectomy patients will also need post-operative radiation, so it is crucial to time the incontinence surgery correctly. Dr. Hudak recommends performing sling surgery before radiation, but concedes that radiation treatment should not be delayed solely due to incontinence surgery. His rule of thumb is: perform surgery if radiation is presumed, but not planned. If he has to perform surgery after radiation therapy, he waits at least 3-6 months after radiation to do so, allowing his patients to restore to their baseline levels of health.