BackTable Urology

Vaginal rejuvenation is often misunderstood, misrepresented, and overdue for honest conversations in medicine. In this crossover episode between BackTable Urology and BackTable OBGYN, Dr. Nirit Rosenblum, a urology and OBGYN professor at NYU Langone Medical Center, is joined by Dr. Karyn Eilber, Chair of the Cedars-Sinai Medical Group Department of Surgery, and Dr. Ariana Smith, Chief of Urology at Pennsylvania Hospital. Together, they bring a multidisciplinary lens to one of the most misunderstood areas of women’s health.

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SYNPOSIS

The discussion revolves around the broad definition of vaginal rejuvenation, distinguishing between medical and cosmetic interventions. They address common misconceptions, the roles of different health professionals, and emphasize the importance of pelvic floor physical therapy and the appropriate use of systemic and vaginal estrogen therapy. The conversation also highlights critical gaps in research surrounding laser and radiofrequency interventions, underscoring the need for stronger evidence, clearer patient education, and continued advocacy around menopause care and sexual function.

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TIMESTAMPS

00:00 - Introduction02:07 - Defining Vaginal Rejuvenation04:31 - Common Procedures and Misconceptions10:00 - Insurance and Coverage of Procedures12:00 - Laser and Radiofrequency Therapies18:06 - Vaginal Estrogen and Lift of Black Box Warning19:55 - The Role of Systemic Hormone Therapy26:52 - Vaginal Rejuvenation Misconceptions32:17 - Pelvic Floor Physical Therapy and Timing of Procedures34:20 - Regional Variations in Therapeutic Availability38:36 - Gender Inequity in Healthcare40:12 - Final Thoughts

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RESOURCES

Joint Report on Terminology for Cosmetic Gynecologyhttps://journals.lww.com/fpmrs/abstract/2022/06000/joint_report_on_terminology_for_cosmetic.2.aspx

Gender affirming surgery is becoming a more visible part of urologic practice, raising practical questions about surgical training, case volume, and multidisciplinary support. In this episode of BackTable Urology, Dr. Eric Walton of The Ohio State University joins Dr. George Koch to examine how gender affirming surgery is being integrated into contemporary urology. Dr. Walton discusses his path into reconstructive urology, structural barriers that limit patient access, and why expanding surgical training pathways is central to closing gaps in care.

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SYNPOSIS

The conversation explores fellowship models, academic versus private practice settings, and the role of multidisciplinary teams in supporting surgical programs. Practical considerations around patient screening, care coordination, and insurance are addressed, reframing gender affirming surgery as a core component of modern urologic care rather than a subspecialty outlier.

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TIMESTAMPS

00:00 - Introduction00:52 - Journey to Gender Affirming Surgery03:29 - Specialized Training in Gender Surgery09:34 - Building a Gender Surgery Program27:54 - Providing Competent and Affirming Care32:54 - Future of Gender Affirming Surgery in Urology39:58 - Final Thoughts and Advice

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RESOURCES

World Professional Association for Transgender Health (WPATH) Standards of Care:https://wpath.org/publications/soc8/

What determines success in the early years of urology practice? In this BackTable Urology episode, produced in collaboration with the Society of Women in Urology (SWIU), this episode of the BackTable Urology Podcast brings on Dr. Raveen Syan, Dr. Helen Hougen, and host Dr. Michelle Van Kuiken to discuss the transition to early career practice in urology.

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SYNPOSIS

Together, the doctors explore the realities that new attendings face, from building efficient clinical systems to managing complications and building support networks. Drawing from personal experience, the guests offer practical guidance on mentorship, recognizing when a role or environment may no longer be the right fit, and building a sustainable, fulfilling professional life.

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TIMESTAMPS

00:00 - Introduction02:54 - Early Challenges06:13 - Finding Support and Building Systems11:49 - Balancing Work and Personal Life15:52 - The Importance of Saying Yes Early On18:16 - Mentorship and Finding Allies22:29 - Decision Making and Cognitive Biases24:36 - Managing Complications27:31 - Prioritizing Clinical Goals38:45 - Knowing When to Leave42:09 - Final Reflections

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RESOURCES

Annie Dukehttps://www.annieduke.com/

Aristotle’s 10 Rules for a Good Lifehttps://www.theatlantic.com/ideas/archive/2023/08/aristotle-10-rules-happy-life/674905/

Personal Productivity: How to work effectively and calmly in the midst of chaoshttps://www.cvdtraining.pitt.edu/wp-content/uploads/2023/01/Johnson2009_Essays.pdf

Understanding Academic Medical Centers: Simone’s Maximshttps://aacrjournals.org/clincancerres/article/5/9/2281/287826/Understanding-Academic-Medical-Centers-Simone-s

The microhematuria guideline just changed. Here’s what clinicians need to know. In this episode of BackTable Urology, Dr. Daniel Barocas (Vanderbilt University) joins host Dr. Ruchika Talwar to break down the 2025 updates to the American Urological Association (AUA) Microhematuria Guideline and why these changes matter in everyday practice.

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SYNPOSIS

They walk through the evidence driving the updates, including revised risk stratification and the expanding role of urinary biomarkers. The conversation highlights how these recommendations affect patient evaluation, imaging decisions, and shared decision-making, with an emphasis on balancing cancer detection, patient burden, and responsible use of healthcare resources.

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TIMESTAMPS

00:00 - Introduction01:33 - What Prompted the Guidelines Update?02:59 - Challenges of a Negative Microhematuria Evaluation06:21 - Initial Evaluation Guidelines07:58 - Risk Stratification18:11 - Imaging in Hematuria Workups21:16 - Use of Urinary Biomarkers33:25 - Potential Future Guideline Updates37:17 - Takeaways for Urologists

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RESOURCES

AUA/SUFU Microhematuria Guidelinehttps://www.auanet.org/guidelines-and-quality/guidelines/microhematuria

How are local and international teams working together to offer reconstructive urology in resource-constrained settings? This week on BackTable Urology, Dr. Jane Kurtzman (University of Utah) joins Dr. George Koch (Ohio State University) to discuss the realities, challenges, and opportunities of international surgical work.

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SYNPOSIS

They break down how global urology programs differ in structure, why cultural understanding is foundational, and what sustainable models look like in practice. The conversation highlights unmet reconstructive needs in low- and middle-income countries, evolving models for subspecialty development, and the growing role of long-term partnerships in shaping the future of global urology.

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TIMESTAMPS

0:00 - Introduction4:46 - Understanding Healthcare Systems Abroad8:12 - Need for Global Urology13:39 - Role of Reconstructive Urology Abroad21:57 - Current Programs27:20 - GU Impacts39:35 - Building Capacity through Training49:00 - Past Successes58:38 - Future Directions1:14:12 - Getting Involved

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RESOURCES

GU Impactshttps://medicine.utah.edu/surgery/urology/gu-impacts

IVUMedhttps://www.ivumed.org/

Urology Care Foundationhttps://www.urologyhealth.org/humanitarianism