BackTable Urology

Can a drug-eluting bladder device change the treatment algorithm for BCG-unresponsive non–muscle invasive bladder cancer (NMIBC)? In this episode of BackTable Urology, Dr. Ruchi Talwar interviews Dr. Sarah Psutka to explore the emerging role of a novel intravesical device that delivers sustained gemcitabine therapy for patients refusing or ineligible for cystectomy. They highlight new FDA-approved treatment options, real-world workflow considerations, and the clinical potential for continuous intravesical chemotherapy in a crowded therapeutic landscape.

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This podcast is supported by

Johnson & Johnson

https://www.inlexzohcp.com/

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Timestamps

00:00 - Introduction02:40 - Why Focus on TAR-20005:35 - Device Basics07:05 - Dosing Schedule Explained11:17 - SUNRISE-01 Trial Results15:07 - Patient Selection and Contraindications20:52 - Indications for Device Removal23:26 - Clinic Workflow Learning Curve25:56 - Tips for Insertion and Device Deployment28:52 - Cystoscopy Findings and Surveillance Protocol32:16 - Treatment Sequencing38:43 - Future Trial and Research Directions45:16 - Biomarkers, AI, and Personalizing Care46:35 - Cost, Supportive Care, and Patient Burden48:42 - Closing Thoughts

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More about this episode

The conversation dives into patient selection, preparation, and side effect management for TAR-200, as well as the key findings from the SUNRISE-01 trial. Dr. Psutka discusses dosing schedules, when to remove the device, and how to handle complications like UTI, hematuria, and LUTS. The episode also covers surveillance protocols, the impact on clinic operations, and the importance of balancing vigilant cancer surveillance with patient burden. Finally, they touch on future directions, including biomarkers, AI-assisted pathology, and optimizing the timing of cystectomy and supportive care for a more personalized approach to NMIBC.

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Resources

TAR-200 for Bacillus Calmette-Guérin–Unresponsive High-Risk Non–Muscle-Invasive Bladder Cancer: Results From the Phase IIb SunRISe-1 Studyhttps://ascopubs.org/doi/10.1200/JCO-25-01651 SUO 2024: SunRISe-5: A Phase III, Randomized, Open-label Study of TAR-200 Compared with Intravesical Chemotherapy After Bacillus Calmette-Guerin in Recurrent, High-risk, Non-muscle Invasive Bladder Cancer SUO 2024: SunRISe-5: A Phase III, Randomized, Open-label Study of TAR-200 Compared with Intravesical Chemotherapy After Bacillus Calmette-Guerin in Recurrent, High-risk, Non-mushttps://www.urotoday.com/conference-highlights/suo-2024/suo-2024-bladder-cancer/156723-suo-2024-sunrise-5-a-phase-iii-randomized-open-label-study-of-tar-200-compared-with-intravesical-chemotherapy-after-bacillus-calmette-guerin-in-recurrent-high-risk-non-muscle-invasive-bladder-cancer.htmlcle Invasive Bladder Cancer

Gemcitabine Intravesical System Plus Cetrelimab or Cetrelimab Alone as Neoadjuvant Therapy in Muscle-Invasive Bladder Cancer: SunRISe-4 Primary Analysis and Biomarker Resultshttps://ascopubs.org/doi/10.1200/JCO-25-02382

INLEXZO - SunRISe-3 Studyhttps://www.jnjmedicalconnect.com/products/inlexzo/medical-content/inlexzo-sunrise-3-study

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

Download the free BackTable app to get early access to new episodes, cases, and courses curated by physicians in your specialty.

► https://www.backtable.com/app

The definitive treatment for adult acquired buried penis is surgery, but successful treatment depends on having a well-coordinated network of patient support, multidisciplinary care teams, and reconstructive urologic surgery expertise. This episode of Backtable Urology overviews this multifaceted disease and dives into reconstructive surgery techniques, featuring Dr. George Koch and Dr. Paul Rusilko.

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Timestamps

00:00 - Introduction04:10 - History of Buried Penis Treatment08:47 - Grafts Versus Flaps11:34 - Hidden Pathologies and Informed Consent13:46 - Research and Insurance Approval18:24 - Delayed Care and Disease Burden22:31 - Deciding When to Operate and Temporizing Procedures30:23 - Building Referral Networks33:13 - Future Directions36:42 - Infection Risk 41:15 - Technique Evolution45:57 - Preop Evaluation Essentials50:50 - Intraop Keys to Success and Graft Protection59:26 - Postop Pathway and Teamwork01:02:54 - W-Plasty Video Walkthrough01:13:52 - Wrap Up

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More about this episode

The doctors explore the nuances of surgical treatment, emphasizing the importance of thorough preoperative counseling given the high likelihood of unexpected intraoperative findings and the need to adjust the surgical plan. Dr. Rusilko also discusses the broader burden of disease, including depression, strictures, occult penile cancer, and the high rate of postoperative complications, most of which are low grade. He stresses that earlier referral may improve patient care. The episode concludes with practical surgical tips, guidance on building a buried penis practice, strategies for setting realistic recovery expectations, and an in-depth case review of his novel W-plasty technique.

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Resources

W-plasty: A novel procedure for the repair of adult-acquired buried penis https://doi.org/10.1016/j.urolvj.2023.100219

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

Download the free BackTable app to get early access to new episodes, cases, and courses curated by physicians in your specialty.

► https://www.backtable.com/app

More neuromodulation options mean more opportunities to personalize care. In this episode, Dr. Ken Peters and Dr. Tracey Wilson join Dr. Jannah Thompson to discuss the latest implantable tibial nerve stimulation and sacral neuromodulation technologies for OAB and UUI. They compare available devices, share practical insights on patient selection, and explore how shared decision making, advanced practice providers, and equitable access influence treatment adoption.

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Get the BackTable apphttps://www.backtable.com/app

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This podcast was developed in collaboration with

Society of Urodynamics, Female Pelvic Medicine & Urogenital Reconstruction (SUFU)

https://sufuorg.com/home.aspx

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Timestamps

00:00 - Introduction07:59 - Overview of Nerve Stimulation Therapies13:22 - Case #122:00 - Case #228:23 - Nuspera 34:21 - APPs in Practice39:21 - Reimbursement Roadblocks47:03 - Multimodal Therapy49:51 - Case #356:06 - Final Advice

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Resources

Randomized trial of percutaneous tibial nerve stimulation versus Sham efficacy in the treatment of overactive bladder syndrome: results from the SUmiT trialhttps://www.auajournals.org/doi/10.1016/j.juro.2009.12.036

Neuspera Medical Announces 12-Month Pivotal Trial Results for the Company’s Integrated Sacral Neuromodulation System for Urinary Urge Incontinencehttps://neuspera.com/neuspera-medical-announces-12-month-pivotal-trial-results-for-the-companys-integrated-sacral-neuromodulation-system-for-urinary-urge-incontinence/

Racial and Socioeconomic Factors Influence Utilization of Advanced Therapies in Commercially Insured OAB Patients: An Analysis of Over 800,000 OAB Patientshttps://www.sciencedirect.com/science/article/pii/S0090429520305574?via%3Dihub

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

Download the free BackTable app to get early access to new episodes, cases, and courses curated by physicians in your specialty.

► https://www.backtable.com/app

Can focal therapy truly “thread the needle” between active surveillance and radical prostate cancer treatment? In this episode of BackTable Urology, host Dr. Tiwa Akinsola is joined by Dr. George Schade from the University of Washington to explore focal therapy as a middle ground between active surveillance and radical treatments. Dr. Schade reviews non-radiation energy modalities including HIFU, TULSA/HI-DU, cryotherapy, and irreversible electroporation, highlighting patient selection, institutional experience, technical nuances, and quality-of-life outcomes from recent trials.

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Timestamps00:00 - Introduction02:09 - Overview of Focal Therapy Modalities04:46 - Deciding Between HIFU and IRE06:56 - Evidence and Trials09:40 - Counseling Patients on Outcomes12:09 - Building a Focal Therapy Program16:12 - Navigating Insurance and Appeals21:48 - Managing Large Glands And TURP25:12 - Preop Workup Essentials and OR Workflow32:32 - Overcoming the Learning Curve35:52 - PostOp Recovery and Surveillance39:04 - Options for Managing Recurrence42:44 - Challenges with Repeat Ablation44:56 - Final Takeaways

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More about this episodeThe conversation covers candidate selection and confirmatory biopsy, perioperative technique and recovery, and ongoing surveillance with PSA, MRI, and biopsy. Dr. Schade also discusses challenges with insurance approvals, building a focal therapy practice, and options for managing recurrence, including repeat ablation, surgery, or radiation. The episode examines how to balance cancer control with quality of life and reviews the evolving evidence base supporting focal therapy’s role in prostate cancer treatment.

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Resources

Irreversible Electroporation for Prostate Tissue Ablation in Patients with Intermediate-risk Prostate Cancer: Results from the PRESERVE Trial:https://www.sciencedirect.com/science/article/pii/S030228382500346X

Focal therapy of localized prostate cancerhttps://pubmed.ncbi.nlm.nih.gov/35996758/

Focal Therapy for Prostate Cancer: Available Technologies, Patient Selection, Follow-Up Protocols and Reported Outcomeshttps://pubmed.ncbi.nlm.nih.gov/41339218/

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

Download the free BackTable app to get early access to new episodes, cases, and courses curated by physicians in your specialty.► https://www.backtable.com/app

As bladder cancer treatment options expand, so do the challenges of delivering them in real-world practice. On this episode of BackTable Urology, community urologic oncologist Dr. Adam Gadzinski joins Dr. Ruchika Talwar to discuss how evolving therapies for non–muscle-invasive bladder cancer (NMIBC) are changing the landscape for both patients and providers. They explore the financial, logistical, and workflow hurdles to adopting new treatments in community settings, as well as the unique opportunities for expanding access through local clinical trials.

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Get the BackTable apphttps://www.backtable.com/app

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This podcast is supported by

Urogenhttps://www.zusduri.com

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Timestamps

00:00 - Introduction02:51 - Delivering Bladder Cancer Care in the Community 09:08 - Navigating Treatment Choices 13:05 - Patient Expectations and Insurance Coverage19:01 - Ablation Strategies for Low and Intermediate Risk22:34 - Making Therapies Community Friendly27:12 - Launching Community Trials31:08 - Referrals and Community Practice Advice36:36 - Cystectomy Counseling Pearls44:46 - Closing Takeaways

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More about this episode

The conversation covers decision-making for bladder-preserving therapies, radical cystectomy, and trimodal approaches, along with strategies for guiding patients through these complex choices. Dr. Gadzinski shares insights on navigating insurance, launching community trials, and sustaining practice growth while maintaining high-quality care. The episode also offers practical advice on referrals, patient counseling, and finding the right practice environment for long-term success in bladder cancer care.

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Resources

Bladder Cancer Basics Handbookshttps://bcan.org/bladder-cancer-basics-handbook/

Wellprepthttps://wellprept.com/foundation

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

Download the free BackTable app to get early access to new episodes, cases, and courses curated by physicians in your specialty.

► https://www.backtable.com/app