BackTable Urology

What opportunities and challenges does private equity bring to urology practices, and how can physicians engage in ways that strengthen their practice and preserve clinical priorities? On this episode of BackTable Urology, Dr. Ruchika Talwar interviews Dr. Benjamin Lowentritt of Chesapeake Urology and United Urology Group to unpack the realities of private equity involvement in medicine. They discuss the motivations behind consolidation, the role of management services organizations, and strategies for building mutually beneficial partnerships while upholding physician autonomy and patient care.

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Timestamps

00:00 - Introduction02:58 - Why Urology Drew Private Equity07:06 - Bad Headlines vs. Reality11:14 - MSOs and Contracts Explained15:24 - Timelines and After Private Equity22:47 - Efficiency and Autonomy Fears27:15 - Why Private Equity Gets Vilified31:23 - Young Urologist Job Market35:42 - Advice for New Grads40:26 - Urology in 2035 and Fair Critiques of Private Equity44:40 - Closing Thoughts

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More about this episode

Dr. Lowentritt outlines the history of private equity in healthcare, noting that consolidation predated private equity and was driven by payer and hospital market power, reimbursement pressure, administrative burden, staffing, and capital needs. He distinguishes private equity’s role in hospitals from physician practice management, describing management services organization (MSOs) as structures that handle back-office functions and provide capital while preserving physician control over patient care and local governance. He also discusses private equity’s limited investment timeline, shaped by the ultimate goal of selling a profitable company, and potential end-states such as acquisition or public ownership, reflecting on his own experiences with United Urology’s acquisition. The conversation further explores recruiting new graduates, evolving partner tracks, mentorship, and maintaining physician leadership to preserve independent practice.

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Resources

Dr. Benjamin Lowentritt is the current treasurer of LUGPA (Large Urology Group Practice Association) https://www.lugpa.org/, the Chesapeake Urology group (https://chesuro.com/), and United Urology Group (which was acquired by One Oncology

https://www.oneoncology.com/UnitedUrologyGroup/). One Oncology eventually was acquired by Cencora (https://www.cencora.com/). Dr. Benjamin Lowentritt email: blowentritt@chesuro.com

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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.

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With multiple clinical trials evaluating PARP inhibitor combinations, how do clinicians determine the best approach for advanced prostate cancer? In this episode of BackTable Urology, Dr. Alan Tan is joined by Dr. Rana McKay and Dr. Emmanuel Antonarakis to discuss how evolving evidence, patient selection, timing, toxicity, and genetic testing are shaping the use of PARP inhibitor combinations in clinical practice.

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This podcast is supported by an educational grant from Pfizer.

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Timestamps

00:00 - Introduction02:51 - PARPi Basics14:12 - Major Study Differences19:00 - Timing and Selection of PARPi Combinations26:39 - Case: Somatic BRCA2 loss and mHSPC35:51 - Case Continued: BRCA2 Reversion39:57 - BRCAAway Study42:59 - Takeaways from the 2026 APCCC

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More about this episode

The conversation reviews lessons learned from major clinical trials, including PROpel, MAGNITUDE, TALAPRO-2, and AMPLITUDE, and addresses how these studies inform real-world treatment choices. The doctors dig into case examples, such as BRCA2 loss and reversion, and highlight practical strategies for using germline and somatic testing to personalize care. Key insights from the 2026 Advanced Prostate Cancer Consensus Conference are also shared, emphasizing the importance of precision medicine in this rapidly evolving field.

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Resources

Study on Olaparib Plus Abiraterone as First-line Therapy in Men With Metastatic Castration-resistant Prostate Cancer (PROpel) https://clinicaltrials.gov/study/NCT03732820

A Study of Niraparib in Combination With Abiraterone Acetate and Prednisone Versus Abiraterone Acetate and Prednisone for Treatment of Participants With Metastatic Prostate Cancer (MAGNITUDE) https://clinicaltrials.gov/study/NCT03748641?tab=study

Talazoparib + Enzalutamide vs. Enzalutamide Monotherapy in mCRPC (TALAPRO-2) https://clinicaltrials.gov/study/NCT03395197

A Study of Niraparib in Combination With Abiraterone Acetate and Prednisone Versus Abiraterone Acetate and Prednisone for the Treatment of Participants With Deleterious Germline or Somatic Homologous Recombination Repair (HRR) Gene-Mutated Metastatic Castration-Sensitive Prostate Cancer (mCSPC) (AMPLITUDE) https://clinicaltrials.gov/study/NCT04497844

BRCAAway: A randomized phase 2 trial of abiraterone, olaparib, or abiraterone + olaparib in patients with metastatic castration-resistant prostate cancer (mCRPC) bearing homologous recombination-repair mutations (HRRm) https://pubmed.ncbi.nlm.nih.gov/39115414/

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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

Is pelvic lymph node dissection still necessary in the era of PSMA PET imaging? In this episode of BackTable Urology, Dr. Ruchi Talwar interviews Dr. Kirsten Greene about how advanced imaging is influencing decisions for radical prostatectomy. They examine the strengths and limits of PSMA PET, the risks and benefits of PLND, and why careful, evidence-based decision-making remains essential.

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Timestamps

00:00 - Introduction03:12 - Risk Calculators and Consent04:39 - Nomograms vs. Complications09:57 - Endpoints That Matter11:38 - PSMA PET Strengths and Limits13:51 - Negative PET Decision-Making15:08 - Positive PET and Multimodal Care18:02 - Fluorescence Guided Surgery19:10 - Counseling on Complications22:27 - Preventing Lymphocele24:56 - How Lahey Wrap Works26:45 - Future Mapping and Therapy28:47 - Research Gaps and Dogma31:07 - Key Pearls and Wrap Up

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More about this episode

Dr. Greene explains her approach using MSK and Briganti nomograms alongside PSMA PET, noting that PET scans may miss small nodal disease and quality varies between centers. She emphasizes PLND as a staging tool rather than a curative procedure, outlining potential complications like lymphocele, lymphedema, vascular and ureteral injury, and neuropraxia. The episode highlights her shared decision-making process, surgical techniques for limiting risk, and the importance of multimodal planning, especially for PET-positive nodal disease. Dr. Greene also shares practical tips for lymphocele prevention, including the use of metal clips and the Lahey wrap.

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Resources

Different lymph node dissection ranges during radical prostatectomy for patients with prostate cancer: a systematic review and network meta-analysishttps://pubmed.ncbi.nlm.nih.gov/36872312/

Limited versus Extended Pelvic Lymph Node Dissection for Prostate Cancer: A Randomized Clinical Trial https://pubmed.ncbi.nlm.nih.gov/33865797/

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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

How can clinics minimize toxicity and maximize outcomes in intravesical bladder cancer treatment? In this episode of BackTable Urology, host Dr. Vignesh Packiam talks with nurse practitioners Mary Dunn (UNC) and Meredith Donahue (Vanderbilt) about how advanced practice providers (APP) workflows and hands-on management are transforming care for non-muscle-invasive bladder cancer. The discussion highlights innovative strategies for symptom management, patient education, catheter techniques, and streamlined operational protocols across both established and emerging intravesical therapies.

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This podcast is supported by an educational grant from Johnson & Johnson.

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Timestamps

00:00 - Introduction04:25 - Non Drug Symptom Tips09:39 - Day Of Treatment Clearance14:50 - Post Treatment Triage20:36 - Treatment Fatigue Strategies24:48 - Pelvic Floor And IC Tools27:33 - Teamwork Final Pearls

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More about this episode

They share individualized pharmacologic and non-pharmacologic approaches for managing lower urinary tract symptoms, such as NSAIDs, anticholinergics, beta-3 agonists, Pyridium, timed voiding, avoidance of irritants, and constipation management. The episode covers patient education resources from the Bladder Cancer Advocacy Network (BCAN), catheterization techniques tailored to patient needs, and a gravity installation method to reduce spasms. The conversation also reviews day-of-treatment clearance and triage protocols, operational considerations for new agents like Enlexo, Adstiladrin, and gemcitabine/docetaxel, as well as financial workflows that prevent drug wastage. Additional topics include managing cumulative bladder toxicity, pelvic floor PT, addressing treatment fatigue, and integrating multifactorial evaluation and exercise into patient care.

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Resources

Bladder Cancer Advocacy Network (BCAN) Basic Handbook & Patient Resources

https://bcan.org/bladder-cancer-basics-handbook/

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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

What happens when urologists look beyond the clinic and take on leadership in the life sciences industry? In this episode of BackTable Urology, host Dr. Raj Pruthi talks with Dr. Kelly Parsons and Dr. Pat Keegan about their journeys from academic urology to executive roles in biotech and pharma. They discuss what motivated their transitions, how physician expertise adds value in industry, and the realities of life outside of traditional clinical practice.

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Timestamps

00:00 - Introduction05:36 - Choosing a Non-Clinical Path11:07 - Reactions from Mentors and Peers14:31 - What Feels Most Fulfilling18:31 - A Typical Week in Biotech26:04 - Working with Investors31:21 - Additional Degrees and MBA Debate35:31 - Is it Risky to Leave Clinical Practice?44:13 - Networking and Next Steps47:59 - Wrap Up

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More about this episode

The conversation explores the day-to-day work of industry leaders, the impact of advanced degrees like MBAs, and the importance of networking for physicians considering a nonclinical path. Drs. Parsons and Keegan reflect on the challenges and rewards of leaving clinical medicine, the support and reactions from mentors and peers, and what they miss most about patient care. They also share practical advice for urologists and other specialists who are curious about new career opportunities beyond the exam room.

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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