Episodes

  • Ep. 285 Guide to Vaginal Rejuvenation: Myths, Realities, & Medical Insights with Dr. Ariana Smith and Dr. Karyn Eilber

    Ep. 285 Guide to Vaginal Rejuvenation: Myths, Realities, & Medical Insights with Dr. Ariana Smith and Dr. Karyn Eilber
    Jan 20 2026
    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. --- 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. --- 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 --- RESOURCES Joint Report on Terminology for Cosmetic Gynecologyhttps://journals.lww.com/fpmrs/abstract/2022/06000/joint_report_on_terminology_for_cosmetic.2.aspx
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    42 mins
  • Ep. 284 Integrating Gender Affirming Care Into Urology with Dr. Eric Walton

    Ep. 284 Integrating Gender Affirming Care Into Urology with Dr. Eric Walton
    Jan 13 2026
    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. --- 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. --- 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 --- RESOURCES World Professional Association for Transgender Health (WPATH) Standards of Care:https://wpath.org/publications/soc8/
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    47 mins
  • Ep. 283 Early Careers in Urology: Strategies for Success with Dr. Raveen Syan and Dr. Helen Hougen

    Ep. 283 Early Careers in Urology: Strategies for Success with Dr. Raveen Syan and Dr. Helen Hougen
    Jan 6 2026
    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. --- 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. --- 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 --- 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
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    47 mins
  • Ep. 282 Updates to Microhematuria Workup Guidelines with Dr. Daniel Barocas

    Ep. 282 Updates to Microhematuria Workup Guidelines with Dr. Daniel Barocas
    Dec 30 2025
    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. --- 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. --- 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 --- RESOURCES AUA/SUFU Microhematuria Guidelinehttps://www.auanet.org/guidelines-and-quality/guidelines/microhematuria
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    41 mins
  • Ep. 281 Global Surgery in Urology: Addressing Reconstructive Needs Worldwide with Dr. Jane Kurtzman

    Ep. 281 Global Surgery in Urology: Addressing Reconstructive Needs Worldwide with Dr. Jane Kurtzman
    Dec 23 2025
    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. --- 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. --- 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 --- RESOURCES GU Impactshttps://medicine.utah.edu/surgery/urology/gu-impacts IVUMedhttps://www.ivumed.org/ Urology Care Foundationhttps://www.urologyhealth.org/humanitarianism
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    1 hr and 6 mins
  • Ep. 280 Genomic Classifiers in Bladder Cancer Management with Dr. Carissa Chu

    Ep. 280 Genomic Classifiers in Bladder Cancer Management with Dr. Carissa Chu
    Dec 16 2025
    Can genomic classifiers close the gap between what we see and what a tumor will do? In this episode of BackTable Urology, Dr. Carissa Chu (UCSF) joins Dr. Ruchika Talwar (Vanderbilt) to explore how genomic classifiers are reshaping the way clinicians diagnose and manage bladder cancer. --- This podcast is supported by: Veracytehttps://www.veracyte.com/decipher-bladder --- SYNPOSIS They discuss the limitations of traditional staging systems and how molecular subtyping is providing deeper insight into tumor biology, treatment response, and prognosis. Dr. Chu highlights where these classifiers can be integrated into real-world clinical decision-making today, where the evidence is still emerging, and which ongoing trials may define the next era of precision medicine in urologic oncology. --- TIMESTAMPS 0:00 - Introduction3:01 - Overview of Genomic Classifiers9:34 - Risk Stratification15:22 - Current Evidence for Genomic Classifiers22:07 - Clinical Implications of Biomarkers27:23 - Ordering Genomic Classifiers33:46 - Future Directions37:57 - Final Takeaways --- RESOURCES Alignment of molecular subtypes across multiple bladder cancer subtyping classifiershttps://pubmed.ncbi.nlm.nih.gov/38480079/ GUSTO Trialhttps://fundingawards.nihr.ac.uk/award/NIHR128103
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    41 mins
  • Ep. 279 Parental Leave for Physicians: Challenges & Strategies with Dr. Danielle Velez

    Ep. 279 Parental Leave for Physicians: Challenges & Strategies with Dr. Danielle Velez
    Dec 9 2025
    If you’re navigating pregnancy, postpartum, or return-to-work stress, you are not alone. In this BackTable Urology × SWIU collaboration, Dr. Danielle Velez (Rutgers Health) joins host Dr. Helen Bernie (Indiana University Health) for a candid conversation on navigating parental leave, lactation, and the emotional turbulence of stepping back into clinical practice. Together, they unpack boundary-setting, finding a support system, protecting partnership time, and giving yourself grace through each stage of early parenthood. --- SYNPOSIS The discussion highlights the power of mentorship, community, and transparency, especially for physicians balancing patient care and family life. From combo-feeding and night nannies to sleep deprivation, identity shifts, and the six-month reevaluation rule, both guests share wisdom they hope future trainees and new parents won't have to learn alone. This episode is a reminder that things get easier with time, that asking for help is strength, not weakness, and that paying it forward makes the path smoother for the next generation. --- TIMESTAMPS 00:00 - Introduction03:07 - Support Systems, Mentorship and Maternity Leave09:03 - Navigating Lactation and Pumping19:21 - Lactation Resources25:58 - Finding Your Village and Outsourcing Tasks34:31 - Balancing Parenthood and Career42:26 - Sleep Deprivation and Protecting Your Schedule55:14 - Maintaining Spousal Relationships59:20 - Rebuilding Your Practice Post-Maternity Leave01:03:56 - Final Thoughts and Advice for New Parents --- RESOURCES Dr. MILK (Mothers Interested in Lactation Knowledge) Support Grouphttps://www.drmilk.org/
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    1 hr and 10 mins
  • Ep. 278 Shared Decision Making in GU Cancer Management with Dr. Hung-Jui "Ray" Tan

    Ep. 278 Shared Decision Making in GU Cancer Management with Dr. Hung-Jui "Ray" Tan
    Dec 2 2025
    When it comes to GU cancers, fear and uncertainty often shape a patient’s treatment decisions well before the clinical data does. Dr. Hung-Jui (Ray) Tan of UNC Health sits down with host Dr. Ruchika Talwar to unpack why decision-making around small renal masses, low-risk prostate cancer, and other GU conditions can be so challenging. Dr. Tan explains the concept of decisional conflict, a patient’s internal uncertainty about the “right” course of action, and how it predicts downstream satisfaction and health outcomes. --- SYNPOSIS Dr. Tan shares practical, evidence-based strategies for improving decision-making conversations, from clearer framing to simple visual aids that reduce anxiety. They discuss how patients often perceive much greater risk of metastasis than what data shows, and why “turning down the temperature” is essential before discussing options. They also touch on evolving tools, including AI, that may improve how clinicians communicate risk and support patients through uncertainty. --- TIMESTAMPS 00:00 - Introduction01:02 - Journey to Decision Science05:59 - Research on Decision Making14:41 - Shared Decision Making in Practice22:39 - Resources for Shared Decision Making39:54 - Improving Decision-Making Conversations --- RESOURCES Decisional conflict among patients newly diagnosed with clinical T1 renal masses: a prospective studyhttps://pmc.ncbi.nlm.nih.gov/articles/PMC11233232/ Decisional Quality in Patients With Small Renal Masseshttps://pubmed.ncbi.nlm.nih.gov/29574123/ Impact of renal mass biopsy on decision-making experience for clinical T1 renal masseshttps://pubmed.ncbi.nlm.nih.gov/41151063/ MUSIC Patient and Provider Resources for Shared Decision Makinghttps://musicurology.com/programs/kidney/ P3P - Prostate Cancer Shared Decision Making Resourcehttps://www.p3p4me.org/users/login Best Case/Worst Case Treatment Decision Toolhttps://patientpreferences.org/best-case-worst-case/ Better Conversations Treatment Decision Toolhttps://patientpreferences.org/better-conversations/
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    42 mins