Monterey 2019 Meeting Take-Aways by Dr. John Barry

Many thanks to Dr. Barry for his thoughtful capturing and sharing of these pearls during the sessions in Monterey during the 2019 meeting.

• Making the foreskin retractable reduces UTIs in infant boys with vesicoureteral reflux.
• A reinforcing suture can prevent vasovasostomy separation.
• A traction device can increase penile length, improve ED scores and reduce the curve of Peyronie’s disease.
• Automated flow cytometry will allow reassessment of the degree of microscopic hematuria that needs a urologic workup.
• Radiologic trocar site hernias are common (27.5%) following robotic-assisted upper tract urologic surgery.
• Skeletal muscle mass on CT is an additional prognostic indicator of frailty.
• The transperineal prostate biopsy is being rediscovered.
• About ¾ of PIRAD5 lesions on MRI are prostate cancer.
• Is focal HIFU treatment of prostate cancer simply an expensive substitute for active surveillance?
• Outpatient TURPs are possible in Oakland.
• The neoprene helmet with surface electrodes has been used to study cortical control of bladder function. This is an exciting concept.
• Trigone and peri-trigone onabotulinumtoxin A injections are effective.
• Single-staged sacral neuromodulation procedures are reasonable.
• Recovery of spontaneous voiding is possible after a bladder outlet procedure in men with detrusor underactivity.
• High home bladder manometry (pressure at catheterization) predicts hydronephrosis.
• Defining the “number of cases to competence” or “operating time” as measures of complexity is an interesting concept, but it doesn’t consider that all surgeons are not created equal.
• With proper patient education, same-day inflatable penile prosthesis surgery and discharge is possible.
• Dr. Ralph Clayman is clever.
• Povodine-iodine bladder irrigation of continent urinary diversions doesn’t prevent UTIs.
• Ultra-low-dose CT is an effective imaging modality for ureterolithiasis.
• There is no universally accepted definition of “stone-free.”
• An inexpensive, clever simulator for ultrasound-guided percutaneous PCNL training has been developed.
• Mannitol and furosemide may be unnecessary in partial nephrectomy if the other kidney has good function.
• The Money Band was a good one.
• The IVU scholar talks should make us thankful for the environment in which we practice.
• Artificial intelligence should be able to assign PIRAD scores to prostatic lesions and be used to Gleason-grade prostate cancers.
• Don’t forget to apply the value equation to diagnosis and treatment.
• Can a radiopharmaceutical be used to treat a primary tumor as well as its metastases?
• The “Near-miss” residents’ conference is a good idea. No attendings allowed.