Healthy debates
Best practices and patient protocol are often debatable.
Many urological treatment approaches are not always unanimously accepted among urologists. AUA2024 education included several debates where experts offered an exchange of ideas to elevate patient outcomes.
Saturday’s “Crossfire: Controversies in Urology: Detrusor Underactivity in Men and Retention: To TURP or Not to TURP?” debated the rationale for recommending TURP in an index patient, a 60-year-old man who experienced two to three episodes of prostatitis yearly. The patient required clean intermittent catheterization four times per day. He had renal insufficiency and a prostate volume of 65 centimeters. He was currently taking finasteride and tamsulosin. His previous procedure included photoselective vaporization of the prostate in 2019. Now he was in your theoretical office with voiding complaints. Would you recommend transurethral resection of the prostate so he could void without catheterization?
Friday's "Crossfire: Controversies in Urology: Ileal Conduit vs. Neobladder: 68-Year-Old Man Who Wants a Neobladder but Is Unsure About Catheterizing" debated the rationale for recommending a neobladder or a standard ileal conduit for an index patient, a healthy 68-year-old man with a recent diagnosis of muscle-invasive bladder cancer but without medical contraindications, who theoretically asks, “Which type of diversion is best for me?”
