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Benjamin P. Saylor is associate editor of Urology Times, an Advanstar Communications publication.

ArteraAI is a multimodal artificial intelligence biomarker test that can predict therapy benefit and prognosticate long-term outcomes in prostate cancer.

Study to evaluate impact of ArteraAI on clinical decision-making for prostate cancer

Pfizer has chosen to no longer pursue an expanded indication for talazoparib plus enzalutamide in non-HRR gene mutated mCRPC in the US as a result of this decision.

FDA does not approve talazoparib plus enzalutamide for non-HRR gene mutated mCRPC

The bkActiv S series is designed to guide nonsurgical urologic, colorectal, and pelvic floor procedures. 

Ultrasound imaging system now available to guide nonsurgical urology procedures

 is compliance officer and medical director of coding and reimbursement, United Urology Group and Chesapeake Urology, in Towson, Maryland.

"We believe the confusion comes from the typical lexicon surgeons use when performing surgeries, rather than the actual code descriptor and the procedure performed," write Jonathan Rubenstein, MD, and Mark Painter.

CPT 49186 vs 38780: Coding retroperitoneal mass excision

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Clinical Focus

Leonard G. Gomella, MD, FACS; Maha Hussain, MD, FACP, FASCO; Daniel P. Petrylak, MD

18th Annual Interdisciplinary Prostate Cancer Congress® and Other Genitourinary Malignancies

Jason Hafron, MD; Aaron D. Berger, MD; Arpeet Shah, MD

Medical Crossfire® in Adjunctive Testing: Charting a New Course in Prostate Cancer Risk Assessment

Pearls & Perspectives: Understanding and Improving Pelvic Health, with Diane Newman, DNP

, host Amy Pearlman, MD, sits down with Diane K. Newman, DNP, a nationally recognized expert in pelvic health, to explore the often-overlooked yet vitally important topic of pelvic floor dysfunction. Newman is an Adjunct Professor of Surgery at the Perelman School of Medicine at the University of Pennsylvania and a trailblazing nurse practitioner with over 35 years of experience treating urinary incontinence and pelvic floor disorders.

Together, they delve into the evolution—and stagnation—of conservative pelvic floor care in the US, the importance of early intervention, and the surprising ways telehealth and technology can close the access gap in pelvic care. Newman shares insights from decades of work in clinical practice, long-term care facilities, and groundbreaking research studies, all underscoring the value of non-invasive strategies like bladder training, bowel management, and pelvic floor muscle exercises.

A highlight of the episode is Newman’s digital resource library at 

, where she offers audio-guided pelvic floor exercise sessions for men and women. Originally developed on cassette tapes and now available as MP3 downloads, these simple, follow-along recordings are designed to help users practice bladder training and pelvic floor strengthening techniques from the comfort of home.

Why Newman believes pelvic floor therapy should be a first-line treatment, not a last resort.

The role of lifestyle, diet, and bowel health in urinary symptoms.

How devices like the Leva system and vaginal weights can support pelvic floor rehabilitation.

Guidance on verbal cues and techniques to correctly isolate pelvic floor muscles.

Newman's pioneering work using telehealth and caregiver collaboration to reduce incontinence, falls, and UTIs in older adults.

Newman also shares her “megaphone message” to clinicians: Ask your patients the right questions, start with simple interventions, and never underestimate the power of conservative treatments.

Pearls & Perspectives: Advancing sexual health in urology, with Rachel Rubin, MD, at AUA 2025

, Amy Pearlman, MD, interviews Rachel Rubin, MD, a urologist and fellowship-trained sexual medicine specialist, about advancing sexual health education and care delivery. Speaking from the 

American Urological Association's (AUA) 2025 Annual Meeting

 in Las Vegas, NV, Rubin discusses her leadership in two key courses—one addressing the diagnosis and management of pelvic pain across all patient populations, and another supporting the rollout of new AUA guidelines on genitourinary syndrome of menopause (GSM).

Rubin offers insight into the guideline development process, which involved collaboration across multiple societies—including AUA, SUFU, AUGS, the Menopause Society, and ISSWSH—and incorporated patient perspectives alongside clinical evidence. The guidelines advocate for broader recognition of GSM as a urologic issue with systemic impact, including increased risk of recurrent UTIs, sepsis, and hospitalizations. Rubin underscores the evidence linking vaginal estrogen therapy to improved outcomes and reduced Medicare costs, pushing back on long-standing misconceptions about hormone therapy safety.

The conversation expands beyond AUA initiatives, as Rubin details her efforts to address the lack of sexual health training in urology and primary care. Through her virtual sexual medicine research collaborative, Rubin mentors medical students nationwide on topics ranging from sexual dysfunction in autoimmune diseases to genitourinary syndrome of lactation (GSL)—a condition she and her team helped define. She also highlights the importance of translating research into advocacy, noting how one of her team’s health economics papers was recently cited in state-level policy discussions.

Rubin emphasizes that empowering clinicians with actionable knowledge is key to improving care. Her educational content—ranging from online CME courses to public-facing talks—focuses on practical skills, prescription guidance, and risk framing to help providers treat patients more confidently. At a time when gaps in women’s sexual health care remain wide, Rubin’s message is clear: evidence-based care exists, and urologists must be equipped to deliver it.

Rachel Rubin, MD, discusses advancements in sexual health education and guidelines at the AUA meeting. 

At this year’s American Urological Association (AUA) Annual Meeting in Las Vegas, Nevada, the AUA released their new guideline on genitourinary syndrome of menopause in collaboration with the Society of Urodynamics, Female Pelvic Medicine, & Urogenital Reconstruction.

, highlights key points from the guideline and illustrates its impact for clinical management of this condition. Kaufman is the Patricia and Rodes Hart professor in urologic surgery, as well as a professor of urology and chief of the Division of reconstructive urology and pelvic health at Vanderbilt University Medical Center in Nashville, Tennessee.

According to Kaufman, the guidelines prioritize shared decision-making, emphasizing that treatment decisions should reflect the patient's individual values and preferences.

Other key updates in the guidelines include:

 via focused patient history on urinary, vaginal, and sexual symptoms.

 at the core of management, acknowledging there is no "one size fits all" approach.

, countering outdated fears from the previous FDA black box warning: low-dose vaginal estrogen does not increase risks of breast cancer, cardiovascular disease, dementia, or endometrial cancer.

Kaufman concluded, “What we've come up with are pragmatic statements that can be rapidly implemented. I do believe we're going to be transformational, both to engage urologists to treat these patients, as well as improve these patients' outcomes in a very global sense.”

, or anywhere that podcasts are available.

1. Kaufman MR, Ackerman LA, Amin KA, et al. The AUA/SUFU/AUGS Guideline on Genitourinary Syndrome of Menopause. 

In this episode, guideline chair Melissa Kaufman, MD, PhD, FACS, highlights key points from the new AUA GSM guideline and illustrates its impact for clinical management of this condition.

Speaking of Urology: Melissa Kaufman, MD, on AUA’s new guideline on genitourinary syndrome of menopause 

, discusses the use of vaginal estrogen. Winter is a urologist and sexual medicine expert in Los Angeles, California.

This discussion originally took place during a live X (formerly Twitter) Spaces event held by Urology Times®. To begin the discussion, Winter explains how she first became interested in advocating for this therapy, noting a lack of education in her early training. During the discussion, Winter also shares insight on the conditions that vaginal estrogen can be used to treat, safety data on the medication, and the different forms that may be given to patients.

In this episode of Speaking of Urology®, Ashley G. Winter, MD, discusses the use of vaginal estrogen. 

Speaking of Urology: Dr. Winter on the use of vaginal estrogen

® Assistant Editor Janelle Hart spoke with 

about a study that was presented at the 2022 Society of Women in Urology Annual Clinical Mentoring Conference. The study investigates the quality of information regarding recurrent urinary tract infections on the social media platform Reddit. Malik is an assistant professor of surgery and director of female pelvic medicine and reconstructive surgery at the University of Maryland School of Medicine in Baltimore.

“I think we as urologists have to be proactive in providing information to our patients so that they avoid financial harm and potentially bodily harm from this sort of misinformation,” says Rena D. Malik, MD.

 Dr. Malik evaluates quality of Reddit content on recurrent UTIs

. He discusses the stigmas associated with vaginal mesh surgery, and how it is the urologist’s responsibility to set the expectations for their patients in terms of possible complications with different slings. Blaivas is a professor of urology in the Icahn School of Medicine at Mount Sinai in New York City, New York.

“To me, the overwhelming thing is understanding that treatments are, by and large, effective,” says Jerry G. Blaivas, MD, FACS.

Destigmatizing Urology: Dr. Blaivas discusses vaginal mesh surgery 

In this episode, we continue a series of podcasts on the topic of genitourinary syndrome of menopause, or GSM. Over the course of this series, 

 will discuss why it is important for urology providers to be educated regarding this condition, how to diagnose it in patients, and how to treat it. Rubin is a board-certified urologist with fellowship training in sexual medicine. She is an assistant clinical professor in urology at Georgetown University and has a private practice in the Washington DC area. In this episode, Rubin discusses common symptoms of GSM to look for and how a physical exam for GSM should be conducted. She spoke with 

"Many people do not examine patients who come in with urinary tract infections or overactive bladder symptoms, and it’s a mistake,” says Rachel S. Rubin, MD.

How to diagnose and treat patients with genitourinary syndrome of menopause

They discuss the efficacy of telehealth visits and how their 

 study, “Patient satisfaction and savings, and clinical outcomes of televisits in female pelvic medicine and reconstructive surgery at an urban academic center,” supports a bright future for telemedicine. Abraham is an associate professor and residency director of the department of urology at Montefiore Medical Center, and Shin is a medical student at the Albert Einstein College of Medicine, Bronx, New York.

“Our study strongly suggests that telemedicine can become the mainstay of treatment within FPMRS even after the COVID-19 pandemic has ended,” says Christina Shin, BA.

How FPMRS patients are reacting to televisits

® Managing Editor Ben Saylor spoke with 

 She discusses the safety and feasibility of same-day discharge after female pelvic medicine and reconstructive surgery cases. Zillioux is a urologist at Cleveland Clinic.

“Same-day discharge is safe and feasible across a broad spectrum of FPMRS cases,” says Jacqueline Zillioux, MD.

Dr. Jacqueline Zillioux discusses same-day discharge after FPMRS cases

The CELLEBRATE trial is aiming to provide additional evidence to support the safety and efficacy of iltamiocel. 

Addressing an unmet need: CELLEBRATE trial explores cell-based therapy for recurrent SUI

"I’m hopeful because women in urology are no longer an exception—they’re becoming the norm," says Shaya Taghechian, MD.

National Women’s Health Week: Celebrating women shaping the future of urology

"The biggest message from this study is that 60% can expect resolution of UUI, simply by fixing the prolapse and placing a sling, which is not normally indicated for UUI," according to Christina M. Mezes, DO, and Catherine A. Matthews, MD.

Vaginal prolapse repair and sling surgery significantly reduce UUI

A recap of the FDA submissions and regulatory decisions in urology from March 2025.

FDA updates in urology: March 2025

The test can deliver diagnostic results for chlamydia, gonorrhea, and trichomoniasis.

FDA grants marketing authorization to at-home diagnostic test for STIs

Residents across specialties reported a lack of formal training on female sexual dysfunction (FSD), which may correlate with their reported discomfort in diagnosing and managing these conditions, according to recent data published in the 

The study was conducted as a cross-sectional survey of 128 residents in urology, obstetrics and gynecology, dermatology, internal medicine, family medicine, and emergency medicine.

Overall, data showed that 78% of residents received training in genito-pelvic pain/penetration disorder, 38% received training in hypoactive sexual desire disorder, 30% received training in female sexual arousal disorder, and 23% received training in female orgasmic disorder. The majority of respondents indicated that they were uncomfortable diagnosing and managing these conditions.

, discussed the implications of these findings for patient care.

Uloko explained, “On average, 1 in 4 people will suffer from pelvic pain, [and] 85 million people currently are suffering from vulva vaginal conditions like recurrent urinary tract infections, pelvic pain, overactive bladder, IC, [and] recurrent vaginal infections. These are conditions that oftentimes take 7 years to get a diagnosis—3 doctors visits. Thirty-five percent of these patients will see up to 15 doctors before they get their first diagnosis, and that's $20,000 [in] out of pocket costs.”

Uloko runs her own practice, MUMD Beverly Hills Sexual Medicine, in Los Angeles, California.

Maria Uloko, MD, discusses the implications of recent study findings for patient care. 

Maria Uloko, MD, on the need for better education on female sexual dysfunction  

The hope, Uloko says, is that health care professionals will become more informed about conditions of FSD so that they can provide appropriate care for these patients from the start.

She concluded, “My goal [for] a lot of the advocacy that I do is that one day [patients] don't have to do our jobs for us. They don't have to go to the internet, to go find their diagnosis, to go find the doctors, to go do all those things. [The hope is that] every single doctor that graduates from medical education and training has very innate understanding of vulva anatomy, vulvar physiology, [and] female sexual dysfunction, so that we can start helping the other half of the population as well.”

1. Milazzo M, Kohut-Jackson A, Negris O, et al. Assessing comfort levels with female sexual dysfunction among medical residents: a nationwide cross-sectional survey study and its implications for medical education. 

. 2025;22(5):694-700.doi:10.1093/jsxmed/qdaf071

Videos

"My goal [for] a lot of the advocacy that I do is that one day [patients] don't have to do our jobs for us," says Maria Uloko, MD.

Overall, data showed that 78% of residents received training in genito-pelvic pain/penetration disorder, as well as only 38% in hypoactive sexual desire disorder, 23% in female orgasmic disorder, and 30% in female sexual arousal disorder. The majority of respondents indicated that they were uncomfortable diagnosing and managing these conditions.

, offered her thoughts on the significance of these findings for clinical care of female patients.

Uloko noted, “The numbers reflected what we see clinically. Patients are having a hard time getting diagnosed because physicians are leaving medical training and medical education without getting this solid curriculum around female sexual dysfunction, vulvar anatomy, physiology, and then also a diagnostic framework and a treatment roadmap for these patients.”

Maria Uloko, MD, discusses data showing a lack of resident training on female sexual dysfunction

Maria Uloko, MD, discusses the lack of resident training on female sexual dysfunction

According to Uloko, these findings should encourage urologists to reflect and ask themselves, “what can I be doing better?”

“Every research that we do is to show what the lived clinical experience is. I see this every day. I hear stories, 1000s of stories, all the time, of medical neglect, and I know the physicians behind it are not meaning to do it; they just aren't being taught and trained,” concluded Uloko. “If we can start spotlighting these areas where we can be doing better, I hope it then leads to widespread change and gives ourselves that grace and that humility to say we need to do be doing better.”

. 2025;22(5):694-700. doi:10.1093/jsxmed/qdaf071

"Patients are having a hard time getting diagnosed because physicians are leaving medical training and medical education without getting this solid curriculum around female sexual dysfunction," says Maria Uloko, MD. 

At the American Urological Association 2025 Annual Meeting in Las Vegas, Nevada, the “Genitourinary Syndrome of Menopause: AUA/SUFU [Society of Urodynamics, Female Pelvic Medicine & Urogenital Reconstruction]/[American Urogynecologic Society] Guideline” was released. One of the topics covered in the guideline is the use of vaginal estrogen for patients with genitourinary syndrome of menopause (GSM). Vaginal DHEA and oral ospemifene are presented as other hormonal options with conditional recommendations. In a recent interview with 

 was asked what patient characteristics or circumstances might lead her to consider these alternatives over first-line vaginal estrogen.

“In my experience, and probably most others, vaginal estrogen alone is probably the most effective. However, there are some women who are just allergic or don't tolerate any of the ones that are commercially available. Those are [patients for whom] you might even consider compounded hormones. But also, DHEA is good for women who maybe want to have a little testosterone. Maybe they have some labial effects or something else that they want some local testosterone for, but allergies, intolerance of vaginal estrogen, and then some women just don't want to put anything in the vaginal area. They find it too messy or too cumbersome. That’s when oral therapy like ospemifene can be useful,” said Eilber, chair of the Cedars-Sinai Medical Group department of surgery and professor of urology, an associate professor of obstetrics & gynecology at Cedars-Sinai Medical Center in Los Angeles, California, and member of the plusOne Wellness Collective.

Karyn S. Eilber, MD, discusses treatment of genitourinary syndrome of menopause

Alternative treatments and patient communication for genitourinary syndrome of menopause

Eilber was also asked about communicating safety information about to patients who may have concerns about hormone-related therapies due to past concerns or anxieties.

“This is probably one of the most difficult things to overcome, because the packaging on vaginal estrogen does imply that it carries the same risks as if you were taking a systemic hormone therapy. But a good example that I often will tell my patients is if you have a steroid pill, you will have all the systemic effects of steroid pill. But if I have a little spot of rash and I just use steroid cream, it's only going to work in that area, and that resonates with most people; they understand the difference between systemic estrogen and just vaginal estrogen,” Eilber said.

Karyn S. Eilber, MD, discusses treatment of genitourinary syndrome of menopause.

At the 2025 American Urological Association Annual Advocacy Summit, 

 gave a talk regarding the use of vaginal estrogen. In an interview with 

®, Santiago-Lastra provided an overview of her talk.

“The key takeaways from the Advocacy Summit were that there is momentum and interest with regards to this problem that's coming not only from the urology community, but is also coming from the patients themselves. We have a baby boomer generation, generation X, and millennial generation that are all either in perimenopause or beyond. Those are millions of women. They are working and living more than ever before, and they experience genitourinary syndrome of menopause, and so the black box warning affects that ability for them to get access to that critical drug, vaginal estrogen,” said Santiago-Lastra, a urogynecologist and an associate professor of urology at the University of California, San Diego.

Yahir A. Santiago-Lastra, MD, discusses barriers to vaginal estrogen access that she discussed at the AUA Advocacy Summit

Yahir A. Santiago-Lastra, MD, discusses barriers to vaginal estrogen access

During the interview, Santiago-Lastra described the barriers that exist regarding women receiving vaginal estrogen.

“A lot of physicians don't know that genitourinary syndrome of menopause can encompass a lot more than just classic menopause symptoms. It can also include bladder symptoms, urgency, frequency, dysuria, and then it can also include urinary tract infections, and so because there isn't that knowledge base, the lack of prescribing of the medication affects women,” Santiago-Lastra said.

She added, “There are already systemic barriers in place that prevent a lot of patients from receiving important treatments that they need. Prior authorization [is one example]. [In addition, there is] the urologist shortage. So many counties in the United States don't actually have a practicing urologist and menopause/vulvar health/vulvar care is not something that has been widely taught to physicians and honestly, sometimes not even taught precisely to gynecologists or urologists, and you would think that that would be their domain.”

Finally, Santiago-Lastra said, there is the black box warning.

“Historically, there has been some risk assigned to vaginal estrogen that is not evidenced by data. The black box warning applies to all estrogen products, including the vaginal, and it really is a totally different beast with completely different risk,” she said.

"The black box warning affects that ability for them to get access to that critical drug, vaginal estrogen," says Yahir A. Santiago-Lastra, MD.

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